2016/17fy workplan wrap-up - digital health... 2 key achievements in 2016/17fy rebuilding faith and...

www.digitalhealth.gov.au

FY2016/17 Workplan Wrap-up

30 June 2017

Board 10 August 2017Item 8.3

Attachment A

2www.digitalhealth.gov.au

Key Achievements in 2016/17FY Rebuilding faith and momentum in digital

health by developing genuine relationships and

networks across the sector and establishing six

Board Advisory Committees.

Co-producing a 2017/18 work program

with jurisdictions that was approved by

AHMAC and COAG Health Council on first

presentation.

Co-producing a National Digital Health

Strategy with thousands of people from the

community, government, technology industry

and healthcare sector, which was endorsed by

AHMAC on first presentation.

Growing clinical document sharing as demonstrated through the sizable increase in the number of

clinical documents uploaded to the My Health Record (doubling and tripling of numbers of documents)

Connecting hospitals and health services to the My Health Record with more than double the

number of private hospitals uploading to the My Health Record system in July 2017

Entrenching the My Health Record in the Australian health landscape securing the Australian

Government’s decision to fund expansion of participation in the My Health Record


Key Achievements (cont.) Entrenching the My Health Record in the Australian health landscape securing the Australian

Government’s decision to fund expansion of participation in the My Health Record.

Highest participation rate in any national health record system in the world by 2018.

Successful deployment of Release 8 of the My Health Record which included new medicines view.

Operated national infrastructure to high reliability.

Laying the groundwork for improved access to health information through developer program

that supports innovators to safely and securely connect to the My Health Record

Engagement at international level with completion of International Strategy and participation in

meetings in Washington and Singapore.

Building a new organisation including recruiting a leadership team, establishing policies and

processes to operate under a new Rule

4www.digitalhealth.gov.au4

2. Operational management and maintenance of systems and services (7.1, 7.2, 7.3, 7.5, 7.6, 7.8, 7.9, 7.10, 7.11, 7.12, 7.13, 7.14, 9.7, 9.16, 12.4)

3. Embed methods of productive engagement and collaboration with healthcare providers, consumers, industry & government (11.0)

4. Develop International Strategy, develop & embed horizon scanning capability (6.0)

PROGRAMMES/PROJECTS

AGENCY STRATEGIC PRIORITIES

ONGOING OPERATIONAL DELIVERY

1. Committing to the prudent use of resources (1.1)

ORGANISATIONAL EXCELLENCE

2. Optimising opportunities as the national digital health agency

(1.2)

3. Earning trust as a reliable operator of national data systems

(1.4)

4. Leading the world in digital health cyber security (2.1)

5. Making the organisation hum (1.5)

6. Exemplifying openness and transparency (1.9)

MY HEALTH RECORD

1. Working with the software industry to improve user

experience and connect GP, pharmacy, aged care providers to

My HR (9.18)

2. Connecting more hospitals to My Health Record (13.3, 13.6,

15.1-9)

3. Innovation in mobile connection for providers to My

Health record (9.13, 13.7)

4. Release 8.0 of My Health Record – improved user

experience, implementing outcomes from meds and path/DI

streams (9.1, 9.4)

5. Return to Government on My Health Record consumer

participation options (12.1, 5.0)

CORE CLINICAL

1. Establish Children’s Collaborative Network for

Innovation

2. Support delivery of the Healthcare Homes Strategy

3. Embed telehealth in clinical consultations

PATHOLOGY & DIAGNOSTIC IMAGING

1. Addressing concerns of private pathology industry

3. Upload Pathology and DI reports to My Health Record from

public hospitals (13.1 & 13.2)

4. Upload Pathology and DI reports to My Health Record in private pathology labs (14.2)

2. Co- design final end to end design and adoption requirements

for private pathology (14.1)

MESSAGING

1. Working with industry to improve user experience (8.1)

2. Develop robust national directory service and meet and

service levels requirements (8.2)

