Australiaâ€™s First and Only Health IT Magazine
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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.
www.ehealthinfo.gov.au 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
www.ehealthinfo.gov.au 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
Learn about the new era in Australian healthcare Visit the National E-Health Transition Authorityâ€™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 http://www.racgp.org.au/ehealthfutures For information about the Healthcare Identifiers Service, visit www.ehealthinfo.gov.au
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: www.nehta.gov.au
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Publisher Pulse Magazine PO Box 7194 Yarralumla ACT 2600 Australia ABN: 19 923 710 562 www.pulseitmagazine.com.au
Editor Simon James Australia: +61 2 8006 5185 New Zealand: +64 9 889 3185 email@example.com
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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.
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: http://www.pulseitmagazine.com.au/editorial
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 28 LEGAL ISSUES
Page 30 NHS TELEHEALTH INITATIVES
Page 32 CHRONIC DISEASE
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 yearâ€™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 Australiaâ€™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 firstname.lastname@example.org
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
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
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
a detailed report on the CDM-Net Chronic Disease
With a focus on “E-health Infrastructure,” the
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 www.pulseitmagazine.com.au
iSOFT Laboratory Solution Increasing efﬁciency and productivity, while enhancing Patient Care
iSOFT is pleased to announce the launch of our Laboratory Solution into the Australian and New Zealand market. The iSOFT Laboratory Solution includes dedicated functionality for every laboratory discipline, including Anatomical pathology and support for local Billing. Each module of the software has been designed to allow users to create intelligent workﬂows, helping them to complete laboratory tasks in the most efﬁcient way. It is compatible with the most widely used information standards and protocols in the industry and helps to connect laboratory employees with people throughout the healthcare ecosystem. Proven at over 300 laboratories across Europe, the iSOFT Laboratory Solution is a market-leading laboratory information management system that helps doctors, scientists, technologists and management staff to track samples and testing processes, communicate results to other health professionals and monitor costs and reporting. iSOFT is working in partnership with healthcare participants across the spectrum of care to improve the patient journey within the healthcare system. Our laboratory information solution supports this journey, streamlining laboratory processes to provide more rapid release of validated patient results, whilst also generating statistical information to facilitate effective decision making.
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 www.isofthealth.com/en/Solutions/Department/Laboratory.aspx E email@example.com P +61 2 8251 6700
Where to for e-health in Australia now we have a new government? Dr David More
MB, PhD, FACHI firstname.lastname@example.org
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
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 http://aushealthit.blogspot.com
MyHospitals website (www.myhospitals.gov.au) 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 patientâ€™s record. With the new apparent â€˜rainbow coalitionâ€™ 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. http://aushealthit.blogspot.com/2010/05/fewdetails-from-minister-roxon-on-e.html 2. http://aushealthit.blogspot.com/2010/06/spendfive-minutes-with-nicola-roxon-to.html 3. http://alp.org.au/federal-government/news/firstplaces-in-australia-to-get-e-health/
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BITS & BYTES
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
for e-health, who will be appearing via
• DICOM and PACS
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: http://www.aths.org.au/
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
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
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
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
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
“We’ll certainly be making efforts
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BITS & BYTES
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
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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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
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
Go to the Best Practice website at www. bpsoftware.com.au to order your FREE Evaluation DvD, email firstname.lastname@example.org 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,”
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.”
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BITS & BYTES
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
since the appointment of a CEO in 2009,
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
bioresearch design and once that data has
been collected, how to separate chance
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
“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
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
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
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: www.himaa.org.au. 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.
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email@example.com LEVEL 22, GRENFELL CENTRE 25 GRENFELL STREET ADELAIDE SA 5000 JLL RLA 1842 www.joneslanglasalle.com.au
firstname.lastname@example.org LEVEL 11, 80 KING WILLIAM STREET ADELAIDE SA 5000 RLA 208125 www.cbre.com.au
0433 691 974 / 8233 8898
0411 049 183 / 8110 3312
“The marketplace will drive the uptake of new technologies...”
BSc(Psychol), MCH, PhD President, MSIA email@example.com
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
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
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
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
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
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
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
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
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
NEHTA is focusing on delivering early e-health services for the most commonly exchanged health information:
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
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 www.nehta.gov.au
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
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
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.
