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Australia’s First and Only Health IT Magazine




19 2010

Telehealth Online Consultations: Medicare Benefits Schedule changes may make these a reality, but legal ramifications abound. NHS Mobile Computing Initiatives: The use of mobile technology and telehealth is enhancing clinical workflows in the United Kingdom. Chronic Disease Management: Online systems can aid healthcare professionals in the delivery of best practice care.

11 12 15 16 19

International Telehealth Conference HISA Board Elections Consumer E-health Survey Results Auslan iPad Application MSIA CEO Forum and AGM

Want to know more about e-health? Whether you are a consumer, healthcare manager, healthcare provider or vendor, you need a central location to quickly find and access e-health information.

Welcome to: Your gateway to the emerging world of modern healthcare. Discover how information technology is delivering a more reliable and efficient health system. Featuring: • The Healthcare Identifiers (HI) Service which commenced operations on 1 July 2010. Access fact sheets for individuals, healthcare providers, healthcare organisations, and medical software vendors • How e-health systems are being designed to maximize security and privacy • Why a national certification capability is an essential foundation for safe, secure and interoperable e-health solutions in Australia • The latest Federal, State and Territory government e-health initiatives • The delivery of a standard clinical language for use across Australia’s e-health implementations and how it is a significant step towards improving the quality and safety of healthcare is jointly brought to you by Australia’s Federal, State and Territory health authorities and the National E-Health Transition Authority (NEHTA) to help you explore the e-health concept and stay in touch with the latest innovations as they unfold

Model Healthcare Community education

simulation demonstration

Learn about the new era in Australian healthcare Visit the National E-Health Transition Authority’s (NEHTA) Model Healthcare Community (MHC) in Melbourne. The MHC is located at The Royal Australian College of General Practitioners (RACGP) at College House in South Melbourne. The MHC shows visitors first hand a demonstration of how the Healthcare Identifiers (HI) Service will work. The HI Service has been developed as a foundation service for e-health initiatives in Australia recognising that a requirement for a safe and secure e-health system is the ability to uniquely identify everyone involved in a single healthcare transaction. The HI Service commenced operations on 1 July 2010. It is a valuable opportunity for stakeholders to see how the HI Service will fit in with the healthcare system and see the ongoing benefits to patients, providers and organisations. To book a tour go to For information about the Healthcare Identifiers Service, visit

National E-Health Transition Authority

NEHTA is the lead organisation supporting the national vision for e-health in Australia. For more information on NEHTA go to:


Publisher Pulse Magazine PO Box 7194 Yarralumla ACT 2600 Australia ABN: 19 923 710 562

Editor Simon James Australia: +61 2 8006 5185 New Zealand: +64 9 889 3185

Subscription Enquiries

Advertising Enquiries

About Pulse+IT Pulse+IT is Australia’s first and only Health IT magazine. With an international distribution exceeding 37,000 copies, it is also one of the 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

Pages 28, 30 and 32 TELEHEALTH This edition of Pulse+IT includes three feature articles relating to Telehealth.

Looking ahead The next three editions of Pulse+IT will feature a selection of articles covering the following themes: • November 2010 - E-health Infrastructure • March 2011 - Electronic Prescribing • May 2011 - Mobilty Pulse+IT welcomes feature articles and guest editorial submissions relating to these themes, as well as articles relating to e-health more broadly. Submission guidelines and deadlines are available online:

Contributors Jacques von Benecke, Janette Bennett, Prof Michael Georgeff, Jon Hilton, Simon James, Dr David More, Geoffrey Sayer, Jennifer Testall and Mark Worsman.

Disclaimer The views contained herein are not necessarily the views of Pulse Magazine or its staff. The content of any advertising or promotional material contained herein is not endorsed by the publisher. While care has been taken in the preparation of this magazine, the publisher cannot be held responsible for the accuracy of the information herein, or any consequences arising from it. Pulse Magazine has no affiliation with any organisation, including, but not limited to Health Services Australia, Sony, Health Scope, UBM Medica, the New Zealand College of General Practitioners, or the Kimberley Aboriginal Medical Services Council, all who produce publications that include the word “Pulse” in their titles.

Copyright 2010 Pulse Magazine No part of this publication may be reproduced, stored electronically or transmitted in any form by any means without the prior written permission of the Publisher.

Subscription Rates Please visit our website for more information about subscribing to Pulse+IT.

Pulse+IT acknowledges the support of the following organisations, each of whom supply copies of Pulse+IT to their members.







Page 6 STARTUP Editor Simon James introduces the 19th edition of Pulse+IT.

Page 28 FEATURE ARTICLE Mark Worsman and Jennifer Tetstall discuss some of the potential legal issues that may arise with online consultations.

Page 11 Australia to host international telehealth conference

Page 30 FEATURE ARTICLE Jacques von Benecke and Janette Bennett highlight some of the telehealth initiatives happening in the United Kingdom.

Page 12 HISA elects new members to board, outlines priorities for coming year

Page 8 GUEST EDITORIAL Dr David More overviews the current government financial allocations to e-health and points to some areas where improvement is needed. Page 20 HIMAA Simon James interviews Natalie Sims, event organiser of this year’s Health Information Management Association Australia Conference. Page 22 MSIA Geoffrey Sayer discusses the important role government policies and purchasing decisions play in guiding the direction of the Health IT market. Page 24 NEHTA The National E-Health Transition Authority overviews the work it is undertaking in the areas of Secure Messaging, Clinical Terminology, and Healthcare Identifiers.

Page 32 FEATURE ARTICLE Jon Hilton and Prof Michael Georgeff present a detailed report on the CDM-Net Chronic Disease Management project.

Resources Page 26 EVENTS CALENDAR Up and coming Australian and international Health IT, Health, and IT events Page 43 MARKET PLACE The Pulse+IT Directory profiles Australia’s most innovative and influential e-health organisations.

NEHTA to outsource National Authentication Service for Health

Australian Medicines Terminology goes live in Victoria Page 15 Consumer e-health survey results released by CSC NEHTA releases updated electronic script transfer specifications Page 16 Free Auslan tutorial application launched for iPad MIMS to add drug-herb interactions to products Page 19 Medical Software Industry Association hold AGM Introduction to health research text book released


Pulse+IT: 2010.4 Simon James

BIT, BComm Editor, Pulse+IT Phone (AU): +61 2 8006 5185 Phone (NZ): +64 9 889 3185

Welcome to the 19th edition of Pulse+IT, Australia’s

Owing to the large number of relevant events

first and only Health IT magazine.

scheduled for the coming months, this edition features

This edition features a guest editorial from Dr David

an expanded calendar occupying the centre spread of

More, who outlines the e-health funding promises that

the magazine. Notable events on the horizon that will

have survived the election process and suggests some

be of particular interest for Pulse+IT readers include

areas where governance and transparency may be

the Australian Association of Practice Managers


(AAPM) conference, which is being held in conjunction

President of the Medical Software Industry

with the GP’10 event in Cairns; the Health Information

Association (MSIA) Geoffrey Sayer discusses the impact

Management Association Australia (HIMAA) National

government policies and purchasing decisions can

Conference; Global Telehealth 2010; the Health

have in guiding the direction of the Health IT industry,

Informatics New Zealand (HINZ) Conference and

and the National E-Health Transition Authority

Exhibition; and the HL7 International Standards and

(NEHTA) overviews the work it is undertaking in the

Education Meeting. Despite having only just completed

areas of Secure Messaging, Clinical Terminology, and

their Health Informatics Conference for 2010, HISA has

Healthcare Identifiers.

already set the conference dates for “HIC2011” — I

encourage readers to “save the date” for Australia’s

Mark Worsman and Jennifer Tetstall discuss some

of the potential legal issues that may arise with the

preeminent e-health event.

improving prospects for online consultations, and

Jacques von Benecke and Janette Bennett highlight

now features more organisations than ever, including

some of the telehealth initiatives happening in the

several new entrants that readers may wish to

United Kingdom.

familiarise themselves with.

Rounding out the set of feature articles for this

Weighing in at eight pages, the Pulse+IT Directory

edition, Jon Hilton and Prof Michael Georgeff present

Looking ahead

a detailed report on the CDM-Net Chronic Disease

With a focus on “E-health Infrastructure,” the

Management project.

November edition of Pulse+IT will profile the technical

This edition’s Bits & Bytes news section traverses

building blocks that are being developed to underpin

some recent NEHTA developments including the

e-health in Australia, as well as reviewing some of the

first live deployment of the Australian Medicines

technologies upon which our current health system

Terminology and the release of updated electronic


prescription transfer specifications. Coverage of the

recent Health Informatics Society of Australia (HISA)

articles, would like to contribute to an edition, or would

board elections and a report on the MSIA’s CEO Forum

simply like to discuss your experiences with e-health,

and Annual General Meeting is also included.

don’t hesitate to get in touch.

As always, if you have any suggestions for future

Pulse+IT eNews & Twitter Service To receive the latest Australian Health IT news delivered free to your Email inbox or Twitter client, visit



iSOFT Laboratory Solution Increasing efficiency and productivity, while enhancing Patient Care

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Waikato DHB Contracts for iSOFT Laboratory Solution Waikato District Health Board in New Zealand has recently contracted into a five-year deal with iSOFT for a laboratory information system to improve the speed, accuracy and reporting of 6.5 million test results a year. The move provides a single solution for all of Waikato Hospital’s pathology services and 190 laboratory staff. Waikato Hospital’s Haematologist Dr. Hugh Goodman said the laboratory’s work flow will be greatly enhanced. “Clinicians need reliable, timely information from the laboratory and the system will enhance these core functions as well as prepare the ground for future initiatives such as electronic ordering,” Dr. Goodman said. ”This has been a clinically-led project with the primary goal of delivering genuine

business transformation and world-class laboratory services,” said Christopher Goldsmith, Waikato DHB’s acting Chief Information Officer. “True clinical leadership has been demonstrated, where the synergy of all disciplines results in a transformation outcome that will deliver significant business benefits to patients,” Goldsmith said. “We have worked in a genuine partnership with Waikato District Health Board to define a solution to meet its current and future needs,” said James Rice, Managing Director of iSOFT Australia and New Zealand. “It also demonstrates our commitment to laboratory services in Australia and New Zealand.”

Find out more about iSOFT’s Laboratory Solution: W E P +61 2 8251 6700


Where to for e-health in Australia now we have a new government? Dr David More


With the election decided (for now at least) it is

The source of the information to populate the portal

probably time to try and assess where we might go

has never been clarified to my knowledge.1,2

over the next few years with e-health.

One good thing that seems to have emerged is

that of a package of measures that were announced

that there does seem to be a considerable political

at the Labor Party policy launch on August 16, 2010.

consensus (from each of Labor, the Coalition and

The announcement was costed at $392 million and was

the Greens) that introduction of reasonable levels of

intended to modernise the health system, including

computerisation and electronic messaging within the

allowing patients to access Medicare rebates for online

health sector can have a significant positive impact

consultations. At the launch Ms Gillard also said a

on the quality, safety and efficiency, while recognising

re-elected Labor Government would use the Internet

there are issues of information security and privacy

to modernise the health system by funding online

that do need to be addressed. This is a least a basic

consultations and video conferencing.

starting point for ‘moving forward!’

A reasonable point to start this brief review is from

1. $250 million for online consultations, providing

the most recent Budget in May 2010, as this was the

about 495,000 services over four years for rural,

first occasion we had a budgetary commitment from

The second e-health related announcement was

The package was made up as follows:

remote and outer metropolitan areas.

the previous Rudd Government outside support for

2. Financial incentives for GPs and specialists to

the half funding of the National E-Health Transition

deliver the online services at a cost of $56.8 million

Authority (NEHTA) in a Council of Australian

and an expansion of the GP after-hours helpline at

Governments (COAG) meeting in November 2008. The

a cost of $50 million.

shared funds ($218 million) were to run NEHTA from

3. $35 million to support training for health

July 2009 to June 2012.

There have been four significant announcements

professionals using online technologies.

Third, we had an announcement3 from the Health

including the Budget announcement.

Minister Nicola Roxon that some of the Budget money

Firstly, in the 2010 Federal Budget the Government

($12.5 million) would be spent on three e-health pilots.

announced an investment of $466.7 million that was

She noted that “each of the e-health sites announced

claimed would revolutionise the delivery of healthcare

today — GPpartners (QLD), GP Access (NSW) and

in Australia. It was said that for those Australians who

Melbourne East GP Network (VIC) — was chosen

choose to opt in, they would be able to register online

because they already have strong e-health capability

to establish a Personally Controlled Electronic Health

and support within their communities”. Each site

Record (PCEHR) from 2012-13. It was later made clear

was to receive $100,000 to be involved and NEHTA

that the service would be provided by a centralised

was to receive $300,000 to co-ordinate and manage

portal and that the patient would control who would be

what are technically very different pilots in terms of

able to access the information held within the portal.

architectures and applications.

Fourth, we had a joint announcement with the

Author Info

Australian Institute of Health and Welfare (AIHW) of a Dr David More is an independent e-health consultant and blogger who has been working in the e-health domain for over 20 years. He is concerned with the lack of clinician and patient focus in much of what is happening in e-health in Australia. His blog, Australian Health Information Technology, is available at

MyHospitals website ( where people could locate comparative information on the performance of the nation’s public hospitals. At the time of writing this is still not operational — despite having been due last month — ‘starting soon’ as they say.



What was missing from all these announcements

was, among other things:

First, any revamp of the national leadership and

governance of e-health in Australia or reform of the way NEHTA supports the whole health sector and not just jurisdictional interests. It has been an ongoing problem that NEHTA has failed to really address the needs of the whole health sector rather than the focus of its directors.

Second, any clarity about just what the PCEHRs

would deliver, what the business case for their implementation was and what information would be used to populate the patient’s record. With the new apparent ‘rainbow coalition’ this really needs to change and fast.

Third, it was hard to see how these announcements

fitted into the priorities which were established in the National E-Health Strategy that had been endorsed and supported by the Department of Health and Health Ministers as recently as December, 2008. Neither was there any commitment to actually proceed with the implementation and funding of this strategy. This is a really serious problem I believe. If we are not implementing that strategy just what are we doing?

Fourth, any coherent explanation of how all

these initiatives were developed and what the organising concept behind these apparently random announcements was. It all seems pretty ad-hoc and non-strategic to me, but I could have missed something.

Fifth, there was really no explanation of how

this was to be implemented and what impact these proposals might have on clinical workflows, liability insurance and so on.

