Solving the Healthcare Interoperability Crisis: Halo Connect

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Best Practice Software congratulates Halo Connect on its launch as it brings to market a modern cloud-based interoperability platform designed for clinical software. In a vote of confidence for the emerging platform, Best Practice Software is pleased to announce a significant investment in the company. 

Halo Connect will provide Best Practice Premier integrators with a single integration point that allows health data to be accessed safely and securely in real-time via an API. The financial investment will allow Halo Connect to supercharge development of a modern cloud-based API that conforms to industry standard FHIR (Fast Healthcare Interoperability Resources).

Chris Smeed, Halo Connect founder, commented, “In building and scaling healthcare start-up “Cubiko”, I came to realise that data analysis leads to better patient outcomes and improved financial sustainability of medical practices. But the data was difficult to unlock, and not many of the software systems would speak to each other. We built Halo Connect to solve this issue.”

This investment represents a significant step in the evolution of the Bp Partner Network and provides assurance around accessing real-time and accurate health information for both patients and integration partners across the current and future cloud products.  

Founder and CEO of Best Practice Software, Dr Frank Pyefinch, said, “with the speed at which digital health is progressing towards omnichannel patient-centred healthcare, providing reliable, quality, secure, and real-time access to patient records is more important than ever.” 

Dr Frank Pyefinch commented, “Best Practice is excited to work with Chris and the Halo Connect team to bring the first ever Best Practice API to market and with the investment will provide a rapid boost to the Best Practice interoperability roadmap as well as the future of interoperability in Australia.”

The introduction of Halo Connect will simplify partner integrations with Bp Premier and cloud platforms, creating a single integration point. The platform will create efficiencies in the provision of partner support and may reduce development costs incurred by partners in the design and development of their tools. Medical practices will benefit from their software providers being able to seamlessly integrate and reduce any unwanted stress on their on-premise infrastructure as well as equipping them for future cloud migrations.  

After a successful beta program across Cubiko customers, work is currently underway to deliver key interoperability projects with Aged Care and Acute Care partners, with the aim to make Halo Connect available to all Best Practice Software partners in October 2022. 

For software vendors interested in integrating with Best Practice and the soon-to-be-available Halo Connect, Best Practice Software offers a Partner Network program. To find out more information on how to apply, please contact partners@bpsoftware.net.  

Best Practice Software and Halo Connect look forward to working with industry partners to provide a seamless API that progresses standards and integrations.  

If you’re interested in joining the waitlist for Halo Connect’s cloud-based APIs for Best Practice, sign up here.

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There is Art to Medicine – As Well As Science

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“Most especially must I tread with care, in matters of life and death”. 

Painted across the Woondooma Street side of the Best Practice Software building, the cursive script reads like an excerpt from an 18th-century poem.

Art to Medicine Blog Best Practice Software Bundaberg Mural PhotoWhen questioned on the Hippocratic Oath, many people will quote the quintessential phrase where the physician promises ‘first do no harm’. One of the more poetic lines from the Oath, however, which very few people would recognise, encourages those in medical practice to, ‘remember that there is art to medicine, as well as science.’

Just like in any other form of art, there is a need for creativity and individuality. Healthcare professionals must be able to apply their generalised knowledge to the specific needs of each individual patient.  In this way, the art of medicine includes both the science of medicine and the ability to apply that science in a way that meets the needs of each patient. 

This is something Best Practice Software founders Dr. Frank and Lorraine Pyefinch know intimately having both worked in healthcare. As a General Practitioner Dr. Pyefinch understands that, “there is an art to medicine, and it starts with understanding the patient.” Quote Best Practice Software is proud to share our special story in the format of this hand-painted mural, which celebrates the story of how Dr Frank & Lorraine Pyefinch developed and grew the idea of creating an electronic medical practice record into one of Australasia’s most successful Health Technology   groups. Lorraine Pyefinch shares that the mural illustrates, “the transformation from when doctors had to write everything by hand to a more modern use of automation and technology.” But above all else, it represents the spirit of innovation and its personal connectedness with Health Practitioners and Patients.