3. Simplify the renewal process for authentication certificates

4. Increase uptake of clinicians using electronic messages

5. Implement new end to end solution

1. National change & adoption programme (12.2)

6. Agency corporate services and internal change management

5. Develop Industry Strategy and establish open innovation arrangements (3.0, 10.1)

1. Design better medicines information for healthcare

providers through My Health Record (9.11, 9.20)

3. Increasing use of electronic prescriptions, electronic

medications management, and terminology (9.80, 13.4, 7.7)

2. Co-produce a robust, integrated and safe 'medicines at

your fingertips' national programme

MEDICINES SAFETY STRATEGY

1. Finalise the national Digital Health Strategy, and forward

work programme (4.0)

FY16-17 High Level Work Plan

Supporting digital innovation across Australia to give people more control of their health and care

6. Victorian e-Referral Program (9.10)


Secure Messaging(multi-year initiative)

MESSAGING

1. Working with industry to improve

user experience (8.1)

2. Develop robust national directory

service and meet and service levels

requirements (8.2)

3. Simplify the renewal process for

authentication certificates

4. Increase uptake of clinicians using

electronic messages

5. Implement new end to end solution

6. Victorian e-Referral Program (9.10)

Achievements Continuing activities in FY 2017/18

• Consensus agreement on changes required to improve end to

end user experience across clinical information systems

(CISs), messaging systems and directories

• The future architecture and roadmap delivered in June 2017.

• Completed testing of National Health Service Directory in QLD

Health, with findings confirming direction for directories

• Design for federated access to directories underway.

• Multiyear initiative. Approach reflected in 2017/18 approved workplan.

• Consortium for allied health did not proceed to contract due to concerns about capacity of consortium to deliver outcomes. Agency to reconsider how to involve allied health in implementing end to end solution to market.

• Replanning completed to take Secure Messaging forward as part of the overall National Digital Health Strategy and four year workplan that is being considered by COAG Health Council in August 2017.

• Project kick off activities underway for the implementation projects.

• Communication plan to be developed.

• Assessment / documentation of current processes that use

private certificates (non-NASH) is complete and the

independent risk assessment was delivered in June 2017.

• Planning also commenced with DHS to implement alternatives

to NASH for individual healthcare providers

• Developing business and commercial model to support

adoption and on-going sustainability.

• Three pilot sites live and referrals being exchanged.

• Working with vendors and sites to gather feedback on

reference architecture, specification and implementation.

• Defined requirements for end to end interoperable solution and released in approach to market.

• Two consortia awarded contracts to implement end to end solution; each involves 10 healthcare providers, two CISs, two messaging vendors, federated use of directories.


Medicines Safety(multi-year initiative)

1. Design better medicines information

for healthcare providers through My Health Record (9.11,

9.20)

2. Co-produce a robust, integrated and safe 'medicines at your

fingertips' national programme

3. Increasing use of electronic

prescriptions, electronic medications

management, and terminology (9.80,

13.4, 7.7


• 9.11 My Health Record Enhancement - decommission the

NPDR. Complete - as part of Release 7.2 December 2016.

• 9.20 Successful Launch Release 8 including new meds view.

Blue Print prepared for distribution to Medicines Safety

Steering Group for prioritisation subject to approval by

management committee. Project Closure Report prepared for

presentation at management committee on 13 July 2017.

• Program Brief for 2017-2018 complete and draft 4-Year

Workplan prepared.

• Develop Interoperability specification to support electronic medication management in acute care, between clinical systems (FHIR based)

• The Framework for Action arising from the national digital

health strategy will inform the final version of the national

program to co-produce a robust, integrated and safe

'medicines at your fingertips' (ETA = Q1 2018).

• 9.80 Electronic prescriptions agreed approach and

implementation plan Project. This is dependent on

outcomes and discussion with DOH.

• Awaiting endorsement by NHIPCC on Draft National

Requirements for Electronic Prescriptions.

• Workshops with Department of Health to define the

current and future state IT requirements.

• 13.4 Continue to Increase use of electronic prescriptions,

electronic medications management, and terminology.

Work ongoing with Northern Territory to upload dispense

records. NSW project to upload dispense record kicked off

in June with contract variation to finish in Dec 2017 in

progress.

