Pulse+IT Magazine - July 2009

PULSE IT 

AUSTRALIA’S FIRST AND ONLY HEALTH IT MAGAZINE

ISSUE 13: JULY 2009

EASYCLAIM ENDGAME

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Publisher Pulse Magazine PO Box 7194 Yarralumla ACT 2600 ABN: 19 923 710 562 www.pulsemagazine.com.au

PAGE 38 PATIENT CLAIMING Simon James provides an update on the recent developments to Medicare’s electronic patient claiming channels.

Editor Simon James 0402 149 859 simon.james@pulsemagazine.com.au Editorial Enquiries editor@pulsemagazine.com.au Advertising Enquiries ads@pulsemagazine.com.au

PAGE 27 EVENTS CALENDAR Up and coming Australian and international Health, IT, and Health IT events.

About Pulse+IT Pulse+IT is Australia’s first and only Health IT magazine. With a national distribution exceeding 38,000 copies, Pulse+IT is also Australia’s highest circulating health publication of any kind. 28,000 copies of Pulse+IT are distributed to GPs, specialists, practice managers and the IT professionals that support them. In addition, over 10,000 copies of Pulse+IT are distributed to health information managers, health informaticians and IT decision makers in hospitals, day surgeries and aged care facilities.

Contributors Simon James, Nicole Kassis, Dr Paul Mara, Robyn Peters, Kerry Stratton, 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, CMP Medica or the Kimberley Aboriginal Medical Services Council, all who produce publications that include the word “Pulse” in their titles.

Copyright 2009 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.

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PAGE 46 MARKET PLACE The Pulse+IT Directory profiles Australia’s most innovative and influential e-Health organisations.

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

HIC’09 PAGE 32

MEDISECURE PAGE 34

CONTINUITY OF CARE PAGE 40

BILLING & BAD DEBTS PAGE 44

REGULAR Sections PAGE 06 STARTUP Editor Simon James introduces the third edition of Pulse+IT for 2009, edition number thirteen.

PAGE 24 NEHTA NEHTA outlines the work being undertaken through its Electronic Medication Management program.

PAGE 08 GUEST EDITORIAL Kerry Stratton outlines the critical factors for successful EHR adoption.

PAGE 25 AGPN AGPN provides an update on the MMeX secure medical communication platform.

PAGE 12 BITS & BYTES Pulse+IT’s news section, delivering the latest e-Health developments from Australia and abroad.

PAGE 27 EVENTS CALENDAR Up and coming Australian and international Health IT, Health, and IT events.

PAGE 28 HEALTHBEYOND In the wake of the HealthBeyond Consumer e-Health conference, NEHTA launch the first in a series of features designed to highlight patient-centric e-Health technology.

PAGE 46 MARKET PLACE The Pulse+IT Directory profiles Australia’s most innovative and influential e-health organisations.

FEATURES Articles PAGE 32 HIC’09 CONFERENCE PREVIEW Pulse+IT discusses the Health Informatics Society of Australia’s forthcoming HIC’09 conference with Professor Peter Croll.

PAGE 38 PATIENT CLAIMING Simon James provides an update on the recent developments to Medicare’s electronic patient claiming channels.

PAGE 34 INTERVIEW: MEDISECURE Pulse+IT checks in with MediSecure CEO, Mr Phillip Shepherd.

PAGE 40 CONTINUITY OF CARE Dr Paul Mara details the importance of consultation notes to the quality and continuity of patient care.

PAGE 42 GENETIC DISCRIMINATION Mark Worsman and Nicole Kassis outline the possible future legal implications of designing software capable of being used to facilitate genetic discrimination.

PAGE 44 BILLING & BAD DEBTS Robyn Peters continues her series on accounting in the practice.

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STARTUP Simon James BIT, BCom Editor, Pulse+IT simon.james@pulsemagazine.com.au

Pulse+IT: 2009.3 Welcome to the thirteenth edition of Pulse+IT, Australia’s first and only Health IT magazine.

It has been an exceptionally busy time for the Australian e-Health community, with several significant developments unfolding in the two short months since the last edition of Pulse+IT was released.

The Health Informatics Society of Australia (HISA), with the support of the National E-Health Transition Authority (NEHTA), hosted the inaugural HealthBeyond Consumer e-Health conference in Melbourne.

The two e-prescribing initiatives, eRx Script Exchange and MediSecure, continue to gather momentum in the market with live deployments expected to ramp up in the coming months as more clinical and dispensing software developers commit to support one or both of these ventures.

As flagged in the last edition of Pulse+IT, the Health Communication Network (HCN) has commenced the wind down of its in-software pharmaceutical advertising business in response to ongoing pressure from the Australian Medical Association, the Royal Australian College of General Practitioners and the National Prescribing Service. While the price rises that have occurred as a result of the removal of advertising has raised the ire of some practices using Medical Director, it is unclear at this time what impact the decision to forgo its advertising revenue stream will have on the company’s long-running dominance of the GP clinical desktop market.

Having been established only a few months ago, the NEHTA Practice Incentives Program Working Group (PIP WG) is reported to be progressing well, with many pleased to witness the emergence of a constructive engagement process between government and participants of the medical software industry.

EASYCLAIM SHENANIGANS Unfortunately not all the e-Health related activity that has occurred in the recent months has been positive.

Unless the reader has been sheltering from the H1N1 virus in an underground bunker for the past few weeks, it is likely that they will have chanced upon some of the patient-focused

advertising material promoting the Medicare Online and Medicare Easyclaim systems. At a cost to tax payers of $2.3 million, this demand generation activity will undoubtedly serve to increase awareness of Medicare’s electronic patient claiming solutions, both of which have only achieved modest — though steadily improving — uptake by practices and their patients.

One wonders however, whether this money would have been better spent providing practices with more substantial financial incentives than the 18 cents currently being paid per electronic patient claim transaction. After all, no amount of demand for electronic patient claiming services will result in the desired outcome for Medicare Australia if practices are not adequately incentivised to supply the service to their patients.

This is not to say the supply side of the Medicare Easyclaim equation has been ignored however, with $6 million in funding being allocated to software vendors and financial institutions to develop and rollout Integrated Medicare Easyclaim solutions to their practices.

Having been promised access to a lucrative stream of 23 cent transaction fees at the launch of Medicare Easyclaim in 2007, financial institutions are to likely view the release of the development funding as an opportunity to revive their original Easyclaim business plans.

Despite the availability of this funding, the process by which it has been allocated appears to be in a state of disarray, with the most likely outcome to be a National Broadband Networkstyle rethink required in the coming months. The reasons for the author’s dim view of this process are as follows: Firstly, despite Medicare Australia announcing the funding offers several weeks after its own prescribed deadline, the government organisation did not extend the original deadline (August 31, 2009) offered to software developers and financial institutions to develop or deploy their solutions. Believed by many to be unrealistic even prior to the development time frame being foreshortened, Medicare Australia has left software vendors with a very narrow window of opportunity in which to negotiate with the numerous financial institutions, and subsequently collaborate to develop a deployable solution with some or all of them.