In collaboration with the vision of Best Practice Software, the artwork’s bespoke design has been created by local artists Mark Terry, Nicole Wone, and Taylor Klaasen , who incorporated several specific elements relating to both the heritage of Best Practice Software and the First Nations People upon whose land the Operations Hub resides.

Evolution was a metaphor and inspiration for the process. To each of the artists, evolution represented something different. For Mark, the goal was to illustrate, ‘how we are all connected through shared human experiences such as life and death’ which is depicted in the changing leaves across the wall.

Best Practice Software Mural Sun ImageNicole, as a local Gooreng Gooreng and Bundaburra Yidinji Woman, wanted to “give an Indigenous perspective to the story of the mural.” She brought to life the “Ginmine” (the Sun) as the giver of all life, with science providing its connection to evolution on Earth, and spiritually how it explores and brings light to unseen energies in all living animals and plants. She also incorporated a tribute to the Rainbow Serpent for the significance it plays in creation and the stunning imagery of the beginning of time and greater movement in the cosmos.

 

Throughout the mural are intricate and delicate patterns woven in by Taylor, which reflect the flow of energy and how everything is interconnected. To her, evolution, “represents change and how the world really works. Everyone is always changing.” These unique patterns demonstrate the individual journey that each person takes in their lifetime.   

Best Practice Software Mural Bird ImageDr & Mrs Pyefinch’s personal stamp on the quality and interoperability of our software products is represented by the mathematical symbol for “Pi” and the Finch bird (together, as Pyefinch), which soars high above. The Finch connects life between the earth and the sun, and how DNA strands interconnect all we do in supporting Healthcare Practitioners 

The mural is a visual representation of how far we’ve come as an organisation, and how our core values have remained the same throughout our evolution – to make a real difference in healthcare. We believe that art has an important role to play in both our personal and professional lives, and we hope that this mural will inspire creativity, connection and pride in all who see it. 

Thank you for being part of our story! 

Learn more about the Bundaberg Mural, and the meaning behind it, here.

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Digital Intake Forms: How Much Time Could You Be Saving?

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Patient intake forms are tedious and time-consuming, not only for the patient but also for the practice. There are often multiple forms that new patients are required to fill out before an initial appointment. Administration staff then need to enter patient details into the Practice Management System (PMS) manually. 

For example, when working with patients who have a history of pain, detailed reports are required to ensure that the level of care matches the depth of the patient’s issue. Specialist centres have carefully curated intake forms that cover the patient’s medical history, including psychometric testing, e.g. DASS21, that must be completed before a patient’s initial consultation. These forms would either be received via email or be filled out by hand in the office on the day of their appointment.  

Prior to the implementation of a digital solution in the form of digital intake forms, practices resorted to cumbersome and time-consuming processes which caused a significant administrative burden. These often involved acquiring completed forms from a patient, having administrative staff calculate psychometric test scores, and finally manually inputting the data into the PMS. These forms could often take hours to process and upload, and they carried with them the risk of human error during data entry. For practices that might see 20+ new patients each week, this created a significant bottleneck.

To help streamline this process, Patient Plus saw an opportunity to alleviate administrative pressure from the intake process by creating digital intake forms that allow patients to update their information and medical history directly into the PMS prior to their first sessions.  

The system’s core functionalities include seamless integration between the form and Best Practice Software, the ability to score and process psychometric testing automatically, and additional form fields that provide access to limitless patient data. With mandatory form fields and input conditions set for certain numerical fields (e.g., the 10-digit limit for Medicare), the risk of human error is drastically minimised. 

The digital intake forms also offer patients the functionality to ‘Save & Resume Later’ by creating a secure, unique link that is sent to their email for completion at a future time. This unique link can also be shared with trusted contacts of patients who might need assistance in completing the form.  

For patients, this allows the flexibility to run through their history at their own pace. By pre-filling their information, they can be confident that their history will be known when they step into the room with their doctor, and they can immediately start focussing on the next steps in their journey. 

Once the form has been processed through the PMS, practices are provided with three options for patient summaries – long-form, short-form, and mid-sized PDFs – that can be generated to give the doctor an overview of the patient in varying levels of detail. 

