Australasiaâ€™s First and Only eHealth and Health IT Magazine
21 MAY 2012
PREPARING FOR THE PCEHR
Stepping up to THE PCEHR
Pulse+IT takes an in-depth look at the steps practices should be taking to prepare for the launch of the PCEHR on July 1.
Calling 1800 PCEHR
Consumers will be able to register for their PCEHR in just six weeks, but what, if anything, will they find?
The eHealth paradigm and the PCEHR Emma Hossack looks back at the noble aims of the 2008 eHealth strategy and finds that things have not gone according to plan.
Publisher Pulse+IT Magazine Pty Ltd ABN: 34 045 658 171 www.pulseitmagazine.com.au Editor Simon James Australia: +61 2 8006 5185 New Zealand: +64 9 889 3185 firstname.lastname@example.org Advertising Enquiries email@example.com
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Looking Ahead Pulse+IT welcomes feature articles and guest editorial submissions relating to the nominated edition themes outlined below, as well as articles relating to eHealth and Health IT more broadly. Pulse+IT is produced in print seven times per year with the remaining four editions for 2012 to be distributed for release in: • • • •
July 2012 ~ Telehealth / HIC2012 Preview Mid-August 2012 ~ PCEHR Analysis / HIMAA Conference Preview October 2012 ~ New Zealand eHealth / HINZ Conference Preview Mid-November 2012 ~ mHealth
Submission guidelines and deadlines are available online: http://www.pulseitmagazine.com.au/editorial
Pulse+IT acknowledges the support of the following organisations, each of whom supply copies of Pulse+IT to their members.
About Pulse+IT Pulse+IT is Australia’s first and only Health IT magazine. With an international distribution exceeding 34,500 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 Bryn Evans, Emma Hossack, Simon James and Kate McDonald. 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 any organisations producing publications that include the word “Pulse” in their titles. Copyright 2012 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.
CALLING 1800 PCEHR
STARTUP Editor Simon James introduces the 28th edition of Pulse+IT.
The Healthcare Identifiers Service is a crucial foundation piece of not just the PCEHR, but many of the government’s other eHealth initiatives including secure electronic correspondence.
INBOX Paul Gerber queries potentially inflated figures about preventable deaths due to medical error.
GUEST EDITORIAL Bryn Evans compares the seeming lack of coherance and governance of Australia’s eHealth system with the Meaningful Use and Accountable Care policies that are transforming healthcare in the US.
MSIA Emma Hossack takes a fond look back at the 2008 National eHealth Strategy, which set out a number of noble aims. Since then, both eHealth strategy and the PCEHR have not gone according to plan.
DCA acquires Communicare, readies for secure delivery of CDA Experts call for national eHealth safety enforcer Zedmed expands electronic prescribing feature set
AN UPDATE FROM THE GP VENDOR PANEL
ACHI criticises lack of PCEHR technical regulation rules
PULSE+IT DIRECTORY The Pulse+IT Directory profiles
CALLING 1800 PCEHR With the launch date for the PCEHR fast approaching, what will consumers be able to do or see on July 1? It seems likely that the ability to register is the only piece ready come launch day.
AMA survey finds general practices not ready for PCEHR
Telehealth funds released for aged, palliative and cancer care
PREPARING YOUR DATA FOR THE PCEHR Pulse+IT looks at two software tools
With seven suppliers of general practice software now engaged by government to deliver updated solutions to interact with the HI Service and the PCEHR, Pulse+IT checks in to see how the vendors are progressing.
SELECTED BITS & BYTES
Emerging Systems develops iPad, iPhone app for hospital use
— already well known to general practice — that have been updated to assist practices to analyse and improve their data for the PCEHR.
NEHTA The National Product Catalogue has the ability to store and share accurate, complete and up-to‑date data on healthcare products between suppliers and providers and is a critical component of Australia’s transition to an electronic health system.
HEALTHCARE IDENTIFIERS SERVICE
Up and coming eHealth, Health, and IT events.
Australasia’s most innovative and influential eHealth and Health IT organisations.
PREPARING FOR THE PCEHR On the eve of the launch of the Personally Controlled Electronic Health Record (PCEHR), the 2012-2013 federal budget has provided a measure of certainty for those involved with the ambitious project. While much work remains to be done, healthcare organisations need not wait for July 1 before starting their preparation for this and other related government eHealth initiatives.
SIMON JAMES BIT, BComm Editor: Pulse+IT firstname.lastname@example.org
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.
The federal budget handed down on May 8 has provided financial certainty for the ongoing development of the Personally Controlled Electronic Health Record, with the government allocating an extra $233 million over two years to continue the implementation of the centrepiece of its national eHealth program. $161.6 million of these funds will be used to operate the PCEHR system, including registration and customer support, adoption assistance, and benefits monitoring and evaluation.
service. An update from the GP Vendor Panel is provided in this edition on page 52. The impending availability of PCEHR‑enabled software does not, of course, say anything about consumer or clinician intentions to utilise the service, however it is apparent that the software developers that spoke to Pulse+IT do not envisage clinicians will need to deviate greatly from their existing electronic record keeping workflows to supply data to the PCEHR, should they wish to do so.
The National E-Health Transition Authority has been given financial certainty as well, receiving $67.4 million over two years as part of the federal government’s share of its COAG funding. Additional money has been allocated to the departments of human services and veterans’ affairs, which will continue as administrators of various parts of the eHealth landscape.
The government revealed in its budget papers that a key performance indicator of the success of the system would be the registration of 500,000 consumers between July 1 2012 and 2013. By 2015, the government wants to see 2.2 million individuals registered and using the PCEHR.
In accordance with the much touted ‘go live’ date of July 1, the budget confirms government’s shifting focus from PCEHR development to its fledgling operational stages. While expectations are being moderated with claims that we are at the “start of an eHealth journey”, discussions with vendors engaged in the PCEHR development process are perhaps a bit more optimistic, with many expecting to have tangible products available on, or soon after, the official launch of the
The government also used the budget to signal what this editor considers both an inevitable — although perhaps equally premature — move to drive general practitioners towards the system, indicating that practices that do not participate will not be eligible for ongoing funding under the eHealth Practice Incentives Program. A Department of Health and Ageing spokeswoman told Pulse+IT that government support “has helped more
“We’ve supported GPs to develop their IT systems, and now we’re supporting them to deliver eHealth to their patients through adopting the PCEHR.” Department of Health and Ageing
than 96 per cent of practices to get the IT they need for eHealth”, with Australia’s GP workforce now the fifth most computerised in the world. “Following consultation, revised 2012-13 Practice Incentive Program payments will make sure that now many practices have most of the IT in place, the government focuses its support on the roll-out and take up of the eHealth record,” she said. “We’ve supported GPs to develop their IT systems, and now we’re supporting them to deliver eHealth to their patients through adopting the PCEHR.” Rather than trying to project forward through the haze of uncertainty and paint a picture of what may or may not be available to practices on July 1, the focus of this edition’s feature articles is on the things that practices can start doing now in preparation for not only the PCEHR, but also the Healthcare Identifiers Service. As outlined on page 42, adopting Healthcare Identifiers in your organisation is not exactly straight forward, however these 16-digit numbers do have applicability that extend far beyond the PCEHR and are likely to be the basis of many electronic clinical messaging transactions in the months and years ahead.
Of similar relevance to general practices is our article on page 48, which highlights two software products commissioned for development by NEHTA that have the specific aim of assisting practices to analyse and clean up data in their clinical systems with a view to ensuring the PCEHR is ultimately populated with accurate and relevant data. Garbage in, garbage out as they say.
Looking ahead To allow time for the PCEHR dust to settle, the next edition of Pulse+IT will take a break from the subject and examine telehealth initiatives in both Australia and New Zealand. The edition will also feature significant pre-event coverage of the Health Informatics Society of Australia’s Health Informatics Conference, which is to be held in Sydney over four days starting July 30. In the meantime, those interested in keeping abreast of the latest Australian and New Zealand eHealth developments are invited to sign up for our free eNewsletter service, or visit us online at: www.pulseitmagazine.com.au As always, I welcome the input of our readers. If you have any suggestions for future articles, would like to contribute to an edition, or would simply like to discuss your experiences with eHealth, don’t hesitate to get in touch.
LETTERS TO THE EDITOR Pulse+IT welcomes feedback from readers about both the articles that appear in the publication and their experiences with eHealth more broadly. Letters should be limited to 500 words, however longer submissions may be considered for publication as guest editorials where feasible.
SIMON JAMES BIT, BComm Editor: Pulse+IT email@example.com
Letter of the month Pulse+IT congratulates Paul Gerber as this edition’s winner of the letter of the month prize. For his contribution to the discussion on the magnitude of preventable deaths and the role of eHealth, Paul will receive an Apple TV digital media player complements of Pulse+IT.
TO THE EDITOR. The report of the recent Health Information Management Systems Society Conference [Pulse+IT, 2 April 2012, pages 8-11] , gave us a glimpse of how IT will transform medical practice in the 21st century. One speaker claimed that: “No longer will there be a dependency on knowledge in a doctor’s head. Shortly we will be able to click on super computers that can sift through 200 million pages of an artificial intelligence evidence‑based medical decision support system in three seconds.”1. Predictably, medical errors causing death became a subject of discussion. One speaker, Stephen Earle, described as a “project consultant”, citing from the 2000 report published by The Institute of Medicine (US)2, claimed that the authors estimated that some preventable 98,000 deaths occurred in the US each year. This exceeds the number of deaths from motor vehicle accidents, breast cancer and AIDS. He claimed that the figure “was but the tip of the iceberg”, the authors now believing “that estimate was understated by a factor of 10”3. This alarming death rate due to medical error has since been cited uncritically in the medical literature, rarely questioned or challenged. It is time to set the record straight. In How Many Deaths Are Due to Medical Error? Getting the Number Right4, the authors
noted that: “The Institute of Medicine (IOM) report on building a safer system created an intense public response by stating that the number of deaths due to preventable error in the United States is between 44,000 and 98,000 per year. The report cited two studies, one based on hospital discharges in New York in 19845, the other based on discharges in Colorado and Utah in 19926.” Critically examining this study, the authors noted: “The two studies cited by the IOM committee substantiate that adverse events occur in 2.9% to 3.7% of hospital admissions. Supporting data for the assertion that about half of these adverse events are preventable are less clear. In fact, the original studies cited did not define preventable adverse events, and the reliability of subjective judgments about preventable deaths due to medical errors was not formally assessed. The Committee’s estimate of the number of preventable deaths is least substantiated. The methods used to estimate the upper bound of the estimate (98,000 preventable deaths) were highly subjective, and their reliability and reproducibility are unknown, as are the methods used to estimate the lower bound (44,000 deaths)”. They added that “By closely examining the two studies and the IOM committee’s report we had hoped to answer the question “How many deaths are due to preventable medical error?” Even after expanding our search to
include related published articles, we are unable to answer this question. Without further examination of the original records, we doubt if anyone can.” If 98,000 preventable deaths claimed to be due to medical error are seriously questioned, expanding their number by a factor of 10 lacks any scientific credibility. Paul Gerber Hon Reader in Legal Medicine School of Medicine, University of Queensland, Brisbane, QLD firstname.lastname@example.org 1. At p. 010 2. Kohn LT, Corrigan JM, Donaldson JM. Institute of Medicine (U.S.) Committee on Quality Health Care in America. To Err is Human: Building a Safer Health System, Washington, DC: National Academy Press; 2000. 3. At p. 010+ 4. Sox Jr HC, Woloshire S. Effective Clinical Practice. Nov/Dec 2000 5. Brennan TA, Leape LL, Laird NM et al. Incidence of adverse events and negligence in hospital patients . Results in the Harvard Medical Practice Study. N Engl J Med. 1991; 324: 370-6. 6. Thomas EJ, Studdert DM, Burstin HR et al. Incidence and types of adverse events and negligent care in Utah and Cokorado. Med Care, 2000; 38: 261-71. TO THE EDITOR. I wanted to say how much I enjoyed Jenny O’Neill’s article “From ehealth blue sky to ehealth grass roots” [Pulse+IT, 20 February 2012, pages 26-28]. I particularly liked her paragraph raising the issue of there being a quantifiable cost, and also laughed at your comment about the feathered nests of consultancy firms. Nothing new there sadly. I do selectively refer to specialists who electronically communicate, but not if they are the wrong specialist for the patient. Working in Melbourne we have the luxury of choice, and it is very difficult to
“incentivize”...hate that word...specialists to communicate in a timely and efficient manner. The hip pocket, sadly, seems the most effective incentive. If you have other suggestions, I would be very interested to hear them. All the best, and once again, thanks for the article, it was succinct. Dr Tamsin Franklin General Practitioner Collins Street Medical Centre TO THE EDITOR. I congratulate Dr Geoffrey Sayer on his excellent article [Pulse+IT, 2 April 2012, pages 36-38]; a must read for everyone. Geoff eloquently outlines an eHealth scenario which has the makings of a Shakespearean tragedy; albeit with no ending in sight. To my mind this eHealth saga has evolved from the failure of too many in positions of power and authority to understand the complexity and enormity of the task and the futility of tackling it ‘holus-bolus’. The root cause is compounded by uncontrolled egos, a fast shootin’ 6-gun draw from-thehip mentality (all too prevalent in the IT industry today), an inability to understand what is required to build a functional collaborative environment, an unwillingness by others to participate in such an environment, a reluctance by those in charge to comprehend from the IT, patient care, and service providers’ perspectives what constitutes the underlying forces, diversity of cultures, emotions and needs in play that drive the work processes which constitute the ‘health environment’ in all its diversity. We need to focus on firmly nailing down these very thorny
issues. Doing so will enable progress on key fronts to be made quite quickly. Dr Ian Colclough Change Management & Strategic Planning Consultant TO THE EDITOR. As a recipient of Pulse+IT, it occurs to me that a “Letters To The Editor” column may allow IT enthusiasts to hear from the hapless and unheard end users of IT in Health (especially in hospitals). We may even be able to mount a debate as to whether IT Health Security now reduces availability of vital information to clinicians and so is sometimes inferior to the old fashioned paper based medical record. Perhaps there are many occasions when hospital IT Security interferes with patient care. I believe it is high time that the cost (patient safety) benefit (patient confidentiality) ratio is debated in public by the end users rather than “IT Experts” and Health Bureaucrats. Dr Tony Krins Locum Obstetrician and Gynaecologist
PCEHR AND THE eHEALTH STRATEGY TO HAVE MEANING ANY TIME SOON, WE NEED FASTER IMPLEMENTATION
The US government is driving a faster adoption of eHealth, through a legislated program termed ‘Meaningful Use’, with financial incentives and implementation benchmarks. Does Australia need to do something similar with its own eHealth strategy?
BRYN EVANS Director: JEMS Consulting email@example.com
The Commonwealth government has an ambitious and laudable eHealth strategy, of which the Personally Controlled Electronic Health Record (PCEHR) is a major building block. At the recent Health‑e‑Nation Conference, the federal Minister for Health, Tanya Plibersek, described the commencement of the PCEHR and its subsequent expansion as the cornerstone of the government’s eHealth strategy. The PCEHR will have two simple but key deliverables on 1 July this year. Firstly, the new system will be available, and secondly, consumers will be able to begin to register. The original plan for the PCEHR to be available to every consumer from 1 July has been amended subtly to a message that says 1 July is just a first step in a journey of 10 years or more.
eHealth in the USA begins to mean something
About the author Bryn Evans has many years’ experience as a chief executive of a clinical software supplier, and chief information officer in public hospitals. He is also an author, and writes extensively across a range of categories and genres, notably in the areas of sport, travel, history, information technology and eHealth.
In contrast, two Health-e-Nation speakers gave an insight into how eHealth is beginning to mean something in US healthcare right now. Jonathan Schaffer, managing director of the world-renowned Cleveland Clinic in Ohio, described how its electronic medical records (EMRs) and health records (EHRs), connected clinicians and patients across Ohio, the USA and globally.
The Cleveland Clinic is at the forefront in using eHealth to both reduce the costs of delivery and improve the quality of care. Its healthcare delivery model has eliminated geographical barriers, to connect the patient with the right doctor, at the right time, anywhere. In just one example of how its eHealth strategy delivers better patient outcomes, a patient is given an option online of seeking a second medical opinion. This has revealed that in 25% of cases, the original diagnosis was either incorrect or requires modification changes. David E. Garets, a long-standing leader in eHealth in the US and worldwide, told the conference of the introduction of the US government’s ‘Meaningful Use’ eHealth program, to drive both greater cost efficiency and quality of care. Through the adoption of EMRs and EHRs, and with more than $US3 billion paid out so far to complying healthcare providers, the ‘Meaningful Use’ program of $US27+ billion was beginning to change US healthcare. The Meaningful Use program pays health service providers to create EHRs, use certain EHR functions, and to share the data with other providers and patients. In the requirements of stage two of the Meaningful Use initiative, one is the benchmark for a minimum of 50% of
each provider’s patients being able within four days to access their EHR online and transfer a copy of their patient histories. By dangling the carrot of funding assistance for compliance, as well as the stick of financial penalties for those who lag behind, eHealth implementation by healthcare providers is being accelerated. In an effort to cut the ballooning cost of US healthcare, Meaningful Use is being closely linked to ‘Accountable Care’, where health service providers are paid for activity performance based upon quality outcomes. Poor performance in diagnosis and treatment e.g. hospital errors and other adverse events in hospital, will increasingly receive no funding at all. The legislation provisions for accountable care organisations are linking healthcare funding and reimbursements to quality indicators for patient care outcomes. In conjunction with the Meaningful Use program, Accountable Care is driving cost efficiency at the same time as improving quality of services.
Why is Australia’s implementation of eHealth so slow and tortuous? Compared with implementing new technology in a government department, a not-for-profit organisation, or a commercial business, the challenge of implementing eHealth nationally across countless health service providers and 22 million consumers faces a debilitating handicap. The national eHealth and PCEHR project lacks coherent and clearly identifiable governance and ownership by users. In this context users comprise state health departments, boards and executive management of health services (both public and private), clinicians, patients and consumers. Despite appearances and a semblance of participation, there is much anecdotal
“By dangling the carrot of funding assistance for compliance, as well as the stick of financial penalties for those who lag behind, eHealth was being accelerated.” Bryn Evans
evidence that the vast majority of users of all categories are not listening, are not committed in any real practical sense, and are totally focused on their own organisational challenges and priorities. Any government department or commercial organisation, whether a business for profit or a not-for‑profit organisation, has a coherence in ownership, governance, responsibility, accountability and financial viability. The national eHealth and PCEHR project does not.
It can be argued that most of the delay, false starts and inertia that have handicapped Australia’s eHealth strategy for a number of years have their root cause in a lack of clear ownership and incentive. Some would say that many of the difficulties being faced by the current implementation of the PCEHR, would be addressed and resolved much more quickly within a more meaningful environment of ownership and governance, assisted by an appropriate regime of regulation, incentives and penalties.
To make eHealth a fundamental part of doing business and delivering day to day health services on a national scale, something else is required. That is why in the US the federal government has sought to impose an eHealth strategy, through a framework of legislated requirements for Meaningful Use and the associated Accountable Care.
Healthcare’s business processes, work practices and funding model must change, to incentivise and raise the pace of adoption. Australia can be at the forefront worldwide, both as a developed country, and in applying eHealth in disadvantaged, indigenous and remote communities. In the mainstream of urban populations it can bring increased personal responsibility, quality of care and greater efficiency.
How does Australia accelerate implementation of its own eHealth strategy? Our government’s eHealth strategy, with the PCEHR as its integral heart, is clearly going in the right direction. There are clear benefits to be gained, for Australia’s indigenous and remote communities, and greater quality and efficiency in healthcare for all of Australia’s population. The technology for eHealth is available — the challenge is in its implementation and adoption.
But for that to happen perhaps we need a carrot and stick approach, similar at least in principle to the USA — funding incentives to generate take-up, and financial penalties for non-compliance. So much of eHealth can be accelerated now with a dynamic adoption approach, and the right mix of incentives, funding enticements and disincentives for non‑adoption, to drive the momentum of eHealth and the PCEHR implementations much faster.
AMA finds general practices are not ready for PCEHR, ramps up incentive campaign A survey carried out by the Australian Medical Association while preparing a guide to using the PCEHR for its members has found that few practices will be ready to use the system when it launches on July 1.
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The survey, an online poll of AMA members run for two weeks in January, showed that only eight per cent of practices will be ready to use the PCEHR on its starting date. While the survey is not representative, the results show that medical practitioners are unsure of the detail of the system and some are unsure of the value and worth it will have in practice.