On the basis of the last four months and this set

of election campaign announcements I fear we are in for more of the glacial, non-strategic, money wasting progress we have seen over the last decade. Time will tell I guess.

Further Reading 1. 2. 3.



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Australia to host international telehealth conference Australia will host Global Telehealth 2010

Training Program of the Health Innovation

(GT2010), the 15th Annual Scientific


Meeting of the International Society for

University of Calgary; and Shuji Shimizu, an

Telemedicine and eHealth (ISfTeH).

Associate Professor in the Department of

Endoscopics Diagnostics and Therapeutics

According to the organisers, the




meeting has become well established

at Kyushu University Hospital, Japan.

as the major international telehealth

conference, which is coming to Australia


for the first time.

speakers. Head of Royal Perth Hospital’s

Australian Fiona Wood joins the contingent



The three day event is being held in

Burns Unit, and Director of the Western

Fremantle, Western Australia, commencing

Australia Burns Service, Dr Wood was


recognised as Australian of the Year in





concluding on Friday, 12 November.





Complementing the keynotes, six

speakers include Desmond Tutu, Nobel

workshops will be held covering the

Prize recipient and and ISfTeH Ambassador

following topics:

for e-health, who will be appearing via


a video hook-up; Elizabeth Krupinski,

• Planning and implementing an ear

a former president of the American Telemedicine Association and current

telehealth service • Telemedicine in the Developing World

Professor and Vice Chair at the University of Arizona in the Department of Radiology;

— Obstacles and Solutions? • Environmental e-Health — Changing

Malcolm Fisk, Founder and Chair of the Telecare Services Association (TSA), which

Your Life • Remote self-monitoring of patients

has over 300 members providing telecare services to over a million people in the

specially aged population • Assessing Image Quality in Telehealth

United Kingdom; Richard Scott, a former


President of the Canadian Society of

Further information about GT2010

Telehealth and current Associate Professor

is available at:

in the Global e-Health Research and


NEHTA to outsource National Authentication Service for Health The National E-Health Transition Authority

healthcare providers authenticating to

(NEHTA) has launched a request for tender

emerging national e-health services risks

process “to deliver the design, build and

undermining the progress it has made

operations of a National Authentication

with its secure messaging initiatives and

Service for Health (NASH).”

scuttling the prospects of the mooted

Personally Controlled Electronic Health

NASH has been a core component

of NEHTA’s work program since the

Record being delivered in 2012.

organisation’s inception in 2005. However

its failure to deliver a service that facilitates


Tender submissions are required by 13



BITS & BYTES AMT goes live in Victoria NEHTA has announced the first live implementation




Medicines Terminology (AMT) in a clinical

HISA elects new members to board, outlines priorities for coming year

environment. Box Hill Hospital, part of

The Health Informatics Society of Australia

months coming up. We have health

Eastern Health Services, has started

(HISA) has announced the results of its

reforms, the long awaited foundations of

generating prescriptions for outpatients



e-health beginning to roll-out, we have

and discharge using AMT, through their

received from 17 candidates, with the

Personally Controlled Electronic Health

HealthSMART Clinical System.

HISA membership tasked with having to

Records (PCEHR) on the agenda now, and

appoint just five of these people to the

continuing investment from states and

approach for the identification and naming

organisation’s board.

territories and the private sector in health

of medicines. This includes standardised




which was held during the organisation’s

coded terminology structure to accurately

Health Informatics Conference (HIC2010)

pieces of e-health infrastructure are being


in late August.

prepared for deployment, Mr Rowlands

computer systems, clinicians and patients.

Katerina Andronis, Dr John Zelcer,

stressed the importance of addressing the

The terminology is intended for use in

Jon Hilton, Tam Shepherd and Prof Peter

health informatics workforce shortages

medication management and prescribing

Croll were elected, joining continuing

to increase the chances of these projects

software in both primary and secondary


being undertaken successfully.

healthcare. While the AMT is provided to

Anthony Maeder and Joan Edgecumbe.

developers of such software at no charge,



interesting new phase, from design and

the implementation of the system is

appointed David Rowlands as Chair,

architecture, to the implementation of

understood to be a nontrivial exercise.

Katerina Andronis as Vice-Chair, and Joan

national e-health initiatives, in the context

Edgecumbe as Secretary.

of a changing health system. What HISA

(DoHV) is using AMT identifiers and


AMT delivers a standard national

conventions marketed




The Department of Health Victoria




Votes were cast at the HISA AGM,






At a time when several large foundation






Following the first meeting of the

needs to do first and foremost is make sure





newly elected board, Philip Robinson was

it is using its wide constituency to ensure




invited to join the board and takes up the

there is good advice and good direction

system. The application uses the identifiers

executive position of Treasurer.

going towards those projects, and to

and descriptions from AMT as the basis


ensure the expertise that is around the

for search and selection of medication

outgoing HISA Chair, Prof Michael Legg,

health sector is being used. We will also

items to create an electronic record and a

for his six years of service in the position,

need to ensure that we are advocating for

prescription that is then printed.

citing the interest from candidates wishing

improvements to the health informatics



In a statement, NEHTA Head of

to nominate for the board positions and


Solutions Development Paul Williams said

participation at the AGM by members as

the implementation was a major milestone

an indication of the strength of the present

for HISA to be involved in a review and

in the development of Australia’s national


contribute to any potential refresh of the

e-health system.







Mr Rowlands also expressed a desire

National E-Health Strategy, which was

“As part of the transition to electronic

Michael guided HISA from a struggling

endorsed by government in late 2008.

health systems, the need for an accessible

organisation at that stage to one that is






Citing some outcomes from last year’s

robust enough to attract 17 nominations

HISA membership survey, Mr Rowlands

to uniquely identify and describe the

for five positions.”

flagged plans to respond to requests


for additional learning and professional





Outlining his vision for the future of

computers, clinicians and patients is

the organisation, Mr Rowlands noted

development opportunities.

essential,” he said.

the underlying reforms that are currently

occurring in the health sector.

to improve and widen the learning and

assist in the wider deployment of the AMT

“HISA wants to make sure we have

development opportunities, to not only

throughout Victorian hospitals that use the

a vibrant health informatics community

HISA members, but the health informatics

Cerner Millennium system.

in Australia. We have an amazing 24

workforce more generally.”

NEHTA has signalled an intention to

12 Pulse+IT

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Consumer e-health survey results released by CSC CSC has released a report detailing the

them by the surveyors, 64% of Australians

findings of a consumer e-health survey


it commissioned in March this year.

electronic health records, with 12% unsure

Conducted by Newspoll, 1208 Australian

and 24% against the concept.

adult health consumers were surveyed by

telephone and asked a range of questions

a willingness to pay an annual fee for

about their own health, their current

electronic health records, with only 6% of

health record keeping practices, and their

these prepared to pay in excess of $100 for

attitudes toward electronic health records.

such a service. CSC calculated the “average










Just 27% of all respondents expressed


annual price that all Australians on average

Australians claim to have heard of the

are prepared to pay for an electronic health

proposals for national Individual Electronic

record” to be $10.

Health Records, with older consumers

(49%) apparently more informed about

Federal and State Governments to become

such initiatives than consumers aged under

a contributing funder to electronic health

35 (29%).

records (88%), with 63% believing private

health insurance companies should also

After having had the concept of

electronic health records explained to

Most survey respondents volunteered

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contribute financially.

NEHTA releases updated electronic script transfer specifications The National E-Health Transition Authority

Government and the Pharmacy Guild of

• We have MIMS – Australia’s most trusted drug database

has released draft version 1.1 of its

Australia, which facilitates a subsidy for

• Support professionals who are truly supportive

Electronic Transfer of Prescription Package,

pharmacists of 15 cents for each electronic

a suite of documents designed to steer

prescription dispensed. Under the current

• Speed and superior stability of 100% SQL performance

the ongoing development of electronic

arrangements, only scripts transferred

prescribing workflows in Australia.

electronically from a prescriber to a

The latest release expands on previous

pharmacy via a script hub are eligible for

versions in three key areas, extending the

the subsidy, effectively excluding the large

transfer of prescriptions to a wider range

number of scripts that are uploaded into

• Great value – subscription $907.50 for both Clinical & Management

of care settings including hospitals and

electronic script hubs by pharmacists.

• Discounts for practices larger than 3 GPs

residential care facilities, and addressing

• Half price for part time practitioners – $453.75

instances where the medications are

to publish a finalised version of the

supplied based on informal instruction

specifications in December 2010. Following

• No downtime for updates or time- consuming maintenance



• More GPs voting for Best Practice with their feet






NEHTA has signalled an intention




It also introduces the transfer of fully

electronic prescribing subsidies for two

electronic prescriptions signed with a

years, after which time they will only

prescriber’s digital signature.

continue to receive the 15 cent subsidies


Version the








prescription (owing script) is provided.




if they dispense electronic scripts from


a script hub that is compliant with the

• No ads, bolt ons or mixed file formats to compromise performance



Agreement (CPA) between the Federal

• Converting your data from MD2, MD3 and MedTech32 virtually automatic

NEHTA specifications.

Pulse+IT 15

Go to the Best Practice website at www. to order your FREE Evaluation DvD, email or phone (07) 4155 8800

BITS & BYTES MIMS to add drug-herb interactions to products MIMS Australia and IMgateway have

Free Auslan tutorial application launched for iPad

announced plans to release a drug‑herb interactions

The Royal Institute for Deaf and Blind

“thanks,” “how are you?” and many more





Children (RIDBC) has released what it is

terms generally found in travel guides.

touting as the “World’s first free Australian

by researchers from the Faculty of



Lam said, “It is the first free Auslan‑based

Pharmacy at The University of Sydney. The

coincide with the organisation’s 150 year

tutorial reference program in the iTunes

project has been headed up by Professor


Store developed for the iPad, which was

Basil Roufogalis and Professor Andrew

The application, dubbed “RIDBC’s

launched in Australia earlier this year.

McLachlan, with the database having

Auslan Tutor: Key Signs” features 150

Thanks to the pioneering efforts of the

been maintained and expanded since its

commonly used terms presented in

Royal Institute for Deaf and Blind Children,

inception in 2002.

Australian Sign Language (Auslan).

it will be a useful resource to anyone

wanting to learn about the basics of what

The database has been developed








The application displays short video

RIDBC Multimedia Developer Ronnie

information has been made available via

clips of 150 signs and has been specifically

is a complex, visual language.”

the IMgateway website since December

designed for use on the Apple iPad, with

2009, the partnership will deliver the

a separate version of the application also

positioned as a “lite” version of the RIDBC’s

evidence‑based database to

available for use on iPhone and iPod touch

more comprehensive Auslan application

audience by leveraging MIMS Australia’s


for Apple iOS devices, which contains

existing range of products.

Each Auslan sign is presented with a

over 500 signs, phrases, full sentences



The “Key Signs” application has been

MIMS National Business Manager,

photo of the handshape used to form the

and grammar instruction, available for

Margaret Gehrig, said, “It is our intention to

sign and a video clip demonstrating how

download for $49.99AUD.

work with our clients and partner vendors

the sign is produced.

to deliver this content as part of our

Users can learn how to communicate

devices running the Apple iOS, the Auslan

integrated data solutions. There is no doubt

a select group of common words including

applications can be downloaded from the

that the use of complementary medicines is

the alphabet, numbers one to 10, “please,”

iTunes Store.

As with all other applications for

increasing and the need for evidence‑based information





prescription medicines is now integral to

Below - An Apple iPad running the RIDBC’s Auslan Tutor application. The handshape and a video demonstration of the sign for “grandmother” is displayed on the device.

the needs of healthcare professionals and consumers.”






Roufogalis described the signing of the MOU between MIMS and IMgateway as “an important development in the delivery of evidence‑based information on herbal/ nutritional




pharmaceutical drugs. There has been a growing demand for this information from doctors, pharmacists and other health professions. The alliance with MIMS provides an excellent opportunity to disseminate the information developed by the Herbal Medicines Research and Education Centre of the Faculty of Pharmacy more widely and for continuation of the underlying research.”

16 Pulse+IT

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Medical Software Industry Association hold CEO Forum and AGM in Darling Harbour

Introduction to health research text book released An introductory statistics text book with a focus on health research has been released by Spinoza Publishers.

Written by biostatistician Dr Ronald


his role, which entails helping Small and

Hicks, “Primer for Health Research: Design

Association’s Annual General Meeting

Medium Sized Enterprises win government

& Basic Statistics” is pitched at health

(AGM) and second CEO Forum for 2010


professionals and other people interested

were held in early September at iSOFT’s

in undertaking health research.

offices in Darling Harbour. With around


80 member companies represented at

Geoffrey Sayer (HealthLink) to continue as

in numerous countries, including Canada,

the meeting, the MSIA believe this year’s

President. Dr Vincent McCauley (McCauley

Sweden, USA, Malaysia and Australia.

AGM was the most well attended in the

Software), Jenny O’Neil (EpiSoft) and

During this time, Dr Hicks has accrued

association’s history. The association’s

Gavan Lim Joon (Healthscope) were

over 70 publications in peer-reviewed

representative base has grown dramatically

returned as Treasurer, Secretary and Public

international journals.

since the appointment of a CEO in 2009,

Officer respectively.

with over 100 medical software companies

In addition to the executive, the MSIA

cites an apparent prevalence of poorly

now MSIA members.

membership elected seven committee

constructed health research projects as

members, namely Ross Davey




The AGM elections saw the office re-elected



Dr Hicks has worked as a biostatistician

In the book’s preface, Dr Hicks


the motivation for writing the text. In the

series of technical presentations covering

Margaret Gehrig (MIMS), John Green

author’s words, the book “establishes

themes including the Healthcare Identifier


the basic requirements for an adequate

Service, Compliance, Conformance and


Accreditation (CCA), and Integrating the


Healthcare Enterprise (IHE).


from systematic resultants via statistical

The Andrew Magennis Award for

tests...this book will provide an important

Fleming (CEO) and David Gonski (Chair) of

Service and Leadership in the healthcare

introduction to biostatistics and thereby

the National E-Health Transition Authority

software industry was awarded to Dr

optimistically increase the quality of

(NEHTA) took questions from the floor

Vincent McCauley and John Green, each of

conference presentations and professional

for an extended period of time, followed

whom received an equal amount of votes

papers, not to mention published results.”

by presentations by Matt Young and Matt

from the MSIA membership.

Corkhill from Medicare Australia.

