NSW electronic health records system goes live

The NSW Department of Health will begin prototyping its new electronic health records project this month in what is believed to be the first, wide-scale online patient information database of its type in Australia.

Dubbed "Healthelink", the project has received $19.4 million in funding for five years and started "well before" the national HealthConnect project came into being, according to assistant director of electronic records strategy for information business solutions at NSW Health Joanna Kelly.

"Healthelink was born out of a review of health in NSW where a major recommendation was that NSW move towards electronic health records which dovetails well into the national network," Kelly told Computerworld. "We're literally days away from developing and prototyping the electronic health records system which will go live in September. The prototyping will be finished by the end of the year."

Healthelink's first implementation will involve GPs and private clinics, then be extended to include other services like pharmacies, and eventually be available to all clinicians, not just GPs, because present health information is "fragmented across many segments".

"HealthConnect has announced statewide implementations in Tasmania, South Australia, and the Northern Territory. We're still listed as a trial but what we are doing will cover more of the state than HealthConnect," she said. "The NSW implementation differs slightly from the national architecture where there are still some things that are undefined."

Regarding the benefits Healthelink will provide, Kelly said the key is diagnosis, preventative care, and to stop duplication of tests.

"Shared practices are limited because there are no common records. It will also reduce the opportunity for an adverse combination of medicines to be prescribed," she said. "Consumers will have access to their electronic health records and can add details, for example, chronic disease sufferers can add information about their conditions which would then be accessible by their GP."

The online record is described as "summary level", not a full record, and users are capable of defining who can see the information. Health marketers will be denied access to Healthelink, and data won't be shared with other government departments, including the police.

"It will be encrypted using digital certificates and will follow HealthConnect's security guidelines," Kelly said. "The system is voluntary and is very much role-based, and there are full audit trails for all access and formal penalties are in place for misuse of the information."

Healthelink project manager Rebecca Reid said the department has partnered with Orion Systems International and LogicaCMG for the development and integration work. Oracle 10g enterprise will be used for the database.

"Healthelink will be hosted by the department's shared services environment in its Sydney datacentre," Reid said. "HP is one of NSW Health's established vendors so the group has looked at Itanium but is not convinced by the price."

The Healthelink user interface is implemented in Java with the Apache Web server and Tomcat as the servlet container. The proposed deployment is to have Apache and Tomcat resident on the same cluster, which is generically referred to as the Web server on HP-UX. This infrastructure is still subject to commercial considerations by the department.

As there are no metrics for the scale of such a project, the pilot will obtain them. It was estimated that Healthelink could have as many as 10,000 concurrent users.

"The commonwealth has been closely involved and we made everything available to them," Kelly said. "We've all learnt from smaller projects in Tasmania, Queensland, and the Northern Territory. Everybody recognizes there is no point in re-doing work and there is the opportunity for others to re-use material we have developed.

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