Australasia’s First and Only eHealth and Health IT Magazine
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6 OCTOBER 2014
NEW ZEALAND ICT & E-HEALTH Portal to patients
General practices in New Zealand are being encouraged to provide online portals to improve communication between patients and practitioners.
Ultra-fast telehealth
NZ is running a telehealth demonstration project to link remote areas to primary healthcare providers using high-speed broadband.
Long white health cloud Orion Health has outlined plans to take on the big players in hospital information management by harnessing the power of the health data revolution.
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Inside
Publisher Pulse+IT Magazine Pty Ltd ABN: 34 045 658 171 www.pulseitmagazine.com.au Editor Simon James Australia: +61 2 8006 5185 New Zealand: +64 9 889 3185 simon.james@pulseitmagazine.com.au Advertising Enquiries Please visit our website for more information about advertising in Pulse+IT magazines, eNewsletters and website.
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Looking Ahead Pulse+IT welcomes feature articles and guest editorial submissions relating to the nominated edition themes, as well as articles relating to eHealth and Health IT more broadly. In addition to our daily eNewsletter service, Pulse+IT is produced in print seven times per year with the remaining edition for 2014 to be distributed for release in: • Mid-November 2014 - mHealth and devices Proposed edition themes for 2015 will be announced in November.
Submission guidelines and deadlines are available online: http://www.pulseitmagazine.com.au/editorial Pulse+IT acknowledges the support of the following organisations, each of whom supply copies of Pulse+IT to their members.
About Pulse+IT Pulse+IT is Australia’s first and only Health IT magazine. With an international distribution exceeding 35,000 copies, it is also one of the highest circulating health publications in Australasia. 32,000 copies of Pulse+IT are distributed to GPs, specialists, practice managers and the IT professionals that support them. In addition, over 5,000 copies of Pulse+IT are distributed to health information managers, health informaticians, and IT decision makers in hospitals, day surgeries and aged care facilities. ISSN: 1835-1522 Contributors Scott Arrol, Tom Bowden, Peter Brown, Simon James, Richard Lawrance, Kate McDonald and Kim Mundell. Disclaimer The views contained herein are not necessarily the views of Pulse+IT Magazine or its staff. The content of any advertising or promotional material contained herein is not endorsed by the publisher. While care has been taken in the preparation of this magazine, the publisher cannot be held responsible for the accuracy of the information herein, or any consequences arising from it. Pulse+IT Magazine has no affiliation with any organisation, including, but not limited to Health Services Australia, Sony, Health Scope, the New Zealand College of General Practitioners, the Rural Doctors Association of Australia, or the Kimberley Aboriginal Medical Services Council, all who produce publications that include the word “Pulse” in their titles. Copyright 2014 Pulse+IT Magazine Pty Ltd No part of this publication may be reproduced, stored electronically or transmitted in any form by any means without the prior written permission of the Publisher. Subscription Rates Please visit our website for more information about subscribing to Pulse+IT.
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SINGAPORE LINKS AGED CARE
Editorials
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STARTUP Simon James evaluates the successes and failures of Australasian eHealth.
PETER BROWN The government has failed to provide a business case for its $7 co-payment, which could end up costing $14 per transaction.
HIMAA HIMAA is focusing on workforce issues for health information managers and clinical coders as part of its national strategy.
Sue Wells is advising the NZ health sector on the implementation of patient portals in general practice.
RACGP calls for online portal for PBS authority medications eHealth standards up in the air as IT-014 program ends
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PUTTING PATIENTS FIRST
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DEMONSTRATING TELEHEALTH
Electronic report for antipsychotics a boon for de-prescribing
The Bay of Plenty telehealth demonstration project aims to build it and see who comes.
eHealth NSW plans to corral acronym soup into eClinical record
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MSIA Australia and NZ may have healthcare systems historically based on the same model, but that’s where the similarities end.
PORTALS FOR PATIENTS
Patients First releases its patient portal review, upgrades GP2GP and looks to software certification.
ORION’S BIG PLANS Orion Health plans to take on the global big guys in hospital information management.
Resources
Telstra gives Verdi a boost as it pursues mobile strategy
Discharge summaries flow to PCEHR as health summaries slow Hills signs with Lincor to put technology at the point of care First point of call in secure identity management for Healthdirect
HINZ Health Informatics New Zealand is moving to a more professional strategy while retaining its most valuable asset: neutrality.
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New Zealand’s health IT vendor community is right behind the objectives of the country’s revised health IT plan.
EVENTS Up and coming eHealth, Health, and IT events.
Pepster device for PEP therapy takes out prize at iAwards Hills partners with medical practices for Lively monitoring
PULSE+IT DIRECTORY The Pulse+IT Directory profiles Australasia’s most innovative and influential eHealth and Health IT organisations.
Singapore to link aged care to national eHealth record Telehealth in the Darling Downs
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Editorial
LESSONS LEARNED FROM ACROSS THE TASMAN New Zealand has gone about its adventure in eHealth in a far different manner to Australia, relying predominantly on a demand-driven strategy with regional implementations as opposed to the top-down approach characteristic of the Australian landscape in recent times. On balance, the Kiwis seem to have got it right, but it can also be said that the smaller cousin has had fewer obstacles to overcome.
SIMON JAMES BIT, BComm Editor: Pulse+IT simon.james@pulseitmagazine.com.au
Having first devoted an edition of Pulse+IT to coverage of New Zealand in October 2012, revisiting Australia’s closest eHealth neighbour two years later in the pages of this magazine has been an interesting exercise. The application of information technology – often characterised by fast-paced development – in typically conservative health systems presents something of a paradox to those with an interest in health IT, but when reflecting on the articles canvassed in the respective editions, tangible, and at times significant, progress is clearly evident. Despite the majority of Pulse+IT readers residing in Australia, the publication has long enjoyed a following from across the Tasman, with our recently launched New Zealand eNewsletter service attracting a strong and growing interest with over 5100 subscribers.
About the author Simon James is the editor of Pulse+IT, one of Australia’s highest circulating health publications of any kind. Prior to founding the publication in 2006 he worked in an IT support capacity for various medical practices, and subsequently for both clinical software and secure messaging developers.
While Australia and New Zealand have traditionally marched in lockstep on a number of issues and we share an overwhelmingly popular commitment to the central role of government in managing and funding our healthcare systems, there are some stark differences between the two. In primary care, New Zealand’s mix of capitation and co-payment, Primary Healthcare Organisations and District
Health Boards (DHB) seems quite complex when compared with Australia’s relatively simple Medicare-subsidised fee for service system. In the acute care sector the reverse is true, with Australia’s state governmentowned and managed hospitals, half funded by the state and half by the Commonwealth, standing in contrast to New Zealand’s more transparent system of DHB‑controlled hospitals funded predominantly from one source. When it comes to eHealth and investment in health IT, again there are some stark differences. Whereas in the recent past Australia has thrown some mind-boggling amounts of money at setting up state and federal projects that are, if not outright failures, at least teetering on the edge, New Zealand has instead relied on regional implementations of small projects that are tried and tested before being rolled out further. New Zealand has three main advantages over Australia when it comes to eHealth: a smaller, less geographically distributed population; a single government; and the farsighted decision to assign each individual consumer a National Health Index (NHI) number back in 1993. Australia didn’t get around to doing that until 2010, and even now, four years later, the
Individual Healthcare Identifier (IHI) is little used outside of scant interactions with the PCEHR. New Zealand does like to boast that competition for scarce health dollars means that only projects likely to succeed get off the ground, with interactions between government and the relatively small group of clinical software vendors seemingly more collaborative, although I’m sure goodwill on both sides of the fence is periodically tested. The almost universal market adoption of a single secure messaging solution in New Zealand has facilitated the transmission of a broader range of electronic clinical messages than occurs in any significant volume in Australia, allowing for closer integration between primary and secondary care. Unfortunately, despite the tens of millions of dollars and years of effort that have been expended trying to make secure messaging interconnectivity between competing vendors in Australia a reality, the fruits of this effort are yet to be realised. There are several projects that New Zealand has managed to successfully implement that stand out to this Australian author, with comparisons to current eHealth activity on the west side of the Tasman able to be drawn. The first is the TestSafe system first implemented at Auckland’s Middlemore Hospital, which over the years has become a clinical data repository for lab results, diagnostic images, medications, clinical documents and electronic orders. It is accessible to authorised hospital clinicians and to individual patients’ GPs, and consumer access is on the cards too. TestSafe is in use in the three Auckland DHBs, is rolling out in Northland, and a TestSafe South system has been set up in Canterbury to act as a single repository for the whole South Island.
“New Zealand does like to boast that competition for scarce health dollars means that only projects likely to succeed get off the ground.” Simon James
Another project is the National Health IT Board’s Shared Care Program, variations of which exist in Auckland and Canterbury, which provide access to a shared record for clinicians caring for patients with chronic illnesses. There is also GP2GP, which has developed technology to allow a patient’s electronic medical record to be transferred quickly and easily to a new practice when the patient moves or swaps providers.
target is likely to take longer to realise. With this in mind the government has recently offered up some money to help with the roll-out, but the cost per practice of implementing portals, both financially and in terms of disrupted workflow, means it might have to come up with some more, or do a better job of selling the associated benefits of such portals to the reluctant providers.
Perhaps it is only in the area of telehealth that New Zealand lags Australia – at least in terms of the number of pilot projects – but even that is changing. While New Zealand certainly does not suffer the extremes of remoteness that its bigger cousin does, there are areas where telehealth can help improve access to care for people living outside of the major metropolitan cities and in underpopulated areas, particularly in Northland, the west coast of the South Island and the Bay of Plenty.
In this issue of Pulse+IT, we take a look at progress in some of those projects. We talk to Sue Wells, a lecturer at the University of Auckland and former GP who is helping to guide the introduction of patient portals, as well as the team from Patients First, which has released a briefing paper on current availability and barriers to implementation of the technology.
While in Australia the ongoing topic of discussion is the personally controlled electronic health record (PCEHR), in New Zealand it is currently about providing patient portals directly to general practice clinical systems, an area where there is a great deal of disagreement and where the government might have to step in. The National Health IT Board would like to see patient portals offered by general practices to all New Zealanders by the end of the year, although at less than 25 per cent coverage as of this month, this ambitious
We also take a look at the Telehealth Demonstration Project, which is testing out how to link GPs with Maori health centres and visiting nurses in the East Cape of the North Island, and we talk to New Zealand’s highest profile health IT company, Orion Health. Back in Australia we are still consumed with interest over the federal government’s determination to introduce a GP co-pay. Fiercely opposed – in its present state at least – by the medical community, it also has consumers worried. Peter Brown from the Consumers eHealth Alliance explores not what it will cost the hip-pocket, but what it will cost to administer.
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Guest Editorial
$7 GP CO-PAYMENT: IS THERE A BUSINESS CASE? The $7 co-payment for GP consultations introduced in the May federal budget is still facing fierce opposition from consumers, general practice groups and, most importantly, the crossbench senators who will ultimately decide whether it goes ahead. What has often been missed in the debate is the real cost of introducing the co-pay. The government has failed to provide a business case for the measure.
PETER BROWN Convenor, Consumers eHealth Alliance sealane1@bigpond.net.au
The budget proposal to raise a charge of $7 per visit to a GP as well as any associated pathology, X-ray or similar diagnostic tests has sparked a great deal of concern. The reason for this relates to the question of fairness for less well-off members of our community, including senior citizens, those with disabilities, the mentally ill, the unemployed, and so on. Quite apart from the obvious financial stress the co-payment may cause for many people – an aspect that has received a great deal of attention – we suggest this proposal also needs to be considered from an economic standpoint. The government has sold the charge as an important contribution towards its aims of reducing the budget deficit and healthcare costs; the proposal is also said to be aimed at reducing over-servicing.
About the author Peter Brown is the convenor of the Consumers eHealth Alliance (CeHA), an unincorporated not-for-profit organisation. Established in 2010, CeHA brings together the voice of a range of consumer organisations interested in harnessing ICT to provide better healthcare for all Australians.
In considering any such pricing issues, it is standard wisdom to consider the business case. In simple terms, this involves comparing the money raised versus the cost of collection. There is no evidence of this having been done, and the business community has been strangely silent on the issue. They
will know that the cost of administration to bill and collect a fee of $7 per transaction will be very much more expensive than the present situation, where health funding is raised via the Medicare Levy on a standard percentage of taxable income. This levy is a very efficient mechanism.
Cumbersome collection Paying out Medicare claims is of course costly, but at least it operates on a “one size fits all” type of criteria, and is largely automated now with most patients able to lodge claims electronically from their GP’s office when they settle their accounts. But the government’s proposal will involve a further, cumbersome, process to calculate when eligible persons reach the safety net threshold. This also requires an extensive reframing of existing software by all parties. If the co-pay is due to start on July 1, 2015, and the legislation for its implementation has not yet been passed the Senate, then the software development project is already two months behind in an area where work is rarely completed on schedule or within the budgeted cost. In this regard, we have already heard the Treasurer, Joe Hockey, complaining that
the current Department of Human Services (DHS) computer system is inadequate to handle the government’s future plans. We also have claims reported in The Australian newspaper, in an article entitled “GP co-payment IT system ‘a big ask’”, that the health IT industry views the DHS system as having severe limitations in handling its present client base and the PCEHR (even with its minuscule user base to date) also having regular downtimes. This report refers to an estimated cost of $14 per transaction to collect each $7 payment from patients on a case-by-case basis, nationwide. Our check with a leading accounting firm confirmed a general
cross-industry average of $15 for each of the healthcare providers affected.
Costly exercise We suggest that it is appropriate to stop and take an independent check on the business case before the proposal proceeds any further, to ensure that there is not a significant increase in the deficit rather than the benefit sought. It is interesting that the German government introduced a very similar co-payment proposal in 2004, which was scrapped in a unanimous vote in 2012. Studies showed that overall, the costs were in excess of revenue collected.
Outsourced Patient Management
Such experience suggests that the Australian government’s proposal should be closely examined, free of any conflict of interest, but involving the experience of all interested parties through public submissions. Meanwhile, the recently released findings of the National Broadband Network (NBN) cost-benefit analysis commissioned by the Communications Minister, Malcolm Turnbull, add weight to the need for rigorous assessment of complex programs prior to implementation. We need to do everything possible to avoid any further misuse of public funds on impractical and unproductive IT projects.
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News
RACGP calls for online portal for PBS authority medications The Department of Health (DoH) is holding public consultations on the authority requirements for prescribing certain PBS medications to gauge opinion on what items should be moved to the streamlined listing or whether prescribing should be unrestricted. Scan this QR code to read and comment on the latest eHealth news online.
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Long a bugbear for many GPs, the authority requirement means doctors must request approval in writing or more commonly by phone to prescribe certain PBS drugs. In addition to taking time during regular consultants with patients, it is seen as a particularly onerous burden for GPs visiting aged care facilities. According to figures from 2009, of the 6.4 million calls made to the authority phone line, only 2.8 per cent resulted in an authority being denied. In June, interested parties were asked to make
submissions on the terms of reference for a postmarket review of authority required PBS listings following the findings of an earlier review into chemotherapy funding arrangements. That review found that authority required listings caused a significant regulatory and administrative burden to prescribing oncologists.
“According to figures from 2009, of the 6.4 million calls made to the authority phone line, only 2.8 per cent resulted in an authority being denied.� The review into authority requirements is now open to public submissions. The submissions will be collated and presented to the Pharmaceutical Benefits
Advisory Committee (PBAC) in time for its November meeting. The department is recommending that the review be undertaken in three tranches based on the regulatory burden they currently place on prescribers. Those medications that represent that largest number of phone authority requests or the most complex formfilling will be looked at first. These include drugs for the treatment of many cancers, multiple sclerosis, rheumatoid arthritis and other arthritis medicines. The department is planning to present these drugs to the PBAC in November, followed by a second tranche of drugs for eye conditions, psychiatric conditions and cardiovascular disease in March next year. All of the other drugs on the list as well as medicines for palliative care will be
presented in a third tranche in July 2015. In its submission, the Royal Australian College of General Practitioners (RACGP) called for the current system to be replaced by an online portal to speed up the process and reduce red tape. The college said the introduction of an online portal to obtain authority approval would substantially reduce red tape and increase efficiency. “The RACGP recommends that an online portal is considered in place of, or alongside the current phone authority system,” the college wrote in its submission. It also recommended that telephone authority be removed when the prescriber wants to increase the quantity of medications after initial authority has been obtained for a number of classes of drug, including antidepressants, antipsychotics, anticonvulsants, antibiotics, antihypertensives, antireflux medications and antiemetics. The submission said that a review of the move to the streamlined authority system in 2007 – in which a four-digit number needs to be recorded for medicines for stable long-term conditions with stable dosage requirements – showed no changes to prescribing patterns or
rates, meaning GPs were not overprescribing these drugs.
“The RACGP recommends that an online portal is considered in place of, or alongside the current phone authority system.” “GPs are responsible prescribers,” the submission states. “The RACGP believes that the authority system is unnecessary as there are already established quality control measures in place to monitor and regulate responsible GP prescribing. “Recent studies indicate over 90 per cent of Australian general practices use electronic prescribing software, with in-built indicators of any authority listing and associated warnings. “The National Prescribing Service is another support to GPs in their prescribing practices, aiming to improve the health of Australians through Quality Use of Medicines (QUM). “The QUM principles assist GPs to select medication management options wisely; choose suitable medicines; and
use medicines safely and effectively.”
HCN to offer integrated online appointments
It also recommended that all prescription medications commonly used in residential aged care facilities, including S8 drugs, be put on the streamlined list as a means of reducing the red tape and high cost and administrative burden on GPs, which the college says discourages many GPs from providing services to aged care facilities.
Health Communication Network (HCN) will offer an integrated online appointments booking module that is fully integrated into its PracSoft practice management system when it releases its planned update at the end of the year.
In its submission, the Australian Medical Association (AMA) said only about 70 per cent of calls to the phone line were answered within two minutes. It wants the full cost of the authority requirement to be assessed, and that if medicines still require an authority, the process be properly resourced. The Pharmacy Guild said PBS items should not need an authority unless there were sound clinical or economic reasons for it.
HCN CEO Phil Offer said the company had built the module in-house following customer feedback, but has also built an application programming interface (API) that will allow practices to continue using third-party appointment booking services. “Obviously there are a number of [appointment booking systems] out there but customers have been saying to us for a while that they want one that is integrated into the program, particularly if they want to manage their existing customer appointments,” Mr Offer said. “They wanted to see if they could do that from directly within PracSoft. They can still use their existing system but we’ve built a new API which will allow the other appointment aggregators to work directly with PracSoft, so the customer can manage appointments from the one user interface.” Practices will be able to display the online appointments on their own websites, but if they don’t have one, HCN will host a web page on the practice’s behalf, which can then provide the link to patients.
It also wants to do away with the necessity for streamlined items to be written on a special form when a regular form could be used and the streamlined code included next to the prescription.
Mr Offer said practices can choose which doctors’ appointments to display or to display the doctor’s name but not their appointments if they are not seeing new patients. If practices are looking for new patients, they can continue to use the other services.
This would necessitate a simple change to prescribing and dispensing software, the Guild said.
HCN is also updating its clinical information system Medical Director in the planned summer release, which should be available at the end of the year.
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Bits & Bytes
Thatcher and Carroll step in temporarily at QLD Health Mater Health Services CIO Mal Thatcher and Queensland Health’s senior director of program delivery Paul Carroll have been appointed on a short-term basis to the roles of chief health information officer (CHIO) and chief technology officer (CTO) respectively with the Queensland Department of Health. Mr Thatcher will act in the new CHIO role for 12 months, beginning in September. Mater’s director of information solutions, Steven Parrish, will take care of Mater’s requirements in his absence. Mr Carroll will temporarily take on the CTO role, which Queensland Health director-general Ian Maynard said was largely focused on operations and program delivery. Mr Carroll has experience in pathology and radiology information systems and was a member of NEHTA’s diagnostic services reference group. Mr Maynard said Mr Thatcher would bring with him significant experience in IT and leadership in delivering high-quality healthcare information systems that support the operational and administration of health services. The two new positions were created following a recommendation in Queensland Health’s 10-year ICT strategic roadmap, released in June. The CHIO position has been defined as a purely strategic one, while the CTO will be in charge of delivery. Queensland Health’s former CIO, Ray Brown, stood down in July after five years in the position. Queensland follows NSW in its decision to expand the CIO role into two. NSW Health has set up a dedicated eHealth division with Michael Walsh as CEO and CIO, with intensive care specialist John Lambert as chief clinical information officer (CCIO).
eHealth standards up in the air as IT-014 technical committee program ends Standards Australia is restructuring the technical committee that coordinates the development of eHealth standards following the end of its 2012-2014 work program, with no forward work program agreed for the new financial year. Technical committee IT-014 covers both health informatics and telehealth, and is charged with overseeing the development of standards and technical specifications in the areas of eHealth information security, messaging and communications, electronic health record interoperability and clinical decision support. Following the restructure, all unfinished projects will be required to be resubmitted through Standards Australia’s ‘proposed projects’ process. IT-014 will serve only as a ‘mirror’ committee for the International Standards Organisation’s technical committee 215 (ISO TC/215). In early June, Standards Australia held a forum to discuss the future plan in relation to health informatics standards development. At that forum, the organisation advised that it planned to make operational and administrative changes when the 2012-2014 work program ended on June 30.
At the time, it said that there was no forward work program agreed beyond that date, and that it would take the opportunity to review its committee structure. Any unfinished projects would be deferred, but that it remained “ready to facilitate health informatics standards development”. In a hint that there is much disagreement within the eHealth standards community, Standards Australia said there had been a number of challenges in the work program but that despite this, a record number of documents had been published in the period. A Standards Australia spokesman said the restructure was not due to funding issues. ”Standards Australia took the opportunity to review its committee structures when the previous work program came to an end in June 2014,” the spokesman said. “Funding is not a factor in the review although we did take the opportunity to review our committee structure at a time when the forward work program has yet to be settled. “Standards Australia is reviewing its committee structures for health informatics standards
development to ensure that the contributions made by all lead to outcomes in the national interest. “This is business as usual for us. It is also business as usual for us to align national committees with international committees.” He said that aside from the international mirror work, all projects which did not complete through the previous work program will be required to be resubmitted for assessment. This does not mean that Australian standards development would not continue, he said. “We welcome project proposals for international as well as national project development work.” He said all projects for the adoption and development of Australian Standards followed the same process and must lead to a net benefit to the Australian community. In terms of the development of technical specifications for the PCEHR, which the National E-Health Transition Authority is heavily involved in, the spokesman said Standards Australia was “working with a range of stakeholders interested in continuing this work program through Standards Australia.”
