Life-cycle of a health organisation connecting to the national digital health ecosystem
HEALTH CARE
Landscape
Chamonix has developed a middleware product for the Australian Government that health organisations can use to connect to the national digital health ecosystem and contribute to by uploading clinical documents such as discharge summaries and pathology reports for consumers and healthcare professionals to view.
This case study describes the typical life cycle that a health organisation will adopt in the course of connecting and contributing to the national digital health ecosystem.
It also shows where Chamonix provides services to the healthcare organisation directly or indirectly via the Australian Government.
Solution
Healthcare organisations such as a public health service or jurisdiction, private hospital, public pathology, private pathology, private diagnostic imaging or aged care facility have a desire or need to contribute to the national digital health ecosystem to share clinical information with other providers as well as the recipient consumer.
There are 3 main choices:
- Their clinical application(s) may already have ability to connect to the national systems
- They may need to make changes to their clinical application(s) to connect to the national systems (this is a substantial undertaking)
- They may choose to integrate their clinical applications to a ready-made middleware product (owned by the Government), which connects to the national systems on their behalf
- It is at the third choice that Chamonix assists with their integration.
- The middleware product has been built by Chamonix and is owned by the Government. There is significant documentation held on the Government’s website for the product. The healthcare organisation can access the information and download a copy of the product and via the documentation provided by Chamonix, start to investigate its use.
- If they decide to proceed with the middleware product, it is usual for the healthcare organisation to be assigned a Government architect.
- There have been occasions where Chamonix has been involved in providing service directly to assist the healthcare organisation where the type of organisation is new to the middleware product. This occurred for pathology and diagnostic imaging organisations, where the product was being used to upload pathology reports and diagnostic imaging reports
- If Chamonix is not working directly with the healthcare organisation, Chamonix integration staff will provide expertise to the Government architects.
- Integration with the national systems is complex and requires specialist knowledge which Chamonix can provide directly to the healthcare organisation or via the Government.
- Integration with the middleware product normally requires the healthcare organisation to make software changes to their clinical systems and/or changes to their integration engine which connects systems and handles the communication protocols required by the clinical systems and the middleware product. The integration engine also has sophisticated queuing systems to ensure no messages are lost between systems and messages are passed in the correct sequence. All these details are provided to the healthcare organisation during the analysis and development phase.
- Health organisations can have multiple clinical systems which can include patient administration systems, electronic medical records, pathology lab systems, diagnostic imaging systems, primary care, emergency department systems, making integrations complex and involving multiple vendors.
- Once the integration changes have been developed, there is normally a rigorous testing phase. Unusual scenarios and edge cases are often raised and Chamonix provides expert analysis and advice to provide solutions that fit with the middleware product functionality and the national systems.
There are several phases to the testing:
- System testing
- Integration Testing
- Compliance Testing
- User Acceptance Testing
- Compliance testing requires the healthcare organisation to show that they are providing an accurate clinical document that conforms to the compliance requirements. The healthcare organisation is not permitted to connect to the national systems until it has passed all necessary compliance and conformance testing and the healthcare organisation attest that they have followed the requirements and approval to connect has been granted. The National System Operator checks the healthcare organisation’s uploaded clinical documents in the national test system to ensure the structure and data quality is acceptable.
- Once the healthcare organisation has been provided approval to connect to the national systems, they will go live with the solution and the middleware product.
- Chamonix provides a support service that enables the healthcare organisation to raise support tickets whenever an incident needs to be resolved or a query needs answering.
- This support service is supplied to the sites that are nominated by the Government.
- Chamonix have also developed a knowledge portal which provides additional assistance by providing solutions to common issues. This website has been developed using the Kentico application. Only sites that have been nominated by the Government are provided access.
- From time to time, Chamonix will be asked to make changes to the middleware product. This is usually arranged via the Government and added to a future release for development, or a commercial arrangement can be organised for a healthcare organisation directly.
Summary
The life cycle of a healthcare organisation connecting to the national digital health ecosystem can take many months and is complex. Chamonix provides the skill and expertise to assist the healthcare organisation either directly or via the Government departments. Once the healthcare organisation starts testing their integration with the middleware product and the national systems, Chamonix provides support which continues when the healthcare organisation goes live with their solution. We have healthcare organisations that have been supported by Chamonix for over 7 years.
