Health bodies have converged to address issues with access to patient medical records, highlighted by a dispute between to ICT vendors Medtech Global and HealthLink earlier this year.
The Ministry of Health hosted an interoperability and standards workshop this month to address the safe sharing of information, says the deputy director-general of health information, Alan Hesketh. He says the effort aims to put in place “common approaches” to the commercial arrangements for interoperability between IT systems used in the health sector.
Hesketh says the ministry’s position is two-fold: how to share information safely and privately and how to do this so the commercial terms between ICT providers do not add costs into the health system.
Members of the New Zealand Health IT Cluster, which represents health technology vendors, participated in the meeting and the cluster is taking action to put in place agreed approaches, Hesketh says. He adds that it isn’t just about Medtech and HealthLink, but also about iSoft and Orion and a host of other players.
The Health Information Strategy Advisory Committee (HISAC) is one of several groups interested in the records review. HISAC, which advises the Minister of Health on the direction of health IT, is driving to have electronic referrals between primary and secondary health providers implemented nationwide by the middle of next year, says chairman Graeme Osborne.
Osborne and Hesketh both say there is no dispute about the ownership of health records: they belong to the patient and are held in trust by health providers. Where issues get trickier is at the integration point between systems, Osborne says.
Osborne says New Zealand is at the early stages of understanding what the fully integrated sharing of patient information means and that in turn means there will be disputes between commercial software providers.
“We take an interest when these disputes are not resolved and that holds back innovations beneficial to patients,” he says.
Osborne says the various parties to the discussions are not that far apart.
Meanwhile, Medtech’s Clinical Advisory Group has reviewed its terms of access and licences and released a letter in reponse to Computerworld’s reporting of the dispute between that company and HealthLink.
In June, HealthLink went to the Commerce Commission saying Medtech, which develops practice management software, was refusing to allow the free exchange of New Zealanders’ patient information.
Medtech’s Clinical Advisory Group is made up of seven practitioners from across the health system, the letter says. They go on to say they were asked by Medtech to review patient data access to the company’s Medtech 32 platform.
The group says Medtech provides full and unimpeded access for practitioners and patients to data held in trust for the patients. They say the only requirements in the licence for third party software to access the database is that it complies with industry safeguards to ensure the system’s integrity.
The letter says there are several commercial integration agreements in place with other vendors.
HealthLink CEO Tom Bowden says his Commerce Commission complaint is still being investigated.
Bowden says the critical question is: “what should be the financial basis upon which a patient’s information is able to pass between systems?”
“Two approaches have been suggested,” he says. “The approach we think is appropriate is for the holder of the information to be paid the actual costs of maintaining and enabling its transference plus a fair commercial margin, as determined by an independent party if necessary.
“We believe this should be a fixed fee per practice per annum for the support of a standards-based interface. We note that government has already funded viable standards for doing this and it is already being done in a number of places.
“The other approach, and one we don’t like, is one in which we are asked to pay a licence fee which is determined by the EMR software company in whose clients’ computer systems the information is stored,” Bowden says.