Australasiaâ&#x20AC;&#x2122;s First and Only eHealth and Health IT Magazine
18 AUGUST 2014
PRACTICE ICT & E-HEALTH Hambleton backs eHealth
The PCEHR review may have recommended disbanding NEHTA, but new chairman and review co-author Steve Hambleton sees a bright future.
Software release round-up
With their initial PCEHR work behind them, general practice software vendors are now concentrating on their development roadmaps.
Shared care records Sharing electronic medical records for patients with chronic disease with other healthcare providers is beginning to blossom in Australia.
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Looking Ahead Pulse+IT welcomes feature articles and guest editorial submissions relating to the nominated edition themes, as well as articles relating to eHealth and Health IT more broadly. In addition to our daily eNewsletter service, Pulse+IT is produced in print seven times per year with the remaining two editions for 2014 to be distributed for release in: • October 2014 - New Zealand • Mid-November 2014 - mHealth and devices
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About Pulse+IT Pulse+IT is Australia’s first and only Health IT magazine. With an international distribution exceeding 35,000 copies, it is also one of the highest circulating health publications in Australasia. 32,000 copies of Pulse+IT are distributed to GPs, specialists, practice managers and the IT professionals that support them. In addition, over 5,000 copies of Pulse+IT are distributed to health information managers, health informaticians, and IT decision makers in hospitals, day surgeries and aged care facilities. ISSN: 1835-1522 Contributors Jenny Gilder, Dr Steve Hambleton, Simon James, Bridget Kirkham, Kate McDonald, Dr Nathan Pinskier and Sid Verma. Disclaimer The views contained herein are not necessarily the views of Pulse+IT Magazine or its staff. The content of any advertising or promotional material contained herein is not endorsed by the publisher. While care has been taken in the preparation of this magazine, the publisher cannot be held responsible for the accuracy of the information herein, or any consequences arising from it. Pulse+IT Magazine has no affiliation with any organisation, including, but not limited to Health Services Australia, Sony, Health Scope, the New Zealand College of General Practitioners, the Rural Doctors Association of Australia, or the Kimberley Aboriginal Medical Services Council, all who produce publications that include the word “Pulse” in their titles. Copyright 2014 Pulse+IT Magazine Pty Ltd No part of this publication may be reproduced, stored electronically or transmitted in any form by any means without the prior written permission of the Publisher. Subscription Rates Please visit our website for more information about subscribing to Pulse+IT.
ROYAL PERTH LINKS TO PCEHR
TELSTRA OUTLINES EHEALTH PLANS
HILLS MAKES A MOVE INTO HEALTH
Simon James introduces the 44th edition of Pulse+IT.
NEHTA’s new chairman on why eHealth is set to deliver.
The RACGP is working to highlight the benefits of IT in care delivery.
FHIR and openEHR hope to develop common information models.
HIMAA Health information management is facing major workforce challenges.
Up and coming eHealth, Health, and IT events.
The Pulse+IT Directory profiles Australasia’s most innovative and influential eHealth and Health IT organisations.
STATE OF PLAY Confusion may abound over the fate of the PCEHR, but Katrina Otto says there are more pressing issues in general practice IT, such as the burden of documentation.
APPOINTMENT SERVICES Despite being early adoptors of technology, medical centres remain very staff-intensive businesses. Outsourcing some tasks may streamline your practice.
SAFE, SOUND AND SECURE When it comes to protecting sensitive data, practices must consider external security, internal security, email, back-up and infrastructure.
GPs must lead the eHealth debate: RACGP president-elect Get out the shredder: medical records found in garden shed Telstra buys Medinexus as DCA eHealth rebrands to HealthConnex Royal Perth begins uploading discharge summaries to PCEHR Short window for expressions of interest in Medicare payments outsourcing The Art of Performance at practice managers’ conference Pathology sector decides against authority to post for PCEHR reports
VENDOR ROUND-UP With their initial PCEHR development behind them, general practice software vendors are now concentrating on their development roadmaps.
Monash students design app that takes a simple selfie to screen for anaemia Hands-free nursing through voiceactivated documentation
SHARED CARE PLANNING Software to create shared care plans for patients with chronic illnesses can not only streamline the process but can boost patient adherence and clinical outcomes.
Hills focuses on interactive technology for acute and aged care HealthLink in the midst of a paradigm shift to online services
PLAYING THE PCEHR WAITING GAME As the government, its departments and agencies consider the future direction of the PCEHR, the rest of the health IT industry continues on its merry way. Speculation is rampant on what Apple plans to do with its new iOS8 health app, and closer to home, everyone wants to know what Telstra is up to.
SIMON JAMES BIT, BComm Editor: Pulse+IT firstname.lastname@example.org
This edition of Pulse+IT went to press in the days following the Health Informatics Conference (HIC 2014), organised by the Health Informatics Society of Australia and held in Melbourne. This year’s conference featured a healthy dose of patient advocacy from international speakers ‘ePatient’ Dave deBronkart and Regina Holliday, serving to remind delegates who the ultimate beneficiaries of health informatics and related technologies are. The rapidly developing field of personal fitness apps and consumer devices also featured throughout the program, with questions from delegates such as “how can I get my Fitbit data to my doctor” highlighting the gulf between patient expectations and the preparedness of current health IT systems to deal with the rapidly increasing number of sources of health and fitness data.
About the author Simon James is the editor of Pulse+IT, one of Australia’s highest circulating health publications of any kind. Prior to founding the publication in 2006 he worked in an IT support capacity for various medical practices, and subsequently for both clinical software and secure messaging developers.
While Pulse+IT is hopeful that the majority of clinicians wouldn’t need such data to determine whether a patient’s exercise regime is adequate in proportion to their dietary choices, the impending release of Apple’s upgraded mobile device operating system, iOS 8, and its much discussed new health platform will only serve to heighten the focus on what is already a rapidly developing field of computing.
In addition to the packed schedule of academic and industry presentations, HIC always provides the health IT industry with an opportunity to network and discuss the latest trends and happenings. With Telstra having been so active on the acquisition trail over the past year, it was to be expected that many discussions on the expo trade floor contained a measure of speculation about the telco’s strategy for eHealth. Since 2013, Telstra Health has purchased or made investments in HealthEngine, Fred IT Group, Medinexus, DCA eHealth Solutions (now HealthConnex) and IP Health (now Verdi). It has also entered into licensing agreements for products such as iScheduler, InstantPHR and Dr Foster. With the company understood to have further investments to finalise and announce before its eHealth shopping spree concludes, it was perhaps inevitable that attendees watching the HIC2014 Q&A session hosted by the ABC’s Tony Jones would ask questions about the telco’s plans for the PCEHR (shortly to be rebadged along the lines of My Health Record), if indeed it had any. During the panel discussion, head of Telstra Health Shane Solomon rejected any suggestion that it was interested in taking over the operation or development
of the PCEHR, but spoke broadly about his company’s plans to introduce a platform to connect “islands of technology and islands of information”, with more details to be made available in the coming months. With the review into the PCEHR currently being considered by the government and a consultation process of sorts being undertaken by the Department of Health, it was refreshing to see some acknowledgement of the missteps that have occurred over the past few years in the development and rollout of the PCEHR. On the same Q&A panel, Department of Health CIO, Paul Madden, said: “The government is committed to an eHealth strategy, but one that is a working eHealth
strategy that delivers the benefits,” he said. “Now, we need to get a system which is unified and supported by and depended on by clinicians, the patients and the consumers, and when I say clinicians it’s all of the people in healthcare provision. “[W]e haven’t made this particularly intuitive or user friendly. We haven’t done it through the eyes of the clinicians … We need to find out how to bridge that gap between informaticians and … the grassroots GPs.” While these sentiments touch on some of the issues highlighted in the PCEHR review, Mr Madden also indicated that the department will review the input gathered through its consultation process to develop
a plan for the ongoing development of the health records system. “Before the end of the year we’ll be presenting a package which I’ll call an overall implementation plan ... that says to implement these things, this is the approach we will take, this is how long some of these elements might take and this is the way that they might manifest themselves,” he said. “We need to get that so the government knows it is not as simple as we agree with [the recommendations], let’s implement them. It is what are the consequences of that in terms of money, time, communication and education and community views.”
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IT’S TIME TO GET INVOLVED IN E-HEALTH Former AMA president Steve Hambleton was appointed chairman of the National E-Health Transition Authority (NEHTA) in June, and was also a member of the three-person panel that conducted a review of the PCEHR for the federal government late last year. The review’s report, released in May, recommended a number of changes to the national eHealth system, including the dissolution of NEHTA.
DR STEVE HAMBLETON MBBS FAMA Chairman, NEHTA
What is eHealth? It is probably one of the sector’s most discussed and yet misunderstood terms. This is disappointing because few developments over the coming years will have as much impact on how patient care is delivered. I believe an effective eHealth system is essential for Australia. A huge amount of investment has gone into IT in this country, and I think there is a real opportunity to make sure we leverage off the investment we’ve made so far and get outcomes that are meaningful. NEHTA has delivered the solid foundational products that we need including individual healthcare identifiers, medicines and disease terminology, secure messaging, and the infrastructure. This has, in effect, created the national eHealth rail gauge (and some of the rolling stock) for securely transporting and sharing clinical information.
About the author Dr Steve Hambleton is the chairman of the National E-Health Transition Authority (NEHTA) and the immediate past president of the Australian Medical Association. Dr Hambleton is a University of Queensland graduate and an experienced GP, having served at the same general practice at Kedron in Brisbane since 1988.
Much of the planning and development conducted by NEHTA since 2005 has now been delivered. However, it’s too simple to define the promise of eHealth by the complex technologies that will enable and support connected care. This is ultimately not about technology; it’s about people. People like you and me, people that share the eHealth goal of safer, quality healthcare for all Australians.
I strongly believe we are on the verge of something that will be fantastic for our health system and will deliver some of the long-term structural savings that we really need. NEHTA’s outputs and standard setting over the past nine years have set Australia up for the 21st century. Widespread adoption and utilisation of those standards and protocols will allow us to communicate better and gain efficiencies across the sector. This is a watershed moment for our health system where the points of care can finally be connected, and deliver safer, better quality care with fewer errors, and ultimately, fewer lives lost.
PCEHR review panel I was fortunate enough to be part of the government’s review panel, chaired by Richard Royle, into the implementation and uptake of Australia’s PCEHR system. When the review was released in May, it contained 38 recommendations to address shortcomings of the system and make it more effective for doctors and patients. Overall, we found strong support for continuing to develop and implement a consistent and effective shared electronic health record for all Australians. The government is currently in consultation with key stakeholders to understand the
issues and consider the implications of the recommendations. It is important to note that the feedback I am getting from government is also positive and shares my view that eHealth has a strong future. Ultimately, we all want to see meaningful use of the PCEHR. It needs to be delivered in a seamless way that fits with the way health practitioners work. Importantly, the right people need to be registered – those with complex and chronic disease and those who need to see multiple providers. Having a system where we can access a patient’s medical information quickly would make our job quicker, safer and more efficient. Let’s take a look at some facts. The cost of delivering healthcare in Australia has reached almost 10 per cent of GDP, and chronic disease in Australia is responsible for about 80 per cent of the total Australian healthcare burden. Changing demographics and the increasing prevalence of chronic and complex disease are driving demand for greater efficiency and effectiveness in healthcare delivery. Every year Australians have an average of 22 interactions with the health system, including: four visits to a GP, 12 prescriptions, and three visits to a specialist. Most of the information from these interactions with patients is held in separate clinical information systems, with a mix of hard copy, paper-based records. Most of these records can’t be shared electronically from practitioner to practitioner. Evidence from research into medication safety indicates that significant patient harm and sub-optimal use of medicines frequently result from the discontinuity that occurs when patients visit different healthcare providers. This is one of the fundamental drivers for eHealth as the benefits will be realised by the reduced incidence of adverse drug events per hospital separation, thereby resulting in
“... the feedback I am getting from government is also positive and shares my view that eHealth has a strong future.” Dr Steve Hambleton
reduced patient harm and mortality in hospital settings. The lack of a cohesive approach to records management also significantly increases the risk of errors such as misdiagnoses, lack of awareness of adverse reactions to treatment, and the over prescribing of medications. Almost two million Australians experience an adverse drug event each year and approximately 200,000 of these end up in hospital. Clinical studies have proven that adverse drug events can drop by up to 60 per cent through better surveillance of prescribing behaviour. This is why access to a patient’s medication history is so important.
Program of work NEHTA’s program of work for the next 12 months represents a focus on adoption and meaningful use, creating a critical mass of users who are connected and meaningfully using eHealth to deliver better healthcare. While it is essential that the focus on quality and safety benefits remains front and centre, there needs to be strong emphasis on ensuring that reliable information from a connected community of healthcare providers is available in the record. NEHTA and the Commonwealth have been working with representatives of the peak health bodies and leadership groups, through a Clinical Usability Program (CUP), to ensure that NEHTA can provide
appropriate guidance to software vendors to improve the usability of the PCEHR in their products. The CUP has three scheduled releases for GP desktop software vendors regarding usability improvements based on the advice of GP consultation workshops. These improvements cover issues such as providing consistent presentation across the vendor packages, removing spurious information from vendor screens and providing a consistent approach to populating the shared health summary. Importantly, all of the usability improvements have been driven by clinicians. The eHealth ‘technical solution’ has been delivered and all stakeholders including the Commonwealth, the state and territory jurisdictions, the NEHTA board and the peak health bodies are working together to improve usability and drive meaningful use. We await the government’s final determination of the Royle review recommendations, which will set the course for the future direction of the PCEHR. I see a lot of opportunity for eHealth to deliver better clinical outcomes for patients and save the sector money. As former AMA president and a member of the PCEHR review panel, I see it as a natural progression to accept the role of NEHTA chair and to provide the NEHTA board with a direct connection to my colleagues at the frontline of Australian healthcare.
GPs must lead the eHealth debate: RACGP president-elect Promoting the status of the expert-generalist and leading the debate on eHealth are two of the main missions for the next president of the Royal Australian College of General Practitioners (RACGP), WA-based GP and adjunct associate professor Frank Jones. Scan this QR code to read and comment on the latest eHealth news online.
Dr Jones will take over the role for a two-year term from Liz Marles when she completes her term in October. Dr Jones is a full-time GP of 30 years’ standing with appointments as senior lecturer in general practice at the University of Western Australia and adjunct associate professor in general practice at the University of Notre Dame.
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He is the owner and practice principal of Murray Medical Group in Mandurah, south of Perth, which he describes as a progressive, multi-disciplinary, noncorporate private practice of
21 GPs with a multitude of allied health professionals working from the same site. He was a procedural GP obstetrician for 25 years and still has visiting rights at his local hospital.
“High quality patient records are fundamental to good patient care, and eHealth records, telehealth and telemedicine is pivotal college business.” In his candidate statement, Dr Jones highlighted the role of the expertgeneralist, the need to promote and refine “brand GP” and “brand RACGP”, and the central role that general practice must play in eHealth. “Information technology must be at the heart of
any discussion around quality 21st century general practice,” he said. “High quality patient records are fundamental to good patient care, and eHealth records, telehealth and telemedicine is pivotal college business: we must lead this debate.” He also highlighted the wealth of information collected by practice systems and how this needs to be better used for research purposes. “Academia needs to reflect front-line GP needs,” he said. Outlining his thoughts on eHealth and health IT to Pulse+IT, Dr Jones said GPs have “a wealth of untapped clinical information within their systems which have the potential to completely alter the way we practice.” “GP based research emanating from our IT records will enable the profession to show government and our communities what a
cost efficient and quality outcomes-based speciality we really are.” He characterised GP clinical information systems as being “years ahead” of hospital systems and that the limited interaction between primary and acute care IT needed to be fixed before a shared electronic record could work. He said he was supportive of the RACGP’s submission to the federal government’s review of the PCEHR, calling it a “sensible, reasoned and reflective response”, but he was critical of the PCEHR rollout, saying that because there was no general agreement on its design, the project had failed. “Even though there was clinical passion for a
system, too many other players with different agendas impeded progress,” he said.
“GP based research emanating from our IT records will enable the profession to show government and our communities what a cost efficient and quality outcomes based speciality we really are.” “As an example, as a practicing physician seeing a patient after hours I need critical clinical information
which will guide me to deliver the best outcome for my patient. Let’s get that bit right first! I do think an opt-out system would be better. I have uploaded a few summaries but to no advantage to anyone at this stage.” IT has revolutionised the way he is able to practice medicine, he said. “Having up to date progress notes, full summaries, recall systems and immediate access to pathology and radiology is now an accepted norm. However, as usual it’s the quality of information input that is most important: ‘rubbish in-rubbish-out’ scenario! “Most medical software is very user friendly; it really then behoves the efficient and caring medic to input correctly.” He also sees huge potential for telehealth and believes it will become more commonplace. Having done a few video consults himself, he says targeting should still be for rural and regional colleagues. “For urban practices I see a great opportunity for [residential aged care facility] consults and [hospital in the home] patients. Telehealth consults have to be clinically appropriate: more educational modules need development. Remuneration has to be based on a proper business case.”
Bug in PCEHR documents created by older software Practices using superseded versions of Medical Director are being encouraged to upgrade to the latest version if they are also participating in the PCEHR, following advice that some CDA documents are including the practitioner’s personal contact details. In a circular to MD users, Health Communication Network (HCN) says it has been advised by NEHTA that some clinical systems operating the PCEHR have been generating CDA documents including personal contact details. It is understood the bug affected other software providers as well. A NEHTA spokesperson said that where NEHTA was aware of a particular vendor experiencing this issue, they have been prompt in issuing updated software. “NEHTA has also included advice to all vendors on the issue as part of the Clinical Usability Program (CUP) second release, to ensure any future vendor build will not incur this concern,” the spokesperson said. HCN says the problem only affects Medical Director users who are operating versions 3.12.1a to 3.14d inclusive. The problem was rectified through the MD 3.14e update, but some users have still not upgraded. HCN issued a major release – 3.15 – in November last year and has since added new PCEHR functionality. The company says CDA documents now only display the healthcare organisation’s contact details rather than the provider’s. It is recommending that all MD practices upgrade to the latest version, 3.15.2, which incorporates the changes along with other PCEHR enhancements. Practices that have not upgraded to the 3.15 release will need to install it from the DVD before downloading version 3.15.2.
Bits & Bytes
Open for comment: DoH survey on PCEHR The Department of Health is running an online survey until September 1 to help gauge opinion on the implementation of the recommendations of the PCEHR review, as part of a month-long consultation process. The consultations, being managed on the department’s behalf by Deloitte, also included a special session at the Health Informatics Conference (HIC) in Melbourne in August. The PCEHR review survey is broken into three groups: healthcare practitioners, consumers and software vendors. For practitioners, it asks whether they actively access any of their patient’s records, and if not, why not. On the latter, practitioners are given the option of stating that the PCEHR is not useful to care delivery, that it takes too much time to access or any liability concerns. It asks if the information contained is useful, and what changes practitioners would like to see in the system in order to start using it in a meaningful way. It also asks what clinical measurements need to be included and what support practitioners need in terms of training to use the system in day-to-day work. One of the most important recommendations of the Royle review was that the system become opt-out. The survey asks providers their view on the key issues and risks of moving to an opt-out approach, including whether they will remain reluctant to access it because it takes too much time or is not clinically relevant. They are also asked what they would do if a patient demanded that a shared health summary be uploaded, including an option to refuse the patient’s request.
Get out the shredder: medical records found in a garden shed A Melbourne medical centre has been found to have committed a breach of the Privacy Act when it failed to properly secure or dispose of old medical records that were discovered in a garden shed after a break-in. Pound Road Medical Centre (PRMC) had operated a medical centre at a site in Narre Warren South for a number of years before moving to a new location, but unintentionally left behind medical records for 960 patients along with other sensitive documents such as batched Medicare vouchers and invoices for payments made. The majority of the records related to individuals who ceased to be active patients of the practice principal prior to 2004. In that year, the practice installed Medical Director and began to scan in paper records and other paper correspondence. Scanned files were kept in a locked room. When PRMC moved to new premises in 2012, it transferred some of the old records from the locked room to the garden shed at the back of the site so renovations could occur. PRMC said it did not recognise at the time that the moved documents included some health records. The old files were
discovered in the garden shed after a break-in in November last year. Privacy Commissioner Timothy Pilgrim said physical security of hard copy documents was just as important as digital security. “There is no point in converting paper records to a secure digital system, and then leaving the paper files unsecured,” Mr Pilgrim said. “If paper records are no longer needed, they should be disposed of securely.”
“Get out the shredder or hire a secure document destruction service.” It is a requirement under the Privacy Act that organisations securely destroy or de-identify personal information that is no longer required. “Get out the shredder or hire a secure document destruction service,” Mr Pilgrim said. “If you don’t, you’re putting your clients at risk of identity theft or fraud, and your company at risk of enforcement action.” Mr Pilgrim noted the seriousness of the breach in
that the records contained full names, addresses, dates of birth and Medicare numbers as well as diagnoses and hospital discharge summaries. While the practice did not believe any patient records were being stored, it did know that other sensitive information such as invoices and payments to other healthcare providers was kept in the shed. Even if there were no health records, the practice’s obligation to securely destroy or identify personal information that was no longer required would still have applied. “The Privacy Act requires organisations to take reasonable steps to protect the personal information of their customers,” Mr Pilgrim said. “I can’t think of any circumstances in which it would be reasonable to store health records, or any sensitive information, in an insecure temporary structure such as a garden shed.” With mandatory data breach legislation likely to be debated this year – it was delayed last year – fines could have been applied as the practice did not notify any of the patients that their data may have been breached.
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Bits & Bytes
Aged care concerned over “policy silliness” The aged care industry needs to step up its lobbying efforts over the direction of the central client record being planned as part of the Aged Care Gateway, with industry representatives voicing concern that it will duplicate the PCEHR and providers will be saddled with two aged care health records for each client. At an industry forum held at the ITAC conference in Hobart recently, panellists including former Aged Care Association Australia (ACAA) CEO Rod Young, the University of Western Sydney’s George Margelis and Feros Care’s manager of allied health and wellbeing, Kate Swanton, voiced their opposition to what they see as a doubling up of effort. Originally designed to be a record of personal and social data on older people as they began to use aged care services, the plan was to link it to the PCEHR as the recognised health record. However, it appears that the closer the central client record comes to final design, the more it is resembling another eHealth record. Mr Young voiced strong disapproval of what he said was the creation of two health-related records for each older person and urged the industry to step up lobbying efforts with the government to change direction. “They are proceeding with an aged care health record, that is what they are proposing, and if we are to change this we need to run a campaign,” Mr Young said. “This is policy silliness.” Dr Margelis agreed, saying it is not a time to be polite. “It is time to shout on the street and say this is ridiculous.” He said it was technically possible to link the central client record to the PCEHR, but that all health IT roll-outs had shown that “a single source of truth for all data is critical”.
Telstra buys Medinexus as DCA eHealth rebrands to HealthConnex Telstra Health has bought the Sydney-based Medinexus radiology and pathology secure messaging solution, adding to a growing portfolio of eHealth companies it has acquired since the division was established last year.