In a statement released after the event,

chapters, each concluded with a selection of

The AGM proper was preceded by a

Following a brief presentation, Peter







(Extensia), Byron

bioresearch design and once that data has


been collected, how to separate chance

Health), Glenn

The 124 page text includes 22 concise


Dr Sayer acknowledged the long running

suggested further readings. Early chapters

Technological Sciences and Engineering

service provided by these winners to the

deal with concepts such as randomisation,

provided some insights from their recent

industry, saying “Both of these individuals

data acquisition, and reliability, with





have done — and do — so much for our


Longevity” and reviewed the business

industry and are deserved winners.”

about regression, factor analysis and

opportunities presented by incorporating

The MSIA also took the opportunity

cluster analysis. The book also includes a

the data from a range of real time patient

to recognise its past presidents and Mike

comprehensive glossary of statistical terms

sensoring technologies into the medical

Maldon, an inaugural MSIA committee

covering basic concepts such as mean,

record. Such technologies are expected to

member and recent retiree from the

delta, and standard deviation, through to

extend independent living arrangements

medical software industry. Past presidents

more complex statistical jargon.

for older patients.

Ross Davey, Dr John Ainge, Dr Andrew

“Smart Tech






“Primer for Health Research: Design

Magennis, Paul Doman and Dr Vincent

& Basic Statistics” (ISBN 978-0-9808000-

the newly created position of IT Supplier



0-5) is distributed by Bookbound and has

Advocate earlier in the year by Minister

were presented with plaques, with the

a RRP of $55AUD. Orders can be made

for Innovation, Industry, Science and

presidential contributions of Tony Firth and

via free call 1800 628 058, or by email:

Research, Kim Carr, gave an overview of

Ian Threlfall also acknowledged.

Don Easter, who was appointed to




Pulse+IT 19


HIMAA Conference 2010 Health Information: The Golden Thread in Health Reform To be held in Sydney from 27-29 October, this year’s Health Information Management Association Australia (HIMAA) conference will bring together delegates from around Australia and New Zealand to share knowledge and stay abreast of the major changes in the healthcare landscape and Health Information Managers’ central role in this changing environment. Pulse+IT speaks with conference organiser Natalie Sims.

Why is ‘Health Information: The Golden Thread in Health Reform’ a relevant topic for this year’s conference?

Dr Tim Smyth, Deputy Director, NSW Department

Health information is one of the essential building

Emil Djakic, Chair of the Australian General Practice

blocks of a strong health system. The conference aim

Network, Dr Mukesh Haikerwal, National Clinical

is to explore how health information management is a

Lead, National E-Health Transition Authority, Mr Peter

constant element throughout the Australian healthcare

Fleming, Chief Executive Officer, National E-Health

reform agenda.

Transition Authority, Professor Kathy Eagar, Director,

There are three key challenges identified in the

Centre for Health Service Development, University of

National Health and Hospitals Reform Commission’s

Wollongong, Dr David Filby, Chair, National Health

report, “A healthier future for all Australians,”

Information Standards and Statistics Committee,

that demonstrate the role of health information

Mr Mark Cormack, Chief Executive Officer, Health

management, and these have been selected for the

Workforce Australia, and Professor Chris Baggoley,

2010 conference themes. These include topic such as:

Chief Executive Officer, Australian Commission on

• How information is being used to redesign our

Safety & Quality in Health Care.

of Health who will be opening the conference, Prof Philip Davies from the University of Queensland, Dr

health system to meet emerging challenges

àà Activity-based funding and casemix

reviewed papers from health information professionals

àà Electronic health records

from around Australia. Topics covered by this year’s

àà Privacy and unique patient identifiers

speakers include e-health, indigenous data collections,

àà E-health technical standards

SNOMED CT, activity based funding, clinical coding,

• How to create an agile and self-improving health system for future generations by using information

The plenary sessions feature a number of peer

workforce issues, data accuracy and digital medical records.

àà Planning and educating a modern health information workforce àà Improvements






healthcare àà Health performance reporting • How information is being used to tackle the major

The conference will also provide the opportunity to assist professionals to develop their skills in other areas. Two workshops presented by Irene Simatos from

access and equity issues

NSW TAFE are scheduled to be held on the second day

àà Improving health outcomes for Aboriginal and

on the topics of change management and achieving

Torres Strait Islander people àà Integrating multidisciplinary primary health care services

20 Pulse+IT

What other items are on the program for the conference?

personal and professional goals. Two other workshops will also cover medical record scanning and concepts to understand SNOMED CT.

Can you tell us about this year’s key note speakers?

Who should attend the 2010 HIM conference?

We have invited a number of keynote speakers to

interest in health information. This includes health

present at the conference this year. They include

informaticians, health information managers, clinical

The conference is relevant to anyone who has an

for their ongoing support of HIMAA

What social events are being held in conjunction with the conference?

researchers, data managers, students and


A welcome reception is being held at

many other health professionals.

coders, public health specialists, health

Medical Solutions and 3M who we thank





We also have a full exhibition officially

the Harbours Edge Events Centre on the

opening on Wednesday night, the largest

evening of Wednesday, 27 October. This

How have the HIMAA conferences evolved over time?

exhibition we have seen for a number

coincides with the official opening of the

of years. Exhibitors include Proscan

exhibition area and gives delegates an

This year is the 28th HIMAA Conference.



opportunity to meet our exhibitors and

Over the years the conferences have

Mountain, Wacom, Lanier voice, Core

network with fellow health professionals.

moved from having a focus on the medical

Medical Solutions, 3M, ACA Pacific-Kodak,

On Thursday, 28 October the conference

record department and hospital-based

Rolls, Government Records Repository,

dinner will be held on a Sydney Harbour

information topics, to reflecting the wide

HealtheWords & PH Primecare, Spellex,

Cruise. The evening will include dinner,

professional scope of health information

Mercury Executive Recruitment, Vital

drinks, dancing and laser clay pigeon

areas in which HIMs now work. The 2010



conference acknowledges these changes

Health, Inelledox/BITG, and the Cancer

and further seeks to solidify the integral

Council Victoria. Like the presentations

role that HIMs play in our rapidly-changing

and workshops, the exhibition provides

How can people register to attend the HIM Conference?

health care system.

an opportunity to learn about what is

You can find out all the details about the







happening and what is new in the industry.

HIMAA Conference 2010 at the HIMAA

Who is supporting the 2010 Conference?

Delegates will have an opportunity to talk

website: The website

directly with experts with practical, in

also includes helpful information about

Our major sponsors this year are Core

depth knowledge of their products.

nearby accommodation.

YOUR BUSINESS VOYAGE OF DISCOVERY • Refurbished areas from 270sqm to 845sqm* • Excellent natural light • Ample parking and amenity • Fantastic Business Park setting, neighbouring Mawson Lakes Town Centre *approx

Tom Budarick


0433 691 974 / 8233 8898

0411 049 183 / 8110 3312

Pulse+IT 21


“The marketplace will drive the uptake of new technologies...”

Geoffrey Sayer

BSc(Psychol), MCH, PhD President, MSIA

This phrase would have to be the bane of vendors

uptake, not demands by patients or GPs or pharmacists

when it comes to dealing with government programs

for a more efficient claiming and processing function.

for e-health. There is in fact a complex relationship

These were policy rather than demand driven

between the marketplace, government policy levers


and program funding that achieves the uptake of new

technologies. Recently all government departments

healthcare lagging behind in its use of IT? Is technology

were in longer than expected caretaker mode and were

relevant to healthcare simply not available? The short

unable to come out and play. However, healthcare

answer is ‘no’. There are innovative software companies

goes on and the marketplace continues to operate. Or

out there who have ‘cool apps’ aimed at improving

does it?

health and healthcare delivery. For example, while we

But why — compared to other industries — is

Health is a marketplace with many emotional

wait to understand the business case for Personally

interests that drive decision making, whether it is

Controlled Electronic Health Records (PCEHR) there

one’s own healthcare choices, or choices made in the

are already EHRs out there that allow patient access,

political arena. Politicians are adept at using health to

responsible sharing, and patient control over their

win votes. A simple view of the recent electoral process

healthcare needs.

was that there were offers to extend healthcare

funding by both sides, with one side concentrating on

that technology clearly moves faster than legislation

‘stopping the wastage’. It is important to understand

can keep up or government’s ability to operate in the

that the marketplace is affected by language that

e-world. If the government of the time has come to the

portrays a clear agenda for the future. Without a

conclusion that there is a need to embrace technology,

clearly articulated agenda this effectively stalls rather

it often believes it must be designed and built from

than stimulates the market. This is because the

scratch. More often than not there are already

healthcare community is waiting for action. Let’s be

solutions in the marketplace and companies ready to

clear: the largest buyers of healthcare and IT products

assist in implementation and perform any necessary

and services for the healthcare sector is effectively

customisation for the ‘uniqueness’ of healthcare

Australian governments on behalf of the Australian

delivery, which is portrayed as different from service to


service, hospital to hospital, and GP to GP.









If we look at the history of IT in health we will see

Recently it was announced that there would be

computerisation in general practice it was the Practice

Medicare item numbers to support telemedicine and

Incentives Program (PIP) that put computers onto

online consultations, in particular focusing on the

desks and delivered prescribing packages to GPs. If we

rural and remote sector. Supported by promises of

look at the successful uptake of Medicare Online and

the National Broadband Network (NBN) it appears

PBS Online, it was government funding that drove the

that new frontiers will now be opened for the first time. The reality is many of these capabilities have

Author Info

been in existence for some time. The concept of As well as being President of MSIA, Geoffrey is General Manager Australia of HealthLink. He has spent the past 20 years working as an epidemiologist in academia, and the public and private sectors. For the past 10 years Geoffrey has occupied senior management positions in medical software companies.

telemedicine has been around for over 10 years but the funding models were not adept at supporting the uptake or use of these types of services. Basically healthcare providers would not be funded for providing telemedicine services. In addition, there were also legislative requirements where the patient had to be

22 Pulse+IT

in the same room as the clinician for the

in the clinical messaging space and will

doesn’t apply buying pressure on those

clinician to be able to claim Medicare

surpass the other messaging segments in

vendors to change their behaviour. Quite

rebates. When technology exists but

less than 12 months. Neither pharmacists,

simply, procurement drives the uptake of

funding and legislative support is not in

GPs nor patients are driving the uptake

standards when procurement is aligned to

place, the marketplace doesn’t change and

of electronic prescribing technologies —

buying pressure. The Australian National

patients don’t receive the benefits. Change

rather it is the largest buyer again.

Audit Office Audit Report No.5 2010 on

the latter two aspects and we will see fast

There is also a call for government

the Practice Incentives Program, which

uptake of new technology with all the

to take leadership in the standards

was released in mid September, clearly

attendant benefits.

development process, however creating

articulates the problems and risks relating

Online consultations are a classic

standards is not the problem — Standards

to the PIP secure messaging incentives

example where purchasing models of the

Australia are good at facilitating that

and the efforts of DOHA, Medicare and

service under Medicare may have held

process but I’m sure could do with more

NEHTA to manage the process. Anyone

back the uptake of these new business

financial support. What is odd with the

interested in how government policy is

models. I always find it odd that my GP

criticism of industry’s role in standards

made and managed will find pages 63-73

can give me advice after an investigation

is that most standards are developed


over the phone for no charge, but if I am in

largely by industry people who see that

the same room receiving the same advice

standards actually take the uncertainty

good for individuals and for the health

he is able to claim at least a bulk billing

out of the product development process.

of all Australians that, on their own, do

fee. Similarly, the referral letter based on

Furthermore, if there are demands for the

not drive a demand for those services.

the result can be picked up from the front

use of those standards by customers who

Foundation pieces such as healthcare

desk with no money changing hands,

pay for products then not surprisingly

identifiers, clinical terminology, security

but sharing advice and a referral with me

those standards are implemented and

frameworks and standards fall naturally

electronically — which one could argues

there is a “win” for all. Remember though,

into those categories. However, standards

gives me more lasting and structured

that government is the largest buyer, so

determination needs to come before

help and a clear audit trail — has not been

unless government is explicit in the use of

purchasing actions. While there are plenty

valued at all.

standards as part of the buying process

of good standards already out there,

There are many things that are

The electronic prescribing market

and further, demands evidence of testing

these standards must be supported by

is also an interesting case study as the

against those standards, then standards


various players became involved because

won’t be implemented.

and Accreditation processes. In addition,

they understood that there are clear


legislative support needs to be in existence

benefits in terms of patient safety and

procurement is vital. Leadership in support

to support innovative business models

the future goal of PCEHRs. While it has

for IT implementation can be misplaced if

of care if we are serious about pursing



one does not understand the marketplace.


electronically for some time, there is still

There has been criticism of industry for

Technology and Information Management

a requirement for a patient to turn up to

not implementing standards or failing to

processes. However, if the standards

the pharmacy of their choice with a hand

deliver interoperability, with claims that it

determination or creation process takes

signed piece of paper as authentication

took government intervention through the

too long or is too far into the future, the

that the script is just and legal. The

PIP to drive interconnectivity in the secure

vendor community will make do with

marketplace got ahead of the government

messaging market via the Secure Message

what they can until procurement drives

in terms of determining the standards

Delivery (SMD) specification. The reality is

the uptake of something different, often

agenda. Government was only able regain

that the money spent on secure messaging

at greater expense and greater confusion

influence over the marketplace’s use of

through the PIP has not changed a

than clearer incremental purchasing steps.

standards because it offered an extremely

purchase decision by a single GP, because

attractive incentive ($75 million worth of

GPs don’t, as a general rule, pay for

Further Reading

incentives at 15 cents a script). I suspect

messaging. If you give someone money for

1. Available for download from http://

that this is now the largest value segment

something they get for free, that money












Pulse+IT 23


E-health: for the good of the health system As the lead organisation supporting the national

promote a standards based approach to Medication

vision for e-health in Australia, the National E-Health

Management so that prescriptions may be securely

Transition Authority (NEHTA) has focused on the

shared between a prescriber and any dispensing

establishment of a national e-health infrastructure.

pharmacy of the individual’s choice.