• 7.7 Operate and maintain national terminology infrastructure

is complete and BAU. SNOMED CT-AU and AMT released

every month to required quality standards. Contribution to

international standards development through IHTSDO.

• WA and ACT jurisdictions have completed their projects to

embed terminology into key systems.

MEDICINE SAFETY


Pathology(multi-year initiative)

1. Addressing concerns of private pathology

industry

2. Co- design final end to end design and

adoption requirements for private pathology

(14.1)

3. Upload Pathology reports to My Health Record from public

hospitals (13.1 & 13.2)

4. Upload Pathology reports to My Health

Record in private pathology labs (14.2


• Engagement with private pathology laboratories is ongoing

• First agreement with Australia’s largest supplier of diagnostic

services Sonic Healthcare reached.

• Significant number of private pathology laboratories

submitted expressions of interest to participate via the

diagnostic software industry partnership offer.

• Technical representatives from the sector working with the

largest private pathology providers on the approach to

participation.

• Changes to HL7 to support electronic consent progressing.

• NSW PathWest hub delayed to Aug 2017 due to systems upgrades, ACT and TAS due in Dec 2017, QLD go live expected in Feb 2018.

• VIC and WA engagements progressing with agreements anticipated QTR 1 2017/18. SA has indicated not in position to start planning until early 2018.

• Agreement on updating pathology paper request form to include withdrawal of consumer consent to upload the data onto My Health Record.

• Sonic, Primary and Australian Clinical Labs will participate in technical working group to agree on approach to managing consumer withdrawal of consent in clinical practice software.

• Changes to HL7 standard to support electronic consent

• 180 pathology labs (inc. at least 20 private labs) sending pathology reports to My Health Record and driving the use of reports in MHR through clinical collaboration and adoption

• Activity rolled into 2017/18 to prepare for expansion program for My Health Record. This activity now includes private diagnostic imaging work.

• Resolution of some technical issues and upgrade of Best Practice GP software. Sonic is participating on the basis of electronic requests from GP practice software.

• Agency has agreements with 5 jurisdictions to progress

upload of pathology reports to the My Health Record.

• NT completed its implementation in June 2017.

• NSW has gone live with SEALS (Sth Eastern Sydney and

Illawarra Shoalhaven local health service district) in April

2017.

• 16 labs currently connected and uploading.

• Australia’s largest pathology supplier, Sonic Healthcare was

connected to the My Health Record test system.

• The Agency released a diagnostic software industry offer on 2

June 2017 to organisations that develop or maintain software

systems to private sector pathology laboratories. Strong

interest from the market. Contracts with industry will be

offered from July 2017.

PATHOLOGY


Diagnostic imaging(multi-year initiative)

1. Addressing concerns of private diagnostic imaging

sector peak bodies.

2. Upload DI reports to My Health Record from public

hospitals (13.2)

3. Upload DI reports to My Health by private providers

(14.2)


• Draft National Participation Approach - Diagnostic Imaging

shared with ADIA and RANZCR for review 30/5.

• Letters sent to ADIA and RANZCR informing them of software

industry offer. Confirmed RANZCR shared letter with

members.

• Agency has agreements with 5 jurisdictions (NT completed in

2015) to progress upload of DI reports to the My Health

Record.

• Three DI practices (NT) have upload 53k reports to My Health

Record at end June 2017

• Jurisdictional DI projects. TAS, ACT upload now due in Dec 2017, QLD Feb 2018. NSW Mar 2018.

• SA has indicated not in position to start planning until early 2018.

• Diagnostic software industry offer to connect to MyHR will close on 7th July 2017.

• Changes to software planned to occur throughout the year

• VIC and WA engagements progressing, agreements anticipated by QTR 1 2017/18.

• Upload of DI reports by private sector did not commence by

June 2017 – expected July 2017.

• Sonic Healthcare was connected to the My Health Record test

system ahead of planned upload of DI reports later in 2017.

• The Agency released a diagnostic software industry offer on 2

June 2017 to organisations that develop or maintain software

systems to DI practices.