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AMA president Steve Hambleton said while he supports patients taking responsibility for their own health, “the PCEHR has practical clinical limitations for medical practitioners in the treatment of patients in respect of the content,
accuracy, and accessibility of the information”. “We accept that the intention is for people to be able to register for the PCEHR from 1 July, but we have advised the government that there will be very few medical practitioners who will have the capability to interact with the system from that date,” Dr Hambleton said. The AMA has also ramped up its campaign to have doctors adequately recompensed for doing work in the PCEHR, launching its own list of suggested item numbers to be added to the MBS. The suggestions were a response to an announcement by Health Minister Tanya Plibersek that doctors could claim longer consultation times if they are creating or adding to a shared health summary which involves taking a patient’s medical history as part of a consultation.
Ms Plibersek said doctors could claim the Level B ($35.60), Level C ($69) or Level D ($101.55) benefit depending on the length of time the consultation took. The AMA, on the other hand, released its own list of items it wants added to the MBS, including a $53 fee for professional service initiated by the patient and rendered by a medical practitioner to prepare or manage a shared health summary for the patient’s PCEHR of not more than 15 minutes duration. It also wants new items to be set at $104 for a service of more than 15 minutes but less than 30 minute, $154 for more than 30 minutes but less than 45 minute, and $210 for a service of more than 45 minutes’ duration. The federal government has not responded. Dr Hambleton said the AMA had taken the initiative to give doctors and their
patients some certainty by setting items that realistically reflect the time, the work and the expertise required. “The items provide guidance to AMA members on medical fees for this important clinical service for their patients,” he said. “It is not a recommended fee. The AMA encourages its members to set their own fees based on their practice cost experience. “The AMA items are timetiered and can be billed in addition to any consultation that is provided to the patient on the same day.” It has also asked the health department to rethink the proposed conditions for registration of healthcare
Dr Steve Hambleton
providers for the PCEHR. In a strongly worded letter to the department, AMA general secretary Francis Sullivan warned the department that the AMA would advise its members not to register unless the proposed conditions were changed. Mr Sullivan said the proposed registration conditions placed “extraordinary obligations on healthcare provider organisations for matters that are largely out of their control”. “As they currently stand, the conditions of registration will deter every medical practice in Australia from participating in the PCEHR system,” Mr Sullivan said. “The AMA is very
disappointed that the Department has seen fit to take this approach.” The letter suggested that healthcare providers would be liable for failures and breaches of the PCEHR. It also appeared that DoHA will require the ability to enter practices and search records in cases where breaches have occurred. However, a DoHA spokeswoman rejected the claims, saying the participation agreement would not require organisations to assume all legal liability or grant officials unrestricted access to premises and records.
Nurses trial digital pen for clinical pathways A nurse-led trial of a digital pen that captures data at the point of care is up and running at Frankston Hospital in Victoria to see if it can improve the care of patients with a fractured head or neck of femur. The digital pen, distributed in Australia by the Print Media Group, uses an in-built camera to capture and convert handwriting into a digital format. The point of care data is sent to a separate server to allow real-time analysis of clinical pathways and faster interventions. The trial’s project manager, Virginia Plummer of Monash University’s School of Nursing and Midwifery, said the digital pen was a practical and cost-effective tool that nurses could easily use to improve clinical outcomes.
“It will not impose unfair or extraordinary obligations on healthcare provider organisations,” she said. “Terms and conditions are a normal feature many government and private sector programs and give the participants certainty about their roles, responsibilities and rights.”
Dr Plummer said while there are other products out there for point-of-care use, such as PDAs, iPads and tablets, nurses usually don’t have access to them in most large public hospitals.
The AMA survey also found 80 per cent of participants were concerned about the administrative requirements of the PCEHR system, and over 70 per cent were concerned about the financial implications.
While the digital pen is able to capture data and relay it immediately back to the server, it also functions like a normal pen, she said. Paper forms are still routinely used, so nurses and allied health professionals can use the pens both on digital paper forms and on ordinary paper.
“This clearly illustrates some of the barriers that face successful adoption of the PCEHR system amongst medical practitioners,” the survey found.
“Digital pens are easily carried in the nurses’ kit and from patient to patient as they are going around the ward and they don’t need to be docked until the end of the care round,” she said.
The trial will run for three months in Ward 5GN at Frankston Hospital on the Mornington Peninsula. Funded by an Australian Research Council (ARC) Linkage grant, the trial also involves NEC, which has designed the database dashboard through which the data can be seen.
Bits & Bytes
MIMS releases AMT map dataset to vendors MIMS has released a test file of its Australian Medicines Terminology (AMT) map data to software vendor partners ahead of the planned version 3 release by the National E-Health Transition Authority (NEHTA) in June. MIMS has been working for over a year towards a complete mapped dataset where the MIMS medicines list will align with the AMT list. This will provide clinical software applications using MIMS medicine information with a dataset that links or maps to the AMT via the AMT codes. The sample test file has been released to vendors to allow them to familiarise themselves the changes in the MIMS data structure. MIMS business development manager for primary care and community pharmacy, Dinah Graham, said the mapping project was a complex one and MIMS was still unsure of what will be contained in the next upgrade of the AMT. However, she said it was important for vendors to have a look at the test dataset and begin the planning process to incorporate the changes into their software. “We have previously sent a test dataset out to our vendor partners working on the PCEHR Wave sites, but we are making this test file available to all of our vendor partners, of which there are over 70,” Ms Graham said. The test dataset contains approximately 400 packs mapped to the AMT and, although only a small subset of the potential 15,000 mapped items, it will give MIMS vendors a full view of the changes required around the MIMS data, she said. Vendors can download the dataset from MIMS’ FTP site.
Health Communication Network signals the end of Medical Director 2 support Health Communication Network (HCN) has urged its customers using Medical Director version 2 to upgrade to version 3 as they will no longer be able to use the system to prescribe from May. MD3 was first released in 2005 and is now used by all but 2% of HCN’s Medical Director customers. The company announced its intentions to cease development of the long‑superseded version of Medical Director in October 2011, and according to HCN’s director of strategy and operations, Tania Taylor, the organisation has been actively communicating with its MD2 user base about the need to upgrade. “We’ve been sending out the warnings on the MDRef updates since October and we’ve been sending periodically to our MD2 customer base emails detailing the percentage of customers on MD2 and stating that it really is time to upgrade and that you’ll only have until May to switch over,” she said. “We’ve been canvassing pretty hard and we’ve made a real dent but there are the final couple where [the doctors] are retiring at the end of the year or people are not ready to move at this stage.”
HCN CEO John Frost discounted the possibility of antiquated computer hardware being an issue for practices that have not migrated from MD2 to the more resource-hungry MD3 version of the product.
“We made improvements to the drug database system in MD3 last year and it got to a point where it just became impossible to support the old structure in MD2 ...” “I can’t for the life of me imagine there are any practices these days that couldn’t run MD3 [on their existing hardware]. To put it in perspective, when we launched MD3 in 2005 — seven years ago — there was probably a meaningful percentage of our MD2 customer base that couldn’t run Windows 2000, which was the baseline requirement for MD3. But these days I can’t imagine there is any hardware that could be that old and still clunking along.” Mr Frost indicated that changes to the MDRef drug database system have
necessitated the imminent cessation of HCN’s support for MD2. “We made improvements to the drug database system in MD3 last year and it got to a point where it just became impossible to support the old structure in MD2, which is a product that has been in maintenance mode for six years,” he said. Ms Taylor indicated that all new development — including features relevant to the PCEHR and other national eHealth initiatives — has, for some time, been directed at MD3. “The benefits people get from upgrading to MD3 now is access to all the eHealth features, which are not being put into MD2. Whatever changes we’re making now are paving the way for future eHealth initiatives hooking into MD3 and we don’t want to be doing this development work across two or three products. MD3 is going to be the product that supports eHealth going forward. “We are very supportive of the government’s eHealth strategy and we work closely with industry bodies to deliver those aspects of eHealth that will make a difference to the doctor and the patient, as we did with Healthcare Identifiers,” Ms Taylor said.
At we’d rather catch you than catch you out
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Not letting you fall. Ever. Work in the interest of our clients from first contact to reaching accreditation. Support and guide our clients through every step of the process. GPA AccrEditAtion plus does things differently.
Accreditation doesn’t have to be the daunting process. As so many of GPA ACCREDITATION plus clients are happy to repeat “GPA’s process has changed what we thought was going to be a hardship into a rewarding experience.” From the beginning your own personal QAM steers you through the entire accreditation process at your own pace. The flexible GPA ACCREDITATION plus modular programs (online or paper-based) are designed to be user friendly, ensuring practices confidently prepare to meet the RACGP standards. We report back to you step by step, giving you the opportunity to make improvements along the way. “I was very happy with the modules – it allowed me to work slowly and consistently through the requirements and I felt supported at the same time.” When your Practice is ready, GPA ACCREDITATION plus will liaise with you to organise a survey visit conducted by experienced surveyors. “GPA ACCREDITATION plus surveyors were very helpful, which made everything run smoothly on the final stage of accreditation – there were no surprises!!” If that sounds different to the way you’ve been used to, call GPA ACCREDITATION plus and let’s get started. call us now on: 1800 188 088 or log on to: www.gpa.net.au
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AGPN calls for payments to individual GPs for PCEHR
Emerging Systems develops iPad, iPhone app for hospital use
General practitioners will require an individual incentive payment as well as practice-level incentives to encourage the uptake of the PCEHR, according to the Australian General Practice Network (AGPN).
Emerging Systems has developed a new iPad and iPhone app that will allow clinicians to both view and update patient details while on the move.
AGPN chair Emil Djakic said the time-based MBS items announced by Health Minister Tanya Plibersek were a “piecemeal approach to developing the PCEHR”.
Emerging Systems, which supplies the EHS clinical information system to St Vincent’s & Mater Health in Sydney and to public hospitals in South Australia, is trialling the new app with clinicians at St Vincent’s before a general release later this year.
Dr Djakic said the PCEHR was at a stage that will need a solid and rapid enrolment of patients, which would require a suite of incentives including a service incentive payment (SIP) to individual doctors as well as practice incentive payment (PIP), paid to practices to support the establishment of the necessary eHealth infrastructure. A spokeswoman for the Department of Health and Ageing (DoHA) said the department was in negotiations with stakeholders to consider an extension to the PIP program for eHealth. However, Dr Djakic said the “quantum of payment” is something that needs to be negotiated with the government. “The incentive is to get GPs proactive to enrol patients into the PCEHR system. We are raising the fundamental principle that the most effective way to do this is through a direct incentive to a patient’s GP.” While he has no rough figure on how much extra funding will be required, Dr Djakic said the AGPN would “need to see the goal posts first” and it was still up for discussion with the department. “Fundamentally, GPs will be the lynchpin for the PCEHR because general practice is the gateway to create a shared eHealth summary and the right blend of incentives will help to fast-track the effectiveness of the PCEHR,” he said.
Emerging’s commercial director Richard Hutchinson said the app was designed to give clinicians the ability to capture information and have ready access to it when they need it. “We created the app to be something that was highly usable for the clinicians, not only to view information, which is very important as obviously you want access to the right information for the right patient when you need it, but we also wanted it to be a tool for clinicians to interact such as creating clinical orders online if you want them,” he said. “The app has the ability to generate any kind of clinical order, be it pathology or radiology, and we can make that happen straight away. Conversely, as you can order things you can also get the results back. You can get them in number
or tabular format and you can see lab results over time. Obviously anything abnormal is highlighted in red and we can graph those same results over time in numbers and in graph format.” The app will allow users to instantly view a snapshot of the patient’s clinical details, enabling a quick care review. It also includes functionality to input patient observation data, view patient lists, view medication and allergies, and create and view progress notes and clinical messages using text or voice recognition. While it is mainly doctors who have taken to the iPad with enthusiasm, Mr Hutchinson said the app had been designed with nurses and allied health professionals in mind. “Nurses and allied health professionals are the people who are very interested in carrying something with them to tick off their care guides and pathways,” he said. “They also want to sit down with and involve patients in their care. This app allows for undertaking risk assessments as well as recording a range of observations such as vital signs.” Any new data uploaded to the app is immediately synchronised with the
patient’s EMR, he said. The EHS clinical information system is web-based and can be accessed from work stations around the hospital. The same database is underpinning this app, so any information generated through it will be fed immediately back into the database. The app will also allow consultant physicians, particularly those in private hospitals, to record their progress notes whenever they like. “This will take the information outside the four walls of the hospital,” Mr Hutchinson said. “Clearly there are security implications and we are very much aware of those, and we are building security features into the application, but the doctors, particularly in the private hospital setting, spend little of their time actually in the hospital. This is about giving them access to their patient information wherever they are.” Emerging Systems has also taken advantage of the increasing reliability of voice recognition software and has added a voice to text function to allow users to create and view progress notes and clinical messages using text or voice recognition. Voice recognition software specialist Nuance
Communications has provided Emerging Systems with its specialist medical dictionary and online voice dictation systems. “We have the ability to generate a progress note or a clinical message and we can compose it and it brings up a keyboard, so they can go to the trouble of typing if they so wish, and if they have a Bluetooth keyboard attached to their iPad that would make it a bit easier,” Mr Hutchinson said. “But there is also a little red button at the top of the keyboard where you say what you need to say, it goes away and brings back hopefully most of what you’ve said. You have the ability to edit that and do what you need to do.” The app also allows users to send clinical messages
and to view information generated by diagnostic and medical devices such as ECGs. “We’ve done some work with Welch Allyn and we can actually take a feed automatically from those sorts of devices straight into our system now, so in that case the iPad would just be a viewer of our information without you having to record it,” he said. “We are also trying to take on board what the Australian Commission on Safety and Quality in Health Care [recommends] about noticing the deteriorating patient and doing something about it quickly. We’ve got this concept within our system of setting up parameters and if something falls outside parameters with the patient, we can automatically generate alerts and messages.
“Within our main app we can automate alerts to a number of places so it’s not just the treating physician, maybe it’s a care team be they doctors or nurses.” Mr Hutchinson said new Apple-based developments were expanding the use of iPads and iPhones for clinical applications, including a docking station he saw at HIMSS in Las Vegas in February that can hold and recharge up to 30 iPads at a time. Emerging Systems is also exploring the use of a heavy-duty case to protect the delicate iPad device when dropped. Emerging Systems is currently in beta testing of the app with clinicians at St Vincent’s Hospital in Sydney before a general release. Mr Hutchinson said he expected this would take three to six months.
Australia joins Facebook organ donation community Facebook has added Australia to its list of countries that enable users to designate themselves organ donors as part of its push to spread the word about organ donation internationally. Facebook users in the US, UK, the Netherlands and Australia can indicate they are a registered organ and tissue donor on their Facebook Timeline by clicking on “Life Event”, selecting “Health and Wellness” and choosing “organ donor”. Ticking the organ donor box does not sign users up to official organ donation registers but provides a direct link to Australia’s Organ Donor Register at www.donatelife.gov.au. Parliamentary Secretary for Health and Ageing Catherine King said the function would allow Australians to start a conversation about their wish to become an organ and tissue donor. “Australians can now indicate that they have registered as an organ and tissue donor on their Facebook Timeline,” Ms King said. “This information will appear in the news feeds of their Facebook friends which can help to start a conversation about their organ and tissue donation wishes.” Facebook is an important tool for increasing awareness of organ and tissue donation, with the DonateLife Facebook page now having close to 50,000 fans, she said. “The Facebook Timeline does not replace the need for Australians to register their decision to become an organ and tissue donor on the Australian Organ Donor Register (AODR), Australia’s only nationally recognised register for organ and tissue donation for transplantation.”
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NEHTA tells inquiry that PCEHR data will be safe The National E-Health Transition Authority (NEHTA) has moved to allay fears over the security of the PCEHR system and who has access to personal health information. Addressing the joint select committee on cybersafety for senior Australians in Sydney recently, NEHTA’s head of architecture David Bunker said that in the design and development of its eHealth systems, NEHTA had implement risk controls to safeguard both services and those who will be using them. Mr Bunker told the committee that NEHTA had developed a National eHealth Security and Access Framework (NeSAF) to support both public and private organisations in national eHealth. “The framework encourages business to adopt a consistent approach to the application of health information security standards and provides better practice guidance in relation to eHealth-specific security and access practices,” he said. “The PCEHR system will also support the receipt, tracking, management and escalation of enquiries and complaints.” NEHTA national clinical lead Mukesh Haikerwal said the PCEHR would be more secure than the current process, in which paper and electronic health records are typically unsecured. “Where we are going is from an ad hoc world to a much more coordinated world where we’ve got information flow at the right time, not when it happens to turn up,” Dr Haikerwal said. Mr Bunker described the encryption and digital signature elements of the PCEHR and said there were technology options available to manage intrusion detection so that inappropriate interactions were monitored.
Intrahealth goes native for Apple iOS devices Medical software vendor Intrahealth has released an iPhone and iPad application for Profile, the company’s integrated practice management system. The new version of Profile is a ‘native’ app, designed specifically for the Apple’s iOS mobile device operating system, Intrahealth’s area manager for Australia, Karam Kanan, said. “It basically means that it follows the look and feel of the operating system that it runs on,” Mr Kanan said. The app, available to download for Profile users from the iTunes app store, allows clinicians on the move to remotely access their patients’ details, update them, allowing for real-time synchronisation when using 3G or WiFi.
“It can do it live-time over 3G and WiFi and when it disconnects for whatever reason it starts storing everything locally,” Mr Kanan said. “Then when it is ready to go back online it synchronises everything [with the server].”
appointments to be loaded along with the associated patient reference data; and tasks view, which allows tasks to be downloaded and categorised and have their status updated on the go. New tasks can be created, even when offline.
The app also enables users to create files or notes for patients. It is aimed at doctors who travel to see patients — such as GPs visiting nursing homes — but also at specialists working remotely in hospitals, community nurses, allied health professionals, disability services and in-home care.
Mr Kanan said the app allowed users to upload information by patient or groups of patients rather than the whole database. “You can have static groups that you can enter manually or dynamic groups, which are based on anyone with diabetes or anyone over the age of 25 for example,” he said.
The app includes a patient view which includes the patient’s notes, measures, results and custom HTML views. There is also an appointments view, allowing
“Or, which is what our users will likely be doing, is you load the patients based on their appointments in the period that you are going to be mobile. So you
choose today plus or minus seven days, for example, and it will load all of those appointments for you and all of the patients details associated with that.” Mr Kanan believes this is one of the first native iPad apps for clinical software in the Australian and New Zealand markets. “What we would normally do beforehand and what others
are likely to do is use a remote access app for the iPad, but what you get is the full desktop interface. The main thing here is that it is touch‑optimised and when you are mobile, you can take things off-line and online as well. We already have an online version of our software where you take the entire database with you but ... this is going to be faster.”
The developers have included extra security measures, including password protection and securing the transmission of data between the mobile device and the server through encryption. “And with Apple devices you have the ability to track and to remotely wipe or lock your device, should you need to,” Mr Kanan said.
Telehealth funds released for aged, palliative and cancer care The federal government has issued an invitation to apply for funding for its new $20 million NBN-Enabled Telehealth Pilots program. The program is open to practitioners who have already received a telehealth incentive payment. It is jointly sponsored by the Department of Health and Ageing (DoHA) and the Department of Broadband, Communications and the Digital Economy (DBCDE) but will be administered by the Health Department. In a joint statement, the Minister for Health, Tanya Plibersek, and the Minister for Broadband and Communications, Stephen Conroy, said the program was designed to promote telehealth in NBN-enabled areas with a specific emphasis on aged, palliative and cancer care.
Senator Conroy said the delivery of high quality health care direct to the home via NBN-enabled telehealth services will make a real difference to the lives of Australians with high healthcare needs, particularly those living in regional, rural, remote and outer metropolitan areas. “The program also aims to provide coaching and healthy living support in the home to improve overall health outcomes for older Australians or those living with serious illness,” he said. The funding will commence in July 2012 and conclude in June 2014. In its guidelines to applicants, the government said it expected the amount of funding provided for individual pilots will generally be around $1 million to $3 million.
“Higher levels of funding may be available for pilot projects that are able to demonstrate exceptional prospective benefits,” the guidelines state. Funding can be used for a number of capital and infrastructure purposes, including equipment such as telehealth monitoring equipment, tablet devices or computers; service delivery; cost of access to broadband internet services; staffing and on-costs, including training for healthcare practitioners and patients; and administrative costs. Funding can also be used for the initial establishment of secure networks, licensing software and patient internet access where it has not previously been funded or does not already exist in the practice. Successful projects will be announced in June.