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Justice Health goes live with Orion Health EMR The NSW Justice Health & Forensic Mental Health Network (JH&FMHN) has gone live with a new electronic medical record suite from Orion Health, which promises to deliver a complete EMR to patients moving between correctional centres, courts and the community. The network provides healthcare to adults and young people in contact with the forensic mental health and criminal justice systems, across community, inpatient and custodial settings. The solution involves the use of Orion Health’s Rhapsody integration engine to streamline and speed message handling between applications and the organisation’s patient administration system. It also uses Orion’s clinical portal to provide a single entry point for all clinical users to access and contribute to the patient’s medical record. The aim is to provide healthcare providers with a seamless view of all patient information, including a summary screen, problem and allergy information, and notifications of events integrated with electronic results reporting and clinical forms. Orion’s solution will provide a platform for Justice Health’s migration to a computerised record and will contain a subset of information previously held in paper medical records, including patient details, medical conditions, appointments, pathology results, electronic forms and medicines prescribed. The data is now held in one consolidated place and therefore available state-wide as opposed to being held in multiple paper files and standalone electronic registers. Justice Health is currently digitising paper-based health records and manual processes such as faxing and posting of pathology results.
Telstra gives Verdi a boost as it pursues mobile strategy When Telstra was looking at building a new health division last year, one of the first companies it began talking to was IP Health, the Melbourne-based firm best known for developing the Verdi suite of products in association with the Peter MacCallum Cancer Centre. Now known just as Verdi, the company has designed a range of products that are in extensive use not only at Peter Mac but also at the Mater hospital group in Brisbane. They include the original capability of providing clinicians with a single view into all of a hospital’s clinical software, including the patient administration system, radiology and pathology systems, pharmacy and specialist clinical
databases. Originally called the Patient Browser, this is now known as V-Chart. Since then, Verdi has gone on to develop extra capabilities, such as its V-Referrals system; V-Notes, a mobile solution that allows clinicians to digitally write and sign notes or to dictate them for transcribing; and V-Photo, which allows clinicians to take a digital image and upload it straight to the patient record. The future, of course, is mobile, so in addition to the latter two solutions Verdi has also developed V-Mobile, which provides much of the same capability as V-Chart in accessing the required clinical programs but does it through the
clinician’s mobile device. The information is tailored so the clinician only sees information that is relevant to workflow. Now, the company is working on a new solution to provide access to digital forms, and is working on a way to harness the explosion in medical apps and mobile medical devices, such as endoscopes that can be attached to an iPhone, to see how they can be integrated with Verdi. It is also harnessing the resources of Telstra to broaden its reach. Telstra is its largest investor and is leveraging its partnerships throughout the acute care sector to get a number of proof of concept trials up and running.
Verdi’s CEO, Ashley Renner, said that with the “Telstra machine” behind it, the product can now be implemented even faster. “Telstra is engaged with pretty much every public and private hospital across Australia, so we’ve now got proof of concepts in very large hospital groups on both private and public sites,” he said. Mr Renner said that at the heart of Verdi is the ability to link in to the many diverse databases found in hospitals and pull them up in real time. “Instead of having to replace all the existing systems and put in a one-vendor approach, you can put this in as an overlay across the existing departmental systems. “To clinicians, the key part of the product is that they can easily get to the information with the fewest numbers of clicks or touches. That’s what they want, and that’s where we’ve put all the effort in the product.” Mr Renner said the technology has the ability to access a range of different clinical software from different vendors, including legacy databases. This isn’t something that an EMR can do, he said. “An EMR just looks at a single vertical and it doesn’t actually solve the problem in hospitals of this heterogeneity of databases. We call them popcorn databases.
“We can quickly go into the existing departmental system using our serviceorientated architecture and we lift that data directly out of those systems. We link into the PAS as a source of truth and then we link into the RIS and the PACS and the pharmacy system and the allied health systems.
“To clinicians, the key part of the product is that they can easily get to the information with the fewest numbers of clicks or touches.” “So we’ve got the access, which is any mobile device – Android, Windows, the iOS ecosystem – then there’s the desktop client, and then there’s a middleware server. That’s where we spent our time, in writing that middleware server, so that we can link in.” It is that middleware server that provides the real value proposition. Hospitals have a tendency to invest large sums in different clinical systems that are unable to integrate with each other. By sitting on top of or overlaying these systems and extracting pertinent data from them, Verdi can then offer that information up to the clinician.
And with the move to mobility, it can do that at the point of care or anywhere for that matter. Mobility is an area the company jumped on early, and is something that suits both it and the workflow of clinicians intuitively. “It’s the ability to look at the patient record from wherever they are, whenever they want. Clinicians tend not to want to enter data, they can’t stand it, and the ability to quickly implement new features is the kind of driver that we have around our modules. It is easy to use and quick to implement.” Verdi has also developed the V-Referral system, which in the hospital setting can prove very complex. It is one reason why there are few if any purpose-built software packages on the market that can handle the hospital end of the referral process. Verdi has designed a solution that can ‘receipt’ a referral from a GP by fax, email or secure messaging, triage that referral and then book it into the hospital’s internal system. It also automatically sends a notification back to the referring physician, meaning they don’t have to send out the same referral to different hospitals with the hopes of getting their patient seen quickly or their receptionist spending time playing phone tag.
3D modelling to pinpoint skin lesions on ApreSkin app Brisbane-based dermatologist Brad Jones and his team from 3D Medical Software have launched a native iPad app called ApreSkin that promises to help streamline the way doctors perform skin consultations and improve the way they track and record patient data. Aimed at dermatologists, plastic surgeons, general practitioners and skin cancer specialists, ApreSkin uses a realistic 3D model to accurately locate and record skin lesions or conditions on the model with automated localisation of the body site. It features fully customisable pop-up lists for data entry of common diagnoses, procedures and phrases, or data can be entered via the keyboard or the iPad’s inbuilt voice recognition. At the moment, many doctors type a description of the location of a skin lesion into the patient’s record or mark a spot on a 2D body map, and then scan this into the record. Clinical photos are also often taken but do not directly attach to the correct patient record. “With the advances in technology and particularly interactive 3D software, I believe we need to modernise our current medical software especially in dermatology, which is a more visual specialty and would benefit from this change,” Dr Jones said. Dr Jones said that by using an iPad, clinicians can easily generate a patient report or medical record of the skin consult using realistic 3D models to accurately mark skin lesions or conditions along with automated data entry of the location. “Then at the press of a button, simply attach photos or screenshots to aid future identification of the lesion,” he said. The ApreSkin app is available on the App Store for $129.99.
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Virtual reality app for people living with dementia Well-known Melbourne-based performer and journalist Mandy Salomon has designed an app for people living with mid-to-later stage dementia, drawing inspiration from the world of virtual reality. Ms Salomon, a senior researcher at the Smart Services Co-operative Research Centre (CRC) who is doing her PhD at Swinburne University of Technology, has for some years been working on a project called Applying Virtual Environments for Dementia Care (AVED), which uses virtual reality to help dementia patients living in aged care facilities. AVED is a prototype of an interactive, tablet-based, 3D environment that includes familiar places such as a sitting room, kitchen and garden. “They can decorate their virtual rooms using colours, fabric swatches and paintings or drag their favourite photos into wall frames,” Ms Salomon said. The prototype has been built by a team from Swinburne led by PhD students James Bonner and Norman Wang, who were also involved in the design of the gaming technology used for the Virtual Dementia Experience at Alzheimer’s Australia Victoria’s Perc Walkley Dementia Learning Centre in Parkville, which won the educational category award at the national iAwards in August.
Electronic report for antipsychotics a boon for de-prescribing in aged care Aged care provider Southern Cross Care (NSW & ACT) is currently evaluating data from the third quarter since it introduced an electronic Quality Use of Medicines (QUM) report to assist in reducing the use of antipsychotics for behavioural and psychological symptoms of dementia (BPSD). The QUM report, designed by NPS MedicineWise in association with pharmacy software specialist Webstercare, allows aged care facilities to identify residents who have been prescribed antipsychotics for more than 12 weeks, alert them to potential problems with polypharmacy and highlight the need for a medications review.
Mr Bonner said the team closely observed aged care residents using the app. “[We] found that when we revisit, they remember us and the application, which, given their condition, is quite profound,” he said.
Launched last year, the report is integrated into Webstercare’s Medications Management Software (MMS) and allows the pharmacist to quickly and easily produce a report on all residents who have been prescribed antipsychotics and for how long. Dose and strength for each medication are also recorded, as are any other drugs prescribed to deal with side-effects of the antipsychotics.
Ms Salomon will present her findings from AVED at the Alzheimer’s Europe Conference in October.
Figures from Alzheimer’s Australia show that up to 80 per cent of people with
The Perc Walkley Centre aims to use serious game technology to transform dementia care education.
dementia and nearly half of people in residential aged care are receiving psychotropic medications. However, international data suggests that only one in five people with dementia receive any clinical benefit from these medications. SCC’s dementia care consultant, Sonali Pinto, said a new policy had been introduced based on the UK’s Time for Action report, which emphasised that all antipsychotics should be reviewed at the 12-week point.
“We’ve also been able to pick up polypharmacy and prescribing cascades.” “We were using a psychotropic drug report but not really looking at the report and analysing what was in it,” Ms Pinto said. “It didn’t really match what we were trying to do with the reduction of antipsychotics because it just told you what people were on and it didn’t tell you how long they were on them for. That’s exactly what this report does.” SCC has now established de-prescribing teams in each of its facilities, involving registered nurses, care assistants,
pharmacists and some visiting doctors. Using the QUM report, these teams are now able to make decisions on de-prescribing based upon real evidence. “They look at each resident that features on the report,” Ms Pinto said. “They look at how long the person has been on the medication and then if they’ve been on it for more than 12 weeks, as the policy states, we look to identify what is the outcome for this person. Is the behaviour still existing, are there side effects? Is it producing more ill-being than wellbeing? “We’ve also been able to pick up polypharmacy and prescribing cascades. When that medication is deprescribed, we are able to say we don’t need all these other medications.” One of the benefits is that care assistants don’t have to collate the data themselves. It is all done at the pharmacy end, with Webstercare’s MMS able to extract all of the required information in mere minutes rather than the hours or days it would take for a nurse to do it by hand. This also avoids transcription errors, lack of knowledge of drugs that fall into the psychotropic class and any potential institutional bias to make the results look better.
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CSC rolls out defence force eHealth system CSC has implemented an eHealth system for the Australian Defence Force (ADF) in three states and is due to complete the roll-out to the other states by the end of the year. The new Defence eHealth Information System – first announced in 2011 and known then as the Joint eHealth Data and Information (JeHDI) project – is live in Queensland, the NT and WA, with SA currently underway and the other states to follow. The system, which was contracted for $56 million, is based on off-the-shelf technology provided by UK firm EMIS, a primary care software specialist that has over 50 per cent of the UK general practice market. EMIS last year acquired Ascribe, the UK’s market leader in acute care electronic patient care and patient administration systems. For the ADF contract, CSC provided systems integration, solution development, project management, organisational change management, user training and ongoing system hosting and system support. The new system will provide health professionals throughout the ADF’s Joint Health Command with access to aggregated health information at the point of care and at all levels of management. Each ADF member will have a comprehensive eHealth record from enlistment through to retirement as well as health management information focused on improving healthcare outcomes, CSC said. The interoperable system will allow health information to be shared with the Department of Veterans’ Affairs as well as civilian health providers. It has also been built to be compatible with the PCEHR.
eHealth NSW plans to corral acronym soup into eClinical record eHealth NSW is currently conducting a tender process to create a panel of electronic medications management (EMM) solutions that local health districts will be able to choose from, and is also evaluating responses to a tender for an incident management system (IMS) that will be rolled out statewide. These are just two of a large number of projects that the new agency is involved in following its official establishment on July 1. In addition to eight complex clinical programs currently in progress, eHealth NSW is also in charge of the corporate ICT program for the NSW health department. At the moment, it is working on a large infrastructure upgrade to provide all hospitals with a minimum of 1GB of bandwidth, a new rural eHealth strategy involving the six non-metro LHDs, and the single email system that Health Minister Jillian Skinner has wanted since the March 2011 election. eHealth NSW’s new heads – chief information officer Michael Walsh and chief clinical information officer John Lambert – outlined the agency’s corporate and clinical strategies at a meeting of the Australian Information Industry
Association’s (AIIA) NSW Healthcare special interest group in Sydney in late August. At the time, Mr Walsh, who is also eHealth NSW CEO, had been in the position for less than two months, and Dr Lambert less than two weeks. However, they are building on a great deal of work done over the last few years by former Healthshare CEO Mike Rillstone and former CIO Greg Wells to create and implement the Blueprint for eHealth in NSW, released in December last year.
“As far as the clinicians are concerned, they don’t care what software packages they are using.” The blueprint outlines a federated approach to ICT in NSW Health and details how the government expects to spend the $400 million allocated to ICT programs, in addition to its specific plan for eHealth in rural and remote NSW. Mr Walsh outlined some of the corporate programs for eHealth NSW that will also have an effect on clinical systems and clinicians themselves. This
includes the establishment of StaffLink, the human resources system that covers the 105,000 people working in NSW Health. “The important thing about StaffLink as a service-wide HR system is that it has now become the core and the single point of truth for people identity,” Mr Walsh said. “We are now able, across our system, to identify who each individual is, which means that we can now move to a single email system. “We can move to messaging services that allow us to ensure that the right messages get to the right location. We can connect all of our other systems to the hierarchy of the organisational structure, so we can do permissions and security based on StaffLink. “This is a huge step forward, and we can now move some services into the cloud because we can manage single identities.” Mr Walsh said eHealth NSW was currently finalising the build of a new rostering system that is being piloted at Concord Hospital and should be rolled out statewide next year. This online system will allow staff to view rosters at home and request changes, and for managers to publish rosters electronically.
A large infrastructure upgrade is currently underway, with the majority of metropolitan and regional LHDs already upgraded to the new Health Wide Area Network (HWAN), which promises a minimum of 1GB of bandwidth in every site. This is now moving to rural hospitals, which Mr Walsh said was incredibly challenging considering the vast distances between some of those sites.
investment in existing and new clinical systems, including the electronic medical record (EMR), EMM, the enterprise image repository (EIR), the outpatient medical record (CHIME, soon to become CHOC), the intensive care clinical information system (ICCIS), the PCEHRlinked HealtheNet and its enterprise service bus (ESB), IMS and the existing clinical information access portal (CIAP).
He said the HWAN would improve reliability for both corporate and clinical systems, but would also enable more video conferencing and collaborative tools to be used to reduce travel. NSW Health has invested in Microsoft’s Lync system, which is integrating more closely with Skype, and will roll it out over the next year.
While these acronyms are a mouthful, they do not represent just one system each but a number of clinical software packages and systems. Dr Lambert hopes to bring them all under the umbrella term of eCR, or electronic clinical record.
With the single identity system up and running, it is now possible to have a single email address across NSW Health. All staff will have a health.gov.nsw.au extension within the next 12 to 18 months, and this is live in six LHDs now. Although he has only been in the job since August 18, new CCIO John Lambert has quickly come to grips with the acronym soup that represents the clinical systems he is now responsible for. In his new job, Dr Lambert is responsible for a huge
“Although we use one name to reflect the electronic medical record, it is not one system,” he said. “We have multiple systems providing electronic medical record functionality across the state and we are in the middle of a tender process to create a panel of electronic medication management solutions. “These programs run essentially independently. My hope is that soon we will be dealing with a slightly different arrangement. I’ve used eCR deliberately because no one else uses that term. I’d like to think that the various programs that we currently have running are going to work
as a unified view of the world. “As far as the clinicians are concerned, they don’t care what software packages they are using. There is one patient and there is one record about that patient. “Given we are going to have these systems for a long time, we want to be able to deliver that unified view. If we don’t have an overview or a vision that groups those entities together, then I don’t think we can provide that view.” HealtheNet is another very important structure, he said. “This is our internal version of the PCEHR and it is allowing an interface between different parts of the system to the PCEHR. It will be wonderful to see what can happen with the PCEHR when it is populated with a high level of information.” He said HealtheNet was going to be a useful tool to cross interstate lines as well for the interface with the PCEHR and other outside systems. “It will allow various elements of the electronic medical record, which in some cases might be inside an application and in some cases it might be split between different applications, and it will cross the boundaries between the LHDs and the area health services, which all do things differently.”
Australian Association of Practice Managers
The Art of Performance 2 0 1 4 N at i o N a l C o N f e r e N C e I A d e l A I d e Co N v e N T I o N C e N T r e I 21 – 24 oC Tober 2014
Welcome to Adelaide ‘The Art of Performance’ AAPM National Conference 2014
F
or those of you who are lucky enough to be joining us in Adelaide from the 21 to the 24 October 2014 the program planning and fun continues in creating the very best experience possible for you! As mentioned many times, sleep is SO overrated! As I am writing this, there are now less than 30 days to an event that I am personally extremely proud to be part of. Whether you are, or are not a member of AAPM we would love to invite and welcome you to join us, it is not too late to register. Come and embrace all that is on offer for you – we have definitely not planned to disappoint! AAPM National, South Australia and the Northern Territory are hosting a program that offers so much to expose us all to new concepts, ideas and ways of being and doing including:
• • •
the opportunity to challenge our mindsets and thinking - could it be that what we have always done may now need a rethink? time to refresh and update our skills, knowledge and ability to lead our teams; sharing time, experiences, conversations, stories with great like-minded people both nationally and internationally – yes we are welcoming teams who are travelling from NZ ‘across the ditch!’
How good will it be to ‘shamelessly steal’ great ideas from PM’s who are so willing to share? The bonus for us all is being able to learn together with old friends and new and to take every opportunity to have a laugh with each other about aspects of our work. I think it would be fair to say that we all get what the world of Practice Management is all about – the great, the not so great, both of which are mixed with a good dose of required optimism daily to continue to go forth and conquer! When flying on a plane these days, it is suggested when introducing the airline’s safety protocol that ‘there is a serious side to the flight’. This of course is also true for AAPM Adelaide. We do however promise to not be too serious – where possible we have mixed it up! Our hope is that we have got the balance right between important, helpful, supportive and valuable educational opportunities with a good mix of some serious fun, laughter and enjoyment. A Flair for Colour is the underlying theme we have embraced this year, as we believe this links in well with Adelaide and the Art of Performance. AAPM’s gala dinner, being held at the Stamford Grand at Glenelg, promises to exceed expectations from the get go. We invite you to have some fun with colour and make Adelaide’s official close of this conference (and the handing over to Hobart for 2015) a colourful event! Registrations welcome right up until the conference. Marion McKay, Convenor www.aapmconference.com.au
Visit the website for full program and registration details: www.AAPMconference.com.au
Conference Design Pty Ltd mail@conferencedesign.com.au www.conferencedesign.com.au P: +61 3 6231 2999
Discharge summaries begin to flow to the PCEHR as shared health summaries slow Consumer registrations for the PCEHR are nearing the two million mark as clinical documents slowly continue to be added to the system, with prescription and dispense records seeing the most growth in volume, the latest figures show. As of September 1, consumer registrations totalled 1,851,693, up by close to 45,000 on the previous month. Howver, the rate of growth in consumer registrations has slowed considerably since December last year, when Aspen Medical finished a contract to approach consumers in healthcare settings to sign them up. Since then, the system is averaging about 10,000 new registrations per week. Whether there is much for those new registrants to see in the system is another matter. The number of uploads of shared health summaries is still very small at 30,879 – an increase of 1657 on the previous month – but hospital discharge summaries are flowing more freely. At the end of August, there were 57,106 discharge summaries on the system, an increase of close to 6500 per month. Discharge summary capability is now available throughout Queensland and South Australia, in several tertiary
hospitals in NSW and the ACT, three public hospitals in Tasmania, Royal Perth Hospital in WA and Eastern Health in Victoria. Where growth has taken off is in prescription and dispense records through the National Prescription and Dispense Repository (NPDR). Department of Health figures show that prescription records have overtaken dispense records to reach 262,823 in September. There were 222,507 dispense records. While the department’s figures cannot break down exactly what documents clinicians are looking at, they show that views of the PCEHR seem to average between 2500 and 3000 per week. This is a combined figure for views through general practice, hospital and aged care software, and the provider portal. Clinicians using the provider portal are still limited by the browsers that can support it, which does not include the latest versions of Internet Explorer or Chrome. Healthcare provider registrations have grown to 7477, including 141 residential aged care services, 172 hospital groups and 1134 pharmacies. These figures are not for individual aged care homes or
hospitals, as provider registrations are done on an organisational level. The bulk of the other 6000 are presumably general practice registrations, as few medical specialists or allied health providers are understood to have registered for the system. Most of the major medical practice software vendors have released updates to their clinical products that incorporate changes to their PCEHR modules following recommendations from NEHTA’s clinical usability program (CUP). Interviews with vendors conducted by Pulse+IT in August show that most of the upgrades were minor and mainly consisted of more streamlined filtering options. The Department of Health has recently concluded a round of consultations with industry and consumer groups about their views on the recommendations of the Royle review into the PCEHR, which was released in May. The consultations mainly centred around views on the move to an opt-out model, and for clinicians, what information they would most value. However, clinicians continue to voice concern to Pulse+IT about the system, particularly its lack of clinical usability and utility.
Anonymous peer support online for mental illness National mental health charity SANE Australia has launched two online peer support forums for people living with mental illness and their families, friends and carers. SANE Australia said it had invested in the best technology available so that people whose lives are affected by mental illness can feel confident to join the conversation online on an anonymous basis and find support. “Despite the significant and welcome investment governments have made in mental health in recent years, the majority of people living with a mental illness are not currently accessing professional help,” SANE Australia CEO Jack Heath said. “We need to be savvy in delivering support in cost-effective and efficient ways. Late help will always be expensive help. The SANE forums can reduce mental health costs by encouraging people to seek help early on.” Health Minister Peter Dutton said the forums would help people by giving them trusted and anonymous access to reliable mental health information, advice and referrals. “While almost half of the Australian population will develop a mental illness at some point in their lives, only 46 per cent of this group will seek any form of support or treatment,” Mr Dutton said. “We know that there are many reasons that people do not seek treatment like a fear of being stigmatised, living too far from a medical practitioner and not knowing how to get information and care.” The Lived Experience and Carers forums have been funded by the Department of Health and are available on the SANE Australia website.
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Drugs and dosage linked to alerts in MedAdvisor app The MedAdvisor medications compliance app has been updated with new functions including the ability to link medications to particular alerts, new scheduling options and a summary view of alerts. While the MedAdvisor apps for iOS, Android and web are free to use for patients, they can only be used in assocition with a participating pharmacy and users must be provided with an activation code to use the system. The platform allows patients to order refills by linking to the pharmacy’s dispensing software through the Pharmacy Guild’s GuildCare software suite, with a medication-specific electronic medical record held on MedAdvisor’s servers. In the latest update to the apps, new functionality has been added to the TakeMy-Meds section to allow one or more medications to be linked to a specific alert, which will remind patients of exactly what doses to take at different times of the day. There are also new scheduling options that allow for alert scheduling for specified days of the week, as well as a tab that provides a list of all alerts scheduled for the day ahead. MedAdvisor has a settings tab that allows for reminders to be set up to take the specified dose and drug at breakfast, lunch, dinner and bed time. This can now be customised in the new version of the app for more complicated medications or dosing regimes. A ‘create new message’ button has also been added so patients can send a message to the pharmacy for review and response by the pharmacist. MedAdvisor has also announced an agreement with health insurer Bupa to promote the app to Bupa’s customers.