All the data is processed and hosted on a secure server, ensuring that the practice complies with data security standards and protects confidential patient information. Patients also have the option to receive a copy of the form submission via email, allowing them to keep a copy for their own records. 

Easing the administrative workload caused by intake form processing means doctors no longer need to spend time scouring through the patient history since the automation ensures they have the relevant information before a patient’s appointment. 

One practice using Patient Plus has seen a dramatic shift in the hours spent processing patient intake forms. With nearly 30 hours back in their week, the practice has been able to shift their full attention from data entry and back to their patients, providing a better in-house experience. 

Patient Plus fills a necessary gap in the healthcare industry, providing a better communication line between patients and their doctors. Implementing digital tools creates an opportunity for doctors to spend more of their appointment time assessing the history, investigating patient concerns, and maximising patient engagement. With seamless integration, security of data, and ease of completion, the form has alleviated the pressure from the doctors, their staff, and the patients. To learn more, visit the Patient Plus website.     

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Are You Running a Thriving Practice?

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A thriving practice is difficult to define.

Every practice owner and manager wants to run a successful practice, but it can be challenging to define and measure what success looks like. Especially across a busy practice that provides dozens of services. Some owners look to expand and buy into other practices within their local metropolitan area, while some are focussed on a single rural practice. Many are simply focused on the output of their practice, and the impact they can make by providing care for their patients. There are many different objectives and criteria that one can measure success by, however, they can all be measured in one form or another.

Defining Success

The first step in knowing if you’re operating a thriving practice is to understand your overarching business goals and objectives. From there it’s up to you to define what success looks like for you, your team and your community.

Breaking down goals into short term and long-term goals can help set perspective for you and your team and is a strategy that has worked for dozens of practices. For example, your long-term goal may be to become the most trusted care provider in your area, and a short-term goal that may facilitate that, is to focus on expanding your Chronic Disease Manage (CDM) services or getting first time patients back in for more regular health checks. Consider what you want to achieve within your practice over the next five years, and what you can accomplish in the next 6-12 months to get you there.

Measuring Success

Once you’ve set your sights on the next big step for your team, you’ll want to find ways of measuring and reporting on your progress.

The best way of measuring patient satisfaction and quality of service is through a combination of anecdotal feedback from patients and data found in your practice management system, many great insights can be surfaced from your best practice data. Metrics are a fantastic way of measuring the impact you’re having as a business, but when it comes to actionable insight, it’s also important to collect patient feedback. Make an effort to regularly survey patients and ask for feedback on how you can improve both the services you offer and the experience patients are left having. Net Promoter Score (NPS) is a popular method of collecting and analysing feedback, as it will give you a singular score you can assess week on week, while also giving patients the opportunity to provide written feedback as well. Make sure to track this for your quality improvements, for instance, patient feedback regarding QI1.2 of the RACGP standards in the 5th edition.

As for metrics you can track, it’s recommended that practices look at billings per hour, diary wait time, patients per hour, and utilisation. These will provide you with a solid overview of your usage of the MBS schedule, how often you run on time, how well your team is equipped to service patients, and how full your diaries are.

Where Do You Find Opportunities for Improvement?

How are you performing? It’s a difficult question to answer. With reports you can often look backwards, and at historical trends. Compare your billings for instance, to the same period last year. Additionally, you can spend all the time in the world creating forecasts and looking forward. However, when we have data, it is vital to have context accompanying it, and to have targets in mind.

What we have lacked in the medical industry is the ability to look horizontally. For instance, you will know that you’re a bulk-billing practice in metro Brisbane, so how do you compare across other bulk-billing practices? Is a billing per hour of $302 across your cohort of GPs good for a bulk-billing practice?

It’s answering these questions and de-siloing General Practice that is to vitally important within the industry. It’s one of the major features, Touchstone, that Cubiko has been working on. For the first time practices around Australia are able to compare and contrast their business metrics to like-for-like practices.

Before Touchstone, available data on how a practice is performing against a national benchmark was very hard to come by. The government intermittently releases state and national numbers on MBS items. While this is useful information, you’re comparing your practice against state and national benchmarks across the board, rather than like-for-like practices.