Stat Health adds eRX, new graphics in upgrade Medical software vendor Stat Health has added electronic prescribing functionality through eRx to its Stat clinical software program. As part of its version 2.3 upgrade, Stat Health has also added new data reporting functionality and new custom designed clinical graphic templates. The data reporting tool will allow users to interrogate clinical data more fully than they have been able to in the past, Stat Health CEO Carla Doolan said. Users will have access to the entire administrative database, the MIMS drug database, the ICPC-2 PLUS coding system, vaccination register and coded pathology results, she said. This allows Stat to identify patient groups based on categories including demographics, conditions, medications, vaccinations, measurements such as height/weight and blood pressure and other clinical information. “The new graphic templates facility will allow users to make comments and various markings on clinical documents and imported photographs,” she said. “The image then becomes part of the clinical consultation note. Stat has its own internal, clinically oriented, drawing package which allows quick and easy manipulation of the images.” Beta testing of version 2.3 was finalised in late April and upgrades were roll out to the client base that week, she said. The company has also launched new Facebook and Twitter pages with regular updates for users. Later this year, Stat Health will partner with SMS Central to provide SMS functionality for appointments.
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Motion adds dual-input display to top tablet Motion Computing has upgraded its topselling F5v tablet PC, adding combined touch and digitiser pen functionality among other features. The new model enables clinicians to use both two-finger touch and pen capability, which Motion’s country manager for Australia and New Zealand, Brett Gross, said was important for clinicians who need to flick through charts at the point of care but also need a stylus for signatures and hand-written data. The upgrade also includes an enhanced MIFARE Classic RFID reader and integrated barcode scanner, along with improved Gobi connectivity. Mr Gross said the tablet was designed for professionals on the go in particular environments, including hospitals and clinics as well as ambulances and community-based care. “It has been designed for walking while working and delivering at the point of care,” Mr Gross said. “The F5v is particularly good for nurses in the hospital environment as it is very hardy and rugged and has been coated in a polymer that means disinfection is easy with common disinfectant wipes. “The screen is made from Gorilla Glass so they can be dropped or knocked around and won’t be damaged. They also have a hot-swap battery function that means you can swap in a charged battery without having to turn the device off.” Mr Gross said the company’s ReadyDock lightweight cabinet was a popular choice for storing and charging the tablets, particularly in nurses’ stations where space is at a premium. The cabinet can store and charge up to 20 tablets at a time, he said.
DCA acquires Communicare, readies for secure delivery of CDA Database Consultants Australia (DCA) has bought WA-based software vendor Communicare, adding the Aboriginal healthcare software specialist to its growing list of assets. DCA, which two years ago bought the Argus secure message exchange software, also owns TCM, a software package that supports community-based service delivery to the aged care, disability and mental health sectors, as well as Connectingcare, a secure messaging service that also includes a web-based directory of health and community services. Communicare will become part of the DCA group and there will be no change to staff or services to existing clients in the short-term, Communicare’s director, Kerry Dunstan, said. Ms Dunstan and her husband Brian, who established Communicare 18 years ago, will remain with the company. “Being part of a larger and better resourced company will afford exciting opportunity for growth and development in both the product and services we can offer existing and new clients,” she said. “We are very much looking forward to joining forces with DCA to maintain and enhance Communicare’s position
as the leader in Aboriginal health-specific eHealth software.” DCA’s executive general manager for health and community services, Peter Young, said the acquisition “will provide further opportunities for future development using the sharing of skills and technology, and provide a support base on both the east and west coast”.
“These standards will enable health records to be securely shared, and empower healthcare providers with information to improve the quality and timeliness of care.” “DCA has about 150 staff and a wider range of technology,” Mr Young said. “Communicare already interfaces to Argus and Connectingcare using the SMD standard.” The two companies have been working together on the Northern Territory’s continuity of care project, which recently
demonstrated the live use of the recently gazetted SMD standard and clinical document architecture (CDA) at the Ampilatwatja Health Service in Alice Springs. The health service will receive secure discharge summaries from Northern Territory hospitals, and will be able to store and retrieve documents from the shared electronic health record operated by the NT Department of Health. Mr Young said both DCA and Communicare were committed to the adoption of standards such as the SMD specification, the use of CDA and support for the evolution of the PCEHR. He said the DCA messaging products used by Communicare and other software applications had passed the National E-Health Transition Authority’s (NEHTA) Conformance, Compliance and Accreditation (CCA) program for secure messaging. “These standards will enable health records to be securely shared, and empower healthcare providers with information to improve the quality and timeliness of care,” he said. DCA’s CEO, Declan Ryan, said the acquisition was a strong strategic fit.
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Zedmed launches online learning for AAPM members Zedmed has launched online learning modules on the Australian Association of Practice Managers (AAPM) website to allow members to keep up with changes in healthcare management. Short previews of the three practice management essentials modules are also available on Zedmed’s website. They include clinical results and reporting, an office module on reporting, recalls and security, and an insurance module. MLC has sponsored this module and has provided the insurance content to help educate practice managers on the importance of medical information in assessing life, critical illness, total and permanent disability and income protection insurance. Online learning is aimed at helping AAPM members to access a range of education programs that they can complete at their own pace and in the convenience of their office or home. On satisfactory completion of each Zedmed module, members will receive one continuing professional development (CPD) point. “The inclusion of the online learning area on the AAPM website will be a valuable complement to the professional development events provided by AAPM state branches and nationally,” AAPM national president Brett McPherson said. “We are confident our members will find the Zedmed modules informative and will assist with educating them on a range of management areas including the recent advancements in the eHealth area.” Zedmed general manager Grant Williamson said the company was delighted with the three modules and he was glad that Zedmed could support AAPM members with their professional development.
Wireless SimMan 3G gives vocal response to nursing students The University of Technology, Sydney, has opened a new clinical laboratory facility for nursing and midwifery students, complete with a third-generation wireless SimMan computercontrolled mannequin.
despite requiring a whole day to install, was incredibly clever.
UTS has invested in several versions of the popular SimMan products over the years, including a number of advanced life support (ALS) simulators.
“It includes RFID tags so whatever you do, it automatically goes on to the log,” Ms Kelly said. “3G also has responsive pupils, blinks, has chest rise and fall, can bleed and sweat as well as many other advanced features. Key to student interaction is real time vocal responses from 3G – via the instructor.”
The tetherless SimMan 3G includes a host of new applications, including a wireless instructor and patient monitors that enable users to observe the mannequin’s vital signs.
The company behind SimMan, Laerdal, recently launched its new SimPad interactive handheld touchscreen product, which enables simulations to be run easily and effectively.
UTS’s director of simulation and technologies, Michelle Kelly, said SimMan 3G,
UTS has not yet upgraded to SimPad but is using Laerdal’s VitalSim vital
signs simulator controller, which dictates ECGs, heart sounds, fetal heart sounds, breath sounds, bowel sounds, blood pressure and pulses from the mannequin. Ms Kelly said the new facility, built to fit an extisting space, has the best technology available, including new audio visual equipment and a management system to record and play back simulation scenarios for debriefing and selfassessment. “It has a control room with one way glass that straddles two teaching labs, equipped with the audio visual management system from B-Line Medical,” Ms Kelly said. B-Line’s system is completely web-based and has a data recording engine that can read, store and report on data in real or delayed time from any computer. Some information can be accessed by students, while other levels can be controlled by academics and managers. Ms Kelly said that in future UTS would look at purchasing the SimJunior for paediatrics and the SimMom, a new full body birthing model that is much more realistic than current birthing mannequins.
Wave sites start consumer registration for eHealth Network Consumers have begun registering for eHealth services through the eHealth Network, established by the three Wave 1 sites and one Wave 2 site for the implementation of the PCEHR. The network and the website were launched earlier this year by the four sites – Metro North Brisbane Medicare Local, Accoras, Hunter Urban Medicare Local and Inner East Melbourne Medicare Local. These groups have set up local eHealth networks in Brisbane North & Moreton Bay, Brisbane South & Ipswich, the Hunter and Melbourne East respectively. A spokeswoman for the National E-Health Transition Authority (NEHTA) said the purpose of the network and website was to provide and promote a ‘local community’ of eHealth in each of the project areas. “The sites have been contracted to test key health information exchanges between healthcare providers, build stakeholder support and momentum in eHealth and deploy and test national eHealth infrastructure and standards in real world healthcare settings,” the spokeswoman said.
The website states that the kind of data that can be stored on the network includes health summaries, discharge summaries and referrals and consultants’ reports.
“There is no direct funding agreement with HIE under the Wave 1 or Wave 2 contracts from [the Department of Health and Ageing (DoHA)] or NEHTA,” the spokeswoman said.
Samples of network records and shared health summaries can be downloaded from the website.
Consumers who sign up to the eHealth Network are signing up to that network only, and the information can not be shared with the PCEHR, she said.
She said consumer registration began in March and in the first two weeks, approximately 1000 consumers signed consent forms to participate, with the first registrations from in the Hunter Urban Medicare Local site. “The four funded sites are developing shared consumer information and collateral in promoting the eHealth Network and its services and this is the banner so to speak under which they are promoting it.” The website has been created and its call centre manned by Health Industry Exchange (HIE), which is sub-contracted by the sites to develop shared services. These services include operating the local electronic health record store, designing and running technical solutions used by all of the sites and running the registration services and support components of the projects.
“Healthcare information that consumers have consented to be shared for these projects can only be done so under the terms and conditions that exist for the eHealth Network.” “It is not possible to migrate this information into the national PCEHR as consumers have not consented to this in the terms and conditions that they have agreed to.” She said if consumers wish to participate in the national PCEHR, they will need to register to participate in a separate process to the one being used by the eHealth Network. The network is only available to consumers and providers within the catchment areas of the sites. The spokeswoman said the project would provide valuable lessons learnt into the process of a national registration program for the PCEHR.
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AAPM names new CEO, adds eHealth roadshow dates The Australian Association of Practice Managers (AAPM) has appointed Gillian Leach as its new CEO, taking over from Dean Barton-Smith. Ms Leach has extensive experience in health service management, her previous role being CEO of Whitehorse Community Health Service in Melbourne. She is also a former CEO of Arthritis South Australia and executive director of Osteoarthritis Australia. She has also been involved at director level with the Australian Institute of Management, the NHMRC injury research committee, the SA government management board and Women Chiefs of Enterprise International. She is a fellow of the AIM and the Australian Institute of Company Directors and a member of the Victorian Health Advisory committee. The AAPM has also added new dates to its national eHealth Roadshow, taking in a number of regional centres as well as capital cities. Delivered by AAPM members Marina Fulcher and Jan Chaffey, the roadshows focus on understanding the foundations of the national eHealth system as well as the PCEHR. Topics covered include the eHealth solutions and how they will work in your practice; how the Healthcare Identifier (HI) Service integrates with your existing medical software; how to register your practice with the HI Service; and more about the PCEHR and how it will affect practice managers. The association has also announced it will present its inaugural National Practice Manager of the Year Award at its national conference in Brisbane in October. State branches of the association already hold practice managers of the year awards, the winners of which will progress automatically into the national selection.
Experts call for national eHealth safety enforcer Australia needs an independent oversight body to ensure the safety of complex eHealth systems like the PCEHR to minimise risks to patients, industry experts claim. In an editorial in the Medical Journal of Australia, Enrico Coiera, director of the Centre for Health Informatics at the Australian Institute of Health Innovation, Michael Kidd, executive dean of the Faculty of Health Sciences at Flinders University, and Mukesh Haikerwal, professor of medicine at Flinders University and NEHTA national clinical lead, have called for a national body to be established independent of government and industry to investigate and act upon significant risks in the eHealth system.
whether the PCEHR is safe or not,” the researchers write. “There is no guarantee that harm events will be rapidly identified or remediated when it is in operation. It is not even clear what safety means for such a system.
to patient harm or death through problems in design or operation. “Chances of harm increase with known risk factors such as poorly designed software or its implementation, including rapid deployment, and poor training and support.
“Even if short-term performance of the new national system turns out to be safe and effective, the international experience suggests that risks will emerge with time. Preventive action to avoid an ehealth “air crash” now is a far better option than picking up the pieces after the event.”
Clinical safety risk governance is beyond the remit of organisations such as NEHTA and the Therapeutic Goods Administration, they write, and while the Australian Commission on Safety and Quality in Health Care does have an interest in the safety of clinical decisionsupport software, it has no regulatory mandate.
They argue that while eHealth can bring rapid benefits to patient care, it can also sometimes lead
They warn that complex systems like the PCEHR pose a particular challenge.
The researchers write that while they have previously argued for regulation of clinical software, they are also now calling for a national clinical safety governance system for eHealth. They warn of the particular risks posed by national-scale systems like the PCEHR. “While we know something about the risks associated with clinical desktop systems, it is not yet possible to make any definitive statement about
Professor Enrico Coiera
“Our capacity to predict outcomes is also hindered because these systems will be used by both clinicians and consumers. “Given the systemic nature of national e-health, harm events will not be confined to individuals and
may affect large groups of patients. What would a patient safety incident look like after the launch of the PCEHR? What would happen, for example, if drug allergies were incorrectly uploaded from local clinical systems, or if medication names and doses were
somehow incorrectly imported and displayed?
NPS updates online medicines brand finder
“Most such informational errors lead to no harm or are picked up by system ‘defences’, such as clinician vigilance. At some point, however, patient harm will occur.”
The NPS online Medicine Name Finder has been updated with a new feature to help consumers make choices between medicine brands.
Orion Health prepares Rhapsody 5 for connections to the PCEHR
Designed to help people find important information about their prescription medicines, the tool has a quick and easy-to-use interface where users can type in the name of their medicine to find out more about the active ingredient and brands available, plus a link to the consumer medicine information leaflet.
Orion Health has released version 5 of its Rhapsody integration engine, which includes new standards to support connections to the PCEHR.
New Zealand International Business Awards, is the key software vendor in the national infrastructure partner consortium building the PCEHR.
This new feature enables users to type in either the active ingredient or brand name of their medicine and, after selecting their prescribed dose, view a list of bioequivalent brands which they may be offered at the pharmacy.
Additions to v5 include native clinical document architecture (CDA) support including translation to and from HL7 2.x, and IHE cross-enterprise document sharing (XDS.b) support, which is required for document exchange to the national PCEHR infrastructure.
Orion Health said major enhancements in version 5 include a new monitoring system that provides highly flexible and intelligent monitoring capabilities, giving administrators awareness and control of their connected network.
Orion Health is currently awaiting its certificate of compliance under the National E-Health Transition Authority’s (NEHTA) Compliance, Conformance and Accreditation (CCA) program, but has already added the ability to search the Healthcare Identifiers Service. Auckland-based Orion, which recently won the supreme award at the 2012
It also features improved personalised notification options that give anywhere/ anytime access to network information, scheduling tools to ensure important updates are received by the right person at the right time, and real-time activity streams, which let users see instantly what is currently occurring with each component, along with an information-rich view of historical activity. Orion said of the 120 new improvements to this
version of Rhapsody, other notable features include Lightweight Directory Access Protocol (LDAP) integration for unified user login, streamlined message searching for faster troubleshooting, and fully internationalised translatable monitoring interface and event logs. Orion Health CEO Ian McCrae said integration engines such as Rhapsody will allow organisations to easily connect to the PCEHR. “Over time the PCEHR will provide many benefits for both healthcare providers and consumers,” Mr McCrae said. “We look forward to working with organisations not only to contribute to the PCEHR, but also to allow them to easily view records in their clinical workflow. The national infrastructure go-live represents the beginning of this exciting journey.”
CEO of NPS Lynn Weekes said the new feature will help consumers identify the different brands available for their medicine, helping them to make a safe and confident choice. “When the active ingredient of a medicine comes off patent, the number of available brands can quickly increase,” Dr Weekes said. “Using the Medicine Name Finder, people can quickly see a list of the different brands available to so they can be sure they are taking the right medicine and avoid confusion.” She said that with the patent for cholesterol-lowering drug Lipitor expiring recently, it’s likely many people will be offered a different brand of medicine than the one they were originally prescribed, and may have been taking for some time. The data about medicines supporting the online tool is provided by DOHA and will be updated monthly. The tool does not cover over-the-counter, natural, herbal or complementary medicines, or medicines that are not listed on the PBS.
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ICT skills shortage threatens economic growth: ACS The value and continued growth of Australia’s digital economy is threatened by an acute shortage of skilled ICT workers, according to the Australian Computer Society (ACS). ACS CEO Alan Patterson told an industry conference recently that a number of issues currently facing ICT in Australia have the potential to hinder the development of the digital economy, and the eHealth sector was not immune. These include declining ICT university enrolments, a drop in skilled migration, an ageing workforce, and community misconceptions about the opportunities and rewards associated with an ICT career. Mr Patterson said acute ICT skill shortages exist at a regional, industrial and occupational level, including in the eHealth and health ICT sector. “eHealth initiatives represent the rapid pace of technological change and the growing role of ICT as an enabling platform for other industries,” he said. “There is a need to foster workforce capacity and education to better utilise eHealth solutions. Demand forecasts suggest 14,000 ICT jobs will be generated in 2012 (across all areas), and an additional 21,000 jobs through 2013. “Emerging technologies in the eHealth space will further drive demand for specialised ICT skills. ICT is critical to the eHealth sector as well as the Australian economy, and skills issues need national coordination and urgent policy focus.” ACS statistical research shows that university enrolments in ICT are currently less than half of what they were a decade ago and there was also a pronounced decline in the vocational education and training sector.
New Zealand expands MedChart medication management roll out Funding has been secured to roll out CSC’s MedChart medications management system to more beds at Dunedin Hospital in New Zealand.
CSC has also announced that a fourth National Health Service (NHS) trust in the UK has signed up to MedChart, known in the UK as ePMA.
The hospital conducted a trial of MedChart in late 2010 under the auspices of the NZ National eMedicines Program.
Harrowgate NHS Trust joins Pennine Acute, Stockport and Leicester NHS trusts to install the system.
The new funding will extend the roll out of the software to a further 120 beds at Dunedin Hospital, with plans to roll it out across Southern District Health Board (SDHB).
The 367-bed trust is ready to go live for clinical use after being integrated with the trust’s existing IT infrastructure, including patient administration system (PAS), laboratory and eDischarge systems.
It is part of NZ’s plan to have all public hospitals in the country participating in the national electronic medication management (eMM) program this year.
A CSC spokesperson said eMM is gathering momentum in the UK, with hospitals increasingly seeing ePrescribing as an essential tool.
The plan has necessitated a change to legislation governing medications in NZ, with a new bill introduced to Parliament in late February to amend the Medicines Act 1981, which required a handwritten signature on all prescriptions.
“The trend is likely to continue with a growing
The new legislation will take into account electronic signatures, as well as extending restricted prescribing status to nurse practitioners and optometrists, similar to that covering doctors, veterinarians and midwives.
body of evidence indicating the effectiveness of electronic medication management,” the spokesperson said. “One such example is new research from Professor Johanna Westbrook of the University of New South Wales. The researchers found significant decreases in medication error when ePrescribing systems were used.” MedChart was one of two solutions evaluated during the study. Wards using MedChart experienced a 57.5 per cent reduction in prescribing errors, harmful errors were reduced by an impressive 44 per cent. CSC’s managing director for the Asia Pacific region, James Rice, said research suggested that electronic medication management is
the most, possibly the only, effective intervention to reduce medication error. “We’ve known for a long time that medication error is one of the greatest causes of harm, waste and cost.Now we also know
that electronic medication management solutions can significantly improve medication safety for better and less expensive care.” In Australia, MedChart has been used at St Vincent’s Hospital in Sydney since
2004, with Macquarie University Hospital implementing it in 2010 and the Little Company of Mary Health Care (LCMHC) installing it at Melbourne’s Calvary Healthcare Bethlehem in November last year.
MedTech launches 32 update, Master training portal Clinical software vendor Medtech Global has released a new version of its Medtech32 practice management system and launched an online training portal called Medtech Master. Medtech Global’s chief technology officer, Rama Kumble, said Version 8.1.0 has a number of enhancements, including the integration of the Healthcare Identifier Service to allow for the querying of a patient’s individual healthcare identifier (IHI) with the touch of a button. Medtech Global successfully completed NEHTA’s CCA program in November last year and has implemented the HI Service functionality in the systems used by the GP Access after-hours service run by the Hunter Urban Medicare Local, which uses Medtech32. Mr Kumble said he didn’t expect users to
begin searching for IHIs individually but would take the bulk loading approach. “After the bulk upload, when most of [the IHIs] do exist in the system, doctors will start getting used to that. They just have to push a button and it will automatically upload, verify and obtain the IHI.” The new release also includes a new filters on the Inbox and a Query Builder function, which allows front and back office staff as well as clinicians to search for a variety of items on the database in an easy and user-friendly way, Mr Kumble said. “For example, to check a patient who is cardiovascular but on bronchodilators, they can search for that,” he said. “And once they pick up that list they can action it – send out a set of letters or put them on recall lists. There is a whole heap of data in their systems but they are very busy and they just want
to filter certain things. They know what they are looking for.” Medtech Global has also launched a new online training portal called Medtech Master to allow users to undertake training on selected aspects of the software when it is most convenient. Medtech Master includes a number of short videos that also come with text to speech. “Help files are usually meant to ‘tell me how to do this’, whereas this one is ‘show me how to do this’, Mr Kumble said. He said the new portal would add a third option for users requiring training, the others being traditional face to face training in a classroom and the regular webinars it runs on special topics. “We get a lot of calls to the help desk asking how do you do this, so with Medtech Master, they can have a go at it themselves.”