“We are continuing to acquire key capabilities in our eHealth strategy and will be providing a full update in coming weeks.”
Telstra’s head of health, Shane Solomon, said the company had acquired Medinexus in full and looked forward “to the opportunities this provides for both parties”.
One of those other capabilities is DCA eHealth Solutions, which Telstra acquired outright from DCA in August last year. DCA eHealth Solutions has now rebranded as HealthConnex in a move it says reflects its commitment to better integration of health services.
“We will be keeping the business operating as usual with the same staff and customer relationships as well as flagging our commitment to investing in the business to continue to improve the solution.”
HealthConnex, which owns the Argus secure messaging service, aged and community care software package TCM, indigenous and community care clinical information system Communicare and
the ConnectingCare point of care communications platform, also manages the National Health Services Directory (NHSD) on behalf of Healthdirect Australia. It has recently released a new consumer-directed care version of TCM, along with a new community telehealth solution. Telstra first signalled its intentions in the healthcare sector with its investment in online directory and appointment booking service HealthEngine in May last year. That was followed by its purchase of DCA eHealth Solutions and a 50 per cent share in pharmacy software vendor Fred IT.
It also invested in Verdi, the new name of acute care information access specialist IP Health.
care coordination, consumer health portals, enabling technologies and data analytics.
Telstra also secured a licence to distribute the Dr Foster risk-adjusted quality measurement tool for hospitals in Australia, and it has an interest in personal health records through US company Get Real Health.
“We have identified what we think are six really bigticket issues in health and if you can put together the six capabilities, you can bring to the mainstream health system a solution,” he said.
Mr Solomon told Pulse+IT last year that the plan was to build on Telstra’s strengths in connectivity and secure data storage by assembling specialised eHealth capabilities in the areas of provider applications, telehealth,
Medinexus is another addition to the portfolio. The Sydney-based company works with radiology and pathology practices and hospitals to deliver a view of diagnostic images and reports to referring doctors, partnering with secure messaging providers Argus,
HealthLink and MedicalObjects.
Telehealth research centre puts theory into practice
It is integrated into GP and specialist practice management systems such as Best Practice, Medical Director, Zedmed, Genie, Shexie and Medtech. Allied health practitioners are also able to access reports and images directly from patient management systems, web browsers, mobile devices and tablets.
The University of Queensland-led Centre of Research Excellence in Telehealth has officially launched, with a focus on translating research findings into clinical practice and training programs.
Diagnostic reports and images are securely stored in a data centre, not in the practitioner’s system, and patients can also be given access by the radiology practice.
It also aims to create an overall body of knowledge to understand how known, effective telehealth strategies can become part of the mainstream healthcare delivery system.
Refreshed national eHealth strategy delayed until COAG meets The “refresh” of the 2008 national eHealth strategy will not be finalised until the federal government finishes its consultations on the review of the PCEHR, the Department of Health says. Deloitte was contracted to develop the 10-year national eHealth strategy in 2008 by the federal and state governments. It sets out a roadmap for four major streams of activity – foundations, eHealth solutions, change and adoption, and governance – and first raised the prospect of an individual electronic health record (IEHR), which
eventually became the PCEHR. Deloitte was again contracted to refresh the strategy last year at its half-way mark. It is understood that the consulting firm finished the refresh before the end of the year, by which time a new government had been elected. The development of a national eHealth business case was also agreed to last year under a memorandum of understanding between the then federal health minster and the state and territory health ministers.
The jurisdictions committed to the business case to enable an agreed share of funding for eHealth beyond July 2014, when most budget allocations expired, including for the PCEHR. A DoH spokeswoman said both the refresh and the business case will be considered along with the review. “To ensure alignment, the national eHealth business case and refresh of the national eHealth strategy will be finalised by the COAG Health Council following government consideration of the recommendations of the review,” she said.
The CRE, announced last year with funding from the National Health and Medical Research Council (NHMRC), will provide support for teams of researchers to pursue collaborative research and develop capacity in telehealth.
It involves six universities with telehealth expertise which will be complemented by specialists in the fields of health economics, IT, engineering, health informatics, workforce planning and management. Telehealth researcher Dominique Bird, who has held positions at Monash University, QUT and with UQ’s Centre for Online Health, has been appointed as the telehealth program manager. Dr Bird has worked on a number of telehealth program, including the TLC Diabetes project. Chief investigators include well-known telehealth researchers and clinicians Len Gray, Deborah Theodoros, Anthony Smith and Trevor Russell, while associate investigators include Elizabeth Beattie, Colin Carati, Sisira Edirippulige and Anthony Maeder. Professor Gray said the CRE in Telehealth will focus on health service settings where access is currently challenging, such as small rural hospitals, residential aged care facilities, people’s homes and indigenous communities.
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ACRRM and HISA join forces to promote telehealth The Australian College of Rural and Remote Medicine (ACRRM) and the Health Informatics Society of Australia (HISA) have agreed to jointly produce webinars promoting the use of telehealth as a tool to overcome the fragmentation of care. The overall aim is to increase the availability of quality telehealth services to people living in rural and remote Australia. The series will focus on topics such as the management of chronic and complex conditions and developing care pathways that include telehealth. Federal and state government policy initiatives such as NSW’s integrated care policy and the Queensland rural telehealth plan will also be covered, as well as bring your own device (BYOD) in telehealth, in which consumers are providing their own hardware and monitoring peripherals. Three webinars have been planned so far, to take place before the Rural Medicine Australia conference in Sydney in October and one before HISA’s Australian Telehealth Conference (ATC) next year. ACRRM has agreed to provide the webinar platform and host the presentation on its eHealth website and YouTube channel, while HISA will be in charge of recruiting and supporting presenters. ACRRM hosted a webinar in June featuring GP and telehealth advocate Ewen McPhee of the Emerald Medical Group in central Queensland, which focused on the practical elements of introducing telehealth to a rural practice. An ACRRM spokesperson said the college is also working with the Royal Australasian College of Physicians (RACP) to encourage specialists visiting rural and remote areas to incorporate telehealth services as an adjunct to face-to-face services.
Royal Perth Hospital begins uploading discharge summaries to the PCEHR Royal Perth Hospital’s Shenton Park campus has become the first WA hospital to begin uploading discharge summaries to the PCEHR, with the main Wellington Street campus set to come online in the next few months. Royal Perth is using the Healthcare Information and PCEHR Services (HIPS) technology designed by SA Health and a vendor partner to link to the national system from its iCM clinical information system. South Australia, Tasmania, the Northern Territory and Queensland are all using HIPS, while NSW, Victoria and the ACT are uploading directly from the various clinical information systems in use.
A Royal Perth spokesperson said discharge summaries are being completed using WA’s new Notifications and Clinical Summaries (NaCS) system, which is due to be rolled out as a statewide solution to centrally host and share clinical documents like discharge summaries and outpatient letters.
was the first hospital in Australia to send electronic discharge summaries into GP practice software via secure messaging back in 2005. Dr Garton-Smith has been working with local GPs to prepare them for the change to the new system, which she said won’t be too different from current practice.
NaCS is due to replace The Electronic Discharge Summary (TEDS) system still in use at the Wellington Street campus. TEDS is due to be progressively phased out at Royal Perth and the other health facilities currently using it in the south metropolitan area.
She also said Fiona Stanley Hospital, which will use iCM when it opens later this year, will be linked to the new NaCS central system.
According to the hospital’s liaison GP, Jacquie Garton-Smith, Royal Perth
For the PCEHR, discharge summaries must be packaged as clinical document architecture (CDA) files, but the hospital spokesperson said they will be sent to GP systems as PDFs for the time being, as
not all recipient systems can accept discharge summaries in CDA format. “Depending on the secure messaging provider, the opportunity exists to send the discharge summaries in both CDA and PDF
format,” the spokesperson said. “This remains a future option dependent upon confirmation of its success.” At Shenton Park, local copies of the discharge summaries are stored
in the hospital’s Global Document Store and are viewable from iCM. The hospital is linking Individual Healthcare Identifiers (IHIs) to its unique medical record number through WA’s Enterprise Master Patient Index.
Short window for expressions of interest in Medicare payments outsourcing The federal government allocated just two weeks for the private sector to submit an expression of interest to provide a claims and payment solution for Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) transactions. Fairfax newspapers revealed in early August that the government was going ahead with its plan to explore a “commercially integrated health payment system”, as briefly outlined in the May budget. Half a million dollars was allocated to the Department of Health (DoH) to develop a proposal in conjunction with the Department of Human Services (DHS) to market test the delivery of a new system. DoH currently contracts DHS to handle MBS and PBS claims and payments on its behalf, with hundreds of millions of transactions being processed each year. Exactly why a new system
is required is unclear, although Health Minister Peter Dutton said the current IT systems that manage the claims and payments processes “are dated and in need of a substantial upgrade”.
“Between 2007 and 2009, the government provided financial incentives to GPs, specialists, pathologists and medical software vendors to transition to online services.” He did not specify what those IT systems were, but said the government believed it was “good process to review and test existing and alternative systems”. DHS has had an automatic payment system for bulk-
billed transactions for almost a decade and is increasingly encouraging online transactions, both from healthcare providers and patients. Between 2007 and 2009, the government provided financial incentives to GPs, specialists, pathologists and medical software vendors to transition to online services under the Transitional Support Package (TSP). Online services now account for the vast bulk of transactions handled by DHS. Mr Dutton hinted that he might have a preferred solution in mind when he addressed the HIMSS conference in Sydney in May. “It’s an area we want to see streamlined and to provide greater support outside of the current regime that will deliver a cutting-edge technology and efficiency gain that we think we can deliver fairly promptly to general practice,” he said.
DoH belatedly agrees to release Pathfinder project The results of the aged care Pathfinder project, set up in 2012 to investigate what systems and processes would be required to get the aged care sector using the PCEHR, will finally be released almost two years after a report was presented to the Department of Health. Aged Care Industry IT Council (ACIITC) chairman Suri Ramanathan told the ITAC conference in Hobart recently that a series of fact sheets advising aged care providers on how best to roll out the system would be released soon. This is despite a Department of Health spokeswoman telling Pulse+IT that the report, while useful, had only been used internally within the department to inform its eHealth agenda. The project was first announced in June 2012 and involved aged care software vendors Leecare, EOS Technologies (ComCare) and AutumnCare. The three vendors worked with aged care provider RSL Care to study how the PCEHR could potentially benefit aged care providers and how the industry could integrate it into future models of care. Led by the then Aged Care Association Australia (ACAA, now LASA), the idea was also to generate lessons learned from adopting PCEHR standards and understand what business process changes would be required to maximise the benefits of PCEHR integration. It aimed to provide a guide to aged care providers on how to implement the system and roll it out to residents. It also involved work on developing a roadmap for future IT deployments in aged care, which eventually became the Digital Care Services IT blueprint, developed by the ACIITC and Accenture, which was released in March.
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Hansen steps up as new chair man of HISA The Health Informatics Society of Australia (HISA) announced the new members of its board and its annual award winners at the Health Informatics Conference (HIC 2014) in Melbourne in August. The new chair of HISA is David Hansen, CEO of the Australian e-Health Research Centre (AEHRC), a joint venture between the CSIRO and the Queensland government. BT Australia’s Karen Gibson, a former general manager of strategic initiatives at NEHTA, was elected vice chair. Jen Bichel-Findlay and Phil Robinson were returned as secretary and treasurer respectively, along with current members Nick Buckmaster and Tam Shepherd. New board members are Accenture’s Leigh Donoghue and Edith Cowan University’s Trish Williams. The winners of the Don Walker Awards for efficiency, effectiveness and access were Cathy Fuhrman of Sharp Healthcare, Steven Shaha of Allscripts and Wendy Carroll of Sanofi. Carey Mather from the University of Tasmania was awarded the Joan Edgecumbe Scholarship. James Bennett won the HISA Apps Challenge with the DoseMe app. Other finalists were Jennifer Tang and Jarrel Seah with Eyenaemia, Dhruv Verma with PROTEGO, and the Northern Sydney Local Health District for the Traffic light guide. Dallas Bastien of Nursing Review won the media award. Mary Lam of the University of Sydney won the Branko Cesnik award for best scientific/academic paper and Hamish Thornburn of the University of Queensland won the best student paper.
Interactive dashboard from qiConnect to graph PCEHR indicators The Improvement Foundation has developed a new interactive dashboard and a set of eHealth indicators for its qiConnect portal, which allows general practices to automatically upload data on certain clinical measurements for analysis and benchmarking. qiConnect is used by participants in the Australian Primary Care Collaboratives (APCC), a program managed by the IF on behalf of the Department of Health. Practices use Pen Computer Systems’ clinical audit tool (Pen CAT) to extract data from their practice software on a range of clinical and non-clinical measures, including those for chronic heart disease, diabetes and COPD. Data is lodged monthly and can be reviewed
by practices to see the percentage of patients who meet certain criteria, such as diabetic patients with a HbA1c of less than seven. Practices can then focus on working more closely with that subset of diabetic patients, as well as benchmark themselves against other practices in the state. The IF has now added eHealth indicators to the portal, including measures such as medication list currency and PCEHRrelated indicators such as number of patients with an uploaded shared health summary (SHS), total number of SHSs uploaded, the age of those uploads and number of patients with a verified Individual Health Identifier (IHI). Real-time feedback graphs can be used to identify
areas where practices can make improvements and then track the results of their improvement efforts. It will also allow them to benchmark progress on a national level. Improvement Foundation CEO Colin Frick said the new indicators will provide an additional insight to identify where improvements can be made and the results of those improvement initiatives. APCC clinical chair Alison Edwards, a GP at the Broughton Clinic in South Australia’s Port Broughton, has been involved in the collaborative ‘waves’ for a number of years, including one that had a focus on heart disease and diabetes. Dr Edwards said she uses the information to monitor how her practice
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measures up in terms of the percentages of patients achieving certain levels, but also to benchmark the practice against others. “We are very competitive, both with other practices and within the practice itself,” she said. “As doctors, we’d like to think we’re doing a perfect job but then we pull the data out and see that we’ve only got 60 per cent of our patients with glycated haemoglobin in the right range. But it allows you to see that some are only just outside the range, or you’re tweaking things and it hasn’t quite had the chance to come back into the range.” The tool allows her practice to analyse the data further and make an assessment on patients who may not have had their bloods done recently. Some may have ceased to be active patients or have entered residential aged care, but some may also be reluctant to accept their diagnosis, she said. “That then highlights to us that the next time they’re in, maybe we can capture them,” she said. The APCC is now up to wave 10, which for the first time involves a chronic kidney disease focus. Dr Edwards’ clinic is looking at its data on a populationwide level to target patients of a certain age with conditions like diabetes and hypertension to ensure they
have had blood and urine tests recently. “It has been great to be able to pull that data out and look at that list and say, potentially there’s 900 of our 2500 patients who should be checked and we’ve only checked about 100 of them. We now can look at that from month to month and see that we’ve managed to catch this many more.”
“We are very competitive, both with other practices and within the practice itself.” Dr Edwards has been doing her own data collection on patients who are involved in the PCEHR, keeping a database of how many patients have expressed an interest in the system, how many have registered and which ones have had an SHS uploaded. This will now all be able to be automated through the dashboard. Her practice was an early adopter of the PCEHR, as it has a higher than average population of older people, including a good proportion of grey nomads for whom the concept of a portable medical record is attractive and which is her target audience for the PCEHR. She does admit that it has been slow progress and she
doesn’t review the records that often, and only one discharge summary has been uploaded for one of her patients.
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While she said she is “confident that it’s not a perfect system”, she has talked her patients through their privacy concerns and most are keen. “I know quite a lot of doctors who have held back, just with concerns about privacy, but my approach is if we don’t play with it and try and get it better, then it’s not ever going to happen. It’s more than 51 per cent good, so we’ve jumped in and gone with it.” One of her cancer patients is waiting for the day in which she will be able to log on to her PCEHR to look at changes in her blood tests, while a new patient who recently moved to SA from the Northern Territory had set up records for her children, and Dr Edwards was able to use the PCEHR to check their immunisation status. “It does work in certain circumstances and I’m sure in time, it will eventually work,” she said. “We have to start somewhere and honestly I think it will be the patients that drive it. I have not yet had any of my grey nomads come back to me and say [they had urged another doctor to use it]. I’m waiting for that moment.”
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The Art of Performance for practice managers The Australian Association of Practice Managers (AAPM) is holding its national conference in Adelaide in October, with a theme of ‘The Art of Performance’. Keynote speakers include Norman Swan, host of The Health Report on ABC Radio National; Bernard Salt, one of Australia’s leading social commentators; and Fortune 500 motivation strategy and design expert Jason Fox. Other speakers include Gill Hicks, Daniel Lock, Vinh Giang, Khoa Do and Justin Vaughan from NIB. The conference is open to all who are involved in health care management and delivery, including practice managers, team leaders, practice team members, practice nurses, practitioners from all specialities of healthcare, policy makers and healthcare managers. New this year is the Ideas Forum, which will showcase projects or systems that practices have implemented that have delivered real benefits. The format will use electronic posters (ePosters). Sessions include a comparative forum between practice management needs in Australia and New Zealand, featuring Gary Smith, Chris Brown, Jan Chaffey and Kevin Rowlett. Chris Bollen will present a session the future of secure messaging and the eHealth agenda in Australia, while the Department of Human Services will provide a Medicare and HPOS update. The exhibitor component of the conference will showcase a wide range of services and products to help make practices more efficient and effective. The conference will be held from October 21 to 24 at the Adelaide Convention Centre. More details are available at www. aapmconference.com.au
Study shows the PCEHR is too hard to register for An observational study of people in their own homes who tried to sign up for the PCEHR found that eight out of the 10 people involved failed in their attempt, with poor design and usability the main culprits. The study, carried out by Melbourne-based Navy Design, a consultancy specialising in health and medical software design, suggests that a usercentred approach is the key to increasing uptake of the PCEHR by consumers, and more extensive testing with end users was needed. As reported by Pulse+IT last year, Navy Design planned to conduct the research with a view to informing the ministerial review into the system from an end user perspective. At the time, Navy Design’s general manager Michael Trounce said the consumer perspective had been lost in the debates over the clinical utility of the PCEHR. “When it comes to eHealth, the quality of the user experience can have a direct impact on health outcomes,” Mr Trounce said. “That’s when good design is really critical. This perspective can be lost when projects are delivered with a focus on IT rather than people.” The results of the research have been released in the
hope that it can also inform the consultation meetings that have been staged around the country with different user groups by the Department of Health and Deloitte.
“Navy Design suggests that at the moment, the record may simply be too hard to use.” Navy’s design consultant and director, Ollie Campbell, said poor design and usability are key contributing factors to the underwhelming performance of the PCEHR, and future versions of the product needed to be designed with end users in mind. Navy Design suggests that at the moment, the record may simply be too hard to use.
were compelling. Each of our research sessions was an hour long. In that time, only two out of 10 people were able to sign up.” He said the number of steps in the sign-up process had also caused problems. “To sign up successfully, you need to understand each step, why you’re doing it and whether you’ve been successful. What is a myGov account? How does it link to Medicare? Very few people were able to answer these questions because of the conceptual complexity involved. “Even when people managed to sign up, they weren’t sure whether they had an eHealth record. People said things like ‘Have I finished now?’ or ‘Is that mine or my son’s?’.
The company’s research used a technique called contextual inquiry, which involved visiting people in their homes and observing them signing up to the PCEHR in their natural environment. Navy Design said government marketing claimed that it should take one minute to create an account.
“The ideal approach would be to simplify the process by reducing the number of steps and conceptual entities. If that’s not possible, a clear framework could be introduced early in the process to orient people, communicate progress and gives feedback on success. This is particularly important when there are subtasks like the myGov sign-up which the user didn’t think they were initiating.”
“We wanted to test that in a real world context,” Mr Campbell said. “The results
The research also showed that simple usability issues was hampering the process.
“Hitting the back button causes the process to break. The password strength requirements are unclear.These are small things, but they can easily
cause people to abandon a process. “ However, despite their difficulty using the system, most participants were
positive about eHealth. The majority saw value in the concept, and several planned to continue the process with the help of their doctor, he said.
EyeSnellen app for iPad validated for measuring visual acuity A study comparing an iPad app using a portable Snellen chart found it is comparable to the traditional chart for measuring visual acuity. The EyeSnellen app for iPad and iPhone has been designed by Perth ophthalmologist Steve Colley. Released in 2012 with an update in December last year, the app uses an iPad to display the Snellen chart and an iPhone or iPod as a remote device via Bluetooth. In a paper published in the Journal of Mobile Technology in
Medicine (JMTM), Fremantle Hospital researchers found that of 67 people with an average age of 57 tested, the Snellen chart function on the EyeSnellen app was equivalent to the traditional Snellen chart at measuring visual acuity at a test distance of six metres.
The authors say that the portability of tablet devices makes them ideal for remote and rural healthcare and for mobile screening units, so they wanted to test the hypothesis that the EyeSnellen app could be confidently used in these settings.
As the authors write, measurement of visual acuity provides a screening tool for the diagnosis of underlying disease and can be used as a predictor of the functional consequences of visual loss.
Their analysis showed agreement between visual acuity measured by Snellen chart on EyeSnellen and visual acuity measured by the Snellen light box chart. “This result demonstrates that EyeSnellen can be used as an alternative to the traditional Snellen light box chart when vision is tested at 6 metres,” they write. Advantages of the EyeSnellen app include the fact that the remote function allowed randomisation of optotypes, which removed the chance of patients recalling them from memory. They say the Snellen chart function on the EyeSnellen app can be reliably used to measure visual acuity in clinical settings.
AutumnCare goes mobile for care staff with version 4.5 Aged care software vendor AutumnCare has launched the latest version of its clinical software, featuring a new dashboard that provides a snapshot of all clinical information as well as a new web app for mobile devices. The new Web Connect function in AutumnCare version 4.5 is designed for staff on the floor and allows users to create case notes and charts, and view resident profiles and care activity lists on smartphones or tablets. Web Connect fully integrates with AutumnCare’s Medicate medication management solution, allowing staff and GPs to view medication profiles on their devices. GPs can create change requests and medication notes directly from their phone, ensuring pharmacies can react quickly to a resident’s changing needs. Medicate has also been improved with double signing, medication review and medication re-ordering functionality. The company’s Home Care module for community care has also been updated to include funding estimation and bulk actualisation of appointments. The new dashboard in version 4.5 allows users to customise indicators to match organisational processes, such as how often care plans are evaluated or managing ACFI funding levels. AutumnCare managing director Stuart Hope said the new release was about currency of information. “We want to empower staff by giving them access to real time information, which enables them to make the most informed decision possible,” Mr Hope said. Version 4.5 also includes ACFI tools, care activity lists and smart form technology that automates the graphing of weight and vital observations.
