Australia’s First and Only Health IT Magazine
Back to Basics Defining the role of the PCEHR A/Prof Charlie Corke positions the proposed Personally Controlled Electronic Health Record. Why is pathology ‘IT’ so hard? Robert Flanagan outlines the challenges faced by professionals supporting IT in the pathology sector. Taking shortcuts will get you lost Dr Geoffrey Sayer suggests more detailed plans are required for the journey towards a PCEHR. National E-Health Transition Authority update NEHTA previews research into healthcare supply chain management. Information security and social engineering Alberto Tinazzi warns practices to remain vigilant about data security. Internet Backup Using these services can help protect practice information.
18 22 22 22 24 24 24
DONORtrak streamlines transplant process IBM awarded NASH contract Maestro Toolbar connects to HI Service Orion Health updates Rhapsody Stat Health Systems commences rollout iMIMS arrives for iPhone and iPad NPS researches GP clinical software
Want to know more about eHealth? Whether you are a consumer, healthcare manager, healthcare provider or vendor, you need a central location to quickly find and access eHealth information.
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www.ehealthinfo.gov.au is jointly brought to you by Australia’s Federal, State and Territory health authorities and the National EHealth Transition Authority (NEHTA) to help you explore the eHealth concept and stay in touch with the latest innovations as they unfold.
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“ The speed at which medical service is provided will be
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See how NEHTA’s work is helping to enable a better health system and support the Government’s goal of personally controlled electronic health records for all Australians. Go to: www.nehta.gov.au
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PULSE IT +
Publisher Pulse Magazine PO Box 7194 Yarralumla ACT 2600 Australia ABN: 19 923 710 562 www.pulseitmagazine.com.au
Editor Simon James Australia: +61 2 8006 5185 New Zealand: +64 9 889 3185 email@example.com
Subscription Enquiries firstname.lastname@example.org
Advertising Enquiries email@example.com
About Pulse+IT Pulse+IT is Australia’s first and only Health IT magazine. With an international distribution exceeding 37,000 copies, it is also one of the higest 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.
Pages 34, 38, 40 BACK TO BASICS
Looking ahead The next three editions of Pulse+IT will feature a selection of articles covering the following themes: • May 2011 - Mobility • July 2011 - Medical Devices • September 2011 - Consumer E-health Pulse+IT welcomes feature articles and guest editorial submissions relating to these themes, as well as articles relating to e-health more broadly. Submission guidelines and deadlines are available online: http://www.pulseitmagazine.com.au/editorial
ISSN: 1835-1522 Contributors Janette Bennett, Paul Clarke, A/Prof Charlie Corke, Robert Flanagan, Simon James, Dr Geoffrey Sayer, and Alberto Tinazzi.
Disclaimer The views contained herein are not necessarily the views of Pulse 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 Magazine has no affiliation with any organisation, including, but not limited to Health Services Australia, Sony, Health Scope, UBM Medica, the New Zealand College of General Practitioners, or the Kimberley Aboriginal Medical Services Council, all who produce publications that include the word “Pulse” in their titles.
Copyright 2011 Pulse Magazine 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.
Pulse+IT acknowledges the support of the following organisations, each of whom supply copies of Pulse+IT to their members.
Page 8 PERSONAL HEALTH RECORDS
Page 11 PATHOLOGY IT
Page 34 INFORMATION SECURITY
Page 6 STARTUP Editor Simon James introduces the 21st edition of Pulse+IT.
Page 34 FEATURE ARTICLE Alberto Tinazzi advises practices to be aware of the imporantance of information security and the risks posed by social engineering.
Page 18 DONORtrak system to streamline organ transplant process
Page 38 FEATURE ARTICLE Simon James overviews the benefits of Internet Backup and their applicability to medical practices.
Page 20 Electronic Journal of Health Informatics releases eighth issue
Page 40 FEATURE ARTICLE Janette Bennett and Martin Ellis detail the importance of standards in the development of clinical information systems.
Page 22 IBM awarded NASH contract
Page 8 GUEST EDITORIAL A/Prof Charlie Corke defines the role of the proposed Personally Controlled Electronic Health Record. Page 11 GUEST EDITORIAL Robert Flanagan outlines the challenges faced by professionals supporting information technology in the pathology sector. Page 28 MSIA Dr Geoffrey Sayer from the Medical Software Industry Association suggests more detailed plans are required for the journey towards a PCEHR. Page 32 NEHTA The National E-Health Transition Authority previews research into healthcare supply chain management
Health-e-Nation conference coming to Melbourne in April
NEC deploys Internet access to senior Australians
Maestro Toolbar connects practice software with Healthcare Identifer Service
Orion Health updates its Rhapsody Integration Engine
Page 26 EVENTS CALENDAR Up and coming Health IT, Health, and IT events.
Page 24 iMIMS drug reference application released for Apple iPhone
Page 43 MARKET PLACE The Pulse+IT Directory profiles Australasiaâ€™s most innovative and influential e-health organisations.
NPS study into GP clinical software shows room for improvement Stat Health Systems commences software rollout
Pulse+IT: 2011.1 Simon James
BIT, BComm Editor, Pulse+IT Phone (AU): +61 2 8006 5185 Phone (NZ): +64 9 889 3185 firstname.lastname@example.org
Welcome to the 21st edition of Pulse+IT, Australia’s first
and competitions. A free weekly email, readers can
and only Health IT magazine.
subscribe at: www.pulseitmagazine.com.au/enews
As foreshadowed in our final edition for 2010,
Pulse+IT has spent the last few months redeveloping
our website and associated online services, and is
Starting in April, Pulse+IT will commence a series of
pleased to report that everything we hoped to put
Webinars focused on the practical application of IT in
in place during the Christmas period is now up and
the health sector. Predominantly pitched at general
running. As has always been the case with our printed
and specialist practice and facilitated by a panel of
magazine, our website’s focus will remain on the
domain experts, a different topic will be presented each
publishing of original e-health related stories, delivered
month. To browse up and coming webinars, register for
with the added benefits of timeliness and scope for
a session, or suggest a topic for future consideration,
readership interaction, which only online mediums can
provide. To take a look at what we’ve come up with, visit: www.pulseitmagazine.com.au
As our online services evolve, readers will observe
For those that want to stay abreast of e-health
Pulse+IT’s magazine and website develop their own
developments as they break, the Pulse+IT twitter feed
unique characteristics, playing to the strengths of
provides a springboard to original and third party
their respective formats. Against the backdrop of
natterings about the “death of print publishing” and recent reports about the financial troubles of many
companies operating in the Australian e-health sector,
Counting over half of Australians as active users —
I am pleased to reassure supporters of our magazine
including amongst this diverse cohort my 10-year‑old
that our online initiatives will not come at the expense
cousin and my 82-year-old grandmother — the
of our printed publication. On the contrary, with 77% of
phenomenon that is Facebook is one that hasn’t been
readers indicating a preference for the publication in its
ignored in our online plans. In keeping with the spirit
printed form, 79% indicating that Pulse+IT is the only IT
of this somewhat informal service, we have launched
or computer publication they read, and 74% indicating
a perpetual weekly competition dubbed the Pulse+IT
that Pulse+IT is the only e-health publication or website
Friday Facebook Freebie. All you have to do to have a
they refer to, the printed magazine has a bright future.
chance of winning each week is click the ‘Like’ button
Online Services and Social Media To complement the new Pulse+IT website, we have
on the Pulse+IT Facebook page, which can be found here: www.facebook.com/pulseitmagazine
launched a range of services to broaden our offering
and provide readers with several ways to keep up to
The next edition of Pulse+IT will focus on the impacts
date and engage with Pulse+IT contributors.
and possibilities that mobile computing devices will have on health professionals and their patients.
Each week, the Pulse+IT eNewsletter service brings
articles, would like to contribute to an edition, or would
together recently published original articles from
simply like to discuss your experiences with e-health,
the Pulse+IT website, events, career opportunities
don’t hesitate to get in touch.
As always, if you have any suggestions for future
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Defining the Role of the Patient Controlled Health Record A/Prof Charlie Corke MB BS, MRCP, FCICM Senior Intensive Care Specialist Barwon Health firstname.lastname@example.org
Australia, in line with a number of European countries,
considered important include current medications
is currently investigating innovative use of Internet
(suggested by 97% of the surveyed population),
technology to improve access to patient information
test results (96%), allergies (98%), diagnoses (97%),
by the broader group of healthcare providers involved
vaccinations (98%) and medical procedures (96%).
in delivering healthcare to an individual. To date most
exchanges of information occur across health teams,
medical information would be much more useful
for example the sending of a discharge summary
to a treating doctor than one with only minimal
from the hospital to the general practitioner. This
data — and would be more likely to be viewed by
might be characterised as an inside-out approach and
the doctor. Conversely one that the treating doctor
has been problematic in respect to ensuring relevant
did not feel would contain information that made
information is sent in a timely manner and is readily
it worth accessing (and consequently didn’t access)
available when the patient presents. New approaches
would be of no clinical value. It seems that there is a
seek to complement rather than replace traditional
strong consensus that a shared medical record needs
exchanges of data and focus on using the patient as
to contain reasonably comprehensive healthcare
the ‘aggregator’, able to bring information themselves
information in order to be clinically useful.
to their next healthcare interaction. This might be
thought of as an outside-in approach.
PCEHR represents an important mechanism to provide
information about the patient to a new doctor who has
This outside-in approach is often referred to as
A shared record that contained this more complete
Beyond a value in emergency situations the
the Personally Controlled Electronic Health Record
never seen the patient before.
(PCEHR). In its most simple form it may constitute
basic emergency medical information that the patient
plans with the patient (particularly those with chronic
carries with them (like an electronic ‘Medi-Alert’
conditions). It could also accept and store results of
bracelet). This could simply involve information such
electronic monitoring that these patients perform
as allergies and might come from the doctor’s records
at home (eg blood pressure readings, blood sugar
or, at the most basic level, could be entered by the
measurements, peak flow values etc.).
A recent survey by the health computing company
Another function of a PCEHR may be to share care
The PCEHR could provide a secure platform for electronic
CSC has provided a valuable and extensive report of
communication is becoming ubiquitous and a secure
Australians’ attitude to shared health records. This
environment for electronic medical communication
report reveals that most Australians believe that the
could be valued by patients and useful for doctors
medical information in a shared record needs to be
(though this may require a review of remuneration
reasonably comprehensive. Data that those surveyed
before it could become widely used and clinically
A/Prof Charlie Corke is past Director and currently a Senior Intensive Care Specialist at Barwon Health in Geelong, Victoria. He is also an Associate Professor with Deakin University, designer of the PROMPT protocol management system, clinical advisor to Medenotes and a Director of Medenotes.
record that they can access2. However they may underestimate the potential for the patients’ need for control and their requirement for privacy to impede implementation of a centralised system.
Doctors recognise the need for a shared medical
record and favour a centralised shared medical
Privacy advocates express significant concerns
associated with the proposal to create
Medenotes to provide patient controlled
centralised medical records3. Of the
obstetric records for all pregnant patients.
general population, 24% of Australians
Patients have been given copies of X-ray
are against electronic health records
images by private radiology practices for
Health Records represent a milestone in
and more than half of these are strongly
many years, and have often been given
the transformation of healthcare delivery
against1. This represents a significant body
copies of discharge summaries. These
and the possibilities for innovation are
of concern that is unlikely to evaporate.
practices have proved acceptable to
patients and effective for doctors.
shared record, most want to control who
It is important to understand what
will provide a critical platform and will
can see their health information and to
people want, and what they will accept,
maintain Australia’s position as a global
dictate what part of the record they can
before committing to a solution. This is
leader in respect to the delivery of safe,
see . While most Australians (84%) wish
no easy task as the potential systems are
high quality and cost effective healthcare.
their current healthcare providers to have
so very different from anything that is
access to their shared record, the vast
available today. We can’t confidently rely
majority (89%) also want the ability to
on what patients say about a system that
1. CSC Health Care Research Report - A
select which (other) healthcare providers
they have never experienced.
Rising Tide of Expectations. Australian
can view their information. They do not
consumers’ views on electronic health
want to give access to health providers
develop and trial a number of Personally
who they don’t know or have not yet
Controlled Electronic Health Records are a
welcome development in this regard.
Of those who accept the need for a
It is difficult to conceive that such
This concept is not entirely novel.
Recent Commonwealth initiatives to
This next wave of development
The Barwon Region has a long
2. Shared Electronic Medical Records —
control could be achieved unless the
track record of e-health development
2010. Australian Medical Association.
patient is actually in control of the shared
including Barwon Health, the Geelong GP
electronic record. In this case, the PCEHR
Association and others. This region has
3. Policy Position eHealth Data and
begun trials of the clinician-developed
Health Identifiers. August 2009.
whereby a patient’s medical information
Medenotes4 patient controlled health
Australian Privacy Foundation. http://
is provided to all the patient’s healthcare
record in an attempt to address the
issues that have been raised in this
whom the patient wishes to share the
paper. Barwon Health is planning to use
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www.hisa.org.au Improving Australian healthcare through technology and information FINAL_HISA2011_PULSEIT180x120.indd 1
Learn and share your knowledge and expertise amongst a national network
21/02/2011 2:51:09 PM
Why is ‘IT’ all so hard in pathology? At the heart of a modern Pathology laboratory is a
all and there is not a lot of choice in the market. With
complex set of Information Technology (IT) systems that
so many country specific requirements for compliance
are critical to its operation. Users are often frustrated
and billing, many of those who would be the vendors of
and disappointed at the difficulties they experience when
choice in Europe or the USA have little or no presence
systems fail, when requesting changes or seeking new IT
in Australia. So we must try to find a system that suits
functionality. Having worked in a number of industries
everyone from a very limited market place.
before coming to Healthcare four years ago, I have tried
to make some sense of why IT is so hard in Pathology.
have done this before and, though it will be painful,
B.Sc. (Syst. Inf.) IT Manager SydPath email@example.com
That, however, is not the major problem. We
we will do it again. The reason I’ve got my thumbs We’re talking normal, run of the mill Pathology, not
grinding the sides of my skull is that this is just the
bio-informatics databases, leading edge cell imaging
start of quite a few stress headaches. Information
or shiny, ground breaking test developments. So why
Technology is generally acknowledged as hard work.
is it so hard to get some seemingly simple functionality
Telecommunications, finance, airlines and other
from your IT Department? Why do all those small
sectors are not immune to IT difficulties and they have
things that would make life a bit easier turn into
seen their fair share of difficult implementations, major
long, drawn out projects that are around so long they
computer failures and systems that did not at all match
become part of the family?
the sales pitch1,2,3. There are studies available on project
I’m sitting here at my desk massaging my temples.
failure, such as the Chaos Report by The Standish
As the IT Manager, I’ve been handed the unenviable
Group4, which indicate that somewhere between 24%
and 68% of IT projects from all types of industries fail,
Management System (LIMS), a job that will earn me
depending on how you define ‘project failure’ (e.g.
no awards, applause or praise. We already know from
not delivered or over-budget, time). While some in
past experience that it will be a difficult and traumatic
the industry debate the accuracy, underlying data and
project for my team as well as the whole organisation.
methods of the Standish Group, from experience it
We will grapple with new technology, interfacing and
feels right to say that only one in five projects will result
new ways of performing old processes. And for all that,
in general satisfaction.
we are not even expecting new functionality. We are
not alone in this dilemma. At this time the IT managers
systems in the past four years. We would consider
of major Pathology providers in NSW, VIC, SA and WA
that most of those projects were successful but they
are actively investigating replacing their LIMS. Some
were hard fought wins and dogged by unforeseen
to modernise and consolidate, others, like ourselves,
complexity. Functionality requests that appeared
as a result of a pullout from the Australian market by
simple and straightforward became mired in —
a significant LIMS vendor. None will get any major new
amongst other things — coding issues, regulation,
functionality. It may be easier to maintain, interface
process inflexibility and interfacing difficulties with
or get better reports, but it is unlikely that any new
other departments and systems. In my opinion, IT in
pathology breakthroughs will come as a direct result of
Pathology is harder than other industries, much harder.