High Performance High Definition and High Reliability The new POC-W211 wide-screen Point-of-Care terminal is designed to meet the growing need for high performance computing in space restrictive medical environments. The medical-grade POC-W211 displays crystal clear, high-definition images on its 21.5” resistive touch display plus with Advantech’s SUSIAccess, provides remote management and control making it ideal for sterile or clean room applications. This high performance, fanless terminal is designed for image intense medical applications in operating theatres, bedside, nursing stations, or other point-of-care locations within the hospital or clinic.
POC-W211 • Intel® Core™ i7 2655-LE 2.2 GHz with up to 16GB DDR3 SDRAM • Optional Bluetooth, RFID, Blu-ray RW, WLAN and Li-ion battery pack • IPX1 water resistant enclosure with additional IP65 dust-tight front panel • Medical Grade - UL60601-1/ EN60601-1 3rd edition compliant
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Bits & Bytes
Leecare takes out top award at ITAC conference Aged care software specialist Leecare Solutions was named ICT company of the year at the Information Technology in Aged Care (ITAC) conference in Melbourne late last week. Leecare, which launched its web browser-based, open standards Platinum 5.0 clinical and care management software in December 2010, produced its first electronic care planning system in 1997, followed by a complete care management software program called leetotalcare in 2002. It upgraded leetotalcare to an enterprise level MSSQL/C#.net system in 2005 and created leecareplus in 2006 by adding an interface to all four aged care accreditation standards.
The new platform also includes a complete care management software program along with quite a few extras, Leecare’s founder and CEO, Caroline Lee, said. “Platinum 5.0 is a whole clinical, lifestyle and management package. We have incorporated all of the HR, the continuous improvement, hazards and incidents, maintenance and supplier management and education [requirements]. “Effectively, in an aged care space, it is all of the aged care accreditation and community care standards. It also has all of the ISO standards in relation to managing an organisation and a person’s healthcare.” Platinum 5.0 is interoperable with medical and proprietary medication management programs
and finance packages. It uses a technology called IntelligentDesign that enables the software to be used on any browser, device or platform. IntelligentDesign is a world-first in aged care, Dr Lee said, as it contains open source technology to allow users the choice of operating in either Microsoft or non-Microsoft environments. It has also been designed to support touchscreen devices such as Androids and iPads. “Because it is web browser-based and we have developed it so it fits and works within all browser types, it doesn’t matter whether it is a mobile phone device, iPad or an Android device. Some clients have iPads, some of them have Toshibas,
Motorolas, Samsung Androids – the whole gamut. You have to have that point of care device so you are not wandering back and forth to the nurses’ station.”
up, monitoring service functionality 24 hours a day, making sure that back-ups are retrievable, they can instead licence the appliance on a monthly fee,” Dr Lee said.
Leecare also offers a number of hosting solutions for Platinum, important to all aged care providers who are looking to reduce costs. It can be fully installed on the client server network or it can be hosted in Leecare’s or the NEC cloud, which was set up to give smaller aged care providers access to a range of agedcare specific software.
“That gives them all of the support and the back-up. They can do it on a cloud, they can have it installed on their internal network or they can contra-licence our appliance and then they don’t have to worry about managing a server.
The company has designed a pre-installed and preconfigured appliance that acts as a Leecare server. “If organisations don’t have sufficient access to the internet or experience with managing a server, which obviously includes managing their back-
“The whole point of this was to completely reduce everybody’s total cost of ownership by ensuring they had affordable software – with no requirement to pay for additional operating system licenses or client access licences (CALs) if they didn’t wish to. “It has been built using open standards, so aged care organisations can
Simavita's Philippa Lewis, ACAA CEO Rod Young and Leecare's Caroline Lee at the ITAC conference awards
select their operating system, installing the software in for example a Linux or Windows server – it’s their choice.” She said licensing fees have increased significantly, adding an even larger burden on struggling aged care providers. “Operating systems and client access licences and a whole range of costs have increased over the last couple of years, so this removes that cost from the equation.” Leecare’s solutions are installed in about 350 sites, some of which have already migrated from the previous platform to Platinum 5.0. The others will slowly migrate this year, she said. “This is an accreditation year for aged care so we are doing it slowly based on people’s coping mechanisms.” Dr Lee said the company would be adding more functionality this year, including connections to the PCEHR and the Healthcare Identifiers Service, which is part of the company’s roadmap for the next few months. “We have started development and we will have access to the HI Service and the PCEHR by 30 June. We’ve been working on that for a long time - this was all a forerunner to making sure that that would be possible as well.”
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Bits & Bytes
ACHI criticises lack of PCEHR technical regulation rules The Australasian College of Health Informatics (ACHI) has criticised the exclusion of rules and regulations covering the technical design and operational control of the PCEHR from a consultation paper released by the Department of Health and Ageing (DoHA) in March. In its response to the paper outlining the proposed rules and regulations for the PCEHR, ACHI called for more time for consultation before the legislation underpinning the system is debated in the Senate this month. The legislation has passed the House of Representatives and a majority Senate community affairs committee recommended it be passed. The ACHI said the exclusion of any rules or regulations relating to the technical design or administrative operations of the system was a “significant omission”. “There will be no independent review of the terms and conditions to participate, which will be at the sole discretion of the system operator (DoHA),” it said. It also said it was disappointing that the proposed rules paper “does not include the actual drafts of the proposed regulations and rules rather than simply providing commentary on the drafting intentions”. The college has made 13 recommendations, including that the regulations and rules involve some mechanism to provide medico-legal protection. It criticised the “very limited information” provided on the rules governing the operations of repository operators, portal providers and contracted service providers and said the proposed rules conflated security provisions with privacy, saying these were two separate concepts in information technology.
Charm Health gets ready to launch CHI Health informatics specialist Charm Health is working on the final stages of its new CHI platform, which was recently selected as the preferred solution for the Chris O’Brien Lifehouse at the Royal Prince Alfred Hospital in Sydney. Charm Health CEO Janine Garrett said the company had been working on the new platform for some years and had incorporated developments such as the Microsoft Health Common User Interface (MSCUI) and its .Net framework for better user experience. CHI (pronounced ‘chee’) will include an electronic medical record (CHI eMR), a medications management module (CHI eMM), a patient administration system (CHI PAS) and enterprise scheduling. At the Lifehouse — a new collaborative cancer treatment and research centre based at RPA Hospital — the system will be known as the Lifehouse Oncology Information Solution, or LOIS. CHI is a different product from Charm Health’s current platform CHARM, first developed by Ms Garrett, a pharmacist with a master’s degree in IT, in 2003. The original platform focused on cancer management for doctors prescribing cancer medications,
pharmacists managing the chemotherapy drug orders and also includes an enterprise scheduling module to assist scheduling of patient treatments. CHARM was installed at Queensland’s Mater Health in 2005 and at the Peter MacCallum Cancer Centre in 2008. Charm also has a state-wide contract with Queensland Health and is used in the ACT and at Cabrini Health. The Chris O’Brien Lifehouse at the RPA, named after the late cancer specialist, is Charm’s first customer for the new CHI platform, with clinicians involved in its design from the outset, Ms Garrett said. “Our platform is browser‑based and we are building a system that is very focused on specific functionality tailored to each of the system’s user roles,” she said. “As a doctor, when you jump on the system you just need to launch into your landing page and from there everything that you need to know to do your job is readily available. For nurses and pharmacists it is very similar. “Patients will be able to access the system via the patient portal and they will be able to share information with their GP, their parents or their children. We want
to make sure it goes way beyond just the walls of the Lifehouse.” The Chris O’Brien Lifehouse is a greenfield site, a new not-for-profit private hospital on the campus of the RPA hospital that is due to open in July next year. “Our vision is that it will be an integrated cancer centre supported by integrated electronic information,” Lifehouse CIO Anne-Marie Hadley said. “Initially we will transition ambulatory services from the Sydney Cancer Centre including radiation services. We will have a service level agreement with the Sydney Local Health District to provide ambulatory cancer services.” Inpatient services will begin in 2015, when the new centre will also open its 96 inpatient beds and seven of its 10 theatres, she said. Ms Garrett said LOIS includes four components, with the design in particular influenced by work done on standards by the National E-Health Transition Authority (NEHTA). “We are aligning our EMR with the PCEHR, and will extend on the clinical content model to include openEHR archetypes that are being developed by the international community,” she said.
“We have also incorporated NEHTA’s Australian Medicines Terminology (AMT) in its native format and our drug catalogue links with Australian content, making prescribing much faster and easier for these very complex medication orders that are the basis of chemotherapy treatment regimens.” The electronic medications management module is a “closed loop” system that captures very quickly and easily what the nurses need to do, she said. “We have focused on doing the really complex medicines first and have looked at some of the great work coming out of Sydney University
that has evaluated the effectiveness of existing systems currently in the marketplace in their ability to reduce medication‑related errors. “Whilst the results from one particular study show an impressive reduction in clerical errors, there was a 35 per cent increase in system design-related errors, which are our area of concern. We are very interested in the functionality and the design features we can incorporate in our system that will reduce these types of errors, such as those resulting from the mis‑selection of the wrong drug, route and dose.
“We have a patient management system which includes enterprise scheduling, waitlist management and billing and we are working with the Australian company Direct Control to seamlessly integrate it into LOIS. Whilst initially we planned on a third party theatre management solution, we are now working with the Lifehouse team to build the components into LOIS.” Ms Hadley said she was in a very fortunate position to be the CIO of a greenfield site. “It’s an enormous challenge, but very cool to be part of such an innovative program ... This is an opportunity to connect people and technology and you don’t get the opportunity very often to say ‘forget what you know; now here is the opportunity to develop a system that not only works for the cancer patient, but also empowers the staff’.” Ms Hadley said the selection of the LOIS vendor was long and protracted and her team had looked at a number of different clinical system vendors and embarked on a rigorous evaluation process. The decision was ultimately made by the end users of the system with Charm Health scoring highly on alignment with the Lifehouse vision, a future roadmap, Australian Standards based, useability and affordability.
LRS Health and Sysmex form trans-Tasman alliance Australian pathology management system provider LRS Health and New Zealand-based laboratory information system vendor Sysmex have formed a collaborative arrangement to allow each country to market their products across both countries. LRS Health’s products include the MediPATH lab management solution and the automatic hospital billing system MediBILL, which interfaces with Medicare. Sysmex markets the Delphic laboratory information system (LIS), the dominant player in the New Zealand market, as well as the Eclair clinical data repository. Sysmex product manager Noel Paggao said the alliance would allow both companies to expand their markets by leveraging each other’s strengths, as well as by integrating with each country’s different billing and blood bank systems. “In the pathology space, there is a fair degree of aggregation by public pathology providers so supporting that is the rationalisation of laboratory information systems into a single solution,” he said. Sysmex CEO James Webster said the agreement would be mutually beneficial for both companies. “We are excited to be working with LRS Health – they have a long-standing reputation in Australia, highly regarded products and strong knowledge of the local industry,” he said. LRS Health chief software architect Andrew Edgley said the agreement would provide his company with the benefits of working with a larger, global organisation. “Our current customers and future customers will benefit from more flexibility, continuity of service and local customer support, plus the advantage of being able to leverage the combined skill and experience from both companies.”
Bits & Bytes
Bizcaps updates software for healthcare tenders Software developer Bizcaps has released a complete revision of its entire business platform and has announced additional enhancements due later this year. The company, which provides among other products software to assist suppliers and users of the National Product Catalogue, has updated its master data management (MDM) and business process management (BPM) software. Bizcaps is a supplier of software that helps create, maintain and synchronise product data through the national GS1net and NPC datapools. It also provides complementary software for state health departments. The new release will offer an enhanced user interface and more seamless interactivity with back-end systems such as SAP and Oracle, allowing customers to install Bizcaps as a friendly front-end to existing systems, Bizcaps’ development director, Bill Blinco, said. He said healthcare MDM clients will gain access to a tender submission workflow process template, allowing them to more easily respond to state health department tenders. “Our new business process design tool, FlowScribe, [allows] users to construct workflows that move dynamically to create readable diagrams,” Mr Blinco said. “Until now only the largest companies could afford to implement detailed workflow processing, but Flowscribe will make easy workflow development and adjustment affordable for smaller organisations.” FlowScribe will be released in the second quarter of this year. Other planned enhancements include the Liberator product, which allows easy integration of data across platforms.
Digital stethoscope wins Australian finals of Microsoft’s Imagine Cup A team of medical and computer science students from the University of Melbourne has won the Australian finals of Microsoft’s Imagine Cup with the StethoCloud device, a digital stethoscope attached to a smartphone which listens to and digitalises a patient’s breathing sounds and patterns. The patterns are then compared against a medical database to deliver an automated diagnosis and treatment plan via an app on the smartphone. The digital stethoscope is aimed at assisting in the early diagnosis of childhood pneumonia in developing countries. The team, consisting of Andrew Lin, Hon Weng Chong, Kim Ramchen and
Masha Salehi (pictured with Microsoft’s Pip Marlow), will now represent Australia at the worldwide finals of the 2012 Imagine Cup, being held in Sydney in July. “The thing about pneumonia is it is an easily treated disease if you catch it early enough – the treatment is antibiotics and they are not expensive. It’s just penicillin,” Mr Chong said. “The problem is that diagnosis of pneumonia is hard and in developing countries you may have to walk several kilometres to the nearest clinic. Sometimes you might wait, and if you wait too long it might be too late to treat.” The team has designed a stethoscope that looks like a traditional device from one end, but instead of the other end being inserted
into the clinician’s ears, there is a common 3.5mm stereo jack, the same as used for iPhones and smartphones. “We utilised the ubiquity of these connections and we have an inline microphone to capture the sounds signals that we get from the stethoscope and simply put them as digital signals into the application, which we then transmit back to our back end for processing,” Mr Chong said. Computer science students Kim Ramchen and Masha Salehi then designed an algorithm for the digital signal. Mr Chong was responsible for the design and development of the phone application on Windows phones and also the cloud infrastructure back-end.
“[First] we do the recording, the recordig gets uploaded to our cloud storage on Windows Azure, we store that temporarily and we notify a process to go look at those sound samples along with some questions that we ask,” he said.
“We put together the respiratory rate with the data that we have collected and we crunch it through our diagnostic model and come back with a result.” Mr Lin said while the group doesn’t not have a firm
marketing plan yet, there is a definite business model. “Basically we can make the stethoscope as it is now for about $15 retail. “We reckon that if we mass produce it we can make it for maybe less than $10.”
Zedmed v18 is available for download from the company’s private support area and will be rolled out to practices shortly. For doctors using eRx to electronically send scripts to pharmacies, notifications of medicines being dispensed by participating pharmacies can now be viewed in the patient record, Zedmed’s general manager, Grant Williamson, said. “Where there is a notification from eRx regarding a particular script, an icon is displayed against the script in the medications summary view tab and existing medications in the prescribing module,” he said.
Zedmed has also added new functionality to allow practices to use both the eRx and MediSecure electronic script exchanges. “In order not to make doctors choose between eRx and MediSecure, there is now the facility to enable both eRx and MediSecure in the Global Options,” Mr Williamson said. “When this is in place, scripts are sent to both eRx and MediSecure, and bar codes for both are printed on the paper scripts.” Zedmed has also achieved integration with MedView, the medications repository that is now being rolled out to several Medicare Locals as part of the Wave 2 sites for implementing the PCEHR. MedView will allow doctors to see medications prescribed for their patients at other practices, aged care facilities and hospitals. The major work on MedView has been finalised and it is now being tested at Barwon
Health Informatics New Zealand (HINZ) and HL7 NZ are hosting a seminar in Auckland in June featuring one of the pioneers of healthcare interoperability, Ed Hammond. Professor Hammond is one of the founders of HL7, the global standardisation body for health information systems interoperability, which was established in 1987.
Zedmed expands electronic prescribing feature set Zedmed has released v18 of its clinical and practice software, featuring a number of enhancements including eRx dispense notifications, MediSecure functionality and a flag for patients with no Individual Healthcare Identifier (IHI).
HINZ and HL7 NZ to host openEHR seminar
Medicare Local in Victoria, Tasmania Medicare Local, Inner East Melbourne Medicare Local and Accoras Brisbane South Division before a wider roll out later in the year. “There is a MedView button in the patient record that the doctor can click to see the MedView information for the patient,” Mr Williamson said. For practices using the Healthcare Identifier Service, a flag has been added to the appointments screen to allow practices to see patients’ IHI status and to easily identify patients who may need details to be checked for an IHI. Other enhancements include the ability to delete documents from a patient’s clinical record, rename incoming results and documents in the results inbox, add encounter audit notes when creating and deactivating recalls, and support for the Pen data extract specification V1.9.
The seminar will concentrate on electronic health records and openEHR, the open standard specification for health informatics in creating electronic health records (EHRs). It will also explain archetypes, openEHR’s methodology for specification of content, and a core component of New Zealand’s Interoperability Reference Architecture. Archetypes have been used by NEHTA to develop its clinical knowledge manager (CKM). Hugh Leslie of Australia’s Ocean Informatics, which worked in partnership with University College London to establish the openEHR Foundation and is part of the National Infrastructure Partner consortium building the PCEHR, will explain the essentials of modelling and demonstrate how to transform archetypes into HL7 clinical documents. HL7 NZ and the openEHR Foundation recently signed a statement of collaboration agreeing to promote EHR interoperability in New Zealand and to work together to create specifications and tools that support the safe and appropriate communication and sharing of personal electronic health records with maximum interoperability. The seminar will be held on June 21 in Auckland. Registrations will soon be open on the HINZ website.
Events May 17
NATIONAL EHEALTH ROADSHOW Toowoomba, QLD p: +61 3 9095 8712 w: www.aapm.org.au
NATIONAL EHEALTH ROADSHOW Albury, NSW p: +61 3 9095 8712 w: www.aapm.org.au
NATIONAL EHEALTH ROADSHOW Gold Coast, QLD p: +61 3 9095 8712 w: www.aapm.org.au
NATIONAL EHEALTH ROADSHOW Brisbane, QLD p: +61 3 9095 8712 w: www.aapm.org.au
AMA NATIONAL CONFERENCE Melbourne, VIC p: +61 2 6270 5400 w: www.ama.com.au
NATIONAL EHEALTH ROADSHOW Rockhampton, QLD p: +61 3 9095 8712 w: www.aapm.org.au
NATIONAL EHEALTH ROADSHOW Mudjimba, QLD p: +61 3 9095 8712 w: www.aapm.org.au
TRANSITION CARE FOR ELDERLY PATIENTS Sydney, NSW p: +61 2 9080 4042 w: www.iir.com.au
HIMSS MIDDLE EAST Abu Dhabi, UAE p: +65 6664 1189 w: www.himssme.org
2ND ANNUAL CYBER SECURITY SUMMIT Canberra, ACT p: +61 2 9080 4371 w: www.informa.com.au
22-24 MAY CEBIT AUSTRALIA 2012 Sydney, NSW p: +61 2 9280 3400 w: www.cebit.com.au
NATIONAL EHEALTH ROADSHOW Hobart, TAS p: +61 3 9095 8712 w: www.aapm.org.au
DATA GOVERNANCE Brisbane, QLD p: +61 3 9326 3311 w: www.hisa.org.au
UPDATE ON THE PCEHR AND PRIVACY Melbourne, VIC p: +61 3 9326 3311 w: www.hisa.org.au
SOCIAL MEDIA IN HEALTHCARE Sydney, NSW p: +61 2 9080 4036 w: www.informa.com.au
NATIONAL EHEALTH ROADSHOW Perth, WA p: +61 3 9095 8712 w: www.aapm.org.au
NATIONAL MEDICINES SYMPOSIUM Sydney, NSW p: +61 7 3848 2100 w: www.nps.org.au
ELECTRONIC MEDICATION MANAGEMENT Melbourne, VIC p: +61 2 9080 4042 w: www.iir.com.au
NATIONAL EHEALTH ROADSHOW Townsville, QLD p: +61 3 9095 8712 w: www.aapm.org.au
NATIONAL EHEALTH ROADSHOW Cairns, QLD p: +61 3 9095 8712 w: www.aapm.org.au
18-20 JULY PRIMARY HEALTH CARE RESEARCH CONFERENCE Canberra, ACT p: +61 2 6281 6624 w: www.phcris.org.au
26-27 JULY 4TH ANNUAL EMERGENCY DEPARTMENT MANAGEMENT CONFERENCE Melbourne, VIC p: +61 2 9080 4042 w: www.iir.com.au
JULY – 2 AUGUST
HIC2012 Sydney, NSW p: +61 3 9326 3311 w: www.hisa.org.au
Save the dates 14-16 SEPTEMBER
THE GENERAL PRACTITIONER CONFERENCE & EXHIBITION - BRISBANE Brisbane, QLD p: +61 2 9422 2007 w: www.gpce.com.au
HIMAA 2012 NATIONAL CONFERENCE Surfers Paradise, QLD p: +61 2 9887 5001 w: www.himaa.org.au/2012
HINZ 2012 Rotorua, NZ p: +64 4 389 8981 w: www.hinz.org.nz
17-19 SEPTEMBER HIMSS ASIAPACIFIC 2012 Singapore p: +65 9299 0802 w: www.himssasiapac.org
16-19 OCTOBER AAPM NATIONAL CONFERENCE Brisbane, QLD p: +61 3 6231 2999 w: www.cdesign.com.au/aapm2012
7-10 NOVEMBER AGPN NATIONAL FORUM Adelaide, SA p: +61 2 6228 0846 w: www.agpn.com.au
16-18 NOVEMBER THE GENERAL PRACTITIONER CONFERENCE & EXHIBITION - MELBOURNE Melbourne, VIC p: +61 2 9422 2007 w: www.gpce.com.au
Online Calendar: To view a comprehensive list of eHealth, Health, and IT events, visit: http://www.pulseitmagazine.com.au/events
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THE eHEALTH PARADIGM AND THE PCEHR The 2008 National eHealth Strategy set out a number of noble aims that were supported by industry and government alike. Industry confidence was at a high when then-Health Minister Nicola Roxon outlined her plans for a national eHealth system. Things have not progressed according to the plan, however, and there are a number of lessons that we can all learn to ensure this doesn’t happen again. EMMA HOSSACK B.A. (Hons) Melb, LLB (Melb), L.L.M Committee member: MSIA firstname.lastname@example.org
About the author In addition to being a Medical Software Industry Association committee member, Emma has been CEO of Extensia for several years following her life as a corporate lawyer. Emma is currently Vice President of the International Association of privacy professionals and is a regular speaker on privacy.