Here are just a couple of examples of facts about

Currently a prescriber either handwrites or uses

the current health system.

a computer to generate a paper prescription that is

• Up to one in six or 18% of medical errors are due to

transcribed into the Electronic Dispensing System

inadequate patient information. This works out at

(EDS) at the pharmacy. There is opportunity for human

around 68,000 adverse events annually — equivalent

error in the transcription process at the pharmacy. With

to 195 full jumbo jets or one and a half times the

the electronic transfer of prescriptions a pharmacy will

seating capacity of the Sydney Cricket Ground.

no longer transcribe prescriptions as the direct transfer 2

• Up to 35% of referrals to hospital are inappropriate.

of information from the Prescription Exchange Service

• 10% of all GP consults are with a patient the doctor

removes the need to re-key the information at the

has never seen before. It is estimated 25% of

pharmacy. This will reduce some types of dispensing

clinicians’ time may be spent collecting data and

errors. As prescribers using Electronic Transfer of


Prescription (ETP) must use computer generated


• A 2001 survey of Sydney GPs found that only 37%

prescriptions this also removes the problem of illegible

received a discharge summary including reasons for

handwritten prescriptions. Fewer transcription errors

changing medications.

will improve patient safety.

Below is an outline of the expected benefits


E-health systems are already in use across Australia.

NEHTA’s work will have for the greater healthcare

What is lacking is being able to pull the participants into


a framework where they can talk to each other with the right standards, security, and interoperability within the

E-health solutions


NEHTA is focusing on delivering early e-health services for the most commonly exchanged health information:

Secure Messaging



NEHTA’s secure messaging initiative will provide the

Management. NEHTA’s work will deliver standardised



foundation for secure electronic communications

e-Discharge Summary information from acute care to

amongst healthcare providers, by defining a set of

General Practice and deliver standardised e-Referral

secure messaging standards to be used in e-health.

information from General Practice to specialists,

ensuring more immediate accurate information and

specifications for secure e-health messaging following

streamlining the handover of care.

the release of Australia’s first national guidelines in

March, 2010. NEHTA is currently supporting early

NEHTA is working with the health sector to

Software developers have begun implementing new

adopters by developing and publishing free open

Author Info

source implementation code, providing technical The National E-Health Transition Authority was established by the Australian Commonwealth, State and Territory governments on 5 July, 2005 to develop better ways of electronically collecting and securely exchanging health information. To learn more about NEHTA’s work go to

workshops and consultancy assistance, and producing test specifications and test tools to help developers assess whether their implementations conform to the specification.

The expected benefits include improving the

security of clinical information exchange between

24 Pulse+IT

healthcare providers; reduced potential for data

accuracy with which information will be linked to the

interception; and vendors having increased confidence

intended patient, provider and organisation; the use

in software development because of national standards.

of an Individual Healthcare Identifier (IHI) reduces the chance of duplicate patient records and improves

Clinical Terminologies

decision making based on more accurate and more

With NEHTA’s Clinical Terminologies program focused

complete patient information being available to

on SNOMED CT-AU (a consistent terminology for

providers; and administrative efficiencies by reducing

recording, storing, retrieving and aggregating clinical

the need to capture the same information numerous

terminology) and the Australian Medicines Terminology

times across the health sector.








NEHTA is identifying a series of metrics and data

identification and naming of medicines, the expected

capturing methodologies so benefits can be measured

benefits include the following: better ability to monitor

for the purpose of informing course, correcting activities

patient care and clinical outcomes through the care

and driving change.

continuum with the use of standardised terminology;

better monitoring of patients on clinical pathways;

to clearly demonstrate the benefits of its work. The

adherence to clinical guidelines and ability to escalate;

above is a snapshot of how the work NEHTA is doing in

and better clinical support systems through consistent,

e-health is expected to deliver real clinical benefits.

standardised language.

Like any organisation NEHTA needs to be able


Healthcare Identifiers (HI) Service

1. Australian

The Healthcare Identifiers (HI) Service commenced




and Welfare,

Australia’s Health 2002.

operations on 1 July 2010. The HI Service offers a direct

2. G J Elwyn and NCH Scott, ‘Avoidable Referrals?

method for linking patients to their medical data by

Analysis of 170 consecutive referrals to secondary

using a unique 16 digit number for each patient and associating that number with every patient/provider interaction. This method of identification significantly

care,’ BMJ 309, 3 September 1994. 3. For Your Information, Australian Audit Commission, Canberra, 1995.

reduces the chance of making identification errors. As

4. Mant A, Kehoe L, Cockayne NL, et al. A Quality

the HI Service is implemented in Australia the expected

Use of Medicines program for continuity of care in

benefits include a reduction in errors and increased

therapeutics from hospital to community. Med J

efficiency in handling health information; increased

Aust 2002; 177: 32-34.

Health Information: The Golden Thread in Health Reform

HIMAA National Conference 2010 27th - 29th October

Harbours Edge Events Centre, Darling Harbour, Sydney, Australia

Pulse+IT 25



International e-Health Joint Conference 20 September - 23 September Brisbane, QLD P: +61 7 3858 5526 W:


HEALTHCON 2010 22 September - 24 September Adelaide, SA P: +61 8 8274 6060 W:


13th Annual Healthcare Facilities Planning and Design Summit 29 September - 30 September Sydney, NSW P: +61 2 9080 4307 W:

26 Pulse+IT

International Conference on the Implementation of Electronic Health Records 26 October Edinburgh, UK P: +44 131 651 3001 W: HIMSS Asia’10 Health IT Congress & Leadership Summit 26 October - 29 October Daegu, South Korea P: +65 9848 5259 W: HIMAA National Conference 27 October - 29 October Sydney, NSW P: +61 2 9887 5001 W:

Health Health Health



HINZ Conference 2 November - 4 November Wellington, NZ P: +64 9 373 7599 W: Australian General Practice Network National Forum 3 November - 6 November Perth, WA P: +61 2 6228 0835 W: Health

HIT Health Health Health

The National Forum on Safety and Quality in Health Care 25 October - 27 October Canberra, ACT P: +61 8 8274 6050 W:

2nd Annual Reducing Medication Errors Conference 2010 28 October - 29 October Melbourne, VIC P: +61 2 9080 4300 W:

HIMSS Middle East 2010 8 November - 10 November Dubai P: +65 9848 5259 W: HIT


2nd Annual Obstetric Malpractice Conference 16 September - 17 September Melbourne, VIC P: +61 2 9080 4300 W:

Rural Medicine Australia 2010 22 October - 24 October Hobart, TAS P: +61 7 3105 8200 W:



Clinical Audit Improvement Conference 13 September -14 September Melbourne, VIC P: +61 2 9080 4300 W:

Primary Healthcare Reform Summit 21 October - 22 October Melbourne, VIC P: +61 2 9080 4300 W:



MedInfo 2010 12 September - 15 September Cape Town, South Africa W:

PharmaMed Logistics 2010 19 October - 20 October Sydney, NSW P: +61 2 9080 4307 W:



Health-e-Nation 2010 9 September - 10 September Sydney, NSW P: +61 2 4365 7500 W:

Computer Based Medical Systems 12 October - 15 October Perth, WA W:

3rd Annual Hospital & Healthcare Security & Safety Conference 28 October - 29 October Brisbane, QLD P: +61 2 9080 4300 W:

Health Information Technology WA Forum 9 November Perth, WA P: +61 8 6304 5039 W: Health



Health IT


Health Information Management


Practice Management



2nd Annual Integrated Cancer Centres Symposium 8 September - 9 September Melbourne, VIC P: +61 2 9080 4307 W:

Correctional Services Healthcare Summit 27 October - 28 October Melbourne, VIC P: +61 2 9080 4300 W:


GP’10 / AAPM Conference 6 October - 9 October Cairns, QLD P: +61 3 8699 0414 W: PM

2nd Annual Operating Theatre Management Conference 2 September - 3 September Sydney, NSW P: +61 2 9080 4300 W:






Technology in Healthcare Summit 2010 16 November - 18 November Melbourne, VIC P: +61 2 8908 8555 W:


HIMSS 20 February - 24 February Orlando, USA P: +1 312 915 9285 W:

HISA Health Informatics Conference (HIC2011) 1 August - 5 August Brisbane, QLD P: +61 3 9388 0555 W: HIT




3rd Annual National Telemedicine Summit 21 March - 22 March Sydney, NSW P: +61 2 9080 4300 W: The 2nd Annual National Disability Summit 4 May - 5 May Melbourne, VIC P: +61 2 9080 4300 W:

HL7 International Standards and Education Meeting 9 January - 14 January Sydney, NSW P: +61 412 746 457 W:


Health HIT Health

2nd Annual Leadership and Change Management 22 November - 23 November Brisbane, QLD P: +61 2 9080 4300 W:


Healthcare Complaints Management Conference 29 November - 30 November Brisbane, QLD P: +61 2 9080 4300 W:

Health Informatics: International Perspectives February 24 - February 27 Victoria, BC, Canada P: +1 250 721 8581 W:


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Pulse+IT 27


Online consultations – legal issues Mark Worsman

Senior Associate DLA Phillips Fox

Jennifer Tetstall

Paralegal DLA Phillips Fox

Telehealth and the increasing focus on providing

of an online consultation. The key difference between

healthcare remotely raises a number of issues that

an online consultation and an in-clinic consultation is,

healthcare providers need to be aware of. Part of the

obviously enough, physical access. This means, from

Australian Labor Party’s election campaign included

a ‘medico-legal’ or negligence point of view, that

the promise to commit funding for online consultations

the nature of the provider’s duty of care to his or her

as follows:

patient will be different to a traditional consultation.

• Three-way consultations between a patient, a

The provider will be relying on someone else to provide

general practitioner and a specialist; or

data, namely the patient, or in the case of a three-way

• Two-way consultations between a patient and

consultation, the specialist will rely on the general

either a general practitioner or a nurse, from a

practitioner’s examination and data.

patient’s place of residence.

Before a healthcare provider becomes involved

complete or correct, the issue of liability is likely to

in such activities, he or she should consider what

be clouded. Inevitably the question that will be asked

precautions should be taken to protect against the legal

is whether the provider should, in the circumstances,

risks that the activity presents. Some of the risks are

have trusted that information. This may, in practice,

obvious, such as the risk of a negligent misdiagnosis.

place providers in a difficult situation.

Other risks are not so obvious. These include:

• privacy






If the data that the provider relies on is not

One way to seek to address this risk is for the


provider to insist that the patient sign an appropriately

consultation, where will it be stored, what are the

worded consent outlining the scope of the provider’s

security measures that the provider takes to keep it

duty and, in the three-way consultation that each


provider agrees the extent of each other’s duty. This

• personal exposure (how would the provider react if the patient, or the other provider in a three‑way consultation, recorded the consultation and

may assist in clarifying the nature and extent of the provider’s duty of care to the patient.

do if part of their diagnosis was placed online in a

Are there situations where consultation should be refused?

manner that was out of context and potentially

In the case of two-way consultations, it may sometimes

misleading?); and

be difficult or impossible for a healthcare provider to

posted it online. What would the provider want to

• insurance coverage (some policies specifically

discharge his or her duty of care to patients, especially if

exclude healthcare that is provided over the

the patient presents with, for example, a broken arm or

Internet, online or by video conference).

a condition where a physical examination or treatment

Negligence or ‘medico-legal’ risk

is required. There may be other circumstances where the provider does not believe the information that is

As with any consultation, a healthcare provider can be

provided by the patient is accurate, but is unable to

liable for negligent acts and omissions in the context

act on his or her suspicion by examining the patient in person. It is unclear what the modus operandi will

Author Info

be in these circumstances or what the provider’s legal Mark Worsman is a Senior Associate and Jennifer Tetstall is a Legal Clerk at DLA Phillips Fox. DLA Phillips Fox has around 700 lawyers across eight offices in Australia and New Zealand. It has an exclusive alliance with DLA Piper, one of the largest legal services organisations in the world, with lawyers in 30 countries.

exposure will be if the provider refuses to facilitate an online consultation.

Privacy Healthcare providers are required by law (including the Commonwealth’s Privacy Act 1988) to treat medical

28 Pulse+IT

records in certain ways. Some of these obligations

the provider may well wish to take corrective action

will extend to the electronic record of the online

and have the content removed. In some jurisdictions, it

consultation, namely the electronic audio‑visual file

may be illegal for a person to record the consultation

recording the consultation. This means that, among

without each participant’s consent, which may assist

other things, a provider must take reasonable steps to

a provider. Nonetheless, providers may wish to ensure

protect that file from misuse, loss, unauthorised access,

that the relevant rights in the recording are agreed on

modification or disclosure. Accordingly, a provider will

in an appropriately drafted patient consent.

need to ensure that the relevant files are treated in the

Will insurance cover online consultations?

same way as other medical records.

Personal exposure






Providers will also need to consider the extent to which

consultations provided over the Internet, online or

a patient or, in the case of a three-way consultation,

by video conference unless the healthcare provider

the other providers may store and disclose audio‑visual

has preceded the consultation by an examination of

files of the consultation. A patient (or the other

the patient or it is in accordance with any relevant

provider) may be able to record the online consultation

Australian Medical Association or medical college

and post that recording online on a website such as


YouTube. While a provider may not be concerned about

the particulars of the consultation, if it (or an excerpt of

to ensure that online consultations are included in their

it) was taken out of context or distorted in some fashion

coverage and that they comply with the requirements

(for example, combining it with defamatory content),

of the policy.

Providers will need to review their insurance policy


General Practice


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Claims management















Totalcare Clinicals “Mozart” Orthopaedics

Clinical coding

Day Surgery


Reporting Efficiency

totalcare medical management software

Paperless Electronic Records


Multilingual Cardiology





Instant Messaging

Surgicial Audit





Dashboards and Workbench

web  email 

phone  +61 7 3252 2425  skype

Pulse+IT 29


Telemedicine and Mobility The roll-out of electronic patient care records across

replacement service for faulty hardware that cannot

MSc, CITP, MBCS, BSc Hons, PgCM, RN Clinical Director (Asia Pacific), BT Health

the English NHS is already improving patient care and

be resolved remotely. These lightweight and tough

delivering cost savings in hospitals and GP surgeries.

laptops have built-in, high-speed mobile broadband

Jacques von Benecke

By providing access to this information at the point of

facilities and an integral NHS smart card reader.

care, these benefits can be extended to community

health staff. One such example is Kirklees Community

their team and they don’t have to return to base for

Healthcare Services. Kirklees employs more than 1200

information. This has resulted in improved productivity

staff supporting the healthcare needs of more than

with staff able to carry out one or two extra visits per

402,000 people across seven localities in the north of

day delivering even better care in people’s homes with

England including Moorland, areas of the Peak District

positive patient feedback. Kirklees also estimates

and the South Pennines with urban areas including

that the solution will save around £600,000 a year in

Dewsbury, Central and South Huddersfield. Like

travel costs alone with an anticipated financial benefit

many NHS organisations, the geographical spread

equating to almost £10m a year with all financial and

means community-based healthcare involves lengthy

productivity benefits achievable without impacting on

travelling time between visits — and the repeated trip

quality and improving patient-focused care.

to the office or GP surgery to pick up notes — which

limits the number of patients that can be seen in any

the technology it has noted other improvements such

one day. It’s also costly in terms of travel, infrastructure

as a reduction in printing costs, alongside a cut in

and productivity.

charges for desktop computer equipment. It has also

Jannette Bennett

MBA (Technology Management) Enterprise Architect, BT Australasia

Nurses are able to communicate with others in

In the short time that Kirklees CHS has been using

Mobile network connectivity is provided by BT.

helped to improve the work/life balance for staff by

The solution enables staff to access their clinical

improving morale and providing greater flexibility for

records application, the Internet and email using a

all concerned. Kirklees is now carrying out a study into

secure mobile VPN connection that safeguards patient

whether it can cut its property estate, because there is

confidentiality. This approach enables a new way of

no longer the same demand for office space.

working that increases efficiency and improves clinical

outcomes and patient experience, productivity and

county is becoming more commonplace such as in

staff wellbeing.