By understanding how your practice is performing against similar practices you can celebrate the successes. If you see that your practice is performing well, share it with the team. If you’re wondering where improvements can possibly be made, looking horizontally at benchmarks can also be useful. But always be wary of benchmarks that aren’t representative of the practice you want to run.

So, is your practice thriving? It’s a question that might be easier to answer with the right tools.

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Time is Precious: Streamlining Aged Care Support

Streamlining Aged Care Support

Time is a precious commodity in any general practice, let alone during a pandemic, so it’s essential to adopt the technology that’s designed to provide you and your patients with a great service.  

The Australian Government’s My Aged Care service is the entry point for senior Australians to access government-funded aged care support and services, with demand for this service set to increase in line with an aging population.

The Department of Health recognises the central role General Practitioners (GPs) play in managing health and well-being concerns for senior Australians, particularly in the community settings.  As such, GPs can make referrals directly to My Aged Care for support services. 

Each year, My Aged Care receives around 250,000 referrals from health professionals, with referrals from hospitals generally following an acute incident where consumers typically require higher levels of care.

Following several years of consultation, GPs have advised the Department of Health that the current referral pathways (Website, Fax, Call Centre) are labour intensive requiring manual data entry, leading to inefficiencies and risks of error which, in turn, affects the quality and accuracy of the information stored in My Aged Care.

To address these problems and encourage more early referrals by GPs (in order to help minimise acute incidents), a My Aged Care eReferral SmartForm web service has been introduced by HealthLink to facilitate direct submission of referrals from Best Practice Software users nationwide.

Adopting an integrated referral solution on both sides of the referral fence (GPs and My Aged Care) achieves the following goals:

  • Reduces the administrative burden and cost associated with the current health professional referral pathways, minimising manual entry;
  • Increases the number of referrals to My Aged Care from health profeissionals (particularly GPs);
  • Encourages early intervention to prevent avoidable hospitalisations, in line with the Department of Health’s re-ablement approach;
  • Promotes more holistic assessment and service delivery, which also better reflects care needs;
  • Enables faster assessments and more timely access to care; and
  • Improves the quality and accuracy of data stored in My Aged Care

The My Aged Care e-Referral SmartForm design makes it quick and easy to use because it’s securely integrated by HealthLink into the Bp Premier patient record.  Upon launch, the SmartForm pre-populates all the patient and practice details and enables files to be attached from the patient’s record to back up the referral.  This allows doctors and nurses to fill the forms out during a patient consultation, ask the patient questions while they are there and get the referral right, the first time.

Once the e-Referrals are submitted to My Aged Care, a confirmation number is provided by My Aged Care on the submitted form, and a copy is instantly saved back into the patient’s file in Bp Premier.

Since the e-Referral’s launch in October 2019, My Aged Care reports more than 35,000 e-Referrals have been sent, showing just how popular the solution has become with general practices.

The overall quality of referrals has improved, as the e-Referral ensures My Aged Care receives complete, detailed, legible patient and medical information every time.  And the faster a referral is sent and processed, the less time a patient has to wait to be assessed.

A general practice in Adelaide that uses Bp Premier hasn’t looked back since introducing My Aged Care e-Referrals following an initial trial period.  Nurse manager Casey Franchi, who’s worked at Chandler’s Hill Surgery, now uses e-Referrals on a regular basis.

Prior to e-Referrals, Casey used the My Aged Care website to send referrals.

“The website referral is time-consuming compared to e-Referrals because you have to manually type all the patient details in from their file, which can also lead to transcription errors.”

“With the website, because it was time-consuming, I’d have to fill the referral out after the patient had left because it required a big chunk of my time to do it. And then if I needed to ask them a question, I’d have to contact them.”

“In comparison, the e-Referral is in the patient file so you can easily and securely access any documents to upload to back up the referral.”

“Life is so much easier now and I would recommend them to any general practice. The time saved means I can focus on the important stuff like caring for patients and not on filling out forms.”

My Aged Care director of online services and communication Kylie Sauer says e-Referrals have improved healthcare workers’ experience by offering better integration into their existing workflow and taking away the need to exit their PMS to send a referral.

