Hi @martin.wilson and @richard.medlicott
We could do a case comparison and present it as HINZ. Might get people talking about whole of NI, says me hopefully but thinks change is unlikely. Any chance of MoH funding this?
Cheers Inga
Happy to do a demo beside Richard. Would help me understand his system. As I understand it not all the NI share Richards system??
the MOH is doing a NZeHR, renamed NHIB, and now called Hira and there is a business case somewhere around treasury pre COVID-19. This MOH model is a database which vendors can create APPS to attach to. I have been involved. Great model but it will only show something to the HCP until after the APPS are made and tested… assuming vendors come to the party. Perhaps we should roll H1 out in parallel.
**If there is any region in the NI that wants H1 and is up to date with concerto and has no-one in their IT department who disagrees PLEASE ASK
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Correct, not all NI share Richard’s system.
One perception that may contribute to adoption of a regional system, is that hospital-based providers ‘don’t care’ about the primary care information. This may be a minority perception, but I’ve heard this from decision-maker-level individuals, so worry about the influence of this perception. Fortunately, this is not the case in my neck-of-the-woods (BOPDHB) where there is a ‘primary care data view’, which I understand is commonly used by at least ED staff. It is buried, though, in a list of other ‘applications’ on the hospital information exchange platform (e.g., ‘CHIP’), so I’m not sure how accessed this is by other departments, and other GPs.
Hi Emily We used the “CHIP” interface regularly in our GP practice in Opotiki when we worked together. My I understanding is that it probably has reasonable uptake from GP in Bay of Plenty. Not sure who is CIO at BOPDHB and whether they on this forum but pretty sure they must measure their “hit rate” and give a clear idea. I liked “chip “ when I used it but seems in essence similar to Testsafe with access to Eclair labs and manual reports on Xrays , outpatient documents and discharges . Nothing like the breadth of Health1 as I was exposed to when on WestCoast SI last and I believe has grown significantly in its offerings since. Acute and chronic care plans , ACP all intergrated . I was reviewing NorthenAlliance ISSP documents which suggest they were running an RFPfor a shared care product but have been unable to find anything more online . The fact that NDHB have opted for Indici to run their NZePS May suggest that Indici shared care ( as per @richard.medlicott) model may be the front runner . Indici PMS is preferred PMS for Procare the largest PHO in Auckland now .
Our DHB in Northland chose Whanau Tahi to provide the Primary care summary report into Concerto. The other modules were not in my opinion really considered and have been used subsequently to try and provide the tools for Primary care flexible funding Kia Ora Vision and Neighbourhood health home and more recently for ACP. Problem for Northland was poor management of rollout and perhaps wrong choice of vendor. GP’s not engaged in WhanauTahi at all due to poor initial comms and rollout. As I said before a “poisoned chalice “now . so maybe a new vendor offering a properly funded and managed roll out in conjunction with Primary care as partners would be more acceptable
Personally I agree that roll out of H1 to NorthIsland whilst we continue to wait for the new National health record makes complete sense . If today’s launch of contactbtracingbApp is anything to go by I have reservations of form and function of this National EHR
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Without really knowing any details I had heard a rumour that H1 has security issues and could relatively easily be hacked - @martin.wilson any comment?
Hi Kerry,
HealthOne conducts regular security testing, the most recent being last year and conducted by Insomnia Security Group, a certified All of Government provider. This testing supports an active cyber security management program geared at protecting the patient information HealthOne holds. So, the short answer is no, HealthOne is not an easy target for hackers 
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Hi Martin, it’s worth noting that currently HealthOne is still based on the same technology it was built with in 2012 and is in need of a technical overhaul to replace both the SSO technology and moving the data views to being API based rather than plain text DB queries. This has been raised a number of times, most recently it was determined that there currently aren’t any FHIR APIs available for retrieving HealthOne data for display in Health Connect South.
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I wonder if its necessary at all - Conporto can pick up the relevant information from the practice PMS in real time, so at this point not sure the SEHR is adding anything! Everything has been such a state of flux. For us I thinks its time to take a breath.