Like any organisation NEHTA needs to be able
Healthcare Identifiers (HI) Service
The Healthcare Identifiers (HI) Service commenced
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
International e-Health Joint Conference 20 September - 23 September Brisbane, QLD P: +61 7 3858 5526 W: www.wcc2010.com
HEALTHCON 2010 22 September - 24 September Adelaide, SA P: +61 8 8274 6060 W: www.sapmea.asn.au
13th Annual Healthcare Facilities Planning and Design Summit 29 September - 30 September Sydney, NSW P: +61 2 9080 4307 W: www.informa.com.au
International Conference on the Implementation of Electronic Health Records 26 October Edinburgh, UK P: +44 131 651 3001 W: tinyurl.com/35s2qfv HIMSS Asia’10 Health IT Congress & Leadership Summit 26 October - 29 October Daegu, South Korea P: +65 9848 5259 W: www.himssasiapac.org HIMAA National Conference 27 October - 29 October Sydney, NSW P: +61 2 9887 5001 W: www.himaa.org.au
Health Health Health
HINZ Conference 2 November - 4 November Wellington, NZ P: +64 9 373 7599 W: www.hinz.org.nz Australian General Practice Network National Forum 3 November - 6 November Perth, WA P: +61 2 6228 0835 W: www.gpnetworkforum.com.au 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: www.sapmea.asn.au
2nd Annual Reducing Medication Errors Conference 2010 28 October - 29 October Melbourne, VIC P: +61 2 9080 4300 W: www.iir.com.au
HIMSS Middle East 2010 8 November - 10 November Dubai P: +65 9848 5259 W: www.himssME.org HIT
2nd Annual Obstetric Malpractice Conference 16 September - 17 September Melbourne, VIC P: +61 2 9080 4300 W: www.iir.com.au
Rural Medicine Australia 2010 22 October - 24 October Hobart, TAS P: +61 7 3105 8200 W: www.acrrm.org.au
Clinical Audit Improvement Conference 13 September -14 September Melbourne, VIC P: +61 2 9080 4300 W: www.iir.com.au
Primary Healthcare Reform Summit 21 October - 22 October Melbourne, VIC P: +61 2 9080 4300 W: www.iir.com.au
MedInfo 2010 12 September - 15 September Cape Town, South Africa W: www.medinfo2010.org
PharmaMed Logistics 2010 19 October - 20 October Sydney, NSW P: +61 2 9080 4307 W: www.informa.com.au
Health-e-Nation 2010 9 September - 10 September Sydney, NSW P: +61 2 4365 7500 W: www.health-e-nation.com.au
Computer Based Medical Systems 12 October - 15 October Perth, WA W: www.cbms2010.curtin.edu.au
3rd Annual Hospital & Healthcare Security & Safety Conference 28 October - 29 October Brisbane, QLD P: +61 2 9080 4300 W: www.iir.com.au
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2nd Annual Clinical Leadership and Change Management Conference Human factors behind the management of clinical redesign 22nd & 23rd of November, 2010 | Hilton, Brisbane Themes include: • Engaging and motivating your staff • Increasing staff efficiency and patient care simultaneously • Building change capability in your organisation • Diagnostic tools to support change • Learn to effectively implement accountability in your team • Develop and engage your staff to have greater responsibility • Effective communication strategies to foster change
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Wednesday 24Th november, 2010 Workshop a: 9:00am-12:00pm staff retention: Facilitated by Robyn Williams, Education & Recruitment Manager, st George Private hospital Workshop b: 1:00pm-4:00pm developing Clinical Leadership to implement change in your organisation: Facilitated by Fiona Rawson, Fiona Rawson, Communications Consultant, momentum
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Online consultations – legal issues Mark Worsman
Senior Associate DLA Phillips Fox email@example.com
Paralegal DLA Phillips Fox firstname.lastname@example.org
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
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:
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
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
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
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.
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
Presence Scheduling Haematology Ophthalmology
Totalcare Clinicals “Mozart” Orthopaedics
totalcare medical management software
Paperless Electronic Records
Dashboards and Workbench
web www.totalcare.net.au email email@example.com
phone +61 7 3252 2425 skype skype.totalcare.net.au
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
charges for desktop computer equipment. It has also
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
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
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.
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
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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
involved and how to improve them.
Prof Michael Georgeff
CEO, Precedence Healthcare michael.georgeff@ precedencehealthcare.com
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
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.