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Secondly, HCN, the developer of the market leading medical billing software application, PracSoft, was not awarded any funding despite having expended a considerable amount of effort to develop and release the market’s first Integrated Easyclaim solution in partnership with Tyro. While the author does not hold the view that e-Health innovation should be dependent on government handouts, rewarding “fast followers” while overlooking the effort expended by early adopters serves only to damage the prospects of ongoing self-funded innovation.

Thirdly, at least five other software developers with considerable market share did not receive any funding from the process and have indicated that they are dedicating their development resources to other areas of their respective software applications.

Fourthly, of the recipients that did receive funding, several have indicated that they received only a small fraction of their proposed amount. Accepting that most proposals for funding tend to include a certain amount of “contingency” padding, it is difficult to understand what benefit a handful of half-coded and hence undeployable Integrated Easyclaim solutions will provide to practices and patients.

Finally, if the software vendors that did receive sufficient levels of funding to integrate Easyclaim functionality into their products are able to do so within the specified time frame, the reality is that these vendors currently service only a small fraction of the total general and specialist practice market, limiting the public benefit that can result from the rollout of this government funded functionality.

The Integrated Easyclaim grant funding process exhibits all the hallmarks of poor stakeholder engagement, with its architects demonstrating a lack of understanding of the machinations of the medical software industry. While the author does not begrudge those parties that received funding of their financial assistance, he sincerely hopes that they have not been handed a poison chalice.

This Edition In addition to further coverage about Medicare Australia’s electronic patient claiming initiatives and the NEHTA PIP Working Group, this edition of Pulse+IT features a guest editorial from Kerry Stratton, Managing Director of Healthcare for InterSystems.

Pulse+IT interviews Phillip Shepherd, CEO of e-prescribing initiative, MediSecure, and also discusses the forthcoming Health Informatics Conference (HIC’09) with Professor Peter Croll. Additional coverage of HIC’09 is provided in our Bits&Bytes section, along with coverage of the Health-e-Nation conference, which is also being held in Canberra in August.

Organisational contributions from the AGPN and NEHTA are included in this edition, with NEHTA additionally presenting a supplement to the recently held HealthBeyond Consumer e-Health conference.

Dr Paul Mara continues his series on the continuity of care with an instalment detailing the importance of consultation notes.

Mark Worsman and Nicole Kassis outline the possible future legal implications of designing software capable of being used to facilitate genetic discrimination, and Robyn Peters continues her series on accounting in the medical practice with a discussion about proper billing procedures and the handling of bad debts.

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Simon James, Editor 0402 149 859 simon.james@pulsemagazine.com.au

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© 2008 InterSystems Corporation. All rights reserved. InterSystems Ensemble and InterSystems Caché are registered trademarks of InterSystems Corporation. InterSystems HealthShare & InterSystems TrakCare are trademarks of InterSystems Corporation.

Other product names are the trademarks of their respective vendors.

GUEST EDITORIAL Kerry Stratton Managing Director, Healthcare for InterSystems.

Electronic Health Record Adoption: Seven Critical Success Factors While some countries are moving faster than others, the need for a regional or national electronic health record (EHR) — a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting — is something that governments and healthcare IT groups around the world are all talking about. But there are some real barriers to achieving success.

The key barrier that I see is successful adoption by clinicians and healthcare providers. If you look at EHR systems, and at electronic patient record (EPR) systems that capture patient data during an encounter at a care delivery organisation, around the world there are not the number of healthcare providers using the systems that we would like — and system users are more likely to be administrative staff than clinicians.

I recently visited a large project suffering from this exact problem. The reasons seem to be twofold: systems do not present information in an intuitive and useful way. And the project sponsors fail to get the message across to their users about the extensive benefits of the EHR — so, buy-in is not achieved.

The reality is that clinicians are reluctant to adopt technology unless they see a benefit to themselves and to their patients and, equally important, unless the technology is easy to use.

But there are also other critical success factors. Based on my own experiences I have identified seven key factors, which I believe determine whether an EHR project will be successful or not.

1. Establish a vision and need I have visited government officials in many countries who all say they want electronic records. The first thing I ask them is ‘Why?’ because not all governments have established a clear need and vision.

Successful EHR and EPR projects that have taken off quickly have this in common: a healthcare leader with a strong vision and an urgent need. It seems without this single factor, these systems tend to languish and not achieve their potential.

The West Metropolitan Health Service in Santiago, Chile is an example where the clinician that headed the local health ministry had a real vision and a real need: get primary care providers talking to acute care providers about medications.

An EHR system was implemented there very quickly after we demonstrated that we could achieve this for him. It seems like a simple place to start, but the clinicians bought into the project from day one.

2. Provide strong leadership In countries where governments are prepared to mandate

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system use, EHRs and EPRs are also more likely to be successful.

The fact is, where there is somebody at the top telling doctors it is obligatory to use the system, projects are more likely to succeed.

It’s interesting to note that developing countries seem to be achieving higher rates of clinical adoption than so-called developed countries.

Bangkok Dusit Medical Services (BDMS), the largest private health provider in Thailand, has nearly universal clinical adoption.

The Government of the Federal District (GDF) of Brasilia, the capital of Brazil, also has close to 100% clinical adoption in its 17 hospitals. Doctors at BDMS and GDF are all using the systems and receiving real benefits.

If you look at healthcare institutions in Western countries, they tend to look at replacing their patient administration systems first before thinking about clinical adoption. Their prime concern is administrative use of patient information after the clinical event.

In Australia, clinicians seem to do e-prescribing and electronic lab test results, but there are fewer places where doctors are entering notes into clinical systems and doing detailed analysis.

Developing countries tend to be more dictatorial in their approach — and it seems to work. In Brasilia there was no question about whether people would use the system once it was mandated by the Secretary of Health. With BDMS in Thailand it was simply a condition of employment.

3. Electronic Patient Records must come before Electronic Health Records EPR adoption is a necessary prerequisite for an EHR. You won’t get the full value from a regional or national EHR — which brings key patient information together in a single view — if the information isn’t being captured at the point-of-care (particularly primary care where the majority of patient data resides).

In the US, fewer than 20% of hospital information systems have clinical EPRs. The fact that most US hospitals only have administrative systems, not clinical based systems, is a barrier to introducing EHRs. The Nordic countries, on the other hand, have nearly universal adoption at the clinical level. By leveraging existing EPRs in Sweden, we’ve just recently been able to get the first region up and running quickly with a meaningful EHR solution.

Although countries and regions are talking about widespread EHR solutions, they must first solve adoption of EPR in hospitals and primary care to realise the full value of an EHR. They have to get the doctors and patients on board and an important step is demonstrating the benefits and presenting the right information at the point of care, to make it easy for the doctor to use.

4. Offer benefits and incentives EPR and EHR systems can only be successful when they achieve critical mass by getting enough doctors to use them. InterSystems has been a leading provider of innovative software solutions to the healthcare industry for the past 30 years and we are focused on helping make it more compelling for clinicians to want to use the systems.

Governments are struggling with this issue of adoption rates.

In Italy, one of the regional governments decided the best way to get doctors to use a new EHR system was to pay them. Now, if they look up medications and prescribe them using the new system, they receive 2 to 3 Euros more than if they use the old paper-based system.

