In October 2016, the Minister for Health commissioned Targeting zero - the review of hospital safety and quality assurance in Victoria.
The Targeting Zero report outlined recommendations to enhance system leadership, make better use of information and data, improve sector governance and strengthen departmental oversight. Recommendations were made, with the aim of improving safety and quality within the Victorian health system. Digital patient identification, electronic capture and sharing of clinical information were identified as critical for enabling management and use of health information for the provision of care and service improvement.
Victoria’s Digitising Health strategy, based on recommendations within the Targeting Zero report, identifies the need for investment in digital health information and related technologies to facilitate the delivery of person-centred healthcare. The focus will initially be on the acute health sector, to target safety and quality areas of most immediate risk to patients.
Three digital health critical enablers have been identified to deliver these improvements:
- further rollout of electronic medical records to Victorian public health services (VPHS)
- a Unique Patient Identification (UPI) capability across the Victorian health sector
- a clinical information sharing platform across Victorian health services
Improved patient identification and the linking of patient records across health services is a prerequisite to the implementation a clinical information sharing platform.
The Department of Health and Human Services (the department) has commenced a program of work in close collaboration with Victorian health service representatives to deliver a UPI capability across the Victorian Public Health Sector (VPHS).
Victorian health services use a diverse range of health applications. Typically, there are separate instances of the same product across health services. Applications that provide the same type of function may be supplied by many different vendors across health services.
Within a single health service, there may be multiple demographic records registered for a patient. The inability to uniquely identify patients due to minor changes in demographic details results in approximately 10-15 percent of duplicate records within a health services. Currently, patient registration details across health services do not have a common link and cannot be safely matched.
UPI is a critical prerequisite for being able to provide a single view of patient’s health information. Currently in Victoria, there is a lack of robust technology to support access to and sharing of patient information across all health services.
A master patient index or a UPI solution is the foundation health technology that will support truly patient-centred integrated models of care. The UPI solution will use probabilistic and deterministic data matching algorithms to match and link the disparate patient records across the VPHS and highlight duplicates within a health service system. This will be the foundation to enable clinicians to have access to health records associated to an individual irrespective of which health service the patient received treatment.
Implementation will involve a health service Patient Administration System (PAS) integrating with the UPI solution by sending real-time notifications of patient registrations,updates and record merges for matching and linking patient records across the sector.
The UPI will:
- Dynamic creation of a single-best-record to represent the ‘best’ unique patient record.
- Auto-linking and unlinking of health service patient records.
- Configurable exceptions to allowing records to auto-linking.
- Configurable exceptions to allowing records or populated values to be sent to the UPI Enterprise Master Patient Index (EMPI).
- Processing of patient registrations, demographic updates, merged patient records and patient record deletes
- IHI lookup on behalf of the health Service using patient demographic information provided in the sent patient record
- Ability to unlink and classification of patient records being ‘similar but different’ people
- A collection of data stewardship tool assisting in governing data quality, error management and conflict resolution.
- The UPI solution implementation across the Victorian public health sector is on track for completion by June 2021.
- The first three health services - Alfred Health, Monash Health and Peninsula Health - were on-boarded in October 2019.
- A phased approach to on-board the remainder of the 82 Victorian public health services will be completed by June 2021.