We have implemented quite a few features and
There are many reasons why my temples need
provide functionality to a range of pathology disciplines with quite varied requirements. Invariably each discipline knows of a system that will work just right for them and invariably the other departments will detest
Robert Flanagan comes from a broad IT background, working in different industries such as Finance and Telecoms in Europe, Africa and Australia. He has been the IT Director for SydPath over the past five years, his first foray into Healthcare.
massaging. We must choose a new system that will
that particular choice. There is no one system that fits
There are some identifiable underlying
This may go some way to explain why
Following the development effort to set
reasons why I believe this is so. We could
an Instrument Interface works fine for
up the new HL7 environment, we applied
broadly group them into the following:
one LIMS but we could spend four years
our messages to one of the GP Practice
• Lack of standards or lack of adherence
connecting it to ours, going back and forth
software packages prominent in Australia.
to those that exist
between developers, instrument vendors
We found the reporting display quite
• Underlying complexity
and users in an attempt to bully the
deficient; missing headers, result history,
• Software development is a ‘degraded
software code into place.
contact details, etc. and, in the opinion
Sending a HL7 message to a General
of the reviewing Pathologist, clinically
• Spending on IT systems
Practitioner, a standard generally accepted
unacceptable. When this outcome was
• Chasm between IT Department
as de facto, is another excellent example.
discussed with customers we discovered
Implementing this for our organisation
that other large providers had come across
required a huge amount of IT resources.
this a long time ago and found a way to
Most of this was spent analysing and then
‘embed’ PIT into the HL7 message in order
coding exceptions because the different
for the message to display nicely as before.
It is surprising to find in health — an
receiving applications have varied from
Those providers did not insist that GP
the HL7 standard in order to meet local
Practice software developers evolve their
assurance, audits and standards — an
customer demands or save time. Why
software to suit the HL7 standard, which
almost complete lack of unity across IT
is this? We started down the road of
has been knocking around Australia for
systems. It seems we need to build each
sending our results using HL7 messaging
over 15 years. Providers like ourselves must
piece of functionality from the ground
because of government pressure on
now have the local standard (PIT) ‘added’
up with a variety of local requirements
GP practices for reporting purposes, a
to the HL7 message in order to be broadly
embedded, reducing future use and value
reasonable expectation. The previously
acceptable. There are other nuances such
to other health entities. This appears to be
widely accepted standard message, PIT ,
as ensuring the ‘copy to doctor’ is read
a feature of the siloed and insular nature
is local to Australia and doesn’t allow
from the PIT part of the HL7 and not from
of Healthcare entities along with the
for database-like reporting. This should
the HL7 part. If this gets confusing for you,
tendency towards fairly static IT evolution.
not have been a major ordeal given we
there was nothing out there on Google to
Systems are developed primarily for local
already produce HL7 for internal reporting
explain it to us! We found that many other
processes, not for interaction with external
systems. That existing HL7 message did
GP practice software providers have used
entities and so adherence to standards
have customisations made to suit our local
something similar but, of course, not all.
is not as important as in the finance
processes which caused us some trouble,
The result was that, after adjusting our
or telecommunications Industries, for
so we immediately found ourselves victims
HL7 message from the standard, we must
of our own non-compliance, I suppose.
now move slowly through the 207 or so
capability and the Big Expectaction
Lack of standards or lack of adherence to those that exist steeped
- CompuDoc Medical
- Healthpoint Technologies
- DoctorWare Australia, Smartrooms
- Healthways Inc
- Access GP
Clinical software providers who integrate MIMS medicines information and decision support into their applications to ensure that clinicians have the most trusted information available at all times.
- Ambulance Australia
- Ambulance Victoria, VACIS
- Cancer Council of Victoria
- Global Health
- Best Practice Software - CDC Systems - charmhealth
- Cardio Vascular Systems
- Cloud9 Software
- Communicare Systems
- DrsDesk Software
- Australian Sports Anti-Doping Authority
- Clintel Healthsolve, The Specialist
- Deltra Pty Ltd, Practice Pro
- Equipoise International, Totalcare - Genie Solutions
- Healthsoft Australia
- Houston Medical Australia - Incisive Medical Systems - InterSystems
- International SOS (Australasia) - Intrahealth Systems, Profile - iSoft Group
• Patient Safety International
- Godbar Software P/L - GPComplete
- Health Track Medical Systems - HealthCare Software
• MedChart • Classic
- Jam Software
- Lane Cove General Practice
other GP Practice software packages used
some time to come. Given the complexity,
supporting functions of IT, billing and
by clients to see what variances they may
cost restrictions and trauma of changing
Specimen Reception are very complex,
require. We must also evaluate if we can
partly as a result of being involved in
adapt our IT environment to cater for the
lifecycle is so long that change cannot
all the approaches across all pathology
variances and determine whether it is
be dramatic. In pathology we can see the
worth the complexity. This is a long and
evidence of this amongst our peers, given
tedious process for something that should
the longevity of not just their systems,
we had, and still have, what we can call
but even down to the versions they have
“uncontrolled evolution”. That is, we
remained on for considerable years.
keep changing and adding more localised
Another area where standards are at
odds with practice is the identification
Over those years of automation,
processes without consideration about
of a pathology test between providers.
how this affects complexity and our ability
Whilst SNOMED CT has been chosen by
Even though this is normal, run‑of‑the‑mill
in the IT department to manage it.
the Government and NEHTA9, pathology
Pathology IT operations work and not
the shiny leading-edge stuff, it is time
complexity of our systems and processes
LOINC but not consistently. So the code
to acknowledge in this paper that it is
becomes a hindrance to the effective
we use for a Sodium test may be different
a fairly complex environment with a lot
delivery of service. This would be seen in
from another provider. Some practice
of interfacing, interactions and human
difficulty to add / change a service, process
software products have built in mapping
interventions. The underlying complexity
or IT system. It is also evident when trying
to cope with these variations from the
of all these systems, how they connect,
to troubleshoot a problem or in dealing
standard but not all. And, again, someone
the workflow and the exceptions quickly
with a failure. Basically, it takes a long time
has to maintain the variations. There is
build up to a picture that we can no longer
to unravel a hill of spaghetti. When things
an AACB Working Party10 progressing
fully grasp in one sitting.
go wrong, reverse engineering a process,
towards standardising LOINC, however,
As we have evolved over the years to
code, script or interface can take a long
until both senders and receivers agree on
become automated, integrated pathology
time. The resulting fix to a problem quite
the terminology it will remain piecemeal.
organisations, we would have put in
often appears to be easy and obvious, now
NEHTA is also reconsidering its position
place processes and systems to handle
that the process is understood. The length
on using SNOMED CT versus LOINC. The
the complexity of delivering service to
of time to discover it, however, is possibly
picture at this stage is very cloudy and
multiple, distinct clients such as hospitals,
a better gauge of the functionality/
appears that it will take years for any real
GPs, health bodies and clinical trials. Each
complexity mix (rather than how inept the
standard to be in place.
of these require distinct functionality
IT Analyst is!).
This lack of Industry-wide consistency
or service so that the workflow can
in its approach to IT systems will remain for
be very different. In particular, the
approach was invaluable in documenting
- Manrex Pty Ltd; Webstercare
- Mater Public Hospital - Medical - Objects
- Mednetwork Systems - Medtech Global
- Merck Sharp and Dohme - MMex
- Mountain Top Systems - Mouse Soft
- Mx Solutions - NPS
- NIB Health Funds
In our organisation, a Lean Process
- Queensland Emergency Services - Queensland Eye Institute - Queensland Government - Shexie Medical System - SmartHealth
- Software for Specialists - Stat Health
- Sydney Adventist Hospital - SurgiWare
- Pen Computer Systems
- Telethon Institute for Child Health Research
- Pharmacy Computer Solutions
There comes a point when the
A special thank you to all those who partner with us to deliver our trusted medicines information and decision support to the point of care.
The team at MIMS
- Western Australia Police
and highlighting both obvious and hidden
three years later for extortionate amounts
budgets and very long system life must
complexity. It turned out to be quite a
of money, well tested and by then it was no
be that the IT industry for healthcare is
visual insight into the many variances and
longer needed or didn’t meet your original
exceptions in our processes and systems. It
also gave us the opportunity to challenge
It’s our fault and we don’t want to
there is an extraordinary amount of
the benefits of some of them.
go back to the old days so now we must
in-house development done by pathology
accept the present reality. Our job now is
to find the best case reality.
Overall, I suggest we do not have a
good handle on how much complexity is in a given process or across a whole
On the flip side, almost by necessity,
organisation. Anecdotally, when I see a
Spending on IT systems
Ordering, Reporting and Billing systems
multitude of spreadsheets, small pieces of
Somebody asked me in a corridor to justify
developed in various IT Departments
code, manual interventions, workarounds
spending money maintaining an IT system
around the nation. This approach is
and local knowledge required for many
over providing a patient with a bed. My
typically easier to get approved, looks
processes and still they require constant
immediate response was “turn off the
cheaper in the near term and sometimes
maintenance, then over-complexity is
computer system”. That may sound like
gets the solution delivered in a reasonable
highly likely to be a hindrance to efficiency.
a smart remark and I was a little pleased
time frame. I believe that, in the long run,
with how easily it rolled off the tongue but
this contributes significantly to our other
Software development is a ‘degraded science’
the question was a valid one. How much
problems of stifled industry innovation and
are these systems worth? Pathology has
our own internal over-complexity.
undergone a big wave of automation to the
point that any provider with volume must
of invest, develop and sell/share but this
have a considerable system underpinning
does not typically happen with in-house
organisation, resulting in slowness, loss
of functionality, lots of bugs appearing,
According to a 2008 Deloitte report
three private providers servicing nearly
workarounds and late nights. There were a
on E-Health Strategy14, the estimated
60% of the pathology market in Australia
lot of questions but two still stand out: “Is
Australian IT spending in health care for
have taken LIMS packages and heavily
it normal for vendors to deliver software
2007 was $1.25 billion compared with
modified them beyond recognition to suit
with bugs in it?” and “Aren’t they supposed
$7.4 billion in the financial services sector.
their internal needs. While this is good
to test it first?”
That is approximately 1.4% of total
for them and provides some ‘competitive
I recently stood in front of a meeting
Software evolution has been a cycle
The answers are ‘yes’ and ‘yes’.
spend compared with 9% invested by the
advantages’, an unintended consequence
Software is a degraded science. We never
financial services sector. This is not very
is that we are left wondering where the
get software delivered free from potential
surprising but given our heavy reliance on
next generation of LIMS is coming from for
bugs although we can be confident the
IT in pathology and a constant downward
this nation? It takes away a large amount of
vendors test it according to their typical
pressure on IT budgets, it is possible that
momentum from the technology evolution.
scenarios. I say software is a science
this is squeezing out innovation at an
The next generation of Australian LIMS
because I have a degree in Computer
enterprise level. By that I mean it is not
is being left to others to reverse engineer
Science. It is a degraded science because
an attractive industry for major software
rather than build upon. I suggest that
we now accept the vendor will give us an
developers to invest in. There are fits and
getting all pathology providers HL7, LOINC
outcome as fact and ask us to let them
starts with large packets of high-profile
/ SNOMED CT, Unique Health Identifier and
know if any bits of their theory don’t work
Government money slotted in for special
Medicare compliant would remove a large
out. It is now the worldwide commercial
projects that attract vendors but it is hard
burden from all pathology IT departments.
standard that the software package we
to see any lasting momentum. Some
They are functions in the national
receive will come with bugs
global players such as Intel and Oracle
interest, are a fundamental demand from
this because we get the software quicker,
have shown some interest in the past few
the government and therefore, not a
cheaper and it will probably do 90% of
years which is encouraging but they will
competitive advantage. Wouldn’t it be
what we want, 90% of the time. Consider
have a limited impact for some time.
great if the next LIMS chosen by all those
the “good old days” in the 1970’s when you
could ask for an application, spend a year
achieve limited traction with just one or
evolved, tried and tested?
defining the specifications, get it delivered
two customers but the realities of the tight
. We accept
now seeking included them as standard, If the same principle of in-house
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development applied to other industries,
noticed that the public sector in particular
in short supply in the industry but these
there would be no impressive Oracle
has a habit of considering staff time as
deficiencies must vary from organisation
Financials, Siebel CRM or even a half
‘free’. They are on payroll and not a capital
decent Microsoft Word.
outlay but staff are still a limited resource.
decision making, project management
Both IT and Lab staff need to be allocated
as well as being able to understand the
Chasm between IT Department capability and the Big Expectation
to the project, de-allocated from what
breadth of a system, its implications on the
they are doing and backfilled. Otherwise
organisation, communicating and setting
So we struggle to maintain what we have.
we must accept that it won’t get done or
expectations would help any significant
Doesn’t everybody? It’s a bit like telling
will not be done very well.
project, IT or otherwise.
friends about your cold. You get back more
rival sickness stories than the sympathy
tends to undervalue or ignore the amount
both public and private organisations
you were expecting. Yet the operational
of effort required for a task. We began
are willing to share approaches and
side of IT in Pathology will struggle that
tracking all significant IT requests and
information. There is ambiguity around
bit harder to meet benchmarks which are
found a vast gulf between the estimate
what are the boundaries when it comes to
taken from other better funded industries.
made by the requesting department (“That
‘commercially sensitive information’ and
It will also have a very hard time to deliver
little report should only take a day. Why
so some conversations come to a reluctant
on the high-level ‘strategic’ initiatives that
am I still waiting?”) and the actual effort
end but the willingness is there. Is there an
are proposed by Government, NEHTA17
involved (“That little report took 60 hours
enthusiastic agency out there to facilitate
and other Health Informatics agencies.
because the underlying data came from
I am not at all suggesting that these
two different systems”). This is a constant
initiatives are not sorely needed or that
feature but at least now we can associate
time and money needs to be given to the
we will not benefit from them in the long
the amount of effort alongside what may
practical realities of handling transitions,
term but for the short term we are asking
sound like excuses to explain delays in
implementations and support.
organisations who already have a lot of
complexity to introduce more. It is not so
Considering staff time as ‘free’ also
I have found that IT managers from
For those larger initiatives, more
Strategically, it would be beneficial
to consider IT solutions in the context
much the implementation of a system
but the transition of current systems,
A lot of IT staff around the country
consolidating functionality and reducing
interfacing and workflow to accommodate
are working hard to achieve poorly
complexity where possible. This involves
them that is of concern.
defined functionality in loose standards
functionality and requires a support
These larger health initiatives, such as
of the whole organisation with a view to
and Electronic Health Records are where
the big money is supposed to be going.