The State of Brasilia is another good example. Doctors now come up to me when I visit and are very enthusiastic, whereas initially they were hesitant. This is a common pattern as users move through the adoption process. You can be forced into doing something, but if you don’t like it you just feel bullied. If you enjoy it, however — if there are real benefits — you become an enthusiast.

I believe the dictatorial approach is often necessary to overcome initial hesitancy. As it becomes a natural system to use and clinicians reap real benefits, they will want to continue using it.

5. Make it easy to use Benefits and incentives are only part of the answer. The system also has to be intuitive and quick in order to deliver information to the doctor about a patient right in front of them. Typically,

this has not been the case with clinical systems where you more likely enter a clinical record and present it later. Unfortunately doctors just don’t work that way.

Using IT has not been made easy for hospital clinicians.

Currently, most doctors write notes on pieces of paper or call out information to a nurse or junior resident. The nurse or junior has to go to the nurse’s workstation, enter the clinical information, place orders and do the medications. It is important to make this easier for clinicians, supporting their existing processes. They don’t want to have to become transcribers to use a system.

Investments need to be made in things like being able to enter medications at the bedside. Part of the issue is the cost of bedside devices. Increasingly, however, professionals carry big screen mobile phones with wireless connections and connecting them to the system is one way to address that.

To make it easier it is necessary to set up different information views for different clinicians. A surgeon wants to see information presented in a different way than a cardiac physician or a psychiatrist. The most important data to a psychiatrist may be the last lot of lab tests and the medications, for example.

Achieving this requires agility — being able to tailor the system so it can present information in the best way to the person who is signed-on and using a particular device. In Sweden we are involved in an EHR project connecting all the regions and all the hospitals. One of the early comments we had from doctors was the importance of ease of use and fast access to data. As a result, we’ve set up a summary clinical record, which displays critical data rapidly to authorised users. From there, users can drill down with a preferred view.

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6. Use flexible deployment, not change management Many commentators say we need better change management to encourage clinical adoption. But change management has largely been a costly service that hasn’t always delivered the anticipated results. The issue is overcoming inertia and reluctance to change familiar practices. If you didn’t have a dictator as the CEO, why wouldn’t you just go about business as usual unless you could see real benefits in using a new system?

The healthcare architects working with me at InterSystems understand how to set things up for different groups of people so they will want to use the system. They are able to demonstrate the benefits and show users how they can achieve a lot more with simple setup and configuration and ease of use. I think this is a key factor to broad-based adoption.

Listening to doctors and healthcare providers as a group and understanding what their real needs are is vital. You can’t do things by consensus in a hospital. If you had six doctors in a room they may want six different things. You need to have the ability, based on experience, to set it up as you think it should work. Then you can let clinicians use it and fine-tune it afterwards.

Healthcare information systems have been notoriously inflexible in the past, with system programming changes often required in order to change anything. InterSystems has set a new standard in this regard, empowering customers to readily configure their systems to best meet the evolving needs of their organisation.

7. Work in true partnership and trust The last, possibly most critical success factor, is this: The flexible deployment model I have been talking about here is only possible when there is a true partnership and trust between the user and the supplier. That level of trust and long term perspective lets you achieve things that would otherwise be prohibitively expensive and risky.

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For example, InterSystems can now set up a healthcare information system tailored for specific regions in the world as a foundation solution. These reflect best international practice and are then adapted to make them specific to a region or country.

We recently set up a foundation solution in Northern Europe, for example. It uses standard TrakCare code, but set up to suit the local market. That enables rapid, lower risk deployment into different hospitals, which is readily tailored to meet the specific needs of individual institutions.

Flexibility is key to this approach, combined with a partnership to make it work. This is a very different approach to traditional change management. Flexible revenue models are also important in this market and that requires a long-term partnership perspective with aligned goals and objectives.

We have simplified the process by having a very adaptable system and working with local customers directly. The big difference is having a system built on a single database where you are able to see information across the entire system. That way, you only have to enter information once, or make a single configuration change, and it becomes available throughout the system. It becomes part of a unified solution, not part of an isolated module.

It used to be that the customer would always pay extra for those sorts of changes. We know from experience this is a recipe for failure. Instead, we have taken the expense of system changes away from the end-user and invested it into the system to make it intuitive, and easy to use, and adapt.

This way, you end up with a solution for a predictable cost.

And that is something that governments like. There is complete predictability because there are no hidden costs or additional options. The clinical systems can be adapted for easy use by the clinicians without expensive changes.

Get these seven critical things right and it will drive adoption by clinicians and you will be well on your way to achieving a successful EHR system.

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Zedmed enhances decision support with advanced MIMS functionality Zedmed has become the first Australian clinical software developer to incorporate the new MIMS Drug Health interaction checker that is designed to allow clinicians to check for contra-indications between patient health problems and medications at the point of prescribing.

MIMS Business Development Manager, Dinah Graham, said the new medicines decision module provides doctors with another level of safety when prescribing.

“Zedmed is one of Australia’s most innovative and successful clinical and practice management software companies,” said Ms Graham.

“They have worked closely with leading GPs and specialists to ensure that their application reflects what is happening in the consultation room as well as ensuring practice accreditation requirements, such as adding allergy requirements prior to prescribing, are met.”

Dr Andrew Pascoe, Zedmed’s Clinical Director, said that the company is “pleased to be the first to market with interaction checking between health problems and medicines. The ability to add this into our medications module along with our drug to drug and drug to allergy checking, demonstrates our commitment to meeting the needs of our customers and helps us to continue to provide a more intuitive

application for the doctors.”

The MIMS Medicine Database is integrated in over 40 clinical software applications in Australia. Decision support modules such as Drug Health are available through the MIMS API. While MIMS has long published its drug databases in a variety of formats, the company indicated that the focus on integrated solutions is expanding.

“MIMS has been publishing healthcare information for professionals for over 45 years and although we continue to print both the MIMS Annual and the MIMS Bi-Monthly it is our electronic products MIMS Integrated, MIMS Online, eMIMS, MIMS on PDA, and MIMS Mobile that are supporting healthcare professionals more and more. One of the fastest growing areas of our business is working with other suppliers, like Zedmed,” said Ms Graham.

“Integrating MIMS medicines data can help ensure currency of information and that doctors have access to evidence based decision support embedded within their prescribing software. When one considers that 2% of all hospital admissions in Australia are as a direct result of adverse drug events, getting the right information at the point of prescribing can contribute to the quality use of medicines in a significant way.”

HealthEngine patient health services portal launched Collaboration between three emergency medicine specialists has culminated in the public release of HealthEngine, a patient health services portal that was launched at the start of July.

Having been in development for several years, the website comprises a directory of health professionals, medical practices, and umbrella medical groups.

Extending beyond a simple directory of names and contact details, HealthEngine is undertaking to provide more detailed information about the organisations and health professionals listed by the service.

Speaking to this point of difference,

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Dr Mike Cadogan, one of the website’s developers said, “The idea is for the public to be able to find the right doctor for them, one that most suits their needs — language, gender, locality, qualifications, and special areas of interest — rather than wait 6 months for an appointment with an orthopaedic surgeon only to be told at the clinic that he or she only deals with shoulder injuries and not ankle injuries, or that they don’t perform gap treatments.