DIAGNOSTIC IMAGING


My Health Record (improvements)(multi-year initiative)

1. Working with software industry to improve user experience and connect

GP, pharmacy, aged care providers to My HR

(9.19)

2. Connecting more hospitals to My Health Record (13.3, 13.6,

15.1-9)

3. Innovation in mobile connection for providers

to My Health record (9.13, 13.7)

4. Release 8.0 of My Health Record –improved user

experience, implementing outcomes from meds and path/DI

streams (9.1, 9.4)

5. Return to Government on My

Health Record consumer participation options

(12.1, 5.0)


• Pharmhos, Communicare, Medtech, Simple Retail and Orion

have completed their contracts to upgrade their software

with a variety of enhancements related to My Health Record.

• All WA hospitals under contract have gone live with ability to

send discharge summaries to MYHR. Ballarat and Barwon are

live with My Health Record access.

• “Best practice” update expected to deliver between Oct-Dec 17.

• “Cerner” delayed and work continuing.

• “CSC – ipharmacy” due to complete in Dec 17.

• “CSC Medchart” – delayed into 17/18 and work continuing.

• Other private hospital sites are in final stages in preparation for go live including Mater North Queensland, 4 sites in Uniting Care Health, 1 site in Monash Health, 1 site at St John of God WA, and Alfred Health VIC.

• Provider access delayed to August 2017, due to ongoing privacy impact, threat and risk assessment activities. Interim product strategy created in March quarter to be revised based on National Digital Health Strategy.

• Delivery of the end-point security capability is underway following procurement of Symantec licenses. Detailed analysis/design for audit logging.

• Roadmap development to capitalise on the Agency’s investment in Symantec products

• New project to be initiated to collaborate with the Digital Transformation Agency on a process to prototype and beta test the Trusted Digital Identity Framework and proposed Whole-of-Government solution.

• A new program has been established to Expand the use of My Health Record nationally on an opt out basis.

• Four consumer apps Chamonix (Healthi), TelstraHealth

(HealthNow), HealthEngine and Tyde are live in production.

• HIPS Mobile Evaluation: Under the current work program the

Agency has done as much work as possible within the

approved funding; this item will not be completed within

approved resource levels.

• National prescribe/dispense repository (NPDR) was

decommissioned as part of Release 7.2.

• Release 8 was delivered which included Medications view and

other enhancements.

• Provided technical and management support to the

Department’s return to government submission approved by

the COAG Health Council and included in Federal Health

Budget 2017/18.

• Agency staff supported the trials which closed in October

2016

MY HEALTH RECORD


National Digital Health Strategy

1. Finalise the national Digital Health Strategy, and forward

work programme (4.0)

Achievements Continuing activities in FY 2017/18STRATEGY

• The final draft strategy, work plan, budget and covering

papers have been completed and endorsed by AHMAC.

• Final approval expected on 4 August 2017 by COAG Health

Council (CHC) , after which the Agency will commence the

co-development of a National Framework for Action with

jurisdictions, consumer groups and industry.

• Further communication activities are either underway or

planned with jurisdictions, industry, consumer and clinical

groups to provide additional assurance to AHMAC and CHC

that the Strategy is broadly supported.

• Completion of the Framework for Action (FFA) post CHC

approval.


Core clinical (models of care)(multi-year initiative)

1. Establish Children’s Collaborative Network

for Innovation

2. Support delivery of the Healthcare Homes

Strategy

3. Embed telehealth in clinical consultations


• NSW Health has established a Steering Committee and

developed a project initiation document (PID). Workshops

held across the country during June and July.

• Identification of shortlist of candidate projects, with recommendation to JAC and Board in October.

• For Health Care homes, any decisions beyond 2016/17 will be subject to Commonwealth Government guidance and subsequent business case approval.

• Telehealth program will continue in 17/18. Rebaselining of jurisdiction telehealth activity has commenced.

• Vendor engagement completed in April 2017 and a set of

draft minimum standards was released by the Department.

• Budget announcement delayed start date for Health Care

Homes trial.

• The Agency and the Department and Health are working to

identify opportunities associated with other programs that

has deliverables within the new time frame, specifically in the

areas of telehealth, diagnostics and imaging and secure

messaging. An analysis and design activity looking at the

optimal means to support Shared Care Planning has

culminated in the development of an options paper. This

options paper is currently undergoing internal assessment.