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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,
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
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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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),
Diabetes Australia (Vic), Global Health,
care team, and patient in achieving best
the GP Association of Geelong, IBM, Intel,
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;
• 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
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
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
GPMP Review (725/732)
TCA Review (727/732)
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)
GPMP Review (725/732)
TCA Review (727/732)
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
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
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
0% HbA1c >= 2 tests
Microalbumin >= 1 test
HDL >= 1 test Prior CDMS
Die>cian Post CDMS
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€“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
of over 1.2 million. In particular, the project
It will leverage other national and state
priorities, including: sets
• The major gaps in healthcare delivery
unavailable health and service-use
• Significantly improve the delivery of
information for CDM in the primary
National Primary Healthcare Strategy,
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
WA TAS VIC QLD
Adoption (Clinical Staff)
Local Divisions Local Divisions Local Division (KPIs) (KPIs) (KPIs)
Healthcare Identiﬁers Electronic Results Reporting
Change Management assistance and ongoing support
GP State Division GP State Division GP State (KPIs) Division GP State (KPIs) Division (KPIs) (KPIs)
Rural and regional population (1,200,000)
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
General Practitioners, February 2010, p5 11. http://www.improvingchroniccare.org/ 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
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.
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
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. http://www.improvingchroniccare.org/ index.php?p=Model_Elements&s=18 8. http://www.improvingchroniccare.org/
Publication No. 08-0104-EF. Rockville, MD: Agency for Healthcare Research and Quality. September 2008., p. 28
2-4 November 2010 - Wellington Town Hall
This programme carries 17 CME points
For exhibition and sponsorship opportunities contact email@example.com
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
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Case Study from Across the Tasman: A Simple and Practical Approach to Complaint Management at Auckland District Health Board (ADHB)
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The Australasian College of Health Informatics is Australasia’s Health Informatics professional body, representing the interests of a broad range of clinical and non-clinical e-health professionals. ACHI is the community of Health Informatics thought-leaders in Australasia. ACHI is committed to quality, standards and ethical practice in the Health Informatics profession. More information is available at: www.ACHI.org.au
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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.
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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
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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.
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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.
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HealthLink Global Health
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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.
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Health Communication Network
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Health Information Management Association Australia
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• • • • • •
The Health Information Management Association of Australia (HIMAA) is the peak professional body of Health Information Managers in Australia.
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Australia’s largest effective secure communication network.
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Health Informatics Society of Australia P: +61 3 9388 0555 F: +61 3 9388 2086 E: email@example.com W: www.hisa.org.au
The Health Informatics Society of Australia is a membership based not-for-profit organisation which has been supporting and representing Australia’s health informatics and e-health community for almost 20 years. HISA aims to improve healthcare through the use of technology and information. We: • Provide a national focus for e-health, health informatics, its practitioners, industry and a broad range of stakeholders • Support, promote and advocate • Provide opportunities for networking, learning and professional development • Are effective champions for the value of health informatics HISA members are part of a national network of people and organisations building a healthcare future enabled by e-health. Join the growing community of organisations and individuals who are committed to, and passionate about, health reform enabled by e-health.
P: 1800 420 066 or +61 2 9669 1844 P: 0800 401 111 or +64 7 834 9354 F: +61 2 9669 1791 E: firstname.lastname@example.org W: www.houstonmedical.net
INTEGRATION ACROSS THE PRACTICE Houston Medical delivers one streamlined system integrating medical equipment with financial, claiming and administrative areas that works reliably and securely for small practices through to large multi‑disciplinary practices.
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 VIP.net for medical specialists and VIP Allied for General practice/Allied Health delivers great ROI through smoother workflow, improved data quality, boosted productivity and reduced costs. FLEXIBLE Individually configurable, Houston’s systems support you in the way you work and deliver better results. TRUSTED Houston delivers software that you can trust - built on 20 years experience and used by many hundreds of leading practices across Australasia and beyond. Our first customer is still a customer.
P: +61 2 9380 7111 F: +61 2 9380 7121 E: anz.query@InterSystems.com W: www.InterSystems.com
P: +61 2 8251 6700 F: +61 2 8251 6801 E: email@example.com W: www.isofthealth.com iSOFT is one of the world’s largest providers of healthcare IT solutions. We work with healthcare professionals to design, develop and implement healthcare solutions that deliver administrative, clinical and diagnostic services to ensure continuity of care across all care settings. iSOFT provides flexible and interoperable solutions to the whole spectrum of providers, from single physician practices through to integrated national solutions supporting thousands of concurrent users. Our capacity to embrace change and keep abreast of emerging new directions in healthcare has allowed our clients to explore the exciting potential of new technologies while securing their existing investments.