Hills signs with Lincor to put technology at the point of care Hills has officially signed a partnership agreement with Irish firm Lincor to distribute its point of care technology in hospitals and aged care facilities in Australia and New Zealand. Hills and Lincor first shook hands on the agreement earlier this year, and in September signed an official agreement that will see Hills market the technology to its existing clients in the acute care sector and tap into the trend of hospitals providing access to electronic medical records, picture archiving systems, patient infotainment and entertainment and integrated nurse call systems at the bedside. Hills is also eyeing off the residential aged care market with Lincor’s range, which has mobile functionality as well as fixed hardware that can be attached to a wall or as a nurse’s workstation in individual rooms. The range consists of PatientLINC, which includes a hand-held telephone and integrated camera for video calls, as well as internet access and entertainment options. Patients also have access to educational materials, and medical staff can “prescribe” videos, audio files and documents to educate patients on a condition, course of
treatment, and postdischarge care instructions. Clinicians can use PatientLINC to access the medical record, order and verify medications and share scans and test results with the patient, and through wireless devices it can also monitor vital signs that can be automatically linked to the patient notes.
“What we’re trying to do is develop checklists at the point of care. We have the device and a screen in front of them so they don’t make those errors.” There is also a ClinicalLINC solution, an addition to PatientLINC that provides secure access to clinical information systems through a wall-mounted terminal adjacent to the bedside. This solution also provides hospitals with an optional bed status management system, a room cleaning checklist and fault reporting. In August, Lincor launched an Android-based patient engagement solution called MediaLINC that delivers a range of education, entertainment and clinical
content direct to standard HD TV sets. MediaLINC allows patients to review educational videos, documents and postdischarge instructions on the TV, and can also be used by hospitals to display information such as facility news or events. Lincor was set up in 2003 by three former Apple executives – Dan Byrne, Pat O’Donnell and Enda Murphy – to develop a healthcarespecific solution that would bring information to the bedside. While the company outsources the manufacture of the units and devices, the Lincor team is intimately involved in its design. However, the company is very much a software rather than a hardware firm, Mr Byrne said. The software is fully integrated into the hardware, with its prime point of difference being that it can interface with the major EMR, PACS and medications software solutions as well as provide internet access, pay TV and video conferencing capability to the patient. It can also integrate with a hospital’s food service software package and allow patients to order from menus electronically, as well as integrate with nurse call systems. For Hills, the plan is to look at how to integrate the technology it has recently acquired
through its purchase of the Merlon and Questek IP and wireless nurse call systems as well as Hospital Television Rentals (HTV). What Lincor says differentiates it from some of the other players on the market is that it has a fully integrated solution that does not involve meshing different software and hardware solutions together. “The most critical thing to say about Lincor is that we’re a software company first,” Mr Byrne said. “Our intellectual property is all our own software. What we want to get to is that we become totally hardware agnostic. “Right now we can put our software onto a multiplicity
of devices, and those devices consist of a bedside terminal, a flat screen TV, on the wall, a nurse station or a clinical station in the room, and ultimately to a tablet and iPad for bring your own device.” In the future, the company is looking at how to transform clinical data into something that can be read and understood by the patient both in and out of the hospital. Currently, clinical data can be displayed to the patient in an easy to read format – for example, colour-coded test results or vital signs – but the company also has a patient portal product that can be used both preadmission and following discharge as an educational
tool for both the patient and their families.
Clinical dashboard to help monitor peak flow for asthma
“And the other area that we’re looking at is the whole area of checklists,” Mr Byrne said.
The developers behind the Breathe Easy asthma management app are currently building an online clinical dashboard that will allow GPs and patients to monitor the results of peak flow testing and other symptoms and let patients adapt their action plans accordingly.
“Before a pilot takes a plane up into the sky the first thing he goes through is a checklist, but if you ask a surgeon to do it before an operation, he won’t, and that’s where errors are made. Simple things are forgotten. “So what we’re trying to do is develop checklists at the point of care. We have the device … and a screen in front of them so they don’t make those errors. That’s the kind of stuff that we want technology to do.”
The Breathe Easy app was developed by Asthma New Zealand in association with John McRae, CEO of promotions and app development firm VADR, who has had asthma since childhood. The Breathe Easy app was developed for the iPhone and launched in 2012. It allows users to monitor peak flow levels and create action plans to share with their GP. It also offers reminders to take medication as well as links to important information and support from Asthma New Zealand. Asthma New Zealand says it is essentially a digitalised system that improves on, and will eventually replace, current paperbased asthma management plans. A key feature of the app is its ability to remind users to use their inhaler or preventer. While a wide range of asthma medication is available, as Mr McRae says, “If you don’t take it, it doesn’t work.” The app also contains an asthma control test that allows users to record, compare and share results with practitioners. VADR is now developing an online clinical dashboard, which will provide GPs with an overview of their patient’s symptoms. Asthma New Zealand said it would give GPs a greater understanding of the condition for individual patients. The app is available from iTunes for free and has also been adapted for Australian and US users.
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ManageMyHealth rolled out for shared care in Central New Zealand’s Central Primary Healthcare Organisation (PHO) has funded the roll-out of a shared care record using Medtech Global’s ManageMyHealth platform to general practices in the MedCentral district, with 18 practices participating. The shared care record includes details of health history, prescribed medicines, allergies, immunisations, reminders, test results and discharge summaries held in general practice systems. It is accessible to clinicians at afterhours GP services, hospital emergency departments, hospital inpatient and outpatient services and aged care facilities in the region, including City Doctors and Radius Accident & Medical in Palmerston North and the Horowhenua after-hours clinic in Levin. All patients enrolled with the Central PHO general practices are eligible for a shared care record but can opt-out completely or choose not to allow specific information from being shared. Central PHO executive clinical director Chiquita Hansen said there was a high demand from patients for this sort of service and many were surprised it wasn’t already available. “The transition of patient care through different times of the week, between health providers and across a range of medical centres has traditionally been a challenging area in health care but the shared care record is a positive step to smoothing the patient journey,” Ms Hansen said. The Shared Care Record project is also being implemented in other areas of the MidCentral District Health Board, which is centred on Palmerston North, as well as in the Wairarapa DHB (Masterton) and Capital & Coast DHB (Wellington).
First point of call in secure identity management for Healthdirect Healthdirect Australia has contracted Brisbanebased identity and access management firm First Point Global to design a secure, centralised identity management solution for its cloud-based health portal platform, which includes the National Health Services Directory (NHSD), My Aged Care and a number of information services and hotlines. The solution is currently live for a range of Healthdirect’s application programming interfaces (APIs), and will provide the identity and access management (IAM) and security foundations for the government-funded organisation’s websites and information portals as they expand and mature. Healthdirect is currently exploring options to provide cloud-based video as well as telephone consultations for its health advisory services. The My Aged Care website recently began publishing maximum accommodation prices for aged care providers as well as a fee calculator for residential aged care. First Point Global has recommended a mix of open source and commercial-off-theshelf technologies for the solution, which covers access
request management, password management, authentication and authorisation – including web access control and single sign-on – as well as access management for the APIs and a range of data protection and security technologies. The company says the advantages of this approach include a better experience for users, easier compliance with legislation, consistency of policy enforcement, and the ability for users to manage their private data irrespective of where it is stored.
“As far as possible we prefer to adopt open source first if it is viable to create as much leverage as we can out of taxpayers’ dollars.” Healthdirect requires rigorous security standards as it provides public-facing government services such as My Aged Care as well as the NHSD, which provides public information on locations and contact details for healthcare services including GPs, community pharmacies and hospitals.
It is also being integrated with the PCEHR and the Healthcare Identifiers (HI) Service. Part of the tender requirements were that the chosen solution provider would adopt an open source-first policy, where proven open source software can reduce costs. “As far as possible we prefer to adopt open source first if it is viable to create as much leverage as we can out of taxpayers’ dollars,” Healthdirect Australia CIO Anton Donker said. “We also prefer to engage with specialist service providers like First Point Global, rather than very large scale commercial vendors.” The access management system for the health portal platform is focused on authentication and identity federation services. End users are given the option to authenticate using social sign-on, or via username and password to the Healthdirect Australia identity store. A security gateway that enforces access management policy for Healthdirect’s APIs, including the NHSD, is also part of the solution, as is secure management of encryption keys for sensitive information.
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Heart app helps patients keep track of dosage The Heart Foundation has released a free app for patients to better manage their heart medication dosage and routine. The My Heart, My Life app aims to help people keep track of and remember to take their medicines. It also has information on heart attack waring signs and a series of healthy recipes. A recent Heart Foundation survey found that 5.5 per cent of people prescribed blood pressure medicines and 16 per cent taking cholesterol medicines were not taking them regularly. The app, available for iOS and Android phones, also allows users to record and monitor health stats such as weight, waist circumference, blood pressure and cholesterol. Measurements can be stored in list and graph format so patients can see how they are progressing over time. There is a searchable database of medications which lists the dose and frequency and allows users to set reminders for the best time to take them. The Heart Foundation’s national director of cardiovascular health, Rob Grenfell, said the app will help patients manage their medication routine, increase their understanding of their condition and ultimately improve their health. “We know the more medications people are taking, the more difficult it is to remember to take them,” Dr Grenfell said. “We also know the app will assist GPs, pharmacists and primary care nurses to help their patients adhere to medicine and lifestyle changes.” The app can be downloaded www. myheartmylife.org.au
Pepster device for PEP therapy takes out entrepreneur prize at iAwards A breathing device that uses gaming techniques to help patients with cystic fibrosis complete positive expiratory pressure (PEP) therapy and lets parents and clinicians monitor progress over time has won its designer a $15,000 prize at the iAwards. Pepster consists of a PEP therapy device that is linked to tablet or smartphone apps to monitor and motivate patients doing respiratory physiotherapy. For the patient, there are two games that encourage the correct technique and duration, while parents and clinicians can monitor progress and collect additional data such as the effect of environmental or lifestyle factors on the patient’s health.
The device is currently being trialled in 30 patients with CF at the Mater Hospital in Brisbane before being readied for the approval process with the Therapeutic Goods Administration (TGA). Designed by University of Queensland engineering PhD students Elliot Smith, Gavin Kremor and Jeremy Herbert – who have subsequently set up HSK Instruments to commercialise the device – Pepster was featured in the Apps4Broadband challenge last year and in August won a $15,000 prize for Mr Smith, who was named the Hills Young Innovator of the Year at the iAwards. Mr Smith said the idea for Pepster came about in the
final year of the team’s electrical engineering degrees, which required a thesis project. He and his colleagues met with clinicians from the Mater about some of the problems faced in motivating children to do their physiotherapy, but also in properly monitoring how the therapy was progressing. “From the clinical perspective, one of the big problems is that once they are out of the hospital, we don’t know if they are doing the physio because of the inability to record anything on the current hardware,” Mr Smith said. “From the parents’ point of view, the lack of incentive and motivation really makes it hard for the parents to
get their kids to do their exercises. So we decided to try to find a system to tackle both of those problems.” PEP therapy uses inhalation and exhalation exercises that are designed to clear the thick mucus characteristic of cystic fibrosis. It is used as an alternative to chest physiotherapy using percussion. Mr Smith and his team have designed a new PEP therapy device that can connect to standard face masks as well as to a tablet device. They have also designed two games that are controlled by the patient’s respiration. “There are different elements in the games that are controlled through the device, so their breathing changes things in the game,” Mr Smith said. “For example, in the space game, the spaceship moves up and down based on whether they are breathing in or out. The way to get the highest possible score in the game is to do what is clinically recognised as ideal physiotherapy.”
doing the therapy and how often they are doing it, to see if they are attempting to do it at all,” Mr Smith said. “Secondary to that, we want to know how well they are doing it. “Essentially they have a goal of breathing in for around about one second and out for three seconds. “Their inspiration is a normal in-breath, and as they breath out there is resistance, which helps build up the pressure, which is what clears the mucus out.
“There’s nothing that combines the gaming and the portable nature of this device.” “If you can imagine the inspiration to be zero and the expiration to be one, you get a square shape, and we are measuring how closely they fit to that shape.”
While the games are a motivating tool for the child, Pepster can also collect a great deal of data for clinical and research purposes that has previously been unavailable.
There is a huge amount of information that can be extracted from the data, including whether the child is actually doing their therapy in the first place, when they are doing it and for how long, as well as changes over time and whether exterior factors have an influence.
“First and foremost we want to know when they are
“Their progression in terms of their physio
performance on different dates is something that we are definitely looking at, and due to the fact that we now have the time stamp of when they have done the physio, we can then gather things like the weather on that day and all sorts of information to see if there are links that we would never have seen before.” Mr Smith said there were other products for respiratory disorders such as asthma that use apps and gaming, and he is aware of one used clinically for measuring forced expiratory volume (FEV) that uses a game to encourage children to do the exercise, but he believes Pepster has something that the others don’t. “There’s nothing that combines the gaming and the portable nature of this device,” he said. “With something that they have to do everyday, it differs from an FEV measurement which they might take once every six months.” Pepster is currently being used in a clinical trial at Mater Hospital, involving 30 patients in total who are given the device for six weeks. They are asked to use it every day for about an hour, which is the typical routine for PEP therapy. “That should all be wrapped up sometime in November and after that we’ll start to look at some of the clinical implications of the data.”
Innovative technologies for healthcare at HITWA The organisers of the Health Information and Technology WA (HITWA) conference being held in Perth in November have put out a call for submissions from researchers and students interested in showcasing their projects during the event. HITWA 2014, jointly organised by the WA branches of the Health Informatics Society of Australia (HISA) and the Health Information Management Association of Australia (HIMAA), will stage a workshop highlighting health IT research in WA, involving a series of three-minute presentations. The research must relate to the conference themes and have been conducted in 20132014. The student projects must have been conducted by a student at a WA university. Keynote speakers include burns surgeon Fiona Wood, who will discuss IT as a core member of the healthcare multidisciplinary team; Fiona Stanley Hospital director of nursing and midwifery Taylor Carter, who will discuss how informatics links to nursing staff; Princess Margaret Hospital senior pharmacist Lea Dias, who will discuss informatics and medication management; and head of Edith Cowan University’s School of Medical Sciences, Moira Sim, on whether we are HIT-ready for baby boomers in aged care. The afternoon session will hear lessons on IT integration from other industries, featuring speakers such as Bankwest CIO Andy Weir and Coles general manager for financial services Richard Wormald. Joshua Boys, director of document and record management and business intelligence firm Ignia will discuss modernising the traditional business intelligence environment. HITWA 2014 is being held in Perth on Friday, November 7.
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e-incident management system for South Island The five South Island district health boards will roll out an electronic incident management system from Canadian firm RL Solutions that will allow staff to more easily report incidents involving patient safety. RL Solutions’ RL6 Risk system is used by 1400 healthcare organisations around the world as well as by NZ’s Health Quality & Safety Commission. It features a simple interface that allows staff to report any type of event and is complementary to the clinical audit process. The system allows reports to be created anytime, anywhere, in various formats without IT involvement, and includes tools such as alerts and automated reporting to help reduce the time needed for staff intervention. RL Solutions is delivering a five-phased approach to introducing the new system into each DHB. A three-month IT build process is underway to enable the development of the taxonomies of incident, risk, restraint, hazard and feedback which will be used by all South Island DHBs. Canterbury DHB will begin the roll out in November, with completion expected by May 2015. Nelson Marlborough DHB will also commence in November with a view to competing it within two months. Southern DHB will pilot the program in two sites in November and roll out the system early in 2015 while West Coast and South Canterbury DHBs will follow suit in early to mid 2015. The system will support the recognition that adverse events and incidents will happen from time to time, and that through promoting a transparent culture of reporting and information sharing, there will be ongoing improvement and refinement of patient care.
Hills partners with medical practices for Lively elderly monitoring Hills is partnering with two Geelong medical practices to offer the Lively in-home sensor technology to help keep elderly patients living independently at home for longer. Lively is a suite of passive wireless smart sensors that transmit signals to a hub containing a built-in cellular service, meaning there’s no need for an internet connection. The hub sends data to a cloud server where it is displayed on a dashboard, which family and carers can log into to monitor an elderly person’s activity. There is also a free smartphone app.
The sensors are designed to attach to a key fob and to kitchen appliances and cupboards such as the fridge door and pantry, which allows the system to monitor whether a person leaves the house and whether they are eating and drinking regularly. There is also a pill box sensor that can monitor daily medication activity. The sensors are able to learn a person’s normal routine, so if there is any deviation, it can send an alert by email. Lively is a San Franciscobased start-up company established in 2012 that has
just added a new personal emergency response safety watch to the suite – not yet available in Australia – with plans to release a clip-on sensor for automatic falls detection next year. Lively signed a distribution deal with Hills earlier this year and is marketing the range online and through Hills’ distribution network for its security alarms. Hills has also just signed a partnership with the Geelong Medical & Health Group, which runs the Myers St Family Medical Practice and The Cottage Medical Centre in Geelong. The Geelong Medical & Health Group is selling the
HealthLink
Secure MessagingTransforming Healthcare HealthLink delivers on the promise of ehealth reform through standards compliance and nationwide secure messaging. range through its website, where it has an existing online shopfront for fitness devices for hire. Geelong Medical & Health Group general manager Durham Green said that while the shopfront was a new venture for the practices, he doubted it would be a big source of revenue in the near future. “We’re selling it through the website at the moment, but primarily [we are offering it] as a service to patients,” Mr Green said. “We can see the benefit, for example, for people that have their loved ones or parents in the home but they’re not quite sure whether or not they’re taking their medication right or whether they’re going to the fridge and getting food.” Mr Green said systems such as Lively would allow older people’s carers to discreetly check on their wellbeing without constantly having to ask. For GPs, it would also take some of the guesswork out of deciding whether or not to refer the patient to other services. “We’ll know when we need to stop and think about what other services we have to arrange, rather than guessing, whether it be getting extra rails or access in the house or providing nursing services or RDNS to help that person stay in their house.
“It also gives us the opportunity to be able to engage the patient more, so instead of seeing them once a year we might see them two or three times a year. “We might go out and do an over-75 health assessment and we can see, on the enterprise dashboard, ‘OK, the patient’s doing this.’
“It also shows that just one in five elderly Australians aged over 70 ask for help when they’re not feeling 100 per cent.” ”And when we ask the questions we can pick up those cues, as in ‘hang on, they’re telling us they’re doing something, but there’s no evidence to prove that.’ And discreetly we’ll input mechanisms to ensure they’re getting the support they need.” Head of Hills Health Solutions Peta Jurd said Lively was an extremely clever and practical application of technology. “Our research shows that three in five adult children worry about something happening to their elderly parents when they’re not with them,” Ms Jurd said. “It also shows that just one in five elderly Australians
aged over 70 ask for help when they’re not feeling 100 per cent. “This technology provides comfort and independence to an ageing population but also addresses concerns felt by their loved ones.” Mr Green said Lively’s ability to track whether elderly patients are opening their pill boxes, getting food out of the fridge or leaving the house would provide invaluable insights and peace of mind. Lively also comes with an optional service that collects photos and greetings from family members and condenses them into ‘LivelyGrams’ that can be emailed to the older person every month. Hills itself is working on developing a new nurse call handset for aged care residents with arthritis in partnership with the University of South Australia. A project team from UniSA is working at the new Hills Innovation Centre in Adelaide to develop the handset.
With a messaging “footprint” like ours we work with you to transform healthcare. HealthLink provides a robust, reliable asset for the secure messaging needs of your organisation. With more than 100 million messages exchanged last year between the largest number of health care providers - Australia wide. HealthLink enables all sectors of health care to help achieve the secure exchange of results, reports, discharge summaries etc and as a result organisational best practice and health care improvements.
Secure Messaging Checklist: Compliance Secure Messaging Large messaging footprint System Integration Working towards Interoperability Standards Based Solution experts Provider Directory Training and Education Leaders in Secure Messaging
“When you think about it many people who end up in hospital have limited dexterity and we want to make it a little bit easier,” Ms Jurd said. Hills now owns two major brands in nurse call systems – Merlon and Questek – and is active in both aged and acute care.
ehealth @healthlink.net
1800 125 036 www.healthlink.net
Group Share
Clinician
Group Share
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Zedmed’s latest innovation! A new feature available soon to all Zedmed customers. In response to requests for security enhancements to patient records, Zedmed will soon release a new feature that enables clinics to better comply with patient confidentiality requirements. We call this Clinician GroupShare.
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In a multi-disciplinary setting where patients are all accessed from one database, it may not always be relevant for some clinician groups to see the Progress Notes written by other clinician groups. Zedmed has this covered. We can now offer you the option to ‘group’ practitioners and ‘share’ or ‘restrict’ access to Progress Notes across groups. Please call our sales team on 1300 933 000 to find out how Zedmed’s Clinician GroupShare. can benefit your practice.
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Singapore to link aged care to national eHealth record via IT enablement program Singapore will link 36 aged care facilities to its National Electronic Health Record (NEHR) and integrated referral management system through a $S6.5 million Nursing Home IT Enablement Program (NHELP), which uses technology from Australia’s Leecare Solutions. Singapore’s Agency for Integrated Care (AIC) said the new program will allow aged care facilities to subscribe to the NHELP IT system as a service. It will be connected to the NEHR and will ensure timelier flows of residents’ electronic health information between different care institutions and participating nursing homes. The system involves Leecare’s full Platinum
5.0 suite suite, including Platinum 5.0 clinical care and lifestyle, P5 Med medication management, P5 Exec operational management and P5 finance. Leecare CEO Caroline Lee (pictured left) said that as Platinum 5 is web-based, aged care staff will be able to view or update their residents’ medical records from any device. It will also be able to facilitate care planning for residents based on their medical history and records, and through electronic tracking of the care plan help nursing homes achieve continuous improvement of quality care. Leecare’s system is able to send reminder alerts to staff on ongoing tasks and care assessments to
be done and will automate the submission of data to Singapore’s Ministry of Health for funding. So far, nine aged care facilities have committed to participating, with the AIC hoping to roll it out to 36 of the country’s estimated 70 nursing homes by 2017. The first facility will go live in February next year. Singapore’s NEHR is a provider-controlled national record that consolidates data and records of each encounter with healthcare providers. It includes a summary care record for each patient including problem lists, medications, hospital discharge and event summaries, as well as referrals and care plans. The architecture was designed by Accenture.
