PULSE IT Ã
AUSTRALIA’S FIRST AND ONLY HEALTH IT MAGAZINE
ISSUE 6: NOVEMBER 2007
NOW ENCOMPASSING AUSTRALIA’S ENTIRE HEALTH IT ENVIRONMENT
• GPs • Specialists • Practice Managers • Health Informaticians • Health IT Decision Makers
PULSE IT +
Publisher Pulse Magazine PO Box 7194 Yarralumla ACT 2600 ABN 19 923 710 562 www.pulsemagazine.com.au Editor Simon James 0402 149 859 firstname.lastname@example.org
COVER STORY: PULSE+IT EXPANDED PAGE 06
Sub-Editor Erica McLellan Editorial Enquiries email@example.com Advertising Enquiries firstname.lastname@example.org About Pulse+IT Pulse+IT is produced by Pulse Magazine, the most innovative publisher in health. Over 15,000 copies of Pulse+IT are distributed quarterly to GPs, specialists, practice managers and the IT professionals that support them. In addition, over 8,000 additional copies of Pulse+IT are distributed to key IT decision makers in hospitals, day surgeries and aged care facilities. With a total circulation exceeding 23,000, Pulse+IT is not only the largest Health IT publication in Australia, but one of the highest circulating health publications of any kind. Contributors Julian Flint, Dr John Goswell, Dr Terry Hannan, Simon James, Dr Heather Leslie, Jane London, Dr David More, Michael Murﬁtt, Dr Ian Reinecke and René Yim. Non-Commercial Supporting Organisations Australian College Of Health Informatics, Australian General Practice Network, Health Informatics Society Of Australia, HL7 Australia, National E-Health Transition Authority (NEHTA), The Royal Australian College of General Practitioners and Standards Australia (IT-014).
PAGE 32 PRACTICE HEALTH ATLAS Julian Flint outlines a tool designed to help practices improve patient care and achieve better ﬁnancial outcomes.
PAGE 46 HOSPITAL COMPUTING Dr David More reﬂects on the causes of Health IT failure.
Disclaimer The views contained herein are not necessarily the views of Pulse Magazine or its staff. The content of any advertising or promotional material contained herein is not endorsed by the publisher. While every care has been taken in the preparation of this magazine, the publisher cannot be held responsible for the accuracy of the information herein, or any consequences arising from it. Pulse Magazine has no afﬁliation with any organisation, including, but not limited to Health Services Australia, Sony or the Kimberley Aboriginal Medical Services Council that all publish printed articles under the title “Pulse”. Further, we have no afﬁliation with CMP (owner of “Medical Observer”), who are endeavouring to trademark “Pulse”. Copyright 2007 Pulse Magazine No part of this publication may be reproduced, stored electronically or transmitted in any form by any means without the prior written permission of the Publisher. Subscription Rates Please visit our website for more information about subscribing to Pulse+IT.
PAGE 48 DESIGNING FOR TOMORROW Michael Murﬁtt encourages developers to be mindful of their systems’ inevitable obsolescence.
NEHTA PAGE 12
GPS PHOTOGRAPHY PAGE 20
RAID PAGE 30
SECURE MESSAGING PAGE 37
REGULARS PAGE 06 STARTUP Editor Simon James introduces the sixth edition of Pulse+IT.
PAGE 12 NEHTA Dr Ian Reinecke outlines NEHTA’s National Product Catalogue and E-Procurement initiatives.
PAGE 16 AGPN Chris Scott outlines the Hunter Urban Division’s eHealth achievements.
PAGE 14 ACHI Dr Terry Hannan introduces the Australian College of Health Informatics.
PAGE 18 INTERVIEW: GENIE Pulse+IT checks in with Genie Solutions’ Managing Director, Dr Paul Carr.
PAGE 15 PULSE+IT SUBSCRIBER OFFER There has been no better time to subscribe to Pulse+IT, ﬁnd out why.
PAGE 56 MARKET PLACE Australia’s most innovative and inﬂuential eHealth organisations.
PAGE 20 GPS PHOTOGRAPHY Dr John Goswell explains how to use GPS technology to get more from your digital photography.
PAGE 30 RAID René Yim discusses RAID, a preventitive backup measure for your practice server.