Jam Software ISN Solutions
P: 1300 300 471 F: +61 2 9280 2665 E: firstname.lastname@example.org W: www.isnsolutions.com.au
P: +61 420 306 556 F: +61 2 9475 0685 E: Admin@HL7.org.au W: www.HL7.org.au 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: www.HL7.org.au/Sydney2011
Anytime Computer Solutions P: +61 2 4934 8560 E: email@example.com W: www.anytime.com.au
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: firstname.lastname@example.org W: www.jamsoft.com.au
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.
P: +61 3 9690 8666 F: +61 3 9690 8010 E: salesAU@medtechglobal.com W: www.medtechglobal.com
JOSE & Associates
P: +61 3 9850 1350 F: 1300 889 012 E: email@example.com W: www.jose.com.au JOSE and Associates – IT Management and Support for Medical Practices • Complete IT support for medical practices: • Support for most clinical and practice management software àà Support for all network topology àà Dedicated help desk àà 24/7 support - response in most cases is immediate • New practice installation • Server maintenance on a monthly basis which includes full monthly reporting • Satisfying IT accreditation standards • Data conversions • Disaster recovery and business continuity plans – monthly data restores • Australia Wide coverage • References available on request
Medical Software Industry Association P: +61 427 844 645 E: firstname.lastname@example.org E: email@example.com W: www.msia.com.au
With the increase in government e-health initiatives, the MSIA has become increasingly active in representing the interests of all healthcare software providers. The MSIA is represented on a range of forums, working groups and committees on behalf of its members, and has negotiated a range of important changes with government and other stakeholders to benefit industry and their customers. It has built a considerable profile with Government and is now acknowledged as the official ‘voice’ for the industry.
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: Sales@practiceservices.com.au W: www.practiceservices.com.au 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
P: +61 2 9901 6400 F: +61 2 9439 6331 E: firstname.lastname@example.org W: www.meditech.com.au A Worldwide Leader in Health Care Information Systems
P: +61 7 5456 6000 F: +61 7 3221 0220 E: email@example.com W: www.medical-objects.com.au 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.
P: 1800 623 633 F: +61 7 3392 1108 E: firstname.lastname@example.org W: www.medilink.com.au 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.
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: email@example.com W: www.mims.com.au MIMS Australia is built on a heritage of local expertise, credibility and adaptation to changing healthcare provider needs. Our information gathering, analysis and coding systems are proven and robust. MIMS information is backed by MIMS trusted, rigorous editorial process and constantly updated from a variety of sources including primary research literature. Our database and decision support modules are locally relevant, clinically reviewed and updated monthly and compatible with a host of clinical software packages. Indeed, the majority of Australian prescribing packages and many dispensing applications are supported by the MIMS medicines data base. MIMS is delivered all the ways you need – print to electronic, on the move, to your patient’s bedside or your consulting room desk. Whatever the format, MIMS has the latest information you need.
Mouse Soft Australia Pty Ltd
P: +61 3 9888 2555 F: +61 3 9888 1752 E: firstname.lastname@example.org W: www.medicalwizard.com.au 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: email@example.com W: www.carbonelle.com.au 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: firstname.lastname@example.org W: www.oasis-software.com.au
P: +61 2 9635 8955 F: +61 2 9635 8966 E: email@example.com W: www.pencs.com.au
Developed in Australia by the leading practice management provider in the Dental Market, OASiS Software has now released OASiS Health. Already used by Medical Specialists, Physiotherapists, Chiropractors, Podiatrists, Physiologists and a variety of other Allied Health Professionals.
Established in 1993, Pen Computer Systems (PCS) specialises in developing information solutions for National and State eHealth initiatives in Primary Health that deliver better Chronic Disease outcomes.
With 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: firstname.lastname@example.org W: www.nehta.gov.au 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: email@example.com W: www.orionhealth.com
Nuance Communications P: 1300 550 716 F: +61 2 9434 2301 E: Vicki.Rigg@nuance.com W: www.nuance.com/au
Nuance (NASDAQ: NUAN) is a leading provider of speech and imaging solutions for businesses and consumers around the world. Its technologies, applications and services make the user experience more compelling by transforming the way people interact with information and how they create, share and use documents. Every day, millions of users and thousands of businesses utilise Nuance’s proven range of productivity applications which include Dragon NaturallySpeaking (speech recognition), OmniPage (OCR), PaperPort (document management) and PDF Converter Professional (PDF creation and conversion).