Pathology IT. All this is done with limited
for Pathology IT departments, we need to
While Medicare did provide some funds to
budgets, training, salaries and career
get back to the reality — we are limited
assist with implementation, it was barely
development prospects. Many projects
in our ability just to achieve the basic
enough for tea, doughnuts and a pack of
are ‘successfully’ delivered more due to
functionality. The shiny, leading edge IT
headache tablets, in order to implement
the goodwill and determination of IT and
part appears to be, unfortunately, another
our side of the Medicare Online interface.
Laboratory staff rather than good project
domain. Or we need a serious champion to
There was, however, a rather firm deadline
go about changing it — in a big way.
set, some vendor negotiations that didn’t
go well, a very limited ‘Test Environment’
from being quite ugly. The shiny, leading
storming down to the IT Department
and the overshadowing thought that
edge parts are mostly done by academics
with a formulated complaint regarding
significant amounts of revenue would not
and the boring operational bits left
why something ‘easy’ has still not been
be coming in after a certain date set by
to IT Departments but with no career
delivered, bring chocolates. And two
Medicare. Basically the transition was not
paracetamol for the IT Manager.
easy and it fell on IT and billing staff to do
on tight budgets, it is not particularly
it. The same people who still have their day
attractive to Software Vendors or other
job doing the other things they do.
industry IT staff.
References are available online at the
Pulse+IT website: http://bit.ly/hBivot
With regards to project staffing, I have
Medicare Online, Unique Health Identifiers
The Pathology IT Industry is suffering
At a high level, some skills are clearly
mechanism from Management.
For those who have great expectations
So the next time you find yourself
BITS & BYTES
DONORtrak system to streamline organ transplant process A clinical information system designed to
were more likely to be accepted for
streamline the administrative and clinical
transplantation if they were donated in
processes associated with organ transplant
the same state where there was a heart/
is being evaluated by the Australian
lung transplantation program. One of
Government’s Organ and Tissue Donation
the reasons we thought this might be the
and Transplantation Authority, alongside
case is because its pretty difficult for the
a number of internationally developed
transplant physicians to have access to
the information they might need to make
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a decision to transplant a heart into a
developed by NEXVIEW Systems in
recipient. It’s a very big decision to make
collaboration with staff of the Flinders
and the process is very time critical.”
Medical Centre, with the intellectual
property for the system now residing with
DONORtrak has a more comprehensive
feature set, the project initially focused on
providing clinicians with access to images
commenced following a chance meeting
at the Flinders Medical Centre in South
Australia, where Catherine Hannan, an
of the information available to the people
Organ and Tissue Donor Coordinator,
making the decisions was not of insufficient
became aware of a system operating in the
quality, but perhaps of insufficient detail.
Cardiac Echo Department that supported
We started off the project to develop a
the remote display of echocardiogram
system which had the capacity to transmit
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images. As South Australia doesn’t have a
heart/lung transplant unit, these organs,
physicians and surgeons could look at the
potentially suitable for transplant, are
images themselves rather than having to
offered to hospitals in other states,
rely on an interpretation from someone
including Queensland, New South Wales,
else,” explained Dr O’Callaghan.
Victoria and Western Australia. Having
seen the applicability of the remote display
includes an Organ and Tissue Donor
of echocardiogram images to the current
organ transplant process — and with a
amount of time populating a substantial
knowledge that hearts being offered from
paper‑based organ referral document with
South Australia for transplant in other
de-identified information contained within
states had less chance of being accepted
the deceased person’s medical record. The
than hearts offered from within these
referral documents contain as many as 27
states — a project to develop a clinical
information system to support interstate
organ transplant began.
Coordinator then undertakes a process of
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“We felt that on balance, the quality
offering the available organs to potential
consultant in intensive care medicine and
the National Medical Director of the Organ
This process involves the relaying of
and Tissue Donation and Transplantation
the information collected in the referral
Authority involved with the project,
explains: “I was concerned that hearts
Coordinator by telephone. This information
BITS & BYTES is subsequently conveyed to the recipient
entered by the donor coordinator are
transplant surgeon, allowing them to make
visible, negating the need for the telephone
Health-e-Nation conference coming to Melbourne in April
a determination regarding the suitability
transcription process to occur. With the
To be held at the RACV Club in Melbourne,
of the organ for transplant into one of their
information centralised in the DONORtrak
CHIK Services’ Health-e-Nation conference
system, multiple people involved in the
returns in its ninth year with the theme,
While fax machines have been utilised
process of the organ transfer can view the
throughout the health sector for many
data simultaneously, which Dr O’Callaghan
years for the transmission of documents
suggests will lead to improvements in the
needing to be sent in a timely fashion, this
quality of care delivery.
include Jane Halton, Secretary, Department
method of communication is not deemed
“From the point of view of information
of Health and Ageing; Peter Fleming,
suitable for use in the organ transplant
sharing in health, systems that minimise
CEO of the National E-Health Transition
process to protect donor and recipient
the potential for data entry errors and can
Authority; Marianne Shearer, CEO of the
confidentiality. The fact that recipient
record and capture information that can
Melbourne East General Practice Network;
donor coordinators may not be at their
be used in a reproducible and consistent
and Rachel de Sain, Director, Flaxworks.
place of work when an organ becomes
way to analyse practice are really crucial to
available has also ruled fax out as a viable
developing appropriate safety and quality
speakers, including Chai Chuah, National
method of communication.
standards,” said Dr O’Callaghan.
Director, National Health Board, New
Confirmed speakers for the conference
The event will also feature international
In addition to replicating the textual
Zealand Ministry of Health; Dr Rina
suitable for implant for four and six hours
information found in the paper-based
Yahalom, Deputy CEO, Kaplan Medical
respectively following retrieval from a
referral document, the electronic nature
Center, Clalit Health Services, Israel; and
deceased donor — and with such organs
of the DONORtrak system has allowed
US presenters Claire McCarthy and Douglas
retrieved from South Australia needing to
the developers to provide additional
Eastman, who will be providing insights in
be transported long distances — improving
functionality that paper-based workflows
their capacity as ‘sustainable change and
the efficiency of administrative processes
can not support. Images and video can be
organisational effectiveness experts’.
was seen as a high priority for the people
uploaded into the system, which typically
collaborating on the DONORtrak system.
include x-rays, echocardiogram videos, and
sessions, the conference will incorporate
With hearts and lungs only remaining
In addition to presentations and panel
high resolution photographs of extracted
an industry exhibition. In contrast with
a heart, there is only four hours to
many larger events, industry exhibits will
surgically retrieve the organ and transport
be collocated within the conference hall,
it to, and subsequently transplant it
to provide what the organisers are calling
into, a recipient. That’s not a lot of time
of such systems as Catherine Hannan
an ‘inclusive and intimate’ setting designed
in a country as big as Australia,” said Dr
describes: “A lung specialist who viewed
to promote the involvement of vendors in
our referral information electronically rang
With these time pressures in mind, the
up and said ‘these lungs look quite wet,
DONORtrak system’s feature set evolved,
do you mind getting the ICU consultant to
Thursday, 7 April, and will be followed by a
and now serves as an electronic replication
give some Lasix’, which is a drug to try and
networking reception and invitational CEO
dry out the lungs. ‘I also see that you have
“When a decision is made to transplant
The conference proper is to be held on
an intravascular diagnostic catheter in this
patient, can you do some pressure readings
the conference, including an invitational
into the electronic referral screen in
for us?’ All of a sudden they weren’t just
CIO meeting and a formal dinner to be held
DONORtrak, the donor coordinator is able
getting the chest x-ray, they were actually
on Wednesday, 6 April. Facilitated by Claire
to offer an organ via the system by simply
understanding more about the way in
McCarthy and Douglas Eastman, a series of
selecting a recipient donor coordinator’s
which the donor was being managed in
workshops will be held on Friday, 8 April,
name and clicking a ‘send’ button. The
the intensive care unit, and were able
concluding the three day event program.
to be involved in some of the clinical
an SMS and an email, which contains a
management of that donor to try and
conference and the associated events
link to the DONORtrak website. After
improve the lungs so that the transplant
authenticating to the system, all details
outcomes would be maximised.”
Two days of related events will flank
BITS & BYTES NEC deploys Internet access to senior Australians NEC Australia has announced the Yarraville
Electronic Journal of Health Informatics releases eighth issue
Senior Citizens Centre as the 2000th site to receive a Broadband for Seniors Kiosk,
facilitated by the Australian Government’s
Informatics (eJHI) has just published its
Professionals” (J. Chen, Y. Park, G. Putzer).
$15 million Broadband for Seniors initiative.
latest issue, Volume 5, Number 2 (2010),
which is available on its website.
eHJI website provides a good overview of
An official flyer available from the
In a statement accompanying the
the scope, objectives, editorial Board and
confidence and skills of senior Australians
release of the eighth issue, Dr Sebastian
other relevant information of the eJHI
Garde, Managing Editor, remarked that
including a brief statement of what it is
increasing community participation and
this “is the first issue to only include
— “an international journal committed to
social inclusion, and helping them live
‘normal’ papers that were unsolicited and
scholarly excellence and dedicated to the
independently for longer.
not part of a Special Issue,” however in
advancement of Health Informatics and
Since the initiative launched in July
the introduction to this issue, Dr Garde,
information technology in healthcare. It
2009, an estimated 94,000 seniors across
confirms that the eJHI will continue to
is a journal for all health professions and
Australia have had access to the kiosks
publish special issues on topics of interest
informaticians of all levels”.
and training in sites from Fitzroy Crossing,
in Health Informatics that are edited by
Western Australia to Swansea, Tasmania,
— providing open access to both authors
dramatically increasing the availability
Since its inaugural issue in 2006, the
(i.e. no publication fee or page charges)
of Internet services and building their
eJHI has published papers around special
and readers (i.e. free access to all papers).
confidence in using technology.
interest topics in health informatics,
In a statement, Chief Editor Professor
In a statement, David Cooke, Group
including systems interoperability, data
Evelyn Hovenga said that the eJHI “can
Manager, NEC Australia, said: “Since
mining, aged care informatics and privacy
The eJHI is an “open access” journal
with papers received from authors from
2009, we have seen a fantastic response
from both volunteers and community
cover a range of health informatics
New Zealand, U.K., U.S., Sweden. Japan,
organisations wanting to get involved.
topics that would be of interest to many
Germany, Greece, India and Indonesia.
The benefits that the initiative offers older
readers and include the following papers:
Prof. Hovenga remarked on the high
Australians — such as providing a supportive
editorial standard of the journal, stating
environment to gain knowledge and skills
Ambient Assisted Living Systems” (J.
that “all eJHI papers are peer-reviewed
in using computers and the Internet — have
Soar, J. Symmonds), “Miscoding Rates
by independent experts with an average
certainly been realised. One major outcome
acceptance rate after one or more review
emerging is the sheer number of older
Trial Results — Software Solution” (R.A.
rounds of around 50%”.
Australians connecting with distant family
Henderson, K.C. Nielsen, S.M. Klein, R.
members both in Australia and overseas.”
Pietrobon), “Computer Skills and the
Australasian College of Health Informatics
Since the initiative kicked off, over
Training of Medical Students in a Ghanaian
43,000 online lessons have been completed,
Medical School” (E. K. Achampong, K.K.A.
Society of Australia (HISA). Articles are
with the most popular courses being
Pereko), “An Evaluation of Patient Usage
indexed or archived by several services
Introduction to Computers, Introduction
of Computers to Manage Information
including Google Scholar, the Directory of
to Word Processing, Introduction to the
Relevant to Diabetes Care” (M. G. Hill),
Open‑Access Journals, PKP Open Archives
Internet and Introduction to Email.
“The Fusion of Clinical Guidelines with
Harvester, Pandora, Australian Journals
Mr Cooke stressed the importance of
Technology: Trends & Challenges” (C.E.
Online, OAIster, and the eGranary Digital
technology to older Australians, stating:
MacDougall, C. McGregor, J. Percival),
“IT literacy is only going to become more
“Pathology Results in the Electronic
important as Australia’s population ages,
Health Record” (J.F. Hamblin, P.T. Bwititi,
available from the website:
and e-health and home based services
H.T. Moriarty) and “An examination of the
become the norm.”
Components that Increase Acceptance
The contents of the latest issue
The eJHI is the official journal of the and
More information on the eJHI is
— Paul Clarke
BITS & BYTES Maestro Toolbar connects practice software with Healthcare Identifier Service
IBM awarded NASH contract The National E-Health Transition Authority
NEHTA to build a system that will give
(NEHTA) has tasked IBM with developing
healthcare professionals timely and secure
software utility that can enable clinical
the National Authentication Service for
access to appropriate patient information,”
Health (NASH), awarding it a $23.6 million
said Peter Fleming, Chief Executive Officer,
Australia’s Healthcare Identifier Service.
NEHTA. “In turn, the NASH program
This repository contains over 23 million
will take us one step closer to broader
Individual Healthcare Identifiers (IHI), which
the launch of the Personally Controlled
healthcare access for all Australians.”
are intended to be used to assist disparate
Electronic Health Record (PCEHR) in July
healthcare organisations to reliably transfer
2012, the service will be responsible for
for IBM Australia and New Zealand, said
patient information electronically.
ensuring that access to health records is
the agreement represented a vital step
in promoting the broader take-up of
software is designed to extract patient
demographic information from a clinical
supplying a software development kit to
database and use this data to interrogate
software vendors to assist them to enable
Australian doctors, nurses and allied health
their systems to interface with the new
providers and accelerate the delivery
the demographic details are matched
of smarter healthcare across the entire
successfully with a record stored by
healthcare system,” said Mr Stevens.
Dubbed the Maestro Toolbar, the
Medicare Australia, the patient’s IHI is
Scheduled to be implemented by
NEHTA has indicated it will be
“Our agreement with IBM enables
Andrew Stevens, Managing Director
“This program will benefit over 600,000
the Maestro Toolbar if the clinical software
Orion Health updates its Rhapsody Integration Engine
does not yet support the storage of IHIs.
Orion Health has released an updated
conditional routing interface are said to
In addition to the Healthcare Identifier
version of its Integration Engine (version
provide faster and simpler configuration of
functionality, the Maestro Toolbar also
4.1), which it states will speed up interface
complex routing rules based on message
brings together a range of other features.
development through the addition of a
The utility can extract patient summaries
unit testing framework and an improved,
from clinical software and upload this
simplified graphical interface to assist with
version include new options for custom
information to a centralised electronic
branding and deployment, with Orion
health record system called Healthbank. A
“Rhapsody is designed for rapid,
Health’s partners now able to place their
reporting function is also included, which
effortless installation and use, and enables
own branding on the product splash
allows practice staff to query their clinical
fast accurate and efficient exchange
screens and other prominent locations,
software database and generate reports,
of electronic health information” said
whilst OEMs will now benefit from
regardless of whether the clinical software
Orion health’s marketing manager, Sarah
unattended installation and configuration
is running at the time.
returned to the Maestro Toolbar. The IHI can then be inserted into the patient’s record in the clinical software, or simply held within
The Maestro Toolbar also includes an
Orion Health states that the addition
Other features supported in this new
instant messaging system, which allows
of the unit testing framework will
practice staff to communicate with other
simplify testing of multiple scenarios
provides support for a wide range of
users of the system within their practice
and configurations, as well as enable
in real time. This messaging system
the test scenarios to be stored within
is complemented by another service
a configuration to support advanced
embedded in the Toolbar called safeNET,
regression testing. In addition, these
information systems, including support
which allows users to send files securely to
test scenarios are able to be easily
for all versions of HL7 (versions 2 and 3)
other practices or external typing services
shared between different configuration
and Clinical Documentation Architecture
by simply dragging and dropping them into
environments — i.e. development, test and
(CDA) and Continuity of Care Documents
a folder on their desktop.
production servers. Improvements to the
(CCA), Web Services, XML Integrating the
The Rhapsody Integration Engine
protocols, standards between
BITS & BYTES Healthcare Enterprise (IHE) profiles, XML,
options for Orion Health Partners; fast,
X.12 and NCPDP.
intuitive interface development; simplified
standards support and advanced interface
With regard to support for Web
Services, in a statement, Orion Health
Product Manager Paul de Bazin said
“The web services framework has been
Integration Engine different to other
based on the international web services
offerings from competitors, Mr de Bazin
interoperability standards (ws-i.org) which
said, “compared to other integration
brings together different web service
technologies, Rhapsody is simpler to
standards into groups of profiles e.g.:
deploy, easier to work with, and handles
WS-Security and WS-Addressing are in the
its own maintenance.”