PAGE 46 HOSPITAL COMPUTING Dr David More reﬂects on the causes of Health IT failure.
PAGE 24 CONSULTING ROOM PRINTERS Simon James presents a consulting room printer buyers guide.
PAGE 32 PRACTICE HEALTH ATLAS Julian Flint outlines a tool to help practices improve patient care and achieve better ﬁnancial outcomes.
PAGE 08 BITS & BYTES News from organisations operating in the eHealth sector. PAGE 10 RACGP Jane London discusses the new RACGP online portals for practice managers and practice nurses.
PAGE 27 FIRST LOOK: GPCOMPLETE Simon James takes a look at practice software solution, GPComplete.
PAGE 37 SECURE ELECTRONIC MESSAGING WITH MEDICAL-OBJECTS Simon James demonstrates a working secure electronic messaging solution.
PAGE 48 DESIGNING FOR TOMORROW Michael Murﬁtt encourages developers to be mindful of their systems’ inevitable obsolescence. PAGE 50 OPENEHR Dr Heather Leslie introduces the readership to openEHR.
PULSE+IT: 2007.4 Welcome to the sixth edition of Pulse+IT, Australia’s ﬁrst and only Health IT magazine.
PULSE+IT EXPANDED Welcome to the sixth edition of Pulse+IT, Australia’s ﬁrst and only Health IT magazine. As our regular readers will note, we have increased both the page count and scope of Pulse+IT, with a view to better encompassing Health IT beyond the hardware and software found in specialist and general practices. As part of this expansion, we have dramatically increased our readership base, many of whom will be receiving a complimentary copy of Pulse+IT for the ﬁrst time.
A BRIEF HISTORY... For the beneﬁt of both our new and existing readers, allow me to bring you up to speed on where we have come from, and give you a hint of what’s to come... Launched in August 2006, Pulse+IT was established as an Information Technology (IT) magazine speciﬁcally tailored for general and specialist practice. While the response from readers in this part of the health sector has been positive, our ultimate goal has always been to provide an interesting and useful IT resource for all the relevant participants in the health sector.
SUBSCRIBING TO PULSE+IT To ensure you keep receiving copies of the printed version of the publication, and to gain unrestricted access to our electronic services, a subscription to Pulse+IT is required. More details about our subscription packages, including information about our immensly popular iPod promotion, are available on pp15.
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While the current state of the Health IT landscape may suggest otherwise, it is obvious that patients and their aliments are not conﬁned to discrete parts of the health system. Further, rarely do GPs and specialists practise solely from their private rooms. The majority also spend time in either hospitals or aged care facilities or both. With these realities in mind, Pulse+IT will move forward with an expanded editorial scope, encompassing Australian Health IT wherever it is to be found. Obviously it would have been possible to produce several sister publications focused on the IT found in hospitals, aged care facilities, day surgeries etc. However, I strongly believe that holistic coverage of IT in the health sector through a uniﬁed publication will assist in the pursuit of a tightly integrated, cohesive Health IT environment, and ultimately, better outcomes for the sector as a whole. In recognition of the support that our existing readership has given us since our launch, and ever mindful of the important role specialist and general practice is playing in the quest for a connected Health IT environment, we have no plans to dilute the historical editorial platform of Pulse+IT. Instead, we will broaden the scope of Pulse+IT by aggressively expanding the page count of the publication, ensuring that all readership groups will be provided with a substantial supply of quality Health IT content.
THIS EDITION Readers from general and specialist practice will be interested in our coverage of the RACGP’s new online portals designed for Practice Managers and Practice Nurses, the Hunter Urban Division’s eHealth initiatives, GPS photography, personal laser printers, RAID, the Adelaide Western GP Network’s Practice Health Atlas, Genie Solutions, GPComplete, and our
signiﬁcant secure messaging article featuring Medical-Objects, MedTech32 and Medical Director 3. This edition also covers openEHR, NEHTA’s e-procurement plans for the public health sector, the Australian College of Health Informatics, software change management, and the causes of hospital IT failure.