CORE CLINICAL

• Contract finalised for NT Health Embedding Telehealth in

Clinical Consultations with extension to August 2017. First

Steering Committee meeting held and project commenced.


Organisation Excellence(multi-year initiative)

1. Committing to the prudent use of Commonwealth

resources

2. Optimising opportunities as the

national digital health agency

3. Earning the communities trust as a

reliable operator of national data systems

4. Leading the world in digital health cyber

security

5. Making the organisation hum

6. Exemplifying openness and transparency


• Budget Framework presented and endorsed by ELT.

• New policies have been drafted – eg. Statement of review

policy.

• Enterprise Risk Framework, policies and toolkit signed off by

all parties. Interim Business Continuity Plan finalised.

• Quality framework developed and approved by all parties.

• Budget framework and policies will be reviewed by Audit and Risk Committee with final expected 3 Aug.

• Privacy Training Program delivery in July and privacy awareness exercises underway for specific business areas within the Agency.

• The real-time monitoring system for security incidents in the My Health Record continues to be improved and Standard Operational Procedures (SOPs) related to its use developed in consultation with the national infrastructure operator (NIO) Accenture.

• The organisation excellence steering committee to meet 16 July to consider recommendations of the Mercer review.

• Approval granted for a value mapping exercise looking at processes in the Agency and where they transition across business areas creating value for the business. Contractors identified and contacts entered – expected 6 month schedule to complete.

• Desktop testing milestones for key Agency systems completed bar Engage with NIO, Legal, Contracts and operations to work through issues for red teaming* testingwhich has been delayed to 2017/18.

• A new program has been initiated around Agency culture and leadership with key activities already underway at all levels.

(* Red Teaming is a process designed to detect network and system vulnerabilities and test security by taking an attacker-like approach to system/network/data access)

• Privacy governance framework is established including roles and accountabilities. Key processes and documents developed and are operationalised.

• Cyber security strategy approved by the Board and Information Security classification framework published.

• Agency Security Awareness training provided.

• Board has endorsed the Agency’s future employment strategy including risks & timeframes.

• Mercer remuneration review now complete. The IT enterprise analysis is complete with deliverables and contract closed out.

• Effective and open Board operations, Board advisory

committees and Board governance structures and processes

established.

ORGANISATIONAL EXCELLENCE


Provider organisation connected

Consumers registered nationally

Production system availability (Exclusive of planned and emergency outages)

MY Health Record Operations• The number of consumers registered nationality continued to grow in FY 16/17. At the end of the

16/17FY, a significant milestone was reached where over 5 million consumers were registered

representing over 20% of Australia’s population.

• We continue to make inroads into the number of organisations connected to MYHR in 16/17 with

growth on all categories

• The availability of MYHR system has been maintained at a high level; any unexpected outage has been

monitored and managed closely for swift resolution.


Production system availability

HI/NASH Operations

Call centre responsiveness• The HI/NASH system has been maintained at a high level of availability with

minimal outages, there was under 5.5 hours of unplanned outages from

July 16 to May 17 (within SLA).

• Call centre responsiveness has not consistently met contracted service

levels during the year, it has been noted in the last reporting period SLAs

were not met due to DHS competing priorities.

• HI Service transaction volumes continue to remain high and above 15/16FY

figures in 16/17FY

HI service transactions


Terminology licences (Cumulative)

National Clinical Terminology Service

Live jurisdictional implementations – number of sites per state/jurisdiction

• The National Clinical Terminology Service (NCTS) and associated tools went

live on 10 October 2016.

• Users are required to register to access or download licensed NCTS or third

party terminology products and tools. All other content is freely available.

• The NCTS utilises the Agency Help Centre to triage contact requests and

provide support to implementers and interested parties.

• Several jurisdictions have implemented terminology in their clinical

systems.

Ontolicences (Cumulative)

2016/17fy workplan wrap-up - digital health... 2 key achievements in 2016/17fy rebuilding faith and...

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