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Interoperable secure messaging for COVID-19 antiviral notifications to GPs

28 September 2022
By Kate McDonald
Image: iStock

Healthdirect Australia’s National Coronavirus Helpline secure messaging service for COVID-19 antiviral treatment eligibility has sent more than 20,000 notifications to GPs and GP respiratory clinics since it began in NSW in May.

The service is using existing secure messaging systems as well as an innovative solution jointly designed and built by Telstra Health that uses Microsoft Azure cloud services and Lyniate’s Rhapsody middleware to integrate Healthdirect’s CRM with each of the messaging networks through standards-based APIs and HL7 messaging.

Healthdirect says the National Coronavirus Helpline is the first and most comprehensive service to notify GPs through clinical secure messaging when their patients are COVID-19 positive and potentially eligible for antiviral treatments.

It is co-funded by the Department of Health and Aged Care, NSW Health, the Victorian Department of Health, Queensland Health and SA Health and is being delivered across the four states, kicking off in NSW in May.

In NSW, COVID-19 positive patients fill in a NSW Health survey. General practices, GP respiratory clinics and Aboriginal Medical Services are then notified by Healthdirect Australia when a person has registered a COVID-19 result and been assessed as being potentially eligible for antiviral treatment.

The patient’s GP then conducts a telehealth consultation to confirm eligibility for antiviral treatment and can issue an electronic prescription.

Adaptations of the model have since been rolled out in Queensland and South Australia in July, with Victoria kicking off in August.

According to Healthdirect, they differ slightly from the original NSW model, which uses NSW Health’s COVID-19 Patient Flow Portal to connect with Healthdirect’s system, notifying GPs of a patient’s result within an average of five hours.

This then enables patients to connect to a GP to fast-track assessment and prescribing of the oral antiviral treatment within the recommended five-day timeframe.

In Queensland, SA and Victoria, the consumer pathway starts when a person calls the National Coronavirus Helpline and is triaged for COVID-19 symptoms and risk factors, along with an initial eligibility assessment for antiviral treatment by clinical call handlers, Healthdirect says.

This information, subject to consent, is then sent to the patient’s regular GP or respiratory clinic via secure messaging, or a state’s virtual outreach ward, via real-time API.

Healthdirect Australia has worked with the major secure messaging providers, including HealthLink, Telstra Health (Argus) and Global Health (ReferralNet), to enable the system to send messages to 85 per cent of general practices. Healthdirect said the other major secure messaging vendor, Medical-Objects, was hopefully going to come online in the coming weeks.

This work included ensuring practice information is accurate and up to date in their secure messaging vendor’s directory and in the National Health Services Directory.

For practices that are not secure messaging-enabled, Healthdirect Australia says it has worked with the Primary Health Networks, the Department of Health and practice managers to enable them to receive notifications into their practice management software.

Healthdirect has also deployed an innovative Telstra Health-designed system to generate and send the secure messages, which is integrated with Healthdirect’s Microsoft Dynamics CRM.

“The system utilises Microsoft Azure cloud services and Lyniate Rhapsody middleware to integrate Healthdirect Australia’s CRM with each of the messaging networks, through standards-based APIs and HL7 messaging,” a Healthdirect spokesperson said. “The system was jointly designed and built/operated by Telstra Health.”

Healthdirect Australia’s CEO Bettina McMahon said the service shows how technology can take complexity out of care pathways.

“The alternative is to run expensive public communication campaigns to educate consumers about the medicines and eligibility requirements, and hope they approach a GP for a prescription,” Ms McMahon said in a statement.

“This approach manages the complexity of eligibility criteria, which can change over time, and connects patients with GPs for a consult. We can do this with a structured data feed in NSW, or through the helpline whenever a consumer with COVID rings us.”

Healthdirect Australia chief medical officer Nirvana Luckraj said time was critical when it came to starting antiviral treatments.

“To aid a fast response to the GP notification, the team at the National Coronavirus Helpline follow up the secure notifications we provide in all states with a phone call to the practice advising a notification has been sent via secure messaging,” Dr Luckraj said. “We also advise the caller to proactively call their GP within 24 hours to make a booking.”

Healthdirect says it has since triaged and connected 23,000 Australians to their GP or GPRC for antiviral treatment assessment and possible prescription across the four states.

Ms McMahon said the service was part of the long road towards axeing the fax. “With this service we’re moving communications into the 21st century, ringing practices when we send secure messages to ensure they are checked as received, and collaborating with PHNs to provide targeted support to practices which aren’t set up or trained to use the technology.”

Disclaimer: Pulse+IT and HealthLink are both part of the Clanwilliam Group.

7 comments on “Interoperable secure messaging for COVID-19 antiviral notifications to GPs”

  1. This system, while good in itself, is not interoperable. It is yet another custom solution because the secure messaging vendors are still not interoperable.

      1. Kate, Yes interoperability has been demonstrated, but is it in use? Can people with one of these secure messaging providers send messages to people on the other two secure messaging providers?

        And we are still missing a FHIR directory that has address information federated across all the secure messaging providers. ADHA and HL7 Australia have created the “standard”, and many vendors have implemented code that supports this “standard”, but AFAIK this is not available from any of the secure messaging providers yet.

    1. Agreed, Larry.

      A truly inter-operable messaging system requires an open messaging protocol. Unless we see the broader adoption of these standards and open-source software in the sector, we will continue to tread the same path of vendor lockin and abandoned projects.

  2. Well all good for interoperability, the changing platform is blockchain. To have permanent transactions stored forever that cant be disputed or corrupted is the way forward. This technology will go overseas and grown in Australia. But Australia wont even look at it. Maybe in 10 years time.

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