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Telstra highlights eHealth as an emerging opportunity Telstra has signalled plans to continue to invest in software solutions and platforms as part of a focus on emerging opportunities such as its new Telstra Health division. In its annual report for 2013-2014, Telstra revealed that it had paid $44 million for the 100 per cent shareholding it took in DCA eHealth Solutions last September. DCA’s eHealth assets, now rebranded as HealthConnex, include the Argus secure messaging service, Communicare clinical software and the TCM aged and community care package, as well as a support contract for the National Health Services Directory (NHSD). It also paid $27 million for a 50 per cent share of the Fred IT Group, which includes Fred dispensing software and eRx Script Exchange. While it did not release any revenue figures for these companies, it has placed a goodwill value on Fred of $21m and $16m for Health Connex. It also recently bought the Medinexus radiology and pathology secure messaging solution, although the price has not yet been disclosed. Last year, it made its first strategic investments in HealthEngine with a 25 per cent share and a 32 per cent share of IP Health, now rebranded as Verdi. It has since invested further in HealthEngine and controls one-third of the company’s shares. These investments combined were valued at less than $8m last year. “Growth to date has been through strategic acquisition and investments, partnership and commercial relationships,” the telco says. “These investments enable us to play a role in eHealth solutions via means such as connectivity of health services, electronic health records and electronic prescriptions.”
RCPA invites comment on pathology information standardisation The Royal College of Pathologists of Australasia (RCPA) is set to release for public comment a draft document outlining updated standards, guidelines, terminology reference sets and preferred units of measure as part of its Pathology Information, Terminology and Units Standardisation (PITUS) project. Public comment will also be invited on the rendering of pathology reports in general practice clinical information systems following a survey of clinicians on how they wanted to view pathology results. The PITUS project follows the completion of the RCPA’s Pathology Units and Terminology Standardisation (PUTS)
project, which last year developed standardised reference sets of terminology for pathology requesting and reporting and preferred units of measurement for results. It includes a list of standardised orderable test codes that cover over 95 per cent of the tests ordered by GPs. The PITUS project is a continuation of this work and concentrates on the implementation of the standards and reference sets in pathology and general practice information systems. Another focus is to ensure all critical information in a report is transmitted safely. The chair of the RCPA’s steering committee for the project, Michael Legg, said
the work on the rendering of pathology reports is also being used to inform the current discussions on how to upload pathology reports to the PCEHR. The Department of Health is currently holding a series of meetings on the topic, as well as on how to upload diagnostic imaging reports. Those discussion have led to a general consensus that pathology reports should be uploaded as an immutable PDF in advance of longer term work on how to upload atomic data. Uploading the full report as a PDF is seen as the safest way to ensure that pathology results cannot be misinterpreted, A/Prof Legg said. “Nobody knows how [atomic data] is going to be rendered at this point, so
until we’re comfortable that it’s working properly, the safest way of doing it is to make sure that’s it is shown in a way that the reporting laboratory would expect it to be,” he said. While the RCPA awaits the results of the public comment, the project’s working groups are concentrating on how to oversee its implementation. Working group one is working on monitoring the implementation of the standardisation of
requesting and reporting in conjunction .
guidelines for the rendering of reports including cumulative ones.
“Nobody knows how atomic data is going to be rendered at this point.”
Working group four has developed guidelines for the representation and rendering of reference values and age ranges provided for guidance on reports. Working group five has worked on standardising reporting to clinical registries such as cancer and communicable diseases registries.
Working group two has mapped the RCPA’s quality assurance program test list to SNOMED-CT-AU codes, while working group three has developed draft recommendations and
The draft will be available on the RCPA website.
Pathology sector decides against authority to post system for PCEHR reports Industry groups involved in devising a method to upload pathology reports to the PCEHR have decided against an authority to post (ATP) method, instead agreeing on a seven-day waiting period before reports are directly uploaded by the pathology provider. Both the pathology and the diagnostic imaging sectors have been debating the best method to include reports on the PCEHR, which the Department of Health (DoH) wants to commence in December. The favoured method appeared to be ATP, in which the referring doctor would send an authorisation message to
the diagnostic provider to upload the report once it has been reviewed. However, at a second pathology consultation workshop held in Melbourne on August 8, participants agreed that there should be a sevenday period in which the referring doctor can view the results – sent by normal secure messaging – before the actual report is made available to the patient on the PCEHR. The workshop agreed that this design would support the appropriate communication of results to the patient by their GP. It would also mean that the majority of results can be authorised to be uploaded
automatically at the time of referral. Metadata from the report will be available immediately to the patient but not the report itself. The reports will be uploaded as PDFs until standardised terminology is finalised and agreed to, meaning atomic data will then be available through the PCEHR. At the HIC in Melbournein August, PCEHR review panel chairman Richard Royle said the panel had agreed in its report that the PCEHR could not move to an opt-out model until one of three essential clinical modules was up and running. These modules were pathology, radiology or medications.
NRMA hits the road with Living Well Navigator Motoring services organisation NRMA is planning to build a ratings platform for home and residential aged care facilities through its Living Well Navigator platform, which launched online recently. Aged care consultant Gillian McFee, a former CEO of UnitingCare Ageing who also led the older Australians health community plan for NEHTA as part of the national eHealth change and adoption strategy, told the ITAC conference in Hobart last month that extensive member research had shown that health, wellbeing and ageing were the issues highest on the agenda for the mutual organisation’s 2.4 million members in NSW and the ACT. NRMA, which is affiliated with other motoring services such as the RACV and RACQ, has developed the Living Well Navigator platform as an extra service to members, providing information on independent living, supported living and health and wellbeing. NSRMA plans to begin developing a rating system for home, community and residential aged care services called the OWL system. It has partnered with Gallup to use its CE11 customer engagement tool to develop the OWL ratings, which are currently being implemented in 30 early adopter retirement villages. Ms McFee said the NRMA platform was complementary to the national My Aged Care site, which recently introduced home and residential aged care fee calculators. It will eventually be the gateway through which older people access the central client record and link to the PCEHR. Ms McFee said the organisation was also looking to add further services through the Living Well Navigator, including potentially partnering with telehealth device suppliers and services to bring self-monitoring devices to a larger audience.
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Decision Assist website goes live with telehealth and app The first stage in the Decision Assist palliative care and advance care planning advisory service has gone live, with a website launched and a 24/7 telephone advice service on advanced care planning now available for GPs and aged care providers.
Monash students design app that takes a simple selfie to screen for anaemia Two Monash University medical students have won the Microsoft Imagine Cup for their Eyenaemia app, which is able to analyse the pallor of the conjunctiva of the eye and calculate the risk of anaemia.
Decision Assist is the collective name for the Specialist Palliative Care and Advance Care Planning Advisory Services, a consortium of seven healthcare organisations and research institutes that successfully won funding of $14.8 million over three years to establish a nationwide palliative care service under the Labor government’s Living Longer Living Better aged care reform package.
Monash students Jarrel Seah and Jennifer Tang picked up $50,000 in prize money for the win. They also made it to the finals of the Health Informatics Society of Australia’s (HISA) App Challenge.
The new service aims to provide GPs and aged care providers with information on palliative care, advance care planning and advance care directives, including the legislation and processes in each state and territory. The national 1300 668 908 advisory phone service on advance care planning is now available, with a palliative care service due to launch in September. It is expected that the palliative care service will provide advice on topics such as symptom control and medication.
While the app – which measures conjunctival pallor by asking users to take a “selfie” of their eye along with a colour standard, and then calculates haemoglobin levels – can be used by anyone, including pregnant women and children, it has been designed to be simple to use and could easily be used as a screening tool in the developing world to
The service also plans to create web-based resources including tablet and smartphone access, apps, and to provide telehealth services to overcome geographic isolation. There are also CPD resources for telehealth and eHealth from the Royal Australasian College of Physicians (RACP), the Australian College of Rural and Remote Medicine (ACRRM) and the Royal Australian College of General Practitioners (RACGP). Training workshops will be held in all states throughout the year, and an official promotional event to launch the full services is scheduled for October.
target conditions such as malarial anaemia. Each user has an account, stored in the cloud, so they can regularly monitor their haemoglobin levels. The user’s target haemoglobin levels are customised according to WHO guidelines for the diagnosis of anaemia. It has also been validated, the duo says, and can objectively evaluate the colour of the conjunctiva and return the same result every time. Mr Seah and Ms Tang went up against 125 students and 34 teams in the Imagine Cup world finals, which were held at Microsoft’s TechReady19 in Washington State in late July. The Eyenaemia app won the world citizenship category and then went up against two other teams: the winner of the games category,
Brainy Studio from Russia, and the innovation category, Estimeet from New Zealand. Monash University’s academic director for clinical programs Christopher Wright said Seah and Tang were exceptionally talented people. “Their win speaks to their technical capability, their communication skills and their vision for the role of technology in the delivery of health care, particularly to the developing world,” Associate Professor Wright said. “It’s very important we understand that the skills required to be a great medical student, and eventually a great doctor, are not incompatible with having a deep interesting in computer science, mathematics and physics.”
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iTransplant goes live for streamlined electronic donor record Queensland has gone live with the new DonateLife electronic donor record (EDR), joining the other states and territories in using the new real-time clinical data repository to streamline data sharing on organ donation and transplantation processes nationally. The EDR is based on the iTransplant medical information system from US company Transplant Connect, an off-the-shelf product that provides a web-based single data repository that can be updated in real time with information needed to support the donor referral, organ offer, donor management and organ retrieval processes. It replaces in a consistent format the 28-page paper form called the Confidential Donor Referral Form (CDRF) and includes all of the necessary donor referral data, medico-social history and family consent information required. iTransplant, which is used by over 50 donor agencies worldwide, was chosen for the new EDR in October 2012 and has since been customised and configured to suit the Australian setting. A spokesperson for Australia’s Organ and Tissue Authority (OTA), which oversees the DonateLife Network of
organ and tissue donation agencies and staff in 72 hospitals around the country, said customisation was required to map each data element from the paper forms to the new application. “Whilst many of the required data elements were contained within the out of the box version, some were missing and needed to be added,” the spokesperson said.
“While the EDR is a clinical system, it will not be accessed by transplant coordinators or clinicians on transplant teams.” “American terminology needed to be replaced with Australian terms and drop down lists needed to be customised to Australia practice.” Most states and territories went live in March after several phases of validation and testing, with Queensland passing a required regulatory change this month to join the national system. Some quite complex legal and governance issues around sharing, accessing,
security, storing and managing data needed to be overcome before the system was implemented. While the EDR is a clinical system, it will not be accessed by transplant coordinators or clinicians on transplant teams, the spokesperson said. Instead, it will be used by DonateLife donation specialists, family service coordinators and other DonateLife clinical staff to enter information that can then transmitted directly from to transplant teams by email as a standard Donor Chart PDF. “The information contained in the system is collected from family interviews, medical charts and laboratory tests,” the spokesperson said. “Donation specialists log on, enter and access the necessary information into the EDR. The information needed to allow each transplant unit to consider an organ offer is securely transmitted from the system.” The EDR is supported 24 hours a day, seven days a week nationally by system administrators within each jurisdiction with further support from the OTA. Transplant Connect will continue to be involved in further developing the product, with updates to the EDR expected up to four times a year.
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Hands-free nursing through voice activation Aged care software vendor HealthMetrics has released a voice-activated, hands-free communication system that allows nurses to document care processes at the bedside by speaking into a lightweight headset, with the notes then integrated into HealthMetrics’ eCase clinical software. Based on the AccuNurse technology from US company Vocollect Healthcare Solutions, the voice recognition technology allows for a two-way dialogue between the nurse and the system, with the nurse able to ask questions and call for assistance as well as receive prompts on care processes. While the underlying voice recognition technology is based on an algorithm originally developed by Nuance Communications, makers of DragonDictate software, AccuNurse is not a dictation system. Rather, it acts as a “clinician in the ear”, allowing the nurse to ask questions and receive a response in real-time. It also has the ability to block out ambient noise and only recognise the user’s voice commands. HealthMetrics has rebadged the technology for the Australian aged care market as eCase Hands-Free. HealthMetrics CEO Steven Strange said four of his aged care clients had committed to trialling the system later this year, and there are also plans to launch a similar system for acute care nurses. Mr Strange said one of the main benefits of the technology is that it allows nurses to complete their documentation at the bedside, without having to enter data into a computer or a paper chart. “They are also able to page other staff if they need assistance, without having to leave the patient’s bedside,” Mr Strange said. The headset leads to a lightweight receiver that can be attached to a belt, and which communicates with a server by WiFi.
Telstra Health plans to ditch the pilot and roll out the jumbo Telstra Health plans to bring to market an interoperable mechanism by which the data held in aged care, general practice and pharmacy software systems is more easily shared, and is also intent on developing affordable solutions for integrated telehealth services for independent living. Telstra Health’s two community care leads – former Victorian minister for health Bronwyn Pike and former Australian Home Care Services CEO Michael Boyce – told the ITAC conference in Hobart recently that they had spent the last year speaking to as many people in the aged and community care sectors as possible, and had now developed a strategy to improve information sharing and bring new products to those markets. Telstra Health plans to use the technology developed by companies it has purchased or taken a stake in – such as pharmacy market leader Fred IT, community and primary care software vendor HealthConnex, and acute care vendor Verdi – to develop infrastructure that links all of the healthcare sectors together for better information sharing. Mr Boyce told the conference that one of the problems in the existing primary and community
care sectors was that it was a low-return industry with many small IT innovators. The customer market isn’t that large, he said, and there is an oversupply of vendors. He said the sectors were also plagued by misaligned incentives and payment systems, which consumerdirected care (CDC) would hopefully help, but the main problem was fragmentation.
“We know that Telstra has a lot of sophisticated technology and capability but it is not really about technology.” “Somehow we need to be able to connect the dots and sometimes it needs a big player with a reasonable balance sheet to play a part in solving those problems,” Mr Boyce said. One area Telstra Health plans to target is to create a link between healthcare practitioners involved in the care of residents of aged care facilities, including their GPs and pharmacists. While aged care, general practice and pharmacy software all holds information about individual patients and residents, that information is not shared.
Telstra plans to provide a solution to that problem, Mr Boyce said. “We have infrastructure coming across … [because] to put GP, aged care and pharmacy together we will need to put new infrastructure in place, and we plan to. “You have a number of software solutions for aged care, vendors that provide clinical management software and medication management software. That information exists, it is online but basically it is not shared outside the business operation. “You’ve got GP software like Best Practice and Medical Director and others. That information also supports health data around patients who are also residents in aged care, but that information is not shared. “You then have a pharmacy with a pharmacy dispensing system. They hold information around a patient’s medication and that patient happens to be a resident of a residential aged care facility. That information, depending on what software you have in the residential aged care facility, is partially shared. “So what Telstra is about through Telstra Health is connecting those three softwares to provide real-time,
contemporary, relevant, valuable information at the fingertips of each of those organisations for patient care and resident care. “If you can connect to those three – and we have a plan to do that – you can also connect to the geriatrician, you can also connect to the primary carer, the speech pathologist, to the dietitian and the various software that they use. What you need to do that is an interoperable mechanism, and we think we have that solution.” Telstra is also planning to ramp up its activity in the integrated telehealth market, Ms Pike said. The organisation is already working with health insurer HCF to roll out vital signs monitoring systems to 3500 clients in NSW, but has plans to use the strength of its existing infrastructure
and business processes to the job of solving connectivity problems in healthcare. “Australia’s biggest telco has decided to build an eHealth business,” she said. “There are lots of reasons for that, but mainly we have seen an opportunity to contribute to the health and wellbeing of the country. There are lots of opportunities to derive productivity from a health system overall that is fundamentally inefficient and is not as productive as it could be.” Ms Pike said one of the most common refrains from aged and community care providers was that they were absolutely sick and tired of the numerous pilot projects that are funded, succeed in their limited outcomes but are not sustainable.
“You don’t want the pilot, you want the jumbo,” she said. “The truth is though that the jumbo is not going to come with a truckload of cash from the government. It is going to come in the development of affordable and sustainable solutions.” Ms Pike said Telstra plans to introduce a number of technologies such as client portals and devices that allow for home monitoring, telehealth and information sharing. While many of the technologies are now available, they are proprietary and do not integrate with core systems. “We don’t want to replicate that,” she said. “We want to make sure that everything that we develop is open, can be integrated, can be seamlessly linked to legacy systems and ... integrated into other primary care providers.”
iPad version of ACE dementia test calculates scores Australian and UK researchers have released a free iPad version of Addenbrooke’s Cognitive Examination (ACE), a popular screening test for dementia and other cognitive disorders, which will allow clinicians to automatically calculate patients’ scores and create a report for their medical records. Developed by Neuroscience Research Australia’s (NeuRA) John Hodges and colleagues at Plymouth University, the ACEmobile app contains the latest version of the ACE test, ACE-III, and will mean users no longer have to refer to the paper manual or calculate scores in their head. The ACE-III test is considered more comprehensive than other tools like the Mini Mental State Exam (MMSE). In a 100-point score, people with scores below 88 may have early dementia and scores below 82 increases the certainty. The test is normally administered with paper and pencil and requires clinicians to calculate the score. It also requires clinicians to use an administration manual to ensure the correct wording is used. The ACEmobile iPad version will do both of these functions automatically, and will also create a report that can be printed out or emailed. It is also aimed at allowing nurses and non-medical staff to administer the test. Professor Hodges, who designed the original test, said the ACE had always been a free test and would continue to be so. It is used around the world, including in developing countries.
Photo courtesy Event Photography
He said ACE as an online medical tool meant greater access to early and decisive diagnoses. “A diagnosis can now be made anywhere there is an internet connection, which is particularly important in parts of the world where resources are limited.”
Bits & Bytes
Clinical e-Audit for asthma management NPS MedicineWise has released the latest in its series of online clinical e-Audits, this one aimed at helping GPs to review how well their patients’ asthma is controlled. The online audit will help GPs to identify risk factors that may contribute to poor asthma outcomes, and includes asthma treatment for children and adolescents as well as adults. The clinical e-Audit follows recent survey findings that showed that over half of all respondents to a survey of adults with asthma said they had experienced symptoms in the past four weeks, including wheezing, breathlessness and night waking. The survey showed that 97 per cent of adults taking asthma medication are confident they are using their medicine correctly, with 57 per cent saying they’re ‘very confident’ in their inhaler technique. However, this does not match with figures from the Australian Asthma Handbook 2014, which reports that up to 90 per cent of Australians with asthma don’t use their inhaler correctly. “Many patients think and tell their doctor that they have their asthma under control, but we know that half of all people with asthma live with poor control of their condition and consider this to be normal,” NPS clinical adviser Andrew Boyden said. The new e-Audit allows GPs to review patients and how well their asthma is actually controlled, and then determine management based on regular review of asthma control. The asthma clinical e-Audit is recognised for the Practice Incentive Program of the Quality Prescribing Incentive. GPs can earn 40 RACGP CPD points or 30 ACRRM PRPD points for completing the activity.
Hills focuses on interactive technology for both acute and aged care Hills Health Solutions has added an exclusive distribution partnership for the Lincor range of interactive patient care technologies to its existing portfolio of IP and WiFi nurse call systems as part of its strategy to provide integrated solutions that underpin the delivery of care in hospitals and aged care. It might sound strange to those who have grown up with Hills and its iconic Hoist, but Hills has long been active in the technology sector, particularly in electronic and video security solutions, audio visual technology and communications and mobility.
Following an agreement to sell its steel manufacturing business to Bluescope last year, Hills has set out on a new path to diversify its markets, including a new venture into healthcare with Hills Health Solutions. For the past 18 months, the company has been scoping the Australian and New Zealand acute and aged care markets and has made some strategic purchases and distribution agreements that now position it as a major player in patient care delivery technologies. This includes the purchase last year of IP nurse call system specialist Merlon and related company Hospital Television Rentals
(HTR), and more recently the purchase of Questek, also a big player in WiFi and analogue nurse call systems, particularly in the aged care market. Hills has also secured an exclusive distribution agreement with MyLive!y, a range of home monitoring sensors that tracks a person’s activity and send alerts if a person does not take their medicine, leaves the house or opens the fridge door. Hills Health Solutions has now also added Lincor’s range to its portfolio, targeting both hospitals and aged care providers with its patient engagement technology, an integrated software and hardware
solution that allows for both patient infotainment and the ability to access clinical systems at the bedside. Head of Hills Health Solutions Peta Jurd said the plan was to become a major player in technologies that enable the delivery of care to hospitals, residential aged care and into the community and home. “We are not an infrastructure player and we don’t at this stage plan to move into the delivery of clinical services,” Ms Jurd said. “We’ve been very strategic in the targets that we’ve identified.” Ms Jurd, who has a background in the private hospital sector, said Hills saw an opportunity in the fragmented healthcare market to provide integrated solutions. “If you add to that the great fortune to have a brand like Hills, which people, particularly of an older demographic who are our key customers in healthcare, they have a very great fondness for Hills and it translates into quality and reliability. “We saw that the timing was right, because of the analogue to digital change. Particularly with Merlon, which has been very successful in having a strong IP solution, we are ahead of some of the others.” A recent big win for the company was a contract
with SA Health to design and build an IP-based nurse call system for the new Royal Adelaide Hospital, which is scheduled to complete construction in 2016. The hospital is expected to see more than 80,000 admissions per year.
“What you are getting is rationalisation in those markets and getting larger customers with large portfolios who want to deal with more than a family business.” The RAH contract will see more than 8500 nurse call devices go into the 800-bed hospital. “This new system is designed for patient comfort and assurance and to empower nurses to provide prompt and effective responses to patients’ calls,” Ms Jurd said. “It will provide critical end user patient safety and staff functions via instantaneous visual and audible alert and messaging.” Hills is also concentrating on the aged care sector. Like the private hospital sector, residential aged care is going through a period of rationalisation that Hills plans to target with its product range.
“What you are getting is rationalisation in those markets and getting larger customers with large portfolios who want to deal with more than a family business,” Ms Jurd said. “We saw after doing quite extensive due diligence that there were some good quality businesses that were under-capitalised and could benefit from a corporate coming along. “With the three acquisitions, we have the customer relationships and we have the opportunity to pull through the other solutions that Hills has.” Ms Jurd said Lincor has been installed in hospitals around the world covering an estimated 30,000 beds, and the Australian and New Zealand markets are prime targets as public hospitals begin to invest in patient infotainment. Hills’ home state of South Australia, for example, has rolled out bedside patient infotainment in all of its public hospitals. “They have a very nice clinical dashboard where you can see a range of personal information about the patient and some biometric information, as well as some extracts from the clinical record. All of that is available on the touchscreen. They have a quality product and we are looking to install that with one of the leading hospital and aged care providers.”
Wearable tags to track the elderly on the go An RFID-based real-time location system that can pinpoint exactly where elderly people are in their homes and track their movements was a finalist in the HISA Apps Challenge, announced at the HIC conference in Melbourne. Designed by 14-year-old Melbourne student Dhruv Verma, the PROactive Technology for Elderly on the GO or PROTEGO app is a concept aimed at providing a cost-effective way of monitoring the elderly at home that can alert family or carers if the person has not moved or has potentially had a fall. Dhruv has designed the real-time location system using RFID tags and wireless antennas as a cost-effective alternative to other systems such as wristbands or pendants, which elderly people are liable to take off or forget to wear. The signals emitted by RFID tags are strong enough to be picked up by the antennas and are able to pinpoint the exact location of the person in the home in real time. “And it is cost effective,” Dhruv said. “The tag costs about eight dollars and the antennas cost eight or nine, and you can probably wire up the whole house for a few hundred dollars. “My solution is an RFID tag as part of a self-adhesive waterproof patch. I’ve got a prototype but my vision is to make the tag even smaller and use smaller button batteries so it can be applied comfortably onto the elderly person. “The battery life is about six or seven months and the patch you would probably need to replace every two weeks.” The concept also involves an app for smartphones or tablets so family members have a view of the layout of the house and can see exactly where the older person is in the house.
