Impact Summary

The MMEx platform is an award winning, evidence based and fully shareable web-based electronic health record system. MMEx was developed at UWA’s Centre for Software Practice and delivered to market by ISA Technologies. It provides practitioners with a patient management system that allows care teams to share information and be guided by risk-based decision support and other tools. Initially developed to manage healthcare for Aboriginal people in the Kimberley, MMEx has since been used to support the health care of large indigenous populations throughout Australia as well as highly specialised care in urban settings. MMEx has been used to collect research data for projects looking at chronic disease management practices, approaches to telehealth, and sexually transmitted infections.

Impact Case Study:

Medical Message Exchange (MMEx) is a web-based e-health record platform that allows patient records to be mobile and accessible amongst service providers and locations. It is a clinical notes record and communication platform with disease-specific modules. It allows referral for specialist care, a high level of diagnostic review, and a centralised mechanism for appointments and reminders, whilst ensuring the data is kept secure and confidential.

MMEx was developed in 2008 by Professor David Glance and his team, at The University of Western Australia’s (UWA) Centre for Software Practice (CSP) in partnership with the Great Southern GP Network, Kimberley Aboriginal Medical Services Council (KAMSC) and the Kimberley Division of General Practice. It has been developed into Australia’s hospital systems and has been a key infrastructure component of the Australian Government’s e-Health platform.

Aboriginal and rural communities

MMEx was developed to coordinate specialised care plans for KAMSC, which collectively represents four independent regionally based Aboriginal Community Controlled Health Services throughout the Kimberley: Broome regional Aboriginal Medical Service, Derby Aboriginal Health Service, Ord Valley Aboriginal Health Services and Yura Yungi Medical Service. In 2015, there were 19,000 medical records in the MMEx platform for the Kimberley region, accounting for 13,500 patients (total regional population is 50,000) who had received care in the previous two years. The Kimberley Renal Unit estimated that 30% of patients were suitable for virtual consultations, resulting in reduced travel burden on patients in a region where attracting health professionals is challenging.

The shared record was developed essentially to support local Indigenous community medical centres where their patients were wandering and seeing another centre 100, 200 or 300 kilometres up the road… the share was an extension of the local record system, and from there it was built into a state-wide system to support Indigenous healthcare delivery, and it worked really well for that specific requirement.

Dr Nathan Pinskier, e-Health and Practice Systems, Royal Australian College of General Practitioners, Hansard.

In 2011, Puntukurnu Aboriginal Medical Services (PAMS) rolled out MMEx to four remote central WA desert communities. “Having an accessible health record facilitates cultural sensitivity for the Martu and without question is an eHealth risk management safety factor in the delivery of safe informed healthcare.” “Real-time eHealth shared care is paramount in the continuity of care for the Martu and is considered gold standard in risk management and best practice in the delivery of healthcare.” Ms Ewing, PAMS. Published in Pulse+IT, 2013.

By December 2016, MMEx had been used by over 6,500 health professionals for the care of 200,000 West Australians and had become one of the biggest platforms providing medical health to about 35,000 indigenous people in the Kimberley.

ISA Healthcare colutions

In December 2013, UWA negotiated the sale of the MMEx software to ISA Healthcare (ISA) under a Software Sale Agreement. ISA had previously been the main distributor of MMEx throughout Australia. After the sale, ISA became solely responsible for delivering the software to market. Dr Glance has remained active in MMEx through consulting.

In 2013, MMEx was listed on the Australian Digital Health Agency register as compliant with the Secure Message Delivery standard. Since 2013, MMEx has been used by many Aboriginal Medical Services to produce data for the National Key Performance Indicators for Aboriginal and Torres Strait Islander primary health care. This key data set is used across government and the health sector to inform policy and monitor activities in Indigenous health. MMEx conforms to the Healthcare Identifiers (HI Service) and the MyHealth Record (previously PCEHR) standards and incorporates the latest technical standards from the Australian Digital Health Agency.

Designed from research undertaken in collaboration with clinical service providers MMEx has the capacity to incorporate research projects into clinical management. “The key differentiator between MMEx and other solutions is that MMEx is centralised, internet-based Electronic Health Record System. This has allowed me to perform my duties anytime and anywhere” Dr Trevor Lord, General Practitioner.

Continual reviews by government consultancies including the Department of Heath WA and ISA clients have cultivated an atmosphere whereby Dr Glance and ISA can directly engage with clients to ensure MMEx meets changing industry needs.

Government agency platform

In 2013, Queensland Health commenced a $35 million project to roll out MMEx to 28 hospitals and clinics in far north Queensland. The Institute of Urban Indigenous Health, who use MMEx to provide care to more than 30,000 patients in Queensland, has provided evidence that their services have resulted in a measurable improvement in health adjusted life expectancy for its patients.

MMEx has been rolled out to Medicare Locals as part of the Australian Department of Health’s 2015 Care Coordination and Supplementary Services Program to support activities to improve the prevention, detection, and management of chronic disease in Aboriginal and Torres Strait Islander people.

MMEx has been used as the clinical platform by the International Health and Medical Services to provide clinical services to Australia’s immigration detention services. It was chosen over other providers due to the mental health module which provides proactive management to support severely traumatised residents.

At the launch of the Australian Government’s PCEHR in Melbourne in 2011, MMEx operating at the Beagle Bay Aboriginal Medical Service was used as a case study to highlight the benefits of a shareable e-health record. It was recognised with a WA Univation WApp Award of $15,000 in 2011 as the best mobile phone application.

Associated Research:

MMEx is a shareable electronic health record with evidence-based decision support for clinical health management including chronic disease management, mental health, primary care and procedures, patient administration and emergency medicine. Each module was created based in consultation with key bodies such as Great Southern GP Network, Kimberley Aboriginal Medical Services Council (KAMSC), the WA Department of Health and the WA Cancer Care Network. A novel, shareable wounds management system was implemented and documented in research jointly conducted by Wounds West, Curtin University and UWA in 2010 [1]. Chronic disease management was implemented via configurable electronic care plans and the research on this area published as a collaboration with KAMSC in 2011 [2]. A national project investigating STI detection and management in remote aboriginal communities was published [4] in 2013 as part of an NHMRC funded research collaboration between UWA, Aboriginal Community Controlled Health Services, Baker IDI, Kirby Institute, University of Melbourne and the University South Australia. Various projects [3, 4] were conducted at UWA to investigate methods of creating structured data from clinician inputted free text using machine learning and other approaches. A collaboration with the Rural Clinical Health School of WA [6, 7] examined the application of decision support in the assessment of diabetic foot risk in aboriginal communities to avoid unnecessary amputations.