“Sending a referral by fax or the My Aged Care website takes longer. By pre-populating patient information and GP details, e-Referrals are the fastest and most efficient way to refer patients to My Aged Care,” she says.

“Faxes are particularly slow to process on the My Aged Care end, which results in patients waiting longer to be referred for an assessment.”

Watch this short video to find out how you can easily e-refer patients to My Aged Care using your Best Practice Software.

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Evrima Technologies – Now Part of the Bp Partner Network

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The following article was submitted by Bp Software Evrima Technologies. You can view their partner profile here

Evrima Technologies is now part of the Bp Partner Network.

Evrima makes it easier for your GP Clinic to offer Clinical Trials as a care option for your patients.

For some patients, clinical trials may be the best or only option to access treatments that are not readily available.  However, this information can be difficult for them to obtain.

As a Healthcare Professional, you are the most trusted source of information for your patients. Research shows people who haven’t been in a clinical trial before would prefer to hear about trials from their doctor or health professional and about 4 out of 5 patients would consider a clinical trial if it was recommended by their doctor.

The Evrima GP search tool, integrated with Bp Premier is free of charge and offers:

  • Access to clinical trials without administrative burden on the practice.
  • Ability to match and recommend clinical trials for your patients.
  • Enables your patients to gain access to treatments that are otherwise unavailable to them.
  • Increase awareness of new research and trials in Australia.
  • Added service to your practice to increase practice profile.
  • Participation in cutting-edge clinical research within Australia.

To activate Evrima integration with Bp Premier, simply follow this link. Once these simple steps have been completed please contact us via clinicians@evrima.com.au to finalise the simple onboarding process.

About Evrima Technologies

Evrima was founded to address the many challenges facing the clinical trial industry, in particular, patient awareness and participation. Evrima recognises the need to bring HCPs and clinical research together to advance clinical trial awareness, participation and thereby helping to accelerate medical development. Our mission is to improve the quality of care for patients by empowering doctors to discuss clinical trials with their patients, simplifying the clinical trial enrollment process and therefore improving our healthcare system.

Learn more about Evrima today by visiting their website.

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Concerned about PRODA? – A Message from Services Australia

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The following is a direct statement provided to Best Practice Software from Services Australia.

Services Australia (the agency) is pleased to be working with the Medical Software Industry Association (MSIA) to ensure their members, and more broadly the healthcare software industry developers, have the correct information available for you and your customers.

Concerns have been raised about the changes to the way healthcare locations transmit claims and payments with the Medicare (including AIR and DVA), PBS and Aged Care programs. We want to assure you that the considerable effort you have put into developing and transitioning to web services and PRODA is not in vain.

Confusion About Services Offered by Provider Digital Access (PRODA)

PRODA is an online authentication system that verifies an organisation or individuals’ identity. It is used by multiple programs and services to ensure the right person is accessing the right services. Once authentication is verified through PRODA, the user is passed to the services they are already registered for. Users do not have to register more than once for PRODA.

The services that use PRODA to authenticate are not limited to healthcare programs, and include a range of services from Student Services, Child Care and eInvoicing.

eInvoicing is not for Medicare, PBS or Aged Care claims and payments. eInvoicing is a program that allows government departments to speed up the way they invoice and pay for goods and services (moving away from sending invoices). It is used for government contracts and payments between government departments.

Other Concerns Identified

Sharing of information: PRODA is used for authentication services for many programs, Once authenticated, no details of your secure transactions with linked services are shared outside that program.

Web services: Moving Medicare, Aged Care and PBS claims and payments to web services is part of the Health Delivery Modernisation Budget Initiative to remove adaptors and the significant technical debt and the log4j vulnerabilities associated with them. Claims are assessed and processed in the same way, regardless of the technology the transmission is submitted through.

Authenticating of behalf of customer: Software developers are able to continue to offer their customers the ability to authenticate on their behalf or have their customers (i.e the site) authenticate themselves.

Organisation structures: There is no requirement for Medicare, Aged Care and PBS healthcare locations, including shared GP practices, to set up an entirely new business structure for claims and payments.