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Data linkages for rural and remote health research How to maximise the use of national, regional and local health data sets for shaping and evaluating frontline rural and remote health services and policy is one of the focuses of the 4th Rural and Remote Health Scientific Symposium, being held in Canberra in September. The symposium will feature speakers from the Australian Bureau of Statistics (ABS), the Australian Institute of Health and Welfare (AIHW), Medicare and the National Health Performance Authority (NHPA). Topics include data linkage and monitoring changes over time, handling some of the challenges with data analysis in rural and remote areas, getting access to reliable small area data and linking big and small data sets for geo-spatial mapping. Speakers will also discuss how to improve collaboration between national data agencies and local health service providers, community groups and earlycareer researchers. The keynote address will be delivered by David Hansen, CEO of the Australian e-Health Research Centre (AEHRC) Dr Hansen will give examples of CSIRO research in rural and remote Australia and how the information gathered can be used to inform government policy and funding models. An important aspect of the work is to extract meaning from the wide range of home and health service data collected as part of service delivery. He will discuss the telehealth trials CSIRO is involved in around the country, as well as the use of mobile phones, tablets and sensor networks to support the delivery of health services in the community, including cardiac rehabilitation, smart home technology to enable older Australians to live safely in their homes, and tele-medicine systems for remote eye screening.
Griffith launches apps for chronic fatigue and headache research Griffith University has launched a new app to help patients with chronic fatigue syndrome better manage their illness, along with a headache app designed to be used in a research study to record daily ratings of head pain.
with anonymised data entered by patients sent to its researchers.
The chronic fatigue app, called CliniHelp, is also suitable for patients with multiple sclerosis and rheumatoid arthritis and allows them to record symptoms, track them on a weekly basis and monitor changes in their condition.
NCNED head Sonya Marshall-Gradisnik said a major advantage of CliniHelp was that it will allow physicians to be more informed of their patients’ symptoms, as cognition can be a major impediment for patients with chronic fatigue syndrome.
Griffith, which has officially opened a specialist chronic fatigue clinic based at its National Centre for Neuroimmunology and Emerging Diseases (NCNED) on the Gold Coast that will receive patients in October, will also use the app for research purposes,
Users’ records can be stored on their mobile phones as PDFs and shared with their healthcare practitioners.
An iOS version of the app is available now, with an Android version due soon. Griffith has also launched an app that can be used by participants in research projects such as its ENHANCE project, which is
studying the effectiveness of managing headaches using a combination of cognitive behavioural therapy (CBT) and a new approach called learning to cope with triggers (LCT). The Griffith Health Institute research team, led by Paul Martin of the Behavioural Basis of Health program, aims to help headache sufferers to become desensitised to triggers such as food, noise and stress or to build up a tolerance to them. In partnership with Wexpert Technologies, Professor Martin’s team has developed an electronic headache diary that can be used by participants in the study in order to record daily ratings of head pain. “Information recorded via the app can be directly downloaded into data files, saving time and eliminating transcription errors,” Professor Martin said. “The technology will enable the team to know when the ratings of head pain are made, rather than relying on the self reports of the participants. This app will benefit the ENHANCE project but will also be a very useful tool for other headache researchers around the world.” The app can be used on smartphones and PCs.
Leecare spins out P5 Exec for accreditation standards Aged care software specialist Leecare Solutions has launched a standalone version of its P5 Exec application, which allows aged care providers to comply with the aged care accreditation standards one and four while retaining their existing clinical software. P5 Exec is an integral part of Leecare’s Platinum 5.0 browser-based clinical, care and lifestyle management application, which also includes the P5 Med medications management system and P5 Finance. Although P5 Exec was developed in 2012 as part of the Platinum 5.0 program, the company has concentrated this year on allowing it to be used as a standalone solution for aged care providers to record and monitor their management, staff, suppliers, quality and safety system requirements. Leecare Solutions’ founder and CEO Caroline Lee said the application includes everything that aged care managers need to have an overview of management and safety requirements, including staff tasks and calendars, messages, reports and education and credentialing. It also includes a comprehensive
maintenance system that includes monitoring of suppliers and assets, as well as a full document library that can be linked to staff messages, as well as forms and report builders that can be tailored to each particular facility’s needs. Dr Lee said P5 Exec was designed to provide a complete corporate governance package.
“We are not there to replace the clinical system, we are there to be an adjunct.” “By covering off standards one and four, which is what clinical systems don’t cover, we effectively complete the whole circle to ensure that as a manager, users can can log in no matter where they are across the country,” Dr Lee said. “They can check each facility for where the particular quality indices are, whether it is a staff incident or it’s a quality improvement complaint or a maintenance issue.” It also means that if an aged care provider is content with its clinical software, it can use P5 Exec to cover the other two accreditation standards. “It means that the gap that
the industry has had is now filled; they’ve got everything now in an IT system,” Dr Lee said. “You don’t have to concern yourself with having this little module on the desktop that does a certain function but doesn’t interface with others. It can be a standalone application and there’s nothing stopping our clients talking to other vendors. We are not there to replace the clinical system, we are there to be an adjunct and fill a really important gap, but in a complete way. “It is not a token document library or a token HR system or a token maintenance system: these are fully fledged, complete components.” With P5 Exec, Dr Lee’s team has built clever internal features so that when a particular document or form is updated, it automatically updates all of the other applications linked, including in the clinical system. For example, the staff incidents and hazards section allows managers to allocate permissions for access and who a message will be sent to. “Staff are contributing and managers don’t have bits of paper from each site being sent to head office, which is where the biggest time saver is.”
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Multilab model for Wellington laboratories NZ’s Wellington region has completed its implementation of Sysmex’s Delphic laboratory information system (LIS), which will help streamline specimen flow across labs at Wellington, Hutt and Kenepuru hospitals. Hutt Valley (HVDHB) and Capital & Coast (CCDHB) district health boards first started planning for the implementation in 2011, when they decided to implement a common LIS to replace an ageing system that was no longer going to be supported. Sysmex CEO James Webster said that because it is a single system shared by the three labs, Hutt and Capital & Coast DHBs have been able to standardise the testing, workflow and business process and benefit from shared infrastructure costs. “This ‘multilab’ model has also been adopted by other New Zealand public and private laboratories on the Delphic LIS,” Mr Webster said. “Further afield in Canada, Diagnostic Services of Manitoba’s Delphic LIS is centred in the city of Winnipeg. “This common LIS is now shared across 18 metro and regional labs with more sites scheduled to join the system over the coming months. We see similar trends emerging in medical labs in Australia as labs aim to regionalise and consolidate their service. The LIS is an essential component to achieve this.” The implementation of a single LIS aligns with the NZ Ministry of Health’s National Health IT plan, which encourages DHBs to integrate clinical services and achieve cost savings through the better use of IT. In addition to Delphic, Sysmex also markets the Eclair web-based clinical information system which is used as the backbone of TestSafe, pioneered in Auckland and also in use in Canterbury.
HealthLink in the midst of a paradigm shift to online services Over the past five years, Auckland-headquartered HealthLink has made the transition from secure messaging provider to what it calls an online services hub, undergoing an intensive development process that it says is set to completely redefine electronic referrals in New Zealand and Australia. According to HealthLink CEO Tom Bowden, more than 70 per cent of the three Auckland District Health Boards’ GP referrals are delivered using its new online eReferral technology, and the company now provides electronic hospital referrals for approximately 60 per cent of New Zealand’s population. HealthLink, which handles pretty much all secure messaging in both the primary and secondary health sectors in New Zealand, is trialling the new technology with a number of GPs and communitybased specialists to ensure the company gets it right before offering it to both the New Zealand and Australian markets. Mr Bowden said messaging-based referrals and specialist reports are widely used in NZ, with an average general practice communicating with 64 other parties electronically. However, the move to online services is what he
calls a new paradigm that will see the traditional referral process changed completely. “The way it works in messaging is that your EMR is used to define a referral and to pick a party you want to send it to,” he said. “That then turns it into a message and squirts it into our system, where it gets picked up by the party you are referring to. But what it doesn’t do is allow the recipient to define what he or she wants by the way of a referral.
“HealthLink will also begin a renewed push in the next few months to get the system implemented in Australia.”
which fields of information to send and which attachments to present.” Mr Bowden said the EMR then automatically populates the referral with a large number of fields of information in a much more comprehensive manner. “It is the recipient of the referral who has defined pretty much what they want to get,” he said. “It is a much smarter process.” Not only will this overcome the problem of inappropriate referrals, but it will ensure that the referrer can no longer send too much or too little information, he said. By defining the fields and allowing the EMR to take care of populating it, the referrers themselves won’t need to do much work.
“Our new system works with the GP selecting the referral type that they want to use and choosing the recipient from a cloudbased server. Whether they are sending a referral to a hospital or to a specialist or whoever it might be, the recipient defines what information he or she would like to receive in the referral.
“We are in the throes of introducing that now and we have put it into a number of pilot sites first,” he said. “And we are doing a lot more development work to improve the service, applying what we have learned, because in our view, the whole thing about the technology is getting it right. We’d far rather spend all our time getting the product right rather than trying to sell it. If you get the product right, it’ll sell itself.”
“That definition then instructs the EMR as to
The online service will be able to be launched
from within practice management systems, which Mr Bowden prefers to call EMR, and as all NZ general practice EMRs use a common interface based on a national standard, it will work for all.
the lower North Island region following its launch in Wellington in late 2011. HealthLink will also begin a renewed push in the next few months to get the system implemented in Australia.
“This is revolutionising the referral process,” he said. “With the hospital referrals, GPs have told us in focus groups that they can already see better patient outcomes from this process.”
“Because it uses the same EMR interface, [NZ users] don’t need to change the EMR system,” he said. “You just plug it in and it pulls out the same fields and off it goes.”
The same EMR interface is being used for another of HealthLink’s products, the eLab pathology ordering system it has developed with Danish company DMDD. eLab allows GPs to order electronically, with the order sent directly into the laboratory’s system with no manual input required.
The company is also implementing its Care Insight system in more NZ regions following its first introduction in Hawke’s Bay. Care Insight, which has been developed in partnership with Dr Info, allows emergency department doctors access to a summary of medical information held in the patient’s GP’s or pharmacist’s system,
Mr Bowden said eLab is now used extensively in
including diagnoses, medications and alerts.
Remote access to GP clinical systems for district nurses
Care Insight is now used in Gisborne, throughout Northland and in Nelson on the South Island. Mr Bowden said the company was also looking at implementing it in other parts of the South Island, as well as the first implementation in Auckland that is now underway.
District nurses in NZ’s Hawke’s Bay are being given remote access to patient notes held in general practice systems in a pilot project that looks likely to be opened up to more clinicians next year.
While HealthLink and Dr Info have been in talks to introduce Care Insight to Australia, recent changes in health policy and health service realignment means that has been delayed somewhat. Australia also lacks a national secure network for general practices, meaning implementing it on the West Island will be infinitely more difficult than in NZ. “There are all sorts of firewalls – or no firewalls – to try to get through in Australia whereas that doesn’t apply in New Zealand,” he said. “In New Zealand we have pretty much have a complete, universal secure network running across every general practice. “The key to Care Insight is its reliability, so if you’ve got 100 medical practices and 10 of them are going offline all of the time, then it won’t work. Care Insight is a very elegant solution but it has to be choreographed correctly.”
Under the pilot, Hawke’s Bay DHB district nurses are being aligned to three general practices and are able to remotely access the practices’ Medtech32 clinical information system while in their patients’ homes. They are also able to file any actions they have taken, note anything they have observed and express any concerns. They can also schedule doctor’s appointments. The nurses are employed and resourced by Hawke’s Bay DHB but they are also closely aligned to the practice, at times physically basing themselves there when not visiting patients at home. Hastings Health Centre GP Alan Wright said the development of closer ties with district nursing staff was long overdue and the project was well integrated. “GPs will learn quickly, as I have, that these district nurses are at the coalface of healthcare, working with patients in their own homes,” Dr Wright said. “Giving them unrestricted access to our files can only benefit general practice. The inputting of their case notes can only advance our knowledge of our patients. Previously we might not have even known that a patient had been seen by a district nurse, and more importantly, what for.” The pilot, which was initiated by the general practices, also involves nurses working in the areas of assessment and advice regarding wounds, catheter and bowel management, administration of prescribed medications and support for patients with the management of other health issues.
Events August 20-23 AUGUST
11TH GUIDELINES INTERNATIONAL NETWORK CONFERENCE Melbourne, VIC p: +61 3 9682 0500 w: www.gin2014.com.au
AUSTRALIAN DIABETES SOCIETY ANNUAL SCIENTIFIC MEETING 2014 Melbourne, VIC p: +61 3 5983 2400 w: www.ads-adea.org.au
CLINICAL EMERGENCY MANAGEMENT PROGRAM - INTERMEDIATE Brisbane, QLD p: +61 1800 626 901 w: www.racgp.org.au/cemp
NZHITC WELLINGTON NETWORKING EVENT Wellington, NZ p: +64 4 815 8177 w: www.healthit.org.nz/events
AIIA HEALTHCARE FORUM - NSW EHEALTH UPDATE Sydney, NSW p: +61 2 6281 9400 w: www.aiia.com.au
ACSA NATIONAL CONFERENCE Adelaide, SA p: +61 8 8981 5119 w: www.acsaconference.org.au
HISA NSW MEETING Sydney, NSW p: +61 3 9326 3311 w: www.hisa.org.au/events
3RD ANNUAL REDUCING AVOIDABLE PRESSURE INJURIES CONFERENCE Melbourne, VIC p: +61 2 9080 4090 w: www.healthcareconferences.com.au
6TH ANNUAL OPERATING THEATRE MANAGEMENT CONFERENCE Sydney, NSW p: +61 2 9080 4090 w: www.healthcareconferences.com.au
HISA WA - EVOLVING HEALTH TECHNOLOGIES IN WESTERN AUSTRALIA Perth, WA p: +61 3 9326 3311 w: www.hisa.org.au/events
28-29 AUGUST 23
GENERAL PRACTICE EDUCATION DAY Sydney, NSW p: +61 1300 797 794 w: www.healthed.com.au
6TH ANNUAL CORRECTIONAL SERVICES HEALTHCARE SUMMIT 2014 Melbourne, VIC p: +61 2 9080 4090 w: www.healthcareconferences.com.au
25-26 AUGUST 4TH ANNUAL CLINICAL AUDIT IMPROVEMENT CONFERENCE Sydney, NSW p: +61 2 9080 4090 w: www.healthcareconferences.com.au
2ND ANNUAL ASSISTANTS IN NURSING CONFERENCE Sydney, NSW p: +61 2 9080 4090 w: www.healthcareconferences.com.au
25-27 AUGUST 15TH INTERNATIONAL MENTAL HEALTH CONFERENCE Gold Coast, QLD p: +61 7 5502 2068 w: www.anzmh.asn.au/conference
4TH RURAL AND REMOTE HEALTH SCIENTIFIC SYMPOSIUM Canberra, ACT p: +61 2 6285 4660 w: www.ruralhealth.org.au/ symposium2014/
RACGP NSW & ACT FACULTY’S MEDICAL RECEPTIONIST COURSE Sydney, NSW p: +61 1800 626 901 w: www.australiandoctor.com.au/events/ medical-receptionist
RANZCR COMBINED SCIENTIFIC MEETING Melbourne, VIC p: +61 1800 193 405 w: www.csm2014.com
AUSTRALIAN COMMUNITY WORKERS CONFERENCE AND EXHIBITION Melbourne, VIC p: +61 2 9080 4307 w: www.informa.com.au
10TH ADMA ANNUAL NATIONAL CONFERENCE Melbourne, VIC p: +61 3 9076 4125 w: www.adma.org.au
GENERAL PRACTICE EDUCATION DAY Melbourne, VIC p: +61 1300 797 794 w: www.healthed.com.au
MANAGING THE DETERIORATING PATIENT Melbourne, VIC p: +61 2 9080 4090 w: www.healthcareconferences.com.au
NZ AGED CARE ASSOCIATION CONFERENCE Wellington, NZ p: +64 4 473 3159 w: conference.nzaca.org.nz
CLINICAL EMERGENCY MANAGEMENT PROGRAM - INTERMEDIATE Launceston, TAS p: +61 1800 626 901 w: www.racgp.org.au/cemp
THE FUTURE OF MEDICAL RESEARCH Sydney, NSW p: +61 2 9080 4307 w: www.informa.com.au
LASA NATIONAL CONGRESS 2014 Adelaide, SA p: +61 2 6230 1676 w: www.lasacongress.asn.au
NATIONAL ACQUIRED BRAIN INJURY CONFERENCE Melbourne, VIC p: +61 2 9080 4090 w: www.healthcareconferences.com.au
4TH ANNUAL HEALTHCARE COMPLAINTS MANAGEMENT CONFERENCE Sydney, NSW p: +61 2 9080 4090 w: www.healthcareconferences.com.au
AAPM 2014 CONFERENCE Adelaide, SA p: +61 3 6231 2999 w: www.aapmconference.com.au
HISA NSW - AGED CARE Sydney, NSW p: +61 3 9326 3311 w: www.hisa.org.au/events
29-30 SEPTEMBER 20
CLINICAL EMERGENCY MANAGEMENT PROGRAM - ADVANCED Launceston, TAS p: +61 1800 626 901 w: www.racgp.org.au/cemp
3RD ANNUAL REDUCING AVOIDABLE PRESSURE INJURIES CONFERENCE Melbourne, VIC p: +61 2 9080 4090 w: www.healthcareconferences.com.au
MANAGING THE DETERIORATING PATIENT CONFERENCE Melbourne, VIC p: +61 2 9080 4090 w: www.healthcareconferences.com.au
HIMAA AND NCCH 2014 NATIONAL CONFERENCE Darwin, NT p: +61 2 9887 5001 w: www.himaa2.org.au/conference
HISA QLD - DATA USAGE SECONDARY INFORMATION AND RESEARCH QLD p: +61 3 9326 3311 w: www.hisa.org.au/events
HISA SA - AGED CARE Adelaide, SA p: +61 3 9326 3311 w: www.hisa.org.au/events
HISA VIC - PCEHR Melbourne, VIC p: +61 3 9326 3311 w: www.hisa.org.au/events
9-11 OCTOBER THE RACGP CONFERENCE FOR GENERAL PRACTICE Adelaide, SA p: 1800 472 247 w: www.gpconference.com.au
28-29 OCTOBER EHEALTH INTEROPERABILITY CONFERENCE Sydney, NSW p: +61 2 9080 4090 w: www.healthcareconferences.com.au
NZHITC CHRISTCHURCH NETWORKING EVENT Christchurch, NZ p: +64 4 815 8177 w: www.healthit.org.nz/events
Online Calendar: To view a comprehensive list of eHealth, Health, and IT events, visit: http://www.pulseitmagazine.com.au/events
DIGITAL TRANSFORMATION OF GENERAL PRACTICE Many general practitioners are still reluctant to fully embrace digital technologies in their day-to-day work, often as a result of a lack of trust in the effectiveness of IT in improving patient care. However, the RACGP is working to improve uptake of these technologies by highlighting the benefits of IT in patient care delivery.
DR NATHAN PINSKIER MBBS, FRAGCP, Dip Prac Man, FAAPM, FAAQHC Chair, RACGP National Standing Committee – Health Information Systems email@example.com
New technologies are pivotal to the continuation of improved healthcare for all Australians. Under the current Australian healthcare system, most general practices operate as private businesses. GPs who choose to establish their own private practice recognise they often do not possess the appropriate business and technology skills to successfully manage a small business, with little education on business development and information technology provided at medical school. In the age of a rapidly emerging digital economy, it is vital that practice principals and GPs have the right tools and resources to embrace new technologies within their practice.
About the author Dr Nathan Pinskier is a general practitioner based in Melbourne and the chair of the RACGP National Standing Committee on Health Information Systems. He is a former clinical lead for NEHTA and has a long interest in using IT to improve clinical care.
The digital revolution is transforming workplaces within the healthcare sector. In general practice, the use of practice management and clinical desktop systems, the internet, eHealth and mHealth technologies have consequently increased the use of PCs, laptops, remote access devices such as smartphones and tablet devices and increased the demand for wireless (Wi-Fi) connections, resulting in widespread uptake of broadband internet and secure external data transfer. Patient privacy, information security and clinical safety are overriding imperatives with the introduction of many new eHealth
initiatives and the implementation of the national eHealth record system. Core to digital technologies is the security, storage and retrievability of business and clinical information. Patient privacy and information security must be considered during the delivery of evidence-based care by informed and educated clinicians and the sharing of critical business and clinical information. General practices often lack the specialist knowledge to deal with both internal and online risks.
Overcoming mistrust Barriers to general practice uptake of technology are traditionally the result of mistrust of and a lack of interest in technology, and the disbelief that technology could ‘improve’ the management of health information and lead to better health outcomes. Additional barriers also include the high cost of investment in expensive technologies, training, and support. Computers and information systems are now an essential part of everyday general practice, however technology as an ongoing business cost is often not strategically considered. There are few benchmarks that general practices can use to calculate or establish the amount of money that should be invested in IT and many general
practices may not know what needs should be considered when planning an IT budget, posing a challenge for many general practices budgeting for IT infrastructure. IT costs can be difficult to value in terms of capital expense, for the purchase, lifeexpectancy of hardware and infrastructure, and the operating costs for ongoing services and licensing. A reluctance to incorporate new technology into general practice is often based on an over-riding concern that new technology and systems show little regard for the complex and dynamic GP-patient relationship. The adage of ‘Your solution is not my problem!’ could not be truer for some.
Attitudes and perceptions regarding the value of technological innovation have contributed to the limited innovation and change in general practice. A 2006 study by Ford, Menachemi and Phillips, Predicting the Adoption of Electronic Health Records, concluded that the appeal of broad-based technologically facilitated strategies to improve quality and management in healthcare delivery could have been inhibited by stakeholder perceptions.
Embracing technology Adoption of technology can be increased if GPs are assured of improved patient healthcare outcomes with minimal impact on their current workflow. Encouraging
Outsourced Patient Management
GPs to fully embrace technology for clinical purposes through highlighting its benefits in patient care delivery is an important step towards achieving the maximum benefits of technology in Australian general practice. The RACGP has a unique opportunity as the trusted representative of the profession to encourage general practices to improve their technology knowledge base and digital skills. Improved knowledge and skills will enable practices to support the delivery of better patient healthcare outcomes, more efficient practice and patient management, and improved timely communication and data collection, which will support the provision of safe and high quality healthcare.
