Secure messaging: the great leap forward?

After a history of disappointment, is digital health reform in Australia on the cusp of a breakthrough?

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A team of outsiders, led by Melbourne GP Dr Nathan Pinskier, will oversee the development of secure electronic messaging for the medical profession so that doctors can finally set a bonfire of the faxes.

Australian Digital Health Agency chief Tim Kelsey said interoperable secure messaging was the top digital-health priority to permit healthcare professionals to communicate with each other easily, safely and routinely.

“Many of the problems we have to resolve are not straightforward ones.  I think we all have recognise this is going to be small steps, small steps to build confidence,” Kelsey told the RACGP eHealth Forum on Thursday.

He acknowledged a “history of disappointment” in digital health in Australia, saying he worried that people were fatigued by the overselling of the digital technology in healthcare.

“There has been over-promising and under-delivery. We can’t do that anymore,” the former NHS change manager said.

The program would be driven by a partnership of software suppliers, health jurisdictions and healthcare professionals, taking practical steps towards tangible goals such as development of an electronic directory for clinicians, he said.

Dr Pinskier has been an outspoken critic of government-led eHealth policies to date, arguing they were bound to fail unless secure point-to-point messaging was achieved and only then could patient information be used for secondary purposes such as the My Health Record.

“I’ve always said this is the number one problem,” Dr Pinskier, chair of the RACGP Expert Committee on eHealth and practice systems, told The Medical Republic.  

“Tim has got the message; he knows we need to fix it.  I’m indebted to him for throwing resources at this problem.”

As the clinical lead, Dr Pinskier will govern the program with two other “senior responsible owners”, Dr Mal Thatcher, CEO of eHealth Queensland, and community representative Fiona Panagoulias from WA.

While the agency remained responsible for the outcome, the external governance was intended to maintain the collaborators’ focus on set goals and hold the agency to account, Mr Kelsey said.

The program will also tackle the formidable issue of increasing the take-up of interoperable digital systems by specialists and allied health.

Dr Andrew Magennis, co-founder of the MedicalDirector practice software group, predicted a messaging system that let doctors find each other and share information quickly would have an instant impact.

“It will greatly improve patient care in the first microsecond it is introduced,” the medical IT pioneer said.

Secure messaging would pay an efficiency dividend by relieving clinicians of dealing with the estimated one billion pieces of paper that float around the health system each year, the forum was told.

It would also reduce prescribing and medication errors and enrich data on mortality rates.

Former RACGP president Dr Chris Mitchell noted the need to support doctors who were not part of eHealth trials and help them deal with problems such as privacy issues in electronic communications and data losses.

“What I am calling out for is a kind of help desk for those of us who are hungry for change,” he said.