Medicare claiming using a PRODA account: Healthcare providers can use their patient management system and web services/PRODA organisation account to claim for Medicare.  The PRODA organisation account is linked to the healthcare provider’s Minor ID or multiple Minor IDs.

A provider may choose to submit claims authenticated by their own PRODA account for the practice location they are servicing from. Alternatively, if there are a number of providers servicing from a location, one provider may submit claims on behalf of other providers. This model requires consent from the other servicing providers.

Re-signing up to PRODA: A user is not required to re-sign up to PRODA. A PRODA user only needs to register once and can use this account to link to multiple services. Signing up to PRODA does not request or confirm tax requirements. The organisation set up for submitting claims to Medicare is not for tax purposes.

Important Information for 13 March 2022

Please know that we understand the large amount of pressure the healthcare industry is under. We appreciate your significant efforts in supporting your customers to either transition to web services or to ensure their renewed PKI certificates are installed.

We’ve already let you know that we will not be turning off adaptor technology on 13 March 2022. If your customers are having trouble transmitting claims online from midday on 13 March 2022, it will be because they have not installed their renewed PKI certificate.

The agency is ready to assist you in monitoring your customers’ progress in installing their renewed certificates and to confirm any that may be at risk of not having their certificate installed in time.

In the weeks after 13 March 2022, we will contact developers and healthcare locations that are still transmitting on adaptors and have not requested and been approved for additional time.

For More Information

You can find out more about linking PRODA services here.

For eLearning, simulations and guides about PRODA click here.

You can find out more about eInvoicing here.

If you still can’t find the information you need, please contact us here.

We’ll work with you to provide the right information to your customers.

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Identifying and Responding to Substance Abuse Disorders: The ASSIST

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The ASSIST is a World Health Organisation endorsed screening and brief intervention framework, designed to help clinicians identify and respond to substance use disorders. ASSIST screens for all drugs, legal and illegal, and stratifies risk for each substance into low, moderate and high levels.

ASSIST Screen 1

ASSIST has several advantages over other screening tools. First, ASSIST covers all drugs, including legal drugs like alcohol or tobacco, and illegal drugs like cannabis, methamphetamine or opioids (and more). Importantly, ASSIST is also able to identify use of non-medical use of prescription drugs. The benefit therefore, over other screening tools, is that ASSIST can also capture polydrug use which is an increasingly common occurrence in primary health settings.

How Does ASSIST Connect to Primary Health?

By providing primary healthcare clinicians with the tools to manage low to moderate risk substance use disorders in-clinic, the ASSIST also has the capacity to reduce the burden of unnecessary referrals to specialist alcohol and other drug (AOD) services. The ASSIST triages risk for the patient into low, moderate or high risk for each substance, and connects that stratification to an appropriate intervention. For low and moderate risk clients, a purpose-built brief intervention is appropriate. 

Therefore, these patients can and should be managed by the primary health clinician rather than being referred to specialist services.

For high-risk cases however, an ASSIST score can also be used as the basis of a referral to specialist AOD service for further assessment or treatment. Only those at high-risk are candidates (those who score 27+ on a given drug) to be referred to specialist AOD services for assessment and treatment if required.  

We have therefore actively encouraged the primary healthcare sector to use the ASSIST to identify those who are at high risk of dependence, and respond by sending only those individuals for further specialist AOD assessment.  

Currently, some specialist AOD services require an ASSIST assessment as part of the referral process. Having an awareness of the ASSIST and how it connects primary and specialist AOD services will be an important feature of the prevention of substance use disorders moving forward.

A new ASSIST word processing template is now available for use within Bp Premier.

The ASSIST program was developed by Associate Professor Robert Ali (MBBS, FAChAM, FAFPHM) and Dr Matthew Stevens (PhD) from the University of Adelaide. 

The full summary of the ASSIST program is available to read here.

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NASH Certificates – It’s Time to Renew!

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National Authentication Service for Health (NASH) Certificates are issued by Services Australia to your Practice to securely access and share information using digital health systems.  NASH Certificates for many practices in Australia will expire on or before 13th March 2022 as Services Australia upgrade the certificate security.

What Purpose do NASH Certificates Serve?