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FIRE AND AIR:
A PROJECT FOR BETTER COLLABORATION While the eHealth sector in Australia has been consumed by speculation about the next steps for the PCEHR, there is some very exciting work being led by Australians on a new, clinically driven collaboration that has flown under the radar. The collaboration between FHIR and openEHR promises to be a valuable step for healthcare software vendors and information managers in how healthcare information is represented.
BRIDGET KIRKHAM CEO, Medical Software Industry Association email@example.com
In early July, a group of four informaticians, representing the FHIR (pronounced “fire”) project, openEHR (“open air”) community and the HL7 patient care working group, gathered virtually to develop a common information model for adverse reactions, allergies and intolerances, based on input from a diverse international group of clinicians and other domain experts. The editorial group includes Heather Leslie, clinical program lead at the openEHR Foundation and modelling lead at Ocean Informatics; Grahame Grieve, primary author of the FHIR specifications and consultant at Health Intersections; Ian McNicoll, board member at the openEHR Foundation and consultant at FreshEHR in the UK; and Russ Leftwich, immunologist and co-chair of the HL7 patient care working group.
About the author Bridget Kirkham is the CEO of the Medical Software Industry Association (MSIA), which represents over 100 Australian and New Zealand health software vendors. She is a former CEO of Arthritis Australia and has worked for healthcare not-for-profits in the UK, USA and New Zealand.
This team is using the international openEHR Clinical Knowledge Manager (CKM) as the tool to coordinate the online, crowd-sourced collaboration from international domain experts. The aim is to develop a common model for allergy/ intolerance, which is a record of an ongoing propensity to react to a substance. From this, both openEHR and HL7 will derive openEHR and FHIR-specific archetypes/resources, which will be
published on CKM and through the FHIR specification for implementation in both communities. The plan is that this will forge a meaningful working relationship which will foster a more collaborative approach in the future. Ocean Informatics founder and openEHR Foundation chairman Sam Heard, who also works as a GP in Darwin, says he wholeheartedly welcomes this new collaboration and the use of CKM in this way. “Standards processes for clinical content need to enable broad participation, particularly by grassroots clinicians who have previously found it difficult to engage in traditional standards development,” Dr Heard says. “This collaborative, online approach to EHR clinical specifications across ostensibly competing health IT standards has enormous potential for benefit. “We can now support agile clinical content development under a formal governance framework, with outputs that can embrace multiple implementation formalisms.” HL7 International CEO Chuck Jaffe says that since its earliest development, the HL7 FHIR standard has held the promise
of enabling true interoperability. “Although FHIR has been a draft standard for less than a year, it has been embraced by developers around the world,” Dr Jaffe. “It is our aspiration that this collaboration will foster better platforms for exchanging health and healthcare data, increased exchange of patient data, and that our patients will ultimately be the beneficiaries of this partnership.”
About FHIR FHIR stands for Fast (to design and implement) Healthcare Interoperability Resources. It is designed to enable the information exchange that supports the provision of healthcare in a wide variety of processes. The specification builds on and adapts standard industry RESTful (representational state transfer) service protocols to enable the provision of integrated healthcare across a wide range of areas. Mr Grieve started the development of the concept in 2011 and it was published as an HL7 draft standard for trial use (DSTU) in January this year. FHIR is based on key principles, focusing on implementer needs, targeting support for common scenarios, leveraging web technologies and providing human readability. In addition, the content is freely available and demonstrates best practice governance. HL7 Australia chair Trish Williams says the excitement that FHIR is generating represents an opportunity for Australia to once again be at the forefront of standards development. “It’s getting considerable use already,” Associate Professor Williams says. “FHIR puts Australia centre and front on the international stage.” Vince McCauley, the Medical Software Industry Association’s national eHealth implementation coordinator, says the FHIR
standard has been taken up more rapidly than any other previous standard. At this stage, it will be confirmed to be a full standard some time late in 2015, he says. The scope and extent of the FHIR standards has led to its rapid adoption by both government and the private sector, including the US Department of Veterans Affairs. FHIR has become the major work item for HL7 International and it is also being supported by health insurer Kaiser Permanente as well as many of the major EMR companies such as Cerner and Epic. Dr McCauley says Australian developers have been at the forefront of FHIR implementation, holding a FHIR ‘connectathon’ in Sydney with another planned for later this year. As a long-time implementer of eHealth standards, Ordashi’s Brett Esler says his experiences as an early adopter of FHIR have reminded him that standards can aid delivery of solutions rather than only being considered a constraint. The standard is supported by technical artefacts, open source code and public servers to make adoption easy, and there is also a very active implementer community. This combination is extremely compelling for solution builders, Mr Esler says. “As the promise of advancement in connecting current clinician-driven modelling approaches moves forward, there is nowhere else I would rather be operating to provide the next generation of effective information systems to support the delivery of healthcare,” he says.
leadership from Ocean Informatics. A wide variety of national programs and EHR system vendors across the world have adopted an openEHR approach, and the European standards body CEN formally adopted it as the basis for EN 13606 (EHR Data Exchange). A core foundation of the openEHR community is the design of ‘archetypes’ that describe the information that should be captured and exchanged between clinicians in support of the healthcare process. Over the lifetime of the project, openEHR has assembled a library of clinical archetypes that are the result of wide collaboration between many experts and system designers across the world. These archetypes are now stored and managed on the CKM, where everyone can benefit from them. However many vendors, jurisdictions and users can’t take proper advantage of this resource because of the ongoing lack of meaningful collaboration between the various standards development organisations and openEHR. “The openEHR community and Ocean have made a tremendous resource available to the community, and Dr Heather Leslie and I are eager to explore how the value currently locked in openEHR can be realised through the HL7 standards,” Mr Grieve says. The collaboration between FHIR and openEHR is a good news story where Australians are taking the lead in an international collaboration that will change eHealth interoperability for ever.
openEHR is a virtual community working on interoperability and computability in eHealth, with a main focus on electronic patient records (EHRs) and systems. The openEHR community has grown over a 15-year period with strong Australian
• For more information on the openEHR Clinical Knowledge Manager, see www. openEHR.org/ckm. • For FHIR, see http://hl7.org/fhir or www.slideshare.net/GrahameGrieve/ introduction-to-fhir
HIMAA STRATEGY CALLS FOR INDUSTRY CHANGE The health information management sector is facing major workforce challenges as opportunities for post-secondary qualifications decline and a lack of understanding of the role of health information managers (HIMs) and clinical coders becomes more prevalent. HIMAA has devised a strategic plan to overcome these challenges.
JENNY GILDER MRA Senior vice president, HIMAA
In the recently launched Health Information Management Association of Australia (HIMAA) Strategic Plan for 2014-2016, the result of membership research involving over 320 member contacts, identifies workforce as the key issue. Members report workforce shortages across Australia leading to role substitution and downward pressure on existing health information managers (HIMs) and clinical coders as the cause of a decline in morale in the health information profession. Erosion of the number of university courses available for undergraduate qualifications in health information management is another readily identified factor in workforce shortage, especially significant in NSW with the loss of the University of Sydney course in 2007.
Executive support lacking
About the author Jenny Gilder’s professional experience includes many years in the management of medical record departments, clinical coding and quality management. Since retiring from the workforce in June 2013, she has taken on a much more active role with HIMAA, holding a variety of positions including senior vice president of the HIMAA board.
Traditionally the profession has been valued as key providers of advice and expertise in the area of health information management and clinical coding, often undertaken as dual roles. But HIMAA research found that poorly informed management, particularly at an executive level, is seen by members as a major source of the decline in standing of health information management in healthcare facilities.
As one senior respondent to our research commented, “When people know HIMs and what they can do they are very, very positive, but we still come across those throughout the health sector who have an old-fashioned view towards medical records. Because we don’t have direct patient contact, we’re not as well known.” The 2013 Health Information Workforce Report from the Health Workforce Agency places a more informaticsfocused chief information officer as the coordinator of a range of clinically oriented CIOs (nursing, medical, clinical). Information management expertise is completely absent from the report’s future configuration of health information at the executive level. Similarly, the PCEHR review report aches for the absence of information management. Besides position titles, the report mentions ‘information’ 235 times. It is most commonly qualified as ‘clinical’ and next as ‘health’. Health information professionals are mentioned once, in appendices to the main report. ‘Health’, ‘information’ and ‘management’ do not occur together at all, nor does ‘information’ and ‘management’. HIMAA, even though it made a joint submission with the Health Informatics Society of Australia (HISA), is omitted from the list of 86 other contributors to the review.
“Clinical classification is the key not only to population health management and epidemiological research but also the flow of funds to quality points of care.” Jenny Gilder
Health information solutions The health information needs of the clinicians are different from those of the bureaucracy, which is itself divided amongst accounts, management and administration services. Then there are the information needs of IT support themselves. The HIM, by virtue of their education and skills, is the professional most aware of these differing needs and is able to respond accordingly, producing health information from the data collected to satisfy the needs of their health facility. Many HIMs are also involved in the quality program as they have a responsibility to ensure the quality of health information management for client-centred care. The accuracy and security of health information is central to the success of continuity of care as each healthcare client makes their way through a very complex health system. Clinical classification is the key not only to population health management and epidemiological research but also the flow of funds to quality points of care. As the gatekeepers to all health information collected and distributed, health information management professionals are key to the cost containment benefits to be had from funding continuity of quality care.
The HIMAA strategy HIMAA’s 2014-2016 strategy aims to redress the workforce decline in health information management through three strategic priorities: • Positioning and advocacy to better inform the industry, and policy developers and decision makers in government, of the value of health information management in the delivery of patient-centred quality healthcare services that meet regulatory requirements as well as satisfying the quality and safety aspirations of care providers and recipients alike • Education and training of HIMs at the tertiary level and clinical
coders at the VET level, in the context of quality assurance to employers and peers at the post-credential level through a robust professional credentialing scheme, complemented by a concerted program of career pathway marketing • Membership development to forge the link between effective positioning and advocacy, education and training, and the advancement of the profession’s core values. HIMAA aims over the next three years to equip its members with practical tools and strategies to remind those involved in the delivery of healthcare with whom they work of the value of health information management to the healthcare system. In three years’ time, HIMAA hopes for reports from its membership of: • Increased enrolments in a consolidating number of HIM tertiary courses around Australia and overseas • Workplace-based training opportunities for clinical coding students at VET level, emerging with dedicated qualifications in their profession • Improvement in the involvement of HIM professionals at management, senior management and executive levels in the health care system and • Recognition of HIM standards for quality practice in health information management and clinical classification • Awareness in government of the need to involve HIM professionals in all health care policy and strategy development requiring the management of health information. The HIM work space will embody the value of health information’s contribution to good patient care, information and data accuracy, care-focused financial management, and statutory requirements relating to privacy and security of the individual in a very complex health environment. The HIMAA 2014-16 Strategic Plan can be found at http://himaa2.org. au/?q=node/45
WAITING GAME FOR GENERAL PRACTICE IT Train IT Medical principal and owner Katrina Otto is better placed than most to judge the current state of IT and eHealth uptake in Australian general practice. She has noticed a lot of confusion in the last six months over the direction of national eHealth measures such as the PCEHR, but she remains a keen advocate of using technology to improve practice processes.
KATE MCDONALD Journalist: Pulse+IT firstname.lastname@example.org
Q: Since the review into the PCEHR was announced last year, have you noticed that practices are still keen on using the system, or has interest dropped away? A: I find that a lot of people think that the PCEHR has stopped, so yes, interest has dropped away. Medicare Locals are no longer funded to support practices with set-up or training for eHealth so now that support has stopped people think eHealth has stopped. What has reinforced this idea is that for many practices their Medicare certificates have expired. Quite a few told me they tried to upload shared health summaries recently only to find it wouldn’t work – this has led to the belief that eHealth has stopped. Previously this would have led them to call their Medicare Local for help but now there is no eHealth help available so confusion reigns. Q: Are practices generally aware that there was a review of the PCHER or were they not really paying much attention? A: No, I haven’t found that there’s a broad knowledge that there was a review or what they were recommending. I have been trying to let doctors know the government didn’t kill the PCEHR – they did say they are going to support it. When I say that two of the recommendations that came out of the review are that it was going to be opt-out and they were going to change
the name, everybody seems to really like those ideas. Whatever the name becomes, changing it from the PCEHR is very popular and the idea of opt out is also very popular. But when we talk about it, the question always comes back to ‘are we are going to get paid to do this? The general feeling is that this is more work for GPs, it will take more time and there is no payment for it. Q: Have practices been discussing the changes to Medicare Locals, which are due to become Primary Health Networks? A: No, I wouldn’t say I’ve had too many discussions with the doctors about the change to Medicare Locals. I haven’t had many conversations at all about the Primary Health Networks, just a general sense of “when are we going to be told what’s going on?” Q: NEHTA has been running a clinical usability program (CUP) that aims to fix some of the issues with the PCEHR. Have you seen any benefits in any of the software packages you are working with? A: I have seen improvements in Medical Director since the clinical usability program. In particular viewing the CDA documents has become easier, and having a filter to be able to sort through the various documents is helpful. I think
that sent a really good message and doctors have indicated to me this is an improvement and feel their comments may be being heard. With each update and improvement eHealth becomes seen as a work in progress. In the first stage of the roll-out there was the thinking that this is the final product finished now, but when they saw the improvements, they see that it is just stage one. In Best Practice it was clearer from the beginning it was just stage one as there was only one CDA document – the shared health summary – so I think everyone knew there was more to come. Q: Beyond the PCEHR, have you noticed more uptake of other eHealth solutions like interoperable secure messaging? A: No. Fully functioning interoperable secure messaging is still number one on my wish list! The providers tell me it’s going to be by the end of the year and I keep saying that’s what you said last year. I certainly find more practices across Australia are using secure messaging. Which secure messaging provider
“Whatever the name, changing it from the PCEHR is very popular and the idea of opt out is very popular.” Katrina Otto
practices use just depends on the area they are in. Overall SMD is clunky and I get negative feedback about functionality from practices using two of the major secure messaging providers so there is much room for improvement. When it works well, it’s brilliant. Q: You are an advocate of using technology to improve practice processes, for example scanning in paper documents before the doctor sees them. Is there a lot of resistance to these new methods? A: Using technology to save time and improve processes in the practice is
always my focus. I have worked with doctors who have been viewing scanned documents for the first time in their software for many years now and know how much they like the benefits it can bring – not the least one being they are no longer tied to their offices so late at night going through paperwork. It is a big change for many though and needs to be well discussed as a practice team and solid practice systems put in place. If we are making changes like scanning first and paperless faxing, reception staff have to be well trained about the seriousness of electronic documents and whether something has already been seen or not,
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“Probably one of the pressing issues I see is that doctors are resenting the amount of time and the general pressure of having to do all of that computer work.” Katrina Otto
or needs to be seen urgently. It’s amazing though, how quickly what originally seemed like a huge change becomes normal. It’s like online appointments. I have been gently suggesting this idea in my training sessions for many years. Originally everyone was horrified, saying “I can’t let the patients control my appointment book!” That has moved to “yes, this could have some good aspects” and now it’s really something that’s proven to be hugely popular. Q: Some practices are still a bit reluctant to use online appointment systems as they still want to retain complete control. Is that your experience? A: Yes, although this reluctance is changing by the minute. Personally I think we do need to have a strong element of control over our appointments, just because of the fact that it is health and there are so many variables and so many complexities with the bookings. Systems like Health Engine are good if the practices are actively seeking new patients, but a lot of practices are struggling to find appointment times for their patients or haven’t had a new patient in years. They are so full and they are so busy. We need flexibility in our technology as practices work so differently. One of my clients who I consult for has a city practice and an outback practice. The needs of the two practices are just so different. Health Engine is great for the city practice that is
seeking patients, tourists who are staying in the city who might be looking for the closest medical centre, but the outback practice, they are merely looking to provide a convenient service to their regular patients so they can make appointments when it suits them, especially as they are often shift-workers. There are different products for different needs and I think for software programs to be really helpful, they need to give us integrated solutions that factor in that variability, give us all the options we could possibly need. Q: In New Zealand, practices are moving towards providing a patient portal that allows online bookings, reviewing of test results and even text or email correspondence with the doctor. Is that likely in Australia any time soon? A: Yes, I think these options will become more common in Australia soon. Where I have heard about that working well now is mainly corporate city practices. One of the practices I consult for in Melbourne is very progressive. Every patient gets notified of their test result because they have an online portal – the doctors write a comment about the result and the patient logs on and reads what the doctor has written. Obviously if there is something urgent the patient is contacted directly but from a practice management perspective this is quite amazing – every result is notified with clear audit trails and protection built in. This works because
of the type of practice it is though and they are now moving forward with online health consultations and telephone health consultations. There are no rebates but the patients are happy to pay in that demographic. Different options for different practices. We need to have these conversations, float these ideas around our practices. Just like online appointments we need clear rules set up about what we want to use, who can access and how, and clear audit trails, especially around access. Q: Talking to many practices around the country as you do, what are the hot topics in terms of IT? A: What is worrying doctors at the moment, more than anything I would say, is the demands of clinical documentation and how much they are expected to document. I get a lot of comments along the lines of, “I can only see four patients a day now because of all of this computer work”, or “So at some stage, will I be able to make eye contact with the patient?” Probably one of the pressing issues I see is that doctors are resenting the amount of time and the general pressure of having to document and follow up everything. “I am a clinician not a data entry clerk” is another common comment I hear. For the principals, it’s about having to maintain all of this, having to pay for it. For the practice managers it is the challenge of keeping up with all these technology changes. I see it as the practice manager’s job to embrace technology and to lead the change. I find people will embrace change if they as they can see the benefits and are involved in the decision making of that change process. Katrina Otto is owner and principal of Train IT Medical, and offers software training and practice management consultancy services across Australia. An experienced practice manager, she has been delivering accredited qualifications in medical administration and technology for the past 20 years.
APPOINTMENT SERVICES Despite being early adopters of computers and information technology in general, medical centres remain staffintensive businesses. The personalised, one-to-one services provided in practices of all types typically extends beyond the consultation room and into the reception and administration functions. However, many of these non‑clinical duties can be outsourced without the patients even knowing it.
SIMON JAMES BIT, BComm Editor: Pulse+IT email@example.com
Businesses of all shapes and sizes are starting to explore the possibilities that internet-enabled workforces can deliver by tapping into global marketplaces such as Elance, oDesk and Freelancer. However, the sensitive nature of the work undertaken in medical centres and the privacy requirements associated with the data contained in practice IT systems precludes many jobs from being performed overseas.
Ms Bennett says. “Answering calls five days a week when patients might be only making two, three, four, five appointments in the whole week is not cost effective.”
Despite this, there are some duties that may lend themselves to being outsourced from your practice, with third-party telephone and appointment-related services available to businesses in the healthcare sector for a number of years.
In addition to taking appointments, VConsult performs duties such as sending appointment reminders via SMS and by telephone as required, processing referral letters for specialist practices, and billing patients.
One such service, VConsult, launched in 2011 as an offshoot of established medical locum service Medic Oncall. Melissa Bennett, managing director of VConsult, says the idea for the business came from a desire to offer the junior doctors the company had worked with as locums some assistance as they started their own practices.
“For some customers we are engaged to do more than for others,” Ms Bennett says. “For some we might just answer the phones, make appointments and do some follow-ups and estimates and that’s about it. With others we’re doing SMS management, booking, in-patient billing, out-patient billing – pretty much everything that a medical secretary would do in the room.”
“What we’re trying to achieve is to allow doctors to not have to worry about staffing headaches and running the practice, especially when they start up and they can’t afford to have a full time secretary,”
The company typically uses the SMS reminder functionality built into the practice’s software, but it can also use a secondary service if that software isn’t capable of sending SMS reminders directly.
While traditional third-party answering services are used by many small businesses and may be applicable for some medical practices, VConsult offers a broader range of services than simply taking and forwarding messages.
While the specifics of how a practice can forward its calls to a virtual reception service will vary depending on its existing telephone infrastructure, generally a call forwarding arrangement can easily be established with its telephone service, meaning the patient need not know they are speaking to someone working remotely from the practice.
â&#x20AC;&#x153;Each separate customer has their own recording which we set up with a professional voice-over. So it would be â&#x20AC;&#x2DC;Thank you for calling Dr Jonesâ&#x20AC;&#x2122; rooms; please hold and a medical secretary will be with you shortly.â&#x20AC;&#x2122; We get advised that it is Dr Jonesâ&#x20AC;&#x2122; call so we would jump into Dr Jonesâ&#x20AC;&#x2122; software and then we would answer that call.â&#x20AC;?
â&#x20AC;&#x153;The service that we want to provide is a seamless, behind-the-scenes service, so the callers donâ&#x20AC;&#x2122;t even know that they are talking to us in Victoria,â&#x20AC;? Ms Bennett says. â&#x20AC;&#x153;They think weâ&#x20AC;&#x2122;re speaking to them from Dr Jonesâ&#x20AC;&#x2122; room, but in reality theyâ&#x20AC;&#x2122;ve dialled through to one of our medical secretaries.
Beyond the basics of taking calls and making appointments, VConsult says staff are routinely asked to provide patients with information about the practice, such as its location and parking arrangements. â&#x20AC;&#x153;A lot of our calls are regarding directions, how to get there, where to park, and
how much parking [costs],â&#x20AC;? Ms Bennett says. â&#x20AC;&#x153;Some of our [staff] have all that information at their fingerprints so you hear quite often when walking through the office, â&#x20AC;&#x2DC;Yes, come down to here, turn left and park. Oh, where are you now?â&#x20AC;&#x2122; Then the patient gets there and actually asks them where the people are theyâ&#x20AC;&#x2122;ve been talking to on the phone, so thatâ&#x20AC;&#x2122;s quite funny as well.â&#x20AC;? To enable VConsult staff to interact with the practiceâ&#x20AC;&#x2122;s appointment book while speaking with patients, remote access arrangements are established with the assistance of the practiceâ&#x20AC;&#x2122;s IT support provider. While remote access has traditionally been used by doctors to
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Please visit our website www.himaa2.org.au under the education tab to read more about the Clinical Coder HDVH YLVLW RXU ZHEVLWH ZZZ KLPDD RUJ DX XQGHU WKH HGXFDWLRQ WDE WR UHDG PRUH DERXW WKH &OLQLFDO HDVH YLVLW RXU ZHEVLWH ZZZ KLPDD RUJ DX XQGHU WKH HGXFDWLRQ WDE WR UHDG PRUH DERXW WKH &OLQLFDO 3OHDVH YLVLW RXU ZHEVLWH ZZZ KLPDD RUJ DX XQGHU WKH HGXFDWLRQ WDE WR UHDG PRUH DERXW WKH &OLQLFDO pathway or visit www.himaa2.org.au/education for courses details. &RGHU SDWKZD\ RU YLVLW ZZZ KLPDD RUJ DX HGXFDWLRQ IRU FRXUVHV GHWDLOV ď&#x20AC; ď&#x20AC; &RGHU SDWKZD\ RU YLVLW ZZZ KLPDD RUJ DX HGXFDWLRQ IRU FRXUVHV GHWDLOV ď&#x20AC; ď&#x20AC; &RGHU SDWKZD\ RU YLVLW ZZZ KLPDD RUJ DX HGXFDWLRQ IRU FRXUVHV GHWDLOV ď&#x20AC; ď&#x20AC; Call our Education Services on 02 9887 5898 or email email@example.com &DOO RXU (GXFDWLRQ 6HUYLFHVď&#x20AC; RQď&#x20AC; RU HPDLO HGXFDWLRQ#KLPDD RUJ DXď&#x20AC; &DOO RXU (GXFDWLRQ 6HUYLFHVď&#x20AC; RQď&#x20AC; RU HPDLO HGXFDWLRQ#KLPDD RUJ DXď&#x20AC; &DOO RXU (GXFDWLRQ 6HUYLFHVď&#x20AC; RQď&#x20AC; RU HPDLO HGXFDWLRQ#KLPDD RUJ DXď&#x20AC; 273475 A2 180 x 120.indd 1
22/08/14 4:02 PM PULSEITMAGAZINE.COM.AU
“They think we’re speaking to them from Dr Jones’ rooms, however in reality they’ve dialled through to one of our medical secretaries.” Melissa Bennett
access patient records when consulting from different locations, the same technical methods can be used to provide access to other staff as well. Access permissions within the practice software can be used to restrict administrative staff to the appropriate parts of the software, in exactly the same way as can be achieved for staff working within the practice. VConsult reports that it is currently logging in to some cloud-hosted servers, as well as more traditional set‑ups where the server is physically located within the practice. Ms Bennett says outsourced services make sense for specialists who consult in multiple locations. “A lot of consultants, particularly the new ones, move around a lot, so they may consult at one set of rooms on a Tuesday morning and they go elsewhere on a Thursday afternoon and consult at another hospital. Do they take their secretary everywhere they go? Does one secretary sit at home or at an office somewhere taking appointments that aren’t made that often? “Sometimes the newer doctors will hire professional rooms that come with a meet and greet secretary. They may take the money on the day if it’s outpatients but they know nothing else about the doctor; they’re really just a face. Other times, particularly if it’s a new doctor, they’re doing that themselves, on the day.”