Mr de Bazin also commented on IHE
uptake of the new version of the Rhapsody
support: “Rhapsody has recently been
Integration Engine has been better than
certified at the January Connectathon in
expected and that “the new features in
Chicago for Cross Enterprise Document
Rhapsody 4.1 have been well received with
Exchange (XDS) and QED profiles.”
over 150 organisations having downloaded
the release already.”
For advanced users, Orion Health
Asked what makes the Rhapsody
Orion Health commented that the
provides a development kit that enables
developers to add new functionality and
been sold in over 30 countries, with a large
protocols via the Rhapsody Application
base in the US, New Zealand, UK, Spain,
Programming Interface (API).
Middle East and with Asia as an emerging
market, particularly in China, Japan and
Orion Health claims the key benefits
The Rhapsody Integration Engine has
of this updated Integration Engine version
Further details on the Rhapsody
“new unit testing framework for faster
Integration Engine are available from
integration of information systems; new
the Orion Health website: http://www.
conditional routing interface for simplified
— Paul Clarke
Below – A screen capture of the Rhapsody Integration Engine that shows the new graphical interface with ‘Drag and Drop’ tools support and other features available for developing complex routing rules.
BITS & BYTES Stat Health Systems commences software rollout Stat Health Systems has commenced the
iMIMS drug reference application released for Apple iPhone
rollout of their new practice software for both general and specialist practice, dubbed
MIMS has released a version of its
downloading data over cellular networks,
‘Stat’. As a fully integrated solution, the
ubiquitous drug reference product for the
the application gives the user the option
product contains both clinical and practice
iPhone and other devices running Apple’s
to defer drug data updates until the next
management features, including billing,
iOS, including the iPad and iPod Touch.
time the device establishes a WiFi network
claiming and appointment functionality.
Stat has been in live beta testing since
reference database containing over 5500
August 2010. Since this time the company
products contextualised specifically for the
Apple iOS devices, MIMS also retails a
has migrated its prescribing data system
Australian healthcare sector. As with other
product called MIMS Mobile. Launched in
to MIMS, having originally developed the
MIMS products, iMIMS brings together
2009, this solution was developed to work
software to use a competing solution from
from within the browser of any modern
Administration (TGA) product information,
mobile device, including smartphones
The product is built around a drug
In addition to the new iMIMS app for
Carla Doolan, Stat Health System’s
in addition to the more user friendly
running Android and Windows Mobile.
Sales and Marketing Manager touted the
‘abbreviated’ product information, which
Being a web-based solution, MIMS Mobile
product’s flexible ‘multi function interface’
includes Pharmaceutical Benefits Scheme
is compatible with a wide array of devices,
as a major strength of the software: “This
(PBS) information where applicable.
however an active Internet connection is
allows the user to commence a new action
A fully referenced evidenced-based
required. As iMIMS stores drug data on
without completing the previous action.
drug interaction checker is also included
the iOS device itself, it does not suffer this
The user has the flexibility to return to the
in the app, allowing users to generate a list
limitation and can work even when the
incomplete task at any time, and can be
of drugs by tapping on a button displayed
phone has no mobile reception.
progressing an unlimited number of tasks.
at the top of a product information screen.
This was the most frequently requested
The app then examines each drug pair in
feature from the market when initial user
the list and reports any potential adverse
requirement surveys were undertaken.
effects as determined by checks made
against primary literature sources.
“All initial screen designs are referred
back to our focus group, which consists of
doctors, nursing and practice administration
launches a pill identifier, which contains a
staff for their input. This liaison with the
database of over 2500 images. If presented
market will continue to be a focus of ours.”
with a medication, the user can attempt to
identify it by querying based on its shape,
Ms Doolan also listed other notable
Below – An iPhone displaying the Pill Identifier functionality of the recently released iMIMS app.
The third tab in the application
colour, form, therapeutic class, in addition
fine grained security controls, a task
to other search criteria.
manager and a recall manager with audit
functionality, and user definable macros to
updates approved by Apple prior to them
speed up common tasks.
being released on its App Store, the
With the intention of focusing solely on
iMIMS app has been developed in such
their own product as the rollout continues,
a way that it allows any new or updated
the company has announced that it will be
drug information to be downloaded from
ceasing support of its Stat Online Claiming
within the application, without the app
System (SOCS) and Stat Services support
itself needing to be updated. This process
at the end of June 2011.
occurs in the background when the user
Stat is being sold on a ‘concurrent user’
launches the program. However due to the
basis, with customers given the option
potential size of such downloads (40MB
to pay for ongoing annual licence fees in
to 70MB typically )and the wide variance
monthly instalments, should they so wish.
in speeds users are able to achieve when
Due to the time it takes to have app
BITS & BYTES
MIMS has indicated it is monitoring the
are $159 per year, plus an additional $15
uptake of other mobile platforms including
per year to unlock the pill identifer, which
Android and Windows Mobile 7. The
is sold as an optional module.
company however, has not yet committed
to developing purpose built applications
for download from the Apple App Store,
for these platforms at this point in time.
which can be accessed using iTunes on a
computer running Microsoft Windows or
The iMIMS application is free to
As with all iOS apps, iMIMS is available
download and trial for seven days,
MacOS X, or directly from an iOS device.
however after this time the user is required
More information about the app
to purchase a subscription to maintain full
access to the application. Subscriptions
NPS study into GP clinical software shows room for improvement NPS better choices, better health (NPS)
variety of systems with markedly different
has continued its research into Australian
clinical software, previewing an as yet
assisting general practitioners to prescribe
unpublished paper in an editorial piece
safely and effectively.”
featured in the February 2011 edition of
evaluated by NPS were Best Practice,
Genie, Medical Director 2, Medical Director
The editorial overviews a process
However an NPS spokesperson indicated
were selected and assessed against a
that the “systems will be de-identified in
comprehensive list of desirable features.
the published manuscript as the intention
This list of features was published in 2010
of the study was to look at features
by Sweidan M, Williamson M, Reeve J,
across all systems and make general
Harvey K, O’Neill JA, Schattner P, et al, in
recommendations for improvements that
their paper: Identification of features of
support quality and safety of prescribing.”
electronic prescribing systems to support
quality and safety in primary care using a
the seven clinical systems evaluated, less
modified Delphi process.
than 50% of the desirable clinical decision
In their recent editorial, authors
support features were observed as “fully
James Reeve and Michelle Sweidan
implemented,” the authors pointing to
lament the lack of standards guiding the
the “lack of clinical information resources
development of general practice clinical
in a format which is suitable for decision
software in Australia, stating: “Over 90%
support.” The authors also noted that
of general practitioners use one of the
“when systems included decision support,
20 or so commercial systems that are
it was often unclear where the information
available to write prescriptions, order
was derived from and whether it was up to
pathology and other tests, record medical
progress notes or communicate with
other healthcare providers. Despite the
the research are available from the NPS
widespread use of e-prescribing systems,
website, with results from the final stages
there are no clear standards or guidelines
of the study expected to be made available
for their development. This has led to a
via the NPS website in June.
The research revealed that for five of
general practice clinical software products
D I S C O VER
iPhone app Available on the
App Store or call 1800 800 629
APP2011 17 March - 20 March Gold Coast, QLD P: +61 7 3831 3788 W: www.appconference.com/
Health-e-Nation 2011 Conference 7 April - 8 April Melbourne, VIC P: +61 2 4365 7500 W: www.health-e-nation.com.au
3rd Annual National Telemedicine Summit 21 March - 22 March Sydney, NSW P: +61 2 9080 4300 W: www.iir.com.au/
APNA National Conference 2011 7 April - 9 April Sydney, NSW P: +61 3 9645 9858 W: www.apna.asn.au
E-Learning Summit 21 March - 22 March Melbourne, VIC P: +61 2 9080 4300 W: www.informa.com.au NZBIO Conference 2011 21 March - 23 March Auckland, New Zealand P: +64 4 916 1247 W: www.nzbio2011.co.nz 13th Annual Health Congress 2011 24 March Sydney, NSW P: +61 2 9080 4326 W: www.informa.com.au 20th Anniversary Medico Legal Congress 28 March - 29 March Sydney, NSW P: +61 2 9080 4300 W: www.iir.com.au Developing the Role of Nurse Practitioner 28 March - 29 March Melbourne, VIC P: +61 2 9080 4300 W: www.iir.com.au Patient Centred Design Forum 28 March - 29 March Sydney, NSW P: +61 2 9080 4300 W: www.informa.com.au Corporate Social Media Summit 2011 30 March - 31 March Sydney, NSW P: +61 2 9080 4300 W: www.informa.com.au
HISA NSW Branch Meeting - Electronic Discharge Reporting 14 April Sydney, NSW P: +61 3 9388 0555 W: www.hisa.org.au/nsw
MAY The 3rd Annual GP Super Clinics Summit 5 May - 6 May Brisbane, QLD P: +61 2 9080 4300 W: www.informa.com.au 12th International HL7 Interoperability Conference 13 May - 14 May Orlando, USA P: +1 734 677 7777 W: www.ihic2011.org HL7 International 16 May - 20 May Orlando, USA P: +1 734 677 7777 W: www.hl7.org Data Governance Conference 19 May - 20 May Melbourne, VIC P: +61 3 9388 0555 W: www.hisa.org.au/data-governance RACP Congress 2011 22 May - 25 May Darwin, Australia P: +61 3 9645 6311 W: www.racpcongress2011.com.au 2nd Annual Managing Ward Finances & Budgets Conference 23 May - 24 May
Brisbane, QLD P: +61 2 9080 4300 W: www.iir.com.au Rural and Remote Telehealth Conference 29 May - 31 May Cairns, Australia P: +61 3 9388 0555 W: www.hisa.org.au/telehealth 11th Annual Hospital in the Home Conference 31 May - 1 June Melbourne, VIC P: +61 2 9080 4300 W: www.iir.com.au eHealth@CeBIT 31 May - 2 June Sydney, NSW P: +61 2 9280 3400 W: www.ehealthexpo.com.au
AUGUST HISA Health Informatics Conference (HIC2011) 1 August - 5 August Brisbane, QLD P: +61 3 9388 0555 W: www.hisa.org.au/hic2011 HISA NSW Branch Meeting - Health Informatics Research 18 August Sydney, NSW P: +61 3 9388 0555 W: www.hisa.org.au/nsw
SEPTEMBER HIMAA National Conference 2011 20 September - 23 September Melbourne, VIC P: +61 2 9887 5001 W: www.himaa.org.au HIMSS AsiaPac 2011 20 September - 23 September Melbourne, VIC P: +65 9848 5259 W: www.himssasiapac.org
To view a comprehensive list of Health IT, Health, and IT events, visit the Pulse+IT website: http://bit.ly/gFr0Vk
data governance in healthcare integrity of data and information healthcare managers leaders executives clinical non-clinical data Health reform & data governance - in a climate of transformational professionals health changes to Australia’s healthcare system, infromaticians leveraging your data as an enterprise asset has never been more crucial. health policy makers academics MELBOURNE 19 - 20 MAY 2011
Data Governance The Sebel & Citigate – Albert Park
Event details & registration at
21/02/2011 2:25:25 PM
HPOS makes it easier for you to do business with Medicare Australia
More and more services are becoming available for health professionals through HPOS. New services recently added include: • Practice Incentives Program (PIP)—register for the PIP and individual PIP incentives • General Practice Immunisation Incentive (GPII)—register and update details for the GPII • General Practice Rural Incentives Program (GPRIP) and HECS Reimbursement Scheme—update banking details, apply for a Rural Relocation Incentive Grant, lodge HECS applications and more
• Track and Scale—view progress towards reducing return of service obligations as part of the Rural Health Workforce initiative • Healthcare Identifiers (HI) Service—view your provider and organisation HI details and access a directory of HI providers. HPOS continues to provide a range of services to make it easier to do business with Medicare Australia, such as: • Patient Verification—confirm and search patient Medicare card details • manage existing banking details • Medicare services—Easyclaim processing and payment reports, manage provider details and add a new Medicare practice location. For more information go to www.medicareaustralia.gov.au/hpos
Health Professional Online Services (HPOS) gives health professionals and delegated practice staff access to Medicare Australia’s online services through a single entry point.
Taking shortcuts will get you lost
Dr Geoffrey Sayer BSc(Psychol), MCH, PhD President, MSIA email@example.com
I spend a lot of time in Auckland. Auckland is a
have done in preparation, homework or consideration
wonderful and beautiful city. I like to think Auckland is
of the details that it actually takes to go from a ‘known’
well known to me. I know Auckland CBD better than
place to an ‘unknown’ place.
the locals. I know how to get to where I want to go.
But because I know Auckland, it doesn’t mean I know
a dead end with a front row view of Auckland Harbour,
the surrounding suburbs of Auckland, the surrounding
bridges off in the distance...and still in Auckland.
regions of Auckland, nor the rest of New Zealand.
For all the city’s charm, I wanted to explore the
from where we are to what we believe will be a better
Northland region to the north of Auckland on the
place, and indeed a place that we haven’t been to
North Island. I clearly had my heart set on going as far
before: the Personally Controlled Electronic Health
‘north’ as possible. The first objective was to get out of
Record (PCEHR). While slightly longer than a long
weekend, there is limited time (July 1, 2012) to connect
Not surprisingly, 50 minutes later I found myself at
In the e-health world, we want to move away
Having set out from the southern suburbs, I wanted
a considerable number of pieces together to achieve
to avoid the traffic that I knew would be banked up to
the deadline. We of course have to be careful that we
cross the Auckland Harbour Bridge. I wasn’t the only
don’t break the pieces in doing so, or we won’t be able
one wanting to go ‘north’ — it was a long weekend.
to make them fit.
I had looked at a less than detailed map that only
covered the main roads in Auckland as I climbed into
the best chance of getting you where you want to go.
my rented Subaru Outback. I decided to take a road
The beauty of careful planning and detailed maps is
that skipped around the city’s western rim. It would
you can share these resources with others. Planning
ultimately end in the general direction of ‘north’. My
and objective setting can also temper overzealous
destination was ‘north’ so as long as I was going ‘north’
ambition, while still delivering tangible benefits from
I would eventually arrive at my destination, despite the
the journey. Remember the journey itself can bring
‘non-north’ pathways I would travel. It would be quicker
delights and benefits.”
to travel the ‘unknown’ route compared to the ‘known’
route. That is what a short cut is all about — avoiding a
a well-mapped journey. During my weekend in the
longer but ‘known’ way.