“A healthy population underpins strong economic growth and community prosperity. Australians therefore have a strong incentive to ensure that our health system is operating efficiently and effectively, and continues to deliver a high standard of care that aligns with both community and individual priorities.”1 One of the ways to realise this is through eHealth. The benefits of eHealth are clear2 and Australia’s current health expenditure is not sustainable if it remains on the current trajectory3. Consultations and reports on the need for eHealth in Australia have been persistent and bipartisan since 19994 and many have been calling for an end to all the talk, and for eHealth to begin with more than unsustainable pilot programs. So why is there so much controversy about the federal government’s $467 million spend on eHealth reform?5 And just why is it so heavily focused upon the PCEHR? The implementation of any new national system is a huge challenge, and can expect to attract controversy. In the field of health it affects everyone — so opinions abound. At present there is politically fuelled criticism, concern about how well it will serve the Australian health consumer6, and trepidation about whether the personally controlled electronic health record will be useful, privacy compliant, secure7, safe8 or efficient9.
Probably of greatest concern of all is the theme which eschews all these as unnecessary worries — because, this line of thought goes, there is not any real likelihood that the PCEHR will be used once the pilot sites have achieved the various goals including Healthcare Identifier matching (an interesting imperative in itself). Yet despite all of this debate, there is an overarching air of genuine optimism in the Medical Software Industry Association about the underlying rationale for the current investment, evincing as it does a clear recognition of the value of eHealth solutions working today, and the willingness of the government to invest in eHealth and reap the benefits of interoperability. eHealth is a noble cause as health is the most significant barometer of a country’s success. It is also Byzantine in its complexity, which means it captivates a unique array of players, all sharing a desire to see eHealth benefits maximised. As one of the consumer stakeholders has aptly pointed out, eHealth, unlike banking and almost every other industry, is an arena where many systems must communicate seamlessly with many other disparate systems for it to work10 in the multi‑tiered, distributed eHealth space. This is not your average bunch of vendors.
At the April 2012 MSIA CEO Forum11 one of the most persistent themes was the participants’ pride in the success of eHealth projects with which they were involved in with their clients, inside and outside the current government spending initiatives, and beneficence — the desire to promote the clinical benefits which resulted from the use of information — not simply the technical prowess of the software solutions.12 Consequently, there is naturally disappointment when things have not gone to plan and a keen desire to help get things back on track.13 It is in this context that some observations will be made on the comparison between what Australians will have on 1 July 2012, and more importantly, what was promised. The path to success is rarely swift and straight as indicated by the recent Parliamentary Library paper ‘The ehealth revolution — easier said than done’14 which provides a useful summary of Australia’s eHealth over the last decade. So right now, just a few weeks before the politically driven deadline when Australians can sign up for their personally controlled electronic health record, let’s have a look at the score card.
“Whatever you can do or dream you can, begin it. Boldness has genius, power and magic in it.” JW von Goethe
The NHHRC endorsed this. It went further in Recommendation 123, which stated that the government should not design, buy or implement eHealth systems. The government endorsed the report, which augured well for Australia. Minister Roxon added to the confidence felt by industry and stakeholders generally when in her launch of the eHealth “revolution” on 30 November 201016 she announced that $467m would be spent on “major infrastructure” for a PCEHR17, and, significantly, she stated: “We’re getting on to deliver the next steps which will result in empowering patients, linking vital information to make doctors and nurses lives easier. We’re doing this based on the hard work already achieved, not trying to build a one-size-fits-all system from scratch. Let me take you through some examples.” Whereupon the minister described the first three “wave” sites of Brisbane North, Melbourne East and Hunter Valley. GPpartners in particular was singled out as ”an Australian leader in eHealth for many years”. The sites were tasked to deploy and test eHealth infrastructure and standards, provide evidence-based results, influence change management processes and inform the process for implementations elsewhere. The message on governance was strong: DoHA was to assume ultimate oversight of the project and NEHTA was its contractor to develop and to deliver infrastructure.
The much lauded Deloitte eHealth strategy 2008 was supported both by the National Health and Hospital Reform Commission and the federal government. Apparently it still is — at least in speeches. It proposed that the eHealth reform should: • Be a 10-year journey. • Build on the success of existing eHealth solutions. • Not be prescriptive but focus on strong infrastructure and where possible robust international standards. • Be sustainable. Provide incentives for clinicians to take up the eHealth solutions. • Have a strong and transparent governance framework to ensure confidence of the industry, clinicians, consumer and governing bodies.15
“We want the best available expertise and experience so there will be an open approach to the market for key elements of the program. I can confirm to you all that this Government is not looking to run the whole system. Our job is to contract partners to build the infrastructure and the linkages and to set the standards and regulations. It will not be our job to deliver all of the technological advances — that’s what we’re looking for from the innovators in industry.”18 In essence we were told that the reform would follow the Deloitte eHealth strategy. However, even on 30 November 2010 the first three Wave sites had been chosen and funded without an open tender process. Tragically for Australian taxpayers, there was no governance around how they would procure eHealth services or manage conflict of interest — be it to continue with existing
suppliers following an open tender process, or instead resolve to make an internal selection and start building something new.19 The appropriate governance emphasised by the minister, and later embedded in the PCEHR Concept of Operations, had been ignored and raised questions about the transparency of NEHTA as manager of the procurement process.
health problems. [Standards] will work to ensure that components will work appropriately, will work in concert with one another where appropriate, and will perform tasks according to a level of efficiency and reliability that is of assistance and utility to the general practitioner as an individual and the general practice community as a whole.21
The industry and specifically providers of robust solutions should probably have banged their drums louder about this sleight of hand. This may have prevented unnecessary cost to the Australian taxpayer by trying to reinvent the wheel rather than using, extending and upgrading current systems.
A standard application programming interface (API) requirement for all clinical systems would create immediate value for interoperability. Where these are not provided, there are serious risks that data will not be shared, or will be extracted or uploaded without both parties’ co-operation to ensure that changes and upgrades do not compromise the doctor’s record and thus patient safety where the data is used to inform decisions. The concerns relating to this practice are documented.22
Dr Kidd said he was grateful Ms Roxon had the opportunity to view the HRX first hand as it was necessary at this stage in the health reform process that the government was kept fully informed regarding the system’s extensive capabilities. “GPpartners is confident that the HRX already provides an effective solution to some of the difficulties health providers face with regard to the sharing of patient medical information across multi-sector, multidisciplinary care environments,” Dr Kidd said. The speed of testing for the infrastructure could have been faster, and a more effective use of funds could be made on change management and not software development which the minister had specifically eschewed previously. Sadly, this was a wasted opportunity to get some solid and valuable results for the promotion of eHealth to Australians. It behoves the industry to ensure that in future the funding bodies are crystal clear on the facts relating to procurement of technology so that the taxpayer gets value for money. Fortunately the second Wave projects followed clear procurement guidelines and whilst there were only nine ‘winners’, the procurement methods were appropriate and there was no concern about probity. The decision to put out tenders for GP clinical information systems was possibly limited. In the health market there and numerous GP desktop systems; some clearly have a market share and others provide more specific needs, such as those for indigenous health practices. As recognised by the RACGP and MSIA in 1995: Standards in general practice information management contribute significantly to a better practitioner working environment [and] better or more accessible information pertaining to patients and their
If instead of selecting a vendor panel, an invitation to apply had been released for the creation or enhancement of APIs for a myriad of other valuable applications, this could have resulted in Australia taking a huge leap ahead in both interoperability, and importantly, realisation of clinical benefits. As it stands, the duplication by many vendors of interfaces to the same system, usually paid for with government funds, create no value after the first interface has been developed — just waste and lack of conformity. Safety risks too, are avoidable. The danger to the market place should not be overlooked either — if your clinical system was not one of the ‘winners’ does that impact on prospective markets? In the period after the Deloitte eHealth strategy, the NHHRC report and the Wave bids, the Shared Electronic Health Record concept seemed to undergo a metamorphosis into an IEHR, PCEHR and now a National Electronic Health Record System
Credit: GPpartners Ltd
For example, pictured below is a photograph of local MP Arch Bevis (standing) and Ms Roxon being shown the HRX system in July 2010 by Dr Richard Kidd, director of GPpartners, just one month before she awarded funding for the Wave 1 sites. A press release20 issued on the day of the visit stated:
“It can only be assumed that someone else with a Svengalian skill of transformation had quite a different vision, or simply wanted to transplant a system built for a different market and population into Australia.” Emma Hossack
(NEHRS). This is not in line with the broader objectives of an eHealth paradigm or successful overseas experience. Indeed, it was not what the minister signed up for in her very specific 30 November 2010 speech. It can only be assumed that someone else with a Svengalian skill of transformation had quite a different vision, or simply wanted to transplant a system built for a different market and population into Australia. This created a bewildering and unnecessarily complex national architecture suited specifically to large-one-size fits-all system. It also created quite a different and unexpected role for NEHTA which became deeply involved in the very activities which the NHHRC warned should not be in the government’s remit.23 The PCEHR Concept of Operations extended some of the original goals beyond recognition and whilst recognising value in the federated conformant repository model24, the clear mandate of the National Infrastructure Partner was to build a one-size-fits all system, or bring it from overseas, irrespective of well-documented evidence that nowhere else in the world had experienced success this way.25 However, this work is not easy or necessarily useful, as we know from the UK experience, which had many of the same players. In 2005 the British Medical Journal printed a case study by Sheila Teasdale on the failed early implementation of Kaiser Permanente in Hawaii.26 The report was written in the vain hope that the English National Programme for IT would learn from these mistakes; namely, to quote Professor Trisha Greenhalgh’s advice to government following her study of the failed UK exercise: • • • • •
There is no ‘tipping point’ for big IT. Don’t try to build systems or write standards. Don’t throw money before you’ve sussed the complexity. Don’t equate knowledge with what is passed up the line. Don’t impose political milestones.
In Australia, now that the 10-year plan proposed by Deloitte has been compressed into 18 months, we have witnessed the inevitable pressure which has resulted in ‘pauses’27 and questions being raised by a Senate inquiry.28 Not surprisingly, there has
also been a clear campaign to reduce public expectations to little more than a patient sign-in to an empty national database. The medical software industry has been providing healthcare solutions for decades, long before the current PCEHR program, and the HealthConnect one before that. There is no doubt that it will continue to do so. However, it is worth reflecting that if the government is going to spend on eHealth again in the future, it would be great if the medical software industry could be empowered to: • Build for real needs not political aspirations. • Use local development for local communities. • Listen to the healthcare providers, privacy practitioners and software industry to support what is working and build on that to get some concrete health improvements. Starting the eHealth reform was a bold move and without doubt a well-intentioned one which should be commended. The plan was good, but not followed. The criticism has been public, but at least it has kicked off the requisite debate and public education. The industry remains optimistic that once the political imperatives are removed, the stakeholders’ desires for systems to be useful rather than useless, extensible not expedient and provided amidst a transparent framework, then greater focus can be given to the improved health outcomes possible with the many eHealth tools. Next time around we will surely be given the chance to get a lot more of it right — and from a lot less — and maybe even see some of the magic in it.29
Competing interests Emma Hossack is CEO of Extensia, a medical software development company. One of Extensia’s principal products is RecordPoint, a shared electronic health record.
References A comprehensive list of references is included in the online version of this article, which is available at the Pulse+IT website.
AUSTRALIA LEADING THE WAY IN
HEALTH PRODUCT MANAGEMENT Australia’s healthcare sector is embracing supply chain reform and the National E-Health Transition Authority (NEHTA) continues to lead the way.
The ability to store and share accurate, complete and up-to-date data on healthcare products between suppliers and healthcare delivery organisations is a critical, foundational component for Australia’s transition to an electronic health system. The National Product Catalogue (NPC) is one of the first in the world to focus exclusively on the needs of the healthcare industry, whilst allowing provision of data about products from other sectors to healthcare purchasers. The NPC is endorsed by all state, territory and federal health departments. The National E-Health Transition Authority (NEHTA) has worked with GS1 Australia to encourage suppliers of healthcare products to use the GS1 Global Data Synchronisation Network (GDSN) compliant NPC hosted on GS1net, to communicate product and price data to all government and private sector healthcare purchasers within Australia.
About NEHTA The National E-Health Transition Authority (NEHTA) has been tasked by the governments of Australia to develop better ways of electronically collecting and securely exchanging health information and is the lead organisation supporting the national vision for eHealth in Australia.
Mark Brommeyer is NEHTA’s supply chain manager. “The NPC is a single repository for product data about medicines, medical equipment and consumables,” Mr Brommeyer said. “The number of NPC users has grown by more than 30 per cent in the past nine
months alone, indicating that more and more companies are realising the benefits of a single, centralised and standardised mechanism for provision of product data to their trading partners. “Aligned with the GS1 Global Data Synchronisation Network (GDSN) standards, the NPC uses GS1’s standard identifier, the Global Trade Item Number (GTIN), as the globally unique product identifier for every NPC record,” Mr Brommeyer said. NEHTA continues to work with industry representatives and stakeholders. Reference groups, industry forums, seminars and site visits ensure the NPC benefits public and private healthcare providers as well as healthcare suppliers. Ongoing monitoring, review and feedback ensure these benefits remain current and dynamic to meet the needs of an evolving industry. “In addition to the NPC, NEHTA has also developed an electronic procurement solution (eProcurement), which is designed to streamline the electronic purchasing process. This solution, in combination with AS5023 Australian Standards for eHealth Supply Chain uses GS1 XML as the messaging format,” Mr Brommeyer said.
NPC in practice
National Product Catalogue benefits
As at March 2012, more than 370 health care suppliers are participating with the NPC. Major Australian healthcare supply companies, such as Abbott, ArjoHuntleigh, Cook Medical and Terumo are benefiting from NPC implementation.
The future With the NPC now being used by all state and territory health departments and increasingly by private healthcare providers for medicines, medical devices and consumables alike, the next areas to be targeted include incorporating a broader range of healthcare product categories, closer alignment with the Therapeutic Goods Administration, and alignment with other national healthcare purchasing and supplier agencies’ data sets. Improving the quality of data captured, stored, shared and used for procurement is a key next phase of activity, as well as further electronic product item data validation, integration and synchronisation
Health Informatics Society of Australia
Australia’s accurate and efficient electronically-enabled network levering the NPC and NEHTA eProcurement Solution offers major advantages for purchasers and suppliers such as: • Current, accurate, standardised product data. • National standardised method for electronic procurement. • Secure pricing information available only to nominated trading partners. • Ensuring reliable continuity of supply with minimum inventory investment. • Removing inefficient paper-based forms and automating the efficient distribution of product information. • Reducing order errors and the supply costs associated with invoice reconciliations, credit claims, returns and refused deliveries.
from the NPC to local healthcare provider product catalogues. Next phases of activity will also include mapping, capturing and tracking supplier and purchaser benefits (already being realised across a number of public healthcare purchasers), along with an increase in eProcurement enabled purchaser and supplier organisations. NEHTA’s current eProcurement messaging suite has been extended to incorporate the functionality for procurement of prosthesis loan kits on consignment, which are marked with RFID technology. This has resulted in efficiency gains and reduction of cost, while enabling the tracking of
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prosthesis implants and providing product information, including the product GTIN, for potential incorporation in the patient health record.
Further information For further information on NEHTA’s work, see: www.nehta.gov.au For specific Supply Chain updates see: www.nehtasupplychain.com.au To keep up-to-date with eHealth developments across Australia, see: www.ehealthinfo.gov.au
Over 30 HISA events in 2012 for you to attend, network and Industry be part of the action Awards presentations, video downloads, SIG forums and more!
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THE HEALTHCARE IDENTIFIER SERVICE AN INTRODUCTION FOR PRACTICES
The Healthcare Identifiers Service is a key foundation technology for not only the Personally Controlled Electronic Health Record, but many other eHealth related services that stand to benefit from more accurate identification of patients, providers, and the organisations for which they work.
SIMON JAMES BIT, BComm Editor: Pulse+IT email@example.com
After years of planning and development, the Healthcare Identifiers Service was switched on in July 2010. The system was built by Medicare Australia (now Department of Human Services) having been contracted by the National E-Health Transition Authority (NEHTA) to develop a system to assign a “unique national healthcare identifier for each patient, practitioner and healthcare organisation”. In Medicare Australia’s own words: “The HI Service is a system that provides a consistent set of identifiers for healthcare individuals and healthcare providers (organisations and individuals). The HI Service enables providers to associate health information about a healthcare individual in a secure, consistent and accurate manner.“
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 much of the discussion around eHealth remains focused on the Personally Controlled Electronic Health Record (PCEHR), it is important to note that while the HI Service plays an important role with the PCEHR, healthcare identifiers have a much broader application. According to NEHTA: “In the near future, identifiers will be used within electronic communications such as discharge summaries, prescriptions, and referrals to correctly identify the patient,
referrer, referring organisation, referee, and referee organisation.” Unfortunately the tangible benefits of healthcare identifiers will not be immediately apparent to many healthcare organisations, as the usefulness of the service will scale in proportion to the number of healthcare organisations using them. In much the same way as the owner of the very first telephone had little reason to celebrate, early adopters of healthcare identifiers are unlikely to extract much benefit until other organisations with whom they communicate also adopt the system. That said, the health sector is certainly not positioned for a standing start and there has already been a considerable amount of money expended by government, both on the HI Service itself and on incentivising software vendors to develop HI Service functionality in their solutions, as outlined on page 52 of this edition of Pulse+IT. In the first year of operations, the HI Service Operator assigned 24,051,919 healthcare identifiers to individuals and over 500,000 to healthcare providers. However despite these impressively large numbers, awareness of these identifiers amongst both consumer and healthcare provider cohorts remains modest.
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“Once logged into this portal, consumers are able to see their identifier’s access history, including the data it was created and any subsequent access thereafter.” Simon James
In the case of consumers, this is not necessarily a problem as it is not a piece of information that they need to know to access healthcare services. However if they so wish, they can retrieve their healthcare identifier from Medicare Australia, either by the telephone or online if registered for Medicare’s Online Services. Once logged into this portal, consumers are able to see their identifier’s access history, including the date it was created, and any subsequent access thereafter. For the vast majority of the first 12 months of operations, the HI Service sat relatively dormant as software developers were not able to interface with the service until the very last days of June 2011. However since funding for the Wave 1 and Wave 2 pilot projects and the GP Vendor Panel emerged, increasing numbers of healthcare organisations are connecting to the service as part of their day to day operations, a trend that is likely to continue as more emphasis is placed on the broader rollout of HI Service compatible software.