Northern Lincolnshire. Here the same mobile devices

A ruggedised laptop was chosen as the preferred

are used by community clinicians and corporate users

mobile device. Waterproof and tolerant of hard use,

who are needed to work flexibly. The solution enables

the lightweight device has in-built Wi-Fi facilities

those users to access the trusts’ networks and clinical

and an integral smart card reader. The laptops are

records application virtually anywhere they are working

pre‑configured and supplied by BT against a standard

via a secure mobile VPN connection.

build, and BT also provides a helpdesk and a next day

Mobile network connectivity in rural parts of the

A post-implementation survey conducted by

the NHS Trust revealed the solution gave 88% of

Author Info

respondents more time to work, while 53% said that it had a positive impact on patient care. Nearly 80% of Janette Bennett is the Clinical Director, Asia Pacific, BT Health and Jacques von Benecke is Enterprise Architect, BT Australasia.

respondents said better access to information in the field enabled more informed clinical decision-making and improved patient safety. The ability to update clinical records in real time at the point of care is improving data quality and offering greater efficiency.

30 Pulse+IT

Clinicians are already reducing ineffective time, such as

laptop computers and other mobile devices enabled by

travelling, and are saving at least an hour a day. Better

wireless technology. However, when applications such

access to clinical records is aiding diagnosis and helping

as PACS are teamed with wireless technology, truly

to avoid unnecessary referrals and admissions.

extraordinary things begin to happen.

This aspect alone could save the Northern

At Cornwall Hospital’s main acute unit in Truro, the

Lincolnshire trusts approximately £450,000 a month

BT-managed hands-free telephony solution uses Voice

In sustainability terms, clinicians are now able

Over IP (VoIP) technology running over the wireless

to work from home rather than go to the office,

network infrastructure. A lightweight “badge” is hung

reducing travelling and carbon emissions. With fewer

around the neck or clipped to clothing. Being entirely

office‑based staff the need for fixed accommodation

voice activated, users are able to get on with their jobs

is decreasing, while flexible working is enhancing the

while simultaneously attending to live phone calls and

work life balance of the people involved.


In the far South of the UK, five Cornish NHS

At the Truro hospital, Clinical Imaging Assistants

Trusts, each of which has multiple sites, have unified

help to move patients and equipment to and from

communications over a single Community Of Interest

— and within — the radiology department. The

Network (COIN). That network uses Multi-Protocol

hospital had been using a semi-automated workflow

Label Switching (MPLS) technology and interconnects

management system that knew which patients needed

with the N3 (the NHS national broadband network)

to be taken from which ward to where but it required

and NHS infrastructure e-health services including the

the Clinical Assistants to report back to base after each

“Spine” patient demographic service, the electronic

assignment to collect the next job.

prescription service, and 14 other sub systems, as well

as local application solutions offering a seamless and

the workflow management tool the hospital is able to

resilient interface between Cornwall and the rest of the

communicate directly with Clinical Imaging Assistants

UK health service.

and dynamically assign jobs to them, dramatically






With VoIP integrated into the wireless network and


reducing wasted time. Before using the system, a

and platform in place, health innovations such as

Clinical Imaging Assistant could walk 15 miles a day.

telemedicine can then safely be put in place. Accidents

Since adopting that distance has been halved and the

are not uncommon on Cornwall’s beaches and remote

very busy Computer Tomography department has

spots, especially in the summer months when the

achieved a productivity improvement of 40%.

population surges with holiday makers. The COIN

interconnects the majority of Cornish GP surgeries and

healthcare professionals to work the way that care

remote minor injuries units, enabling them to share

is delivered. Supporting those professionals on the

images with main A&E departments as well as using

move will both improve patient care and make it more

video conferencing with centrally located doctors to aid

efficient. The case studies presented above are great

diagnosis. PACS images such as X-rays and MRI scans

examples of 21st Century technology supporting 21st

are stored electronically and viewed anywhere from

Century healthcare and all of it is both relevant to, and

the patient’s bedside or even at a remote surgery using

achievable in, Australia.

Mobility through wireless technology enables

Pulse+IT eNews & Twitter Service To receive the latest Australian Health IT news delivered free to your Email inbox or Twitter client, visit

Pulse+IT 31


Why is telemedicine not more widely used? Jon Hilton

In a country like Australia, telemedicine should be a

practitioners, their care teams, and patients in making

Program Manager, CDM-Net Australia

‘no-brainer,’ yet it seems to be perpetually waiting in

that shift, but only if we look carefully at the processes

the wings.

involved and how to improve them.

Prof Michael Georgeff

CEO, Precedence Healthcare michael.georgeff@


Telemedicine efforts have traditionally focused the






of chronic disease, a model for process improvement

equipment necessary to provide ‘remote’ presence.

in health that is backed by evidence and focuses on

Other telemedicine efforts have focused on the

chronic disease management, some early results

communication or sharing of data, such as a summary

from a web-based service that implements the major

Electronic Health Record (EHR). The continued slow

features of the model, and plans for the national rollout

progress in getting widespread adoption of such

of that service.

technologies indicates that something is missing.

The authors believe that part of the problem is

The Challenge of Chronic Disease

that we have paid insufficient attention to process (or

The World Health Organisation (WHO) predicts by the

services) and process improvement. That is, we have

year 2020, chronic disease will account for almost three

focused too much attention on data and enabling

quarters of all deaths1. In Australia, chronic diseases are

technologies without considering the processes that

estimated to be responsible for more than 80% of the

will use these capabilities, and whether or not the

burden of disease and injury2 and account for over 60%

processes themselves can be improved.

of healthcare costs3 ($60 billion per annum). Chronic

Just as in manufacturing and every other industry, it

disease significantly impacts on workforce productivity

is process improvement that makes the big difference

($8 billion per annum)4 and threatens the sustainability

in quality and outcomes. However, despite the evidence

of the healthcare system as we know it. Over 30% of

from other fields, this area receives relatively little

the Australian population has a major chronic disease5

attention in healthcare and poses many challenges,

but less than 5% of these people receive best practice

particularly in the primary healthcare environment. If


we cannot learn from other industries, we are going to

continue to have problems in incorporating technology

models of collaborative care are needed that involve

into the practice of healthcare.

planned and continuous management by a team of

To illustrate our viewpoint, we will consider one

care providers and the patient themselves, in contrast

of the greatest challenges to established medical

to conventional episodic, siloed care delivered by

practice: the onslaught of chronic disease. In this case

a single healthcare professional or organisation.

the challenge is to change the healthcare paradigm

However, without supporting information technologies,

from ‘point‑to‑point, episodic, referral’ to ‘continuous,

these new models of care cannot be cost effectively or


equitably delivered to those suffering chronic illness.





technologies of telemedicine can assist in helping

Author Info

This article discusses the magnitude of the problem

Professor Michael Georgeff is Founder and CEO of Precedence Health Care and Professor in the Faculty of Medicine, Nursing and Health Sciences at Monash University. He has been widely influential in driving health reform and e-health initiatives in Australia. Mr Jon Hilton is the Program Manager for CDM-Net Australia. He has substantial experience with web-based systems in primary healthcare, and is a member of the Board of the Health Informatics Society of Australia.

If this drag on the nation is to be overcome, new

The Chronic Care Model The Chronic Care Model (CCM)6 was developed to address the challenge of chronic disease. It “identifies the essential elements of a healthcare system that encourage high-quality chronic disease care. These elements are the community, the health system, self‑management support, delivery system design, decision support and clinical information systems.

32 Pulse+IT

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Evidence-based change concepts under

Table 1: Elements of the Chronic Care Model

each element, in combination, foster productive interactions between informed patients who take an active part in their care and providers with resources and expertise.”7

The key to implementing the CCM is to

focus on process.

“Although healthcare differs in many

ways from manufacturing, there are also surprising similarities: Whether building a car or providing healthcare for a patient, workers must rely on multiple, complex processes to accomplish their tasks and provide value to the customer or patient. Waste — of money, time, supplies, or good will — decreases value.

“Examples of [process improvement

principles] in healthcare demonstrate that, when applied rigorously and throughout an entire organization, [they] can have

End to End Disease Management Assure the delivery of effective, efficient clinical care and self-management support Provide navigation through the health care process Planning Identify relevant sub-populations for proactive care Use planned interactions to support evidence-based care Embed evidence-based guidelines into daily clinical practice Use proven provider education methods Collaboration (Team Care) Develop agreements that facilitate care coordination within and across organisations Define roles and distribute tasks among team members Integrate specialist expertise and primary care

a positive impact on productivity, cost, Provide clinical case management services for complex patients

quality, and timely delivery of services.”8

The processes involved in the CCM can

be broken down into the stages of care outlined in Table 1.

Monitoring Monitor performance of practice team and care system

In addition to these elements from the

CCM, processes to support documentation and (in Australia) Medicare compliance are

Provide timely reminders for providers and patients Review and Follow-up

also key to efficiency. Regularly assess disease control, adherence, and self-management status

The Role of IT The processes above are complex and it is not surprising that busy practices, already heavily overloaded and at the limit of their workload, find adopting these processes across their chronically ill population simply infeasible.






virtually impossible without information systems that assure ready access to key data on individual patients as well as populations of patients.”9

What are required are mechanisms to

support these processes from end to end, over the complete life cycle of care, rather than in bits and pieces. While there are various tools and software that go some of the way to facilitating this, there has,

34 Pulse+IT

Ensure regular follow-up by the care team Patient Self Support Empower and prepare patients to manage their health and health care Share evidence-based guidelines and information with patients to encourage their participation Facilitate individual patient care planning Share information with patients and providers to coordinate care Use effective self-management support strategies that include assessment, goal-setting, action planning, problem-solving and follow-up Give care that patients understand and that fits with their cultural background Emphasise the patient’s central role in managing their health Organise internal and community resources to provide ongoing self-management support to patients

to date, been nothing that attempts to

comprehensive and flexible; otherwise

(CDM) items (formerly Enhanced Primary

provide a complete solution.

the IT solution will not take hold. The

Care Program) and the Practice Incentives

Improving Chronic Illness Care website

Program (PIP).

page on Practice Change is instructive of

how much effort needs to go into this part

group intervention services provided by

of process improvement.

eligible dietitians, diabetes educators

The Importance of Change Management The Royal Australia College of General Practitioners (RACGP) recognises the


There are also Medicare items for

and exercise physiologists within this


The Dilemma of Medicare Chronic Disease Management Incentives

“The management of chronic diseases,

A key element of the CCM is that

difficulties confronting general practice if it

including diabetes, requires a paradigm

appropriate incentives should be in place to

wishes to adopt the best practice principles

shift from acute episodic care to a system

encourage and support best practice care,

established by the CCM and at the same

of care that is more suitable for the needs

particularly the evidence-based processes

time receive payment for this additional

of those with chronic conditions.”

and (potentially) outcomes. Fortunately,


Medicare supports many of the elements

cannot alone effect this shift in thinking.

of the CCM through various payments to

practitioners use the Medicare CDM items

general practitioners and other healthcare

across their full population of chronically

telemedicine, needs to be introduced


ill patients, raising the question as to

as part of a comprehensive approach to

“The Australian Government supports

whether or not these people are receiving

process improvement in the practice.

high quality care through a series of

best practice care. In Australia, according

This is not a trivial undertaking. There

non-fee-for-service payments to general

to Medicare claims data, only about 25%

is a lot to be done and it is important

practitioners and general practices. These

of people who should be on a care plan are

that the approach is well considered,

include the Chronic Disease Management

on one13, 3, half of these are likely not best

need to change the way we think about providing care for people with chronic





Information technology, particularly






themselves complex, further increasing the

As a result, relatively few general

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Pulse+IT 35

practice14, and only one in five is followed

Precedence Health Care. The collaborating

and infrastructure for supporting chronic

up and reviewed . If Medicare claims

partners were: Barwon Health, Cisco


reflect best practice, then only 3% of the





broadband-based (or ‘cloud’) service for

chronically ill population is receiving best





supporting the general practitioner (GP),

practice care.

Diabetes Australia (Vic), Global Health,

care team, and patient in achieving best

the GP Association of Geelong, IBM, Intel,

practice care.

Monash University, and Victoria University


Results from an Implementation





cdmNet supports the entire care

Centre for Strategic Economic Studies.

management process, from the creation

Introducing some results from an early

The project received funding from

of individualised care plans to review

trial: “CDM-Net: A Broadband Health

the Australian Government Department

and follow up, continuously monitoring



of Broadband, Communications and the

the care of the patient in real time across

Disease Management”. This project was

Digital Economy (DBCDE) under the Clever

the whole care team. cdmNet also

supported by funding from the Australian

Networks program, from the Victorian

automates and manages the processes

Government under the Clever Networks

Government Department of Innovation

and documentation for meeting Medicare



requirements and billing.










Networks program and by the Victorian

(DIIRD), from Multi Media Victoria, from

cdmNet allows a provider to take a

Department of Innovation, Industry and

the Victorian Department of Human

systematic, evidence-based approach to

Regional Development, Department of

Services, and from the collaborating

the management of their entire population

Human Services, and Multi Media Victoria.


of chronically ill patients without the heavy overheads this usually involves.