Northland region, the effects of a cyclone flooded
Careful planning and detailed maps will give you
Unforeseen things will always happen, even on
There are many pathways to a destination. It
many areas and landslides were common, resulting
wouldn’t matter which one I took. I believed the
in changed road conditions or total closures. It was
pathway would just open up before me and there
necessary to back track, take stock and change the
would be signs reassuring me that I was going the right
immediate plan but not the long term goal of reaching
way. I could reassess my direction as I was going along
the Bay of Islands.
— as long as I was moving ‘north’ it would be all good.
My intention was well meaning and my desire was
to deliver the promise of a PCEHR. The work being
there. These qualities would cover any shortfalls I may
undertaken by the Wave 1 sites (GP Access, GPpartners
There are considerable pressures on many people
and Melbourne East General Practice Network) and
the Wave 2 of the PCEHR project, as the names imply, As well as being President of MSIA, Geoffrey is General Manager Australia of HealthLink. He has spent the past 20 years working as an epidemiologist. For the past 10 years Geoffrey has occupied senior management positions in medical software companies.
are building up momentum. It is important that these waves don’t come crashing down on the unsuspecting clinicians and healthcare users if not carefully managed. The pressure to deliver on ambitious promises will result in short cuts around the implementation of standards that could end up causing longer term
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Incorporating HIMAA 2011 National Conference
The place to connect with global leaders who are advancing healthcare through IT.
The HIMSS AsiaPac 2011 Conference & Leadership Summit, incorporating the HIMAA 2011 National Conference, will provide for unlimited networking with the best minds in health care and technology. For both attendees and exhibitors, this provides tremendous opportunities to exchange ideas and stay on top of the latest developments in technology, policy and industry practice. Save the date!
20-23 September 2011 melbourne Convention and exhibition Centre, auStralia www.himssasiapac.org For inquiries: Mr. Steven Yeo, HIMSS Asia & Middle East | +65 9848 5259 | firstname.lastname@example.org For HIMAA Corporate members: Ms. Rose Wong, HIMAA | +61 2 9887 5001 | email@example.com
problems or take us to dead ends.
what is being attempted. It is speculated that there
The point of technical standards is to ensure quality,
will be 10-15 successful bids which, if correct, will
consistency and interoperability. It is important that
leave 80+ bids unfulfilled. Now while we all want value
we look at the standards work that has been done
for money and are keen to show that the PCEHR
previously. At times the market moves faster than the
can deliver tangible benefits, how do we harness the
standards setting process. There are also lessons to be
enthusiasm that is on display? Were the bids that will
learnt from why the previous standards haven’t been
ultimately miss out unable to demonstrate an ability to
implemented consistently. We need to make sure we
deliver tangible benefits? Were the pathways they were
don’t just develop new standards in an attempt to
mapping out taking us to places where we don’t want
overcome the perceived implementation problems
of previous ones. Many problems have occurred in
the past from the lack of harmonisation and testing
initiatives there will be cycles of redevelopment. While
of compliance with the standards, not because of the
there is a belief that it provides an advantage to those
software vendors participating early, any iteration of
If I have a criticism of New Zealand it’s that they
software code comes with extra burdens of quality
don’t have as many road signs as Australia in rural and
assurance and testing. Testing processes under the
remote areas. What is considered a major road on a map
Conformance, Compliance and Accreditation (CCA)
is not a major road in my Australian experience. You
program are also evolving. Companies who get involved
therefore need to make sure you speak to the people
earlier will most likely be required to repeat cycles of
who know the roads and pathways — those who have
travelled the area before. It is rewarding talking to the
locals as you learn things you haven’t even considered
participating in the PCEHR program to take short cuts,
or you can discover things that are not on the map. You
while many non-participating companies will wait
find real short cuts from the people who know.
until the dust has settled. Furthermore, unless there
As we learn from the lessons of these early
There will be pressure on software vendors
There has been an ever increasing recognition for
is alignment of the business cases that will attract all
the role for software vendors in delivering the building
vendor participation and sustainable business models,
blocks that will underpin the PCEHR. Vendors are an
then the participation by vendors will be further
experienced and valuable asset to provide guidance
reduced over time.
in what is possible and how long things actually
take. However, software vendors are unfairly cast
where we want go, but haven’t bothered to consider
as putting money before patient safety and as road
the steps it actually takes to get us there. A high level
blocks to progress. It is fair to say the software vendor
view is not enough. A desire is not enough. It is a form
community has given more than they have actually
of risk taking when we take short cuts — we are not
received from the funding directed to e-health in the
sure it will work but we feel it is better than the longer
last five years. Recently a vendor emailed the MSIA
way. The problem we create for ourselves is that we
with a simple analysis they had undertaken that showed
are trying to achieve too much at once in too short
that the vendor community had possibly spent more
a time. A long journey is best broken up into smaller
money on assisting in the development of the building
journeys. Each one brings their own benefits — IHIs,
blocks and engaging in the bidding process for Wave 1
SMD, terminologies and patient summaries. With the
than what has been reported will be available to those
addition of other journeys we will have the ability to
vendors who are in negotiations to be on the GP Vendor
have PCEHRs for those who want one to assist in their
journey through the healthcare system.
Bidding takes time and money. For Wave 2 ($55
Many of us have taken short cuts because we know
For my own road trip the benefits were new
million) there have been reports of over 90 applications
friendships formed; drinking with the locals at the Boar
from consortia of like minded software vendors and
and Marlin in Oponini; counting stars and satellites as
healthcare organisations. This shows the considerable
they appeared on a clear night on Cable Beach; and the
interest in the PCEHR program but we need to be
view across the Bay of Islands from a hilltop vantage
mindful that there is only limited funding relative to
point on horseback.
New research offers insight into Supply Chain reform Why is it that companies such as Wal-Mart, Zara and Dell find their way into any text on supply chain management whereas there is rarely a mention of a hospital that is a leader in this field? That’s the question at the centre of new research by Melbourne University academic Dr Vikram Bhakoo ... The study, scheduled for release later this month,
is the first of its kind in Australia and one of the first
or so behind other industries in technology adoption
internationally to focus on supply management
despite growing and unrelenting pressure from factors
in healthcare. It offers rare insight into e-business
such as Australia’s ageing population, technological
adoption behaviour and the drivers and impediments
innovation and demand for higher standards of care.
to technology uptake. Dr Bhakoo uses 15 in depth
Despite these facts, hospitals have been reluctant to
case studies, from the pharmaceutical hospital supply
embrace strategic supply chain thinking as a solution
sector, to reveal some interesting findings with specific
to the escalating costs.
implications for technology providers, healthcare
managers and government regulators alike.
that make it very different from other industries,
such as grocery or retail, where the supply chain is
The release of Dr Bhakoo’s report coincides with
Dr Bhakoo points out that healthcare is decade
“Health is an industry with unique characteristics
the Commonwealth Government’s proposed reforms
connected and automated,” he said.
designed to improve public hospital services, ensure
the sustainability of the health system and bolster
numerous systems that don’t talk to each other.
Unlike other industries, you also have various levels of
maturity, for example between jurisdictions, and no
The study highlights that waste and inefficiency are
“In health, you have multiple participants and
key cost drivers in the health system with supply chain
powerful market leader to set the pace.
representing the second largest component, or one-
third of all hospital expenses1. This supports estimates
even further, particularly between manufacturers and
from the Productivity Commission that some public
wholesalers/distributors, which cause bottlenecks
hospitals may be running up to 20% less efficiently
that significantly restrict the end to end integration of
than best practice . At the same time, there is evidence
to show that supply chain costs can be significantly
reduced by effective supply chain practices3 which, in
standards so we cannot afford to fragment our
turn, improves labour productivity and frees additional
demands or the large international companies won’t
time for operational improvement with significant
play. This emphasises the need for a uniform national
flow-on benefits for patient safety.
approach to interoperability, aligned with international
“The complexity of supply relationships extends
“Australia is a very small market by international
standards, and therein lies the challenge for Australian The National E-Health Transition Authority was established by the Australian Commonwealth, State and Territory governments on 5 July, 2005 to develop better ways of electronically collecting and securely exchanging health information. For more information about NEHTA visit: http://www.nehta.gov.au, for more information about e-health visit: http://www.ehealthinfo.gov.au
supply chain reform.”
Overall, the study identified a range of operational,
financial and strategic factors and a complex range of institutional factors operating within pharmaceutical hospital supply.
“This poses key changes for technology suppliers
who need to customise their product offerings, and
Dr Vikram Bhakoo is a lecturer in Operations Management, Department of Management and Marketing at the Faculty of Business and Economics, University of Melbourne. He has international experience in textile manufacturing and the IT industry with a BA (Hons) (Economics) from Delhi University, and a PhD and Masters in Information Management & Systems, from Monash University.
are key drivers for uptake by hospital
devices in use across the country.
In 2010, Australian Federal, State
manufacturers are more attracted by
financial advantages and a return on
signed an agreement committing to the
investment. Conversely, clinicians are
collaborative development and adoption
both distributors and consumers in the
of national eHealth standards in supply
pharmaceutical supply chain and are
chain management as a mechanism for
motivated largely by the potential for
improving patient safety and service
technology to improve patient safety and
quality. This commitment includes working
quality of care.”
towards effective adoption and utilisation
The study supports the work of the
of the National Product Catalogue and
National E-Health Transition Authority
the NEHTA eProcurement Solution, which
defines specifications for secure electronic
establishing specifications for a supply
transfer of transaction messages such as
purchase orders, invoices and dispatch
manufacturers, wholesalers, distributors
and purchasers across the Australian
healthcare sector. A key element of the
work is establishment of the National which
marketing messages, to suit the needs of
different players in the sector.
provides standardised identification for
References are available online at the
more than 100,000 medical products and
Pulse+IT website: http://bit.ly/ic16Rk
“For example, operational benefits
Visit NEHTA’s Supply chain website:
Rural and Remote
Telehealth Conference Cairns 29 - 31 May 2011
conference focus • • • •
Provide policy relevant input to Federal Government Articulate the strategic and operational attributes of telehealth Demonstrate operational key success protocols and practices Network with clinicians and high level executives with a passion for telehealth
event themes • • • •
The clinical user experience Clinical workflow integration and EHR National Broadband Network design and opportunities The practice of telehealth
event detail and registration
www.hisa.org.au/telehealth FINAL_RR2011_PULSEIT180x120.indd 1
28/02/2011 2:06:32 PM
Information security and social engineering Alberto Tinazzi
IT Security Consultant eHealth Security Services firstname.lastname@example.org
Often, when I discuss the topic of Internet security with
these being patients or more generic customers and
health professionals, I receive a lot of scepticism and a
suppliers in the healthcare sector. A practice needs to
common question: “We are not a bank or a corporation
protect its patients’ records not only to comply with
with valuable trade secrets! Why would someone be
legal requirements, but also to protect the privacy of
interested in hacking into my practice information
patients who have given their information in good
system? Why would a hacker be interested in accessing
faith that it will be stored and treated with maximum
my patients’ clinical records?”
When a malicious individual (hacker) attempts
For any business, including medical practices,
to penetrate an information system, they do not
information is the most valuable and irreplaceable
necessarily know what they will find and how valuable
asset, requiring adequate protection. It is, in fact, a
that information is to them until they actually get inside
common mistake to think that medical records have no
the information system and take a look around. They
simply take a gamble.
According to the Australian Businesses Assessment
The first step for a hacker would be to identify a
of Computer User Security (ABACUS) report 2009,
vulnerable target. This is quite an easy task to perform
from the Australian Institute of Criminology, crimes
even for a non-professional hacker. In fact, there are a
involving identity theft have increased in recent years
number of automated tools available on the web that
and businesses operating in the healthcare sector
can be used to scan and detect the vulnerabilities of an
manage a large quantity of personal data, making
information system connected to the Internet.
them prime targets for this kind of crime.4 Personal
A large number of intrusions are perpetrated by
information stolen through security incidents can be
young people (script-kiddies) that use hacking tools
used to commit more serious crimes. For example,
downloaded from the Internet just for fun and simply
an individual in possession of a patient’s personal
because they can get away with it.
information could ring the patient’s bank and organise
The FBI Internet Crime Report 2009 indicated that
a money transfer. In fact, if you forget your telephone
in 2009 7.9% of cyber-crimes have been motivated
banking password, how does the operator generally
by vandalism while identity theft scores 14.1%.2 The
identify and authenticate you? By asking a few personal
2010 Data Breach Investigations Report from Verizon
questions such as name, surname, address, date of birth
indicates that 36% of security breaches are perpetrated
— information that is also stored in clinical software.
against random targets.
The Australian Taxation Office reported identity
Computers used in a business context, compared to
theft to be the single biggest component of the $65
home computers, handle very different types of data.
million worth of fraud they identified in the first two
Home computers hold data related to an individual and
months of this financial year.5
perhaps their family members. Business computers
store information concerning many other individuals,
can also be used by perpetrators to blackmail patients,
In addition to identity theft, stolen information
threatening to disclose their information if they do not Alberto Tinazzi is a Certified Information Systems Security Professional (CISSP). He works as an independent information security consultant specialised in the healthcare sector. He has 16 years experience as an IT professional, specialised in information management and security. He has spent the last 10 years working within the health sector covering a number of different roles within the Division of General Practice Network.
agree to pay a ransom.
In May 2009, the Virginia Department of Health
Professions (DHP) received a request to pay a US$10 million ransom.6 The perpetrator claimed to have downloaded a copy of their database containing records of over 35 million prescriptions and to have encrypted the original database making it inaccessible
to legitimate users. It was ultimately discovered that this claim was actually a hoax, but such scenarios may really happen. However, rather than targeting a large enterprise, which probably has good security in place, and for a huge amount of money, which will be very difficult to cash and launder without being detected, hackers may prey on smaller, more vulnerable targets.
The consequences of an attack of this kind can
impact on both confidentiality and availability of information, and may have very serious repercussions on a business from a legal point of view, as well as causing loss of trust and patient confidence.
The recent introduction of the Unique Healthcare
Identifier and the determination of the government to establish personal electronic health records in the next 18 months puts enormous pressure on practices to get their information system up-to-scratch, particularly from a security point of view.
Social Engineering Social engineering is a hacking technique that focuses on exploiting the natural human tendency to trust. The objective of a hacker is always to gather confidential information, but in this instance, using psychology rather than technology. This type of attack is carried out against people, not against technology and is therefore very effective at bypassing even the strongest technical security countermeasures that a business may have in place.
It consists of manipulating people into performing
certain actions or revealing sensitive information. Social engineering is normally carried out in person or over the phone.
The hacker, in order to prevent their behaviour
becoming suspicious, will avoid requesting too much information from a single victim or during a single conversation. The perpetrator will gather a little bit of information from multiple people, or over time, by building up a friendly relationship with the victim.