Telehealth community gears up for SFT-14 conference A draft program for November’s Successes and Failures in Telehealth (SFT-14) conference has been released, featuring keynote speakers Gordon Peterkin, former director of the Scottish Telehealth Centre, and Peter Soyer of the University of Queensland’s Dermatology Research Centre, who will discuss the future of teledermatology. The draft program for the two-day event also features some of the bestknown researchers and practitioners in Australian telehealth, including the Australian e-Health Research Centre’s Yogi Kanagasingam; the Centre for Online Health’s Dominique Bird, Anthony Smith and Len Gray; the University of Adelaide’s Tory Wade; and Flinders University’s Alan Taylor and Colin Carati. One complete session will be dedicated to a workshop for the Centre for Research Excellence in Telehealth, which was officially launched in July to focus on translating research findings into clinical practice. One topic of interest as changes are made to the roll-out of the National Broadband Network is a presentation by UQ’s Liam Caffery on the quality of video consultations performed using 4G mobile. New Zealand will be represented by Stephen Jennison of the Northland District Health Board, who will discuss rural outpatient heart failure management. A roundtable session will also be held on national telehealth strategies, with panellists including invited representatives from various state health departments. Organised by the Centre for Online Health in association with the Australasian Telehealth Society, SFT-14 will be held from November 17 to 18 at the Hilton in Adelaide.
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CCMS to be rolled out for at risk patients in North Island Counties-Manukau District Health Board will roll out HSAGlobal’s CCMS connected care platform to all general practices in the district by June next year to allow them to provide a care plan to up to 30,000 patients with long-term conditions. Counties-Manukau DHB’s At Risk Individuals program (ARI) is aimed at providing earlier intervention and patientcentred care by allowing primary carers to identify at-risk patients and better coordinate their services. The DHB will enrol people in ARI who have one or more long-term conditions, such as diabetes or heart disease, as well as other risk factors like inadequate housing or low health literacy. CCMS is used throughout New Zealand for care coordination and forms the technological basis of Auckland’s shared care program. It is also used by Canterbury DHB and has a small but growing footprint in Australia. Once enrolled by their GP, every person will have a designated care coordinator responsible for developing individual care plans in CCMS and monitoring progress in consultation with other providers of health and social services. A summary health record will be available to healthcare teams through their existing Concerto patient record software so that key information relating to the patient is visible to everyone involved in their care. Counties-Manukau has an existing program using CCMS that targets 3000 intensive healthcare users at high risk of readmission to hospital. The DHB uses CCMS under a licence covering the Northern region DHBs. CCMS is licensed on a population basis, so DHBs are able to use the care platform for as many programs as they like.
Dedicated telehealth services double in Queensland’s Darling Downs Close to 18 months since initial planning and a year since its official launch, Queensland’s Health-eRegions telehealth project is putting some early runs on the board, including providing comprehensive geriatric assessments for nursing home residents, conducting weekly ward rounds at a small regional hospital and developing a sustainable business model so the project can continue in the longer term. Health-e-Regions is centred around the Darling Downs towns of Dalby, Chinchilla and Miles, and involves providing a range of telehealth services for paediatric, adult and geriatric patients in a number of settings. Led by the University of Queensland’s Centre for Online Health (CoH) with the support of Queensland Health and UQ’s research commercialisation arm UniQuest, it has been funded by a $1.3 million investment from natural gas company QGC. At the heart of the project is the extension of existing telehealth services established and run by COH such as the long-standing Queensland Telepaediatric Service and the adult and geriatric services run from the Princess Alexandra Hospital (PAH), as well as scoping out the potential for new telehealth services
to create a “whole-ofcommunity” system that best suit the needs of the towns and their surrounding regions. This includes working with aged care facilities, regional hospitals and general practices to assist in setting up telehealth services or creating better connections for existing services with remote clinicians in Brisbane and Toowoomba.
“... we have installed one of our mobile telemedicine trolleys which connects to the 4G network, and it can be transported around the entire facility.” While part of the project does involve helping facilities to implement telehealth systems, such as through the COH’s recently commercialised RES-e-CARE business, the majority of the work involves scoping out needs and building relationships with local healthcare services and providers. A community event was recently held in Chinchilla – pop. 5500 and 300km from
Brisbane – to mark a year since the official launch and raise more awareness of what is available through Health-e-Regions. According to the COH’s deputy director and project lead Anthony Smith. the next event will be in Dalby – pop. 12,000 and 210km from Brisbane – where the local hospital now runs weekly ward sessions for its predominantly elderly patients with geriatric specialists in Brisbane. In Chinchilla, the Healthe-Regions team has been working closely with Illoura Village, a 66-bed aged care facility operated by Southern Cross Care that is serviced by GPs from the Chinchilla Medical Practice. The project is delivering the Res-e-Care service to Illoura, with a specialist geriatrician from Brisbane actively seeing patients for the last six months. “They are generally doing weekly rounds with patients and they do comprehensive assessments, which do require a bit of time,” A/Prof Smith said. “They’ve done 26 consultations since March for 19 residents who have had a complete review. All of that information is shared with the GP so they can review the care plan. In some cases the GPs can be involved in the telehealth consultation and talk to the
geriatrician. That is working really well.” Illoura Village is using a mobile telehealth trolley, which can be transported to the bedside. A/Prof Smith said one of the main concerns when setting up in each town was that they have not yet been connected to the NBN, and both ADSL and 4G can be a bit hit and miss. “Fortunately in Chinchilla the 4G connectivity is excellent, so we have installed one of our mobile telemedicine trolleys which connects to the 4G network, and it can be transported around the entire facility,” he said. “The video quality is excellent during a call.”
He very much attributes the success of the program at Illoura to the people working in the facility and the nearby medical practice, who he says have put a great deal of work into making it possible. Some of the Chinchilla GPs themselves have previously done some telehealth consults using their iPads and Skype, but like many rural clinics space is at a premium so a dedicated telehealth room is not possible. This will hopefully change in Dalby in the next year following some capital works, but for the Chinchilla GPs, the project is providing a mobile trolley to support a range of new specialist services including endocrinology.
A/Prof Smith said probably the major barrier to expanding GP telehealth services in regional towns is not the technology but who the GP can refer to and how to do that referral. “That’s a really important process, so now we’re working with the GPs to assist them in relation to information. For example, if they have a patient with one of these conditions, here are the doctors they can refer to at these facilities.”
South Island PICS gets the official go-ahead
At Dalby Hospital, the COH has been providing remote general ward rounds in one of its medical wards. Most of the ward rounds have been in relation to elderly patients, so that service is being provided through the PAH geriatric telehealth service as a weekly clinic.
The system is being built by Orion Health based on its Consult solution, a product suite that includes what was formerly known as Concerto. It aims to streamline the patient journey and help to coordinate care between different hospitals and providers and eventually reach out into community care.
The new South Island Patient Information Care System (SI PICS) has been given the official go-ahead from the New Zealand government, with the start date for the roll out to begin next year. SI PICS is a single patient management and administration system that is being introduced to all hospitals in the South Island and will replace systems such as HOMER that currently handles patient demographics, admissions, transfers and discharges.
The plan is to use the system to standardise patient flow across the five DHBs and will include data on patient demographics, appointments, clinical records, in-patient admissions, discharges and scheduling. “Replacing each district health board’s patient information system with a single streamlined regional system will provide health professionals with more accurate information, and allow them to spend less time on administration and more time on caring for patients,” former health minister Tony Ryall said. “It will also manage a number of patient services for district health boards, including patient appointments, admissions, discharges, and transfers. “The new system will also be more timely and cost-efficient than the patient information systems it replaces. Together, the DHBs are expected to save around $40 million over the next 15 years.”
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Events October
7 OCTOBER
BEST PRACTICE: CLINICAL MODULE FOR NEW AND EXISTING USERS Adelaide, SA p: +61 7 4155 8888 w: www.bpsoftware.com.au
7-9
OCTOBER
HIMAA AND NCCH 2014 NATIONAL CONFERENCE Darwin, NT p: +61 2 9887 5001 w: www.himaa2.org.au/conference
12
OCTOBER
CLINICAL EMERGENCY MANAGEMENT PROGRAM - ADVANCED Adelaide, SA p: +61 3 8699 0300 w: www.racgp.org.au/cemp
15
OCTOBER
NZ AGED CARE ASSOCIATION CONFERENCE Wellington, NZ p: +64 4 473 3159 w: conference.nzaca.org.nz
16
OCTOBER
MARKETING YOUR PRACTICE Online p: +61 3 9095 8712 w: www.aapm.org.au/events
18
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GENERAL PRACTICE EDUCATION DAY Brisbane, QLD p: +61 1300 797 794 w: www.healthed.com.au
20
8
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BEST PRACTICE: MANAGEMENT MODULE FOR NEW AND EXISTING USERS Adelaide, SA p: +61 7 4155 8888 w: www.bpsoftware.com.au
8
OCTOBER
CLINICAL EMERGENCY MANAGEMENT PROGRAM - INTERMEDIATE Adelaide, SA p: +61 3 8699 0300 w: www.racgp.org.au/cemp
8
OCTOBER
HISA VIC - PCEHR Melbourne, VIC p: +61 3 9326 3311 w: www.hisa.org.au/events
9-11 OCTOBER THE RACGP CONFERENCE FOR GENERAL PRACTICE Adelaide, SA p: 1800 472 247 w: www.gpconference.com.au
OCTOBER
SAFE AND SECURE HOSPITALS CONFERENCE Sydney, NSW p: +61 2 9080 4307 w: www.informa.com.au/conferences
20-22 OCTOBER
28-29 OCTOBER EHEALTH INTEROPERABILITY CONFERENCE Sydney, NSW p: +61 2 9080 4090 w: www.healthcareconferences.com.au
29
OCTOBER
NZHITC CHRISTCHURCH NETWORKING EVENT Christchurch, NZ p: +64 4 815 8177 w: www.healthit.org.nz/events
30
OCTOBER
RURAL MEDICINE AUSTRALIA 2014 (RMA2014) Sydney, NSW p: +61 7 3105 8200 w: www.acrrm.com.au
LASA NATIONAL CONGRESS 2014 Adelaide, SA p: +61 2 6230 1676 w: www.lasacongress.asn.au
21-24 OCTOBER AAPM 2014 CONFERENCE Adelaide, SA p: +61 3 6231 2999 w: www.aapmconference.com.au
23
OCTOBER
HISA NSW - AGED CARE Sydney, NSW p: +61 3 9326 3311 w: www.hisa.org.au/events
25
OCTOBER
GENERAL PRACTICE EDUCATION DAY Perth, WA p: +61 1300 797 794 w: www.healthed.com.au
30
OCTOBER
THE SPECIALIST PRACTICE Online p: +61 3 9095 8712 w: www.aapm.org.au/events
November
1
NOVEMBER
GENERAL PRACTICE EDUCATION DAY Adelaide, SA p: +61 1300 797 794 w: www.healthed.com.au
6
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WORKING WITH TECHNOLOGY CHANGE AT THE FRONT DESK Online p: +61 3 9095 8712 w: www.aapm.org.au/events
11
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12
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6TH AUSTRALIAN RURAL & REMOTE MENTAL HEALTH SYMPOSIUM Albury, NSW p: +61 7 5502 2068 w: anzmh.asn.au/rrmh/
12
NOVEMBER
RCPA PATHOLOGY INFORMATICS SEMINAR Sydney, NSW p: +61 2 8356 5858 w: www.rcpa.edu.au/events
13
7
NOVEMBER
HEALTH INFORMATION AND TECHNOLOGY WESTERN AUSTRALIA CONFERENCE 2014 Perth, WA p: +61 3 9326 3311 w: www.hisa.org.au/events
10
NOVEMBER
HINZ 2014 CONFERENCE AND EXHIBITION Auckland, NZ w: www.hinz.org.nz/page/conference/ conference-2014
10
NOVEMBER
NATIONAL ACQUIRED BRAIN INJURY CONFERENCE Sydney, NSW p: +61 2 9080 4307 w: www.informa.com.au/conferences
11
NOVEMBER
HIC 2014 QUEENSLAND REPRISE Brisbane, QLD p: +61 3 9326 3311 w: www.hisa.org.au/events
NOVEMBER
HISA NSW - CHRISTMAS PARTY PLUS SPEAKERS Sydney, NSW p: +61 3 9326 3311 w: www.hisa.org.au/events
NOVEMBER
BEST PRACTICE: MANAGEMENT MODULE FOR NEW AND EXISTING USERS Melbourne, VIC p: +61 7 4155 8888 w: www.bpsoftware.com.au
12
27
December
2
DECEMBER
CLINICAL TRAINING & WORKFORCE PLANNING SUMMIT Melbourne, VIC p: +61 2 9080 4307 w: www.informa.com.au/conferences
3
DECEMBER
2ND ANNUAL HIP FRACTURE MANAGEMENT CONFERENCE Sydney, NSW p: +61 2 9080 4307 w: www.informa.com.au/conferences
NOVEMBER
BEST PRACTICE: MANAGEMENT MODULE FOR NEW AND EXISTING USERS Melbourne, VIC p: +61 7 4155 8888 w: www.bpsoftware.com.au
17
NOVEMBER
SUCCESSES AND FAILURES IN TELEHEALTH (SFT-14) Adelaide, SA p: +61 7 3876 4988 w: event.icebergevents.com.au/sft-2014/
26
NOVEMBER
4
DECEMBER
HISA VIC - AGED CARE Melbourne, VIC p: +61 3 9326 3311 w: www.hisa.org.au/events
THE PHILOSOPHY OF BILLING Online p: +61 3 9095 8712 w: www.aapm.org.au/events
26
NOVEMBER
3RD ANNUAL ELECTIVE SURGERY REDESIGN CONFERENCE Melbourne, VIC p: +61 2 9080 4307 w: www.informa.com.au/conferences
9
DECEMBER
3RD ANNUAL HEALTH TECHNOLOGY ASSESSMENT CONFERENCE Sydney, NSW p: +61 2 9080 4307 w: www.informa.com.au/conferences
Online Calendar: To view a comprehensive list of eHealth, Health, and IT events, visit: http://www.pulseitmagazine.com.au/events
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HIMAA
WORKFORCE FOCUS FOR
NEW HIMAA INFRASTRUCTURE The Health Information Management Association of Australia (HIMAA) has set up new working groups to spearhead the implementation of its national strategy, which has a strong focus on workforce issues. The working groups will inform the development of strategies that underpin the profession’s two recognised occupations: health information manager (HIM) and clinical coder (CC).
RICHARD LAWRANCE BEd, MEd (Hons), Grad Dip (Management) CEO, HIMAA ceo@himaa.org.au
As the Health Information Management Association of Australia’s (HIMAA) senior vice president Jenny Gilder noted in the last issue of Pulse+IT, workforce is the overall theme driving HIMAA’s strategic plan over the next three years. At its national conference in Darwin this month – being held in association with the National Centre for Classification in Health – HIMAA announced the formation of three working groups, a communication reference group, and a new committee of the board to spearhead the implementation of the primary strategic priority of the plan: positioning and advocacy. One of the working groups, the research working group, was formed as a result of the use of a “wild card” vote during the strategic plenary at HIMAA’s 2013 conference in Adelaide.
Research focus
About the author Richard Lawrance is the CEO of the Health Information Management Association of Australia (HIMAA). He has been an education and strategy consultant for several general practice organisations and spent nine years as the national rural manager for the RACGP.
The aim of this fourth ‘vote’, in addition to more conventional first, second and third priorities, was to enable leaders of the profession gathered at the plenary to elevate a lower ranked priority upwards because it merited more of the profession’s attention. Research emerged strongly as an area for HIMAA to address from independent membership segments focus grouped as part of HIMAA’s strategy review in 2013.
As HIMAA president Sallyanne Wissmann summarised in the most recent edition of the Health Information Management – Interchange journal, “The overall aim of a research agenda for HIMAA would be to promote, undertake and facilitate research related to the management of health information. “This could include research evidence related to the development, implementation and impact of information and communication technologies on healthcare delivery, health professionals’ work and patient outcomes, and the quality and utility of health information for patient care and for the management of health services. “This research would inform policy and practice change related to the management of health information.” The first task of the group is to develop a position paper on the value of health information research to best practice, the development of the profession’s knowledge, and the advancement of the profession. It will also advise the on the promotion of HIM research in Australia, coordination of a HIM research agenda, and development of a HIMAA funding strategy to support research.
Practice standards The practice quality and safety standards committee of the board launched at the Darwin conference also emerged from a combination of independent membership segment focus groups and the “wild card” priority vote by the profession’s leadership attending the 2013 strategic plenary. The need for an industrial advocacy role for HIMAA was a surprise issue to emerge from the focus group program, but again it came from independent market segment focus groups, and was strongly prioritised in plenary. However, members were clear in the focus groups that they did not want HIMAA to replace their existing industrial agencies. The HIMAA board’s response has been to build on a call from members of HIMAA’s regional health special interest group for professional practice guidelines to underpin the defence of health information manager (HIM) and clinical coder (CC) job classifications at the local health service level. The committee will develop and promote quality practice and safety standards for the profession, particularly in its two recognised occupations. National practice standards and corresponding guidelines can underpin job classifications, best practice and award structure negotiations around the country. They will also set the practice quality agenda for the profession. The new committee is to be chaired by Jenny Gilder.
Professional credentialing The role of standards in positioning the health information management profession is a strong feature of the HIMAA board’s plan to implement its 2014-16 strategy. Revision of the association’s professional credentialing scheme, another initiative launched at the 2014
“The need for an industrial advocacy role for HIMAA was a surprise issue to emerge from the focus group program.” Richard Lawrance
HIMAA NCCH national conference this month, is more firmly based on HIMAA’s national competency standards for the profession. The scheme’s foundation on the principle of outcomes-based continuous quality improvement is also an enhanced feature of the re-launched program. The scheme has been opened up to non-members on a fee-for-service basis, and will be advocated to employers as a key source of quality assurance. Unlike the certified health information Australia (CHIA) program, in which HIMAA partners with the Australian College of Health Informatics (ACHI) and the Health Informatics Society of Australia (HISA), HIMAA’s professional credentialing scheme is predicated on credentials gained elsewhere, through HIMAA-accredited or HIMAA-approved education and training. The scheme recognises the continuing professional development participants undertake to maintain currency of their professional credentials through quality improvement activity. On completion of a biennial cycle, participants are eligible to use the post-nominals CHIM (certified health information manager) and CHIP (certified health information practitioner). Clinical coders can also achieve HIMAA’s CCC (certified clinical coder) post-nominal through a biennial exam.
HIMAA believes the scheme has a persuasive role to play in better positioning the profession in industry.
Workforce strategy Collaboration with HISA and ACHI is also an aim of a second of the three new board working groups. The workforce working group, chaired by the Victorian Department of Health’s health information workforce manager Julie Brophy, has been formed specifically to ensure that the overall driving theme of workforce receives sustained attention across initiatives to implement the 2014-16 HIMAA strategy. In particular, the group will develop a workforce strategy for the profession, advise on workforce advocacy, identify champions of workforce strategy success and on changes in career path and occupations. HIMAA has approached HISA and ACHI to partner in the development of a comprehensive health information workforce strategy to implement the six recommendations of Health Workforce Australia’s (HWA) 2013 health information workforce report. HIMAA believes that these three organisations form the natural coalition to constitute the single peak body called for in the report. HIMAA’s workforce working group will be our main channel for participating in joint strategy development and delivery.
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MSIA
EXACTLY THE SAME BUT ENTIRELY DIFFERENT We may share a common language, historical ties and healthcare systems based on a similar model, but the way Australia and New Zealand has gone about automating those health systems over the last two decades is very different. While Australia continues to struggle to get the PCEHR to work, New Zealand has an enviable system of electronic exchange of information between the different tiers of healthcare provision.
TOM BOWDEN Dip B.I.A. MBA CEO, HealthLink tom.bowden@healthlink.net
Their flags are almost indistinguishable and, to someone from the US or Europe, so are their accents. New Zealand and Australia are two fiercely independent modern nation states separated by a thousand miles of sea. Though viewing themselves as entirely different from their Australian cousins, most New Zealanders are unaware of the fact that until 1901 their country was in fact part of the state of NSW, Australia’s most populous state. A difficult stretch of sea and an entrenched unwillingness of the peoples of Western Australia and New Zealand to agree on racial laws and policies meant that when push came to shove, New Zealand did not become part of the Australian Federation and became its own sovereign nation.
About the author Tom Bowden is chief executive officer of HealthLink, which has operations in both Australia and New Zealand. Much of Tom’s work is in developing business models to enable government and private sector organisations to work together to accelerate health system transformation.
Camaraderie and fierce rivalry both characterise our relationship. Little known is ‘The Battle of the Wazzir’, four days in 1915 when the two countries’ armies were involved in a pitched fight with one another. The battle was in fact a four-day brawl that involved 2500 Australian and New Zealand troops en route to the bloody battlefields of Europe. It took place in the brothel district of Cairo. Four days on, four soldiers were found to have been injured and no winner was declared. The two armies sailed on to Europe where they fought together bravely and sustained enormously tragic losses. The famed ANZAC spirit was born.
Today, the two countries’ rivalry is mostly played out on sports fields with the fiercely contested Bledisloe Cup rugby games an annual highlight. Many New Zealanders live in Australia, which has a population five times larger than New Zealand’s, and there are also a growing number of Australians now residing in New Zealand. In terms of health systems, there are significant differences between the two countries as well as similarities. Both have health systems based on the British healthcare model, with general practices prominent and with governments playing a key role in funding and administering healthcare. Both the New Zealand and Australian health systems rank well in Commonwealth Fund comparisons of health system efficiency and effectiveness. Australia’s per capita expenditure on healthcare is slightly higher than New Zealand’s, both in absolute terms and as a proportion of gross domestic product, but the citizens of both countries enjoy some of the world’s best healthcare. The major differences in the two countries’ health systems are driven by disparities in health policies, political agendas and governmental structures. In 1992, the New Zealand government reformed its health sector, placing much more emphasis on
primary care, in particular channelling significant amounts of healthcare funding through approximately 40 general practice support organisations. In Australia there has never been a similar level of concerted, highly focused healthcare reform. While general practice is recognised as being very important in Australia, primary care is far less central to the healthcare delivery model than it is in New Zealand. The readiness to initiate and then dismantle Divisions of General Practice and Medicare Locals in Australia shows the reform is just a passing phase at best. In Australia, hospital care is funded by the state governments and primary care is funded federally. In New Zealand there is no federal structure, with public health funding administered from one single source. In the hospital sector, New Zealand has a much bigger emphasis on public healthcare provision. Accordingly nearly all acute hospital care is delivered by the public health system, whereas in Australia hospital services are a mixture of public and private.