Project partners The













Web-based chronic disease management

cdmNet supports all the key elements

of the CCM, including:

The primary output of the project was

HealthLink/Medinexus Half Page 180 x 120 led by cdmNet, a network of computing services

• Creating a registry of patients with

Pusechronic IT Mag disease;

connecting healthcare

36 Pulse+IT

• Creating a shared health record for these patients;

providers (including practice nurses), and

Disease Management (CDM) items: GP

733 patients with diabetes. From a baseline

Management Plans (GPMPs), Team Care

• Creating best practice, personalised

of zero, cdmNet broadband services

Arrangements (TCAs), and the subsequent

care plans and distributing these to the

generated 725 new care plans and 186 care

reviews of GPMPs and TCAs after a

patient’s care team and to the patient;

plan reviews. cdmNet also collected over

recommended period of six months.

• Monitoring plan,





30,000 health measurements, recorded



over 2,000 appointments, and facilitated

adoption of cdmNet for a sample of five


GPs in the EGR and eight GPs in the BSWR

appointments; • Ensuring








Analysis of data pre and post the

between care providers. cdmNet sent 322

showed increases of:

simplifying review of the care plan;

SMS reminders and 385 email reminders to

• 88-205% in GPMPs;

• Facilitating collaboration by sharing

patients. These services were provided to

• 80-201% in TCAs;

the health record, care plan, and

patients and healthcare providers covering

• 310-595% in GPMP first (six-month)

progress against the care plan among

71 postcodes across regional, rural and

the care team and with the patient;

remote areas of Victoria and Western

• Supporting patient self-management

reviews; and • 220-358% in TCA first (six-month)



by sending alerts, reminders, and

In the 16 months over which users






notifications to assist with adherence

progressively enrolled in CDM-Net there

graphically, and compares them with the

to care plans and the achievement of

were over 90,000 page downloads from

expected figures for “best practice” in

wellness goals;

the cdmNet web site. This represents

chronic disease management based on

600     processes of CCM; and complex

interactions with cdmNet per patient per

chronic disease in Australia.3

year. Of these, 26,336 (or approximately


30%) involved care team members outside

work processes to accommodate the use


the GP practice, including allied health,

of cdmNet, it can reasonably be assumed

specialists, and pharmacists.

that these gains resulted in large part from

BS CDM   Items  200 per   FWE   GP  (Australia)   • Seamlessly navigating through Annual   the anMaverage of about care provider an estimated 7 million people with major • Removing the administrative burden associated



and  500   management






documentation necessary to meet 400    

As the practices did not change their

improved productivity of the GP and/or

Medicare and best practice guidelines.

Estimates of care planning activity

the practice nurse through the use of the

These elements have been identified

The primary measure of efficacy is the

cdmNet system.


degree to which the use of cdmNet

management of chronic disease and are

increased care planning activity. This was

extrapolating the above results, given the

recommended by the RACGP.15

measured by the level of provision of

relatively small sample sizes and the pre/

Medical Benefits Scheme (MBS) Chronic

post study design.







They 200   also address what the evidence  

suggests are the key deficiencies in current practice:






Figure 1 - Results from Barwon South Western (Vic) and Eastern Goldfields (WA) trials (n = 13, t-test, p < 0.01)

“Those include: 100  deficiencies  

Annual MBS CDM GP (Australia) Annual M BS  CDM  Itvems Items  per  Fper WE  GP  FWE (Australia)  

• Rushed practitioners not following established practice guidelines;


-­‐        care coordination; • Lack of Management  Plan  (721)   • Lack of active GP   follow-up to ensure the

Team Care  Arrangement  (723)  

best outcomes; and • Patients


Current (2009)  



GPMP Review  (725/732)  


BSWR Trial  

TCA Review  (727/732)  

BeEt PraFGFe  


manage their illnesses.” 16 300    

General metrics Under the project, cdmNet was trialled17 in the Barwon South Western Region (BSWR) of Victoria and the Eastern Goldfields Region (EGR) of Western Australia. These trials involved 97 GPs, 268 other healthcare



-­‐         GP  Management  Plan  (721)  

Team Care  Arrangement  (723)   Current  (2009)

BSWR Trial  

GPMP Review  (725/732)  

TCA Review  (727/732)  

BeEt PraFGFe  

Pulse+IT 37

Estimates of planned service use

either many of the care plans created

they had experienced both positive and

Important measures of both the quality of

prior to cdmNet did not include these

challenging aspects of cdmNet.

care plans and whether or not these plans

recommended healthcare services or that

are acted upon is the degree to which

patients were not followed up to ensure


patients are provided with the services

that they received these services.

connected, of which 70% were using

recommended by best practice guidelines,

email and 70% were conducting Internet

such as HbA1c (blood glucose) tests and



searches. Approximately 75% of the

podiatrist services.

services is further multiplied by the

patient participants owned mobile phones

Figure 2 depicts the results of an

increase in the number of patients on care

and, of these, about 40% were using

analysis of Medicare claims data for the

plans resulting from the use of cdmNet.

SMS. Hence cdmNet interactions with

BSWR research cohort of 99 patients over a

This results in the following overall

patients, especially reminders for tests and

10-month period shows that patients using

increases in service use on a population

appointments via email or SMS, could be

cdmNet receive a greater proportion of


sent to around half of this population.

these services than patients on care plans

• 82% in HbA1c tests (compared with 4%







prior to the use of cdmNet. The proportion

The actual change in the number of

Approximately two thirds of the reported



Questions were also asked about

beliefs and attitudes to, and satisfaction

of patients on a care plan who received the

• 75% in microalbumin tests (12%);

with, cdmNet. 61% of patients agreed

recommended services increased by:

• 66% in HDL tests (-4%);

that they believed the care plan developed

• 25% in HbA1c tests;

• 1645% in dietician services (26%);

through cdmNet improved their control

• 5% in microalbumin tests;

• 151% in podiatry services (53%); and

of diabetes and helped them comply

• 0% in High Density Lipoprotein (HDL)

• 498% in HMR services (23%).

with their care plans, with 29% unsure.




Of the 50% of respondents that used

• 707% in dietician services;

Users’ 20% perspectives

• 68% in podiatry services; and



80% found cdmNet reminders and alerts

• 185% in Home Medicines Review

patients reflected a positive view of their

helpful. Of importance to this study,

involvement 10% in the CDM-Net project and

two thirds of respondents agreed they

their experience with cdmNet. All indicated

would recommend that cdmNet be made

(HMR) services.






email or received SMS, approximately


Figure 2 - Comparison of planned service for patients with care plans without cdmNet and with cdmNet. Results from Barwon South Western 0% (Vic) trial (n = 99). HbA1c  >=  2  tests  


Microalbumin >=  1   test  

HDL >=  1  test  

Prior CDMS  


Post CDMS  







0% HbA1c  >=  2  tests  

Microalbumin >=  1   test  

HDL >=  1  test   Prior  CDMS  

38 Pulse+IT

Die>cian Post  CDMS  


Medicines Review


The Conference for General Practice The Conference for General Practice The Royal Australian College of General Practitioners andRoyal the Australian Practice Managers The AustralianAssociation College of of General Practitioners combinedofnational and the Australian Association Practiceconference Managers combined national conference

Cairns Convention Centre 6â&#x20AC;&#x201C;9 October 2010

Shape Our Future

available to others with diabetes, with 9%



potential of the National Broadband

• Expand collaborative care services by

Network (NBN) to provide high-quality,

linking with other major national and

high-speed CDM health services reliably,

Rolling Out Now

state initiatives in these regions and

securely, and equally to metropolitan,

The CDM-Net-Australia project aims to

establishing a network of high priority

regional, rural, remote, and indigenous

expand cdmNet across regional, rural and

e-health solutions including telehealth,


remote regions of Victoria, Queensland,


Tasmania, and WA, covering a population






prescribing; and

of over 1.2 million. In particular, the project

• Provide


It will leverage other national and state

priorities, including: sets

• The major gaps in healthcare delivery

aims to:

unavailable health and service-use


• Significantly improve the delivery of

information for CDM in the primary

National Primary Healthcare Strategy,

care setting.

the Health and Hospitals Reform

CDM-Net-Australia will leverage the

Commission report, and the COAG

chronic disease management services in regional, rural and remote regions of





Figure 3 - A high level model showing how cdmNet fits works with the health reform initiatives and the various jurisdictions and interested parties.

National Primary Health Care Strategy

Health and Hospitals Reform Commission

COAG Human Capital Reform Agenda

Digital Regions Initiative Model TAS VIC QLD

State Health Department Technology


Process Change Management


E-Health Initiatives

Change Management

Adoption (Clinical Staff)

Provider Directories

Local Divisions Local Divisions Local Division (KPIs) (KPIs) (KPIs)

Healthcare Identifiers Electronic Results Reporting

Change Management assistance and ongoing support

Electronic Discharge


GP State Division GP State Division GP State (KPIs) Division GP State (KPIs) Division (KPIs) (KPIs)



Allied Health


e-Referral Patient





Information Flows

Community Health

Rural and regional population (1,200,000)

40 Pulse+IT

Diagnostic Services


Community Care

End Users

Human Capital Reform Agenda;

different expectations for the visit; and


• The e-health priorities identified in the

staff may not be fully used to help with

National E-Health Strategy and the

the organization of the visit and delivery


work of NEHTA; and

of care. These ‘check-back’ visits, while


scheduled in advance, are often not


• Queensland’s 10-year $150M CDM


efficient or productive for the provider and

The Digital Regions Initiative Model


presented in Figure 3 shows how CDM‑Net


10. The team approach to diabetes in general practice/A guide for practice nurses, Royal Australian College of

Australia is aligned with the various


National and State initiatives, across all

The authors would like to thank for their

jurisdictions for all public and private

contributions to the research studies

healthcare providers with an interest in

reported here Professor Leon Piterman

chronic disease management, which is

AM, Associate Professor Peter Schattner,

almost all of them.

Dr Kay Jones, and Dr Akuh Adaji from

Practice, Sixteenth Edition, 2010/11,

Monash University, Department of General

Royal Australian College of General

Practice, and Professor John Catford,

Practitioners, p. 32

The Challenge

General Practitioners, February 2010, p5 11. index.php?p=Practice_Change&s=3 12. Diabetes Management in General

By focusing on process improvement,

Professor Trisha Dunning AM, Dr Beth

cdmNet was able to achieve large changes

Costa, and Ms Kristine Fitzgerald from

Reports, Calendar Year 2009. https://

in practice productivity and adherence

Deakin University.






can be expected to lead to significant


improvements in safety and quality of

1. World Health Organization (WHO)

13. Medicare Australia Statistics, Item

statistics/mbs_item.shtml 14. McGlynn E. A., Asch S. M., Adams J, Keesey J, Hicks J, DeCristofaro

life as well as a more efficient and equally

(2005) Preventing chronic disease: a

A, Kerr E.A. , The quality of health

accessible healthcare system for those

vital investment: WHO global report.

care delivered to adults in the

with chronic disease.

Geneva: WHO

United States. N. Engl. J. Med.,

The challenge is to make planning

2. National Health Priority Action


and collaboration as simple as possible for

Council (NHPAC) 2006. National

general practitioners and other healthcare

Chronic Disease Strategy, Australian

to diabetes in general practice: A guide

providers. Ideally, creating and sharing

Government Department of Health

for practice nurses.” RACGP. Feb, 2010.

a plan should be as easy as creating and sending a referral.

and Ageing, Canberra 3. Australian Institute of Health and

15. For example, see “The team approach

16. The Chronic Care Model. Improving Chronic Illness Care. http://www.

We need to make planning and

Welfare (AIHW) 2006. Chronic diseases

collaboration simple enough so that it

and associated risk factors in Australia,


is just a normal part of practice. We also

2006. Canberra: AIHW

17. Georgeff, M. P., et al., CDM-Net:

need to encourage healthcare providers to

4. Potential Benefits of the National

accept that the way they are doing things

Reform Agenda, Report to the

Transforming Chronic Disease

now, while it has been working well in the

Council of Australian Governments,

Management, Final Report,

past, does not serve us well in the current

Productivity Commission, February

Precedence Health Care, March, 2010.

healthcare environment, let alone in the future.

2007 5. Australian Institute of Health and

A Broadband Health Network for

18. Integrating Chronic Care and Business Strategies in the Safety Net. (Prepared

“Many healthcare providers believe

Welfare (AIHW) 2006. Chronic diseases

by Group Health’s MacColl Institute for

themselves to already be doing ‘planned’

and associated risk factors in Australia,

Healthcare Innovation, in partnership

2006. Canberra: AIHW

with RAND and the California

visits. They note that their patients with chronic conditions come back at defined

6. http://www.improvingchroniccare.

Healthcare Safety Net Institute,

intervals. Upon closer inspection, however,


under Contract No./Assignment

these visits may look a lot like acute


No: HHSA2902006000171). AHRQ

care. The provider might lack necessary information about the patient’s care needs; provider and patient might have

7. index.php?p=Model_Elements&s=18 8.

Publication No. 08-0104-EF. Rockville, MD: Agency for Healthcare Research and Quality. September 2008., p. 28

Pulse+IT 41

2-4 November 2010 - Wellington Town Hall

This programme carries 17 CME points

For exhibition and sponsorship opportunities contact

Healthcare Complaints Management Conference 29th–30th November 2010 | Brisbane Marriott Hotel A Comprehensive Conference Addressing: • National RegistrationNational Significance • Where Does Accountability Rest When Things Go Wrong? The Patient, the Clinician or the ‘System of Care’? • Integrating Complaints Management and Incident Disclosure

• Triage of Staff Complaints About Senior Clinician Competency Concerns: A Case Series • Professional Indemnity and Negligence Claims: When a Patient Sues for Damages • Code Dread: Responding When The Media Goes Critical

Case Study from Across the Tasman: A Simple and Practical Approach to Complaint Management at Auckland District Health Board (ADHB)

Practical Workshop: Frontline Conflicts and Complaints Resolution Led by Caroline Rose, BA, BSW, Consumer Advocate, Royal Women’s Hospital, Victoria

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42 Pulse+IT


P: +61 3 5335 2220 F: +61 3 5335 2211 E: W:


P: 1800 196 000 or +61 3 9095 8712 F: +61 3 9329 2524 E: W: The Australian Association of Practice Managers (AAPM) represents Practice Managers and the profession of Practice Management. Founded in 1979, AAPM is a non-profit, national association recognised as the professional body dedicated to supporting effective Practice Management in the healthcare profession. The Australian Association of Practice Managers: • Represents Practice Managers and the profession of Practice Management throughout the healthcare industry. • Promotes professional development and the code of ethics through leadership and education. • Provides specialised services and networks to support quality Practice Management.