Using HealthEngine, the increasingly web-savvy public are able to do some homework before hand.”

In addition to the directory component,

BitS & BYTES HealthEngine is publishing a rapidly developing range of patient-centric health related articles and information.

For practices and doctors, the site offers the ability to realise marketing benefits by improving their visibility to online users. By allowing the listings to contain specific areas of expertise and interest, listed organisations can seek to attract patients specific to these criteria.

While basic listings are available at no cost, doctors and practices may elect to purchase premium listings for $49 and $249 respectively. A premium entry allows the listee to upload photos and logos, add links to external websites, publish additional textual information, list special areas of medical expertise and interest, and publish their own articles.

The HealthEngine interface has been refined to facilitate rapid navigation, however Dr Cadogan indicated that there is considerable complexity in the underlying database driving the solution.

HealthEngine manages the relationships between practitioners, physical sites of service, and medical groups, with these underlying linkages permitting, for example, a doctor to be associated with multiple groups working from varying locations.

HealthEngine launched with over 11,900 practices and 32,000 doctors listed in its database. During the site’s

development, Dr Cadogan undertook the arduous task of manually procuring contacts for the database and keeping this data current.

While doctors and practices will ultimately be able to maintain their own profile after registering with the site, Dr Cadogan indicated that initially he will undertake to perform all updates manually to maintain the quality of the data entered into the system.

With a keen interest in emerging media and web technologies, Dr Cadogan has utilised social networking tools to promote the HealthEngine site in advance of its official launch. He has established a Twitter feed, Facebook page, and regularly updates a blog linked to the site to provide information about the ongoing development of HealthEngine, in addition to commentary about wider health related topics.

This approach — plus the website’s favourable Google ranking — appears to be paying early dividends, with the website currently receiving 62 thousand page views per month, and over 850 unique visitors per day.

With the HealthEngine listings now publicly available, Dr Cadogan has urged practices to review their entry and get in touch if they have any corrections, additions, or concerns about being listed on the site: www.healthengine.com.au

Below - An extract from the HealthEngine website, showing a listing for an organisation that has undertaken a premium placement with the service.

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NEHTA and MSIA collaborate to progress secure messaging The National E-Health Transition Authority (NEHTA) and the Medical Software Industry Association (MSIA) have commenced a series of working group sessions to address the problems associated with the fragmented secure clinical messaging landscape.

The catalyst for the formation of the group can be traced to the release of the recently revised Practice Incentive Program (PIP) eHealth requirements.

Amongst these new requirements was a mandate that practices must use a software solution from an “eligible supplier”. For a software vendor to be considered eligible, the company is required to engage with NEHTA, either directly or through a representative body like the MSIA or the Australian Information Industry Association (AIIA).

To mitigate the risk of being seen to be standing between GPs and their so called “incentive” payments, software vendors committed en masse to the process almost immediately following the release of the PIP requirements. In fact the governmental compulsion was so effective, literally dozens of software vendors with no previous discernible interest in secure messaging are now classified as eligible suppliers.

While general and specialist practices have long had the ability to receive — and to a lesser extent send — clinical information electronically, the capacity of the various secure messaging products to communicate with each other has not yet developed in a meaningful way. In practical terms, this has resulted in both the senders and receivers of clinical messages having to install multiple secure messaging solutions to maximise the number of healthcare professionals and organisations with whom they can communicate by electronic means.

With this reality in mind, the primary purpose of the PIP Working Group (PIP WG) is to develop a set of functional specifications designed to allow secure messaging solutions developed by competing software vendors to interconnect. In the absence of legislation to support the introduction of Universal Healthcare Identifiers (UHI) for both patients and healthcare providers, the development of the specifications is

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viewed as an interim step towards a more robust secure messaging platform.

According to Tina Connell-Clark, NEHTA Standards Manager and Co-Chair of the PIP WG’s meetings, it is intended that a draft specification providing a framework for such connectivity to commence will be submitted to Standards Australia through IT-014 later in the year.

While the specific scope of the PIP WG’s undertaking is still being refined, Paul Burnham, a NEHTA project manager supporting the PIP WG process, indicated that the group’s focus will exclude any discussion about the specific content of clinical messages at this time. That is, the current focus of the group is on transmitting “blobs” of data in a secure and reliable fashion, preserving patient privacy throughout the transmission process.

The first PIP WG meeting was held in late March, shortly after the public release of the new eHealth PIP requirements.

While many members of the software vendor community were disappointed by this after-the-fact engagement, it has emerged that NEHTA themselves were recruited into the process by their government peer group under similarly poor circumstances.

Subsequent to the inaugural March PIP WG meeting, a single-day session has been held in each of April, May and June. Initially pitched at a high level, Mr Burnham indicated that the subject matter canvassed at each meeting has become progressively more technically detailed.

Despite these meetings invariably imposing financial and time burdens on the participating software vendors, the response by the developer community to NEHTA’s approach to engagement within the PIP WG has been overwhelmingly positive. Dr Vincent McCauley, President of the MSIA noted that the PIP WG is the first initiative that has resulted in the logos of both NEHTA and the MSIA appearing together on an e-Heatlh project’s terms of reference, a symbolic gesture that exemplifies the improving relationship between the two groups.

Dr McCauley said, “The PIP WG process is consolidating the ongoing move to closer ties and cooperation between MSIA and NEHTA.”

When clinical software pioneer Dr Frank Pyefinch and his team launched the ad-free alternative GP software, Best Practice, in 2004 it was to prove that the right clinical program could compete successfully with the market leader. Even without advertising revenue. Five years on, we’re proud of the way our program has evolved in response to users’ needs.

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Our outstanding reliability can save you the stress of downtime and your e-waste can be reduced significantly, so you can be saving money and the environment at the same time!

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BitS & BYTES

HISA prepares for 2009 Health Informatics Conference The Health Informatics Society of Australia (HISA) is preparing for the peak group’s Health Informatics Conference 2009 (HIC’09), which will commence on the evening of Wednesday, August 19, at the National Convention Centre in Canberra.

With a theme of ”Frontiers of Health Informatics”, the conference has attracted an impressive contingent of local and international keynote speakers, including Steven Conroy, Minister for Broadband, Communications and the Digital Economy, Peter Fleming, Chief Executive of the National E-Health Transition Authority (NEHTA), James Kavanagh, Microsoft Australia’s lead technical health architect, Lawrence Paratz, an ICT expert with a distinguished professional career in the telecommunications sector, Dr Louise Ryan, Chief of CSIRO Mathematics and Information Sciences, and Michael Legg, current President of the Health Informatics Society of Australia.

Complementing the local presenters are a quartet of distinguished speakers from the USA, including Dr Laurence Clark (Branch Chief for Imaging Technology Development Branch, Cancer Imaging Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute at National Institute Health, USA), Bruce Friedman (Emeritus Professor of Pathology in the Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan), Omid Moghadam (Global Director of Business for Intel Genomics, an Intel division focused on providing services to the Genomics market), and Ronald Tompkins (Sumner M. Redstone Professor of Surgery at the Harvard Medical School, the Chief of the Burns Service of the Massachusetts General Hospital, the Chief of Staff of the Shriners Hospitals for Children, Boston, and a world leader in the application of translational medicine).