While the service initially focused on fledgling specialist and allied health practices, Ms Bennett says VConsult is also gaining traction with larger practices with existing support staff. “There are practices where they have these staff on site but they’re so busy and there’s so many other things to do that they decide to outsource the calls to us,” she says. “One of our clients has three secretaries plus a practice manager looking after the practice, but we look after the calls. We work very closely with the onsite secretaries to make sure the communication flows both ways. That is a really big practice. I think there are five surgeons there and we were taking about a thousand calls a month for that practice.” As well as ongoing work, Ms Bennett says VConsult has been engaged on a casual basis by various clients to act as cover during holiday periods. “We’ve had a couple of practices come on just over Christmas. For example, the practice manager might be the partner of the doctor so they’re both going away on holidays. We’ll take over for the required time and make the appointments for when they come back. “Other practices put us down for a time period when they are on holidays but can’t get a locum, for example. So at least
the appointments are still made and the phones still answered.” Ms Bennett also pointed to examples where the service is used by clients on certain days of the week where the practice would otherwise be closed. “We have a customer in ACT and she’s only open Monday to Thursday, so that’s fully staffed. However, on Friday they just used to have an answer phone message and then someone on Monday would have to call back all those patients. Now, they just transfer the calls through to us on the Friday and we make the appointments.” Typically, VConsult allocates each practice one or more dedicated staff members, with other staff from the outsourced service able to answer practice calls during peak times if required. “We feel that our customers like having that sort of arrangement with one or two secretaries so that communication between them remains pretty strong. It’s like they have their own medical secretary, even though our staff work with maybe five or six customers.” Ms Bennett acknowledges the recent rise of online appointment booking services, but views these offerings as complementary to the service provided by her own company. “You always need someone at the end of the phone as well. We have had some customers that do have a web booking system, so we work with that but at the end of the day everyone’s still going to make a phone call to find out the fee structure and things like that.” Ms Bennett says many appointments still need to be triaged, particularly for clients with long waiting lists, with VConsult also processing referrals for specialist practices using the service.
Zedmed’s latest innovation! A new feature available soon to all Zedmed customers. In response to requests for security enhancements to patient records, Zedmed will soon release a new feature that enables clinics to better comply with patient confidentiality requirements. We call this Clinician GroupShare.
In a multi-disciplinary setting where patients are all accessed from one database, it may not always be relevant for some clinician groups to see the Progress Notes written by other clinician groups. Zedmed has this covered. We can now offer you the option to ‘group’ practitioners and ‘share’ or ‘restrict’ access to Progress Notes across groups. Please call our sales team on 1300 933 000 to find out how Zedmed’s Clinician GroupShare. can benefit your practice.
1300 933 000 | firstname.lastname@example.org | zedmed.com.au
THE INFORMATION IN YOUR PRACTICE A paperless medical practice is nirvana in terms of efficiency and many practices are now moving to the cloud for certain functions or for the full monty. While there is still some resistance to cloud-based services due to security fears, in reality the cloud wins hands-down. There is no room for complacency, however, so here’s what you should look out for to protect your – and your patients’ – information.
SID VERMA BE, MBA (MMM) Managing director, Corazon Systems email@example.com
In terms of information technology, a medical practice can be characterised as a micro enterprise business with medium enterprise needs. Almost every medical practice is a micro business in terms of size – a server, a handful of computers, printers and a few other bits and bobs. However, medical practices are medium enterprises in every other respect: compliance with stringent privacy laws, eHealth, telehealth, electronic medical records, back-up and disaster recovery, pathology and radiology downloads – the list goes on. And therein lies the problem. At what point in time does the practice realise that almost every single transaction, both internal and external, is important? And what tools are OK to use without hampering the regular functioning of the practice?
The privacy laws
About the author Sid Verma is the managing director of Corazon Systems, a health IT consulting and network security firm headquartered in Melbourne. Corazon Systems implements secure paperless processes in medical practices that comply with the new Australian privacy principles.
As widely publicised and documented, the updated privacy laws came into effect on March 12 this year. The Office of the Australian Information Commissioner, which includes the office of the Privacy Commissioner, has renewed powers, the penalties are harsher and compliance with the new laws is even more critical. The new privacy laws include the 13 Australian Privacy Principles (APPs), which apply to what is call as an “APP entity”.
Medical practices by their very nature in handling sensitive personal medical records qualify as an APP entity. However, while everyone has been talking about the privacy laws, what does it mean for medical practices at the grassroots level? What is it that a practice specifically needs to do to ensure that they are compliant?
Understanding the risk Australia is undergoing a digital health transformation. Technology is evolving rapidly even in a sector like healthcare, which has typically been behind the curve when it comes to adopting new concepts. However, a strong movement of digital health, technically savvy doctors and patients and access to mature technology is making it easier for medical practices to become paperless. But, as more practices become paperless, it is important to understand the associated risks. According to US data, in 2011 healthcare accounted for 22 per cent of reported security breaches, followed by educational institutions at 20 per cent. Almost 92 per cent of these breaches could have been avoided if the organisations had proper data access control (42 per cent), secure data back-up (32 per cent) and secure data encryption (28 per cent).
Closer to home, the CSIRO reported that in 2008 almost 5.4 million Australians were victims of cyber-crime. The story of the Gold Coast family practice being hacked and held to ransom was also widely reported in the media. So what does this all mean? Is it all doom and gloom? Are we resigned to the fact that getting hacked is just a matter of time and as such why bother? Not in the slightest. As mentioned earlier, over 92 per cent of security breaches could have been prevented. So, if we are able to identify those specific areas at risk and put the right solution in place, things start to look a lot more secure and in control.
Identifying the risk Whether you are a sole practitioner, a small practice or a large multi-disciplinary medical centre, the same privacy laws apply. However, an increase in size is proportionately related to the level of associated risk. As more staff work at the practice or in more than one location, areas of risk open up. Ineffective use of passwords, improper and unsecured connectivity between sites and an inadequate back-up system are some of the usual suspects. For older practices that still haven’t migrated across to a paperless system, the paper files stacked in shelves (often unlocked or open access) pose an even greater risk. The recent case of the Pound Road Medical Centre in Melbourne, where sensitive medical records and Medicare claims information were found in a garden shed, demonstrates that even after taking proper care, an inadvertent oversight meant that the personal sensitive information of 960 patients was exposed. As a business that regularly implements paperless medical practices, we come across some typical scenarios. It is almost
“Practices that are being accessed remotely from multiple locations are more vulnerable to external cyberattack unless appropriate security measures are in place.” Sid Verma
a pattern symptomatic of the three main “profiles” of practices: 1. Sole practitioner. Usually a single laptop-based practice, sole practitioners are typically at maximum risk. Clinical and practice management software, emails and documents are stored on a single device. Back-ups are typically non-existent or at best copied onto a USB stick/drive, but usually only when the practitioner remembers to do so. 2. Medical practice. For a medical practice, the risks start to increase as there are more employees. The practice typically has a server and a few computers. Each device that is added on to the network adds to the risk. Different people use and access the computers in their own way. Some access public email sites such as Gmail, Hotmail or Yahoo Mail. Some users store files on local machines often not backed up properly. Over time, data gets spread across multiple devices, and is stored in an unstructured manner. There is also the increased risk of inadequate network security – firewall, anti-virus and antimalware. 3. Medical centre or clinic. The bigger end of town means a larger network, multiple locations, more IT infrastructure, multiple staff – all of which adds to the complexity of the situation. These organisations have a
lot more invested in their IT infrastructure, and in most cases have a reasonable level of control over the information in the practice. However, while most large clinics would like to believe that they have effective measures in place, this is often not the case.
Addressing the risk When it comes to protecting the information in your practice, there are five main areas to look at: external security, internal security, email, back-up and disaster recovery, and infrastructure. External security When we conduct IT security audits or accreditation audits for medical practices, almost 90 per cent of the sites we visit still have the default login (username/ password) details for their internet router. This is an open invitation to anyone with a half decent knowledge of computers to get access to the network (servers, computers, back-up etc.). Medical practices must change the default login details for their internet router. In addition, use a business-grade, fully managed and monitored firewall with content filtering. This will ensure that all data traffic entering or leaving the practice network is checked.
“Thanks to the willingness of the medical centre to publicise the breach, a lot of other practices took notice and implemented security measures.” Sid Verma
To add that extra layer of security, which is now more or less a necessity, practices would benefit by investing in a more secure DMZ solution, which is now available on the cloud. Practices that are being accessed remotely from multiple locations are more vulnerable to external cyberattack unless appropriate security measures are in place. There are faster and secure enterprise grade solutions available at a fraction of the cost. Remote desktop connection (RDC) is an easier and faster way to connect to your practice. However, proper security measures have to be in place to safeguard against potential threats or attacks. We prefer to implement a highly secure, “defence grade” security layer on top of the practice to deliver that added protection. Internal security When it comes to the biggest offenders against protecting the information in your practice, internal security beats them all. We regularly find an inadequate password policy, not enough anti-virus protection on all devices, users downloading or installing unauthorised content, and an ineffective software update policy (Microsoft security updates). Practices must ensure that all devices have a licensed and regularly updated antivirus/anti-malware/anti-spam protection. Proper security policies must be in place to
ensure that users are allowed to download and install software only with the approval of the practice manager. Finally, each practice must have a welldocumented security policy. This includes using different passwords for each application and setting them to expire every 60 days. Remembering passwords shouldn’t be a memory challenge, but more of a “system” that not only ensures updating of passwords on a regular basis, but also following a pattern to remember it easily enough. Email Paperless medical practices also mean more electronic communication, and email is still the most widely used tool for communication. Free email services from Gmail, Hotmail and Yahoo Mail have been around for a while. However, these are not the ideal fit in healthcare. With the advent of cloud services, access to secure email services such as Office365 from Microsoft is a cost effective and efficient alternative. The emails can be accessed from multiple devices, is constantly backed up and is easy to manage. Users are spoilt for choice when it comes to using cloud hosted email services. The one that we particularly like to implement for medical practices has “legal hold” capabilities. This ensures that no emails are ever deleted from the
account, even if they have been deleted from the email client (Microsoft Outlook or similar). This comes in handy if there is an audit. Back-up and disaster recovery You can never have enough back-up. And then, back up your back-up. Disc space is cheap, but this does not mean the USB drives that most practices use to do their back-up and swap on a daily or weekly basis. Proper practice involves online back-up to a secure, Australian-based data centre. Automate the back-up. Every practice must have a primary on-site back-up and then a subsequent secondary off-site back-up. Needless to say, backups have to be encrypted and password protected. The case of the Miami Family Medical Centre in Queensland has been reported extensively in the media. This is a practice that was using an onsite server with backups and thought it had everything in order. However, the practice’s network security was compromised, the server was locked and the back-ups encrypted. Instead of paying the ransom, the practice chose to restore from its back-up, which they had copies of off-site. Even so, it took the business two weeks to get new hardware, re-install all the software and then restore their back-up. Thanks to the willingness of the medical centre to publicise the breach, a lot of other practices took notice and implemented security measures. However, a lot more can still be done. There are several back-up and disaster recovery solutions available. We always implement a system wherein a full image of the server is taken on a regular basis. In the event of a disaster, this image can be restored onto another machine and get it up and running within hours instead of days. We also implement a file level back-
up with a regular daily/weekly/monthly schedule. This ensures that in the event of a disaster, instead of restoring the entire system, a specific file can be fixed. Infrastructure If we were having this conversation two years ago, it would be a different story. Now, “cloud enabling” the medical practice is a mainstream conversation. More practices are adopting cloud technology. Additionally, with a lot of medical practices still using the “end-of-life” Windows XP operating system, now is the perfect time to review your entire IT infrastructure and implement something that is more current, efficient and easy to manage.
Review your server hardware, operating system and any installed software. Talk to your IT solution provider and ask them to give you a cost comparison between an onpremise and cloud-hosted solution. Review the network security (both external as well as internal) of your practice. Evaluate how you are currently using as well as intending to use your infrastructure. If you are planning to expand your practice by adding more locations, then flexibility, connectivity and accessibility is important. In our opinion, cloud wins hands down. However, none of this is of much use if you don’t have a reliable IT partner. How is your IT service provider? Do they manage and monitor your network on a regular
HealthLink now puts referrers in the picture
basis? Are you usually calling them up to report a problem or do they already know of the issues and are working on it to find a solution? Are they an authorised support partner of your clinical software provider? Do they get involved on a need-to-know basis, or are they actively and regularly talking to you about your network and how they are protecting it? It is essential to build a “culture of security” across your practice, implement solutions that protect it and last but not least, align yourself with the right IT partner. It is all about protecting the most valuable asset – information.
Referrers can now see images from the patient record HealthLink already delivers tens of thousands of diagnostic reports every day. Now in conjunction with Medinexus, referrers can access reports and images directly from their clinical system or via a web portal - no matter where they are. In association with
Tel: 1300 79 69 59 Email: help@ medinexus.com.au Suite 1102, 1 Newland Street, Bondi Junction NSW 2022
“We attract more referrers by delivering our reports and images via the HealthLink and Medinexus system” Radiologist, Liverpool NSW
“One of the great things with HealthLink and Medinexus is that when the radiologist calls me regarding an abnormal finding I already have the images and reports available on my screen ‘straight away’ so I can see exactly what he is referring to” Referrer, Pennant Hills NSW
“It’s so simple to use. There’s no longer any need for film or a hard copy report to be delivered to me. It’s also so convenient that I can access reports and images no matter where I am” Referrer, Sydney City
GP SOFTWARE VENDORS DISCUSS
POST PCEHR DEVELOPMENT ROADMAPS While the government considers the findings of the review into the PCEHR and decides upon its next course of action in relation to the system, GP software vendors are using the opportunity to consolidate the work they have done on the PCEHR, and revisit their other development priorities.
SIMON JAMES BIT, BComm Editor: Pulse+IT firstname.lastname@example.org
Development work on the PCEHR commenced in earnest with the formation of the GP vendor panel in 2011. The process, coordinated by the National E-Health Transition Authority (NEHTA), provided funding assistance and support to six clinical software development companies with a view to fast-tracking the rollout of PCEHR-enabled solutions to the general practice market. In the intervening years, these software developers, as well as several others not engaged in the GP vendor panel process, have built interfaces to not only the PCEHR, but some of its underlying foundations including the Healthcare Identifiers Service (HI Service). Despite the fact that many of these interfaces have largely been ignored by the clinicians the government intended to use them, the programming and refinement of PCEHR features in GP software has nevertheless consumed considerable development resources. As one software developer reported to Pulse+IT: “A lot of our resources have been dedicated to the initial release of the PCEHR. Now that that’s all been released, we are working on finalising the minor changes that need to be done, so we are now able to focus on other things that need to be done for our customers.”
Those minor changes relate to the Clinical Usability Program (CUP), which was established by NEHTA in response to criticism about some aspects of the PCEHR’s implementations within GP software. According to one software developer, the improvements suggested in the CUP process appear to be written in response to perceived problems in some of the software vendors’ initial PCEHR implementations. “I’m sure looking at some of the requirements of the CUP, it’s clear that they were based on some of the implementations of other software. It was clear that they looked at some other software and said ‘well, we need to fix this so we’ll put a requirement in for that’.” The extent to which the problems highlighted by the CUP process were significant enough to dissuade GPs from using the PCEHR functionality in their software has been challenged by several software developers, with some saying that the changes made the PCEHR interfaces less consistent with other parts of their program. Software vendors also reported that such issues stem from a desire by NEHTA to have each PCEHR interface in GP software
behaving consistently between products, a curious ambition given that the vast majority of doctors use the same clinical software product each and every day. While acknowledging that there was room for improvement in some PCEHR interfaces, another developer pointed to broader issues relating to the rollout strategy for the PCEHR. “You hear the story all the time that the doctors are saying that they’re not using it because it’s so dated and primitive ... and, I don’t disagree with [that]. I think it could [be improved] in a lot of aspects. “We think we’ve done reasonably well, but what I think the whole process is missing is that if they had got us on board with some buy-in, we would have implemented this quite happily and put a lot of effort into it and pushed it with our clients.”
Software roadmaps With the bulk of the PCEHR development work now behind them, Pulse+IT checked in with some of the clinical software vendors that have deployed PCEHR‑enabled solutions to see where their future development resources will be directed. While software developers are almost always reluctant to talk about future developments and the release dates for forthcoming features, some vendors were in a position to volunteer limited amounts of information about the future direction of their products. Best Practice says major improvements to the reporting module in the company’s practice management solution are being prepared for release before the end of the year. Best Practice’s clinical software will be updated to introduce an Australian Defence Force checkbox to enable users of the software to more easily identify
“... if they had got us on board with some buy-in, we would have implemented this quite happily and put a lot of effort into it and pushed it with our clients.” Software developer
working service personnel, and future versions will also be able to populate the National Inpatient Medicine Chart templates. Genie Solutions has recently developed an interface to allow online appointment booking services to integrate more fully with the software. While the company has previously offered limited access to third‑party developers for this purpose, the new application programming interface (API) will allow appointment services to access and manipulate more data within Genie, which in turn will allow more functionality to be provided to patients booking appointments online. Health Communication Network, developer of Medical Director and PracSoft, has recently announced plans to offer its own online appointment booking service, whilst retaining the ability for practices to continue to use third-party solutions should they so wish to do so. Medtech Global’s version 9.2.0 includes CUP improvements, as well as a wizard to speed up eHealth document creation and uploading. The version will also includes full integration with the Pen Clinical Audit Tool (CAT), allowing practices to see a population overview of the practice data and participate in the Improvement Foundation’s eCollaborative programs. The subsequent version, 9.2.1, will also allow batch Individual Healthcare Identifiers
(IHI) searching and validation, although this will be kept as a separate utility as Medtech does not expect practices to do much batch IHI processing. New functionality for practices that work closely with allied health professionals will also be included, such as DVA allied health claiming via Medicare Online, and recurring appointment booking and group appointment booking. Stat Health is currently beta testing its latest version, which includes integration with the Doc Appointments service. Both online appointment booking and patient self-registration features are included in the release, along with the changes required by the CUP process. Zedmed has revealed plans to add bulk billing functionality to its existing Medicare Easyclaim integration with Tyro EFTPOS terminals. The next release of its product, version 24, will also include the CUP refinements, as well as a major feature called Clinician Group Share, which provides practices with the ability to restrict access to patient notes based on the type of provider using the system. The developers have indicated that this is particularly relevant in multidisciplinary practices where, for example, GPs can be grouped together and given one level of access to patient files, with allied health providers allocated to a different group and provided with a different level of access.
PROVIDE A PORTAL TO SHARED CARE At their simplest, shared care software packages can prove to be an easy way for general practices to create general practice management plans (GPMPs) and team care arrangements (TCAs), both of which attract a full Medicare rebate. But at their best, they can provide a platform to fully automate and streamline shared care for patients with complex and chronic illnesses, and to break through healthcare information silos.
KATE MCDONALD Journalist: Pulse+IT email@example.com
While shared care software is not exactly new, getting busy GPs to actually use these systems has always been a struggle. The concept behind them – in which all of a particular patient’s care providers can view and add to an electronic shared care plan – is sound, but a combination of lack of time, lack of incentive and lack of IT capability with some healthcare providers has meant that their use is still not particularly widespread in Australia.
That study involved the use of cdmNet from Precedence Health Care, probably the best known shared or collaborative care product on the market. cdmNet has been around for a number of years and its use is particularly strong in its home state of Victoria. Others are emerging, however, including Ocean Informatics’ Multiprac CP, which has been installed by the Western Sydney Medicare Local (WentWest) and rebranded as the LinkedEHR.
That is changing somewhat as Medicare Locals have begun to invest in these systems on behalf of local primary care providers, and it is possible that even with the government’s planned move to fewer and larger Primary Healthcare Networks (PHNs) the momentum will not end as evidence mounts that shared care plans can work for patients with common chronic diseases.
New Zealand company HSAGlobal’s CCMS also has a footprint in Australia for use in the Access to Allied Psychological Services (ATAPS) program and in district nursing, but is the technology underlying New Zealand’s ambitious National Shared Care Plan program. We take a look at what these three platforms offer.
A study published in the Medical Journal of Australia last year, for example, showed that using a web-based platform for GPMPs and TCAs for patients with types 1 and 2 diabetes led to a boost in the number of plans that were regularly reviewed, which in turn led to an improvement in patient adherence to best practice self-management. It also showed clinical improvements in overall levels of measurements such as blood glucose and cholesterol levels.
cdmNet from Precedence Health Care has been around since 2007 and was originally aimed at providing a platform for general practice to more effectively manage patients with chronic disease. As it has been built on web-based technologies, it can also be used for team or shared care, allowing allied health practitioners, nurses, community pharmacists and specialists to view and contribute to a patient’s care plan. Patients can also be provided with a view of their plan.
Australian Association of Practice Managers
The Art of Performance 2 0 1 4 N at i o N a l C o N f e r e N C e I A D e l A I D e Co n v e n T I o n C e n T r e I 21 – 24 oC Tober 2014
This conference is open to all who are involved in health care management and delivery:
• • • •
practice managers practice team members practitioners from all specialities of healthcare healthcare managers
• • • •
team leaders practice nurses policy makers government staff
Delegates will be spoilt for choice with a program that incorporates ongoing professional development, up-to-date information relating to our profession, as well as a careful blending of very creative surprises to exceed expectations.