Practice communications The two countries’ healthcare information technology strategies have diverged as well. New Zealand’s health reforms spurred the development of a lot of technology aimed at supporting primary care, and by the year 2000, all of New Zealand’s 1050 general practices were computerised and exchanging electronic messages. This level of automation was achieved primarily because electronic claiming for patient visits became compulsory and other electronic services were developed to complement that process and build onto that infrastructure. A value proposition was established for the inclusion of these new services and increasing use of data communications delivered ongoing value to the users. The
“In Australia, a typical general practice has at least four proprietary download applications provided by its local pathology laboratories ...” Tom Bowden
number of parties that an average New Zealand general practice communicates with grew from approximately four in 2000 to over 60 today. A New Zealand general practice communicates electronically with laboratories, hospitals, specialists, health insurers and is beginning to prescribe electronically too. In Australia, a typical general practice has at least four proprietary download applications provided by its local pathology laboratories and third-party messaging systems. The average general practice in Australia communicates with approximately 10 other organisations. The potential for practice improvement is far greater for an Australian GP than for his or her New Zealand counterpart. Whereas New Zealand general practices were forced to implement electronic communications in order to be able to claim electronically, Australian general practices automated through the government-funded Practice Incentive Program (PIP), HIC Online and PBS Online. In most respects GP electronic medical record (EMR) products in the two countries are not that much different from one another. The way they are used though is very different though. Furthermore, the levers that have been used to increase functionality of these systems have been very different. Australian practices have relied on PIP programs for the automation of general
practice, but these initiatives have had relatively little success in improving connectivity between healthcare organisations. Initially, through the PIP process, practices were provided grants for hardware and software and were able to keep the change if they did not spend all of the funding they were given. More recent PIP programs have attempted to focus on the introduction of healthcare identifiers, terminologies and secure message delivery. Once again there has been relatively little success given the amount of money spent.
Technology creating value New Zealand, on the other hand, has not had a nationally funded eHealth project but quite a lot of progress has been made in areas such as electronic referrals, pathology and radiology. As opposed to Australia, New Zealand has relied on creating value via the automation of general practice. Exchanging information electronically appears to work very well in New Zealand without national mandates. Delivering value through the exchange of information is encouraging senders and receivers of the information to implement these systems. In fact, the level of messaging exchange in Australia is directly related to the benefit that they deliver with high levels of automation surrounding diagnostic services and claiming accounting.
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These services account for over 400 million electronic transactions.
has shown very little by way of tangible progress.
It will not take a PIP program to drive the increased use of discharge summaries given the benefits to transfer of care from hospitals to community. Large sums of money expended on a national program to deliver a centralised repository of clinical information has not realised the same value.
Despite Australia’s seeming obsession with creating an electronic health record, in both countries the common view is a simple one – GPs play a fundamental role in the providence of the patient record and need to be able to share information with their patients and the many players that provide assistance in the care of patients.
Australia’s personally controlled electronic health record (PCEHR) is the single largest difference in the two countries’ strategies to improve sharing of information. This federally funded initiative, which is said to have cost the Australian taxpayer more than $1 billion, owes its origins to a decision by the Council of Australian Governments (COAG) to establish the National E-Health Transition Authority (NEHTA) to develop and implement a national eHealth strategy.
Tangible benefits
It certainly was a logical move to form a national organisation to coordinate various state-based efforts, but the outcome has been mixed. The PCEHR project has soaked up a lot of resources and to date
measurable change really does occur. With the emphasis fading on its national agenda, Australia is once again starting to stimulate procurements, innovation, market dynamics and most importantly choice. Market forces and governments are now required to deliver value to end customers with sustainable business models. Removing paper from all areas of healthcare and funding is an activity that is experiencing renewed vigour.
In both countries, patients are being encouraged to be more active in their own care and to make choices, including how they fund their own healthcare. However, if we are to achieve sharing of information, interconnection and interoperability, we must have timely delivering of capability across all sectors that can be used by the different actors.
It is expected that Australians will in time be able to provide assistance to their New Zealander cousins as the scale and size of Australia allows greater opportunity to experiment and innovate. It is also likely that that New Zealand’s health IT entrepreneurs will continue to look for and find opportunities in Australia’s much larger marketplace. Innovation and collaboration on both sides of the Tasman should be encouraged and supported.
This must be done through the use of standards that are firmly supported and ‘owned’ by industry with effective support and education of end users and appropriate business and financial drivers. These are the things that will ensure
It does seem sensible to go back to our starting point, when automation of healthcare first began. Good medical record keeping and the sharing of information with funders, carers and patients clearly delivers tangible benefits.
www.hitcommunications.asia
HINZ
HEALTH INFORMATICS NEW ZEALAND WHERE TO FROM HERE?
Health informatics underpins a nation’s ability to deliver an affordable, flexible health system that will provide better health outcomes to its citizens, but how do you create a health informatics expert? Do you teach a clinical person about IT, or do you teach an IT person about healthcare? The short answer is we need to do both.
KIM MUNDELL Dip. Business, Grad Cert (Change Management) Chief executive, HiNZ ceo@hinz.org.nz
Health Informatics New Zealand (HiNZ) is a non-profit organisation founded 14 years ago from the amalgamation of two special interest groups: nursing informatics and medical informatics. A group of energetic volunteers then established an annual conference to provide a platform to leverage local and international best practice, and support the development of the health informatics field in New Zealand. Since then the New Zealand health sector has changed dramatically. Topics such as predictive analytics, self-management and the patient portal are more broadly developed yet they continue to change and influence health policy. There has been a significant shift in the way health IT projects are funded, controlled and delivered with the establishment of the National Health IT Board and its subsequent release of the National Health IT Plan in 2010.
About the author Kim Mundell was appointed chief executive of HiNZ in April 2014. Kim was previously CEO for a government-funded disability service provider and owner of Healthy Food Guide magazine. Through her consulting business, Kim provides business advice to non-profit organisations. She originally trained as a registered nurse.
“HiNZ is in a transition phase,” HINZ chair Liz Schoff says. “To deliver better value to our members we have moved from an allvolunteer structure focused on an annual event, to a more strategic model with a full time chief executive. Our goal is to deliver additional services, ongoing communities of practice and collaboration with other health organisations in New Zealand.”
Health informatics matters Health informatics underpins a nation’s ability to deliver an affordable, flexible health system that will provide better health outcomes to its citizens. Health informatics is the field that deals with the storage, retrieval, sharing and optimal use of health information, data and knowledge for problem solving and decision making. It covers a broad range of activities including electronic health records, knowledge management, decision support, telemedicine and telehealth, standards, evidence for benefit/harm, ethics and security. But it is about far more than technology. Increasingly, the focus within the health informatics field is on communication and change management. Without effective communication, technology projects are unlikely to be successful. Delivering on these large-scale health sector projects requires the use of multi-disciplinary teams. To deliver workable solutions we need the combined expertise of clinical experts and technology experts. So how do you create a health informatics expert? Do you teach a clinical person about IT? Or do you teach an IT person about healthcare? The short answer is we
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need to do both. If we are to be successful in designing effective solutions to transform the health sector, New Zealand needs clinicians who know about IT and technology experts who know about health. In other words, we need many more health informatics practitioners, now and in coming decades.
“The key differentiator of HiNZ is its neutrality. Our most important function is to provide a safe, neutral environment, within which collaboration can sprout and grow.”
The purpose of HiNZ HiNZ has five key reasons for being: • To provide a platform for the distribution of information about best practice in health informatics • To encourage and enable collaboration on health informatics issues • To support the professional development needs of our members in the field of health informatics • To encourage more people to develop dual expertise in health and technology • To raise awareness of the value that health informatics brings to the health sector. The funding for HiNZ comes from membership fees, event registration fees, trade exhibitions, vendor sponsorship and government grants. We have no majority funder from any institution, organisation or government source, which allows us to be an independent entity. Membership of HiNZ is for anyone with an interest in health informatics. As a consequence, compared to other professional organisations, ours has an unusually diverse membership base. Members include clinicians, health sector managers, government personnel, vendors, academics, IT professionals and other NGOs. HiNZ builds and strengthens connections between these groups. The key differentiator of HiNZ is its neutrality. Our most important function is to provide a safe, neutral environment, within which collaboration can sprout and grow.
Kim Mundell
The health IT sector encompasses a wide range of stakeholders, from non-profits to commercial entities; from organisations with 10,000 employees to one-man consultancy practices. HiNZ is not a lobby group for any one group, we have no political affiliations, and we do not choose favourites. HiNZ aims to provide a level playing field and encourages the sharing of ideas across the sector. Many HiNZ members are in competition with each other. Some are competing for a slice of government funding or for research grants. Others are competing to win commercial contracts. Some compete within an organisation for a share of its limited operational budget. It can be difficult in such a competitive environment for important conversations to take place, but they need to take place if the field of health informatics is to reach its full potential and enable the delivery of effective health solutions to all New Zealanders. HiNZ helps give everyone a voice around the table.
Changes underway For 13 years HiNZ has run a conference that brings together the movers and shakers in health informatics. The conference has been the foundation activity of HiNZ, and this will continue, but to be effective HiNZ needs to do much more.
Since my appointment as chief executive, I have spent a lot of time listening to members: researching what they want, how they want it delivered, and where and when they want it. It is already clear we need to deliver information and support to our members in more diverse ways. Based on international trends, we also need to be ready to support further changes in communication technologies, portability, genomics and telehealth in addition to managing changing public expectations and the digital divide. Importantly, we need to broaden our reach beyond the current HiNZ membership. The health sector has changed and there is a broader awareness of the need for integrated health teams that include all players in the health sector: information specialists, clinical specialists, administrative staff, policy makers and patients. HINZ is reaching out to those who have not been able to easily leverage the value of health informatics. Historically, HiNZ has primarily engaged with people who are knowledgeable about both technology and the health sector, and who might identify themselves as a health informatician. For health informatics to deliver on its full potential, HiNZ needs to engage with a much wider group. We need to more directly target health sector experts who have minimal knowledge of
technology, and technology experts who have limited knowledge of health. For technology solutions to be successful, the clinician’s point of view must be taken into account, and end users need to understand more about technology. This wider group includes decision makers who will have a large influence on the future of the New Zealand health care sector. HiNZ is now focused on this broader constituency when planning and assessing future activities.
Looking ahead to 2015 To engage with clinicians we are taking health informatics to them, rather than expecting them to seek us out. Last year HiNZ launched the popular Primer Series, free workshops held in hospitals for clinicians who wished to learn more health informatics. HiNZ has been invited to deliver a health informatics stream within the 2015 Lab Meeting for senior laboratory staff and pathologists. We welcome invitations from other professional groups who would like their members to learn more about health informatics.
In 2015 HiNZ will support a wider range of seminars and events, starting with a hackathon on self-care health solutions at the University of Auckland next February. The Certified Health Informatics Australasia (CHIA) qualification was recently launched by the Health Informatics Society of Australia (HISA) and the Australasian College of Health Informatics (ACHI). We are in discussions with these organisations to bring a local version of the CHIA certification to New Zealand. As a visible symbol of our transition, we have updated the HiNZ logo to reflect our role as a member based organisation that brings together a diverse group of people to collaborate.
HiNZ Conference We are currently focused on preparing an exceptional 2014 conference. The HiNZ Conference, “Making IT work for you today: Routes to transformational change”, is being held at Sky City in the Auckland CBD from November 10 to 12.
Here are five reasons why you should attend the 2014 HiNZ Conference: • Gain actionable solutions: learn practical ideas and best practices from end user case studies and scientific papers. • Meet the leaders: hear about transformation priorities direct from the PHO and DHB CEOs and NHITB. • Share ideas: connect and share with your peers at networking functions across three days. • Be inspired: by expert keynote speakers such as Dr Ngai-Tseung Cheung (CMIO), Dr Ciro Cattuto (director, ISI Foundation Italy), Geraldine McBride (ex-SAP), Craig Richardson (Wynyard Group), Professor Enrico Coiera (University of NSW), Professor Trish Greenhalgh (Prof Primary Health Care), Robyn Cook (University of NSW), and others. • Attend expert workshops: dive deeper into your area of expertise by attending one of five optional workshops. For more information on the conference, see www.hinz.org.nz
BE A pArt of A growIng CommunIty of E-hEAlth ExpErts JoIn hIsA toDAy
Influence the agenda Build professional networks Be part of a national community Career development and certification Exclusive member-only benefits and resources hIsA.org.Au
Access Australia’s largest network of e-health experts and leaders
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NZ HIT Cluster
VENDOR COMMUNITY
SUPPORT FOR NZ HEALTH IT PLAN Considerable progress has been made in achieving the overall objectives of New Zealand’s 2010 health IT plan, with an update released late last year. The health IT vendor community is supporting the updated plan’s priorities, which include electronic medication management, national clinical solutions, regional information platforms and community-based integrated care initiatives.
SCOTT ARROL MBA CEO, NZ Health IT Cluster scott.arrol@healthit.org.nz
New Zealand’s health sector has experienced considerable levels of change and progress over the past five years, with IT being viewed positively as an enabler in supporting quality-based health outcomes. A key driver for this has been the leadership provided by the National Health IT Board (NHITB) with the development and implementation of the National Health IT Plan (IT Plan). The original version of this plan was released in September 2010 and was based on the sector implementing a limited number of regional and national platforms as well as a focus on developing shared care to support an integrated model of care. This has also been supported by the vendor community taking up the challenge to develop the systems required as well as accepting their part in leading the much-needed sector changes.
About the author Scott Arrol was appointed CEO and director of the New Zealand Health IT Cluster in June this year. He was previously general manager of community services for home and community-based health support services provider Healthcare of New Zealand, and a strategic consultant in change management in the health sector.
The IT Plan was then reviewed with an update released in 2013 that took the original plan further. There were four priorities identified for IT investment in 2014 and beyond: electronic medication management, national clinical solutions, regional information platforms and community-based integrated care initiatives. Considerable progress has been made in achieving the overall objectives of the original plan as well as the priorities established in the updated plan.
Whilst strong and purposeful leadership from right across the sector has been a cornerstone to achieving so much in a relatively short period of time, there still remain challenges that will need to be addressed in order for progress to continue. In the IT Plan these revolve around governance, funding and capability whilst standards, common platforms, surety of investment and reduction of inefficient practices are factors that the vendor community would also view as important.
Investment in health IT The New Zealand Health IT Cluster (NZHITC) has been playing an important role in both supporting the NHITB in the development and implementation of the IT Plan, as well as providing health IT vendors with a vehicle by which they can make a valuable contribution to the future direction of the country’s health services. Representing the majority of health IT operators, NZHITC takes a cooperative and strategic approach by bringing together both private and public sector organisations with an interest in increasing the capability, innovation and investment in health IT. The reasons behind the progress in the sector in recent times can be summed up as leadership, a common shared purpose
and a commitment to create positive, high-quality outcomes for health service consumers. New Zealand is recognised as a centre of excellence for health technology worldwide and we are advanced in terms of connecting health providers and improving information exchanges between them. However, this doesn’t come easily and has required significant investment from all parties to design and implement systems that have to take into account rather outdated legacy systems. Coupled with this have been the usual tensions created by a highly competitive employment market that makes it difficult to attract and retain the best and brightest whilst trying to balance budgets and create reasonable returns for shareholders. Despite this, global interconnectivity has created the ability for solutions to be developed from almost anywhere in the world – not only for the New Zealand market but for international health markets where a number of NZ-based companies have proven to be successful.
“Global interconnectivity has created the ability for solutions to be developed from almost anywhere in the world.” Scott Arrol
IT as an enabler As this edition of Pulse+IT goes to press, New Zealand will have a new Minister of Health following the retirement of Tony Ryall from politics. The review of the IT Plan will be in progress and everyone with an interest in the country’s health system will be focusing on where to from here. NZHITC believes that the country is on the threshold of some exciting times that will create opportunities and a whole new set of challenges that will demand innovative solutions developed by providers committed to the long haul.
We know that in 20 years’ time health services have to be delivered in very different ways. Demographic changes and pressures brought about by specific health states mean that we’ve got to think about a very different health system. This is where higher levels of complex clinical services are provided directly into consumers’ homes and the consumer takes increased responsibility for their state of health. This places IT firmly in the position of being an enabler of the flow of information so that people receive the right service, at the right time, in the right place, by the right person.
FUNDAMENTALS OF DATABASE SYSTEMS FOR HEALTH INFORMATION MANAGEMENT PROFESSIONALS HIMAA PROFESSIONAL DEVELOPMENT SERVICES Working in eHealth environment? Considering a career change into that environment? Need to develop skills to use database systems and database design tools? HIMAA’s new Fundamentals of Database Systems Course is just for you! From problem definition to design and implementation. Real-world software tools to assist in design and create structures, add data, and query the database. 6 online modules. No entry requirements. On completion you should be able to: ✓ Design and develop a database; ✓ Add tables, fields and records to it; ✓ Query the data using the most common language used in the database world: SQL; ✓ You will be provided with great software to use on your own system.
More information about the Course: Phone: 02 8877 5378 Email: information@himaa.org.au Web: http://www.himaa2.org.au
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Feature
PATIENT PORTALS: START SIMPLE, START SMALL One of the key components of New Zealand’s National Health IT Plan is to provide both patients and the health professionals caring for them with electronic access to a core set of personal health information. For patients in the community, the obvious vehicle is through the provision of general practice patient portals. While the technology is available, there are numerous barriers to their more widespread use, not the least of which is cost.
KATE MCDONALD Journalist: Pulse+IT kate.mcdonald@pulseitmagazine.com.au
Allowing patients to communicate electronically with their GPs through secure, online patient portals is one of the priority areas outlined in New Zealand’s National Health IT Plan, although whether they are available to the majority of the population this year as hoped remains to be seen. With the main GP software vendors all now offering patient portal capability and a number of general practice groups and PHOs having implemented them, the momentum is building towards the plan’s eHealth vision, which states that all New Zealanders and the health professionals caring for them should have electronic access to a core set of personal health information by the end of 2014. For general practices themselves, however, there are a number of challenges in setting up and using patient portals, not the least of which is the cost, the time and the difficulty in doing so. As in most areas of healthcare policy, the vision is one thing – the reality is another.
About the author Kate McDonald is a senior staff journalist for Pulse+IT. Formerly the editor of Australian Life Scientist magazine, she has also edited industry titles Hospital & AgedCare and Nursing Review. Her interests cover health ICT, biotechnology and translational research.
One person who is uniquely situated to advise on the challenges of implementing patient portals is Sue Wells, senior lecturer in health innovation and quality improvement at the University of Auckland’s School of Population Health. Dr Wells is a public health physician who
spent 10 years in general practice and has a research interest in computerised decision support systems and health informatics, amongst others. Recently, she was awarded a Harkness Fellowship to Harvard University, where she undertook a research project about patient engagement and interaction with healthcare services via patient portals. Part of her research involved interviewing CIOs and clinicians at a number of organisations that offer patient portals in the US, researching what strategies were most effective in successfully implementing them, what providers thought the value was to the patient and what they were specifically doing in terms of the design, navigation and involvement of patients in their portals. As well as successful strategies, Dr Wells investigated the main barriers to uptake. While the US primary healthcare system and its mishmash of private insurers and state, federal and not-for-profit providers cannot be directly applied to New Zealand, some of the lessons certainly can. Dr Wells is now working with the Royal New Zealand College of General Practitioners (RNZCGP) and the National Health IT Board to develop a range of resources to help guide practices in how
to go about setting up a portal, including templates and guidelines for privacy impact assessments and the like. A shared website will be established to provide these resources to practices so they can learn from the early adopters and don’t have to start from scratch. While patient portals are relatively simple technology on the outside – and their backers emphasise the improvements in practice productivity as well as better informed patients – the practicalities of implementing them can be onerous. “Some of the strategies for implementation are reasonably generic – what worked and what didn’t work at the practice and for frontline care – and that is what I have brought back,” Dr Wells says. “How would this work in New Zealand, what are the key learnings, and what are the major barriers for both patient adoption and provider adoption?” Dr Wells says those barriers fall into three main categories. While patients are uniformly enthusiastic and positive about the possibilities of using portals and the technology, by far and away the biggest hurdle is getting buy-in from doctors and practices. “There is the fear about the impact on their workload and the perceived impact on what it would mean for patients,” she says. “They fear it is going to be confusing for patients and that they will be bombarded by patient queries. “In order for them to buy into this and decide to use it, because it’s such a partnership between them and the patient, there’s got to be a win for the practice and for the clinician. And there are many wins. “In fact, several large US healthcare organisations reported that this was the best and the most popular intervention, for both patients and providers, that they’d ever introduced.”
“Several large US healthcare organisations reported that this was the best and the most popular intervention, for both patients and providers, that they’d ever introduced.” Dr Sue Wells
The second barrier is the workload involved in registering practices and patients. Dr Wells says it is essential that registration processes are streamlined. “In the States they often had very complicated procedures for the patients. They might send them a password but the patient might lose the letter or forget the password. They would forget how to log in. It might be a temporary password but by the time they get on – because they only get on when they need to get on – it’s out of date. “So the second big thing that I came back with is yes, it’s got to be a win for the practice, but you’ve got to make it easy for the patient and the practice for registration. “And the third biggest barrier from the provider perspective was patient access to a computer and their computer literacy. That was way down [in terms of barriers to uptake], but the major innovation being increasingly introduced to reduce the digital divide and the disparities in uptake, was to offer portals through a mobile platform. The use of smart phones was the technology of choice for disadvantaged communities. “So there are three things: it’s got to be a win, you’ve got to make it easy, it’s got to be mobile.”
Cost implications All four of the dominant general practice software vendors are now offering portals or soon will be. Market leader Medtech Global’s product is called ManageMyHealth, which is used not just in general practice but as the foundation technology for a number of national public health programs, including Beating the Blues, an online cognitive behavioural therapy-based program. It is also used to bridge the gap between the primary and secondary care sectors, as some hospital clinicians can access the system, and Medtech has also worked with medical emergency information and identification service MedicAlert to allow hospital doctors and emergency personnel to “break the glass” and access a patient’s medical history through ManageMyHealth in case of emergency. Like the other portals, ManageMyHealth lets practices offer online appointment bookings, repeat script request functionality, recall reminders for pap smears and immunisations and the ability for patients to view their medical records or lab results from within the portal. It also allows practices to communicate electronically with patients in a secure way, and is configurable for each individual practice and their preferences.
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“If anything it actually saves the practice a reasonable amount of time and money and offers new revenue streams like online consults that can actually pay for the portal.” Dr Ashwin Patel
been a lot of effort making sure it works without obstructing people’s workflow and there is no more effort for doctors to do online consults or repeat scripts. “If anything it actually saves the practice a reasonable amount of time and money and offers new revenue streams like online consults that can actually pay for the portal, so it is cost neutral or potentially a revenue earner rather than a burden.”