The identifiers While all the new Healthcare Identifiers are 16-digits in length, there are four different types that organisations should be aware of. As defined by the National E-Health Transition Authority in its practice‑centric literature: IHI The Individual Healthcare Identifier (IHI) has been allocated to all consumers enrolled in the Medicare program or those who are issued with a Departments of Veteran’s Affairs treatment card, and others who seek healthcare in Australia. HPI-I Healthcare Provider Identifier - Individual (HPI-I) numbers are allocated to healthcare providers involved in providing patient care. All healthcare providers registered with the Australian Healthcare Providers Regulation Agency (AHPRA) have been allocated a HPI-I, which they can retrieve from AHPRA’s website after logging in.
HPI-O Healthcare Provider Identifier - Organisation (HPI-O) numbers are allocated to organisations, such as medical practices and hospitals. As discussed later, there are two types of HPI-O, however most organisations are likely to only need to obtain one. CSP While a detailed discussion of CSP identifiers is outside the scope of this article, a fourth identifier designed for ‘Contracted Service Providers’ is also defined by the system. In practical terms, a CSP is most likely to be a software vendor that acts on behalf of a healthcare provider organisation with the organisation’s explicit authority to do so.
The people Before continuing with the deluge of acronyms, it’s worth noting at this juncture that healthcare organisations need to assign people to be the HI Service’s main points of contact. A full explanation of their roles and responsibilities is available on the Healthcare Identifiers Service application form and has therefore been excluded from this article, however from a high level, the two classes of people authorised to act on behalf of the organisation as far as the HI Service Operator is concerned are: Responsible Officer The Responsible Officer (RO) is the officer of a healthcare organisation who has accepted responsibility for participation of the organisation in the HI Service. The RO is primarily responsible for ensuring their organisation complies with the rules and regulations that govern the HI Service, and appointing at least one Organisational Maintenance Officer. Organisational Maintenance Officer (OMO) An Organisation Maintenance Officer (OMO) is an officer of a healthcare organisation that is responsible for maintaining information about their organisation within the HI Service. They act as an authorised representative of the healthcare
organisation and maintain the accuracy and completeness of the HPI-O record, add new OMOs, maintain the links between the organisation identifier and the provider identifiers, and manage the organisation hierarchy as explained later in this article.
staff register as something that needs to be managed when the practice manager finishes up with the practice.”
Marina Fulcher, a past president of the Australian Association of Practice Managers and member of the National E-Health Transition Authority’s clinical leads team suggests that medical practices need to ensure ROs and OMOs are accounted for in practice staff policies and procedures to ensure continuity. Ms Fulcher also provided an example of how typical practices might assign people to these roles:
As the HI Service is designed to cater for healthcare organisations of all shapes and sizes, two types of HPI-O classifications have been defined:
“It’s a discussion that needs to happen in your practice to work out what suits you, however we would recommend that you have at least two OMOs in case something happens to one of them. It’s probably best that one of the business owners is setup as the RO, but if they agree that it should be the practice manager for example, that’s fine, it just needs to be noted in the practice
Seed HPI-O A Seed HPI-O is to be obtained by any legal entity that delivers healthcare services, including for example medical practices, community healthcare organisations, and hospitals. Network HPI-O A Network HPI-O is a sub-entity of a Seed HPI-O that provides healthcare services, including for example branch practices or individual hospital departments. Network HPI-Os cannot exist in isolation and require a linkage to a Seed HPI-O.
HealthLink/Medinexus Half Page 180 x 120 Puse IT Mag
“It’s a discussion that needs to happen in your practice ... however we would recommend that you have at least two OMOs in case something happens to one of them.” Marina Fulcher
It should be noted that the HI Service Operator takes an IT-centric view of the healthcare system, and in some cases a practice with multiple locations may in fact not need to obtain Network HPI-Os. For example the more simplified HPI-O arrangement may be applicable if the healthcare organisation uses a single database that is accessed remotely by branch practices.
register. Because people don’t understand what it is, they aren’t registering. If you look at the form, there are a few lines about the Healthcare Provider Directory on the front page, but when you’re filling out the form and you get to the section on ‘HPD details’, and the first option is ‘no’, I gather it’s somewhat confusing for practices.” Ms Fulcher said.
The Healthcare Provider Directory
As part of the HI Service registration process, healthcare organisations are able to elect to have their organisation listed on the Healthcare Provider Directory. While there are certainly other provider directories and health services directories in operation around the country, this particular service is specifically designed to allow healthcare providers to look up details of healthcare organisations and providers participating in the HI Service.
There are several resources practices may like to refer to with a view to extending their understanding of, and ultimately registering for, the HI Service.
Marina Fulcher stressed that organisations should make themselves aware of the Healthcare Provider Directory and encouraged them to add their details into the directory, taking care when completing the HI Service registration form. “It’s a service that people don’t currently know a lot about. It has the potential to be extremely useful but it needs people to
Comprehensive information about the Healthcare Identifiers Service including registration forms is available from Medicare Australia: http://www.medicareaustralia.gov.au/provider/healthidentifier/index.jsp As outlined in this edition’s events calendar on page 34, the Australian Association of Practice Managers is conducting a National eHealth Roadshow, with the HI Service being a dominant theme of the presentations. Many divisions of general practice and Medicare Locals are also distributing resources via their websites, with some assisting practices with HI Service registrations.
eHealth: it’s happening now!
AAPM National eHealth Roadshow These workshops will cover: • What you need to know about eHealth • How your practice can be eHealth compliant • Why eHealth is important for every practice • How eHealth will change the future of healthcare delivery for everyone
• $60 AAPM members, $75 non-members • Attendance earns 4 CPD points • Numbers limited to 20 per session – book early to avoid disappointment
To register, or for more information, go to: www.aapm.org.au
This national eHealth roadshow is proudly sponsored by the National E-Health Transition Authority (NEHTA) on behalf of the Governments of Australia.
PREPARING PRACTICE DATA FOR THE PCEHR AN OVERVIEW OF SOFTWARE THAT CAN HELP
High quality and accurate clinical notes are an integral part of a computerised general practice. However the ongoing transition from paper based and hybrid records to fully electronic records has resulted in some variability. The PCEHR may serve as a catalyst to improve electronic records, with this article highlighting two software products designed this aim in mind.
SIMON JAMES BIT, BComm Editor: Pulse+IT email@example.com
To assist practices to analyse and improve the quality of their electronic patient records in preparation for uploading to the PCEHR, the National E-Health Transition Authority (NEHTA) engaged Pen Computer Systems, developers of the Clinical Audit Tool (CAT)1, and the Canning Division of General Practice, developers of the Canning Tool2, to add a collection of reports to their existing data extraction tools. Collectively known as the Clinical Data Self‑Assessment (CDSA) module, the products are designed to extract a snapshop of selected data from a clinical system for analysis, presenting the user with reports built upon the RACGP’s GP eHealth Summary recommendations3. It is understood that as part of NEHTA’s funding arrangements with each developer, the CDSA functionality is to be made freely available to any practice that wishes to install the software. Details about the arrangements each vendor has made in this regard are outlined later in the article.
Data Indicators In consultation with NEHTA, Pen Computer Systems was engaged to develop specifications for both their own purposes and for the Canning Tool. As such, there is a large amount of commonality between the two products as far as their CDSA
reports go, with each product particularly focused on active patients, being those that have presented at least three times in the last two years. The list of data indicators that are analysed and reported on in the CDSA utilities are as follows: Allergies and adverse reactions The number of patients with an allergy status recorded is retrieved. In addition, of those patients that do have an allergy status that isn’t flagged as ‘no known allergies’, the number of allergies that are recorded from a coded table as well as the number of allergies that have content in the reaction field is also presented. Medicines The ‘reason for prescribing’ for current medications is extracted, where the clinical software supports this data being recorded in a coded pick list. Medical history This indicator refers to the number of diagnoses entered in the past history that have been entered in a coded format, compared with the total number of diagnoses. Health risk factors This collection of indicators analyses smoking data, including whether smoking
status is recorded, the number of cigarettes per day, and a cessation date for past smokers. The recording of waist circumference for patients with BMI over 25 and BMI under 18.5 is also reported on, as is the recording of alcohol status for both quantity and frequency for patients 14 years and over. Immunisations Compares the number of active patients with immunisations recorded in the system to the total number of active patients. Relevant family history Compares the number of active patients with family history recorded in the system to the total number of active patients. Relevant social history Provides a report on whether living arrangements, ethnicity, occupation, employment status and relationship status are recorded, as well as whether patients are flagged as carers, or they themselves are under such care. Duplicate patients This indicator is designed to assist practices to de-duplicate their patient database by comparing key demographic details such as names and dates of birth, in addition to various identifiers such as those provided by Medicare and DVA.
The Canning Tool Developed by Ian Peters of the Canning Division, the Canning Tool is reported to be used in around 1200 practices across Australia. Originally sold through licensing agreements with a large number of divisions, the Canning Tool is now being made freely available starting with version 4.10, which is the version that introduced the CDSA module. While the Canning Tool can extract and analyse data from seven different clinical products, the CDSA functionality currently only works with Medical Director 3 and Best Practice. However the developers have indicated that the CDSA functionality will be extended to MedTech, Practix and Zedmed in May.
Some of the Canning Toolâ€™s CDSA reports including a high level dashboard, some of the 19 data indicators, and a graph showing data improvements over time.
Clinical Audit Tool
More commonly known as CAT, Pen Computer Systems’ Clinical Audit Tool is currently available to around 85% of GPs via licensing arrangements with their Medicare Locals and divisions.
1. http://www.pencs.com.au/product-cat-overview.html 2. http://www.canningdivision.com.au/dataextraction.html 3. http://www.racgp.org.au/ehealth/summary
Licensed users of the product may already have access to the CDSA functionality via CAT’s auto-update features, however for those practices that do not have access to CAT presently, Pen Computer Systems has made available at no charge a version of the tool that only includes the NEHTA‑funded CDSA module.
Some of the Clinical Audit Tool’s CDSA reports including a data completeness visualisation in addition to numeric breakdowns.
Only a subset of CAT’s software extractions — which work with Best Practice, Communicare, Medical Director 2, Medical Director 3, Genie, Medinet, Medtech 32, Practix and Zedmed — currently support the CDSA module at this point in time, however Best Practice and Medical Director 3 customers can use the software now, with Practix compatibility coming soon according to the developers. Pen Computer Systems has advised that other clinical software developers wishing to provide CDSA functionality to their customers via the Clinical Audit Tool will first need to update their data export routine to version 1.13 of the CAT extract.
Switch to Best Practice and switch on automatic SMS reminders/replies
Your appointment reminder cards may disappear in their jeans pockets going through the wash but today’s patients can’t forget appointments when you remind them via their constant companion, their mobile phone! For just a few cents and virtually no effort, new automatic SMS reminders (and confirmation reply) in Best Practice can do much to eliminate the cost and disruption of No Shows. There’s no faster, more streamlined system than BP SMS! Benefits of SMS in Best Practice Management
• Integrates seamlessly into the Best Practice Management Appointment module.
• Interchangeable Practice SMS templates allow tailored messages with a single click. • Complies with National Privacy standards of an opt in or out system. • Exclude SMS Appointments reminders for Appointments made within a certain number of days. • Practice allocated mobile number (additional costs apply) • Delivery reports - Confirmation the Patient received the SMS (2 delivery reports = 1 SMS Credit). • Only quality Tier 1 Australian SMS Providers used.
• Patients can be reminded within minutes of making a new appointment on their Mobile phone. • Seamless two-way SMS communications, allows Patients to confirm an appointment via SMS with a simple YES reply. • SMS messaging simplifies Patient communication, it saves time and money while greatly reducing the risk of No Show appointments.
Cost Prepaid • 1000 SMS credits
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• 2500 SMS credits
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• 5000 SMS credits
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• 10000 SMS credits
• 25000 SMS credits
Practice allocated mobile number = $50
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(12c Per SMS) (12c Per SMS) +GST
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For more information contact us: T: (07) 4155 8800, SMS: 0427 767 833 or E: SMS@bpsoftware.com.au
AN UPDATE FROM THE VENDOR PANEL COMMENCING THE MIGRATION TO PCEHR-ENABLED SOFTWARE
As the centralised PCEHR infrastructure being developed by the National Infrastructure Partner is being prepared for launch, a group of primary care software developers are hastening to extend the functionality of their own products in support of the government’s ambitious eHealth timelines.
SIMON JAMES BIT, BComm Editor: Pulse+IT firstname.lastname@example.org
Continuing this edition’s focus on what practices are able to do in preparation for the PCEHR, this article provides brief updates from seven software vendors who develop solutions for the primary care market. The article assumes basic knowledge of the Healthcare Identifiers Service, which is covered in pages 42-46 of this edition of Pulse+IT. With funding support from government, a ‘GP Vendor Panel’ was convened to incentivise software developers to create interfaces to the PCEHR, and in doing so, ensure practices will have access to ‘PCEHR-enabled’ versions of their existing practice software. The panel initially comprised Best Practice, iSoft (now CSC’s Healthcare Group), Medtech Global and Zedmed. Genie Solutions and Communicare Systems were later added to the panel in reflection of their relevance in various Wave 2 pilot projects and their leading positions in the specialist and indigenous health software markets respectively. Notably absent from this initial vendor cohort was Health Communication Network (HCN), however it is believed the dominant supplier of clinical software to Australian general practice has since been engaged by government to undertake a similar program of work to that of the vendor panel.
While many of the aforementioned software developers retail solutions to other parts of the health sector, for general practices particularly, the work of the vendor panel is of increasing importance — the government’s 2012‑2013 budget has indicated that practices may be required to use PCEHRenabled software to continue to access eHealth PIP payments from February 2013. While this may cause some practices a measure of concern, it should be noted that previous eHealth and IT/ IM PIP criteria have been anything but strongly worded. In fact if history serves as a useful guide, it may well eventuate that a vague ‘intention’ to interact with the PCEHR may qualify a practice for incentive payments, at least while the national record system is in a fledgling state. Despite the uncertainty relating to general practice incentives and the shifting project arrangements software developers are having to navigate on the eve of the PCEHR’s launch, it remains both prudent and timely for practices to start to increase their knowledge of the work being undertaken by their software supplier as it pertains to the HI Service and the PCEHR. In consultation with their software vendor and IT support professionals, it may be that organisations should consider upgrading to recent versions of their software with a view to
better familiarising themselves with the currently included functionality in advance of the launch of the PCEHR.
Best Practice Best Practice will release its HI Service functionality in version 184.108.40.2065 in May this year. In addition to downloading IHIs on a per-patient basis, Best Practice will analyse future patient appointments and attempt to retrieve IHIs, allowing practice staff to check patient details for obvious errors in their demographic details before the patient presents. As is the case with other software interacting with the HI Service, matching and downloading an IHI requires that a first name, last name, date of birth, and either a Medicare or DVA number be accurately recorded for the patient. Dr Frank Pyefinch used his concluding address at the Best Practice Summit, held in Bundaberg in March, to give conference delegates a glimpse of his product’s forthcoming HI Service and PCEHR functionality. Speaking to Pulse+IT at the event, Dr Pyefinch indicated that more features relating to the HI Service were planned in accordance with the vendor panel work program, including the ability for users of his company’s software to look up the HPI-Is and HPI-Os of other providers and organisations for the purpose of sending them secure electronic correspondence. “HPI-Os are going to be the primary identifier for sending electronic mail to other people. So if you want to send to a specialist, you would actually use the HPI-O of his clinic rather than his HPI-I. The reason is most medical practices these days have more than one person in them and if they go on holidays and you’ve addressed something to the HPI-I, then only that person can view it. Whereas if you address it to the organisation, other doctors can view it and determine
“... it remains both prudent and timely for practices to start to increase their knowledge of the work being undertaken by their software supplier as it pertains to the HI Service and the PCEHR.” Simon James
who within the organisation should deal with the incoming correspondence,” Dr Pyefinch explained. “We have done the work to do it but haven’t gone through the National Association of Testing Authorities (NATA) accreditation yet, so it’s not live and it’s not connecting to the Medicare servers. At the moment users have to manually type them in. We’ll do the accreditation in the next couple of weeks so that it will be done in time for the July PCEHR launch but up until now, the NATA accreditation agencies haven’t been ready to accredit it.” Describing how the HI Service HPI-O lookup will work when implemented, Dr Pyefinch said, “You can look up an organisation’s HPI-O based on the name of the organisation. Unfortunately it has to be a pretty exact match. You need to know the formal name the organisation has registered with Medicare Australia, and if you do you should get the HPI-O back. For example if I type in ‘Millbank Medical Practice’, it may return a HPI-O but ‘Millbank Medical Clinic’ will not.”
Communicare Systems Communicare Systems first made its HI Service functionality available last year in version 11.3, which allowed users of the software to download patient IHIs. More recently, version 11.4 added the ability
for HPI‑Is and HPI-Os to be recorded, which are necessary for interfacing with the PCEHR and likely to be important for future secure messaging between healthcare organisations and providers. Heidi Tudehope of Communicare Systems indicated that the company’s work with healthcare identifiers is familiar to their users, many of whom were using the somewhat similar Medicare Online Patient Verification features of the product. “In a lot of ways we’ve mimicked the user functionality that we already had for referencing Medicare numbers so that it is an easy transition for users. In the same way as we have developed our existing Medicare Online functionality, we display colour coding over the healthcare identifier number to indicate whether it has been validated or not,” said Ms Tudehope. The company indicated it was in a strong position to deliver PCEHR functionality, pointing to its experiences with other shared record projects. “While the PCEHR deliverables for the vendor panel are not in the same format exactly, we already do a similar thing with the Northern Territory Shared Electronic Health Record and another shared record product called RecordPoint, developed by Extensia,” said Ms Tudehope.
Asked if Communicare is advising customers to clean up their data in advance of the launch of the PCEHR, Ms Tudehope indicated that unlike many other healthcare organisations, Communicare’s users typically work in areas that mandate the use of coded clinical data, such as indigenous health clinics. This means that the quality of their data as far as the PCEHR is concerned will already be quite high and unambiguous.
CSC understands that a CCA process will need to be performed to enable the PCEHR B2B gateway functionality within our product set. We have undertaken similar CCA processes for both the HI Service and Secure Message Delivery, and will undertake the PCEHR testing in the same manner, for our contracted delivery for NEHTA.”
CSC’s Healthcare Group
Genie Solutions’ HI Service functionality started to emerge in version 8.2 in October 2011, providing users in some of the Wave pilot sites with the ability to download and verify patient IHIs, in addition to the ability to display discharge summaries and referral letters sent in CDA format. The functionality was extended to Genie’s broader user base with the release of Genie version 8.2.7 in March this year.
Recently acquired by CSC as part of its acquisition of iSOFT, a version of Practix containing HI Service functionality has been available for installation by practices since July 2011. However at present, the company hasn’t deployed it to practices, a spokesperson stating that, “We are currently working with our customer base to identify early adopter sites for this version of our software.” Discussing the way the company envisages the software will be used once their users start interacting with the HI Service, the spokesperson said, “We understand that many of the Wave sites are using batch methods for understanding the level of data quality, however we feel that obtaining the IHI upon presentation is the best method of locating the identifier. In an effort to maximise the number of matches that we receive for looking up an Individual Healthcare Identifier (IHI), we recommend the real‑time lookup of an identifier, whilst the patient is presenting for care. In this way, changes in key information can be rectified to receive the patient’s IHI.” As far as the development of broader PCEHR functionality and connectivity to the service is concerned, the spokesperson said, “CSC is currently in negotiation with NEHTA to amend our deliverables to provide a PCEHR B2B gateway enabled version of Practix. We expect it to be finalised shortly and then development will commence on the required functionality.
When asked about Genie’s progress developing functionality specific to the PCEHR, managing director Dr Paul Carr indicated that his company has completed most of the development work required to upload both event summaries and shared health summaries, and will commence testing its interface to the PCEHR infrastructure soon to complete the CCA process. “We’ve pretty much done all the groundwork now, so it’s just a matter of trialling it within NEHTA’s new test environment. I think our vendor panel deadline to deliver this functionality is end of October so things will progress in the coming months.” In addition to the work Genie Solutions has been undertaking for the PCEHR, the company has also been working on similar shared record functionality as part of its involvement with the Mater Hospital. “We’ve also completed work to enable O&Gs to upload a pregnancy summary to the Mater Hospital in Brisbane as part of
the Wave 2 project we’ve been involved with. This is basically the same thing as the PCEHR work we’ve undertaken, it just uses a slightly different interface but many of the same PCEHR specifications. “The Mater has been testing it for the past week and everything is fine so they’re now about to roll it out at one of their users’ practices. Technically the functionality is already available more broadly but we’ve hidden it from the wider user base while the testing is being finalised.”