Adelaide eSquare

P: +61 8 8234 1600 F: +61 8 8234 6785 E: W: One stop shop IT Solutions Provider: • Official Medilink Dealer for sales and support in South Australia • Computer hardware and software sales, support and servicing • Computer Networking solutions and troubleshooting • Web Site design and development • Email solutions • Web Site Hosting • Domain Name Registration and Hosting • Friendly and highly responsive team

ArgusConnect provides and supports Argus secure messaging software that enables doctors and healthcare organisations to exchange clinical documents securely and reliably. Argus can be used to send specialist reports to referring doctors but it can also exchange pathology and radiology reports, hospital discharge summaries and notification between healthcare providers. Healthcare practitioners can use any of the popular clinical software packages to send reports and other clinical correspondence via Argus. Argus is the messaging solution chosen by over 50 percent of all Divisions of General Practice across Australia through the ARGUS AFFINITY DIVISIONS program.

Brisbane, QLD Software7

P: +61 412 626 769 F: +61 7 3378 4163 E: W: Business Information Technology Solutions Provider. Some of our services are: • Authorised Medilink Dealer for sales and support in Brisbane. • Deploy, manage, procure and support computer hardware, software and networking solutions. • Web site design, development and hosting services. • Email solutions. Our team is friendly, professional and highly responsive with a strong customer focus.

Advantech Australia

P: 1300 308 531 F: +61 3 9797 0199 E: W:

Australasian College of Health Informatics P: +61 412 746 457 F: +61 3 9569 9449 E: W:

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:

Advantech’s medical computing platforms are designed to enhance the quality and efficiency of healthcare for patients and users alike. All products match the performance of commercial PCs and tough medical safety ratings like UL60601-1 and EN60601-1; adding to this they are all IPX1 certified dust resistant and come with water dripproof enclosures. Advantech offers long term support and a proven track record of reliability. The medical range extends through: • Point-of-Care Terminals. • Mini-PC and Medical Imaging Displays. • Mobile Medical Tablets. • Patient Infotainment Terminals. Advantech is also an official distributor of Microsoft Windows Embedded software across Australia & New Zealand.

Join the ACHI Info email list at:

Best Practice

P: +61 7 4155 8800 F: +61 7 4153 2093 E: W: Best Practice sets the standard for GP clinical software in Australia offering a flexible suite of products designed for the busy GP practice, including: • Best Practice Clinical (“drop-in” replacement for MD) • Integrated Best Practice (clinical/ management) • Top Pocket (PDA companion software for Pocket PC)

Carbonelle Consulting

P: +61 2 9889 1311 F: +61 2 9889 1411 E: W: Carbonelle support over 600 clients Australia wide. We have 21 years of experience in Medical IT and run a dedicated Help desk. Supported Software: Medilink • Medilink Clinical • ReferralNet • Secure Messaging • Redmap Paperless and Scanning • Voice Transcription Services • Patient SMS Reminders • Medical Director • Best Practice • Secure Online Backup • Zedmed • Genie • MHagic • Microsoft Terminal Services Experts Hardware and Services Division: Medical Software Installations • Hardware Maintenance Contracts • Software Support Contracts • Onsite Support and Training • Offsite backup Solutions • MD Data Conversions (MD2 to MD3) • Paperless Installations and Configurations Your Medical IT 1 Stop Shop

Pulse+IT 43

Cerner Corporation Pty Limited P: +61 2 9900 4800 F: +61 2 9900 4990 E: W:

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

200,000: The number of copies of Pulse+IT produced each year.


The cost of participating in the Pulse+IT Directory in all of these copies. For more information about advertising in Australia’s first and only Health IT magazine, call Simon James on +61 2 8006 5185 or +64 9 889 3185

CH2 (Clifford Hallam Healthcare) P: 1300 720 274 F: 1300 364 008 E: W:

Clifford Hallam Healthcare (CH2) is today Australia’s largest pharmaceutical and medical healthcare service provider with a catalogue of over 15,000 products servicing metro, regional and rural customers across Australia. Supported by a National Network, CH2 utilises local knowledge and local people to provide pharmaceuticals, medical consumables and equipment products to the healthcare market. CH2 is represented by a National Sales Force as well as a local Customer Service team in each state. CH2 understands the value of quality data and are committed to implementing the GS1 system throughout our business and with our partners. The use of EANCOM standard messages, Global Trade Item Numbers (GTIN) for product identification, Global Location Numbers (GLN) for location information and Serial Shipping Container Code (SSCC) labels are paramount to our industry moving forward. CH2 are passionate supporters of these philosophies and believe the uplift in quality systems will result in improved patient safety. CH2 are currently working with partners to implement the National E-Health Transition Authority (NEHTA) National Product Catalogue. “Our aim is to be a great company to do business with. The right product, at the right price, at the right time.” WardBox® is CH2’s direct to ward distribution system. It is a just in time replenishment system where orders are created in a theatre or ward area and then transmitted electronically to one of CH2’s warehouses using SOS or an EDI interface. The service incorporates barcode scanning technology, direct delivery to individual wards or departments, monthly invoicing and comprehensive reporting. WardBox® is designed to assist our customers in reducing purchasing and supply operating costs. This valuable service increases supply chain efficiencies, improves service delivery models and assists in achieving economies of scale. WardBox® distribution is used for pharmaceuticals, medical, surgical and general supplies at numerous healthcare facilities. In 2009 CH2 won the ASCLA Information Management Award and are gold sponsors for the ASCLA Awards 2010.

44 Pulse+IT

Computer Initiatives

P: 1300 85 39 39 (Melbourne) P: 1300 85 39 85 (Brisbane / GC) E: W:

Communicare Systems P: +61 8 9332 2433 F: +61 8 9310 1516 E: W:

Established in 1994, Communicare Systems have built an enviable reputation for delivering results, supported by excellent service based on mutual respect, mutual trust and mutual benefit. Communicare is the electronic medical records and practice management system of choice for Aboriginal Health Services employing multidisciplinary holistic healthcare, featuring: • Ease of use for all providers • Shared electronic health records • Standards based electronic messaging • Comprehensive easy to use automated reporting • Scalable from small service to multi organisational enterprise • Multi axial security and access logging

Computer Care

Computer Initiatives has been supporting the medical profession for over 15 years. Providing IT consultancy services, quality hardware, professional support with qualified engineers. Recommended and preferred by a number of Divisions of General Practice and specialist software providers we: • Supply and install of hardware/ software and peripherals • Implement disaster recovery and replication plans • Remote monitoring and diagnosis • Advanced networking deployment and support • Prompt and competitive support • Internet configurations and content filtering services • Security audits, configurations and monitoring • Regular maintenance services • Microsoft Gold Partner and a Microsoft Small Business Specialist

Cutting Edge Software

P: +61 2 9410 0405 (NSW) P: +61 3 9646 0141 (VIC) E: W: Computer Care works as a business partner with medical practices and other health organisations to accommodate all IT needs, covering: • Experience in all major practice management software (migration, upgrades, etc) • Computer systems & networks • Security • Hardware • Help Desk support • IT consulting • Technology trouble shooting

P: 1300 237 638 F: +61 3 9787 8210 E: W: 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.

Direct Control Digital Medical Systems P: +61 3 9753 3677 F: +61 3 9753 3049 E: W:

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: W: 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 Education Pty Ltd

P: +61 3 9653 9433 F: +61 3 9653 9307 E: W: • The Registered Training Organisation specialising in quality Health Informatics education provided by senior, education qualified HI professionals. Educational programs are designed to up-skill clinicians, technical staff, consumers and administrators in healthcare. • Delivery options include focused workshops, single subject courses or fully integrated programs delivered face to face or online through our extensive and quality assured online education delivery infrastructure. • Servicing professional and education organisations, we also aim to support professional and healthcare education providers. You can deliver your material using EHE infrastructure, or we can help you develop and/or deliver quality educational material.

Emerging Health Solutions P: 02 8853 4700 F: 02 9659 9366 E: W:

Emerging Health Solutions (EHS) is a web-based Clinical Information System for hospitals that is patientcentric capturing and providing appropriate, timely, clinical information in a secure and auditable environment. to assist clinicians deliver effective, quality care. Our prestigious clients include St Vincents & Mater Health Sydney and the Government of South Australia Department of Health. EHS has integrated Sabacare’s Clinical Care Classifiaction (CCC) System, a diagnosis framework integrated in SNOMED CT. EHS’ extensive list of modules work seamlessly with other systems via our integrated interface engine which accepts HL7 and other accepted Health IT standard protocols complying with the Australian Technical Specification: ATS 5822:2010 eHealth Secure Message Delivery.

GE Healthcare Australia Pty Ltd P: +61 2 9846 4000 F: +61 2 9846 4001 E: W:

GE Healthcare is a $17 billion business of General Electric Co. and provides a broad portfolio of healthcare technologies and services. GE Healthcare’s ‘Healthymagination’ initiative is a $6 billion commitment to improve healthcare through innovation - reducing costs, improving quality and expanding access for millions of people. A leader in solutions for the entire healthcare enterprise. GE Healthcare has extensive global experience in successful ehealth implementations and offers a broad ehealth solution portfolio including Personal Health Manager, Provider Portal, Master Patient Index and Health Information Exchange Solutions. GE Healthcare also provides the Centricity® suite of integrated information technology for enterprise hospital information systems and specialist clinical information solutions, for theatre, anaesthesia, intensive care, cardiovascular, radiology and maternity.

Equipoise (International) Pty Ltd Totalcare P: +61 7 3252 2425 F: +61 7 3252 2410 S: E: W:

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: W: Genie is a fully integrated appointments, billing and clinical management package for Specialists and GPs. Genie runs on both Windows and Mac OS X, or a combination of both. With over 1900 sites, it is now the number one choice of Australian specialists.

Pulse+IT 45

HealthLink Global Health

P: +61 3 9675 0600 F: +61 3 9675 0699 E: W:

P: +61 2 9906 6633 F: +61 2 9906 8910 E: W:

Global Health is a premier provider of technology software solutions that connect clinicians and consumers across the healthcare industry.

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.

ReferralNet Messaging is a secure message delivery system for sending healthcare information efficiently to industry professionals. MHAGIC is the most comprehensive mental health electronic medical record (EMR) system in Australia. MasterCare EMR is an electronic medical record system for specialists and allied health professionals. Locum is a clinical information management system for GPs.

P: 1800 125 036 E: W:

Health Communication Network

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 Australia¹s major hospitals

Health Informatics New Zealand E: W:

Health Informatics New Zealand (HINZ) is a national, not-for-profit organisation whose focus is to facilitate improvements in business processes and patient care in the health sector through the application of appropriate information technologies. HINZ acts as a single portal for the collection and dissemination of information about the New Zealand Health Informatics Industry. Membership is for anyone who has an interest in health and informatics.

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.


P: +61 7 5665 7995 F: +61 7 5502 6543 E: W:

Health Information Management Association Australia

HealthEasy is a 100 percent web‑based “Cloud Computing” solution as used by leading Web 2.0 apps like BaseCamp and SalesForce.

P: +61 2 9887 5001 F: +61 2 9887 5895 E: W:

• • • • • •

The Health Information Management Association of Australia (HIMAA) is the peak professional body of Health Information Managers in Australia.

No hardware upgrades No local Server needed No manual software upgrades No local backups required No contracts (pay monthly) Runs on Windows, Mac & Linux

eHealth Initiatives Support: • Electronic Prescribing (eRX) • Personal Health Record (IEHR) • Unique Health ID (UHI) Built using Open Source tools with source code available.

• Fully integrated with leading GP and Specialist clinical systems • Robust; Reliable and Fully Supported Join the network that more than 60 percent of GPs use for diagnostic, specialist and hospital communications.


P: +61 8 8203 0500 E: W: HealthSolve provides Care Management systems for aged, acute, and community care that can be shared across all health care sectors.


P: 1800 188 088 F: 1800 644 807 E: W:

Australia’s largest effective secure communication network.

Features: • Web-based. • Flexible, dynamic, and highly configurable. • Mirror your specific work flow and document style. • Resident/client centric with a focus on the whole “journey.” • Brings together administration, staff, providers, and facilities.

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.

We invite expressions of interest from all sectors of the industry. Demonstrations available under NDA due to late 2010 release.

46 Pulse+IT

Health Informatics Society of Australia P: +61 3 9388 0555 F: +61 3 9388 2086 E: W:

The Health Informatics Society of Australia is a membership based not-for-profit organisation which has been supporting and representing Australia’s health informatics and e-health community for almost 20 years. HISA aims to improve healthcare through the use of technology and information. We: • Provide a national focus for e-health, health informatics, its practitioners, industry and a broad range of stakeholders • Support, promote and advocate • Provide opportunities for networking, learning and professional development • Are effective champions for the value of health informatics HISA members are part of a national network of people and organisations building a healthcare future enabled by e-health. Join the growing community of organisations and individuals who are committed to, and passionate about, health reform enabled by e-health.

Houston Medical

P: 1800 420 066 or +61 2 9669 1844 P: 0800 401 111 or +64 7 834 9354 F: +61 2 9669 1791 E: W:


INTEGRATION ACROSS THE PRACTICE Houston Medical delivers one streamlined system integrating medical equipment with financial, claiming and administrative areas that works reliably and securely for small practices through to large multi‑disciplinary practices.

InterSystems Corporation is the worldwide leader in software for connected healthcare. With headquarters in Cambridge, Massachusetts, and offices in 24 countries, InterSystems provides advanced software technologies for breakthrough applications. InterSystems TrakCare™ is a Web‑based healthcare information system that rapidly delivers the benefits of an Electronic Patient Record. InterSystems CACHÉ® is a high performance object database that makes applications faster and more scalable. InterSystems Ensemble® is a seamless platform for integration and the development of connectable applications. InterSystems HealthShare™ is a platform that enables the fastest creation of an Electronic Health Record for regional or national health information exchange. InterSystems DeepSee™ is software that makes it possible to embed real-time business intelligence in transactional applications.

GREATER ROI for medical specialists and VIP Allied for General practice/Allied Health delivers great ROI through smoother workflow, improved data quality, boosted productivity and reduced costs. FLEXIBLE Individually configurable, Houston’s systems support you in the way you work and deliver better results. TRUSTED Houston delivers software that you can trust - built on 20 years experience and used by many hundreds of leading practices across Australasia and beyond. Our first customer is still a customer.