Flanking both sides of the HIC’09 conference proper are several Health Informatics and Health IT related conferences dealing with nursing, aged care and policy domains.

The conjoined events program commences on Tuesday, August 18, with the Nursing Informatics Australia 2009 Conference. Hosted by HISA Special Interest Group (SIG), Nursing Informatics

Australia, the theme selected for the conference is “Bench to Bed: E-Health Supporting Nursing Practice”.

On Wednesday, August 19, an Aged Care Informatics Symposium convened by the HISA Aged Care SIG will be held.

The symposium’s theme this year is “Developing & Realising a Vision for Aged Care Informatics for Australia and the Region”.

On the same day, CHIK Services will host their annual Health-e-Nation conference.

The theme for the event is “Economic and social imperatives of e-health”. To complement their conference, CHIK Services will host an invitational CIO workshop to follow Health-e-Nation on Thursday, August 20.

The formal opening of the HIC’09 conference will be directly preceded by a series of 17 health informatics workshops and tutorials, which commence at 8:30am.

As was the case last year, the organisers of Health-e-Nation and HIC’09 have teamed up to co-host a joint industry exhibition, which will run for the duration of both conferences.

With Health IT vendors offered a rare opportunity to showcase their products and services in the nation’s capital, the event organisers report that exhibition space is selling well despite the prevailing economic conditions.

For the fifth consecutive year, an Interoperability Showcase will be held at the HISA event. To be positioned prominently at the centre of the exhibition hall, the showcase will allow vendors participating in the IHE-coordinated event to demonstrate the interoperability capabilities of their products in real time.

The busy week of academic and industry proceedings will be complemented by an array of social and networking engagements. Among these are the Health-e-Nation invitational dinner (August 18), the HIC’09 Welcome Reception and Official Exhibition Hall opening (August 19), and the HIC’09 Gala Dinner, to be held in the Parliament House Great Hall (August 20).

Further information about HIC’09 and the other events and functions associated with the conference is available from: www.hisa.org.au/hic09

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MIMS Mobile released for web enabled smart phones MIMS has released a new addition to its range of medicines database products.

Dubbed MIMS Mobile, the product is specifically designed to operate on the growing number of modern smart phones flourishing in the market.

MIMS has produced PDA and smart phone versions of their products for many years under the MIMS for PDA moniker, however this software was limited to specific mobile operating systems, including Windows Mobile and platforms from Palm.

MIMS Mobile, on the other hand, is a new product designed to work within a smart phone’s web browser, independent of the underlying phone hardware or mobile operating system. As such, the product can be deployed on a much wider range of mobile devices without the product having to be tailored for each smart phone on the market.

MIMS Mobile was developed in conjuction with m.NET Corporation, an Adelaide-based company that specialises in solutions for mobile devices. Under the

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JAM Software hosts annual user forum in Sydney

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terms of the agreement between the two organisations, m.NET will be responsible for ensuring that the MIMS Mobile solution is functional on new mobile devices as they enter the market.

By utilising the smart phone’s web browser and Internet connection, the developers have been able to negate the need for users to have to download medicines database updates to their smart phone periodically. That is, when the company updates its databases, the revised information will become available to customers instantly through the browser.

As an online application, the MIMS Mobile solution is also accessible from a web browser running on a laptop or desktop computer, a workflow that may be beneficial in the event of a flat phone battery or poor cellular coverage.

Access to the MIMS Mobile service is made available under a $170 annual subscription, or it can be bundled with the MIMS Annual printed edition for $270 until the end of August.

JAM Software, one of the Australian medical software industry’s pioneers, held its annual user conference in May. Founded in 1985, JAM’s flagship product, Medical Electronic Desktop (MED4i), is a suite of customisable program modules encompassing clinical, billing, and practice management functionality.

Over 60 doctors, nurses and practice managers attended the Annual MED User Meeting, which was held at The Menzies Hotel in Sydney.

The JAM development and customer services teams attended the meeting, which covered topics including the use of ECLIPSE for inpatient medical claims, advanced template creation using “MED Formz”, and discussions about the software’s work list features and various methods of usage.

According to M.A. Zahra-Newman, JAM Software’s Managing Director, the user meeting was a great success, noting

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that it was one of the company’s largest gatherings since the introduction of the GST. “These annual meetings are greatly enjoyed by all. Both sides of the support desk hot line enjoy being able to put faces to the people they interact with. Methods for extending usage and functionality were also exchanged, demonstrated, and discussed. Many questions were answered and extended feedback and great suggestions were received, said Ms Zahra-Newman.

“JAM Software users enjoy this high level of interaction and exchange. Based on the feedback generated at the user meetings, JAM Software often amends or reshapes its development plans to take these comments into consideration. The development process is a very dynamic and exciting process at JAM. We just all wish there were more hours in the day and night.”

BitS & BYTES

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Benefits will depend on the nature of your business, the printers and copiers currently in use and the level of printing and copying.

Stat Health Systems appoints inaugural CEO Practice software developer, Stat Health Systems, has appointed a new chief executive officer.

Mike Noordermeer, who previously held the position of senior software developer, has become Stat Health’s first CEO, following the resignation of founding managing director, Ian Threlfall.

Mr Noordermeer has a long history in the IT industry, having worked for over 25 years in both R&D and management.

In 1987, he founded Micro-Active Australia Pty Ltd (MAA), a company specialising in the development and commercialisation of numerous laboratory instrument software products.

Over a 17-year period MAA’s software products were distributed on an OEM basis by three of the top four instrument manufacturers in the world – Applied Research Laboratories (Switzerland), Spectro (Germany), and Thermo (USA).

Approximately 2000 laboratories use Micro-Active software.

He invented and patented the

Noordermeer high solids nebuliser, used in thousands of analytical laboratories around the world.

He has also worked for Mount Isa Mines, Worsley Alumina, Australian Laboratory Services, and QML (Queensland Medical Laboratories).

Mr Noordermeer has a Bachelor of Applied Science degree, a Masters degree in e-Business, a Masters degree in Project Management, and is also a chartered chemist.

On commencement of his new role with Stat Health, Mr Noordermeer — who has been with the company for 18 months said, “I’m looking forward to leading a company which provides exceptional customer service to GPs and specialists around Australia.

“This is a very exciting time for Stat Health in that we are working on additional products for the healthcare sector which has long sought comprehensive software packages which are both technologically advanced and user friendly.”

Ramsay Health Care commits to NEHTA’s Product Catalogue Australia’s largest private hospital group Ramsay Health Care has committed to a national approach to e-health supply chain reform by signing up to NEHTA’s National Product Catalogue (NPC).

The signing of Ramsay Health Care is part of NEHTA’s strategic effort to support collaboration with the private sector and is a significant step towards achieving widespread e-health adoption.

NEHTA’s NPC uniquely identifies healthcare products, including medicines and medical devices and equipment, and records important supply chain and clinical information about those products such as the components of products and pack sizes.

Australia is one of the first countries in the world to develop a single, national product catalogue.

In a statement, NEHTA indicated that it intends for the NPC to be the primary source of data for all health related purchasing in Australia.