HCN HCN, which counts more general practice customers than any other clinical software vendor in Australia, released HI Service functionality in January 2012 in Medical Director version 3.12.1b, making it available to all customers at that time. When asked about PCEHR-specific functionality, a spokeswoman for HCN stated that the company does not pre‑announce its product roadmaps, and was not able to be drawn about what future functionality it would release, and its expected timeframes for such releases. However, the spokeswoman did reaffirm the company’s interest in the PCEHR project, stating that “HCN is committed to Australia’s eHealth strategy and we will deliver those aspects that makes sense to and are a benefit to our customers.”
MedTech Global Medtech Global first released its initial HI Service functionality in late 2011 to support a selection of the clinics using its software in the Wave 1 geographic regions. Notably, one such healthcare facility in the Hunter Region of NSW has a database with over 250,000 patient records, providing a useful testing environment for both MedTech’s HI functionality and the HI Service itself. MedTech 32 version 8.1.2 was the first release of the software to include HI
Service features, however Rama Kumble of Medtech Global indicated adoption of these parts of the product are subdued at the moment due to a lack of general awareness about the HI Service.
and other things like that. The real value add by Medtech would be to provide practices and especially doctors innovative ways of making use PCEHR repository of documents for the benefit of the patient.”
“We haven’t done a major push for the HI Service outside of the Wave sites, as our customers need to be properly educated about it before turning it on. We believe NEHTA is putting together education campaign material in this regard which will help over time, however if a customer wants to adopt it now, they can contact us and patch their software to add the functionality. We’ve produced a reusable component and made only minimal changes to MedTech32. Nearly everything is in a component which we can pick up and use in other MedTech products, such as MedTech Evolution and Rx,” said Mr Kumble.
“Our development focus is now more geared towards the PCEHR and getting ready to deliver on our vendor panel commitments, such as reading a CDA document, publishing a shared health summary, publishing an events summary,
Zedmed first released HI Service functionality in version 16 of its product in August last year, providing users with the ability to download patient IHIs both on an individual basis, and also in batches. As with the other participants on the vendor panel, the company is waiting on additional specifications to be released by NEHTA before it can complete its development and testing of additional HI Service functionality, such as the ability to retrieve HPI-Os and HPI-Is directly from the HI Service for the sake of secure messaging with other healthcare organisations. Overviewing Zedmed’s progress with its PCEHR development, a representative from Zedmed said, “We are working away and aim to finish our PCEHR functionality
towards the end of June. We are focusing on the Shared Health Summary initially and connectivity to the PCEHR. We have access to the test environment and we can run calls against the PCEHR environment, but we can not do the corresponding CCA tests yet as they are not completely finalised. “What we’re planning to do is put in place the functionality to allow doctors to use the PCEHR to their best extent, but not disrupt them in the process. For example if no new medications are prescribed or only a basic antibiotic, we won’t channel them into screens that ask them to upload such information to the PCEHR. Ultimately it will be up to the doctor to decide how they interact with the system.” Zedmed did not believe that practices would need to take additional steps to prepare their data in advance of the launch of the PCEHR, stating that, “If doctors have good clinical records in place, they won’t need to do anything different with the PCEHR. Maintaining good records is part of a normal workflow and if you have these in place, there won’t be any problems.”
CALLING 1800 PCEHR CONSUMER REGISTRATION FOR THE PCEHR
With the launch date for registration for the PCEHR fast approaching, what will consumers be able to do or see on July 1? Very little as yet, it seems. With neither the consumer nor the provider portal yet functional and few practitioners geared up to load clinical data, it seems likely that the ability to register is the only piece of the puzzle ready for the average consumer come launch day.
KATE MCDONALD Journalist: Pulse+IT email@example.com
When the federal Treasurer announced the creation of a personally controlled electronic health record in his budget speech on May 11, 2010, he said the government would invest $466.7 million over the following two years to establish an individually controlled record that consumers could use to securely store their health information, and to allow access to that information by healthcare providers. That same day, thenâ€‘Health Minister Nicola Roxon released a statement saying consumers would be allocated an Individual Healthcare Identifier, and if they chose to opt in to the PCEHR, they would be able to register online at some stage in 2012 or 2013. Since then, not much has changed for the average consumer. The registration date has been set at July 1, and, as it seems that the online registration option will not be ready in time, a 1800 number has been set up. But apart from that, little fanfare has been aimed at the average person in the street.
About the author Kate McDonald is a senior staff journalist for Pulse+IT. Formerly the editor of Australian Life Scientist magazine, she has also edited industry titles Hospital & AgedCare and Nursing Review. Her interests cover health ICT, biotechnology and translational research.
For those who are interested, the government has set up a website at www. ehealthinfo.gov.au that contains some broad descriptions of both the HI Service and the PCEHR, and there are links to further information sources at www. yourhealth.gov.au, but even if they want to
get more detail, it is not readily available. This is not too surprising, given that both DOHA and NEHTA have repeatedly stated that the plan is to target certain segments of the population in the first instance rather than consumers as a whole. According to a recent presentation by Mick Reid of McKinsey & Co, part of the National Change and Adoption Partner (NCAP) consortium, these target populations are mothers and newborns, older Australians, people with chronic conditions like diabetes, people being treated for prostate, breast and bowel cancer, mental health consumers, clients of the Department of Veteransâ€™ Affairs (DVA), the Department of Defence and private health insurers, and clients of Aboriginal Controlled Community Health Services (ACCHS). The marketing plans for the Wave sites responsible for implementing the PCEHR have not factored in broad consumer information activities to begin until May or June, and consumer recruitment from the target demographics only began at the start of the year, and was then delayed by the notorious glitch in the GP desktop software. DoHA secretary Jane Halton recently told the Health-e-Nation conference that close to 1.4 million consumer identities
have been matched through the Wave sites, but according to a spokeswoman for DoHA, any information collected by the sites will not necessarily transfer to the PCEHR from July 1. Consumers involved in those projects will have to register for the national PCEHR, just like everyone else. Steve Saunders, project manager for the Eastern Sydney Connect Wave site, said that as of May 4, 424 GPs from 100 practices and 4444 consumers have been recruited for the St Vincent’s & Mater Health project, but these consumers will need to re-consent to their information being used in their PCEHR when the legislation has passed. The DoHA spokeswoman said consumers involved in the lead eHealth sites “have been provided with information to inform them of the benefits of participation in their local network”. “Information regarding registration for the eHealth record for these patients and the wider community will be released following passage of the eHealth record legislation,” she said.
“Information collected by local systems established as part of the lead eHealth sites will not in itself transfer to the national infrastructure from 1 July 2012. However, a GP can post a patient’s shared health summary generated in their own clinical system – once capable of this functionality – to the PCEHR from 1 July 2012, with the patient’s consent.”
In person and by phone So what can the average consumer do on July 1? The DoHA spokeswoman said consumers will be able to register for an eHealth record at a Department of Human Services (DHS) Medicare shop front, by calling 1800 PCEHR1 (1800 723 471) or by submitting a paper application form. “Online registration will be available after 1 July,” she said. She said they will also be able to enter their own information come July 1. “The consumer will be able to create their own consumer health summary record and enter information for sharing with healthcare providers: their emergency contact
details, the location of advanced care directives, any allergies or adverse reactions they have had and a list of medications they are taking, including prescription and over the counter medications. “The consumer can create their own private ‘diary’ area of the eHealth record, where they can enter their own health–related notes. These private notes will not be able to be viewed by healthcare professionals. “A consumer can set access controls in regard to their PCEHR to determine who can access the record or documents in the record. They can also consent to have data held by DHS–Medicare (such as MBS and PBS information, DVA claims and Repatriation Pharmaceutical Benefits Scheme claims, child immunisation records and organ donor information) made available as part of their eHealth record.” However, it is not yet clear whether this will be done through the promised consumer portal, which is being built by Orion Health, part of the National Infrastructure Partnership consortium. Orion is also building the provider portal for the PCEHR, but the company is tight-lipped on when that will be ready. It is also not clear whether consumers will be able to register online for their PCEHR through Medicare Online or the australia. gov.au site, which links various online accounts from the Department of Human Services – Medicare, Centrelink and Child Support – as well as the DVA. According to eHealth blogger Charles Wright, who attended a NEHTA-organised stakeholder “super summit” in Sydney in April, NEHTA’s head of the PCEHR, Andrew Howard, told attendees that online registration capability had not yet been delivered and he could not “give an iron-clad date on that yet”. Mr Wright also wrote that once an individual has registered by phone or at a Medicare office, they will be sent a code in the mail “which will allow them to set up a record and choose what features they want to have uploaded”. He also reported that “assisted registration — where a doctor helps a patient set up a health record — will not be available until around October”.
registration of consumers for an eHealth record within their own practice. Where GPs do not have the required software, consumers can register for an eHealth record at a DHS Medicare shop front, by calling 1800 PCEHR1 or by submitting a paper application form.” She said consumers do not need to know their IHI to register for an eHealth record. “When a consumer registers and their eHealth record is created it will be automatically linked to their IHI. If consumers would like to know their IHI they can contact the HI Service. [Medicare] operates the HI Service and consumers can obtain their IHI by going into a Medicare shop front, contacting the HI Service on 1300 361 457 or via Medicare Australia’s Online Services.”
Consumer marketing In the meantime, DoHA says an “online eHealth record Learning Centre” will be available before July 1. “The Learning Centre will feature a range of information about the eHealth record system and the infrastructure that will support it,” the spokeswoman said. “This online tool provides interactive features for the general public, who may be hearing about eHealth records for the first time, and for healthcare professionals who may be looking for more detailed material.” She also said an events program is underway. “This has involved presenting to and having exhibition displays at conferences targeting key consumer cohorts, including Aboriginal and Torres Strait Islander peoples, older Australians and mothers and their newborn children.” According to Mr Reid of the NCAP, part of the promotional plan was to launch the national PCEHR call centre in April, along with a second wave of e-collaboratives. (The Wave 1 sites have already set up an eHealth Network (www.ehealthnetwork.com.au) taking in the catchment areas for the four organisations involved The website has been created and its call centre being manned by Health Industry Exchange (HIE), which is sub-contracted by the sites to develop shared services.)
The DoHA spokeswoman said that once a consumer has registered for their PCEHR, they can then ask their GP to set up a shared health summary, as long as the GP has compliant software and has registered for an HPI-I and HPI-O. “Organisations that have upgraded to eHealth record-compliant clinical software with the support of their software vendor will be able to create shared health summaries,” she said.
The marketing plan for this month, supposing that the legislation passes the Senate, includes a pre-registration announcement and activities such as the launch of the electronic “blue book” for newborns which is being created by the Greater Western Sydney Wave 2 site. Consumer-based assisted registration is also being developed, according to Mr Reid.
“As eHealth record-compliant software is progressively made available, healthcare professionals will be able to facilitate the
A staged media event of the Minister for Health signing up for an eHealth record is planned for July 1.
ONE EASY STEP TO THE
Connect your iSOFT PAS to the HI service today Once enabled your iSOFT, now CSC Patient Administration System, will be able to lookup a patient’s Individual Healthcare Identifier via the national HI Service and then update that patient’s record – ultimately providing access to better patient information. Your enabled PAS will also broadcast the Individual Healthcare Identifier to other hospital information systems. In one easy step you are ready for the PCEHR.
Pulse IT May 2012
Visit CSC.COm/HEAlTH_IdEnTIFIERS for more about healthcare data sharing. Ready to get started? Call +61 2 8251 6700 or email firstname.lastname@example.org today.
NATIONAL CONFERENCE Brisbane Convention & Exhibition Centre
Tuesday 16 – Friday 19 October 2012
AAPM Member, non-member but wanting to know more about Practice Management. Join us in Brisbane this year for the AAPM 2012 national conference. To complement the invited speakers the committee have a fantastic program with a variety of concurrent sessions on offer where you will ﬁnd it difﬁcult to make a choice as to which one you should attend!
ABOUT THE AUSTRALIAN ASSOCIATION OF PRACTICE MANAGERS
Concurrent presentations will include:
The Australian Association of Practice Managers (AAPM) represents Practice Managers and the profession of Practice Management. Founded in 1979, AAPM is a non-proﬁt, national peak association recognised as the professional body dedicated to supporting effective Practice Management in the healthcare profession.
• Worksplace OH&S
The Australian Association of Practice Managers:
• Fair Work Australia
• represents and unites practice managers and the profession of Practice Management throughout the healthcare industry
• Lasseter’s Reef
• promotes professional development and the code of ethics through leadership and education • provides specialised services and networks to support quality Practice Management The AAPM has a National Board and State Branches across Australia. The National Board consists of representatives from State Branches. Its function is to manage the overall direction of AAPM including areas such as membership and accreditation, education, marketing, publications and regulations. State Branches conduct education programs, including courses, seminars and workshops. AAPM provides an array of beneﬁts for our members including providing advocacy, education, resources, networking, assistance and advice.
• Stress and Time Management • Benchmarking • Medicare • Avant and MDA will address medico-legal issues • Manual for specialist practice – ISO Group • UNEP Model
• AMA discussions on Industrial Relations • AMAQ There will be an e-Health workshop each day.
SOCIAL FUNCTIONS Tuesday 16 October Welcome Reception and First Time Attendees Dinner Wednesday 17 October Happy Hour and UNE Partnerships Graduation and Awards Thursday 18 October Gala Dinner There will also be the opportunity to attend state Breakfasts
AAPM National Conference website – www.aapm.org.au This site will be updated as new information becomes available and will provide all the detail required to register for the conference, organise accommodation and book social functions and workshops. All enquiries to: Conference Design Pty Ltd T. 03 6231 2999 E. email@example.com
ACSS AAPM P: 1800 196 000 / +61 3 9095 8712 F: +61 3 9329 2524 E: firstname.lastname@example.org W: www.aapm.org.au The Australian Association of Practice Managers (AAPM) represents Practice Managers and the profession of Practice Management. Founded in 1979, AAPM is a non-profit, national peak association recognised as the professional body dedicated to supporting effective Practice Management in the healthcare profession. The Australian Association of Practice Managers: • Represents Practice Managers and the profession of Practice Management throughout the healthcare industry. • Promotes professional development and the code of ethics through leadership and education. • Provides specialised services and networks to support quality Practice Management.
Australasian College of Health Informatics P: +61 412 746 457 F: +61 3 9569 9449 E: Secretary@ACHI.org.au W: www.ACHI.org.au The Australasian College of Health Informatics is Australasia’s Health Informatics professional body, representing the interests of a broad range of clinical and non-clinical e-health professionals. ACHI is the community of Health Informatics thought-leaders in Australasia. 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: 1300 788 005 / +61 2 9632 0026 F: +61 2 9632 0096 E: email@example.com W: www.acsshealth.com ACSS provides innovative and customisable patient management software streamlining day-to-day operations for GPs, Allied Health, Specialists, Radiologists, Pathologists, Private and Public Hospitals. eClaims® — Comprehensive and robust appointment and billing system with digital/voice recognition capabilities, electronic reporting transmissions and HL7 PACS system integration. eClaims® Hybrid — A solution tailored to Hospitals and other health service providers including billing agents who lack online capabilities. eClaims® Hybrid is the interface solution for connecting you to Medicare and health funds through ECLIPSE. SimDay® — Proven PAS (Patient Administration System) specifically designed for day surgeries and private hospitals – Now with ECLIPSE integration.
P: +61 3 5335 2220 F: +61 3 5335 2211 E: firstname.lastname@example.org W: www.argusdca.com.au
P: +61 3 9023 0800 F: +61 3 9614 2650 E: email@example.com W: www.precedencehealthcare.com
Argus provides and supports Argus secure messaging software; a popular electronic solution that enables healthcare practitioners to exchange pathology, radiology and specialist reports, hospital discharge summaries, referrals and clinical data securely and reliably.
cdmNet is an online service specially designed to manage the entire life cycle of a patient’s chronic disease.
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. Argus is the messaging solution chosen by 65 Divisions of General Practice through the ARGUS AFFINITY program. With over 12,800 users Argus continues to grow in popularity by delivering a highly secure message, reliable product, backed by outstanding customer service all at the lowest cost possible.
cdmNet delivers best practice chronic disease management, including creation of GPMPs, TCAs and Reviews. In addition, collaboration with your care team is quick, easy and ongoing. cdmNet minimises the bureaucracy, eliminates the paperwork, and ensures compliance with Medicare requirements for chronic disease management. cdmNet optimises patient care, simplifies care team collaboration and reduces administration & paper work. Find out more about how cdmNet can assist you and your practice by typing cdm.net.au/info into your browser address bar. cdmNet: Chronic Disease Management just got a whole lot easier.
Cutting Edge Software
P: 1300 308 531 F: +61 3 9797 0199 E: firstname.lastname@example.org W: www.advantech.net.au
P: 1300 237 638 E: email@example.com W: www.cesoft.com.au
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 P: +61 7 4155 8800 F: +61 7 4153 2093 E: firstname.lastname@example.org W: www.bpsoftware.com.au Best Practice sets the standard for GP clinical software in Australia offering a flexible suite of products designed for the busy GP practice, including: • Best Practice Clinical (“drop-in” replacement for MD) • Integrated Best Practice (Clinical/ Management) Visit us at the following conferences throughout the year: • GPCE Sydney, 18 - 20 May • RDAQ Gold Coast, 8 - 10 June • GPET Melbourne, 5 - 6 September • GPCE Brisbane, 14 - 16 September • AAPM National Conference Brisbane, 23 - 26 October • ACRRM Fremantle, 25 - 28 October • AGPN Adelaide, 10 - 14 November • GPCE Melbourne, 16 - 18 November
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.
Cerner Corporation Pty Limited P: +61 2 9900 4800 F: +61 2 9900 4990 E: AsiaPacific@cerner.com W: www.cerner.com.au Cerner is a leading supplier of healthcare information systems and our Millennium suite of solutions has been successfully installed in over 1200 sites across the globe. Cerner’s technology has been designed so that it can be adapted to meet the needs of the very different healthcare delivery systems that exist, with a universal framework that allows clinician workflow to seamlessly span role and venue. Our innovative leadership is allowing us to push boundaries by: • Leveraging clinical and pharmaceutical data for new discoveries in Condition Management and Personalised Medicine • Connecting the community with personal and community health records • Seamlessly connecting the patient record across the continuum of care
Clintel Systems P: +61 8 8203 0555 E: email@example.com W: www.clintel.com.au The Specialist: A complete solution for your Appointments, Billing including Online Claiming and Clinical requirements in an intuitive scalable solution. Clintel provides systems to Specialist and Day Surgeries nationally. Powerful, highly configurable and easy to use, our systems mirror the needs and workflow of your practice and individual specialty. Our industry standard SQL database enables a true “paperless” practice. Our leading edge architecture is future proof, it is designed to meet changing requirements and offers first class reporting and analysis of clinical and business data. Standalone or networked multi-site installation which runs on both Mac OSX and Windows operating systems. Our support is first class, our philosophy is “whatever it takes”.
Direct Control Digital Medical Systems P: 1300 865 977 F: +61 3 9753 3049 E: firstname.lastname@example.org W: www.dgs.com.au Easier ICT is a technology partnership with DMS — we make I.T. work for you. DIGITAL MEDICAL SYSTEMS has provided ICT solutions and services to medical practice clients across Australia since 1990. We have specialist expertise and experience in the installation and support of leading medical software applications. DMS is a Business Partner for IBM, Lenovo, HP and Microsoft. Other leading ICT brands include Trend Micro, Symantec, CA, Cisco, Toshiba, Canon, Epson, Kyocera, Fujitsu and Brother. Accreditation is easier with the customised DMS IT Systems Documentation. Ensure your practice has the best quality IT policy, security and maintenance program that meets and exceeds the standards guidelines from the RACGP and AGPAL and GPA. World leading DTech provides 24x7 near Real-Time Monitoring and Management that alerts and enables our engineers to quickly troubleshoot and solve problems of security, network, Internet, Server and software remotely on almost any client computer system or device. Medical IT systems are automatically maintained by DTech to the most highly available status to minimize downtime by preventing problems from occurring or reducing their impact. Proactive, Flexible, Consistent, Reliable, Audited, and Affordable — for even the smallest practice. Call DMS for: • Systems Analysis & Consulting • Solutions Design • Procurement & supply of hardware, software, network and peripheral products • Installation & Configuration • Support Services inc Help Desk • DTech Monitoring, Maintenance & Management • Disaster Recovery solutions • Fully managed & automated Online Backup customised for clinical data Easier IT — we make I.T. work for you.