P: +61 2 9380 7111 F: +61 2 9380 7121 E: W:


P: +61 2 8251 6700 F: +61 2 8251 6801 E: W: iSOFT is one of the world’s largest providers of healthcare IT solutions. We work with healthcare professionals to design, develop and implement healthcare solutions that deliver administrative, clinical and diagnostic services to ensure continuity of care across all care settings. iSOFT provides flexible and interoperable solutions to the whole spectrum of providers, from single physician practices through to integrated national solutions supporting thousands of concurrent users. Our capacity to embrace change and keep abreast of emerging new directions in healthcare has allowed our clients to explore the exciting potential of new technologies while securing their existing investments.

Jam Software ISN Solutions

P: 1300 300 471 F: +61 2 9280 2665 E: W:

Hunter Valley

HL7 Australia

P: +61 420 306 556 F: +61 2 9475 0685 E: W: HL7 Australia is the representative of the HL7 International standards organisation in Australia and supports the user and implementer community with standards, training, professional certification and implementation support. HL7 Australia is hosting the HL7 International Standards and Education Meeting 9-14 January 2011 which will provide the forum for more than 50 Work Groups, Committees and Task Forces to progress the HL7 V2.x, CDA, V3 and EHR Standards. More information is available at:

Anytime Computer Solutions P: +61 2 4934 8560 E: W:

Complete ICT Solutions: • Medicare Online and ECLIPSE • DVA Paperless • Medicare Easyclaim • SMS 2 way reminders • Secure eMessaging • Clinical EMR • Paperless Solutions • Online Training • Support 24/7 • Microsoft Channel Partner • Hardware & Networking • Phone and network cable systems Solutions when you need them

P: +61 2 9799 1888 F: +61 2 9799 4042 E: W:

ISN Solutions is a medical IT company that specialises in the design, setup and maintenance of computer networks for medical practices.

MED™4i (Medical Electronic Desktop™) streamlines Health Care with easy-to-use customisable interfaces. Modular Versatility & Connectivity backed by friendly expert engineers.

Our consultants and engineers are dedicated to the medical industry, understand your business needs and know what is required to run a practice. We strive to take away the pain from you, on managing the day to day IT issues regardless of which medical application you use. Our claim is supported by strong industry references.

Comprehensive Patient database with multiple-format billing including electronic Online Patient Verifications & Claiming to Medicare, DVA & Health funds (paperless), Letters, Prescriptions (including MIMS), Orders, e-Results, MS Office integration & CustomDB including surgical & other audits. Now with HL7 Secure Messaging.

Some of our solutions include but are not limited to: • A paperless practice • Speech Recognition • Capped cost medical support & maintenance plan • Ability to consult remotely • Linking your imaging equipment to your network • Medical application Support

Your specific needs can be accommodated easily, onsite & remote installation, training, ongoing support including upgrades to meet the ever‑changing health requirements.

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Medtech Global

P: +61 3 9690 8666 F: +61 3 9690 8010 E: W:

JOSE & Associates

P: +61 3 9850 1350 F: 1300 889 012 E: W: JOSE and Associates – IT Management and Support for Medical Practices • Complete IT support for medical practices: • Support for most clinical and practice management software àà Support for all network topology àà Dedicated help desk àà 24/7 support - response in most cases is immediate • New practice installation • Server maintenance on a monthly basis which includes full monthly reporting • Satisfying IT accreditation standards • Data conversions • Disaster recovery and business continuity plans – monthly data restores • Australia Wide coverage • References available on request

Medical Software Industry Association P: +61 427 844 645 E: E: W:

With the increase in government e-health initiatives, the MSIA has become increasingly active in representing the interests of all healthcare software providers. The MSIA is represented on a range of forums, working groups and committees on behalf of its members, and has negotiated a range of important changes with government and other stakeholders to benefit industry and their customers. It has built a considerable profile with Government and is now acknowledged as the official ‘voice’ for the industry.

For 25 years, Medtech Global has been enhancing the quality of patient care by working with healthcare professionals in developing and delivering award-winning industry‑proven technology products. Our technology solutions are both sophisticated and user-friendly, designed for the comprehensive management of patient information throughout all aspects of primary and secondary healthcare, mental health and corporate health. Some of our products include: • Medtech32 and Medtech Evolution – practice management and clinical software packages • Manage My Health – an online patient portal that holds electronic health records • MDAnalyze – a surgical audit/ clinical outcomes software • We are also able to provide training, data services and consultancy.

Join over 100 other companies across all areas of medical IT/IM so your voice can be heard.

Melbourne & VIC Practice Services P/L

P: +61 3 9819 0700 F: +61 3 9819 0705 E: W: 15 years as Authorised Medilink Dealer selling, installing, training and supporting Medilink Practice Management Software • Fixed Cost Onsite and Remote Support • Medilink = Intuitive ease of use • Solo Drs up to Hospitals in size • Cut debtors and boost cash flow with Online Claiming via EFTPOS or Medicare Online for Funds, Patients, DVA & bulk billing • Many optional modules • Links to many third party packages and services Our Users are our best Salespeople

MEDITECH Australia

P: +61 2 9901 6400 F: +61 2 9439 6331 E: W: A Worldwide Leader in Health Care Information Systems


P: +61 7 5456 6000 F: +61 7 3221 0220 E: W: Medical-Objects has provided secure messaging to over 10,500 health professionals with referrals, reports, letters and discharge summaries. Delivering directly into leading practice software, removing the need for scanning and faxing. Referrals are digitally signed and encrypted, moreover, compatible with Medicare’s requirements and in line with NEHTA’s eHealth PIP direction. Using Medicare supported PKI, you can trust that referrals are digitally signed with PKI and we are working with NEHTA as an eHealth PIP eligible secure messaging vendor.

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P: 1800 623 633 F: +61 7 3392 1108 E: W: Integrated best of breed solutions: • • • • • • • • • • •

Medicare Online DVA Paperless ECLIPSE Medicare Easyclaim SMS 2 way Reminders Secure eMessaging Clinical EMR Paperless Solutions Online training Support 24/7 Unbeatable value

20 years of caring for practices.

MIMS Australia

MEDITECH today stands at the forefront of the health care information systems industry. Our products serve well over 2,300 health care organisations around the world. Large health care enterprises, multi‑hospital alliances, teaching hospitals, community hospitals, rehabilitation and psychiatric chains, long-term care organisations, physicians’ offices, and home care and hospice agencies all use our Health Care Information System to bring integrated care to the populations they serve. Our experience, along with our financial and product stability, assures our customers of a long-term information systems partner to help them achieve their goals.

P: +61 2 9902 7700 F: +61 2 9902 7701 E: W: 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.

Mouse Soft Australia Pty Ltd

P: +61 3 9888 2555 F: +61 3 9888 1752 E: W: Where do Specialists and Day Surgeries big and small go when they want comprehensive, flexible and customisable medical software with unlimited training, support and award‑winning customer service? To Medical Wizard of course. Over the past 17 years Medical Wizard has been developed, maintained and supported by experienced professionals in Australia. • Appointments & Accounts • Clinical / EMR / Paperless Wizard • Day Surgery Compliance Reporting (for All States) + HCP, PHDB, DVA • HIC Online Claiming • Secure Email / SMS Communications • Image Capture (Cosmetic & Endoscopy) • ScribeWiz (Mouse-Driven Endoscopy Report Writer)

NSW & NT Carbonelle Consulting

P: +61 2 9889 1311 E: W: Carbonelle support over 600 clients with 21 Years of Experience. Medilink Practice Management and Clinical Integrated Systems Specialists, General Practitioner and Allied Health Software • • • • • • • •

Medicare Easyclaim Medicare & DVA Online Electronic Appointment Book Eclipse (Health Fund Claims) 2Way SMS Patient Reminders ReferralNet (Secure Messaging) Medilink Clinical Paperless & Scanning Systems

Software of Excellence

Pen Computer Systems

P: +61 3 8872 5500 F: +61 3 8872 5524 E: W:

P: +61 2 9635 8955 F: +61 2 9635 8966 E: W:

Developed in Australia by the leading practice management provider in the Dental Market, OASiS Software has now released OASiS Health. Already used by Medical Specialists, Physiotherapists, Chiropractors, Podiatrists, Physiologists and a variety of other Allied Health Professionals.

Established in 1993, Pen Computer Systems (PCS) specialises in developing information solutions for National and State eHealth initiatives in Primary Health that deliver better Chronic Disease outcomes.

With fully appointment book and clinical functionality, many customers have used OASiS Health to create the paperless practice by taking advantage of OASiS Health powerful document and image handling features. Described as the most flexible practice management system available, OASiS Health specialises in Multi-Branch, Multi-Practitioner and Multi-Discipline practices. OASiS Health is designed to create a Healthy, Profitable business.

PCS expertise extends to: • Chronic Disease Prevention and Management • Population Health Status, Reporting and Enhanced Outcomes • Decision-Support tools delivered LIVE into the clinical consult • Web-based Electronic Health Records (EHRs) • SNOMED-CT and HL7 Standards Frameworks Our Clinical Audit Tool (CAT) for example delivers an intuitive population reporting and patient identification extension to the leading GP systems in Australia. CAT delivers enhanced data quality and patient outcomes in general practice.

Pulse+ IT Orion Health


P: +61 2 8298 2600 F: +61 2 8298 2666 E: W: The National E-Health Transition Authority identifies and fosters the development of the best technology necessary to deliver an e-health system for Australia. This includes national health IM and ICT standards and specifications.

P: +61 2 8096 0000 / +64 9 638 0600 F: +61 2 8096 0001 / +64 9 638 0699 E: W:

Nuance Communications P: 1300 550 716 F: +61 2 9434 2301 E: W:

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).

Orion Health is a global leader in integrated healthcare IT solutions. We specialise in electronic health records solutions, disease management, clinical decision support, and hospital administration tools. More than 200,000 clinicians in more than 20 countries use Orion Health products. Using our solutions, Orion Health’s customers have reduced operational costs, reduced risk and improved patient safety, improved communications across their organisations and between primary and secondary care. 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 elegant and intuitive solutions to meet your organisation’s current and future needs.

Pulse Magazine

P: +61 2 8006 5185 / +64 9 889 3185 F: +61 2 9475 0029 E: W: Pulse Magazine is the publisher of Pulse+IT, Australia’s first and only Health IT magazine. Pulse+IT is distributed to all corners of the health sector and is enjoyed by General Practitioners, Specialists, Practice Managers, Hospital and Aged Care decision makers, Health Informaticians, Health Information Managers and Health IT industry participants. Having grown rapidly from its launch circulation of 10,000 copies in August 2006, Pulse+IT’s current bi-monthly distribution of 37,000 printed copies ranks it as Australia’s highest circulating health publication of any kind. In addition to printed magazines, Pulse+IT offers a number of digital products including a weekly eNewsletter service, Twitter and RSS feeds, an online events calendar, and an interactive website.

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P: +61 2 8014 4573 E: W:








SmartRooms by Doctorware P: +61 3 9499 4622 F: +61 3 9499 1397 E: W:

SmartRooms provides a comprehensive software solution for specialist practices for both Mac and Windows. Comprising both practice management and clinical software, our all-in-one patient record and superior after-sales support provides the basis for a stable and time effective software solution for specialist practices of all sizes. SmartRooms is available in an appointments and billing-only version for practices with uncomplicated software needs.

The Specialist

P: +61 8 8203 0500 E: W: “The Specialist” is an intuitive and comprehensive tool that allows management of patients within specialist medical practices and day surgeries. The Specialist includes 5 modules: • Accounting • Correspondence • Time Manager • Medical Records • Mobile Data Facility Key features: • Runs on both Macintosh™ and Windows™ platforms. • Scales easily from stand-alone users, to multi-site networks. • Industry standard, and readily interoperable with other systems. • Comprehensive data migration tools for most systems. • Unlimited training and support. • Designed with the future in mind.

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Spellex has been the leading provider of comprehensive medical dictionary enhancement software to thousands of the world’s most prominent healthcare companies for 21 years. Our easy-to-use Australian medical spell checking software integrates fully with all Microsoft programmes, Web-based applications, and popular platforms. Spellex Medical is available for end-users to ensure the medical accuracy of documents and to enhance their productivity. Spellex software development kits can also be integrated with developer’s custom programmes and Web sites. Whether you’re an individual transcriptionist or you need to provide greater medical documentation accuracy across an entire hospital or campus, Spellex has a solution that’s right for you. For a free trial of Spellex software, go to and click the Free Trial tab.

Syber Scribe

Vensa Health

P: +61 3 9569 4890 / 1300 764 482 F: +61 3 9569 5543 E: W: Syber Scribe provides Internet-based medical typing services for hospitals and clinics. • Fast turn around and excellent quality. • Connection to most Patient Management Systems, possible for filing purposes. • Victoria’s largest supplier to hospitals. • References available on request.

Real Outcomes Real Productivity Minimising Waste

Trend Care Systems

P: +61 7 3390 5399 F: +61 7 3390 7599 E: W:

Stat Health Systems (Aust)

P: +61 7 3121 6550 F: +61 7 3219 7510 E: W: 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 has chosen to partner with First Databank for their drug database. The Stat roll-out has begun and we are able to convert data from all existing software. Stat also provides a premium support service and the Stat Online Claiming Solution (SOCS).

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 planning. • Rostering and work allocation. • Efficiency, productivity and HRM reporting. • Discharge analysis, bed management and clinical handovers. • Clinical pathways with variance reporting. • Patient assessments and diets. • Staff Health Tracking.

P: +64 9 522 9522 F: +64 9 522 9523 E: W: The next time you receive a text message mobile reminder or an alert from your doctor, hospital or physio you now know its done by Vensa. Vensa Health is a mobile health (mHealth) provider in the health care sector offering eHealth integrated mobile solutions, enabling text-messaging for patient communications for applications such as appointment reminders, medication reminders, test results alerts, recalls for screenings such as mamograms, immunisations and more. Vensa has invested substantially into developing products and services that offer communication solutions to better content providers with patients, including mobile text-messaging, voice, mobie sites and Telehealth services delivery.


P: +61 3 9284 3300 F: +61 3 9284 3399 E: W: 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 Zedmed eXchange – a 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.

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Pulse+IT Magazine - September 2010  

Pulse+IT Magazine - September 2010 - Australasia's first and only eHealth and Health IT magazine.

Pulse+IT Magazine - September 2010  

Pulse+IT Magazine - September 2010 - Australasia's first and only eHealth and Health IT magazine.