By Laurie Hawkins, Advocate for Health/Human Services Directories
Virtually every health and human service provider in nearly every country has some form of list, address book, directory or service arrangement which they independently maintain, source information about other providers and, in some cases, arrange the transfer of information electronically. Large organisations across public, private and not-for-profit settings typically have many of these covering both their own organisation as well as selected information about other providers they deal with regularly.
These are used on a daily basis by doctors, nurses and allied health professionals to aid the transfer and management of care. They range from simple lists to relatively sophisticated databases, separate to or embedded within other health systems. Few of these, however, are linked to a capacity for eHealth communication.
This plethora of directories (Provider Directories) as noted by a survey undertaken for the Office of the National Co-ordinator (ONC) in 2010 in the USA, is frustrating health service providers and is a major obstacle in improving healthcare. They are often out of date or in accurate; unable to sustain electronic communications information or link to professional accreditation bodies; have content management processes that are highly variable; with maintenance costs that are duplicated 1000’s of times; and service providers who don’t want to respond to multitudes of requests to maintain or insert their information into the various directories.
Service and provider information must be available quickly, easily and with the highest possible degree of accuracy and reliability, alongside the emerging identification, authentication and messaging regimes. This needs to happen if we are to use electronic communications effectively to support health and human services.
In almost every country there is a widespread requirement for a directory combining provider and service information across the sector. This challenge was recognised in Victoria, Australia in 2004, both from a public and private perspective, which led to the creation of the Victorian Human Services Directory (HSD).
The Victorian HSD is a directory that integrates both service and operational information, covering both health and human services including healthcare providers. Information is provided for a range of uses, with different information accessible to different users of the directory, governed by a security and consent model. Moreover it provides a consistent directory for the private and not-for-profit groups across the sector. Few of the not-for-profit groups are included consistently in current directories.
It also has a much greater breadth and depth of information (than Provider Directories) to enable service providers to be located based on functions or characteristics. Therefore, key search fields relevant to care planning and effective electronic communications, such as referrals, are supported. These include opening hours, languages spoken, service types provided at a location, facilities, payments accepted, telehealth capable and electronic address information.
The HSD has grown significantly since its inception in 2004. It is now acknowledged as the prime source of accurate service and provider information by the Department of Health and Human Services, many professional bodies and organisations in the sector. This includes the former General Practice Victoria (GPV) which listed all its members on the site, and actively encourages listings from its members. It also has comprehensive coverage of health service providers –i.e. across all public and private sector settings and service types– from acute care and specialist services to aged and community care. Most stakeholders see the inclusion of various “human” services as valuable to healthcare.
It now contains:-
· 11,000 Agencies
· 15,000 Sites (physical)
· 7,700 General Practitioners (Doctors)
· 8,000 Specialists (including Allied Health)
· 30,000 Services (offered at the various sites)
Effective implementation of E-Health initiatives and integration of primary, mental health, community, social and aged care, requires high quality provider and service information, which can be accessed by many different methods including business systems (clinical, aged care, community, etc.),web portals and other means. Examples of this accessibility include:-
· A public web portal, the Better Health Channel which provides Government (State) credentialed health information, healthy living and medicines. This website receives over 1 million hits/month and been awarded numerous national awards.
· Coordination of care plans which include the ability to do referrals for patients from regional communities who require data to be passed to general practitioners, pharmacists and allied health when leaving a Metropolitan hospital.
· Enables National, State and Local programs such as Nurse on Call program (Call Centre) to provide relevant information to consumers about demographic and geographic services information (e.g. direct a mother to her nearest pharmacy after hours).
· An award winning Victorian mobile app, which includes “Find a Service” utilizing an API (Web service)
The Victorian HSD has been incrementally developed (Agile) to provide better and more effective functionality over the past several years in conjunction with consumers and health/human services provider’s business requirements. It has proven to be scalable and sustainable, all from the “Cloud”.
Because of its success, the Australian Capital Territory (ACT) started to use it for their health consumers and organisations, followed by the Northern Territory (NT) as a Directory to hold Electronic Identifiers for Secure Messaging between all health and human services. This has further evolved into a National Health Services Directory (NHSD) which is now used by all State, Territory, and Federal Government, and the private sector.
The NHSD has now grown into a Single National Repository of human and health services, which enables all stakeholders, including Federal, State and Local governments, public and private service providers and consumers, to access data across the eco-system of health and human services. It is now the “Single source of Truth” for E-Health across Australia.
It is now the:
o National Health/Human Services Directory (350,000 services
o National Provider Directory (300,000 accredited healthcare professionals)
o National Telehealth Directory
o National Health Provider Identifiers – Providers (HPI-P’s)
o National Health Provider Identifiers – Organisation (HPI-O’s);
· and receives 7,000,000 transactions/months and growing;
· all using just ONE API (Web Service) for all health/human services software
Given Australia now has this significant knowledge base; it has been used to form the basis of a “Health Data Platform”. This data platform aims to help overcome the “islands of data” held across the sector by combining an expanded range of data sets, such as census, health workforce, health insurance, transport, education, urban planning etc.
The National Health Services Directory (NHSD) acting as a catalyst for e-health, combined with a Health Data Platform delivering greater accessibility to relevant health sector data, provides a wealth of information resources to the health sector and consumers. Given the long term impacts of increasing chronic disease, an ageing population and escalating demands on services, the combination of the technology resources presents opportunities to plan, build and support healthier and more sustainable communities through a greater focus on informed evidence based decision making.
About the Author:
Laurie is an “Advocate” and “Subject Matter Expert” for Health/Human Services Directories that will provide significantly better health outcomes for communities across the World. He has facilitated the development and growth of the Victorian Human Services Directory (HSD) from a much maligned tool to the “Tool of Choice” for State Chief Information Officers (CIO’s) across Australia.