P: 1300 557 550 F: +61 7 5478 5520 E: email@example.com W: www.directcontrol.com.au Direct CONTROL is an affordable, intuitive and educational Medical Billing and Scheduling application for Practitioners of all Disciplines. Seamless integration with Outlook, MYOB or Quickbooks. Direct CONTROL’s Clinical Module manages Episodes of Care and includes State, Federal and Health Fund Statistical Reporting for Day Surgeries/Hospitals. Direct CONTROL facilitates Medical Billing Australia-wide and overseas. Included is all Medicare, DVA, Work Cover, Private Health Insurance fee schedules with built in rules relevant to each medical discipline (allied health, general practice, surgeons, physicians, anaesthetists, pathologists, radiologists, day surgeries/hospitals). Ideal for the single practitioner or the multidisciplinary Practice. Direct CONTROL supports ALL your Business needs letting you and your staff get on with earning a living doing what you enjoy most … Patient Care.
eHealth Security Services P: 1300 399 116 / +61 2 9016 5378 F: +61 2 9016 5379 E: firstname.lastname@example.org W: www.ehealthsecurity.com.au eHealth Security Services (eHSS) specialises in the provision of security as a service and offers an extensive range of Managed IT Services including IT Support for small to medium businesses in the health sector. eHSS’ MediAccess® service provides comprehensive and cost-effective managed security and remote access solutions. eHSS has thorough knowledge and understanding of IT matters in the health industry and its regulatory aspects. eHSS has extensive experience reviewing and assisting with organisational policies and procedures and technical implementations against applicable standards.
Emerging Systems P: +61 2 8853 4700 F: +61 2 9659 9366 E: email@example.com W: www.emerging.com.au/ehealth Emerging Systems EHS web-based Clinical Information System records the clinical care delivered to a patient from pre-admission through to discharge. EHS interfaces with the hospital’s PAS system, capturing and providing all of the information Clinicians require during a patient stay to support the delivery of effective, appropriate, quality care outcomes in a secure and auditable environment. Importantly, EHS links Clinical Care with Workforce Rostering and Staff Allocation allowing for predictive Resource Allocation based on the care required, enabling valuable productivity improvements. EHS is a proven and highly useable electronic medical record developed within Australia and operating successfully in St Vincent’s & Mater Health, Sydney and Government of South Australia, Department of Health Hospitals. EHS provides: • Pre-Admission • Patient History • Orders & Results • Clinical Care Guides • Assessments • Progress Notes • Referrals • Labour & Birth • Medications Reconciliation • Clinical and Non Clinical Messaging • Diets • Discharge Summaries • Appointments • Rostering & Allocation • GP Connect • Workforce Resource Calculation • Clinical Dashboard and more EHS supports interactions with the health identifier service and PCEHR. EHS’ extensive list of modules work seamlessly with other systems via our integrated interface engine which accepts HL7 and other accepted Health IT standard protocols complying with the Australian Technical Specification: ATS 5822:2010 eHealth Secure Message Delivery. Accessibility: EHS is accessible on a range of devices according to user preference including our latest iPad / iPhone application
Equipoise (International) Totalcare
GPA P: 1800 188 088 F: 1800 644 807 E: firstname.lastname@example.org W: www.gpa.net.au
P: +61 7 3252 2425 F: +61 7 3252 2410 S: skype.totalcare.net.au E: email@example.com W: www.totalcare.net.au Equipoise International Pty Ltd (EQI) is the developer and supplier of the ‘Totalcare’ clinical and office management system. Used since 1995 by health care facilities across Australia including General and Specialist practice, Radiology, Day Surgery and Hospitals. Totalcare is a fully integrated Clinical, Office and Management software suite. Totalcare is stable, scalable, customisable and easy to learn and use. From a small practice to a distributed, multi site, multi disciplinary corporate entity or hospital, Totalcare can provide a solution for your needs.
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.
GPA ACCREDITATION plus has given general practices a reliable alternative in accreditation. GPA is committed to offering a flexible accreditation program that understands the needs of busy GPs and practice staff. GPA assigns all practices an individual quality accreditation manager to support practices with their accreditation. Choose GPA for more support, improved service and greater choice.
Genie runs on both Windows and Mac OS X, or a combination of both. With over 2400 sites, it is now the number one choice of Australian specialists.
Healthbank Consult Extensia P: +61 7 3292 0222 F: +61 7 3292 0221 E: email@example.com W: www.extensia.com.au Extensia links healthcare providers, consumers and their communities for better and more efficient health care. The products used to do this can be custom branded for all Organisations and include: • RecordPoint – a proven Shared Electronic Health Record that links all clinical systems, hospital settings, care plan tools and any other sources of information available. It provides a secure means of sharing critical patient data in a privacy compliant and logical structure. • EPRX – an Electronic Patient Referral Exchange and Directory. It streamlines the process of selecting a provider and completing a referral. Patient information is transferred seamlessly from clinical software. The most relevant providers, services and products are presented instantly and referral documents are generated and sent electronically.
Global Health P: 1300 723 938 F: +61 3 9675 0699 E: firstname.lastname@example.org W: www.global-health.com Global Health is a leading provider of e-health solutions that connect clinicians and consumers across the healthcare industry. Global Health’s portfolio consists of: • ReferralNet - a cloud-based secure message delivery system for the exchange of information between healthcare providers. • MasterCare® - a suite of health information systems that provides tools to collect, manage and access clinical and patient information at the point of care. • LifeCard® - a personal health management system for keeping all your important medical information in ONE secure location. With LifeCard® you can maintain a personal health record, access emergency health information and be rewarded for looking after your health.
Health Communication Network P: +61 2 9906 6633 F: +61 2 9906 8910 E: email@example.com W: www.hcn.com.au Health Communication Network (HCN) is the leading provider of clinical and practice management software for Australian GPs and Specialists and supplies Australia’s major hospitals with online knowledge resources. HCN focuses on improving patient outcomes by providing evidence based software tools to health care professionals at the point of care. Market snapshot: • 17,000 medical professionals use Medical Director • 3,600 GP Practices use PracSoft • 800 Specialist Practices use Blue Chip and • 2,100 Specialists use Medical Director • Leading suppliers of Knowledge Resources to Australia’s major hospitals
P: 1300 856 722 F: 08 8301 4001 E: firstname.lastname@example.org W: www.healthbankconsult.com.au Healthbank Consult is a telehealth system developed in Australia for Australian healthcare providers. Secure, fully encrypted and HD capable, Healthbank Consult is designed to be compatible with your clinical desktop for easy integration with your practice’s workflow and retains an audit trail for Medicare. Compliant with RACGP telehealth guidelines, Healthbank Consult will qualify Rural GPs, Specialists, Aged Care Facilities and Aboriginal Medical Services for a $6,000 Medicare telehealth rebate plus ongoing fees.
Health Informatics Society of Australia P: +61 3 9326 3311 F: +61 3 8610 0006 E: email@example.com 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: firstname.lastname@example.org W: www.houstonmedical.net “We provide time to health professionals through efficient practice management software”
Health Information Management Association Australia P: +61 2 9887 5001 F: +61 2 9887 5895 E: email@example.com W: www.himaa.org.au The Health Information Management Association of Australia (HIMAA) is the peak professional body of Health Information Managers in Australia. HIMAA aims to support and promote the profession of health information management. HIMAA is also a Registered Training Organisation conducting, by distance education, “industry standard” training courses in Medical Terminology and ICD-10-AM, ACHI and ACS clinical coding.
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
MEDITECH Australia ISN Solutions P: +61 2 9280 2660 F: +61 2 9280 2665 E: firstname.lastname@example.org W: www.isnsolutions.com.au ISN Solutions is a Medical IT company that specialises in the design, setup and maintenance of computer networks for medical practices and private hospitals. We manage IT services, we are dedicated to the medical industry. We know that if you are consulting then you need a quick response. Our support model is designed to minimise the interruptions to the doctor specially. We are familiar with most medical software applications in Australia. We have strong industry references. Some of our solutions include, but are not limited to: • Cloud based computing tailored to medical industry • Medical voice recognition • Capped cost medical support and maintenance plan • Ability to consult remotely • Medical application support
HealthLink P: 1800 125 036 (AU) P: 0800 288 887 (NZ) E: email@example.com W: www.healthlink.net Australia’s and New Zealand’s largest effective secure communication network. • Referrals, Reports, Forms, Discharge Summaries, Diagnostic Order and Reporting • Provider of Secure Messaging Delivery (SMD) services • Fully integrated with leading GP and Specialist clinical systems • Robust; Reliable and Fully Supported Join the network that more than 70 percent of GPs use for diagnostic, specialist and hospital communications.
InterSystems Corporation is a global leader in software for connected care, with headquarters in Cambridge, Massachusetts and offices in 23 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, and the creation of Electronic Health Record on a local, regional or national scale. HealthShare leverages InterSystems iKnow and DeepSee technologies to unlock all patient information, including unstructured data, and to enable real-time analysis. InterSystems Ensemble® is a platform for rapid integration and the development of connectable applications. InterSystems CACHÉ® is the world’s most widely used database system in clinical applications.
A Worldwide Leader in Health Care Information Systems MEDITECH today stands at the forefront of the health care information systems industry. Our products serve well over 2,300 health care organisations around the world. Large health care enterprises, multi‑hospital alliances, teaching hospitals, community hospitals, rehabilitation and psychiatric chains, long-term care organisations, physicians’ offices, and home care and hospice agencies all use our Health Care Information System to bring integrated care to the populations they serve. Our experience, along with our financial and product stability, assures our customers of a long-term information systems partner to help them achieve their goals.
Medtech Global Ltd P: 1800 148 165 E: firstname.lastname@example.org W: www.medtechglobal.com
InterSystems P: +61 2 9380 7111 F: +61 2 9380 7121 E: anz.query@InterSystems.com W: www.InterSystems.com
P: +61 2 9901 6400 F: +61 2 9439 6331 E: email@example.com W: www.meditech.com.au
iSOFT P: +61 2 8251 6700 F: +61 2 8251 6801 E: firstname.lastname@example.org W: www.isofthealth.com iSOFT, a CSC company, is one of the world’s largest providers of healthcare IT solutions. We work with healthcare professionals to design, develop and implement healthcare solutions that deliver administrative, clinical and diagnostic services to ensure continuity of care across all care settings. iSOFT provides flexible and interoperable solutions to the whole spectrum of providers, from single physician practices through to integrated national solutions supporting thousands of concurrent users. Our capacity to embrace change and keep abreast of emerging new directions in healthcare has allowed our clients to explore the exciting potential of new technologies while securing their existing investments.
For over 28 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.
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.
OzeScribe Mouse Soft Australia Pty Ltd P: +61 3 9888 2555 F: +61 3 9888 1752 E: firstname.lastname@example.org W: www.medicalwizard.com.au Medical Wizard saves time and money through greater efficiency and comprehensive integration. Throughout its 19 year history, Medical Wizard has led the way with innovative solutions. We are constantly evolving Medical Wizard to meet the challenges of the medical profession for today and tomorrow. A software of choice for discerning Specialist practices, notably Gastroenterologists, Cosmetic Surgeons, Ophthalmologists, General Surgeons, IVF Centres and Day Hospitals amongst others. All aspects of practice management from appointments, billing, clinical, theatre management and compliance reporting are covered and backed by a dedicated local support team.
Nuance Communications P: +61 2 9434 2300 F: +61 2 9929 0815 E: Vicki.Rigg@nuance.com W: australia.nuance.com W: newzealand.nuance.com Nuance (NASDAQ: NUAN) is a leading provider of speech and imaging solutions for businesses and consumers around the world. Its technologies, applications and services make the user experience more compelling by transforming the way people interact with information and how they create, share and use documents. Every day, millions of users and thousands of businesses utilise Nuance’s proven range of productivity applications which include Dragon NaturallySpeaking (speech recognition), OmniPage (OCR), PaperPort (document management) and PDF Converter Professional (PDF creation and conversion).
P: 1300 727 423 F: 1300 300 174 E: email@example.com W: www.ozescribe.com.au OzeScribe is the dictation and transcription solution for 7/10 Australian university teaching hospitals and major private clinics. It really does make sound business sense to let OzeScribe worry about managing transcription, technology and staff, and show you how we can provide a free electronic document delivery service OzePost to your EMR and your associates’ EMR, saving you thousands of dollars in time, packing and postage. OzeScribe is the provider of the most advanced solutions available. • Australian trained typists. • Manage dictation and transcription via computers, iPhone, iPad, android or smartphones. • Integrated M*Modal speech recognition technology on demand.
Feature Rich. Dynamic. Innovative.
Pen Computer Systems Orion Health NEHTA P: +61 2 8298 2600 F: +61 2 8298 2666 E: firstname.lastname@example.org W: www.nehta.gov.au
MITS:Health P: 1300 700 300 E: email@example.com W: www.mitshealth.com.au Managed IT Services for the Health Industry MITS:Health provides a full range of IT services specifically tailored for medical centres, GPs and specialists across Melbourne. • • • • • •
Equipment supply and installation Remote monitoring and support Data backups Networking Internet Website Development
The National E-Health Transition Authority was established by the Australian, State and Territory governments to develop better ways of electronically collecting and securely exchanging health information. NEHTA is the lead organisation supporting the national vision for eHealth in Australia.
P: +61 2 8096 0000 / +64 9 638 0600 E: firstname.lastname@example.org W: www.orionhealth.com Orion Health is a world leader in the e-health industry. We specialise in electronic health record (EHR) solutions, disease management, clinical decision support, and hospital administration tools. More than 300,000 clinicians in 30 countries use Orion Health products. Our EHR solutions have been widely adopted across Canada, Europe and the USA to enable secure crossorganisational and regional sharing of patient information, resulting in improved patient care. Our Rhapsody Integration Engine, a healthcare dedicated and standards based Integration hub, is used by customers to easily create interoperability between existing healthcare information systems. Our solutions are designed to support emerging health IT trends and standards, we work closely with our customers, clinicians, government bodies and other industry leaders to deliver intuitive solutions to meet your current and future needs.
P: +61 2 9635 8955 F: +61 2 9635 8966 E: email@example.com W: www.pencs.com.au Established in 1993, Pen Computer Systems (PCS) specialises in developing information solutions for National and State eHealth initiatives in Primary Health that deliver better Chronic Disease outcomes. PCS expertise extends to: • Chronic Disease Prevention and Management • Population Health Status, Reporting and Enhanced Outcomes • Decision-Support tools delivered LIVE into the clinical consult • Web-based Electronic Health Records (EHRs) • SNOMED-CT and HL7 Standards Frameworks Our Clinical Audit Tool (CAT) for example delivers an intuitive population reporting and patient identification extension to the leading GP systems in Australia. CAT delivers enhanced data quality and patient outcomes in general practice.
Sysmex New Zealand
from Practice Services P: +61 3 9819 0700 F: +61 3 9819 0705 E: Sales@practiceservices.com.au W: www.practiceservices.com.au Medilink Practice Management Software • 21 years young, large user base • Medilink = Intuitive ease of use • Solo Drs up to Hospitals in size • Claiming via integrated EFTPOS ◊ and/or integrated HICAPS ◊ and/or Medicare Online ◊ and/or ECLIPSE • Many standard features • Many optional modules • Links to many third party packages and services • Cut debtors and boost cash flow • 17 years as an Authorised Medilink Dealer, selling, installing & training • Fixed Cost Support, Onsite or Remote
P: +64 9 630 3554 F: +64 9 630 8135 E: firstname.lastname@example.org W: www.sysmex.co.nz
P: 1800 061 260 E: email@example.com W: www.tg.org.au
Sysmex New Zealand is a market leader in the development and implementation of health IT products and services for clinical laboratories, hospitals and healthcare organisations. We offer the following health IT solutions: • Delphic LIS – a market-leading laboratory information system for hospital and community laboratories with a strength in providing multi-lab solutions. Specialised modules manage workflows in the anatomical pathology, haematology and microbiology work areas. • Eclair – an advanced clinical data repository (CDR) which stores patient data from a range of systems including laboratory, radiology, pharmacy and clinical document sources to create a secure patient-centric record. Eclair provides complete electronic ordering functionality.
Real Outcomes Real Productivity Minimising Waste
Stat Health Systems (Aust) P: +61 7 3121 6550 F: +61 7 3219 7510 E: firstname.lastname@example.org W: www.stathealth.com.au Stat Health Systems (Aust) has built a progressive and resilient system that introduces a new level of stability and flexibility to the medical software market. Stat is an integrated clinical and practice management application which has embraced the latest Microsoft technology to build a new generation solution. Fully scalable and the only medical software application to incorporate a multi-functional intuitive interface, Stat is at the forefront of computing technology. Stat Health provide a premium support service, clinical data conversion from existing software and tailor made installation and training plans for your practice. Facebook: facebook.com/StatHealth Twitter: @NotifyStat
Therapeutic Guidelines Ltd
Trend Care Systems P: +61 7 3390 5399 F: +61 7 3390 7599 E: email@example.com W: www.trendcare.com.au A national and international award winning solution recognised for its ability to provide real benefits in the acute and sub-acute health care settings. TrendCare is an international leader for e-health solutions excelling in all of the following: • Patient dependency and nursing intensity measures. • Projecting patient throughput and workforce requirements. • Rostering and work allocation. • Efficiency, productivity and HRM reporting. • Discharge analysis, bed management and clinical handovers. • Allied health registers with extensive reporting. • Clinical pathways with variance reporting. • Patient assessments and risk analysis. • Diet ordering and reporting. • Staff health tracking and reporting.
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. 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. 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. 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. It is widely used by practitioners and pharmacists in community and hospital settings in all Australian states and territories. Updated three times per year, eTG complete meets the criteria for ‘key electronic clinical resources’ in the Practice Incentives Program (PIP) eHealth Incentive. The March 2012 release of eTG complete includes updates of selected Cardiovascular topics and a complete revision of the Oral and Dental guidelines. miniTG The mobile version of eTG complete is miniTG, offering the convenience of having vital information at the point of care and designed 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.
Vensa Health P: +64 9 522 9522 F: +64 9 522 9523 E: firstname.lastname@example.org W: www.vensahealth.com Vensa Health is the leading mHealth solutions provider focusing on delivering mobile health innovations worldwide. If you have received an SMSfrom your doctor, hospital or physio it is almost certain Vensa Health was responsible for its delivery. At Vensa we are focused on offering solutions and innovations, which add value to our clients, this is the fundamental philosophy underpinning all of our services and technology offerings. With nearly 80% adoption of mobile health in New Zealand and a solid customer base, Vensa Health is focusing on Australasia and Middle East regions in its expansion with a BHAG of closing the gap for 10% of earth’s population health.
Zedmed P: +61 3 9284 3300 F: +61 3 9284 3399 E: email@example.com W: www.zedmed.com.au Owned by Doctors who understand the challenges facing the medical profession everyday and backed by nearly 30 years of experience in medical software programming, Zedmed provides innovative, full featured and sophisticated practice management and clinical records software solutions. Zedmed would also like to introduce to you Medical Record eXchange – a free, simple solution allowing Doctors to send patient’s medical information to insurance companies electronically. Using the latest in data extraction technology and fully encrypted, this is a secure, time-saving solution to one of the most dreaded requests Doctors receive on an almost daily basis. For more information please visit: www.medicalrecordexchange.com.au
The Model Healthcare Community
NEHTA’s Model Healthcare Community – showcasing Australia’s eHealth programs – is touring Australia For more details visit:
www.nehta.gov.au This national eHealth roadshow is proudly sponsored by the National E-Health Transition Authority (NEHTA) on behalf of the Governments of Australia.
Better Communication, Better Care
Just what the Doctor ordered “Our Electronic Referrals initiative has been very well received by our GPs. At our recent strategic planning meeting, electronic referrals was raised as one of the best initiatives that we have undertaken in recent years.
This project is already making a difference for GPs and patient care and will open up huge opportunities for better communication and collaboration between our Primary Care and hospital clinicians.”
Better Communication, Better Care
The HealthLink eReferral system is currently being implemented across more than 60% of New Zealand’s hospitals and general practices. It is now ready for implementation in any Australian or New Zealand region. Call us today
Dr Adrian Gilliland, Clinical Advisor Primary Care, Capital and Coast District Health Board HealthLink serves 9,000 practices (75% of Australia’s general practices, 100% of New Zealand’s) and exchanges more than 65 million clinical transactions annually. HealthLink has seven offices across Australasia focusing on web services and online communications.
AUS: 1800 125 036 NZ: 0800 288 887 Email: firstname.lastname@example.org www.healthlink.net
Better Communication, Better Care
Pulse+IT Magazine - May 2012 - Australasia's first and only eHealth and Health IT magazine.