BONUS ONLINE CONTENT Despite increasing our page count and maintaining a high content-toadvertising ratio, we were unable to include all of our editorial submissions within the conﬁnes of this magazine. Several quality articles had to be omitted, including organisational contributions from HISA, HL7 Australia and Standards Australia. In addition, feature articles encompassing the Vocera Communication System, document scanners, Microsoft Vista, and the Telstra Bedside Solution also had to be left out. While we will endeavour to include many of these articles in the printed version of our forthcoming February 2008 edition, this content has already been made available at our website — I encourage you to take the time to check it out.
LOOKING AHEAD Before Christmas, we expect to complete a signiﬁcant website redevelopment that will make our site more visually appealing, more functional, and most importantly, allow us to release content more frequently. The next edition of Pulse+IT will be sent to subscribers in early February 2008. As always, in the run up to this edition, I look forward to your feedback and editorial suggestions, and wish you all the best for the Christmas period and beyond. Simon James, Editor email@example.com
Authorised by the Australian Government, Capital Hill, Canberra.
BITS & BYTES EQUIPOISE INTERNATIONAL RELAUNCHES Equipoise International, the developer of the Totalcare suite of medical software has relaunched at the MedInfo 2007 conference. Touting new corporate branding and a relaunched website, the Australian software developer is redoubling its promotion of Totalcare, the company’s integrated clinical, billing and patient management offering. Designed with ﬂexibility in mind, the Totalcare suite of products can be conﬁgured for deployment in GP and specialist practices, day surgeries, and larger hospital settings. In addition to the relaunch of Totalcare, Equipoise has found time to establish a charitable initiative to encourage parents to read to their children. The company has provided several thousand dollars worth of books to doctors who have committed to pass them along to patients with young children. Equipoise International www.totalcare.net.au
GENIE INSTALLS ITS 1000TH SITE Genie Solutions, developer of the specialist and GP practice software product Genie, have recently installed their software in their 1,000th medical practice. Established by then GP, Dr Paul Carr in 1995, Genie was originally developed as a Macintosh product directed at GPs. Genie was later ported to Microsoft Windows in 1999, allowing practices to run Genie on Mac OS, Windows or mixture of both systems. Andy Matthews, Genie Solutions’ Victoria and Tasmania Sales Manager, recalls that before Windows compatibility was added, selling Genie to practices running Microsoft Windows was a difﬁcult proposition. “We didn’t just have to sell the Genie software, but often times had to convince the practice to replace their entire Wintel computer system with Apple Macintosh hardware.”
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While Genie Solutions now has several hundred GP sites, the company has found greater success in the Specialist market. With customised modules for Obstetrics, IVF, Ophthalmology, Orthopaedics and other specialist disciplines, the company now boasts over 750 specialist customers. Reﬂecting on his company’s success, Dr Carr said, “This is a tough industry, so it’s very satisfying to reach this milestone. When I ﬁrst started Genie Solutions I never really thought it would grow this big. However, after a small celebration, we are now focussed on our next goal of reaching 2000 sites by 2011.” Genie Solutions www.geniesolutions.com.au
“IHE CD CHALLENGE” HOSTED AT THE RANZCR ANNUAL SCIENTIFIC MEETING The Royal Australian and New Zealand College of Radiologists (RANZCR) held their Annual Scientiﬁc Meeting in early October. As part of this event, the college hosted an initiative focused on improving the way in which images are provided to clinicians on CD and DVD. While there are international standards deﬁned, a variety of formats exist in Australian and New Zealand. The inconsistency between these formats is reported to be causing problems for both referring clinicians and radiologists. Via discussions facilitated by the AMA, the RANZCR has been liaising with Orthopaedic and other procedural specialists in an effort to address this problem. The adoption by radiologists of image delivery solutions that are compliant with the IHE Proﬁle for Portable Data for Imaging (PDI) was identiﬁed as part of a possible solution. IHE is an international organisation established by healthcare professionals and the IT industry that seeks to improve the way computer systems used in healthcare share information. Dubbed the “IHE CD Challenge”, radiology providers were asked to prepare a CD or DVD containing a routine CT brain study and knee x-rays. Once submitted, disks were tested for compliance with the IHE PDI proﬁle.