An example of social engineering could be someone
pretending to be from your bank calling you late in the evening and asking for your authorisation in relation to a transaction of $2000 for the purchase of a digital camera in Israel. You are obviously shocked at the news having not been to Israel before, let alone bought a digital camera! The caller reassures you by telling you that they can reverse the unauthorised transaction
by you simply confirming your name and
and replaced legitimate EFTPOS machines
The email includes a link to an online
entering your credit card number and
with compromised card-skimming versions
form, which requests the recipient supply
expiry date into the phone. Many people
of the device. It has been estimated that in
personal details, which are then used by
in the spur of the moment will succumb
NSW only the scam netted over $50 million
the malicious sender to steal the victim’s
to such a request. Don’t be fooled, be
in 12 months.7
identity and commit more serious crimes.
suspicious. The best advice in this case is
Social engineering attackers also make
So, to be safe, never open or reply to
always to tell the caller that you will call
use of email. These so-called ‘phishing
suspicious emails but rather contact the
your bank directly to verify.
emails’ are fraudulent messages sent
credit institution or government agency via
by someone pretending to be a trusted
phone to verify that the message received
engineering, known as baiting, occurs when
source, with the objective of tricking
hackers strategically drop some kinds of
the recipient into revealing confidential
media in conspicuous places, such as a USB
information. The most common appear
engineering is training and awareness.
key containing malware. A passer-by will
to be sent by credit institutions asking
A medical practice should have in place
soon spot it and pick it up. Not knowing it
the recipient to change an online banking
strong policies that all employees are
is a virus-infected device, the curious finder
password. The email provides a link, which
familiar with. Staff should be aware of the
will use it on their work or home computer.
once clicked-on connects the recipient to
risks posed by social engineering tactics. If
Some computers are set-up to auto-run
a fake website resembling the real one.
they suspect that they have been subjected
inserted media, in which case the computer
Once the recipients log on to the website,
to this kind of attack, they should be
will immediately be infected.
their credentials are collected and the
encouraged to immediately report it to the
perpetrator can later use them to steal
An example of a recent and very
money from the victim’s bank accounts.
involved a few major cities in Australia.
One of the most recent examples of
People pretending to be technicians sent
‘phishing emails’ is one that claims to be
8,9 HalfTaxation Page 180 x 120 by the bank visited various retailHealthLink/Medinexus outlets from the Australian Office.
References References are available online at the
Puse IT website: Mag http://bit.ly/hGCP8M Pulse+IT
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Internet Backup for medical practices Simon James
BIT, BComm Editor, Pulse+IT email@example.com
computer to be backed up (usually the practice server),
The importance of performing daily backups of clinical
the user specifies the files they wish to backup and
data is well understood by medical practices and larger
schedules the times of day they wish these backups to
The devastation that befell a number of such
Internet backup solutions are typically configured
organisations as a result of the recent Australian
to backup files on a computer system incrementally.
floods and the tragic Christchurch earthquake serves
This means that only files that have been modified
as a telling reminder for the need for robust, off-site
since the last backup occurred are copied to the remote
backup procedures to be in place. However, reflecting
facility, reducing the time a backup takes to execute. To
on the sheer scale of the recent natural disasters, what
optimise this incremental process even further, some
a business defines as ‘off-site’ needs to be carefully
solutions use sophisticated “block level technology”.
considered. Any entrenched perceptions that the
This technology is designed to detect and upload the
separation of a backup from the original data by a few
discrete parts of large files that have been modified
kilometres is adequate must surely be challenged in
since the last backup, negating the need for the entire
light of recent events.
file to be re-uploaded.
Fortunately, ongoing improvements to Internet
The first time an Internet backup is performed, all
infrastructure now afford medical practices the ability
the data the user wants to protect must be uploaded
to mitigate the chance of total and catastrophic data
to establish a baseline for subsequent incremental
loss occurring by leveraging the distributed nature of
backups. Depending on the speed of the practice’s
Internet connection and the amount of data, this
How does Internet Backup work?
may take hours, days or even weeks! However after this first upload has completed, subsequent backups
Backups in most medical practices are currently
occur in a much more timely fashion. To be considered
achieved through the utilisation of CDs, DVDs,
a viable backup solution, ongoing backups need to
tapes, USB thumb drives, external hard drives, or a
be achievable in a matter of 24 hours at most, or the
combination of these technologies. Internet backup
timeliness of the most recent backup will degrade
solutions retain the same principles of redundancy,
to the point where unacceptable levels of data loss
however instead of utilising a local storage device,
will occur in the event of deletion or corruption of the
practice data is transferred across the Internet, usually
to purpose-built data facilities with redundant capacity
spread across multiple cities, and potentially across the
listing the files that were backed up and the length of
time it took to perform the transfer. This log file should
While there are a vast array of companies offering
be monitored at frequent intervals to ensure that the
Internet backup services, from the users’ perspective
backup is being performed reliably. Emails can be sent
they work in much the same way as described below.
by most backup software at regular intervals to assist
in this monitoring process.
Following the installation of some software on the
As backups are performed, reports are generated
As with all backup systems, frequent audits of the
backed up data need to occur to ensure that what is Simon James is the editor of Pulse+IT, Australia’s highest circulating health publication of any kind. Prior to founding the publication in 2006 he worked in the statistics division of a clinical research organisation, in an IT support capacity for various medical practices, for a clinical software developer, and subsequently for a secure clinical messaging developer.
diligently being backed up can successfully be restored.
Is Internet backup secure? Before transferring your practice data to a remote backup site, it is important that it is encrypted to prevent third parties intercepting the data whilst it is
in transit and when stored on the remote server. Encryption is a feature of all popular Internet backup solutions, however the
quota to avoid excess data charges or
backup solutions a viable option for many
medical centres, and one that can provide
enhanced protection for patient data.
sensitive nature of medical records dictates
Internet data charges associated with
While few practices are in a position to
that practices need to ensure they are
restoring a backup in the event of data
move to using the Internet as their only
properly informed about the type of access
loss should be calculated and assessed
backup medium, a far greater number
the service provider themselves may have
will find Internet Backup solutions to be a
to such data — clearly this needs to be
• The time it will take to upload a single
none! The privacy policies of the provider
day’s worth of new data is important.
worthwhile complement to their existing
should be examined, as should the relevant
Practices with large clinical databases
laws of the country or countries in which
may need to consider performing
Read more online
the provider locates their data centres.
weekly uploads, complemented by
A comprehensive, expanded version of
their existing daily backup procedures.
this article is available online. Readers
• The number of days of “roll back”
are invited to discuss this article and ask
Despite the convenience and additional
provided by the Internet backup
questions of the author at the Pulse+IT
data protection Internet Backup services
solution provider should allow the
provide, there are several factors that
practice to restore a data “snap shot”
practices should consider before adopting
from any period in history.
such a solution:
Webinar Pulse+IT will host a free webinar in April
• Practices need to ensure their Internet
to elaborate on the themes presented in
Service Provider does not count
The increasing availability of cheap, fast,
this article. For more information and to
uploaded data toward their monthly
reliable Internet access has made Internet
register, visit: http://bit.ly/fsa6pE
Multiple Video Source Billing Scheduling
Robust Clinical coding
Endoscopy Claim management
“Liszt” - Live Video
Endoscopy Machines Integrated DRG Grouper
medical management software
Paperless Electronic Records
Dashboards and Workbench
Touch Screen Technology
web www.totalcare.net.au email firstname.lastname@example.org
phone +61 7 3252 2425 skype skype.totalcare.net.au
“First do no harm” – Clinical Safety Management in e-health Janette Bennett
MSc, CITP, MBCS, BSc Hons, PgCM, RN Clinical Director (Asia Pacific) BT Health
Patient Safety Director BT Health
Whilst rare, it is an unfortunate fact of life that the very
shift their focus on standardisation to enable safer
health services that the public rely on to make them
better can end up causing them harm.
Errors in medication management, incorrect or
sparked urgent debate in the international health
‘wrong-side’ surgery and hospital acquired infection
informatics community about how best to control
can all contribute to patient mortality and morbidity.
the risks of harm associated with introducing new
No wonder then that patient safety management
technology. Those responsible for procuring and
is becoming such a high priority for the boards of
implementing healthcare IT are also considering their
healthcare organisations. However, to date much of this
options for managing the associated clinical risks.
has been focussed on traditional “Quality and Safety”
areas such as falls, wound infections, medication
international standards specifically addressing the
misadventure, etc and does not include an Information
management of patient safety associated with the
Technology (IT) clinical safety management function.
development and deployment of health software.
Events and the anxieties of standards bodies have
It is globally recognised that there are no
IT is often introduced as a frequent and powerful
Attempts to address this materialised in the form
component of providers’ strategies to reduce clinical
of the introduction of the following two draft ISO
risks, but this presents a paradox. IT also has the
standards accepted for joint work under the Vienna
potential to introduce new hazards for patients:
agreement between ISO/TC215 and CEN/TC251. BT
electronic drug charts, for example, may not be
through its work with and requirements of the NHS,
available on an organisation-wide basis, or electronic
in combination with experience in digital hospitals and
health records may fail to correctly display critical
shared electronic records in the UK and elsewhere,
clinical information for individual patients .
was a significant participant and contributor in the
development of these two draft standards:
With the progressive integration of IT within
healthcare there is further potential to introduce new
• ISO/DTS 29321 — Health Informatics: Application
causes for harm to patients through the increased
of risk management to the manufacture of health
use of networks, mixing of medical and non-medical applications, as well as some poor software design
software. • ISO/DTR 29322 — Health Informatics: Guidance
and the threat of virus2 and malicious attacks. Some
on risk evaluation and management in the
standards bodies are calling for greater controls.
deployment and use of health software.
For example, the British Standards Institute3 has
recommended that manufacturers and departments
the joint working group but have since been adopted
need to stop on-site informal design and adaptation
by the NHS Information Standards Board as DSCN
of medical software, and that regulators need to
14:2009 and DSCN 18:2009.
These two draft standards were later withdrawn by
On a more unified international front things
are still progressing rapidly. In October 2010 a new international standard, ISO/IEC 80001-1: Application Janette Bennett is the Clinical Director, Asia Pacific, BT Health and Martin Ellis is Patient Safety Director, BT Health.
of risk management for IT-networks incorporating medical devices was approved. This standard is aimed at healthcare organisations, ensuring that they assess the risks associated with integrating a medical device into a health IT network, and relies upon medical
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24/02/11 2:10 PM
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device manufacturers and IT suppliers
• Review Service Incidents and update
methodologies, together with a quality
having already conducted safety work
the Hazard Register with the relevant
prior to bringing their product to market. In
9001:2000. Additionally, the assumption
addition, some countries have addressed
Sentry is a robust clinical safety
is that other work streams will conform
the issue in different ways, in some cases
management system built on safety
to the appropriate standards in their area,
by extending the scope of medical device
management principles adopted from
e.g. Service Management with ISO/IEC
regulations. In ensuring BT is globally
other industries in which managing
20000 and Information Security with ISO/
compliant, BT Health has in place a clinical
risk is critical (for example aviation and
management system, Sentry, which has
nuclear engineering) and adapted to the
primarily adopted from:
healthcare IT environment by clinicians
work in e-health is taking place in the
• IEC 61508 — Functional safety of
and safety engineers. In working with
northern hemisphere and globally the
electrical, electronic, programmable
ISO on the standard, BT has ensured it
standards journey is still in its infancy, the
electronic safety related systems
is fully cognisant of the intended global
southern hemisphere cannot ignore the
implementation of ISO/IEC 80001.
implications. It is not just software vendors
Application of risk management to
A strong clinical safety management
and systems integrators that will be
system must contain a set of policies
required to adopt and inform the evolving
and procedures that aligns with the IT
standards. The organisational impact
within healthcare organisations has yet to
• ISO 14971:2007 — Medical Devices —
• ISO/TS 23258 — Classification of Risks from Health Informatics products • ISO/TR 27809:2007 — Health
risk management activities conducted
be fully realised, but will be both necessary
Informatics — Measures for ensuring
and documented at key stages in the
and significant to ensure that their own
patient safety of health software
e-health programmes also “first do no
All of the standards call for a
and in-life phases. This wraparound
systematic process to be in place that
assurance ensures that adherence to the
safety process and verification of safety
• Identifying clinical hazards in the
requirements is evidenced throughout the
design phase • Identifying what controls are currently in place
complete lifecycle of a product/service.
The integrated approach culminates in
the development of a formal clinical safety
• Designing in new controls
case for each release of a healthcare IT
• Testing that the controls work
• Manage issues arising
• Present findings/evidence to the
safety management system cannot stand
Faraday House, 6 Hills Way,
alone. Sentry is dependent upon a project
Stevenage, Herts, UK
Customer • Residual Risk as low as reasonably practicable
However, to be effective a clinical
being managed using appropriate project management and software development
hospitals.html 3. Sensible Standards, IET, Michael
4. http://ancienthistory.about.com/od/ greekmedicine/f/HippocraticOath.htm
Advantech Australia AAPM
P: 1800 196 000 or +61 3 9095 8712 F: +61 3 9329 2524 E: email@example.com W: www.aapm.org.au The Australian Association of Practice Managers (AAPM) represents Practice Managers and the profession of Practice Management. Founded in 1979, AAPM is a non-profit, national association recognised as the professional body dedicated to supporting effective Practice Management in the healthcare profession. The Australian Association of Practice Managers: • 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. • Provides specialised services and networks to support quality Practice Management.
Advantech’s medical computing platforms are designed to enhance the quality and efficiency of healthcare for patients and users alike. All products match the performance of commercial PCs and tough medical safety ratings like UL60601-1 and EN60601-1; adding to this they are all IPX1 certified dust resistant and come with water dripproof enclosures. Advantech offers long term support and a proven track record of reliability. The medical range extends through: • Point-of-Care Terminals. • Mini-PC and Medical Imaging Displays. • Mobile Medical Tablets. • Patient Infotainment Terminals. Advantech is also an official distributor of Microsoft Windows Embedded software across Australia & New Zealand.
P: +61 3 5335 2220 F: +61 3 5335 2211 E: firstname.lastname@example.org W: www.argusdca.com.au
P: +61 412 746 457 F: +61 3 9569 9449 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.
P: 1300 720 274 F: 1300 364 008 E: email@example.com W: www.ch2.net.au
P: +61 7 4155 8800 F: +61 7 4153 2093 E: firstname.lastname@example.org W: www.bpsoftware.com.au Best Practice sets the standard for GP clinical software in Australia offering a flexible suite of products designed for the busy GP practice, including: • Best Practice Clinical (“drop-in” replacement for MD) • Integrated Best Practice (clinical/ management) • Top Pocket (PDA companion software for Pocket PC)
Cerner Corporation Pty Limited P: +61 2 9900 4800 F: +61 2 9900 4990 E: AsiaPacific@cerner.com W: www.cerner.com.au
Australasian College of Health Informatics
CH2 (Clifford Hallam Healthcare)
P: 1300 308 531 F: +61 3 9797 0199 E: email@example.com W: www.advantech.net.au
Argus provides and supports Argus secure messaging software that enables doctors and healthcare organisations to exchange clinical documents securely and reliably. Argus can be used to send specialist reports to referring doctors but it can also exchange pathology and radiology reports, hospital discharge summaries and notification between healthcare providers. Healthcare practitioners can use any of the popular clinical software packages to send reports and other clinical correspondence via Argus. Argus is the messaging solution chosen by 65 Divisions of General Practice across Australia through the ARGUS AFFINITY program.
