Digital innovation is giving us greater choice and richer experiences in retail, education and even at work. This innovation is also creating exceptional opportunities in healthcare. Health software specialist, Medtech Global, quickly saw an opportunity to help people get more out of their regular doctor’s visits. Digital healthcare can offer so much more than online consultations. It can be used to change the lives of both doctors and patients, freeing up doctors’ time by reducing paperwork and increasing efficiency and accuracy. Whilst giving patients ownership of their health data and access to a huge range of health services from one platform. Leading this change, and world first in health interoperability, is Medtech’s Azure-powered ALEX platform (Application Layer EXchange) – it is just what the doctor ordered.
The human body is one of the most complex inter-related systems – and the healthcare system designed to look after it comes a close second. GPs not only need to be able to diagnose and treat almost any health issue from depression to diabetes and asthma to angina, but they also often manage their own practice as well. On any given day, practices process an enormous amount of information through consultations, prescribing, referring, requesting hospital appointments, reviewing lab results and keeping the practice accounts up to date.
They couldn’t do this efficiently or as safely without a Practice Management System like Medtech. To be truly effective, a Practice Management System needs to give specialists and other healthcare providers access to very specific patient data, without exposing an overwhelming amount of irrelevant and outdated patient history. It also needs to give patients online access to their own data and allow them to book appointments, receive test results, check their medical records or order prescriptions without having to call their practice.
The traditional solution to meet all these requirements is a centralisation of the data in a shared “data lake”. But this had limitations and security issues. All information in the “data lake” is readily available to anyone in the system. The patient has trusted their doctor with their personal medical information, but in a centralised system they have no control over who else can access that information.
On top of this, the patient-doctor relationship has not changed much in 40 years. It may be possible to book an appointment or request a repeat prescription online, but the services a patient can access are still by and large the same online as they have traditionally been face-to-face. In today’s self-service world, Medtech knew the doctor-patient relationship could be transformed by providing access to a whole range of connected services in one place, from mental health support to health insurance. A transformation that would reduce the practices’ administration involved in record-keeping, transfer of care and running the business, and free GPs up to concentrate on treating patients.
“No one’s ever done it this way before, and I find that exciting”
ALEX is just what the doctor ordered.
Short for Application Layer EXchange, ALEX acts as a hub that connects Practice Management Systems seamlessly and securely with third parties, giving both practices and patients the ability to choose their services and solutions.
ALEX creator Medtech is a New Zealand-based health software provider on a mission to free up doctors’ time so they can focus on caring for their patients while enabling each practice to offer services tailored to its own region or specific needs.
Medtech started out creating Patient Management Systems, but Managing Director, Geoffrey Sayer, and Chief Information Officer, Mark Smith, soon recognised that though there was an abundance of useful health innovators in the market, it wasn’t easy to integrate these solutions into a Patient Management System.
“We wanted to service different models of care and enable our platform to integrate with any practice’s existing technology system. The current lack of integration is stifling innovation. Many smart tech entrepreneurs offering unique benefits to patients and practitioners face cost barriers to getting into the market. Developing, hosting and marketing your own product can cost millions of dollars, and contracts need to be negotiated separately with expensive single-use proprietary interfaces to get access to information,” Sayer says.
“We saw an opportunity to remove those barriers by opening up our platform to third parties and other PMS companies. We wanted to create an environment that encourages more innovation – and ultimately benefit both patients and practitioners. No one’s ever done it this way before, and I find that exciting.”
Geoffrey Sayer – Managing Director at Medtech
Technical firepower with total privacy
ALEX is built and hosted in Microsoft Azure using an FHIR health data API. ALEX can scale up to support as many practices and patients as needed, with the highest levels of security and permissions. Microsoft and partners Aura and Umbrellar supported Medtech with technical advice and the combined firepower has made ALEX a reality. They worked hard to make the platform as easy to use and bandwidth-friendly as possible since many medical practices have legacy computers and networks with limited processing capacity, and little in-house tech expertise.
“We wanted a baseline of the least technologically-advanced practice possible, so we simulated running the platform on old hardware using Windows 7 and a poor broadband connection to make sure ALEX worked in the real world with legacy systems,” says CIO Mark Smith. “We tested it with 60 transactions a minute. We also built it on Microsoft Azure because it’s a battle-hardened, tested platform that we could use like Lego bricks to easily build a secure and scalable solution.”
Unlike an “always on” centralised health database, ALEX enables the GP or specialist to be the custodian of all the data, releasing digital records to hospitals or other practitioners from their own PMS ‘just in time’ on request for a specific patient only. Not only does that boost patient privacy, it also means users’ systems are not being overloaded with unnecessary information that can create lags and double-bookings. Specialists also receive only the most relevant records rather than downloading an entire (potentially outdated) medical history.
To enable GPs to be effective stewards of their patients’ data, Medtech’s approach requires informed consent from both practices and patients. Practices need to opt into the platform before any requests for information can be shared, and the same applies to the third-party services they choose to share on their platforms.
“People said this sort of thing was three or four years away”
ALEX is now ready to see its first patients in New Zealand, and Australia is next.
“Working on our own we’d have taken 18 months to develop the platform, but together with Microsoft and our partners we’ve done it in less than six,” Sayer says. “People said this sort of thing was three or four years away.”
The platform has been even more popular with health software innovators than expected. Medtech thought it might get half a dozen partners, but it already has over 25 partners, with an equal number knocking on the door. As pleasantly surprising is the fact that ALEX works across both Medtech’s older PMS product (Medtech 32) and its new PMS product (Evolution). Medtech’s PMS competitor, MyPractice, is also working on integrating into the ALEX platform, creating a bigger ecosystem in which other parties can operate. Being built in the cloud, ALEX is also easily migrated to countries such as the UK and Ireland, and the first enquiries are already rolling in.
“Medtech is the perfect example of a gutsy New Zealand tech company punching well above its weight on the world stage, and it’s giving other tech businesses a leg up as well, says Matt Bostwick, Partner Director for Microsoft New Zealand. “When it comes to healthcare, greater collaboration and smart use of technology are key to improving patient outcomes and alleviating the stress of being a busy medical practitioner, and ALEX is a truly innovative platform that allows both health organisations and software businesses to share innovation at scale. From a Kiwi collaboration between three tech partners, we’re delighted to see it growing into a global ecosystem with even more features that will help patients and doctors around the world.”
Patients can still view their health details such as immunisation status, pathology results, allergies and medications easily via their usual PMS integrated with ALEX. It‘s possible to offer appointments via the ALEX platform too. But that’s just the beginning. Medtech’s partners already include software innovators with tools to provide mental health services on top of regular GP treatments, and help doctors manage back-office operations, so they can spend more time looking at X-rays than financial spreadsheets. Sayer and Smith plan to hold hackathons to enable even more third-party innovators to come to the (operating) table.
Rather than software companies competing to be the best at getting access to data, Medtech’s platform is allowing them to create their own niche solutions to help clinicians and patients access even more services and deliver new models of care that are better suited to an ever-challenged healthcare system. And that means the future of health innovation has a very good prognosis indeed.