Of the 30 disks that were entered into the challenge, none were found to be fully compliant with the IHE PDI proﬁle, however 2 disks were described as “coming close”. The organisers of the event were able to display images from all the media submitted, however considerable effort and IT expertise were required to get some disks to function as intended. Dr Peter MacIsaac, Director of MacIsaac Informatics, was responsible for coordinating the challenge. Dr MacIsaac has been involved in the coordination of several interoperability initiatives including the successful MedInfo interoperability demonstration held in Brisbane in August this year. Speaking after the event, Dr MacIsaac said, “The conference was a great opportunity to get the views of radiologists and also describe to them what is happening with their CDs out in the ﬁeld. The results conﬁrm the problems reported and indicated a need not only for CD standards but ways to tackle the upgrading of specialist’s and hospital’s IT systems to cope.” As a follow-up to the IHE CD Challenge, the RANZCR has planed a 3 day workshop focussing on IHE, radiology proﬁles, cross enterprise document and image sharing (XDS and XDS-I) and PDI. The event will commence on 10th December, and will feature a keynote presentation from Mr Chris Lindop, the Co-chair of the IHE Radiology Committee. This workshop will be preceded by an AMA-facilitated meeting, designed to better understand the needs of orthopaedic surgeons and other relevant clinician groups. It is hoped that these workshops will lead to the formation of an IHE Australia/AsiaPaciﬁc branch and the implementation of IHE proﬁles in the region. Integrating the Healthcare Enterprise (IHE) www.ihe.net IHE Australia www.ihe.net.au RANZCR ASM www.ranzcrasm.com
BITS & BYTES BEST PRACTICE RELEASES MEDICARE ONLINE FUNCTIONALITY Best Practice has released an update to their practice software suite under the moniker of version 18.104.22.1685. Most of the improvements to the software are contained in Best Practice Management, the companyâ€™s patient and practice management solution. Of these, the most signiďŹ cant enhancement is the addition of Medicare Online functionality (formerly HIC Online). Bulk billing, DVA Paperless Claiming, and Patient and DVA Online VeriďŹ cation features are now available, with Online Patient Claiming functionality to be added in a future release. The Medicare Online functionality has been available to Best Practice beta testers for some time, however issues with the Medicare Australia certiďŹ cation process delayed the ofďŹ cial release of the software. The update was ďŹ rst made publicly available at the recently held Australian Association of Practice Managers conference in Hobart. The new version will be rolled out to existing Best Practice Management users throughout November, and will be available to new customers thereafter. Dr Frank PyeďŹ nch, the companyâ€™s founder and lead developer, indicated that the addition of this long-anticipated
functionality is likely to increase adoption of Best Practice Management by existing users of his companyâ€™s clinical product, Best Practice. Dr PyeďŹ nch also stated that he expects his company will enjoy increased enquiry rates from potential customers looking to migrate to a fully integrated practice software solution. Best Practice www.bpsoftware.com.au
MAXON RELEASES NEXT G LAN SOLUTION Maxon have released a hardware router for Telstra and Bigpond Next G wireless broadband solutions. Dubbed the â€œEthermax USB Docking Stationâ€?, the device is designed to bridge a Next G broadband wireless connection to either a single ethernet-connected computer or an entire ethernet network. Maxon is a key supplier of Next G modem hardware to Telstra, manufacturing the Telstra Turbo Modem, the Bigpond Next G USB Mobile Card and the Bigpond Next G USB Desktop Modem.
APPLE SET TO UNLEASH LEOPARD On 26th October, Apple will release its sixth major iteration of Mac OS X. Code named â€œLeopardâ€?, the new operating system will come bundled with all new Macintosh computers. Alternatively, it will retail for $158 for a single licence, or $249 for a ďŹ ve user family pack. Along with a heavy dose of eye candy, Leopard introduces some signiďŹ cant features to the already mature operating system. Among the most notable are â€œTime Machineâ€?, a realtime backup solution complete with versioning control, â€œSpacesâ€? for multipledesktop functionality, and â€œQuick Lookâ€?, a sophisticated ďŹ le-previewing tool. SigniďŹ cant improvements have also been made to â€œAutomatorâ€?, Appleâ€™s desktop macro development environment, and the powerful â€œSpotlightâ€? desktop search engine. Apple claims Leopard has over 300 new features, however this tally includes a slew of relatively minor enhancements made to the operating systemâ€™s bundled application suite.