Significant barriers Medtech’s chief technology officer, Rama Kumble, says ManageMyHealth offers general practices the ability to conduct more chronic disease management programs while increasing the efficiency of the front desk. “One difference between our online booking and some of the others on the market is that it is very tightly integrated into the practice management system,” Mr Kumble says. “It manages all of the communications that happen between the practice and the patient, and allows the front desk staff to manage incoming online appointment requests from within the Medtech32 application.” Smaller player Intrahealth also allows patient access through its Accession product, while Houston Medical is currently working with Medtech to integrate with ManageMyHealth. The other major player, MyPractice, is also in the middle of the roll-out of its portal product, Health365, which was piloted last year and has been implemented in a number of practices over the last few months. MyPractice CEO Ashwin Patel says Health365 allows patients to access a range of information held about them in MyPractice, including a summary of their problem lists, medications, allergies and
immunisations as well as access to their full clinical notes, should their doctor think it appropriate. It also allows them to make a number of transactions with their GP, including appointment bookings, repeat prescription requests and online consults. In the future, there will be the ability for patients to upload their own health data such as blood pressure and weight measurements should they be using monitoring equipment at home. MyPractice has also developed a provider arm so hospital emergency departments and after-hours GP services can access the portal, with the patient’s permission. Any access by another healthcare provider is logged both in Health365 for the patient to see and in MyPractice’s own systems, Dr Patel says. Cost, however, is a significant barrier to wider use. Health365, like ManageMyHealth, has an upfront installation fee and a monthly subscription fee. Dr Patel emphasises that this is balanced by a reduction in administration costs for the practice, as well as the ability to offer more paid services to patients. “One of the advantages that we’ve had is that we’ve had a lot of feedback from both patients and from clinical people involved before we started,” he says. “There has
While there are obvious productivity benefits, the significant upfront costs in purchasing the technology and ongoing subscription costs for practices have limited their uptake. According to the recently retired minister for health, Tony Ryall, 78 general practices are currently offering a portal, although Medtech puts that figure at over 200. Mr Ryall announced in early September that $3 million would be made available to help general practices introduce portals, but it is unclear as yet how this money will be distributed. It is also unclear if it will overcome the upfront costs. Practices may be able to charge patients an annual fee for the convenience of using the portal, but the financial return is yet to be quantified. Dr Wells suggests that implementing patient portals needs to be looked at from a primary health organisation (PHO) level, rather than by individual practices. “This is such good technology, it’s going to potentially benefit a large proportion of our enrolled patients, but the cost barriers to practices doing it are high,” she says. “If the PHOs get together and there’s transparent contracting and pricing, they can work it out that way.” It can be a hard sell when it comes to busy practices. Supporters of patient portals make the case that there are many
efficiencies to be gained, but no one should underestimate the time it takes to set one up, Dr Wells says. “My colleagues can see that portals would make a difference, but introducing them into the practice means they have to pay for it, set up new systems and processes, have to organise the security, privacy, brochures and other patient information ... and they’re justifiably wary about all that.” They are also still a little nervous about the change in relationship that patient portals bring, with many remaining suspicious about the worth of providing clinical information to patients. GPs also often voice fears about their clinical notes being open to view and prey to misinterpretation.
When she encounters these fears, Dr Wells points to the OpenNotes project set up in the US in 2010. That project has done a lot to dispel fears about what patients would do with access to visit notes. The majority of patients who viewed at least one visit note reported that they understood their health conditions better and were able to remember their plan of care. Three out of four patients said that after reading their notes, they would also take their medications better. And doctors said there were no issues in extra workload or increased patient enquiries or concerns. Dr Wells’ research in the US has also provided evidence of what patients most value in their medical record.
HealthLink now puts referrers in the picture
“Basically, the idea is to start small, start simple, start with something that patients really value,” she says. “And the four things that were consistently reported to me from each institution that I investigated were the ability to view lab test results, ask for a prescription, being able to message their doctor and asking for or making an appointment online. They are very simple things that make a world of difference. “Do some of those things or one of those things – start simple, start small, but start and then look to see whether you want to open your notes. When you look at the OpenNotes project, it was really a nonevent for the American doctors.”
Referrers can now see images from the patient record HealthLink already delivers tens of thousands of diagnostic reports every day. Now in conjunction with Medinexus, referrers can access reports and images directly from their clinical system or via a web portal - no matter where they are. In association with
Tel: 1300 79 69 59 Email: help@ medinexus.com.au Suite 1102, 1 Newland Street, Bondi Junction NSW 2022
“We attract more referrers by delivering our reports and images via the HealthLink and Medinexus system” Radiologist, Liverpool NSW
“One of the great things with HealthLink and Medinexus is that when the radiologist calls me regarding an abnormal finding I already have the images and reports available on my screen ‘straight away’ so I can see exactly what he is referring to” Referrer, Pennant Hills NSW
“It’s so simple to use. There’s no longer any need for film or a hard copy report to be delivered to me. It’s also so convenient that I can access reports and images no matter where I am” Referrer, Sydney City
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FEAR AND LOATHING FOR PATIENT PORTALS New Zealand’s not-for-profit health IT organisation Patients First has released the first of four reports in round two of its practice management system (PMS) review, focusing on the capabilities and potential for patient portals in line with the NZ National Health IT Board’s roadmap. It has also released an updated version of its GP2GP patient file transfer system, and has seen the CEO baton change hands from founding CEO Andrew Terris to new chief Jayden MacRae.
KATE MCDONALD Journalist: Pulse+IT kate.mcdonald@pulseitmagazine.com.au
Patients First first published the original version of its practice management system (PMS) review in 2012, investigating and scoring the capabilities of New Zealand’s four main primary care PMS vendors – Medtech, MyPractice, Houston Medical and Intrahealth. The report was designed to provide a comprehensive evaluation of primary care systems in NZ and had five areas of focus: structured data within the PMS; standardsbased application programming interfaces (APIs); support for interoperability standards, with eDischarge, eReferral and ePrescribing as the priorities; information security, access and privacy; and usability, with an initial focus on ‘alert fatigue’. The first review caused a bit of a ruckus in the industry as it gave a comparative score, with some of the vendors disagreeing with the end result. For the second round of the review, Patients First has taken a different tack and will focus on four main areas, only one of which will be scored. “There’s quite a lot of learning that we took out of the first review and that was applied to the second one,” Patients First founding CEO Andrew Terris says. “Whereas the last review focused on some specific areas that we scored, what we’ve agreed with this review is that some of the areas are pretty nascent in terms of the technology
or expertise in New Zealand, so rather than have a full scored report for all of the areas, we are actually treating this more as an educational resource for the sector.” Rather than produce a large report, Patients First has decided to release it in stages as a series of briefing papers, focusing on four areas: patient portals, hosting in the cloud, support, and prescribing, with only the latter receiving a score in comparison to the other PMSs. The patient portal report, released in late September, found that while the technology is now readily available and is beginning to be adopted, there are many barriers to be overcome, including what a consumer representative characterised as “fear and loathing” from healthcare practitioners. The review provides an overview of what functions are currently available, what patients themselves want from portals and raises some questions about portals that the review panel says need to be addressed in order to reach a tipping point “which will move us from ‘why?’ to ‘why not?’” It compares the functions available in the three products on the market and also compares New Zealand’s “organic”, demand-driven and market-led approach to a national roll-out with the centralised, fully funded models that have been tried,
and some would say failed, in the UK and Australia. While it finds that there are not necessarily any architectural barriers to wider use, it does recommend that standards be introduced to untether patient portals from the vendor-specific PMS and allow data from other sources to be able to feed into existing products. What the review predominantly looks at is the questions that need to be asked at this early stage of the roll-out. These include whether patients should have full access to their EMR and whether consumergenerated data should be added to portals. It also questions the commercial viability of patient portals, raising the issue of payment models and whether consumers should contribute to the cost, as well as questions on whether patient portals increase or decrease clinician workload. While the review forecasts that it is likely that within five to 10 years a significant proportion of the population, patients and clinicians alike, will be using portals in everyday practice, it also looks at the perceived barriers to adoption in general practice. These include concerns over the additional workload of “email” consults, the uncertain financial effects of different ways of consulting – for example, through secure messaging rather than face to face – and a lack of general interest from the GP community and from patients. These barriers are also covered in an appendix by Jo Fitzpatrick, a consumer representative from the National Health IT Board’s consumer panel. “Patient portals have the potential to change the face of primary care and healthcare in general,” Ms Fitzpatrick writes. “While the possibilities are exciting, the reality is more sobering. It is easy to leap ahead to a dizzying array of possibilities and potentialities but these are accompanied by an equally dizzying
“That will provide a very easy way for purchasers and the user community to look online and see that if they are choosing this product, how do they know it is actually compliant with the standards.” Andrew Terris
array of challenges and barriers. It is important to tread carefully and walk before we run. The path forward is one of small steps ...” Ms Fitzpatrick urges that the value to the patient of better communication with healthcare providers not be forgotten in the discussion on barriers to implementation, and that while cost is one of those barriers, she warns that there is “no consumer enthusiasm or expectation” that these costs will be borne by patients. However, the biggest barrier to the use of portals, she says, is “the fear, and sometimes loathing, from anxious health practitioners who imagine a future fraught with the multiple challenges of change”. “While this fear is not unfounded, it is one we can discuss and resolve together. We need to start the journey towards patient portals, one small step at a time, always ensuring that we are all comfortable with the incremental changes involved.”
Software certification Patients First hopes to add the information gained in these reviews to its plans for a national certification system for medical software. Patients First has already built an integration platform through which vendors can test their products against certain technical standards. The idea is to
ensure that there is an independent way to assess vendor offerings and offer guidance to vendors on how to comply. “One of the original criticisms that was levelled at us – and it was probably fair – was that the first review was quite subjective and not that objective,” Mr Terris says. “It was probably 70 to 80 per cent subjective and 20 per cent objective, and the goal is basically to invert that ratio. “We still see a need for a clinical expert group of users to be able to make comments on the various PMSs’ usability, but we want to balance that out with ... published standards that PMSs should be complying with. That will provide a very easy way for purchasers and the user community to look online and see that if they are choosing this product, how do they know it is actually compliant with the standards.”
GP2GP Patients First has also released an updated version of its GP2GP patient file transfer system, featuring an increase to the file size limit and some back-end fixes that promise to make the system run more smoothly. GP2GP has been operating in New Zealand for over two years to allow general practices to easily transfer medical data when a patient moves out of an area or to a new practice.
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“You do have some people with quite a lot of information in their medical records so we are now supporting 20MB transfers.” Jayden MacRae
Patients First’s new CEO, Jayden MacRae, says the main new feature was an increase in message size from 5MB to 20MB. “It has been limited to 5MB in the past, which for most patients is more than sufficient, but you do have some people with quite a lot of information in their medical records so we are now supporting 20MB transfers,” Mr MacRae says. “That’s a four-fold increase and should cover the vast majority of the population.” GP2GP is a completely voluntary system with no financial incentives to use it, and yet Mr Terris estimates that it has seen upwards of 95 per cent adoption across the general practice community.
“We think that adoption is driven on the utility that they find with the service,” Mr Terris says. “We went out there and said we think this functionality will save you time and it is much safer than getting an inbox document with all of the previous records in an unstructured way.” Mr Terris says the main incentive for practices to use the system was the time saved by practice staff on printing, photocopying and licking envelopes. On the importing side, it also saves time for the receiving practice in that they don’t have to re-enter patient data. The actual technology behind how it works is a case study in co-operation between the PMS vendors to achieve an easy to use
system, something that seems unlikely to happen any time soon in Australia. Mr Terris says the secret weapon was a toolkit developed by Patients First and the vendors that they affectionately call babelfish, after the instant translator in Douglas Adams’ The Hitchhiker’s Guide to the Galaxy. Babelfish acts as a piece of middleware between the differing systems that is able to translate data moving from one system to another, where it is downloaded straight into the recipient’s PMS. “Using that approach rather than going to each vendor and getting them to build a component is probably a bit lucky, but on reflection it is an incredibly useful way of doing it and is a contrast with some of the challenges that you are experiencing in Australia,” Mr Terris says. “We use the term ‘co-opertition’. Yes you can compete on your service and your products, but when you actually have the same functionality, it makes sense to team up. And that’s really the philosophy that the PMS vendors went into GP2GP with.”
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TELEHEALTH DEMONSTRATION PROJECT:
BUILD IT AND SEE WHO COMES A telehealth demonstration project that has been running in New Zealand’s Bay of Plenty region over the last 18 months has recently been extended for another six months, having experienced good uptake in Maori health clinics but also facing a number of challenges for district nurses and residential aged care. It is one of a number of new ventures in telehealth in NZ that aims to take advantage of ultra-fast broadband.
KATE MCDONALD Journalist: Pulse+IT kate.mcdonald@pulseitmagazine.com.au
The telehealth demonstration project has been funded by New Zealand’s Ministry of Business, Innovation and Employment (MBIE) to demonstrate the capability of telehealth to improve healthcare delivery as part of the roll-out of New Zealand’s Ultra-Fast Broadband and Rural Broadband initiatives. It was designed to see what would happen if a dedicated project facilitator was put in place to actively provide assistance to healthcare providers to get started using telehealth. While there are several other regions using telehealth – including Canterbury, which provides services to the west coast of the South Island, and throughout Northland – this project aimed to get a better understanding of what the drivers of the broadband roll-out would be in the health sector. Project facilitator Ernie Newman says the Bay of Plenty region was chosen as the national demonstrator, with a focus on primary and community care rather than hospitals. The Tairawhiti region then came onboard, with the project concentrating on the long stretch of coastline on the east coast between Opotiki and Gisborne. “The National Health IT Board and the Ministry of Business, Innovation and Employment are partners as well, so we’ve had 18 months to see what can be done
if you put a project facilitator in place and go around offering people assistance to actually get telehealth started, then leave them and see what emerges and see what doesn’t,” Mr Newman says. “The terminology I use sometimes is ‘build it and see who comes’. It’s a matter of targeting health sector people who face issues with isolation and who are changereceptive, and giving them video facilities. They’ve usually already got the connectivity and they’ve already got the computer – and all the project has to do is give them a high-speed, high-definition camera on long-term loan and work with them on how to build video into their business models and clinical pathways.” The project is using the free version of Cisco’s Jabber video platform rather than Skype, for both security and quality reasons. The quality of Jabber cameras is excellent, Mr Newman says, but there is a concern about the long-term support Cisco is planning to provide to the platform. “The hard part is to inculcate this into clinical workflows and practices,” he says. “Software is the least of our worries. There are other systems there that could pick it up if by any chance Jabber falls over.” While video conferencing has been used in the hospital sector for a number of
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years, predominantly for case conferencing and education, this project was aimed at healthcare provision beyond the hospital sector. “We didn’t look to reinvent what was already happening so that’s why our mission has been to go out into GP practices, Maori health clinics, hospices, aged care, and other health premises where we can see the potential for the use of this technology,” Mr Newman says. “We’ve had a focus particularly on areas where remoteness is an issue.” This is where the project has had some early successes, such as the Matakana Island video doctor service. The small island situated in Tauranga Harbour has a
population of about 300 and was formerly visited by a GP from the mainland every fortnight. Now, the GP is accessible by video every weekday. Mr Newman said this had proven both more economical for the health system and more flexible for the island residents, who no longer have to take as many trips onshore.
Opotiki telehealth community Another success has been the Opotiki Telehealth Community, where every GP now has video capability, both in their clinics and at home. The small Opotiki Community Health Centre, which has a handful of in-patient beds predominantly
for maternity patients, is staffed by nurses who periodically get an emergency case. Using video conferencing, nurses can contact the duty GP after hours at his or her home, and they can also directly link to the emergency department at Whakatane Hospital if needed. “That’s being used quite regularly now and is resulting in much better decisions about how to handle those cases,” Mr Newman says. “Also, it’s providing a lot of comfort to the patient and their family because they can see that the doctor is not just an inanimate voice at the end of a one-way phone call. That one’s working pretty well.”
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Several other of the small health clinics and Maori medical centres dotted along the coastline between Opotiki and Gisborne are also hooked up. “If you take the long way around East Cape it’s about 340 kilometres to Gisborne,” he says. “There are a couple of population centres but you’re talking about a dairy, gas station and a pub and nothing much else. “Most of those centres have a health clinic operated by, in most cases, a Maori health provider organisation. There are nine of these, and we have put video capability into all of those nine. Much of the time they are staffed just by a nurse with doctors who rotate and visit a different clinic each day. “The benefit of telehealth is that the nurse can then call up the doctor if they need to over video, and the doctor and the nurse together can evaluate the patient and they can share the decision about the pathway for them.” While Tauranga Hospital has extensive video capability for internal staff, the project hopes to encourage some hospitalbased services, particularly for mental health and long-term conditions, to also be delivered by telehealth into the community. It is also working well for patients with diabetes to receive dietary advice and to keep in regularly contact with care teams, as well as with smoking cessation programs. “With those sorts of programs, the patient benefits from a brief video session every week, rather than just a longer one once every three months,” Mr Newman says. “They can come down to the clinic and they can meet with the person running the program by video. “And increasingly other hospital services are starting to come in behind that. We’ve got hopes that a lot of long-term conditions
can be monitored with a balance between physical visits and video.
a visiting nurse doesn’t add up. We’re not quite ready for that yet.”
“What we’re doing is not rocket science. It’s simply applying some resources for busy clinicians who otherwise would be too preoccupied with business as usual. We’re giving them the encouragement and support to innovate, in the expectation of starting a chain reaction.”
For aged care, the main barrier seems to be that GPs still prefer to see a patient in person, even if that means transporting an elderly, frail person away from their bed. This is a complicated sector of healthcare that has a number of unique challenges, Mr Newman says.
Challenges in aged and community care
“To my mind, video for aged care facilities should be universal. My personal view is that every aged care facility should have video, and every GP working in the aged care service ought to be able to connect from time to time by that means. But it’s not that easy to actually convince busy GPs to give it a try.
Not everything the project has tried has worked, with a number of challenges in district nursing and aged care. Mr Newman says the use of video by district nurses was one area the project hoped to see good uptake, but bandwidth in residential areas has proved a problem. “There’s a lot of health premises where bandwidth is available and is running really well, and the reason we’ve been able to connect all of those clinics is that there is now fibre optic right around there which was put in for the government’s rural broadband initiative to strengthen the cell phone network in rural areas. “That fibre optic cable enables a wireless link to be set up from the nearest link point through to the health clinic, and support very acceptable video quality. But we haven’t yet got the cellular network to a point that they can take video into a patient’s home and have a reasonable chance of being able to video back to base with the patient in the picture. “The rural cellular network has strengthened the voice network, but to get the data on it requires a directional aerial on the roof of the premises pointing at the nearest cell site. “That’s workable for health clinics, because they’re using this with some regularity. But obviously in a domestic situation, the cost of that purely to support
“There are a number of reasons for that including the remuneration model, and the sense that it looks a lot more complicated to connect with a patient by video than to have them join their place in the queue in the doctor’s rooms. And medico-legal risks have not really been addressed. “All of those are valid concerns, and until we can get around those telehealth in aged care facilities is going to be quite challenging, but I see that as an area of real potential for telehealth.” The designated timeframe for the Telehealth Demonstration Project has been extended, but it is likely that the government will encourage the District Health Boards to take over responsibility for promoting telehealth, he says. The next steps are still being discussed, but what the project has been able to investigate is what works and what doesn’t at the moment. “It’s all about creating and building up the networks so that over time it will become an expectation that every health premises is video connected just as you’d expect them to have a telephone.”
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ORION PLANS TO TAKE ON THE BIG GUYS IN HEALTH DATA REVOLUTION
Orion Health has grown into one of New Zealand’s best-known IT companies over the last decade and plays an active part in the acute care sector in both Australia and New Zealand. Its major market, however, is the US, where it is a leader in health information exchange (HIE). In the next decade, it plans to take on the big players in hospital information management by harnessing the power of the health data revolution.
KATE MCDONALD Journalist: Pulse+IT kate.mcdonald@pulseitmagazine.com.au
Orion Health has certainly come a long way since founder Ian McCrae set up Clearfield Consulting in 1991 and started tinkering with software for clinical purposes in his spare time. In 1997, McCrae and his team came up with the idea of a web browserbased portal for clinical applications, something that was completely unheard of at the time. Over the years, the company has brought out a range of products – many with a musical name, which Mr McCrae says had no particular reasoning behind it – including the Rhapsody integration engine, Concerto clinical portals, Symphonia messaging and mapping tools and Soprano medical records and specialty forms. Since then it has grown steadily, with big wins in the US, where it is widely used for regional health industry exchanges (HIE), as well as a firm footprint in its home nation and a good slice of the market in Australia, where its technology has been used to build the consumer and provider portals for the PCEHR. Now, Orion Health has outlined its plans to overtake the global health IT giants and do to healthcare what Facebook has done to social media by developing “thinking” software that can harness new data sources, use machine learning and provide more precise healthcare delivery.
Orion Health CEO Ian McCrae says the company plans to double its product development capabilities by the start of 2016 and to invest in large-scale R&D programs to “have a crack” at revolutionising healthcare much like Facebook has done to our social lives. Orion Health has also restructured internally and dropped some of those musical brands, splitting into three solution groups called Intelligent Integration, Healthier Populations and Smarter Hospitals to better reflect the different market segments they service. Within the latter, Orion has developed three different solutions – Enterprise, Consult and Medicines – that together can provide a solution that can run a whole hospital end to end but can also to reach into community healthcare. It is with these solutions that it plans to take on the big guys. While the company’s current position in the HIE market has been improved by the buy-outs of most of its competitors – Medicity, Axolotl, CareFX and dbMotion – Mr McCrae plans to expand beyond HIE and overtake the giants: Cerner, McKesson, Epic and Allscripts. The big four bring in enormous revenues – Cerner’s annual revenues are estimated to
be $3 billion, as is McKesson’s, while Epic brings in about $1.7b and Allscripts $1.4b – and in comparison Orion’s are a relatively paltry $160 million. However, Mr McCrae believes that a revolution in health data over the next decade will fundamentally change that, and the face of health IT. “We are going to go from 500 petabytes of data (in 2012) to 25,000 petabytes pretty quickly (2020),” he says. “The clinical data repositories out there today can’t store that amount of data. Over the next decade, lots of things are going to happen in genomics, wearable sensors, ingestibles, tissueembedded sensors, mobile health and social health.
“Over the next decade, lots of things are going to happen in genomics, wearable sensors, ingestibles, tissue-embedded sensors, mobile health and social health.” Ian McCrae
“Over the next decade, things are going to change a lot. We would like to become one of the leading software vendors pretty much like Facebook did to our social lives.
Orion Health CEO Ian McCrae (left) with Waitemata District Health Board CEO Dale Bramley.
“There is an opportunity for someone to do that in the health area. We’d like to have a crack at it.”
R&D investment Mr McCrae says Orion’s real strength lies in the fact that its current technology is pretty recent while others are still working with relatively old tech. It also uses just two code bases – the Java web-browser code set it started with and the Microsoft code set it inherited with its purchase of Microsoft’s Amalga health information system (HIS) in 2012 – which the company is current combining. “Many of our competitors are M&A companies with 30, 40, 50, 100 different code bases and they have a problem trying to merge those things together,” he says. Orion now plans to heavily invest in R&D to be in the position to harness what Mr McCrae calls the health data revolution. “[Currently] all we do is take existing data, format it up and present it back to the users. It’s pretty dumb software. We should have thinking software – we should be reasoning, making suggestions all the time. At the end of the day it is the doctors and nurses who make the final determination, but we can help a lot. “The first thing to do with thinking software is to get all of the data from the traditional data sources and put it into a bucket, then format it nicely and serve it back up to
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doctors and nurses. We can do that today and do it pretty well. Then the next thing you want to do is serve it up to the patient and their circle of care. “Then we need to add new data sources – devices, genomics, business data, payer data – all into the same repository. Then we need to add machine-learning, reasoning logic to the data, because ultimately what we want to do is have precise health. “So to get from here to there, we are talking about some very large R&D programs. All of the products that we have today will probably be obsolete a couple of times over, so R&D is very important. We are going to grow our product development
shop quite significantly, across several locations. “What we are about to see is this fundamental, once in a generation change in healthcare, which is pretty exciting. What we are about is creating modern, web 2.0, thinking software.�
Smarter hospitals Wayne Oxenham, Orion Health’s executive vice president for Smarter Hospitals, says that in addition to segmenting the business into three solution groups, the product portfolio had also been split into three different solutions – Enterprise, Consult and Medicines – with the latter’s full-line solution to be launched in 12 months.