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.
P: +61 2 8006 5185 / +64 9 889 3185 F: +61 2 9475 0029 E: firstname.lastname@example.org W: www.pulseitmagazine.com.au Pulse Magazine is the publisher of Pulse+IT, Australia’s first and only Health IT magazine. Pulse+IT is distributed to all corners of the health sector and is enjoyed by General Practitioners, Specialists, Practice Managers, Hospital and Aged Care decision makers, Health Informaticians, Health Information Managers and Health IT industry participants. Having grown rapidly from its launch circulation of 10,000 copies in August 2006, Pulse+IT’s current bi-monthly distribution of 37,000 printed copies ranks it as Australia’s highest circulating health publication of any kind. In addition to printed magazines, Pulse+IT offers a number of digital products including a weekly eNewsletter service, Twitter and RSS feeds, an online events calendar, and an interactive website.
P: +61 2 8014 4573 E: email@example.com W: www.spellex.com.au
SmartRooms by Doctorware P: +61 3 9499 4622 F: +61 3 9499 1397 E: firstname.lastname@example.org W: www.doctorware.com.au
SmartRooms provides a comprehensive software solution for specialist practices for both Mac and Windows. Comprising both practice management and clinical software, our all-in-one patient record and superior after-sales support provides the basis for a stable and time effective software solution for specialist practices of all sizes. SmartRooms is available in an appointments and billing-only version for practices with uncomplicated software needs.
P: +61 8 8203 0500 E: email@example.com W: www.clintelsystems.com “The Specialist” is an intuitive and comprehensive tool that allows management of patients within specialist medical practices and day surgeries. The Specialist includes 5 modules: • Accounting • Correspondence • Time Manager • Medical Records • Mobile Data Facility Key features: • Runs on both Macintosh™ and Windows™ platforms. • Scales easily from stand-alone users, to multi-site networks. • Industry standard, and readily interoperable with other systems. • Comprehensive data migration tools for most systems. • Unlimited training and support. • Designed with the future in mind.
Spellex has been the leading provider of comprehensive medical dictionary enhancement software to thousands of the world’s most prominent healthcare companies for 21 years. Our easy-to-use Australian medical spell checking software integrates fully with all Microsoft programmes, Web-based applications, and popular platforms. Spellex Medical is available for end-users to ensure the medical accuracy of documents and to enhance their productivity. Spellex software development kits can also be integrated with developer’s custom programmes and Web sites. Whether you’re an individual transcriptionist or you need to provide greater medical documentation accuracy across an entire hospital or campus, Spellex has a solution that’s right for you. For a free trial of Spellex software, go to spellex.com.au and click the Free Trial tab.
P: +61 3 9569 4890 / 1300 764 482 F: +61 3 9569 5543 E: firstname.lastname@example.org W: www.syberscribe.com.au 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: email@example.com W: www.trendcare.com.au
Stat Health Systems (Aust)
P: +61 7 3121 6550 F: +61 7 3219 7510 E: firstname.lastname@example.org W: www.stathealth.com.au Stat 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: email@example.com W: www.vensahealth.com The next time you receive a text message mobile reminder or an alert from your doctor, hospital or physio you now know its done by Vensa. Vensa Health is a mobile health (mHealth) provider in the health care sector offering eHealth integrated mobile solutions, enabling text-messaging for patient communications for applications such as appointment reminders, medication reminders, test results alerts, recalls for screenings such as mamograms, immunisations and more. Vensa has invested substantially into developing products and services that offer communication solutions to better content providers with patients, including mobile text-messaging, voice, mobie sites and Telehealth services delivery.
P: +61 3 9284 3300 F: +61 3 9284 3399 E: firstname.lastname@example.org W: www.zedmed.com.au Owned by Doctors who understand the challenges facing the medical profession everyday and backed by nearly 30 years of experience in medical software programming, Zedmed provides innovative, full featured and sophisticated practice management and clinical records software solutions. Zedmed would also like to introduce to you 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.
GPA thinks a change would do you goodâ€Ś When it comes to accreditation, GPAâ€™s new online program
is guaranteed to change your life!
We invite general practices to trial this latest advancement in accreditation. Call us today to find out more about A+ and the 7 day no-obligation free trial. 1800 188 088 or go online at www.gpa.net.au
Pulse+IT Magazine - September 2010 - Australasia's first and only eHealth and Health IT magazine.