The Ethermax device retails for $299 and is available from Maxonâ€™s online store. Next G modem hardware and either a Bigpond or Telstra data plan is also required.
The system requirements for Leopard have increased beyond those required for Leopardâ€™s predecessor, Tiger, however all Macintosh hardware released after 2003 with at least 512MB of RAM will be able to run the new operating system.
Maxon Australia www.maxon.com.au
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MYGENERAL PRACTICE FOR PRACTICE NURSES AND PRACTICE MANAGERS Jane London
MY PRACTICE TEAM General practice is not just about GPs. Practice managers, practice nurses, and medical receptionists contribute signiﬁcantly to the delivery of quality services in general practice. However, the ‘business’ of general practitioners is sometimes replicated in other general practice roles unnecessarily. There are over 1,100 practice managers1 and 4,924 practice nurses2 active in Australian general practice. The general practice workforce is now approaching 75,000. While GPs within their role are well serviced by clinical and prescribing applications, practice managers and practice nurses only have access to waiting room/scheduling applications, some billing applications, and scant clinical resources. There are very few purpose built applications for practice managers or practice nurses. The recognition of this gap by the RACGP has led to the development of a desktop portal for practice managers and practice nurses that will address issues of resource accessibility in general practice. The portal will offer a range of services and resources — a one-stopshop for their work needs. The portal has been developed with funding from the Australian Government Department of Health and Ageing through a Managed Health Network Grant.
THE PORTAL The desktop portal for practice managers and practice nurses will use a client-server Internet desktopmanagement technology that facilitates integration of multiple information sources, networks, and technologies in a
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simple, customised, centrally-managed information environment. The portal provides secure single sign-on access to the Internet, network, and local computer resources and technologies. The single sign-on feature means that once all passwords are programmed into the system, logging on to the portal at the beginning of the day allows convenient access to all sites and resources that may need to be used during the day. The portal will facilitate standards-based applicationto-application messaging, allowing multiple information resources to share a common decision-making context. Some of the Portal’s resources are explored below: Clinical Audit Tool A clinical audit tool will allow the interrogation of practice data under a number of clinical groupings. This tool will allow practices to explore where they are succeeding in the delivery of care, and where they may need to improve. The ability to successfully identify gaps in delivery of care will enable practices to improve patient satisfaction and quality of care, strengthen their processes, and maximize various incentive payments. GPDirect GPDirect is an e-procurement tool that can be used to order consumables, vaccines, and medical equipment. It simpliﬁes and enhances ordering by allowing for product comparison, and shifts purchasing power to practices. Stock purchased this way is provided by standard third-party distributors that many practices would currently use. The ability to interrogate purchasing data will also be built into the system. This means that practice staff will be able to review their ordering history and further streamline their practice. For example, vaccine ordering can be explored to make sure that stocks are at maximal capacity, and minimise wastage.
Secure Vault Secure Vault is a program that allows the storage of personal and small business information in secure personal online ‘vaults’. This can include — but is not limited to — ﬁnancial and accounting information, human resources, and small business incorporation documents. Any data exchange that occurs by using the program is transmitted using 128-bit encryption. Other Resources, Tools and Links The prospect of incorporating a secure clinical messaging program into the new practice portal is currently being explored by a technical group. Along with this possibility, other practice process support items such as practice management resource kits, MBS Online, PBS Online, employment toolkits, and a number of other resources such as clinical and management links for practice nurses (e.g. wound management, diabetes management). The RACGP will be conducting pilot phases over the coming months and launching the new general practice portals for practice nurses and practice managers in the New Year. The MyGP Portal for Practice Managers and Practice Nurses is a companion to the existing MyGP Desktop portal. Should you wish to ﬁnd out more information about the portals, please contact Jane London at the RACGP. Jane London firstname.lastname@example.org MyGP Desktop www.mygeneralpractice.org.au 1 - Figure provided by the Australian Association of Practice Managers 2 - Australian Divisions of General Practice. National Practice Nurse Workforce Survey Report. April 2006. Manuka, Canberra: ADGP, 2006. www.tinyurl.com/23txbk
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