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The Enterprise solution encompasses the full product offering that can run a hospital end to end, including electronic medical records, patient administration systems, clinical systems and health information exchange. Much of the core of the solution has been developed from Microsoft’s Amalga HIS, which Orion purchased in 2012. The Consult solution, which is based on Concerto, and the Medicines solution, which is still in development, can be provided separately but are also part of the full Enterprise solution. “It is is functionally rich and can run a whole hospital end to end,� Mr Oxenham says. “We think is has some really nice
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the informational and learning power of the networking event of the year. The Conference already offers a stellar line-up, ď€ ď€ with: Dr Berdirhan Ustun ofď€ the WHO (Geneva) on international clinical classification developments, Assoc Prof Joanne Accelerated Designed who and wishJulie to complete our Comprehensive &RPSUHKHQVLYH 0HGLFDO 7HUPLQRORJ\ ď€ -XO\ 6HSWHPEHU 1R SUHUHTXLVLWHV ď€ &RPSUHKHQVLYH 0HGLFDO 7HUPLQRORJ\ ď€ -XO\ 6HSWHPEHU 1R SUHUHTXLVLWHV ď€ &RPSUHKHQVLYH 0HGLFDO 7HUPLQRORJ\ ď€ -XO\ 6HSWHPEHU 1R SUHUHTXLVLWHV ď€ Callen on eHealth, Assoc Prof Terri Jackson onProgram safety and –quality, Assocfor Profstudents Graeme Miller Gordon on linking primary and tertiary care through classification, Cathy Richardson, workshopping SNOMED-CT, classification, Medical Terminology course andNEHTA, HLTCC301B Produce coded clinical data within ,QWURGXFWRU\ ,&'ď€ ď€$0 $&+, DQG $&6 +/7&& % -XO\ HQUROPHQWV ď€ ,QWURGXFWRU\ ,&'ď€ ď€$0 $&+, DQG $&6 +/7&& % -XO\ HQUROPHQWV ď€ ,QWURGXFWRU\ ,&'ď€ ď€$0 $&+, DQG $&6 +/7&& % -XO\ HQUROPHQWV ď€ terminology,QWHUPHGLDWH ,&'ď€ ď€$0 $&+, DQG $&6 +/7&& % $XJXVW HQUROPHQWV ď€ and analytics for,QWHUPHGLDWH ,&'ď€ ď€$0 $&+, DQG $&6 +/7&& % $XJXVW HQUROPHQWV ď€ HIMs, the NT’s pioneering My eHealth Record, Adj Prof Rick Marshall on casemix in the UK, ,QWHUPHGLDWH ,&'ď€ ď€$0 $&+, DQG $&6 +/7&& % $XJXVW HQUROPHQWV ď€ 12latest months. and James Downie, IHPA, on the in ABF.
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[user interface]. We’ve got integration strength and this solution also pulls in open technologies, so we can take information into our system and export it out of our system or publish it from our system so other people can use it. “A lot of people are frustrated with things like patient administration systems where you can’t put data in unless you key it in. You can’t get data out in a useful form unless you get someone to write a lot of expensive code. We are passionate about creating open systems with good integration points that other people can leverage. “We are pretty close to finishing off a solution that is multi-tenant – we can install one instance of our Enterprise solution, and it can run many hospitals. It is very scalable, and the technology that underlies it can grow rapidly with the demands on it.” The Consult solution encompasses what most users would know as Orion’s Concerto suite in addition to some added extras. This includes a clinical review – what Concerto can do now in terms of webbased, single sign-on access to a range of clinical systems – along with diagnostics, whiteboards and problem lists, and the new Medicines solution. This solution will be suitable for Commonwealth countries like New Zealand and Australia, where hospitals and health services have limited funding and need to continue to use clinical software bought over time. “You might have bought a patient administration system, a lab system, a radiology system but you don’t have them all together and accessible in one place to make sense to its users,” Mr Oxenham says. “Consult is really about sitting on top of those best-of-breed solutions and
“Consult is really about sitting on top of those best-of-breed solutions and providing views that are relevant to the user into that existing system.” Wayne Oxenham
providing views that are relevant to the user into that existing system. Then we have ‘doing on top of the viewing’, which is about orders, referrals, clinical documentation, whiteboards, problem lists. Our Consult sits on top of other people’s solutions.” The Medicines solution will have full medication ordering, pharmacy, medicines administration, medicines reconciliation and clinical decision support. While the medicines reconciliation function is available now, the full end-to-end solution is still in development and will be available sometime in the next year. Orion Health is about to go live in the next few weeks in a brand new hospital in Turkey that uses the full end-to-end solution, the Koc University Hospital in Istanbul.
Long white health cloud Closer to home, the new Patient Information Care System (SI PICS) that is due to be rolled out to all hospitals in the South Island of New Zealand from next year is being built on the Consult platform. SI PICS will be a single patient management and administration system used by all hospitals in the South Island and will replace systems such as HOMER, which currently handles patient demographics, admissions, transfers and discharges.
It aims to streamline and standardise patient flow across the five South Island district health boards (DHBs) and help to coordinate care between different hospitals and providers. The solution will include data on patient demographics, appointments, clinical records, in-patient admissions, discharges and scheduling, and will eventually reach out into community care. Orion has also signed a three-year agreement with Waitemata District Health Board (DHB) to co-develop eHealth initiatives at Auckland’s North Shore Hospital based on its national Long White Health Cloud (LWHC) platform. Orion Health’s NZ country manager Jerome Faury says the LWHC platform – which includes the Smarter Hospital and Intelligent Integration solutions – can be provided as a software-as-a-service (SaaS) model that supports the company’s latest products with continuous delivery architecture. An initial focus of the partnership will be on making the two wards paperless by using a range of electronic systems to replace traditional paper-based processes, and can potentially involve patient engagement systems, direct secure messaging, clinical portals, mobile technologies, medicines management and clinical information system, as well as its big data platform and electronic referrals.
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Argus ACSS AAPM P: 1800 196 000 / +61 3 9095 8712 F: +61 3 9329 2524 E: headoffice@aapm.org.au W: www.aapm.org.au The Australian Association of Practice Managers (AAPM) was established in 1979 as the national peak association supporting effective practice management in the healthcare sector. The Australian Association of Practice Managers: • Provides education, resources, networking, advice and assistance to promote excellence in healthcare practice management. • Represents practice managers and the profession of practice management throughout the healthcare industry. • Promotes professional development and the code of ethics through leadership and education.
ACIVA E: secretary@aciva.org.au W: www.aciva.org.au The Aged Care IT Vendors Association (ACIVA) was formed in early 2010, a not-for-profit organisation, incorporated in NSW. ACIVA represents the residential aged and community care sectors and vendors at various national forums regarding strategic developments and eHealth. ACIVA members are residential aged and community care software vendors, industry benchmarking software, financial software, call-bell, hardware, networking, infrastructure and industry partners. Members are committed to furthering the interests of residential aged and community care in national forums to ensure eHealth and access to the personally controlled health record (PCEHR) becomes a reality for the aged care industry in the very near future. Contact: Emma Pate emma.pate@eostech.com.au
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P: 1300 788 005 / +61 2 9632 0026 F: +61 2 9632 0096 E: sales@acsshealth.com W: www.acsshealth.com ACSS provides innovative and customisable patient management software streamlining day-to-day operations for GPs, Allied Health, Specialists, Radiologists, Pathologists, Private and Public Hospitals. eClaims® — Comprehensive and robust appointment and billing system with digital/voice recognition capabilities, electronic reporting transmissions and HL7 PACS system integration. eClaims® Hybrid — A solution tailored to Hospitals and other health service providers including billing agents who lack online capabilities. eClaims® Hybrid is the interface solution for connecting you to Medicare and health funds through ECLIPSE. SimDay® — Proven PAS (Patient Administration System) specifically designed for day surgeries and private hospitals – Now with ECLIPSE integration.
P: +61 3 9037 1000 F: +61 3 5335 2211 E: argus@argusconnect.com.au W: www.argusdca.com.au Argus provides and supports Argus secure messaging software; a popular electronic solution that enables healthcare practitioners to exchange many forms of patient related information securely and reliably and to Australian standards.
Best Practice
Argus interfaces with most clinical software applications sending directly from within your letter writing facility or word processor and runs virtually invisibly in the background. Documents sent using Argus can be automatically added to electronic patient records; thus avoiding the need to scan or manually file them.
Best Practice sets the standard for GP clinical software in Australia offering a flexible suite of products designed for the busy GP practice, including:
Argus is the messaging solution chosen by many Medicare Locals through the ARGUS AFFINITY program delivering eHealth strategies across Australia. With over 17,000 users Argus continues to grow in popularity by delivering highly secure messages, a reliable product, backed by outstanding customer service all at the lowest cost possible.
Advantech’s medical computing platforms are designed to enhance the quality and efficiency of healthcare for patients and users alike. All of Advantech’s medical PCs match the performance of commercial PCs but are medically rated to UL/EN 60601-1 third revision, IPX1 drip‑proof enclosures and are designed to suit ward and theatre based applications. Advantech offers long term availability and support plus a proven track record of reliability. The medical range extends through: • Point-of-Care Terminals. • Mini-PC and Medical Imaging Displays. • Mobile Medical Tablets. • Computerised Medical Carts. • Patient Infotainment Terminals. Advantech is also an official distributor of Microsoft Windows Embedded software across Australia & New Zealand.
• Best Practice Clinical (“drop-in” replacement for MD) • Integrated Best Practice (Clinical/ Management) • Best Practice Automatic SMS reminders Visit us at the following conferences throughout the year: • • • • •
BP Summit, 14-16 March GPCE Sydney, 23-25 May RDAQ Brisbane, 6-8 June GPCE Brisbane, 12-14 September RACGP Adelaide, 9-11 October
Cerner Corporation Pty Limited
Advantech P: 1300 308 531 F: +61 3 9797 0199 E: info@advantech.net.au W: www.advantech.net.au
P: +61 7 4155 8888 F: +61 7 4153 2093 E: sales@bpsoftware.com.au W: www.bpsoftware.com.au
Australasian College of Health Informatics E: Secretary@ACHI.org.au W: www.ACHI.org.au The Australasian College of Health Informatics is Australasia’s Health Informatics professional body, representing the interests of a broad range of clinical and non-clinical e-health professionals. ACHI is the community of Health Informatics thought-leaders in Australasia. ACHI is committed to quality, standards and ethical practice in the Health Informatics profession. More information is available at: www.ACHI.org.au Join the ACHI Info email list at: www.ACHI.org.au/List
P: +61 2 9900 4800 F: +61 2 9900 4990 E: AsiaPacific@cerner.com W: www.cerner.com.au Cerner is a leading global supplier of health care information technology solutions engaging across Australia for 24 years. We partner with health services ranging from tertiary referral academic hospitals to rural health facilities. Our vision of proactive health care management drives innovation to address today’s health care challenges, while creating a foundation for tomorrow. The best way to solve a challenge is through innovation as evidenced by our Forbes ranking as 13th most innovative company worldwide. Our focus for Australia is driven by realising improvement in clinical outcomes. Facilitating clinical transformation, while delivering capability to manage the overall health status of the population, contributes to better health and care.
CONNECT DIRECT Pty Ltd
cdmNet P: +61 3 9023 0800 F: +61 3 9614 2650 E: info@precedencehealthcare.com W: www.cdmnet.com.au cdmNet is the Number One collaborative care management product in Australia. cdmNet is the only care management product endorsed by the RACGP as supporting quality improvement in general practice. cdmNet helps practices take a systematic approach to chronic disease management and preventive care. It simplifies collaboration with the care team and ensures regular follow up and review. University trials show cdmNet results in improved quality of care and better patient outcomes (Med J Aus, 201; 199: 261-265). cdmNet eliminates paperwork and makes compliance with Medicare requirements easy. It increases the productivity of the entire practice. Regular users of cdmNet show substantial increases in revenues from MBS-rebated services. If you wish to use cdmNet to provide high quality care for your patients while increasing your revenues, contact us now.
Cutting Edge Software P: 1300 237 638 E: enquiries@cesoft.com.au W: www.cesoft.com.au Cutting Edge produces affordable, intuitive billing solutions for Mac, Windows, Linux and iPad. Cutting Edge is ideal for practitioners who prefer to maintain control of their own billing from a number of sites. Cutting Edge Software is approved by Medicare Australia to manage your electronic: • Verification of Medicare and Fund membership • Bulk Bill and Medicare claims • DVA paperless claims • Inpatient claims to Health Funds We have solutions tailor-made for: • Anaesthetists • Surgeons/Surgical Assistants • Physicians • GPs • Allied Health The software comes with up-to-date schedules for MBS/Rebate, Gap Cover (all registered health funds), Workers’ Compensation, Transport Accident authorities and DVA.
Cloud9 Software P: 1300 875 297 F: +61 2 9715 6573 E: globalsales@c9s.com W: www.c9s.com At Cloud9 we understand the complexity of healthcare. We understand the importance of having the right information available when and where it’s needed. So Cloud9 created an eco-system to connect healthcare providers that supports the availability of key information to improve outcomes for the patient, clinician and organisation alike. An information infrastructure with real-time access across primary, community and acute setting benefits Clinicians trying to provide the best care for individuals as well as Researchers looking to improve safety and effectiveness of treatments. Our e-Health infrastructure has been designed to fit in with your current systems, whilst Cloud9’s next generation administrative and clinical applications allow you to upgrade existing systems as your business grows. Cloud9 Solutions: • Cloud9 Spine, Health Information Exchange • Synchronicity, Application Integration Suite. • Clarity for GP’s and Specialists. • Clarity Hospital Information System.
Digital Medical Systems P: 1300 865 977 F: +61 3 9753 3049 E: inform@dgs.com.au W: www.dgs.com.au EASIER MEDICAL IT is a technology partnership with DMS – we make IT work for you. DIGITAL MEDICAL SYSTEMS has provided ICT solutions and services to medical practice clients across Australia since 1990. We have specialist expertise and experience in the installation and support of all Australian leading medical software applications. DMS is a Business Partner for IBM, LENOVO, HP, CISCO and Microsoft. Other leading ICT brands include Webroot Secure Anywhere, StorageCraft, CA, Toshiba, Canon, Epson, Kyocera, Fujitsu and Brother. Accreditation is easier with the customised DMS IT Systems Policy and Procedures Documentation. This ensures your practice has the best IT policy, security and maintenance program that meets and exceeds the standards guidelines from the RACGP.
P: 1300 557 550 / +61 7 5478 5510 F: +61 7 5478 5520 E: support@directcontrol.com.au W: www.directcontrol.com.au Direct CONTROL is the innovative answer to administrative excellence integrating with Microsoft Office, accounting applications, the OOP, clinical applications and Medicare Online. Included are all fee schedules (Medicare, DVA, Work Cover, TAC, CTP, Private Health Insurance) with built in rules relevant to each medical discipline (Allied Health, General Practice, Surgeons, Physicians including Oncology, Anaesthetists, Pathologists, Radiologists, Day Surgeries/Hospitals). Manage Episodes of Care including State, Federal and Health Fund Statistical Reporting for Day Surgeries/ Hospitals. Restructuring work flow with Direct CONTROL guarantees to provide remarkable results, enabling you to grow your business and increase cash flow.
World leading DTech provides 24x7 near Real-Time Monitoring and Management technologies sends alerts and enables our engineers to quickly troubleshoot and remotely solve problems fast of security, network, Internet, server and software on almost any client computer system or device – most are fixed in minutes… Proactive, Flexible, Consistent, Reliable, Audited, and Affordable - for the smallest to the largest practice. Call DMS for: • Systems Analysis, Solutions Design & Consulting • IT Systems Documentation for Accreditation & Compliance • Procurement & supply of leading brand hardware, software, network and peripheral products • Full Installation & Configuration services • On-Site and Remote Technical IT Support • 24x7 IT support Help Desk with extensive medical software expertise • 24x7 DTech Monitoring, Maintenance & Management • Disaster Recovery solutions • Fully managed Online Backup customised for clinical data • Fully managed Internet and Web Security
Doctors Control Panel E: www.pracsoftutilities.com W: PSU_admin@pracsoftutilities.com • Download and trial DCP software for GP’s and health teams. • DCP is your digital PA and guidelines advisor. • DCP facilitates TCA, GPMP and MHCP creation and tracking. • Contains guidelines licenced from RACGP. • Low annual subscription. • The best preventive care add-on software in Australia. • Compatible with MD3 and BP. • Achieve new heights in preventive care performance. • Significant benefit for patients. • Increase your revenues. • Streamline your workflow. • 3000 current users. • Several research projects based on DCP. • Try it today.
EASIER MEDICAL IT – Call 1300 865 977
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Emerging Systems P: +61 2 8853 4700 E: sales@emerging.com.au W: www.emerging.com.au/ehealth Emerging Systems is a market leader of healthcare information and integration technology solutions. Our eHealth products and services have supported clinicians in leading Australian public and private hospitals for over a decade to deliver safe, quality healthcare. The award-winning EHS Clinical Information System is a modular, patient-centric system providing a wide range of clinical functionality to track, record and monitor patient care from pre-admission to discharge creating a multi-disciplinary EMR - improving clinical communication and patient flow while reducing patient risk. PCEHR Compliant. EHS Clinical Mobility Solution further enhances multi-disciplinary clinical communication. Emerging Systems provide clients with a full range of tailored IT services including Consultation and Managed IT Services.
Extensia
GE HCIT Solutions
P: +61 7 3292 0222 F: +61 7 3292 0221 E: enquiries@extensia.com.au W: www.extensia.com.au
P: +61 2 9846 4000 F: +61 2 9846 4001 E: GEHCinfo@ge.com W: www3.gehealthcare.com.au
Extensia links healthcare providers, consumers and their communities for better and more efficient health care. The products used to do this can be custom branded for all Organisations and include:
Connecting productivity with care
• RecordPoint – a proven Shared Electronic Health Record that links all clinical systems, hospital settings, care plan tools and any other sources of information available. It provides a secure means of sharing critical patient data in a privacy compliant and logical structure. • EPRX – an Electronic Patient Referral Exchange and Directory. It streamlines the process of selecting a provider and completing a referral. Patient information is transferred seamlessly from clinical software. The most relevant providers, services and products are presented instantly and referral documents are generated and sent electronically.
P: +61 2 8985 6688 / 1300 799 904 E: enquiries@episoft.com.au W: www.episoft.com.au Accessible anytime, anywhere and on any device, Episoft deliver comprehensive clinical, practice and research management software in one seamless system that facilitates multicentre investigator initiated trials.
Affordable and scalable, EpiSoft is used by: • Private Hospitals • Medicare Locals • Public Hospital outpatient departments • Specialist clinics Create multidisciplinary teams, collaborate effortlessly and streamline workflows with our intuitive cloud based software.
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• Clinical solutions to drive improved patient outcomes • Robust clinical data at the point of care • Imaging solutions to drive productivity • Analytics to improve efficiencies and reduce cost • Interoperability with other systems. Centricity Perinatal integrates documentation and foetal monitoring. The Connect module integrates perinatal information in context with other clinical data, continuously and on one screen – enabling clinicians to see perinatal and enterprise EMR data at the same time. Remote access allows clinicians to view foetal strips while away from the hospital, providing continuous access to clinical expertise. Centricity Perioperative integrates and simplifies surgery management and anaesthesia workflows throughout the pre-op, intra-op and post-op care areas, helping to manage anaesthesia and nursing documentation, scheduling, operating theatre inventory and more.
EpiSoft
EpiSoft has developed platforms for chronic disease management for: • Cancer including surveillance and infusion medication management • Hepatitis treatment including GP shared care programs • Mental Health • Indigenous Health • Respiratory disease • Specialised surgery • Pre-admissions patient portal
GE Healthcare IT provides robust clinical and imaging solutions that help you do more with less.
Genie Solutions P: +61 7 3870 4085 F: +61 7 3870 4462 E: sales@geniesolutions.com.au W: www.geniesolutions.com.au Genie is a fully integrated appointments, billing and clinical management package for Specialists and GPs. Genie runs on both Windows and Mac OS X, or a combination of both. With over 3000 sites, it is now the number one choice of Australian specialists.
Centricity Imaging Solutions will help you simplify your workflows, access data, and collaborate efficiently. They provide radiologists and physicians with tools to collaboratively inform the patient treatment plan and enhance decision-making. Our portfolio includes: Picture Archiving System (PACS), Radiology Information System (RIS), Universal Viewer, Vendor Neutral Archive, and Image Exchange for departments, enterprises, and communities. GE Services can increase usability, enhance performance, and optimise a solution’s ROI. Our offering includes consulting, implementation, customisation, education, support, and enablement services.
GPA P: 1800 188 088 F: 1800 644 807 E: info@gpa.net.au W: www.gpa.net.au Specialising in general practice accreditation, and with a well-deserved reputation for meeting practices’ needs, GPA ACCREDITATION plus continues to deliver innovation, attention and proven customer satisfaction to practices nationwide. Founded in 1998 by a team of general practitioners, GPA was established to give practices a choice of accreditation provider, making a commitment to promote the benefits of accreditation, and encourage ongoing quality improvement in the process. Whilst accreditation gives practices access to Practice Incentive Program payments, we believe it should offer benefits that go beyond financial incentives. The GPA program offers a unique preliminary document review, using a secure online portal that doubles as a library of your practice documents. Your dedicated Quality Accreditation Manager will guide you through the accreditation process, providing you with feedback and advice. Our carefully selected surveyors will ensure your survey visit is an opportunity to show off your practice and engage with your peers. Finally, a GPA certificate on your wall acknowledges your achievement, and assures your patients that your practice meets exacting standards in efficiency, risk management and patient care. GPA is committed to providing support and resources that enhance and promote general practice accreditation. Our series of free webinar sessions delivers training on the Standards for general practices, as well as pertinent accreditation topics. Our app for iPad encourages practices, and those that support them, to participate in self-assessment for accreditation preparation as well as continuous improvement between accreditation rounds. Our video series brings selfled training and resources directly to practices in a weekly email format, and our fortnightly eNews keeps you up-to-date with current accreditation information. GPA continues to lead the way in delivering comprehensive, quality accreditation to general practices across Australia. Contact us now to make the switch, and discover an accreditation provider that gives you more.