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The NPC is designed to reduced the chance of erroneous data being introduced into procurement transactions, thereby mitigating the costs associated with these errors.

“Ramsay Health Care will benefit greatly from using NPC because many of our vendors are already posting to the NPC. The standards implemented in the NPC will eliminate problems we have had in the past with getting product information in an agreed and standardised format, and provide accuracy improvements throughout our supply chain,” said Andrew Potter Group, Inventory Manager at Ramsay Health Care.

Ken Nobbs, NEHTA’s Medical Products Program Manager said that the NPC is an example of the kind of collaboration required to make e-health a reality for Australia. “It’s great to now see both the public and the private sector coming on board to work together to achieve common goals,” he said.

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Canberra to play host to Health-e-Nation in August Recent events have shown that a financial crisis can unlock billions of dollars overnight, yet the crisis in our health system continues unchecked under our collective noses.

What is needed to unlock but a fraction of the funding being used to bail out banks and car manufacturers? Will our political leaders direct funds towards re-invigorating and transforming the way our nation’s health is being served?

After all, Australia’s health sector accounts for around 9% of GDP and employs 7% of the national workforce.

Leaving aside the personal aspirations of every one of us to be healthy and live life to the full, it makes economic sense to ensure that Australia’s healthcare system works efficiently and effectively to deliver safe care within a quality framework.

In an environment of mounting challenges we need to resist distractions that serve to hinder the process of reform and move forward with the sense of urgency that the seriousness of the challenge demands.

Conceived with these thoughts in mind, CHIK’s Health-e-Nation’09 conference seeks to moves the e-Health debate beyond the health arena, recognising that an effective health system affects Below - Mr Shane Solomon, CEO of the Hong Kong Hospital Authority will be one of several business leaders to share insights on the value of e-Health at Health-e-Nation.

every aspect of Australia’s future.

To be held in Canberra on Wednesday, August 19, the conference draws on the themes presented in CHIK’s recent discussion paper, A Pebble in the Pond: A Vision for E-Health enabled Healthcare Transformation.

According to Sally Glass, CHIK’s Managing Director, some of the Health-eNation conference program’s underlying elements include the need to recognise that the viability of our health system affects every aspect of Australia’s future, and the need to recognise the critical role that e-Health plays in achieving successful health reforms.

“With direct impact on the productivity, economic health and prosperity of our nation, the transformation of healthcare must not be constrained to discussion and review within a health paradigm but should be given due recognition as a national priority. The health sector is eager to get behind national e-health leadership to move forward with a common vision and purpose, as well as a sense of urgency,” Ms Glass said.

In 2009, Health-e-Nation includes a rapid summary of the “e” aspects of Australia’s key national health agendas to set the “State of the Nation” context.

Speakers for the conference have been drawn from Australia, Hong Kong, India, Canada, the United States and the United Kingdom for the one-day event, and will provide aspirational examples of what can be achieved in terms of clinical, economic, business and social outcomes.

In addition to the conference proper, CHIK will be hosting an invitational CIO workshop, bringing together public and provider CIOs and a contingent of international speakers from Healthe-Nation. CHIK will also convene their advisory panel, which will this year focus on the rapidly evolving field of medication management.

For the second consecutive year, the Health-e-Nation industry trade exhibition is being held in partnership with HISA’s HIC’09 event, which commences shortly after the conclusion of Health-e-Nation on the evening of Wednesday, August 19.

Further information about Health-eNation is available at the conference website: www.health-e-nation.com.au

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In collaboration with the team at Improvement Foundation Australia (IFA) and the RACGP, Pen Computer Systems (PCS) has been expanding the functionality of its Clinical Audit Tool (CAT) to include the new Australian Primary Care Collaboratives (APCC) Program measures and embrace additional measurement for Chronic Obstructive Pulmonary Disease (COPD) and prevention. These measures reflect the latest evidence and report on significant chronic disease management and prevention data from clinical software.

CAT is an information system that works as an adjunct to several GP clinical software solutions. It allows practices to easily report and target specific cohorts of patients within their practice‘s clinical database. CAT converts practice population report graphs into patient lists that allow the practice to achieve better health outcomes, quality outcomes, and business outcomes for the general practice.

According to the IFA, experience has shown that improving practice systems, particularly those that support disease registers and patient recall, can deliver better outcomes for patients.

The new measures increase the potential for practices to measure beyond the diabetes and CHD measures in the First Phase of the Program. CAT now supports the APCC Program practices with a much broader view of practice information.

This has been developed by expert reference panels working with IFA and includes input from GPs, practice nurses, specialists, and representatives from key organisations, such as the RACGP, Heart Foundation, National Lung Foundation and Diabetes Australia. PCS has played an active role during development to ensure consistency in the data definitions and also helped produce the necessary technical schema.

“While CAT was previously capable of reporting a number of these measures, it was important to standardise the format for APCC reporting,” said John Johnston, Managing Director of PCS. “This opportunity allowed us to increase the power of CAT and to ensure that CAT continues to be aligned with broader national e-Health programs.

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We are delighted that CAT is becoming increasingly recognised as a useful tool for general practice by many of the agencies that define best practice in chronic disease management in Australia and the association with the APCC Program is a very important one for our company.”

The Clinical Audit Tool will allow consenting practices to submit their monthly Program data electronically to a web portal. Earlier in the month, IFA issued user credentials and security tokens to more than 500 APCC practices who currently subscribe to CAT to support this capability.

While CAT is available through 66 Divisions of General Practice throughout Australia, APCC practices that do not currently have access to CAT will not be disadvantaged. IFA and PCS are providing the APCC Report function within CAT to all APCC practices including those who do not currently subscribe to the tool. This will allow practices that are not CAT subscribers to experience its wider range of features for 2 months before they have to decide whether to undertake an ongoing subscription or revert to a version of CAT with only the APCC reporting components accessible.

“PCS have worked closely with IFA and we are pleased to provide all APCC Program participants with the opportunity to assess the power of CAT with their own data,” said Mr Johnston.

Over the coming months IFA will be issuing installation instructions and login credentials to APCC practices who are not currently subscribers to CAT. For those Divisions and Practices who would like to familiarise themselves with the features and functionality of CAT prior to the APCC Program deployment, there is a free demo version available from www. clinicalaudit.com.au, which includes a sample de-identified database that does not require clinical software to be installed or configured.

Once APCC practices have been contacted by the IFA to setup CAT, a number of resources will be made available from www.apcc.org.au. These include a CAT APCC User Guide which will assist practices to achieve better outcomes from their Collaboratives engagement.

Improving patient care and safety with eRx e-scripts You can now feel even more confident about your patient’s health with e-scripts available right around Australia for the first time.

Electronic scripts improve patient safety and care, as a result of reduced risk of prescribing and administration errors.

With eRx, you can send e-scripts knowing that they can be dispensed in 99% of pharmacies around Australia.