• • • • • •
Gillian Hicks Dr Norman Swan Vinh Giang Khoa Do Hugh Kearns Dr Amanda Rischbieth
• • • • •
sPeAkers Bernard Salt Catherine Norton Dr Robyn King Justin Vaughan Daniel Lock
• • • • •
Dr Jason Fox Brett McPherson Stacey Barr Dr Chris Bollen David Wenban
Visit the website for full program and registration details:
Do you have a project that was a success, a system your practice has implemented that has delivered real benefits or, perhaps, an idea to share and develop?
The Australian Association of Practice Managers’ annual conference has a reputation as one of Australasia’s leading conferences for healthcare managers.
At the 2014 conference we will be introducing the Ideas Forum for delegates to share projects and practices that have delivered positive outcomes within their practices. The format will be electronic posters (ePosters). ePosters will be prepared in PowerPoint and displayed during the conference on monitors in the exhibition and catering area. The posters will rotate automatically and each poster can have up to three slides. Delegates will be able to pause ePosters to view them in more detail. There will also be an index to allow delegates to find an individual ePoster. All topics will be considered, this is an opportunity to both share and receive feedback. The ePosters are not intended as commercial presentations.
REGISTER NOW: www.AAPMconference.com.au
Conference Design Pty Ltd firstname.lastname@example.org www.conferencedesign.com.au P: +61 3 6231 2999
“In Western Sydney in the first quarter of 2013, there were about 33,000 of a combination of GP management plans and team care arrangements billed through Medicare.” Paul Campbell
cdmNet is integrated into Medical Director, Best Practice, Zedmed and Monet, and allows GPs to easily create GPMPs or shared care plans based on information existing within the medical record. The plans are hosted on the secure cdmNet website that is also accessible by the other practitioners involved in the patient’s care, as well as the patient themselves. It also has a desktop component to alert the GP that a review is due or that a new patient should be considered for a care plan. The use of cdmNet is also growing, particularly by Medicare Locals such as Barwon ML but also in the corporate general practice market. Precedence Health Care signed an agreement with IPN late last year to roll it out throughout that network. Practices do have to pay to use cdmNet, claiming a small percentage of each chronic disease MBS item, but the company has long argued that the increased income from the ability to provide more of these services, as well as the productivity gains that a practice can achieve through better collection of documentation and automated reminders for patients, far outweigh the small fee for using the product. This year, Precedence has expanded the capabilities of cdmNet to include a number of common preventative health assessments such as the 45-49 health check and home medicine reviews so they
can be integrated into one plan of care. It is also offering the system for free to GPs who can use it for sharing health information, tracking patient care, and preventative health planning for prediabetes, for example. The idea is to continue to use it for longterm management of chronic disease but also harness its capabilities for preventative health. While the basic model is free, those applications within cdmNet that add to the productivity of the practice will still continue to be charged the fee for revenue-earning MBS items. cdmNet has also been used as the technology underpinning the federal Diabetes Care Project, the results of which are due next year. The program is assessing the use of technology, care facilitators and flexible funding models to improve care for people with diabetes. The DCP is the largest ever diabetes trial in Australia, with over 6500 active patients, 650 participating GPs and practice nurses and over 800 allied health professionals. It is also used by Healthdirect Australia for its after hours GP helpline, as the primary care aspect of the Clinical Audit Research electronic Health Record (CAReHR) for refugee populations in Victoria, and most recently has been in an NBN-Enabled Telehealth Program trial in Victoria and Tasmania in association with the RDNS.
Multiprac CP Multiprac CP (Care Planning) from Ocean Informatics is a shared care planning system built on the same architecture used for the Northern Territory’s My eHealth Record (MyEHR), which has been running successfully for a number of years and now includes over 60,000 predominantly Aboriginal patients. Multiprac CP enables the creation of centralised care plans from within GP desktop systems that can be shared with allied health, community health and aged care facilities. It uses Ocean Informatics’ OpenEHR Clinical Data Repository, which supports CDA documents and can be linked to the PCEHR, as well as accepting atomic data for accurate decision support. The system has now formed the basis for the LinkedEHR project being run by WentWest, with an initial focus on diabetes. WentWest has bought a licence for the system on behalf of healthcare providers in its catchment so it is free to use by authorised providers. The LinkedEHR involves a centralised repository hosted by WentWest that can accept GPMPs, TCAs and other documents extracted from Medical Director and Best Practice via Pen Computer Systems’ Sidebar tool. Other practitioners involved in the patient’s care have access to the repository and the care plan through a provider portal, and the patient can also view their plan through a read-only consumer portal. WentWest is also working with the Western Sydney Local Health District (LHD) to provide access to the plans to hospital clinicians in the area and it is also being linked to WentWest’s HealthPathways webbased clinical decision support portal. Paul Campbell, PCEHR program lead with WentWest, said one of the ideas behind
rolling out LinkedEHR was the realisation that GP management plans and team care arrangements were not being reviewed that often. While they can be created from within the GP’s desktop software, most actual information sharing with allied health practitioners and medical specialists was still being done on paper.
for patients with long-term conditions in the three Auckland region district health boards (DHBs). This program involves primary, community and acute care providers and is the lead pilot project that the National Health IT Board has supported as part of its vision for a nationwide system.
“In Western Sydney in the first quarter of 2013, there were about 33,000 of a combination of GP management plans and team care arrangements billed through Medicare, but in that period there were only 21,000 reviews of these plans,” Mr Campbell said. “One would have expected two to three times the number of reviews as basic plans.”
Patients taking part in the program have a shared care plan developed for them, which includes a summary of personal health information, their health goals and the treatment and follow-up care they receive. They can access the plan electronically, as can all of the health professionals caring for them.
CCMS HSAGlobal’s Connected Care Management System (CCMS) is another product that has been around for some time but is increasingly seeing the fruit of its labours. CCMS forms the basis for the Auckland’s shared care plan project, which began in 2010 to provide shared care planning
The aim is to have the majority of patients with a long-term condition provided with a care plan that can be accessed by GPs, nurses, pharmacists, allied health practitioners and hospital-based clinicians. HSAGlobal CEO Matt Hector-Taylor says CCMS offers a care plan and assessments as well as a variety of notification and communications mechanisms that mean
the whole team is working with the person’s single integrated plan. The shared care plan involves bidirectional data that is kept in sync. “CCMS integrates with the different practice management systems and those at hospitals and pharmacies so that people still work in their own systems, but the data they are working with is also visible to the other members of the care team as well,” he says. Most recently, HSAGlobal has begun proof of concept trials with community pharmacies in four DHBs to see how pharmacists can use CCMS to share medication adherence plans with GPs. It has also developed the capability to create and share advance care plans. In Australia, CCMS has been used by Victorian early childhood and parenting centres QEC and Tweddle to develop a new client and clinical management system. It is also being used by South Eastern Sydney Medicare Local to manage its ATAPS and Partners in Recovery programs.
31st Annual National Conference 2014
Health Information Management: Driving the Information Highway Health Information Driving the Information Highway Double TreeManagement: by Hilton Esplanade Darwin, NT
7th - 9th October 2014
Driving the Information Highway - this year’s lighthouse health information management event ✓ veritable road train of keynote speakers ✓ unprecedented number of abstracts
Don’t miss out!
We look forward to welcoming you.
✓ program bursting with HIMs and Clinical Coders sharing ideas, models of practice, ✓ systems new and old, and research aplenty ✓ truckload of workshops on clinical coding, research, databases and terminology This is truly Top End haulage you will be able to take home with you. Check out the program and register today.
Web: www.himaa2.org .au/conference Email : himaa@hima a.org.au Phone: 02 9887 5001 273475 A1 280 x 80.indd 1
30/07/14 3:57 PM PULSEITMAGAZINE.COM.AU
Argus ACSS AAPM P: 1800 196 000 / +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) was established in 1979 as the national peak association supporting effective practice management in the healthcare sector. The Australian Association of Practice Managers: • Provides education, resources, networking, advice and assistance to promote excellence in healthcare practice management. • Represents practice managers and the profession of practice management throughout the healthcare industry. • Promotes professional development and the code of ethics through leadership and education.
ACIVA E: firstname.lastname@example.org W: www.aciva.org.au The Aged Care IT Vendors Association (ACIVA) was formed in early 2010, a not-for-profit organisation, incorporated in NSW. ACIVA represents the residential aged and community care sectors and vendors at various national forums regarding strategic developments and eHealth. ACIVA members are residential aged and community care software vendors, industry benchmarking software, financial software, call-bell, hardware, networking, infrastructure and industry partners. Members are committed to furthering the interests of residential aged and community care in national forums to ensure eHealth and access to the personally controlled health record (PCEHR) becomes a reality for the aged care industry in the very near future. Contact: Emma Pate email@example.com
P: 1300 788 005 / +61 2 9632 0026 F: +61 2 9632 0096 E: firstname.lastname@example.org W: www.acsshealth.com ACSS provides innovative and customisable patient management software streamlining day-to-day operations for GPs, Allied Health, Specialists, Radiologists, Pathologists, Private and Public Hospitals. eClaims® — Comprehensive and robust appointment and billing system with digital/voice recognition capabilities, electronic reporting transmissions and HL7 PACS system integration. eClaims® Hybrid — A solution tailored to Hospitals and other health service providers including billing agents who lack online capabilities. eClaims® Hybrid is the interface solution for connecting you to Medicare and health funds through ECLIPSE. SimDay® — Proven PAS (Patient Administration System) specifically designed for day surgeries and private hospitals – Now with ECLIPSE integration.
P: +61 3 9037 1000 F: +61 3 5335 2211 E: email@example.com W: www.argusdca.com.au Argus provides and supports Argus secure messaging software; a popular electronic solution that enables healthcare practitioners to exchange many forms of patient related information securely and reliably and to Australian standards.
Argus interfaces with most clinical software applications sending directly from within your letter writing facility or word processor and runs virtually invisibly in the background. Documents sent using Argus can be automatically added to electronic patient records; thus avoiding the need to scan or manually file them.
Best Practice sets the standard for GP clinical software in Australia offering a flexible suite of products designed for the busy GP practice, including:
Argus is the messaging solution chosen by many Medicare Locals through the ARGUS AFFINITY program delivering eHealth strategies across Australia. With over 17,000 users Argus continues to grow in popularity by delivering highly secure messages, a reliable product, backed by outstanding customer service all at the lowest cost possible.
Advantech’s medical computing platforms are designed to enhance the quality and efficiency of healthcare for patients and users alike. All of Advantech’s medical PCs match the performance of commercial PCs but are medically rated to UL/EN 60601-1 third revision, IPX1 drip‑proof enclosures and are designed to suit ward and theatre based applications. Advantech offers long term availability and support plus a proven track record of reliability. The medical range extends through: • Point-of-Care Terminals. • Mini-PC and Medical Imaging Displays. • Mobile Medical Tablets. • Computerised Medical Carts. • Patient Infotainment Terminals. Advantech is also an official distributor of Microsoft Windows Embedded software across Australia & New Zealand.
• Best Practice Clinical (“drop-in” replacement for MD) • Integrated Best Practice (Clinical/ Management) • Best Practice Automatic SMS reminders Visit us at the following conferences throughout the year: • • • • •
BP Summit, 14-16 March GPCE Sydney, 23-25 May RDAQ Brisbane, 6-8 June GPCE Brisbane, 12-14 September RACGP Adelaide, 9-11 October
Cerner Corporation Pty Limited
Advantech P: 1300 308 531 F: +61 3 9797 0199 E: firstname.lastname@example.org W: www.advantech.net.au
P: +61 7 4155 8888 F: +61 7 4153 2093 E: email@example.com W: www.bpsoftware.com.au
Australasian College of Health Informatics E: Secretary@ACHI.org.au W: www.ACHI.org.au The Australasian College of Health Informatics is Australasia’s Health Informatics professional body, representing the interests of a broad range of clinical and non-clinical e-health professionals. ACHI is the community of Health Informatics thought-leaders in Australasia. ACHI is committed to quality, standards and ethical practice in the Health Informatics profession. More information is available at: www.ACHI.org.au Join the ACHI Info email list at: www.ACHI.org.au/List
P: +61 2 9900 4800 F: +61 2 9900 4990 E: AsiaPacific@cerner.com W: www.cerner.com.au Cerner is a leading global supplier of health care information technology solutions engaging across Australia for 24 years. We partner with health services ranging from tertiary referral academic hospitals to rural health facilities. Our vision of proactive health care management drives innovation to address today’s health care challenges, while creating a foundation for tomorrow. The best way to solve a challenge is through innovation as evidenced by our Forbes ranking as 13th most innovative company worldwide. Our focus for Australia is driven by realising improvement in clinical outcomes. Facilitating clinical transformation, while delivering capability to manage the overall health status of the population, contributes to better health and care.
CONNECT DIRECT Pty Ltd
cdmNet P: +61 3 9023 0800 F: +61 3 9614 2650 E: firstname.lastname@example.org W: www.cdmnet.com.au cdmNet is the Number One collaborative care management product in Australia. cdmNet is the only care management product endorsed by the RACGP as supporting quality improvement in general practice. cdmNet helps practices take a systematic approach to chronic disease management and preventive care. It simplifies collaboration with the care team and ensures regular follow up and review. University trials show cdmNet results in improved quality of care and better patient outcomes (Med J Aus, 201; 199: 261-265). cdmNet eliminates paperwork and makes compliance with Medicare requirements easy. It increases the productivity of the entire practice. Regular users of cdmNet show substantial increases in revenues from MBS-rebated services. If you wish to use cdmNet to provide high quality care for your patients while increasing your revenues, contact us now.
Cutting Edge Software P: 1300 237 638 E: email@example.com W: www.cesoft.com.au Cutting Edge produces affordable, intuitive billing solutions for Mac, Windows, Linux and iPad. Cutting Edge is ideal for practitioners who prefer to maintain control of their own billing from a number of sites. Cutting Edge Software is approved by Medicare Australia to manage your electronic: • Verification of Medicare and Fund membership • Bulk Bill and Medicare claims • DVA paperless claims • Inpatient claims to Health Funds We have solutions tailor-made for: • Anaesthetists • Surgeons/Surgical Assistants • Physicians • GPs • Allied Health The software comes with up-to-date schedules for MBS/Rebate, Gap Cover (all registered health funds), Workers’ Compensation, Transport Accident authorities and DVA.
Cloud9 Software P: 1300 875 297 F: +61 2 9715 6573 E: firstname.lastname@example.org W: www.c9s.com At Cloud9 we understand the complexity of healthcare. We understand the importance of having the right information available when and where it’s needed. So Cloud9 created an eco-system to connect healthcare providers that supports the availability of key information to improve outcomes for the patient, clinician and organisation alike. An information infrastructure with real-time access across primary, community and acute setting benefits Clinicians trying to provide the best care for individuals as well as Researchers looking to improve safety and effectiveness of treatments. Our e-Health infrastructure has been designed to fit in with your current systems, whilst Cloud9’s next generation administrative and clinical applications allow you to upgrade existing systems as your business grows. Cloud9 Solutions: • Cloud9 Spine, Health Information Exchange • Synchronicity, Application Integration Suite. • Clarity for GP’s and Specialists. • Clarity Hospital Information System.
Digital Medical Systems P: 1300 865 977 F: +61 3 9753 3049 E: email@example.com W: www.dgs.com.au EASIER MEDICAL IT is a technology partnership with DMS – we make IT work for you. DIGITAL MEDICAL SYSTEMS has provided ICT solutions and services to medical practice clients across Australia since 1990. We have specialist expertise and experience in the installation and support of all Australian leading medical software applications. DMS is a Business Partner for IBM, LENOVO, HP, CISCO and Microsoft. Other leading ICT brands include Webroot Secure Anywhere, StorageCraft, CA, Toshiba, Canon, Epson, Kyocera, Fujitsu and Brother. Accreditation is easier with the customised DMS IT Systems Policy and Procedures Documentation. This ensures your practice has the best IT policy, security and maintenance program that meets and exceeds the standards guidelines from the RACGP.
P: 1300 557 550 / +61 7 5478 5510 F: +61 7 5478 5520 E: firstname.lastname@example.org W: www.directcontrol.com.au Direct CONTROL is the innovative answer to administrative excellence integrating with Microsoft Office, accounting applications, the OOP, clinical applications and Medicare Online. Included are all fee schedules (Medicare, DVA, Work Cover, TAC, CTP, Private Health Insurance) with built in rules relevant to each medical discipline (Allied Health, General Practice, Surgeons, Physicians including Oncology, Anaesthetists, Pathologists, Radiologists, Day Surgeries/Hospitals). Manage Episodes of Care including State, Federal and Health Fund Statistical Reporting for Day Surgeries/ Hospitals. Restructuring work flow with Direct CONTROL guarantees to provide remarkable results, enabling you to grow your business and increase cash flow.
World leading DTech provides 24x7 near Real-Time Monitoring and Management technologies sends alerts and enables our engineers to quickly troubleshoot and remotely solve problems fast of security, network, Internet, server and software on almost any client computer system or device – most are fixed in minutes… Proactive, Flexible, Consistent, Reliable, Audited, and Affordable - for the smallest to the largest practice. Call DMS for: • Systems Analysis, Solutions Design & Consulting • IT Systems Documentation for Accreditation & Compliance • Procurement & supply of leading brand hardware, software, network and peripheral products • Full Installation & Configuration services • On-Site and Remote Technical IT Support • 24x7 IT support Help Desk with extensive medical software expertise • 24x7 DTech Monitoring, Maintenance & Management • Disaster Recovery solutions • Fully managed Online Backup customised for clinical data • Fully managed Internet and Web Security
Doctors Control Panel E: www.pracsoftutilities.com W: PSU_admin@pracsoftutilities.com • Download and trial DCP software for GP’s and health teams. • DCP is your digital PA and guidelines advisor. • DCP facilitates TCA, GPMP and MHCP creation and tracking. • Contains guidelines licenced from RACGP. • Low annual subscription. • The best preventive care add-on software in Australia. • Compatible with MD3 and BP. • Achieve new heights in preventive care performance. • Significant benefit for patients. • Increase your revenues. • Streamline your workflow. • 3000 current users. • Several research projects based on DCP. • Try it today.
EASIER MEDICAL IT – Call 1300 865 977
Emerging Systems P: +61 2 8853 4700 E: email@example.com W: www.emerging.com.au/ehealth Emerging Systems is a market leader of healthcare information and integration technology solutions. Our eHealth products and services have supported clinicians in leading Australian public and private hospitals for over a decade to deliver safe, quality healthcare. The award-winning EHS Clinical Information System is a modular, patient-centric system providing a wide range of clinical functionality to track, record and monitor patient care from pre-admission to discharge creating a multi-disciplinary EMR - improving clinical communication and patient flow while reducing patient risk. PCEHR Compliant. EHS Clinical Mobility Solution further enhances multi-disciplinary clinical communication. Emerging Systems provide clients with a full range of tailored IT services including Consultation and Managed IT Services.
GE HCIT Solutions
P: +61 7 3292 0222 F: +61 7 3292 0221 E: firstname.lastname@example.org W: www.extensia.com.au
P: +61 2 9846 4000 F: +61 2 9846 4001 E: GEHCinfo@ge.com W: www3.gehealthcare.com.au
Extensia links healthcare providers, consumers and their communities for better and more efficient health care. The products used to do this can be custom branded for all Organisations and include:
Connecting productivity with care
• RecordPoint – a proven Shared Electronic Health Record that links all clinical systems, hospital settings, care plan tools and any other sources of information available. It provides a secure means of sharing critical patient data in a privacy compliant and logical structure. • EPRX – an Electronic Patient Referral Exchange and Directory. It streamlines the process of selecting a provider and completing a referral. Patient information is transferred seamlessly from clinical software. The most relevant providers, services and products are presented instantly and referral documents are generated and sent electronically.
P: +61 2 8985 6688 / 1300 799 904 E: email@example.com W: www.episoft.com.au Accessible anytime, anywhere and on any device, Episoft deliver comprehensive clinical, practice and research management software in one seamless system that facilitates multicentre investigator initiated trials.
Affordable and scalable, EpiSoft is used by: • Private Hospitals • Medicare Locals • Public Hospital outpatient departments • Specialist clinics Create multidisciplinary teams, collaborate effortlessly and streamline workflows with our intuitive cloud based software.
• Clinical solutions to drive improved patient outcomes • Robust clinical data at the point of care • Imaging solutions to drive productivity • Analytics to improve efficiencies and reduce cost • Interoperability with other systems. Centricity Perinatal integrates documentation and foetal monitoring. The Connect module integrates perinatal information in context with other clinical data, continuously and on one screen – enabling clinicians to see perinatal and enterprise EMR data at the same time. Remote access allows clinicians to view foetal strips while away from the hospital, providing continuous access to clinical expertise. Centricity Perioperative integrates and simplifies surgery management and anaesthesia workflows throughout the pre-op, intra-op and post-op care areas, helping to manage anaesthesia and nursing documentation, scheduling, operating theatre inventory and more.
EpiSoft has developed platforms for chronic disease management for: • Cancer including surveillance and infusion medication management • Hepatitis treatment including GP shared care programs • Mental Health • Indigenous Health • Respiratory disease • Specialised surgery • Pre-admissions patient portal
GE Healthcare IT provides robust clinical and imaging solutions that help you do more with less.
Genie Solutions P: +61 7 3870 4085 F: +61 7 3870 4462 E: firstname.lastname@example.org W: www.geniesolutions.com.au Genie is a fully integrated appointments, billing and clinical management package for Specialists and GPs. Genie runs on both Windows and Mac OS X, or a combination of both. With over 3000 sites, it is now the number one choice of Australian specialists.
Centricity Imaging Solutions will help you simplify your workflows, access data, and collaborate efficiently. They provide radiologists and physicians with tools to collaboratively inform the patient treatment plan and enhance decision-making. Our portfolio includes: Picture Archiving System (PACS), Radiology Information System (RIS), Universal Viewer, Vendor Neutral Archive, and Image Exchange for departments, enterprises, and communities. GE Services can increase usability, enhance performance, and optimise a solution’s ROI. Our offering includes consulting, implementation, customisation, education, support, and enablement services.
GPA P: 1800 188 088 F: 1800 644 807 E: email@example.com W: www.gpa.net.au Specialising in general practice accreditation, and with a well-deserved reputation for meeting practices’ needs, GPA ACCREDITATION plus continues to deliver innovation, attention and proven customer satisfaction to practices nationwide. Founded in 1998 by a team of general practitioners, GPA was established to give practices a choice of accreditation provider, making a commitment to promote the benefits of accreditation, and encourage ongoing quality improvement in the process. Whilst accreditation gives practices access to Practice Incentive Program payments, we believe it should offer benefits that go beyond financial incentives. The GPA program offers a unique preliminary document review, using a secure online portal that doubles as a library of your practice documents. Your dedicated Quality Accreditation Manager will guide you through the accreditation process, providing you with feedback and advice. Our carefully selected surveyors will ensure your survey visit is an opportunity to show off your practice and engage with your peers. Finally, a GPA certificate on your wall acknowledges your achievement, and assures your patients that your practice meets exacting standards in efficiency, risk management and patient care. GPA is committed to providing support and resources that enhance and promote general practice accreditation. Our series of free webinar sessions delivers training on the Standards for general practices, as well as pertinent accreditation topics. Our app for iPad encourages practices, and those that support them, to participate in self-assessment for accreditation preparation as well as continuous improvement between accreditation rounds. Our video series brings selfled training and resources directly to practices in a weekly email format, and our fortnightly eNews keeps you up-to-date with current accreditation information. GPA continues to lead the way in delivering comprehensive, quality accreditation to general practices across Australia. Contact us now to make the switch, and discover an accreditation provider that gives you more.