GPsupport P: +61 3 9999 1212 F: +61 3 8678 0607 E: admin@gpsupport.com.au W: www.gpsupport.com.au Information Systems for the health care industry. When associated with GPsupport all your technology needs are completely managed, freeing you to focus on patient care and clinical operations. Your I.T is for us to worry about. Since 2008, GPsupport has been dedicated to delivering I.T solutions to General Practice, Allied Health and Aged Care providers. • • • • • •
Healthcare Centric IT Support Private Cloud Services Equipment Supply and Installation Multi-site networks Disaster Recovery Planning Accreditation Compliance
Our private cloud service is fast becoming the preferred choice for healthcare providers to relieve the pain of maintaining in-house systems while adhering to accreditation standards and your future needs.
HealthLink P: 1800 125 036 (AU) P: 0800 288 887 (NZ) E: enquiries@healthlink.net W: www.healthlink.net Transforming healthcare by connecting healthcare providers. Australia and New Zealand’s most effective secure communications service. • NEHTA compliant Secure Messaging Delivery (SMD) services • Fully integrated with leading GP and Specialist clinical systems • Referrals, Reports, Forms, Discharge Summaries, Specialists, Diagnostic Orders and Reporting • Affords all healthcare providers efficiencies in reducing paper based handling • Expert partnerships with Healthcare organisations, State and National Health Services • HL Connect for Allied Health, Telehealth and Aged Care Providers • Working with Medicare Locals Australia-wide for eHealth delivery Join HealthLink and connect with more than 85 % of Australian GPs and 99% of NZ GPs who are already part of the HealthLink community.
Health Informatics Society of Australia P: +61 3 9326 3311 F: +61 3 8610 0006 E: hisa@hisa.org.au W: www.hisa.org.au HISA is Australia’s health informatics organisation. We have been supporting and representing Australia’s health informatics and e-health community for almost 20 years. HISA aims to improve healthcare through the use of technology and information. We: • Provide a national focus for e-health, health informatics, its practitioners, industry and a broad range of stakeholders • Support, promote and advocate • Provide opportunities for networking, learning and professional development • Are effective champions for the value of health informatics HISA members are part of a national network of people and organisations building a healthcare future enabled by e-health. Join the growing community who are committed to, and passionate about, health reform enabled by e-health.
Houston Medical P: 1800 420 066 (AU) P: 0800 401 111 (NZ) E: info@houstonmedical.net W: www.houstonmedical.net “We provide time to health professionals through efficient practice management software” Our multidiscipline software provides interfaces to every major manufacturer, enabling many clinics to save space by becoming completely paperless! We are a progressive medical software company and take pride in working with our health care clients to deliver tailored EMR and PMS packages based on each unique situation and practice requirements. We’re focused on helping to make their businesses more efficient and productive as well as delivering measurable improvements in customer satisfaction and market share. You can arrange a free demonstration of our software by visiting: www.HoustonMedical.net
InterSystems Health Informatics New Zealand Health Communication Network P: +61 2 9906 6633 F: +61 2 9906 8910 E: hcn@hcn.com.au W: www.hcn.com.au Health Communication Network (HCN) is the leading provider of clinical and practice management software for Australian GPs and Specialists and supplies Australia’s major hospitals with online Knowledge resources. HCN focuses on improving patient outcomes by providing evidence based software tools to health care professionals at the point of care. Market snapshot: • 17,000 medical professionals use Medical Director • 3,600 GP Practices use PracSoft • 800 Specialist Practices use Blue Chip and • 2,100 Specialists use Medical Director • Leading suppliers of Knowledge Resources to Australia’s major hospitals
E: admin@hinz.org.nz W: www.hinz.org.nz Health Informatics New Zealand (HINZ) is a national, not-forprofit organisation with a focus on collaboration, education and advocacy for the use of IT in the health sector. HINZ enables professional collaboration through conferences, seminars and an interactive online portal, bringing together clinicians, administrators, allied health professionals and many others with an interest in health IT and the advances it can enable. HINZ provides a platform to share information about the Health Informatics industry - leveraging best practice from New Zealand and overseas, as well as facilitating networking activities to bring industry experts and interested parties together to collaborate. Membership is for anyone with an interest in Health Informatics.
P: +61 2 9380 7111 F: +61 2 9380 7121 E: anz.query@InterSystems.com W: www.InterSystems.com.au
Health Information Management Association of Australia P: +61 2 9887 5001 F: +61 2 9887 5895 E: himaa@himaa.org.au W: www.himaa2.org.au The Health Information Management Association of Australia Ltd (HIMAA) is the peak professional body for health information management professionals in Australia serving the profession since 1949. Recognised occupations include health information managers and clinical coders. HIMAA provides quality standards for the delivery of education and training, including the accreditation of degreelevel HIM courses and online delivery of VET-level courses in Medical Terminology and ICD-10-AM, ACHI and ACS Clinical Coding. We strive to promote and support our members as the universally recognised specialists in information management at all levels of the healthcare system.
InterSystems is a global leader in software for connected care, with headquarters in Cambridge, Massachusetts, and offices in 25 countries. InterSystems TrakCare® is an Internet-based unified healthcare information system that rapidly delivers the benefits of an electronic patient record. InterSystems HealthShare® is a strategic platform for healthcare informatics, enabling information exchange and active analytics across a hospital network, community, region or nation. InterSystems CACHÉ® is the world’s most widely used database system in clinical applications. InterSystems Ensemble® is a platform for rapid integration and the development of connectable applications. InterSystems’ products are used by thousands of hospitals and laboratories worldwide, including all of the top 15 hospitals on the Honor Roll of America’s Best Hospitals as rated by U.S. News and World Report. For more information, visit InterSystems.com.
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Intrahealth P: +61 2 9956 3827 (AU) P: +64 9 480 7442 (NZ) E: enquiries@intrahealth.com W: www.Intrahealth.com Intrahealth is a global software and associated services company supplying solutions to the outpatient environment. Intrahealth provides a highly configurable integrated EMR (including case management), web access applications for real time patient, provider and external provider connectivityand a native application for the iPad and iPhone. Intrahealth solutions function across multiple community based practice types (Primary Care, Specialist Physician, Community Care, Home Care, Residential Care, etc). Intrahealth’s suite of products are used in: Individual community based clinics, Chains of clinics, Corporate medical environments & Large scale Government implementations.
Medical Software Industry Association E: ceo@msia.com.au E: president@msia.com.au W: www.msia.com.au With the increase in government e-health initiatives, the MSIA has become increasingly active in representing the interests of all healthcare software providers. The MSIA is represented on a range of forums, working groups and committees on behalf of its members, and has negotiated a range of important changes with government and other stakeholders to benefit industry and their customers. It has built a considerable profile with Government and is now acknowledged as the official ‘voice’ for the industry. Join over 100 other companies across all areas of medical IT/IM so your voice can be heard.
P: 1800 556 022 E: mail@medrefer.com.au W: www.medrefer.com.au MEDrefer is a secure online referral tool used by GPs, Specialists and Allied Health Professionals to manage the referral process for the benefit of patients. MEDrefer is a free service for GPs with an extensive search directory and profile of Specialists and Allied Health Professionals, a search reveals their listing in order of relevance and availability. MEDrefer provides an automatic tracking system for the GP to know if the patient attends their appointment, assisting duty of care. Now integrated with Best Practice and Genie software, as well as other systems, through the MEDrefer Manager. Join MEDrefer today to close the loop on your referral process.
MIMS Australia P: +61 2 9902 7700 F: +61 2 9902 7701 E: info@mims.com.au W: www.mims.com.au MIMS Australia is built on a heritage of local expertise, credibility and adaptation to changing healthcare provider needs. Our information gathering, analysis and coding systems are proven and robust. MIMS information is backed by MIMS trusted, rigorous editorial process and constantly updated from a variety of sources including primary research literature. Our database and decision support modules are locally relevant, clinically reviewed and updated monthly and compatible with a host of clinical software packages. Indeed, the majority of Australian prescribing packages and many dispensing applications are supported by the MIMS medicines data base. MIMS is delivered all the ways you need – print to electronic, on the move, to your patient’s bedside or your consulting room desk. Whatever the format, MIMS has the latest information you need.
Medtech Global Ltd MEDITECH Australia P: +61 2 9901 6400 F: +61 2 9439 6331 E: sales@meditech.com.au W: www.meditech.com.au A Worldwide Leader in Health Care Information Systems
Leecare Solutions P: +61 3 9339 6888 F: +61 3 9339 6899 E: enquiries@leecare.com.au W: www.leecare.com.au Leecare Solutions, with their products Platinum 5 & P5 Exec, are the aged care industry’s leading web browser based clinical and management software system. Since 2000, Leecare has provided relevant, contemporary software solutions for Australian and New Zealand aged care organisations. Leecare’s mission and products provide outstanding clinical decision making support, and management support tools that use any device, can be installed on multiple platform types and in any location. Used in over 30,000 aged care places, it is the solution used by quality providers, proven through thousands of accreditation, validation and other regulatory visits, as it is based on professional clinical and lifestyle provision concepts.
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MEDITECH today stands at the forefront of the health care information systems industry. Our products serve well over 2,300 health care organisations around the world. Large health care enterprises, multi‑hospital alliances, teaching hospitals, community hospitals, rehabilitation and psychiatric chains, long-term care organisations, physicians’ offices, and home care and hospice agencies all use our Health Care Information System to bring integrated care to the populations they serve. Our experience, along with our financial and product stability, assures our customers of a long-term information systems partner to help them achieve their goals.
P: 1800 148 165 E: salesau@medtechglobal.com W: www.medtechglobal.com For over 30 years, Medtech Global has been a leading provider of health management solutions to the healthcare industry enabling the comprehensive management of patient information throughout all aspects of the healthcare environment. Medtech’s Medtech32 and Evolution solutions improve practice management and ensure best practice for electronic health records management and reporting. Clinical Audit Tool integrates with Medtech32 and Evolution providing fast, efficient and secure analysis of patient data enabling practices to identify and deliver services, which address health care priorities across their population. Medtech’s ManageMyHealth patient and clinical portal enables individuals to access their health information online and engage with their healthcare provider to support healthy lifestyle changes.
Orion Health P: +61 2 8096 0000 / +64 9 638 0600 E: enquiries@orionhealth.com W: www.orionhealth.com Orion Health is New Zealand’s largest privately owned software exporter and a global leader in eHealth technology. Founded in 1993, by CEO Ian McCrae, Orion Health has grown from a specialist health integration vendor into a company that sells a comprehensive suite of eHealth solutions. Orion Health has extensive experience in the design and installation of complex systems within demanding healthcare environments. Orion Health designers and engineers work right alongside in-house clinicians in order to develop elegant and intuitive products that encourage swift adoption with minimal disruption, allowing your clinicians to focus on patients. Today, our products and solutions are currently implemented in more than 30 countries, used by hundreds of thousands of clinicians, and help facilitate the care for tens of millions of patients.
OzeScribe
PicSafe Medi
P: 1300 727 423 F: 1300 300 174 E: sales@ozescribe.com.au W: www.ozescribe.com.au
P: +61 419 572 222 E: kerri-anne@picsafe.com W: www.picsafe.com
OzeScribe is the dictation and transcription solution chosen by most Australian university teaching hospitals and major private clinics. Our system is entirely flexible and can be tailored to your specific requirements, whether it be co-source or total outsource, for one doctor or a public hospital! We provide free electronic document delivery - via OzePost - to your EMR, your associate’s EMR, saving you thousands of dollars in time, packing and postage. OzeScribe is the provider of the most advanced solutions available, interfacing with most market leading PAS/Practice management solutions. OzeScribe is: • Run by doctors - for doctors. • Free NEHTA compliant electronic delivery to referring GPs etc via OzePost - powered by Argus. • Australian based and trained typists. • Superior accuracy via Quality Assurance (QA) transcription guaranteed. • Windows and Mac compatible web‑based dictation, transcription and document management portal. • Free app for iOS and Android devices. • Integrated M*Modal speech recognition technology on demand. With demonstrated time and cost saving benefits, it really does make sound business sense to let OzeScribe take care of managing your dictation, transcription and associated technology. To speak with a consultant call us now on 1300 727 423!
The Secure Mobile Clinical Imaging System Designed by Australian and US Dermatologists and Plastic Surgeons to be used by a wide range of healthcare professionals working in a variety of clinical settings, the patented PicSafe Medi app is as simple as using the normal camera function on your mobile smart device except... your patient’s photo is completely secure and legally compliant in its consent, transmission, and storage when taken with PicSafe Medi. Both iOS and Android compatible, PicSafe Medi simultaneously suffices patient privacy and related government regulatory requirements (including new Federal APP’s, commencing 12th March, 2014) surrounding the capture, use, and storage of medical photographs. Using PicSafe Medi, healthcare professionals can now quickly connect and efficiently document a patient’s status pictorially, facilitating the medical referral process and, ultimately, improving patient outcomes and satisfaction. Stored clinical photographs are fully patient-consented (including authorisation for specific usages of their photo), watermarked to assure authenticity, and managed in a highly secure, auditable, private server environment, accessible only to authenticated PicSafe Medi users. From the time you take a patient’s photo with a smart device, to the encrypted transmission and secure storage phases of photo handling, the process is seamless and non-intrusive to both photographer and patient. • Increase your efficiency and improve your patients’ clinical outcomes • Remove the worry surrounding costly patient privacy breaches • Assure quick, efficient pictorial documentation of your patient’s status • Facilitate a streamlined medical referral process • Fully document your patient encounters for billing, auditing, and medical-legal purposes • PicSafe Medi is “the missing link” in compliant and secure mobile clinical photography. PicSafe Medi is “the missing link” in compliant and secure mobile clinical photography.
Precision IT P: 1300 964 404 F: +61 2 8078 0257 E: info@precisionit.com.au W: www.precisionit.com.au • Cloud Computing Specialists. • Onsite Medical IT Support. • VoIP Telephone Systems and Internet Connectivity. • IT Equipment Procurement. • Experience with all clinical & practice management software packages. • Sydney, Brisbane, Gold Coast and Melbourne. Precision IT is a highly competent and impeccably professional IT support firm with a primary focus on working with GPs and Specialists. Working with our clients, we develop reliable, robust and feature rich IT systems to meet the demands of the modern medical practice today and into the future. Our Precision Cloud service is fast becoming the choice for new and established practices and covers all of the standard guidelines from the RACGP and AGPAL and GPA. Talk with us today about the future of your practice!
Prospection P: +61 2 9209 4035 E: info@prospection.com.au W: www.prospection.com.au Prospection is a specialist healthcare information and analytics consultancy. • Clinical Intelligence Solutions – medication specialists • Commercial Effectiveness and Consulting • Clinical, technical and commercial expertise • Geo-mapping visualisation and reporting solutions Prospection specialises in the design, development and hosting of clinical and costing intelligence systems and consulting solutions. Our PharmDash platform allows us to analyse and report on complex healthcare datasets, and deliver web‑based reporting. We have particular expertise in understanding medication utilisation working with large, complex pharmaceutical databases. Our clients include over 30 large Australian healthcare companies in both specialist and chronic therapy areas. We can assist public and private healthcare organisations to improve commercial and clinical outcomes.
Shexie Medical System Professional Transcription Solutions P: 1300 768 476 E: marketing@etranscriptions.com.au W: www.etranscriptions.com.au Australia’s Most Trusted Teaching Hospital and Private Practice Transcription Provider • Web-based - Dictate and receive reports anywhere • Double-edited with over 99.5% accuracy • Fast turn-around within 24 - 48 hours, as required • All medical and surgical specialities covered in Australia’s largest teaching hospitals • Rapid documentation of recorded HR interviews, Research and Expert Reports • Guaranteed cost savings • Data held securely at a State Government owned data centre • Call our friendly staff anytime for your overflow, backlog or all of your typing or data entry requirements • Call us now for a no obligation free trial
P: 1300 743 943 F: 1300 792 943 E: info@shexie.com.au W: www.shexie.com.au Shexie is an Australian owned business which has been developing software for medical practices for over 15 years. Our industry and technical knowledge allows us to provide the ultimate ‘easy to use’, ‘fully functioned’ and ‘robust’ product on the market. Shexie Medical System clinical and practice management software is ideal for surgical or specialist practices of any size. Many fully integrated features including Paperless Office, SMS, full Paperless Electronic Claiming including Eclipse, MIMS Integrated, statistical analysis, security, synchronize appointments with Outlook/PDAs, transcription interface, diagnostic equipment interface, automated MBS/Fund rates updates. Soon to be released Shexie Platinum version also contains eHealth - Health Identifiers, PCEHR and Secure Messaging.
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Stat Health Systems (Aust) P: +61 7 3121 6550 F: +61 7 3398 5064 E: carla.doolan@stathealth.com.au W: www.stathealth.com.au
P: 1800 061 260 E: sales@tg.org.au W: www.tg.org.au
Stat Health Systems (Aust) has built a progressive and resilient system that introduces a new level of stability and flexibility to the medical software market.
Therapeutic Guidelines Limited is an independent not-for-profit organisation dedicated to deriving guidelines for therapy from the latest world literature, interpreted and distilled by Australia’s most eminent and respected experts.
Stat is an integrated clinical and practice management application which has embraced the latest Microsoft technology to build a new generation solution. Fully scalable and the only medical software application to incorporate a multi-functional intuitive interface, Stat is at the forefront of computing technology. Stat incorporates all eHealth requirements as per the NEHTA specification.
These experts, with many years of clinical experience, work with skilled medical editors to sift and sort through research data, systematic reviews, local protocols and other sources of information, to ensure that the clear and practical recommendations developed are based on the best available evidence.
Stat Health provide a premium support service, clinical data conversion from existing software and tailor made installation and training plans for your practice. Facebook: facebook.com/StatHealth Twitter: @NotifyStat
eTG complete Incorporates all topics from the Therapeutic Guidelines series in a searchable electronic product, and is the ultimate resource for the essence of current available evidence. It provides access to over 3000 clinical topics, relevant PBS, pregnancy and breastfeeding information, key references, and other independent information such as Australian Prescriber (including Medicines Safety Update), NPS Radar, NPS News and Cochrane Reviews.
P: +61 3 9013 4445 E: info@sysmex.com.au W: www.sysmex.com.au
eTG complete is available in a range of convenient formats – online access, online download, CD, and intranet access for hospitals. Multi-user licences, ideal for a practice or clinic, are also available.
Sysmex is dedicated solely to helping your healthcare organisation achieve more in less time, with fewer errors and better patient outcomes.
It is widely used by practitioners and pharmacists in community and hospital settings in all Australian states and territories.
Sysmex leads the way in eDiagnostics: • Providing an essential building block for the electronic medical record with the Eclair Clinical Information System • Enabling sharing of key patient information across regions through the Eclair Clinical Data Repository • Completing the electronic loop with laboratory and radiology order request management (CPOE) • Streamlining all areas of the anatomical pathology laboratory workflow from request to report with Delphic AP • Improving reporting times and reducing costs through an enterprise Delphic LIS, shared across multiple laboratories
The July 2014 CD release of eTG complete contains an important update on the treatment of osteoporosis, to reflect new information published by the Therapeutic Goods Administration in April.
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No other changes to the content will be published at this time. Antibiotic Guidelines version 15 will be coming out in November in eTG complete and in print. miniTG The mobile version of eTG complete is miniTG, (in offline format), offering the convenience of vital information at the point of care for health professionals who practise and consult on the move. It is supported on a wide range of mobile devices, including Apple®, Pocket PC®, and selected Blackberry® devices.
Webstercare
Totalcare
P: 1800 244 358 F: 1800 626 739 E: info@webstercare.com.au W: www.webstercare.com.au
P: +61 7 3252 2425 F: +61 7 3252 2410 E: sales@totalcare.net.au W: www.totalcare.net.au Totalcare is a fully integrated Clinical, Office and Management software suite designed to suit the particular needs and processes of healthcare providers. Used since 1995 by health care facilities across Australia including General and Specialist practice, Radiology, Day Surgery and Hospitals, Totalcare is stable, scalable, customisable and easy to learn and use. From a small practice to a multisite, multi-disciplinary corporate entity or hospital, Totalcare can provide solutions for your needs. • • • • • • • •
Admissions / Appointments Billing Statutory Reporting Integrated SMS Prescriptions Orders & Reports Clinical Notes Letter/Report Writing, Document and Image Management • Scanning and Barcode recognition • Video and Image Capture • HL7 Interfaces
Webstercare is a world-leading medication management innovator and was recognised in 2013 by BRW as Australia’s sixth most innovative company. About 30 years ago, Webstercare developed Webster‑pak®, the world’s first medication dose administration aid, and today the majority of Australia’s community pharmacies use the Webster-pak system to help consumers maximise their medication use. Webstercare has since developed another 300 products and services– all developed to solve existing problems. These include MedsPro®, a system for maximising the efficiency of dispensing Webster-paks; MedsCom® Connect which connects pharmacies with aged care facilities and GPs; and MedSig® to streamline clinical medication administration processes.
Zedmed ™
VIRTUAL CONSULTING ROOMS
VConsult P: 1300 82 66 78 F: 1300 66 10 66 E: admin@vconsult.com.au W: www.vconsult.com.au VConsult offers outsourced practice management solutions for medical and allied health practitioners allowing the focus to be on your professional practice and patient care. VConsult provides a seamless “behind the scenes” service by professionally managing your telephone calls, reception, invoicing and medical transcription requirements. VConsult is perfect for your practice if you are: • Setting up, already established or winding down in Private Practice • Working in a public appointment and want to portray a professional image • Looking to minimise your overhead costs • Requiring your patient calls to be answered by a professional and experienced medical receptionist.
P: 1300 933 000 F: +61 3 9284 3399 E: sales@zedmed.com.au W: www.zedmed.com.au At Zedmed, we provide general practice, specialist and allied health clinics with turnkey software solutions for their most common practice needs. We’re committed to producing best in class products and services and are consistently striving to provide additional value-added products and services to help practices work more profitably and efficiently, so our customers can focus on delivering patient care. Zedmed - Focused Innovation.
The GPA Webinar Series‌ Delivering free online training for accreditation and beyond
Live events designed to fit in with the busy schedules of practices Join from your location (including mobile devices) The comprehensive Standards Educationals series looks at every criterion in detail Certificates of participation available for attendance at the live webinars AAPM CPD points available for attendance at Standards Educationals webinars Subscribe to the GPA YouTube channel and catch up on any webinars you missed
Find the full schedule, and links to register, at www.gpa.net.au/webinars
HealthLink
Adding a whole new dimension to healthcare
At HealthLink we understand our products work best when they free up medical practitioners to concentrate on what they do best - personalised patient care - while giving them the accurate, timely and complete information to further enhance that care. Today’s complex, hurried healthcare environment demands patient information systems that are absolutely dependable. At HealthLink we work through every challenge to ensure our clients have nimble, fit -for- purpose systems that deliver peace of mind performance.
www.healthlink.net