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
Cerner is a leading supplier of healthcare information systems and our Millennium suite of solutions has been successfully installed in over 1200 sites across the globe. Cerner’s technology has been designed so that it can be adapted to meet the needs of the very different healthcare delivery systems that exist, with a universal framework that allows clinician workflow to seamlessly span role and venue. Our innovative leadership is allowing us to push boundaries by: • Leveraging clinical and pharmaceutical data for new discoveries in Condition Management and Personalised Medicine • Connecting the community with personal and community health records • Seamlessly connecting the patient record across the continuum of care
Clifford Hallam Healthcare (CH2) is today Australia’s largest pharmaceutical and medical healthcare service provider with a catalogue of over 15,000 products servicing metro, regional and rural customers across Australia. Supported by a National Network, CH2 utilises local knowledge and local people to provide pharmaceuticals, medical consumables and equipment products to the healthcare market. CH2 is represented by a National Sales Force as well as a local Customer Service team in each state. CH2 understands the value of quality data and are committed to implementing the GS1 system throughout our business and with our partners. The use of EANCOM standard messages, Global Trade Item Numbers (GTIN) for product identification, Global Location Numbers (GLN) for location information and Serial Shipping Container Code (SSCC) labels are paramount to our industry moving forward. CH2 are passionate supporters of these philosophies and believe the uplift in quality systems will result in improved patient safety. CH2 are currently working with partners to implement the National E-Health Transition Authority (NEHTA) National Product Catalogue. “Our aim is to be a great company to do business with. The right product, at the right price, at the right time.” WardBox® is CH2’s direct to ward distribution system. It is a just in time replenishment system where orders are created in a theatre or ward area and then transmitted electronically to one of CH2’s warehouses using SOS or an EDI interface. The service incorporates barcode scanning technology, direct delivery to individual wards or departments, monthly invoicing and comprehensive reporting. WardBox® is designed to assist our customers in reducing purchasing and supply operating costs. This valuable service increases supply chain efficiencies, improves service delivery models and assists in achieving economies of scale. WardBox® distribution is used for pharmaceuticals, medical, surgical and general supplies at numerous healthcare facilities. In 2009 CH2 won the ASCLA Information Management Award and are gold sponsors for the ASCLA Awards 2010.
Cutting Edge Software Communicare Systems
P: +61 8 6212 6900 F: +61 8 6212 6980 E: firstname.lastname@example.org W: www.communicaresystems.com.au Established in 1994, Communicare Systems have built an enviable reputation for delivering results, supported by excellent service based on mutual respect, mutual trust and mutual benefit. Communicare is the electronic medical records and practice management system of choice for Aboriginal Health Services employing multidisciplinary holistic healthcare, featuring: • Ease of use for all providers • Shared electronic health records • Standards based electronic messaging • Comprehensive easy to use automated reporting • Scalable from small service to multi organisational enterprise • Multi axial security and access logging
P: 1300 85 39 39 (Melbourne) P: 1300 85 39 85 (Brisbane / GC) E: email@example.com W: www.cinet.com.au Computer Initiatives has been supporting the medical profession for over 15 years. Providing IT consultancy services, quality hardware, professional support with qualified engineers. Recommended and preferred by a number of Divisions of General Practice and specialist software providers we: • Supply and install of hardware/ software and peripherals • Implement disaster recovery and replication plans • Remote monitoring and diagnosis • Advanced networking deployment and support • Prompt and competitive support • Internet configurations and content filtering services • Security audits, configurations and monitoring • Regular maintenance services • Microsoft Gold Partner and a Microsoft Small Business Specialist
P: 1300 237 638 F: +61 3 9787 8210 E: firstname.lastname@example.org 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.
P: 1300 557 550 F: +61 7 5478 5520 E: email@example.com W: www.directcontrol.com.au Direct CONTROL is an affordable, intuitive and educational Medical Billing and Scheduling application for Practitioners of all Disciplines. Seamless integration with Outlook, MYOB or Quickbooks. Direct CONTROL’s Clinical Module manages Episodes of Care and includes State, Federal and Health Fund Statistical Reporting for Day Surgeries/Hospitals. Direct CONTROL facilitates Medical Billing Australia-wide and overseas. Included is all Medicare, DVA, Work Cover, Private Health Insurance fee schedules with built in rules relevant to each medical discipline (allied health, general practice, surgeons, physicians, anaesthetists, pathologists, radiologists, day surgeries/hospitals). Ideal for the single practitioner or the multidisciplinary Practice. Direct CONTROL supports ALL your Business needs letting you and your staff get on with earning a living doing what you enjoy most … Patient Care.
P: 1300 237 638 F: +61 3 9787 8210 E: firstname.lastname@example.org W: www.doctorbill.com.au
Digital Medical Systems P: +61 3 9753 3677 F: +61 3 9753 3049 E: email@example.com W: www.dgs.com.au
Easier ICT is a technology partnership with DMS — we make I.T. 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 leading medical software applications. DMS is a Business Partner for IBM, Lenovo, HP and Microsoft. Other leading ICT brands include Trend Micro, Symantec, CA, Cisco, Toshiba, Canon, Epson, Kyocera, Fujitsu and Brother. Accreditation is easier with the customised DMS IT Systems Documentation. Ensure your practice has the best quality IT policy, security and maintenance program that meets and exceeds the standards guidelines from the RACGP and AGPAL and GPA. World leading DTech provides 24x7 near Real-Time Monitoring and Management that alerts and enables our engineers to quickly troubleshoot and solve problems of security, network, Internet, Server and software remotely on almost any client computer system or device. Medical IT systems are automatically maintained by DTech to the most highly available status to minimize downtime by preventing problems from occurring or reducing their impact. Proactive, Flexible, Consistent, Reliable, Audited, and Affordable — for even the smallest practice. Call DMS for: • Systems Analysis & Consulting • Solutions Design • Procurement & supply of hardware, software, network and peripheral products • Installation & Configuration • Support Services inc Help Desk • DTech Monitoring, Maintenance & Management • Disaster Recovery solutions • Fully managed & automated Online Backup customised for clinical data Easier IT — we make I.T. work for you.
DoctorBill is a simple and secure way for doctors to accept online payments through a single portal without the need to setup a website. You can accept direct deposits, credit card via PayPal® or your existing Merchant Facility if you have one. All of the available payment methods are secure and can be used with confidence. We provide you with a customised website address to put on your stationery which directs your patients to your practice’s DoctorBill page. For an example of what patients will see when using the service, visit: www.DoctorBill.com.au/DrExample If you already have a website, you can easily place a link to direct patients to the page. Patients receive a receipt and your practice is advised by email when payments are made. Setting up DoctorBill for your practice is easy and affordable, and transactions cost just 90 cents each (excluding bank fees).
eHealth Education Pty Ltd
P: +61 3 9653 9433 F: +61 3 9653 9307 E: firstname.lastname@example.org W: www.ehealtheducation.net • The Registered Training Organisation specialising in quality Health Informatics education provided by senior, education qualified HI professionals. Educational programs are designed to up-skill clinicians, technical staff, consumers and administrators in healthcare. • Delivery options include focused workshops, single subject courses or fully integrated programs delivered face to face or online through our extensive and quality assured online education delivery infrastructure. • Servicing professional and education organisations, we also aim to support professional and healthcare education providers. You can deliver your material using EHE infrastructure, or we can help you develop and/or deliver quality educational material.
eHealth Security Services
P: 1300 399 116 / +61 2 9016 5378 F: +61 2 9016 5379 E: email@example.com W: www.ehealthsecurity.com.au eHealth Security Services (eHSS) specialises in the provision of security as a service and offers an extensive range of Managed IT Services including IT Support for small to medium businesses in the health sector. eHSS’ MediAccess® service provides comprehensive and cost-effective managed security and remote access solutions. eHSS has thorough knowledge and understanding of IT matters in the health industry and its regulatory aspects. eHSS has extensive experience reviewing and assisting with organisational policies and procedures and technical implementations against applicable standards.
Equipoise (International) Pty Ltd Totalcare P: +61 7 3252 2425 F: +61 7 3252 2410 S: skype.totalcare.net.au E: firstname.lastname@example.org W: www.totalcare.net.au
Equipoise International Pty Ltd (EQI) is the developer and supplier of the ‘Totalcare’ clinical and office management system. Used since 1995 by health care facilities across Australia including General and Specialist practice, Radiology, Day Surgery and Hospitals. Totalcare is a fully integrated Clinical, Office and Management software suite. Totalcare is stable, scalable, customisable and easy to learn and use. From a small practice to a distributed, multi site, multi disciplinary corporate entity or hospital, Totalcare can provide a solution for your needs.
GE Healthcare Australia Pty Ltd P: +61 2 9846 4000 F: +61 2 9846 4001 E: GEHCinfo@ge.com W: www.gehealthcare.com
GE Healthcare is a $17 billion business of General Electric Co. and provides a broad portfolio of healthcare technologies and services. GE Healthcare’s ‘Healthymagination’ initiative is a $6 billion commitment to improve healthcare through innovation - reducing costs, improving quality and expanding access for millions of people. A leader in solutions for the entire healthcare enterprise. GE Healthcare has extensive global experience in successful ehealth implementations and offers a broad ehealth solution portfolio including Personal Health Manager, Provider Portal, Master Patient Index and Health Information Exchange Solutions. GE Healthcare also provides the Centricity® suite of integrated information technology for enterprise hospital information systems and specialist clinical information solutions, for theatre, anaesthesia, intensive care, cardiovascular, radiology and maternity.
Extensia Emerging Health Solutions P: 02 8853 4700 F: 02 9659 9366 E: email@example.com W: www.emerging.com.au
Emerging Health Solutions (EHS) is a web-based Clinical Information System for hospitals that is patientcentric capturing and providing appropriate, timely, clinical information in a secure and auditable environment. to assist clinicians deliver effective, quality care. Our prestigious clients include St Vincents & Mater Health Sydney and the Government of South Australia Department of Health. EHS has integrated Sabacare’s Clinical Care Classifiaction (CCC) System, a diagnosis framework integrated in SNOMED CT. EHS’ extensive list of modules work seamlessly with other systems via our integrated interface engine which accepts HL7 and other accepted Health IT standard protocols complying with the Australian Technical Specification: ATS 5822:2010 eHealth Secure Message Delivery.
P: +61 3 9675 0600 F: +61 3 9675 0699 E: firstname.lastname@example.org W: www.global-health.com Global Health is a premier provider of technology software solutions that connect clinicians and consumers across the healthcare industry. ReferralNet Messaging is a secure message delivery system for sending healthcare information efficiently to industry professionals. MHAGIC is the most comprehensive mental health electronic medical record (EMR) system in Australia. MasterCare EMR is an electronic medical record system for specialists and allied health professionals. Locum is a clinical information management system for GPs.
P: +61 7 3292 0222 F: +61 7 3292 0221 E: email@example.com W: www.extensia.com.au Extensia links healthcare providers, consumers and their communities to deliver better and more efficient health care outcomes. The products used to do this can be custom branded for all Organisations and include: • 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, then the most relevant providers, services and products are presented instantly and referral documents are created automatically and sent electronically.
P: 1800 188 088 F: 1800 644 807 E: firstname.lastname@example.org W: www.gpa.net.au
P: +61 7 3870 4085 F: +61 7 3870 4462 E: email@example.com W: www.geniesolutions.com.au
GPA ACCREDITATION plus has given general practices a reliable alternative in accreditation. GPA is committed to offering a flexible accreditation program that understands the needs of busy GPs and practice staff. GPA assigns all practices an individual quality accreditation manager to support practices with their accreditation. Choose GPA for more support, improved service and greater choice.
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 2000 sites, it is now the number one choice of Australian specialists.
P: +61 8 8203 0500 E: firstname.lastname@example.org W: www.healthsolve.com.au
Health Communication Network P: +61 2 9906 6633 F: +61 2 9906 8910 E: email@example.com 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
HealthSolve provides Care Management systems for aged, acute, and community care that can be shared across all health care sectors.
Health Informatics New Zealand E: firstname.lastname@example.org W: www.hinz.org.nz
Health Informatics New Zealand (HINZ) is a national, not-for-profit organisation whose focus is to facilitate improvements in business processes and patient care in the health sector through the application of appropriate information technologies. HINZ acts as a single portal for the collection and dissemination of information about the New Zealand Health Informatics Industry. Membership is for anyone who has an interest in health and informatics.
Health Informatics Society of Australia
Health Information Management Association Australia P: +61 2 9887 5001 F: +61 2 9887 5895 E: email@example.com W: www.himaa.org.au
The Health Information Management Association of Australia (HIMAA) is the peak professional body of Health Information Managers in Australia. HIMAA aims to support and promote the profession of health information management. HIMAA is also a Registered Training Organisation conducting, by distance education, “industry standard” training courses in Medical Terminology and ICD-10-AM, ACHI and ACS clinical coding.
P: +61 3 9388 0555 F: +61 3 9388 2086 E: firstname.lastname@example.org W: www.hisa.org.au
P: +61 7 5665 7995 F: +61 7 5502 6543 E: email@example.com W: www.healtheasy.com.au HealthEasy is a 100 percent web‑based “Cloud Computing” solution as used by leading Web 2.0 apps like BaseCamp and SalesForce. • • • • • •
No hardware upgrades No local Server needed No manual software upgrades No local backups required No contracts (pay monthly) Runs on Windows, Mac & Linux
eHealth Initiatives Support: • Electronic Prescribing (eRX) • Personal Health Record (IEHR) • Unique Health ID (UHI) Built using Open Source tools with source code available. We invite expressions of interest from all sectors of the industry.
The Health Informatics Society of Australia is a membership based not-for-profit organisation which has 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 of organisations and individuals who are committed to, and passionate about, health reform enabled by e-health.
P: 1800 125 036 (AU) P: 0800 288 887 (NZ) E: firstname.lastname@example.org W: www.healthlink.net Australia’s and New Zealand’s largest effective secure communication network. • Fully integrated with leading GP and Specialist clinical systems • Robust; Reliable and Fully Supported Join the network that more than 70 percent of GPs use for diagnostic, specialist and hospital communications.
Features: • Web-based. • Flexible, dynamic, and highly configurable. • Mirror your specific work flow and document style. • Resident/client centric with a focus on the whole “journey.” • Brings together administration, staff, providers, and facilities.
P: 1800 420 066 or +61 2 9669 1844 P: 0800 401 111 or +64 7 834 9354 F: +61 2 9669 1791 E: email@example.com W: www.houstonmedical.net INTEGRATION ACROSS THE PRACTICE Houston Medical delivers one streamlined system integrating medical equipment with financial, claiming and administrative areas that works reliably and securely for small practices through to large multi‑disciplinary practices. GREATER ROI VIP.net for medical specialists and VIP Allied for General practice/Allied Health delivers great ROI through smoother workflow, improved data quality, boosted productivity and reduced costs. FLEXIBLE Individually configurable, Houston’s systems support you in the way you work and deliver better results. TRUSTED Houston delivers software that you can trust - built on 20 years experience and used by many hundreds of leading practices across Australasia and beyond. Our first customer is still a customer.
Demonstrations available under NDA due to late 2010 release.
P: +61 2 9380 7111 F: +61 2 9380 7121 E: anz.query@InterSystems.com W: www.InterSystems.com InterSystems Corporation is the worldwide leader in software for connected healthcare. With headquarters in Cambridge, Massachusetts, and offices in 24 countries, InterSystems provides advanced software technologies for breakthrough applications. InterSystems TrakCare™ is a Web‑based healthcare information system that rapidly delivers the benefits of an Electronic Patient Record. InterSystems CACHÉ® is a high performance object database that makes applications faster and more scalable. InterSystems Ensemble® is a seamless platform for integration and the development of connectable applications. InterSystems HealthShare™ is a platform that enables the fastest creation of an Electronic Health Record for regional or national health information exchange. InterSystems DeepSee™ is software that makes it possible to embed real-time business intelligence in transactional applications.
