My Health Record Put on the RACC

At its launch in February 2019, the Commonwealth said My Health Record (MHR) would help to improve the consistency and quality of the care experienced by patients as they move between their General Practitioner, specialist and hospital.

To assist in fulfilling that goal, the Australian Digital Health Authority (ADHA) funded an $8.5 million Digital Health Test Bed program to trial the use of patient information gathered by MHR for new approaches in chronic healthcare, palliative care, and post-hospital support.

Under the program, members of Sydney Health Partners led by Professor Clara Chow and supported by Professor Tim Shaw and members of the Digital Health and Informatics Network, established the Western Sydney Cardiology Care Test Bed.

“The project aimed to test the use of MHR data to improve patient care in existing Rapid Access Cardiology Clinics (RACCs) and scope the feasibility of a cardiology application populated with information from the MHR,” said Professor Chow.

“We looked at how the data could help the risk assessment of patients referred to RACCs, identify the patients who most need RACCs, reduce duplicate testing, and support improved communication between health care providers via shared health summaries.”

RACC is a novel, hospital-based, cardiologist-led outpatient clinic which provides rapid assessment and management of low-to-intermediate risk patients who present to emergency departments with chest pain. Research supported by Sydney Health Partners demonstrated that at hospitals using the RACC model of care, the proportion of people who were admitted after presenting to emergency with chest pain fell significantly, and fewer patients underwent unnecessary invasive testing.

Over two years the Test Bed project determined that the MHR system was not able to effectively include data from outpatient services like RACC. eHealth NSW, which has responsibility for the implementation of MHR in the state, was called upon to find a solution.

The result is the addition of a Specialist Letter Template to the MHR system. When implemented, it will enable RACCs to upload significant clinical data to the My Health Record platform and send secure messages to a patient’s GP to alert them to the information.

“People with complex medical needs such as cardiology patients require integrated, accurate, and complete health records across multiple health platforms,” said Professor Chow.

“Without effective integration of the RACC model into the MHR, there is a risk that important information about a patient’s condition will not get to other healthcare providers and the effectiveness of our treatment will be compromised. An accurate and seamless flow of information between patient, RACC, specialist and GP is fundamental in guiding clinical decision making.”

In June 2020, the Western Sydney Cardiology Care Test Bed received additional funding from the Australian Digital Heath Agency to support the next stage of the project.

The initial site for integration with My Health Record will be the RACC at Westmead Hospital, but Professor Chow expects the solution will translate to other RACC sites across Sydney Health Partners.

It is also hoped the solution will be scalable across NSW, enabling all Local Health Districts and Speciality Health Networks to publish a wider variety of clinical documents.