Key benefits include • Notification of dispense events can strengthen confidence about your patient’s care (based on patient consent) • More efficient management of new prescription and emergency supply prescription requests • A better patient experience, as a result of improved communication and coordination of care between GPs and pharmacists • Paving the way for individual electronic health records (based on patient consent) • Patient and medical information is retrieved direct into dispensing software, reducing the risk of re-keying errors • There is no change to the prescribing process. The only difference is that there is an eRx logo on the patient’s prescription From the time you prescribe until the script is dispensed, e-scripts are encrypted with three layers of security, so you can have full confidence that your patient’s personal and medical information is safe.

Available now.

To find out more about sending e-scripts, visit www.eRx.com.au or call 1300 700 921 eRx Script Exchange. Improving patient safety and care with e-scripts.

NEHTA

Electronic Medication Management Adverse drug events place a substantial burden on the healthcare system and the broader community through the increased cost of treating those affected by adverse drug events and lost productivity. The increase in chronic disease, coupled with the increasing use of pharmaceuticals to treat and support chronic disease, requires better ways to manage medications to reduce the cost of healthcare and increase the health outcomes of Australians.

Federal, State and Territory governments have commenced strategies to improve the use of medications and reduce adverse drug events. In State and Territory public health systems, plans are in place to implement electronic medication management systems, primarily of inpatients. The Federal government has established the National Medicines Policy as the over-arching framework to improve the use of medications.

In supporting these strategies and with the view of advancing the e-health agenda, the National E-Health Transition Authority (NEHTA) has been evaluating opportunities for standardisation of prescribing and medication information to improve the ability to share information across healthcare settings through the Electronic Medication Management (EMM) program.

E-medication management involves electronic prescribing and means that healthcare providers can see what medications their patients are taking, be assured the right medications in the right doses are dispensed to their patients, and receive decision support at the time of prescribing to help ensure what is prescribed is correct in the first place. E-medication management will also enable electronic billing, generation and transmission of notifications including the Australian Child Immunisation Register and the Adverse Drug Reactions Advisory Committee.

National standardisation of e-health technologies Across the Australian health sector many healthcare organisations are utilising technology to send prescriptions electronically. Even though many of these projects enjoy varying degrees of success, it is recognised that the greatest benefits in safety and quality, cost efficiencies and improved patient outcomes will be achieved by a national standardisation of technologies. That is, the best results will be achieved when the health system implements the same technologies for healthcare communications.

Benefits of the EMM program are broad and include benefits for consumers, healthcare providers and across the industry at large.

Consumers will enjoy improved health outcomes through better medication compliance and reduced adverse drug events. Healthcare providers will receive the benefit of increased knowledge of, and access to, medication information for improved decision making, which will reduce the time and improve the outcome of treating individuals suffering from adverse drug events through improved prescribing, dispensing and administration information. Reductions in time spent on the

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administration of repeat, lost and “owed” scripts, particularly in aged care, will also be realised through streamlining of processes.

The NEHTA EMM program comprises five major components which include the electronic transfer of prescriptions, adherence monitoring, medication histories — a comprehensive history of prescription and dispensing information, current medication list and medication management decision support and secondary uses.

Implementation of all EMM components will improve the health system’s capacity to achieve all of these benefits.

Realisation of all benefits is expected to take several years and is dependant upon the speed of adoption across the health industry.

Moving from paper prescribing to comprehensive electronic medication management is time-consuming and complex. This change requires intelligent planning, coordination and flexibility.

Collaboration at the heart of responsible innovation The objective of the e-Medication Management program is to work with healthcare organisations to understand the processes and technologies currently used for electronic prescriptions and to determine what projects deliver the most effective outcomes.

This analysis will inform a best practice approach to developing a national e-Medication Management solution.

The e-Medication Management program will identify healthcare organisations to trial proposed e-Medication Management solutions in real world contexts or pilot sites. Once the most effective solution is established, the e-Medication Management program will create recommendations to bring existing projects in line with national standards and establish a blueprint for an e-Medication Management solution for new projects yet to be implemented.

Strategic approach to best practice implementation The e-Medication Management program will employ a staged and facilitated approach to achieve the best possible national solution. In summary, this will involve: • Evaluating the technologies used in e-Medication Management projects that are currently working both locally and internationally.

• Developing a best practice model for e-Medication Management taking into consideration issues with current approaches and what is currently working.

• Identifying healthcare organisations to trial a best practice model in a real world exchange of healthcare communications.

• Creating recommendations to bring existing projects in line with national standards.

• Establishing a blueprint model for e-Medication Management for new projects yet to be implemented.

AGPN

The Network forges ahead with e-Health solutions General practice networks around Australia are pushing ahead with developing secure discharge summaries and patient record sharing systems, making the Network the ideal space to develop these initiatives.

A particularly successful example is the Great Southern Division of General Practice which partnered with the University of Western Australia’s Centre for Software Practice to develop the Great Southern Managed Health Network (GSMHN).

With Department of Health and Ageing funding the partners were able to develop an innovative solution for securely communicating and sharing important patient health information amongst various health providers including general practice, allied health and hospitals. By doing so, the GSMHN ensures that when it comes to patient information, the right information is available at the right place and time.

To achieve this, GSMHN makes use of a piece of software developed by UWA’s Centre for Software Practice known as Medical Message eXchange (MMeX). MMeX is an Internet hosted messaging solution using web services. With an interface designed to resemble webmail, MMeX is intuitive and easy to use while providing health professionals with functionality including secure email, electronic referral and discharge and facilitation of shared care planning.

The approach is celebrated by the Network’s national body — the Australian General Practice Network (AGPN) — which is Below - An extract of the patient summary screen from the Medical Message Exchange (MMeX) system.

developing eHealth initiatives across the country, says CEO Mr David Butt. “eHealth solutions such as GSMHN provide an important service by facilitating communication across the fragmented health sector, improving the patient journey, and ultimately, health outcomes,” says Mr Butt.

To use it general practitioners (GPs) simply log on to a website and can access patient information. They can access whatever information is stored there – from patient records to discharge summaries.

“This gives GPs the opportunity to keep and send messages to other health professionals and share information in a secure environment. It is also a relationship building tool, and breaks down the silos of the different health sector areas,” said Mr Butt.

Once a GP is logged on they can see the latest patient medicines information, when they were discharged from hospital and what other allied health professional services they are accessing, which saves relying on patient memory.

GSMHN is being used by a variety of health professionals including GPs, allied health professionals, pathology providers and hospitals. Created in Western Australia, GSMHN has seen strong uptake in the west with several general practice networks currently involved in supporting its uptake.

Through strong collaboration with Western Australian Country Health Services, GSMHN has evolved to meet the specific needs of rural primary and community health by providing an online clinical information system interface. This interface allows facilities with no systems of their own to maintain accurate and complete electronic health records while allowing health professionals access to their clinical records from anywhere with an Internet connection.

In February, the GSMHN was one of two Australian systems chosen for inclusion as case studies in an international research project on the uptake of information and communications technologies in the health sector, conducted by the Organisation for Economic Co-operation.

It was the winning project in the regional category of the 2008 West Australian Information Technology and Telecommunications Awards, which recognises excellence in an information technology and telecommunications product, project, or service provided by an individual or organisation servicing regional and country areas of WA. The focus of the program is to bring long-lasting improvements to health outcomes for patients using eHealth advances through the general practice networks. With the advantage of having portals available to anyone who can get to a website, it means rural and remote communities can also make use of it.