P: +61 2 8251 6700 F: +61 2 8251 6801 E: firstname.lastname@example.org W: www.isofthealth.com iSOFT is one of the world’s largest providers of healthcare IT solutions. We work with healthcare professionals to design, develop and implement healthcare solutions that deliver administrative, clinical and diagnostic services to ensure continuity of care across all care settings. iSOFT provides flexible and interoperable solutions to the whole spectrum of providers, from single physician practices through to integrated national solutions supporting thousands of concurrent users. Our capacity to embrace change and keep abreast of emerging new directions in healthcare has allowed our clients to explore the exciting potential of new technologies while securing their existing investments.
JOSE & Associates
P: +61 3 9850 1350 F: 1300 889 012 E: email@example.com W: www.jose.com.au JOSE and Associates – IT Management and Support for Medical Practices • Complete IT support for medical practices: • Support for most clinical and practice management software àà Support for all network topology àà Dedicated help desk àà 24/7 support - response in most cases is immediate • New practice installation • Server maintenance on a monthly basis which includes full monthly reporting • Satisfying IT accreditation standards • Data conversions • Disaster recovery and business continuity plans – monthly data restores • Australia Wide coverage • References available on request
Jam Software ISN Solutions
P: 1300 300 471 F: +61 2 9280 2665 E: firstname.lastname@example.org W: www.isnsolutions.com.au ISN Solutions is a medical IT company that specialises in the design, setup and maintenance of computer networks for medical practices. Our consultants and engineers are dedicated to the medical industry, understand your business needs and know what is required to run a practice. We strive to take away the pain from you, on managing the day to day IT issues regardless of which medical application you use. Our claim is supported by strong industry references. Some of our solutions include but are not limited to: • A paperless practice • Speech Recognition • Capped cost medical support & maintenance plan • Ability to consult remotely • Linking your imaging equipment to your network • Medical application Support
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: +61 2 9901 6400 F: +61 2 9439 6331 E: email@example.com W: www.meditech.com.au
MED™4i (Medical Electronic Desktop™) streamlines Health Care with easy-to-use customisable interfaces. Modular Versatility & Connectivity backed by friendly expert engineers.
Comprehensive Patient database with multiple-format billing including electronic Online Patient Verifications & Claiming to Medicare, DVA & Health funds (paperless), Letters, Prescriptions (including MIMS), Orders, e-Results, MS Office integration & CustomDB including surgical & other audits. Now with HL7 Secure Messaging.
Medical-Objects has provided secure messaging to over 10,500 health professionals with referrals, reports, letters and discharge summaries. Delivering directly into leading practice software, removing the need for scanning and faxing.
P: +61 427 844 645 E: firstname.lastname@example.org E: email@example.com W: www.msia.com.au
P: +61 2 9799 1888 F: +61 2 9799 4042 E: firstname.lastname@example.org W: www.jamsoft.com.au
Your specific needs can be accommodated easily, onsite & remote installation, training, ongoing support including upgrades to meet the ever‑changing health requirements.
Medical Software Industry Association
P: +61 7 5456 6000 F: +61 7 3221 0220 E: email@example.com W: www.medical-objects.com.au
Referrals are digitally signed and encrypted, moreover, compatible with Medicare’s requirements and in line with NEHTA’s eHealth PIP direction. Using Medicare supported PKI, you can trust that referrals are digitally signed with PKI and we are working with NEHTA as an eHealth PIP eligible secure messaging vendor.
A Worldwide Leader in Health Care Information Systems 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: +61 2 9902 7700 F: +61 2 9902 7701 E: firstname.lastname@example.org W: www.mims.com.au
P: +61 2 8298 2600 F: +61 2 8298 2666 E: email@example.com W: www.nehta.gov.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.
The National E-Health Transition Authority was established by the Australian, State and Territory governments to develop better ways of electronically collecting and securely exchanging health information. NEHTA is the lead organisation supporting the national vision for eHealth in Australia.
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.
Mouse Soft Australia Pty Ltd
P: +61 3 9888 2555 F: +61 3 9888 1752 E: firstname.lastname@example.org W: www.medicalwizard.com.au Medical Wizard saves time and money through greater efficiency and comprehensive integration. Throughout its 17 year history, Medical Wizard has led the way with innovative solutions. We are constantly evolving Medical Wizard to meet the challenges of the medical profession for today and tomorrow. A software of choice for discerning Specialist practices, notably Gastroenterologists, Cosmetic Surgeons, Ophthalmologists, General Surgeons, IVF Centres and Day Hospitals amongst others. All aspects of practice management from appointments, billing, clinical, theatre management and compliance reporting are covered and backed by a dedicated local support team. Feature Rich. Dynamic. Innovative.
Software of Excellence
Pen Computer Systems
P: +61 3 8872 5500 F: +61 3 8872 5524 E: email@example.com W: www.oasis-software.com.au
P: +61 2 9635 8955 F: +61 2 9635 8966 E: firstname.lastname@example.org W: www.pencs.com.au
Developed in Australia by the leading practice management provider in the Dental Market, OASiS Software has now released OASiS Health. Already used by Medical Specialists, Physiotherapists, Chiropractors, Podiatrists, Physiologists and a variety of other Allied Health Professionals.
Established in 1993, Pen Computer Systems (PCS) specialises in developing information solutions for National and State eHealth initiatives in Primary Health that deliver better Chronic Disease outcomes.
With full appointment book and clinical functionality, many customers have used OASiS Health to create the paperless practice by taking advantage of OASiS Health powerful document and image handling features.
P: 1300 550 716 F: +61 2 9434 2301 E: Vicki.Rigg@nuance.com W: www.nuance.com/au
Nuance (NASDAQ: NUAN) is a leading provider of speech and imaging solutions for businesses and consumers around the world. Its technologies, applications and services make the user experience more compelling by transforming the way people interact with information and how they create, share and use documents. Every day, millions of users and thousands of businesses utilise Nuance’s proven range of productivity applications which include Dragon NaturallySpeaking (speech recognition), OmniPage (OCR), PaperPort (document management) and PDF Converter Professional (PDF creation and conversion).
Described as the most flexible practice management system available, OASiS Health specialises in Multi-Branch, Multi-Practitioner and Multi-Discipline practices. OASiS Health is designed to create a Healthy, Profitable business.
PCS expertise extends to: • Chronic Disease Prevention and Management • Population Health Status, Reporting and Enhanced Outcomes • Decision-Support tools delivered LIVE into the clinical consult • Web-based Electronic Health Records (EHRs) • SNOMED-CT and HL7 Standards Frameworks Our Clinical Audit Tool (CAT) for example delivers an intuitive population reporting and patient identification extension to the leading GP systems in Australia. CAT delivers enhanced data quality and patient outcomes in general practice.
P: +61 2 8096 0000 / +64 9 638 0600 F: +61 2 8096 0001 / +64 9 638 0699 E: email@example.com W: www.orionhealth.com Orion Health is a world leader in the e-health industry. We specialise in electronic health record (EHR) solutions, disease management, clinical decision support, and hospital administration tools. More than 300,000 clinicians in 30 countries use Orion Health products. Our EHR solutions have been widely adopted across Canada, Europe and the USA to enable secure cross‑organisational and regional sharing of patient information, resulting in improved patient care. Orion Health Patient Portal enables patients to access their personal medical record, request appointments, and communicate with their care providers. Our solutions are designed to support emerging health IT trends and standards, we work closely with our customers, clinicians, government bodies and other industry leaders to deliver intuitive solutions to meet your current and future needs.
from Practice Services P/L
P: +61 3 9819 0700 F: +61 3 9819 0705 E: Sales@practiceservices.com.au W: www.practiceservices.com.au Medilink Practice Management Software • 21 years young, large user base • Medilink = Intuitive ease of use • Solo Drs up to Hospitals in size • Claiming via integrated EFTPOS àà and/or integrated HICAPS àà and/or Medicare Online àà and/or ECLIPSE • Many standard features • Many optional modules • Links to many third party packages and services • Cut debtors and boost cash flow • 17 years as an Authorised Medilink Dealer, selling, installing & training • Fixed Cost Support, Onsite or Remote
Pulse+ IT Pulse Magazine
P: +61 2 8006 5185 / +64 9 889 3185 F: +61 2 9475 0029 E: firstname.lastname@example.org W: www.pulseitmagazine.com.au Pulse Magazine is the publisher of Pulse+IT, Australia’s first and only Health IT magazine. Pulse+IT is distributed to all corners of the health sector and is enjoyed by General Practitioners, Specialists, Practice Managers, Hospital and Aged Care decision makers, Health Informaticians, Health Information Managers and Health IT industry participants. Having grown rapidly from its launch circulation of 10,000 copies in August 2006, Pulse+IT’s current bi-monthly distribution of 37,000 printed copies ranks it as Australia’s highest circulating health publication of any kind. In addition to printed magazines, Pulse+IT offers a number of digital products including a weekly eNewsletter service, Twitter and RSS feeds, an online events calendar, and SR Logo_65x42mm.pdf an interactive website.
P: +61 8 8203 0500 E: email@example.com W: www.clintelsystems.com “The Specialist” is an intuitive and comprehensive tool that allows management of patients within specialist medical practices and day surgeries. The Specialist includes 5 modules: • Accounting • Correspondence • Time Manager • Medical Records • Mobile Data Facility Key features: • Runs on both Macintosh™ and Windows™ platforms. • Scales easily from stand-alone users, to multi-site networks. • Industry standard, and readily interoperable with other systems. • Comprehensive data migration tools for most systems. • Unlimited training and support. • Designed with the future in mind. 20/02/09
Stat Health Systems (Aust)
P: +61 7 3121 6550 F: +61 7 3219 7510 E: firstname.lastname@example.org W: www.stathealth.com.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. 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 Health provide a premium support service, clinical data conversion from existing software and tailor made installation and training plans for your practice.
Real Outcomes Real Productivity Minimising Waste
P: +61 2 8014 4573 E: email@example.com W: www.spellex.com.au
SmartRooms by Doctorware P: +61 3 9499 4622 F: +61 3 9499 1397 E: firstname.lastname@example.org W: www.doctorware.com.au
SmartRooms provides a comprehensive software solution for specialist practices for both Mac and Windows. Comprising both practice management and clinical software, our all-in-one patient record and superior after-sales support provides the basis for a stable and time effective software solution for specialist practices of all sizes.
Spellex has been the leading provider of comprehensive medical dictionary enhancement software to thousands of the world’s most prominent healthcare companies for 21 years. Our easy-to-use Australian medical spell checking software integrates fully with all Microsoft programmes, Web-based applications, and popular platforms. Spellex Medical is available for end-users to ensure the medical accuracy of documents and to enhance their productivity. Spellex software development kits can also be integrated with developer’s custom programmes and Web sites. Whether you’re an individual transcriptionist or you need to provide greater medical documentation accuracy across an entire hospital or campus, Spellex has a solution that’s right for you. For a free trial of Spellex software, go to spellex.com.au and click the Free Trial tab.
SmartRooms is available in an appointments and billing-only version for practices with uncomplicated software needs.
P: +64 9 522 9522 F: +64 9 522 9523 E: email@example.com W: www.vensahealth.com The next time you receive a text message mobile reminder or an alert from your doctor, hospital or physio you now know its done by Vensa. Vensa Health is a mobile health (mHealth) provider in the health care sector offering eHealth integrated mobile solutions, enabling text-messaging for patient communications for applications such as appointment reminders, medication reminders, test results alerts, recalls for screenings such as mamograms, immunisations and more. Vensa has invested substantially into developing products and services that offer communication solutions to better content providers with patients, including mobile text-messaging, voice, mobile sites and Telehealth services delivery.
Trend Care Systems
P: +61 7 3390 5399 F: +61 7 3390 7599 E: firstname.lastname@example.org W: www.trendcare.com.au A national and international award winning solution recognised for its ability to provide real benefits in the acute and sub-acute health care settings. TrendCare is an international leader for e-health solutions excelling in all of the following: • Patient dependency and nursing intensity measures. • Projecting patient throughput and workforce requirements. • Rostering and work allocation. • Efficiency, productivity and HRM reporting. • Discharge analysis, bed management and clinical handovers. • Allied health registers with extensive reporting. • Clinical pathways with variance reporting. • Patient assessments and risk analysis. • Diet ordering and reporting. • Staff health tracking and reporting.
P: +61 3 9284 3300 F: +61 3 9284 3399 E: email@example.com W: www.zedmed.com.au Owned by Doctors who understand the challenges facing the medical profession everyday and backed by nearly 30 years of experience in medical software programming, Zedmed provides innovative, full featured and sophisticated practice management and clinical records software solutions. Zedmed would also like to introduce to you Medical Record eXchange – a free, simple solution allowing Doctors to send patient’s medical information to insurance companies electronically. Using the latest in data extraction technology and fully encrypted, this is a secure, time-saving solution to one of the most dreaded requests Doctors receive on an almost daily basis. For more information please visit: www.medicalrecordexchange.com.au
Kelvin’s eHealth Journey
Greeted by medical centre receptionist Lucy Black, the receptionist is logged into her computer and Kelvin is then added to the waiting list by Lucy.
Kelvin is on holiday in far North Queensland Kelvin lives in Croydon, Victoria with his wife Betty. He is reasonably healthy, only suffering from hypertension that is well controlled with medication. He has an allergy to Penicillin. Over a period of three weeks he develops cramps and pain in his abdomen when he eats fatty food.
Kelvin’s IHI number is retrieved from the HI service electronically and seamlessly added to the local practice record. Kelvin takes a seat in the waiting room.
He is under the care of Dr Adam Jones at his local GP Practice.
Dr Grant opens Kelvin’s medical record on his PC which now also includes his Healthcare Identifier. Kelvin complains to Dr Grant of cramps in his stomach, especially after eating pizza and fish and chips which he has suffered from for about three weeks.
Kelvin presents to a medical centre While on holidays his condition gets worse and he presents to a medical centre in the town he is staying.
National E-Health Transition Authority
Dr Grant performs an examination and makes a provisional diagnosis of gallstones. He then orders an ultrasound which confirms the presence of gallstones. After discussing with Kelvin, Dr Grant refers to a General Surgeon: Dr James Brecker at Bay Hill Hospital. The referral is sent electronically via secure messaging.
Kelvin’s eHealth Journey is brought to you by the National E-Health Transition Authority (NEHTA). NEHTA is the lead organisation supporting the national vision for eHealth in Australia.
Pharmacy Kelvin takes his prescription from Dr Brecker to a Community Pharmacy. The pharmacist scans the prescription barcode. The prescription is retrieved from the PES (Prescription Exchange Service) and dispensed.
Dr James Brecker receives the e-referral. Frank is booked in for an appointment by his GP’s staff. Dr Brecker reviews Kelvin’s ultrasound, performs an examination and determines that Kelvin needs surgery to remove the gallstones.
Pathology As per the recommendations on Kelvin’s discharge summary, he has a follow-up blood test for liver function done on the day he is to return home from holiday. The GP has requested that the pathology test results be copied to Kelvin’s usual GP.
Admission to hospital for surgery Kelvin is admitted to the General Surgery ward. Kelvin then undergoes surgery by Dr Brecker, and he makes an uneventful recovery. Kelvin is discharged three days later, much improved and is referred back to his GP for follow up. An e-discharge summary is sent to Dr Adam Jones, his local GP.
For more information about NEHTA visit www.nehta.gov.au For more information about eHealth including the Healthcare Identifier (HI) Service visit www.ehealthinfo.gov.au
9 Returns from holiday Kelvin goes home without receiving his results but on his return home he goes to his usual GP who has received the blood test results and a copy of the discharge summary. After consultation with Kelvin, Dr Jones confirms that the blood tests are normal.
What a wonderful outcome!