Martin is right, due to changes in local systems we have ended up with a bit of a mix. I was a bit of a Conporto skeptic, not really believing that a ‘web scraper’ model would work fast, but have been pleasantly surprised. Still think there are things that some of the olde parts do better. For example I prefer the Concerto view of the hospital record.
Anyway, this whole Covid thing and the rebuild of the entire Tu Ora Compass IT stack and our data breach of the old stack has meant the shared care record stuff has been on hold. (Apart from Conporto working on their UI). Time to get moving again with it.
Will try and post some screen shots at some stage, but once again I find myself writing this up on Friday evening when I get some time - not sure that is healthy - must be better things to do!
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I asked AshleybBloomfield and Juliette Rumble-Smith for HealthOne National at PHO Clinical Leads meeting last night . He said no but he has suggested to Minister he accept current business case for National shared care record and not spend another bucket of money on further consultancy costs. Hopefully more robust implementation than the contact tracing app. Wasn’t one venue Inwent to today that had a QR code
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It is interesting that HealthOne is a no and a huge expensive business case is a yes. I am very supportive or the ministry model (as I have said already I was part of the Hira / Nhib, NZeHR business case project) but in the interim I believe it is likely that most NI patients will be having some negative outcomes because of the lack of a whole of NI system. As Richard says a “pepper pot” response to solving the problem of integrated care in the North Island ranging form nothing in some areas (See Inga above) to his Comporto “internet scraper”.
All I can say about this is HealthOne accesses have been steadily increasing over the past few years. Since May 2017 accesses have increased from approximately 100,000 per month to now being over 200,000 per month. I think one can draw the conclusion from these figures that HealthOne is a huge benefit to the patients in the South Island.
Hi Gavin,
As you know we’ve been working together on this and have already made significant progress toward replacing the SSO technology. HealthOne’s existing FHIR API architecture does require expanding to accommodate this data transfer. A recent review of our FHIR technology was very positive, which reinforced the importance of investing in building quality FHIR interfaces. Fortunately the current connectivity exists on a secure private network as originally designed by Orion and HealthOne, so we don’t need to compromise the FHIR API by attempting to rush it.
We look forward to continuing this work with Orion and would encourage you to reach out to us in the future with such concerns.
cheers Martin
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Hi Richard,
It is time I ended my ignorance of Comporto. Can I come and perhaps sit in with you and watch it in action please.
I know you are busy but would be very interested in genuine coal face experience. Sitting in and watching an experienced user will give me the insight I need.
Cheers M
I work in NI and SI. I am in northern region DHB so have access across northern DHBs, good access to pharmacy and lab, minimal access to primary care record, and no shared editable documents like shared care plans. The bare bones necessary infonis the, but such a pain to find we often doubt bother. H1 is vastly superior, everything in one place, fast and intuitive (I use in primay care in SI). North Island clinicians aren’t clambering because they’ve no idea what they’re missing. Only thing I like up north is that Concerto pulls dispensing into my document so drug management in hospital feels safe. Would like this in primary care too
Just so others can visualise H1 here are some screen shots which are from production.
hopefully i have expunged and NHI or name but this patient has consented to his / her file to be used for demonstration purposes
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Thanks for that Marin - looks very tidy. Here are some screen shots from our system. Its a work in progress, UI not as fully fledged in terms of filtering, but improvements in the pipeline:
Open with click on ‘sidebar’
Provider and NHI detail passed thru - check re consent of break glass and reason:
List of organisations where data is held. Note this NHI linked to multiple test patients, so NZePS a bit confused as DOB discrepancies! No data in hospital for him either - will try and find hospital test patient as well…
Reconciliation page - if was a real patient on the right panel would show dispended against the prescribed med.
Each tab has the information you would expect to fine, like diagnostics, meds, allergies. Hospital record shows whats in concerto, including appointments, but not as rich as full concerto access.
Sorry, between patients - no access to a hospital record patient right now. Anyway, very light system. Works in realtime. One to add to the mix…
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Looking forward to seeing it in action Richard
Cheers M
Nice to have such positive feedback thanks Sarah