Disparate systems and scattered health information across the Australian healthcare system have kept clinicians from providing better care and securing better outcomes for patients. One primary health network rose to the occasion and worked on improving information sharing within the health ecosystem.

THE PROBLEM

Interoperability is a "perennial challenge" for healthcare delivery in Australia's healthcare system, says Dr Keith McDonald, CEO of the South Western Sydney Primary Health Network (SWSPHN).

"The out-of-sync and inefficient sharing of clinical datasets from multiple services and disparate systems often inhibits clinicians from being better informed to deliver improved patient health outcomes."

Dr Keith McDonald, CEO, SWSPHN

As interoperability continues to stagnate, it has been a major priority for the country's healthcare sector to ensure a continuum of care through accessibility, timeliness of information, and quality data.

PROPOSAL

As part of its efforts to remedy this long-standing issue, SWSPHN partnered with Altera Digital Health, formerly the Allscripts Hospitals and Large Physician Practices business segment, in 2017 to develop the integrated Real-time Active Data or iRAD. 

The project is based on Altera's interoperability platform, dbMotion, which runs through the Microsoft Azure cloud. It aggregates and harmonises patient-consented data from various clinical information systems and delivers information to clinicians in a "usable and actionable" format at the point of care. It is said that iRAD was the first implementation of dbMotion in Asia-Pacific and the first international implementation on Microsoft Azure.

The project enables various health facilities and services to provide "easy and timely access" to patient-consented health records across the care spectrum. It extends to general practices, outpatient services, antenatal shared care sites, after-hours clinics, residential aged care, and palliative care services.

"For example, across a general practice and a hospital situated in the same community, where a host of patient and clinical information can be shared, including demographics, diagnoses, medications, allergies, immunisations, vital signs, and surgical procedures."

Nick McGhie, Digital Health and Data Manager, SWSPHN

McGhie also noted that iRAD supports clinical decision-making and is able to help reduce clinicians' administrative burden by saving time and limiting duplication.

According to Dr McDonald, "iRAD was a breath of fresh air for participating patients who no longer need to explain their health issues to multiple clinicians or [have] duplicate tests undertaken unnecessarily".

Additionally, iRAD ensures the privacy of patient information by securely hosting them in the cloud through Microsoft Azure. The platform is also said to benefit patients with health literacy or language barriers.

MEETING THE CHALLENGE

The pilot phase of the iRAD project, which began in 2017 with a few GPs and an after-hour service, was concluded in mid-2020. Since then, it has expanded with the aim of becoming the most comprehensive connected community health network in Australia. 

By the end of August 2020, 30 additional sites within the South Western Sydney region joined the platform. In the next six months, 40 more sites got involved in the project, including those from the Western New South Wales PHN.

Moving forward, the project seeks to continue increasing the number of participating acute care, aged care, and other specialists and PHNs on the platform.

RESULTS

To date, approximately 70 care locations, including GPs, specialists, and allied health, and one hospital are involved in the project with about 8,000 patients consenting to share their health information. The platform has so far facilitated the sharing of more than 10,000 documents, such as referral letters, specialist reports, and lab results.

McGhie stressed that "the success of the project so far reflects the enthusiastic willingness of a diverse range of health service providers to deliver their services as part of a connected community in Australia".

"Delivering the right care to the right patient at the right time is only possible with interoperability," Dr McDonald emphasised in his advice to other health systems trying to resolve their interoperability issues. "Partnering with an organisation specialising in interoperability has been a key success factor. The success of iRAD is in the individual patient journeys that have been helped, supported and cared for by clinicians using iRAD as part of their care delivery".