In your Best Practice Software product, your NASH Certificate is used to support the following functions:

  • My Health Record
  • Electronic Prescribing with eRx
  • Healthcare Identifiers (HI) service for both eligibility and validation checks

These certificates expire every two years, and a current NASH certificate is required to continue to use the functions listed above. Previously, the HI Service, and eRx both used your Practice’s Medicare Site Certificate for these secure communications instead, however both services now require the use of your NASH certificate.

Updating Your NASH Certificate

If your certificate is due to expire on or before 13th March 2022, you can renew this now, there is no need to wait until the expiry date.  You can request and download a renewed NASH Certificate for your Practice through Healthcare Professions Online Services (HPOS), and install this into your software. Doing so ensures that My Health Record, prescribing with eRx, and HI lookups will continue to function in your Practice without interruption.

To request an updated NASH Certificate, your practice’s nominated Organisation Maintenance Officer needs to log onto the HPOS portal through your practice’s PRODA account and request an updated certificate.  The Australian Digital Health Agency have provided several resources to assist with requesting your new Certificate, including:

Once you have renewed your NASH Certificate, you can then install this into your software to continue your access to My Health Record, prescribing with eRx, and the HI service. 

Need Extra Assistance?

Not sure what to do in your software? Help is available on our Knowledge Base! Simply log in to your software, open the ‘Help’ menu, and click ‘Online’ to be taken to the relevant Knowledge Base to find step-by-step instructions to guide you through this process. As always, the Bp Support team are here to help as well, and you can contact us on 1300 401 111 for assistance.

Authored by:

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Bec Bland
Training & Deployment Leader at Best Practice Software

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The New Generation of Practice Management Systems – From Interoperability to AI

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Early practice management systems (PMS) were born out of the need to provide better continuity of care for patients and more efficient operations for a GP/practice, both of which contribute to the improved quality and safety of care delivery. They have created significant and perhaps intangible benefits to individuals and society over the last several decades.

The new technology enablers, however, make it possible to transform PMS into more federated, better connected, and evidence-based systems by leveraging the emerging interoperability standards and Artificial Intelligence (AI) technologies.  This will make the new generation of PMS even more central to primary care systems within the overall healthcare care continuum.

This will enable future generations of Best Practice Software to bring many new benefits to patients, practitioners, and the community at large – contributing to a ‘more sophisticated and connected community healthcare management’, as mentioned in a recent Wild Health article.

Technology Enablers

The technology enablers include web-based and cloud infrastructure, now being used as the basis for the next generation of Best Practice Software, referred to internally as Titanium.

When used in conjunction with new interoperability standards such as HL7 FHIR®, cloud technology adds new mechanisms to the way various parties in the delivery of healthcare are connected, including support for patient engagement.

Through the cloud, AI solutions can be built leveraging huge amounts of data created by clinicians, including as part of collaboration with other clinicians, and in some cases, generated by medical devices. Such solutions can provide new insights to the clinicians and support new models of clinician-patient collaborations, with added emphasis on preventative and personalized health.

The Added Value of Interoperability

Architecting for interoperability adds dynamic and evolvable aspects to the way health systems of the future are connected, typically using APIs over cloud. This allows constructing and managing flexible event-driven clinical workflows supporting multiple participants, including hospitals, Aged Care facilities, community health centres, and patients.  This is not currently possible using HL7 v2 messaging integration approaches.

The emerging HL7 FHIR® standard provides a common information model for representing digital health data (the so called FHIR Resource entities) and API interfaces, both of which support building interoperable and connected digital health systems, and many international vendors are now embracing it.  In some cases, this is in response to regulatory requirements, such as the US Office of National Coordinator (ONC) cure act Final Rule.  This rule was designed to give patients and their healthcare providers secure access to health information. It also aims to increase innovation and competition by fostering an ecosystem of applications to provide patients with more choices in their healthcare, in part through the standardized API interfaces.

Best Practice Software recognizes the many benefits that the FHIR® standard can bring in the context of cloud technologies and is currently establishing a long term FHIR® adoption roadmap as part of its strategic direction.