GPsupport P: +61 3 9999 1212 F: +61 3 8678 0607 E: firstname.lastname@example.org W: www.gpsupport.com.au Information Systems for the health care industry. When associated with GPsupport all your technology needs are completely managed, freeing you to focus on patient care and clinical operations. Your I.T is for us to worry about. Since 2008, GPsupport has been dedicated to delivering I.T solutions to General Practice, Allied Health and Aged Care providers. • • • • • •
Healthcare Centric IT Support Private Cloud Services Equipment Supply and Installation Multi-site networks Disaster Recovery Planning Accreditation Compliance
Our private cloud service is fast becoming the preferred choice for healthcare providers to relieve the pain of maintaining in-house systems while adhering to accreditation standards and your future needs.
HealthLink P: 1800 125 036 (AU) P: 0800 288 887 (NZ) E: email@example.com W: www.healthlink.net Transforming healthcare by connecting healthcare providers. Australia and New Zealand’s most effective secure communications service. • NEHTA compliant Secure Messaging Delivery (SMD) services • Fully integrated with leading GP and Specialist clinical systems • Referrals, Reports, Forms, Discharge Summaries, Specialists, Diagnostic Orders and Reporting • Affords all healthcare providers efficiencies in reducing paper based handling • Expert partnerships with Healthcare organisations, State and National Health Services • HL Connect for Allied Health, Telehealth and Aged Care Providers • Working with Medicare Locals Australia-wide for eHealth delivery Join HealthLink and connect with more than 85 % of Australian GPs and 99% of NZ GPs who are already part of the HealthLink community.
Health Informatics Society of Australia P: +61 3 9326 3311 F: +61 3 8610 0006 E: firstname.lastname@example.org W: www.hisa.org.au HISA is Australia’s health informatics organisation. We have been supporting and representing Australia’s health informatics and e-health community for almost 20 years. HISA aims to improve healthcare through the use of technology and information. We: • Provide a national focus for e-health, health informatics, its practitioners, industry and a broad range of stakeholders • Support, promote and advocate • Provide opportunities for networking, learning and professional development • Are effective champions for the value of health informatics HISA members are part of a national network of people and organisations building a healthcare future enabled by e-health. Join the growing community who are committed to, and passionate about, health reform enabled by e-health.
Houston Medical P: 1800 420 066 (AU) P: 0800 401 111 (NZ) E: email@example.com W: www.houstonmedical.net “We provide time to health professionals through efficient practice management software” Our multidiscipline software provides interfaces to every major manufacturer, enabling many clinics to save space by becoming completely paperless! We are a progressive medical software company and take pride in working with our health care clients to deliver tailored EMR and PMS packages based on each unique situation and practice requirements. We’re focused on helping to make their businesses more efficient and productive as well as delivering measurable improvements in customer satisfaction and market share. You can arrange a free demonstration of our software by visiting: www.HoustonMedical.net
InterSystems Health Informatics New Zealand Health Communication Network P: +61 2 9906 6633 F: +61 2 9906 8910 E: firstname.lastname@example.org W: www.hcn.com.au Health Communication Network (HCN) is the leading provider of clinical and practice management software for Australian GPs and Specialists and supplies Australia’s major hospitals with online Knowledge resources. HCN focuses on improving patient outcomes by providing evidence based software tools to health care professionals at the point of care. Market snapshot: • 17,000 medical professionals use Medical Director • 3,600 GP Practices use PracSoft • 800 Specialist Practices use Blue Chip and • 2,100 Specialists use Medical Director • Leading suppliers of Knowledge Resources to Australia’s major hospitals
E: email@example.com W: www.hinz.org.nz Health Informatics New Zealand (HINZ) is a national, not-forprofit organisation with a focus on collaboration, education and advocacy for the use of IT in the health sector. HINZ enables professional collaboration through conferences, seminars and an interactive online portal, bringing together clinicians, administrators, allied health professionals and many others with an interest in health IT and the advances it can enable. HINZ provides a platform to share information about the Health Informatics industry - leveraging best practice from New Zealand and overseas, as well as facilitating networking activities to bring industry experts and interested parties together to collaborate. Membership is for anyone with an interest in Health Informatics.
P: +61 2 9380 7111 F: +61 2 9380 7121 E: anz.query@InterSystems.com W: www.InterSystems.com.au
Health Information Management Association of Australia P: +61 2 9887 5001 F: +61 2 9887 5895 E: firstname.lastname@example.org W: www.himaa2.org.au The Health Information Management Association of Australia Ltd (HIMAA) is the peak professional body for health information management professionals in Australia serving the profession since 1949. Recognised occupations include health information managers and clinical coders. HIMAA provides quality standards for the delivery of education and training, including the accreditation of degreelevel HIM courses and online delivery of VET-level courses in Medical Terminology and ICD-10-AM, ACHI and ACS Clinical Coding. We strive to promote and support our members as the universally recognised specialists in information management at all levels of the healthcare system.
InterSystems is a global leader in software for connected care, with headquarters in Cambridge, Massachusetts, and offices in 25 countries. InterSystems TrakCare® is an Internet-based unified healthcare information system that rapidly delivers the benefits of an electronic patient record. InterSystems HealthShare® is a strategic platform for healthcare informatics, enabling information exchange and active analytics across a hospital network, community, region or nation. InterSystems CACHÉ® is the world’s most widely used database system in clinical applications. InterSystems Ensemble® is a platform for rapid integration and the development of connectable applications. InterSystems’ products are used by thousands of hospitals and laboratories worldwide, including all of the top 15 hospitals on the Honor Roll of America’s Best Hospitals as rated by U.S. News and World Report. For more information, visit InterSystems.com.
Intrahealth P: +61 2 9956 3827 (AU) P: +64 9 480 7442 (NZ) E: email@example.com W: www.Intrahealth.com Intrahealth is a global software and associated services company supplying solutions to the outpatient environment. Intrahealth provides a highly configurable integrated EMR (including case management), web access applications for real time patient, provider and external provider connectivityand a native application for the iPad and iPhone. Intrahealth solutions function across multiple community based practice types (Primary Care, Specialist Physician, Community Care, Home Care, Residential Care, etc). Intrahealth’s suite of products are used in: Individual community based clinics, Chains of clinics, Corporate medical environments & Large scale Government implementations.
Medical Software Industry Association E: firstname.lastname@example.org E: email@example.com W: www.msia.com.au With the increase in government e-health initiatives, the MSIA has become increasingly active in representing the interests of all healthcare software providers. The MSIA is represented on a range of forums, working groups and committees on behalf of its members, and has negotiated a range of important changes with government and other stakeholders to benefit industry and their customers. It has built a considerable profile with Government and is now acknowledged as the official ‘voice’ for the industry. Join over 100 other companies across all areas of medical IT/IM so your voice can be heard.
P: 1800 556 022 E: firstname.lastname@example.org W: www.medrefer.com.au MEDrefer is a secure online referral tool used by GPs, Specialists and Allied Health Professionals to manage the referral process for the benefit of patients. MEDrefer is a free service for GPs with an extensive search directory and profile of Specialists and Allied Health Professionals, a search reveals their listing in order of relevance and availability. MEDrefer provides an automatic tracking system for the GP to know if the patient attends their appointment, assisting duty of care. Now integrated with Best Practice and Genie software, as well as other systems, through the MEDrefer Manager. Join MEDrefer today to close the loop on your referral process.
MIMS Australia P: +61 2 9902 7700 F: +61 2 9902 7701 E: email@example.com W: www.mims.com.au MIMS Australia is built on a heritage of local expertise, credibility and adaptation to changing healthcare provider needs. Our information gathering, analysis and coding systems are proven and robust. MIMS information is backed by MIMS trusted, rigorous editorial process and constantly updated from a variety of sources including primary research literature. Our database and decision support modules are locally relevant, clinically reviewed and updated monthly and compatible with a host of clinical software packages. Indeed, the majority of Australian prescribing packages and many dispensing applications are supported by the MIMS medicines data base. MIMS is delivered all the ways you need – print to electronic, on the move, to your patient’s bedside or your consulting room desk. Whatever the format, MIMS has the latest information you need.
Medtech Global Ltd MEDITECH Australia P: +61 2 9901 6400 F: +61 2 9439 6331 E: firstname.lastname@example.org W: www.meditech.com.au A Worldwide Leader in Health Care Information Systems
Leecare Solutions P: +61 3 9339 6888 F: +61 3 9339 6899 E: email@example.com W: www.leecare.com.au Leecare Solutions, with their products Platinum 5 & P5 Exec, are the aged care industry’s leading web browser based clinical and management software system. Since 2000, Leecare has provided relevant, contemporary software solutions for Australian and New Zealand aged care organisations. Leecare’s mission and products provide outstanding clinical decision making support, and management support tools that use any device, can be installed on multiple platform types and in any location. Used in over 30,000 aged care places, it is the solution used by quality providers, proven through thousands of accreditation, validation and other regulatory visits, as it is based on professional clinical and lifestyle provision concepts.
MEDITECH today stands at the forefront of the health care information systems industry. Our products serve well over 2,300 health care organisations around the world. Large health care enterprises, multi‑hospital alliances, teaching hospitals, community hospitals, rehabilitation and psychiatric chains, long-term care organisations, physicians’ offices, and home care and hospice agencies all use our Health Care Information System to bring integrated care to the populations they serve. Our experience, along with our financial and product stability, assures our customers of a long-term information systems partner to help them achieve their goals.
P: 1800 148 165 E: firstname.lastname@example.org W: www.medtechglobal.com For over 30 years, Medtech Global has been a leading provider of health management solutions to the healthcare industry enabling the comprehensive management of patient information throughout all aspects of the healthcare environment. Medtech’s Medtech32 and Evolution solutions improve practice management and ensure best practice for electronic health records management and reporting. Clinical Audit Tool integrates with Medtech32 and Evolution providing fast, efficient and secure analysis of patient data enabling practices to identify and deliver services, which address health care priorities across their population. Medtech’s ManageMyHealth patient and clinical portal enables individuals to access their health information online and engage with their healthcare provider to support healthy lifestyle changes.
Orion Health P: +61 2 8096 0000 / +64 9 638 0600 E: email@example.com W: www.orionhealth.com Orion Health is New Zealand’s largest privately owned software exporter and a global leader in eHealth technology. Founded in 1993, by CEO Ian McCrae, Orion Health has grown from a specialist health integration vendor into a company that sells a comprehensive suite of eHealth solutions. Orion Health has extensive experience in the design and installation of complex systems within demanding healthcare environments. Orion Health designers and engineers work right alongside in-house clinicians in order to develop elegant and intuitive products that encourage swift adoption with minimal disruption, allowing your clinicians to focus on patients. Today, our products and solutions are currently implemented in more than 30 countries, used by hundreds of thousands of clinicians, and help facilitate the care for tens of millions of patients.
P: 1300 727 423 F: 1300 300 174 E: firstname.lastname@example.org W: www.ozescribe.com.au
P: +61 419 572 222 E: email@example.com W: www.picsafe.com
OzeScribe is the dictation and transcription solution chosen by most Australian university teaching hospitals and major private clinics. Our system is entirely flexible and can be tailored to your specific requirements, whether it be co-source or total outsource, for one doctor or a public hospital! We provide free electronic document delivery - via OzePost - to your EMR, your associate’s EMR, saving you thousands of dollars in time, packing and postage. OzeScribe is the provider of the most advanced solutions available, interfacing with most market leading PAS/Practice management solutions. OzeScribe is: • Run by doctors - for doctors. • Free NEHTA compliant electronic delivery to referring GPs etc via OzePost - powered by Argus. • Australian based and trained typists. • Superior accuracy via Quality Assurance (QA) transcription guaranteed. • Windows and Mac compatible web‑based dictation, transcription and document management portal. • Free app for iOS and Android devices. • Integrated M*Modal speech recognition technology on demand. With demonstrated time and cost saving benefits, it really does make sound business sense to let OzeScribe take care of managing your dictation, transcription and associated technology. To speak with a consultant call us now on 1300 727 423!
The Secure Mobile Clinical Imaging System Designed by Australian and US Dermatologists and Plastic Surgeons to be used by a wide range of healthcare professionals working in a variety of clinical settings, the patented PicSafe Medi app is as simple as using the normal camera function on your mobile smart device except... your patient’s photo is completely secure and legally compliant in its consent, transmission, and storage when taken with PicSafe Medi. Both iOS and Android compatible, PicSafe Medi simultaneously suffices patient privacy and related government regulatory requirements (including new Federal APP’s, commencing 12th March, 2014) surrounding the capture, use, and storage of medical photographs. Using PicSafe Medi, healthcare professionals can now quickly connect and efficiently document a patient’s status pictorially, facilitating the medical referral process and, ultimately, improving patient outcomes and satisfaction. Stored clinical photographs are fully patient-consented (including authorisation for specific usages of their photo), watermarked to assure authenticity, and managed in a highly secure, auditable, private server environment, accessible only to authenticated PicSafe Medi users. From the time you take a patient’s photo with a smart device, to the encrypted transmission and secure storage phases of photo handling, the process is seamless and non-intrusive to both photographer and patient. • Increase your efficiency and improve your patients’ clinical outcomes • Remove the worry surrounding costly patient privacy breaches • Assure quick, efficient pictorial documentation of your patient’s status • Facilitate a streamlined medical referral process • Fully document your patient encounters for billing, auditing, and medical-legal purposes • PicSafe Medi is “the missing link” in compliant and secure mobile clinical photography. PicSafe Medi is “the missing link” in compliant and secure mobile clinical photography.
Precision IT P: 1300 964 404 F: +61 2 8078 0257 E: firstname.lastname@example.org W: www.precisionit.com.au • Cloud Computing Specialists. • Onsite Medical IT Support. • VoIP Telephone Systems and Internet Connectivity. • IT Equipment Procurement. • Experience with all clinical & practice management software packages. • Sydney, Brisbane, Gold Coast and Melbourne. Precision IT is a highly competent and impeccably professional IT support firm with a primary focus on working with GPs and Specialists. Working with our clients, we develop reliable, robust and feature rich IT systems to meet the demands of the modern medical practice today and into the future. Our Precision Cloud service is fast becoming the choice for new and established practices and covers all of the standard guidelines from the RACGP and AGPAL and GPA. Talk with us today about the future of your practice!
Prospection P: +61 2 9209 4035 E: email@example.com W: www.prospection.com.au Prospection is a specialist healthcare information and analytics consultancy. • Clinical Intelligence Solutions – medication specialists • Commercial Effectiveness and Consulting • Clinical, technical and commercial expertise • Geo-mapping visualisation and reporting solutions Prospection specialises in the design, development and hosting of clinical and costing intelligence systems and consulting solutions. Our PharmDash platform allows us to analyse and report on complex healthcare datasets, and deliver web‑based reporting. We have particular expertise in understanding medication utilisation working with large, complex pharmaceutical databases. Our clients include over 30 large Australian healthcare companies in both specialist and chronic therapy areas. We can assist public and private healthcare organisations to improve commercial and clinical outcomes.
Shexie Medical System Professional Transcription Solutions P: 1300 768 476 E: firstname.lastname@example.org W: www.etranscriptions.com.au Australia’s Most Trusted Teaching Hospital and Private Practice Transcription Provider • Web-based - Dictate and receive reports anywhere • Double-edited with over 99.5% accuracy • Fast turn-around within 24 - 48 hours, as required • All medical and surgical specialities covered in Australia’s largest teaching hospitals • Rapid documentation of recorded HR interviews, Research and Expert Reports • Guaranteed cost savings • Data held securely at a State Government owned data centre • Call our friendly staff anytime for your overflow, backlog or all of your typing or data entry requirements • Call us now for a no obligation free trial
P: 1300 743 943 F: 1300 792 943 E: email@example.com W: www.shexie.com.au Shexie is an Australian owned business which has been developing software for medical practices for over 15 years. Our industry and technical knowledge allows us to provide the ultimate ‘easy to use’, ‘fully functioned’ and ‘robust’ product on the market. Shexie Medical System clinical and practice management software is ideal for surgical or specialist practices of any size. Many fully integrated features including Paperless Office, SMS, full Paperless Electronic Claiming including Eclipse, MIMS Integrated, statistical analysis, security, synchronize appointments with Outlook/PDAs, transcription interface, diagnostic equipment interface, automated MBS/Fund rates updates. Soon to be released Shexie Platinum version also contains eHealth - Health Identifiers, PCEHR and Secure Messaging.
Stat Health Systems (Aust) P: +61 7 3121 6550 F: +61 7 3398 5064 E: firstname.lastname@example.org W: www.stathealth.com.au
P: 1800 061 260 E: email@example.com W: www.tg.org.au
Stat Health Systems (Aust) has built a progressive and resilient system that introduces a new level of stability and flexibility to the medical software market.
Therapeutic Guidelines Limited is an independent not-for-profit organisation dedicated to deriving guidelines for therapy from the latest world literature, interpreted and distilled by Australia’s most eminent and respected experts.
Stat is an integrated clinical and practice management application which has embraced the latest Microsoft technology to build a new generation solution. Fully scalable and the only medical software application to incorporate a multi-functional intuitive interface, Stat is at the forefront of computing technology. Stat incorporates all eHealth requirements as per the NEHTA specification.
These experts, with many years of clinical experience, work with skilled medical editors to sift and sort through research data, systematic reviews, local protocols and other sources of information, to ensure that the clear and practical recommendations developed are based on the best available evidence.
Stat Health provide a premium support service, clinical data conversion from existing software and tailor made installation and training plans for your practice. Facebook: facebook.com/StatHealth Twitter: @NotifyStat
eTG complete Incorporates all topics from the Therapeutic Guidelines series in a searchable electronic product, and is the ultimate resource for the essence of current available evidence. It provides access to over 3000 clinical topics, relevant PBS, pregnancy and breastfeeding information, key references, and other independent information such as Australian Prescriber (including Medicines Safety Update), NPS Radar, NPS News and Cochrane Reviews.
P: +61 3 9013 4445 E: firstname.lastname@example.org W: www.sysmex.com.au
eTG complete is available in a range of convenient formats – online access, online download, CD, and intranet access for hospitals. Multi-user licences, ideal for a practice or clinic, are also available.
Sysmex is dedicated solely to helping your healthcare organisation achieve more in less time, with fewer errors and better patient outcomes.
It is widely used by practitioners and pharmacists in community and hospital settings in all Australian states and territories.
Sysmex leads the way in eDiagnostics: • Providing an essential building block for the electronic medical record with the Eclair Clinical Information System • Enabling sharing of key patient information across regions through the Eclair Clinical Data Repository • Completing the electronic loop with laboratory and radiology order request management (CPOE) • Streamlining all areas of the anatomical pathology laboratory workflow from request to report with Delphic AP • Improving reporting times and reducing costs through an enterprise Delphic LIS, shared across multiple laboratories
The July 2014 CD release of eTG complete contains an important update on the treatment of osteoporosis, to reflect new information published by the Therapeutic Goods Administration in April.
Therapeutic Guidelines Ltd
No other changes to the content will be published at this time. Antibiotic Guidelines version 15 will be coming out in November in eTG complete and in print. miniTG The mobile version of eTG complete is miniTG, (in offline format), offering the convenience of vital information at the point of care for health professionals who practise and consult on the move. It is supported on a wide range of mobile devices, including Apple®, Pocket PC®, and selected Blackberry® devices.
P: 1800 244 358 F: 1800 626 739 E: email@example.com W: www.webstercare.com.au
P: +61 7 3252 2425 F: +61 7 3252 2410 E: firstname.lastname@example.org W: www.totalcare.net.au Totalcare is a fully integrated Clinical, Office and Management software suite designed to suit the particular needs and processes of healthcare providers. Used since 1995 by health care facilities across Australia including General and Specialist practice, Radiology, Day Surgery and Hospitals, Totalcare is stable, scalable, customisable and easy to learn and use. From a small practice to a multisite, multi-disciplinary corporate entity or hospital, Totalcare can provide solutions for your needs. • • • • • • • •
Admissions / Appointments Billing Statutory Reporting Integrated SMS Prescriptions Orders & Reports Clinical Notes Letter/Report Writing, Document and Image Management • Scanning and Barcode recognition • Video and Image Capture • HL7 Interfaces
Webstercare is a world-leading medication management innovator and was recognised in 2013 by BRW as Australia’s sixth most innovative company. About 30 years ago, Webstercare developed Webster‑pak®, the world’s first medication dose administration aid, and today the majority of Australia’s community pharmacies use the Webster-pak system to help consumers maximise their medication use. Webstercare has since developed another 300 products and services– all developed to solve existing problems. These include MedsPro®, a system for maximising the efficiency of dispensing Webster-paks; MedsCom® Connect which connects pharmacies with aged care facilities and GPs; and MedSig® to streamline clinical medication administration processes.
VIRTUAL CONSULTING ROOMS
VConsult P: 1300 82 66 78 F: 1300 66 10 66 E: email@example.com W: www.vconsult.com.au VConsult offers outsourced practice management solutions for medical and allied health practitioners allowing the focus to be on your professional practice and patient care. VConsult provides a seamless “behind the scenes” service by professionally managing your telephone calls, reception, invoicing and medical transcription requirements. VConsult is perfect for your practice if you are: • Setting up, already established or winding down in Private Practice • Working in a public appointment and want to portray a professional image • Looking to minimise your overhead costs • Requiring your patient calls to be answered by a professional and experienced medical receptionist.
P: 1300 933 000 F: +61 3 9284 3399 E: firstname.lastname@example.org W: www.zedmed.com.au At Zedmed, we provide general practice, specialist and allied health clinics with turnkey software solutions for their most common practice needs. We’re committed to producing best in class products and services and are consistently striving to provide additional value-added products and services to help practices work more profitably and efficiently, so our customers can focus on delivering patient care. Zedmed - Focused Innovation.
Continuity of care including clinical handover 3 Sept Triage 9 Sept Coordination of care 23 Sept Medical records - part 1 30 Sept Medical records - part 2 8 Oct Collaborating with patients and third party presence 30 Oct Patient feedback
Adding a whole new dimension to healthcare
At HealthLink we understand our products work best when they free up medical practitioners to concentrate on what they do best - personalised patient care - while giving them the accurate, timely and complete information to further enhance that care. Todayâ&#x20AC;&#x2122;s complex, hurried healthcare environment demands patient information systems that are absolutely dependable. At HealthLink we work through every challenge to ensure our clients have nimble, fit -for- purpose systems that deliver peace of mind performance.