The Added Value of AI

In general, AI is a collection of interrelated technologies used to solve problems autonomously and perform tasks to achieve defined objectives without explicit guidance from a human being. AI adds value through automating many tasks typically involving human actions and decision making.

Examples of AI use in healthcare are in the interpretation of medical images, e.g., X-rays and MRI scans, in the personalized treatment of patients based on their medical history and genetics, and in the optimization of clinical workflows.

A key component of AI is machine learning (ML), whereby computers ‘learn’ without being explicitly programmed, making use of the large amount of clinical data collected over time (aka training data) and applying advanced computational reasoning techniques. This can be in the form of:

  1. statistical machine learning searching for a predictive function from the training data
  2. reinforcement learning approaches constructing AI algorithms with “rewards” or “penalties” based on their problem-solving performance, inspired by control theory approaches
  3. deep learning solutions based on the use of artificial neural networks.

Other AI applications are in natural language processing, computer vision, used in many clinical image processing applications, and robotics. Another area of use in health is knowledge representation, particularly used to document clinical knowledge in a computable form such as SNOMED-CT clinical terminology.

Many rule-based Clinical Decision Support (CDS) systems can also be regarded as a form of AI.  Best Practice Software has included since its initial release CDSs aimed at helping clinicians to provide safer and more personalized healthcare. For example, when prescribing, background checks are made for potential allergies, drug interactions, contra-indications etc.  The use of new AI approaches can add another level to CDS, leveraging data-based solutions, contributing to better evidence-based healthcare provision.

Best Practice Software is currently looking at AI technologies for its future products to advance the creation of learning health systems for primary health providers as part of connected health ecosystems. The aim is to support more effective, evidence-based, and personalized clinical care and adaptable clinical workflows, as well as more efficient administrative operations of practices, based on the large volumes of historic data that has been collected. Possibilities include analysis of previous investigations of patients to support predictive clinical actions, text mining of correspondence with specialists, hospitals, and other clinicians, to help better decision making in case of similar future symptoms and so on.

While interoperability delivers more connected and event-driven care, analytics and AI provide augmented decision making for clinicians.

Establishing Trust for Providers and Consumers - Guidance for Developers

An important consideration when discussing AI technologies is to ensure that clinicians trust the decisions that are made as a result of the use of the AI system. This is often referred to as an explainability problem, which requires mechanisms to support clinicians in understanding how AI systems make decisions.

There is a further element of trust, whereby that learning health systems need to ensure that personal and societal confidence in IT systems is preserved in the presence of the data proliferation and sharing. To this end special care needs to be taken to express rules related to privacy, policy and ethics.  These concerns were discussed at more length in the paper delivered by Best Practice Software at the recent AI in Healthcare workshop in Oct 2021, and highlighted next.

One way to create trust is to develop “explainable” AI, where developers can present the underlying basis for decision-making in a way that is understandable to humans and can demonstrate that the system is working as expected by clinicians.

Another part of the guidance for developers is related to the problem of expressing computable expressions of policies, such as obligations, permissions, accountability, responsibility, and delegation. These expressions can be implemented in code as part of any digital health application, including the AI solutions. For example, they can be used to encode rules associated with privacy consent, governing the rules of access to personal healthcare information, or with research consent, governing the rules of clinical research. 

Computable expressions of policies are also important when one needs to express responsibilities associated with passing of healthcare data between providers, taking into account various legal constraints such as data ownership or custodianship or regulatory constraints associated with privacy.

AI brings its own set of policy issues such as how one can go about specifying ‘responsibility’ of AI applications, e.g. in the case of safety concerns, is this a responsibility of the AI developer, the IT staff involved in deploying the system or of the users of the system such as the clinicians.

These are issues which are currently yet to be addressed as part of legal systems, but the computable policy framework should be a required prerequisite when building scalable AI in any healthcare organization.

Co-authored by:

New Generation of Practice Management Systems Author Headshots

Dr Frank Pyefinch
CEO at Best Practice Software
&
Dr Zoran Milosevic
Interoperability and AI Consultant at Best Practice Software

Footnote

The paper presented at the AI in Healthcare Workshop is available upon request. If you would like to obtain a copy, please contact Dr Zoran Milosevic here.

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