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19 - 21 August 2009 National Convention Centre Canberra HIC09 delivers an exceptional program of workshops, lectures and practical industry presentations from world leaders in Health IT. HIC09 brings together a diverse collective of healthcare professionals and information specialists. The fusion of thought is what makes the event so special – something you can’t afford to miss.

ASSOCIATED EVENTS: • National Nursing Informatics (NIA) Conference – Tuesday 18th August gust • Aged Care Informatics Symposium – Wednesday 19th August

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413 Lygon Street Brunswick East 3057 Victoria Australia t: +61 3 9388 0555 f: +61 3 9388 2086

EVENTS CALENDAR Data Centre Management 2009 July 20 - July 23 Sydney, NSW P: 02 9229 1000 W: www.iqpc.com.au Claims Processing 2009 July 29 - July 31 Sydney, NSW P: 02 9229 1000 W: www.iqpc.com.au

OCTOBER 26th International Records Management Association of Australasia Convention Adelaide, SA 20 - 23 September P: 1800 242 611 W: www.rmaa.com.au/natcon2009 GP’09 October 1 - October 4 Perth, WA P: 08 9389 1488 W: www.gpconference.com.au

JUNE

AUGUST

IADIS International e-Health Conference June 21 - June 23 Algarve, Portugal W: www.ehealth-conf.org

Nursing Informatics Australia National Conference August 18 Canberra, ACT P: 03 9388 0555 W: www.niaonline.org.au

HIMAA National Conference 2009 October 14 - October 16 Perth, WA P: 02 9887 5001 W: www.himaa.org.au

2009 Aged Care Informatics Symposium August 19 Canberra, ACT P: 03 9388 0555 W: www.hisa.org.au/agedcare

AAPM National Conference October 20 - October 23 Melbourne, VIC P: 03 6231 2999 W: www.cdesign.com.au/aapm2009

Health-e-Nation August 19 Canberra, ACT P: 02 4365 7502 W: www.health-e-nation.com.au

NOVEMBER

Brownfield Hospitals June 23 - June 24 Sydney, NSW P: 02 9080 4307 W: www.informa.com.au The 5th Annual Australia’s Ageing Population Summit June 25 - June 26 Brisbane, QLD P: 02 9080 4307 W: www.informa.com.au Medical Product & Equipment Sales Forum 2009 June 29 - June 30 Sydney, NSW P: 02 9229 1000 W: www.iqpc.com.au

HISA Health Informatics Conference 2009 (HIC’09) August 19 - August 21 Canberra, ACT P: 03 9388 0555 W: www.hic.org.au

Health Facilities Design and Development June 29 - July 1 Melbourne, VIC P: 02 9229 1000 W: www.iqpc.com.au

Medical Informatics Europe (MIE2009) Sarajevo, Bosnia and Herzegovina August 30 - September 2 P: +387 33 655 346 W: www.mie2009.org

JULY

SEPTEMBER

IAAS International Congress of Ambulatory Surgery July 3 - July 6 Brisbane, QLD P: 03 9249 1273 W: www.iaascongress2009.org

Hospital Management and Information Innovation 2009 Nanjing, China September 22 - September 23 P: +86 21 5273 0733 W: www.hmii2009.com

The 8th Annual Health Insurance Summit July 28 - July 29 Sydney, NSW P: 02 9080 4307 W: www.informa.com.au

AGPN Forum 2009 November 4 - November 7 Sydney, NSW P: 02 6228 0835 W: www.gpnetworkforum.com.au GPCE November 13 - November 15 Melbourne, VIC P: 1800 358 879 W: www.gpce.com.au/melbourne Aged Care Association Australia National Congress 2009 November 15 - November 17 Melbourne, VIC P: 03 9805 9400 W: www.agedcareassociation.com.au Asia Pacific Association for Medical Informatics Conference 2009 November 22 - November 24 Hiroshima, Japan F: +81 82 257 5081 W: www.tinyurl.com/d4hfdg

To view more Health, IT, and Health IT events, please visit the Pulse+IT website.

Events can be submitted for consideration via the calendar on the website, or via email to: editor@pulsemagazine.com.au

PULSE + IT

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National E-Health Transition Authority www.nehta.gov.au

The future of health Australia’s inaugural e-health consumer expo HealthBeyond was held in Melbourne on May 7. The event showcased an amazing array of advancements in the field of health technology to manage chronic illness and achieve better well being and good health. GPs, specialists, nurses, pharmacists, and allied health workers had the opportunity to see the latest advancements in patient care.

Consumers interested in taking better care of themselves got to see the latest on offer. Staged by the Health Informatics Society of Australia (HISA), in association

with the National E-Health Transition Authority (NEHTA), the event gave over 300 attendees the opportunity to meet exhibitors and speakers specialising in cutting edge areas like home technology, gaming and interactive media, personal health records and virtual communities.

Attendees were most impressed with the innovation on display.

As one attendee commented:

“ I went away with ideas and a glimpse into the future world of health.”

Innovation was certainly the theme of the day. Attendees had the chance to see the Wii Fit game in action, now being hailed as part of a new wave of gaming that will allow gamers to become more physically active and monitor their health. And using a new approach to an old form of entertainment, who would have thought that the humble video game could be applied to a range of healthcare initiatives?

These types of technology advances are allowing Australians to enter a new era in healthcare. Watch out for more e-health consumer expos in the years to come as advancements in this area continue.

Be at the centre of your healthcare.

Be at the centre of your healthcare.

Be at the centre of your healthcare.

Be at the centre of your healthcare.

Be at the centre of your healthcare.

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e-health brief e-health – yourdiabetes healthcare information at your fingertips “Diabesity” – when you need it, where you The world’s needbiggest it.

epidemic

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Peter Howard

The celebrity chef deals with diabetes

The Anti-Diabetes Diet Latest research reveals foods you need

E-health

Improved management of diabetes

ARTHRITIS e-HeAlTH bRIef

AsthmA e-heAlth brief e-health – your healthcare at your fingertips The information Boom –Asthma when you need it, where you Why asthma need it.has been

on the rise

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Penny Farthing for Your Thoughts Michael Cowan: asthma sufferer and fundraiser

Asthma Research Stress and mum’s diet impact risk

E-health

Better healthcare for asthma sufferers

disease e-health brief e-health –heart your healthcare at your fingertips Your information –Heart when you need it, where you Factors need that threaten it.

heart health

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Biggest Winner TV contestant beats heart disease

Wine, Garlic & Love Research reveals a healing heart trio

E-health

Looking after your heart

e-HeAlTH bRIef e-health – yourARTHRITIS healthcare information at your fingertips Arthritis – when you need it, where you Prevention need it.

Lifestyle choices /////////////////////////////////////////////////////////////// to reduce your risk

cancer e-health brief e-health – your healthcare information at your fingertips – when you need it, where you need it. ///////////////////////////////////////////////////////////////

Art & Academia

Living with

The National E-Health Transition Authority

Living with

Asthma

Triggers, allergies and quality of life The National E-Health Transition Authority

heart disease Living with

Keep your heart healthy, happy & pumping The National E-Health Transition Authority

E-health & chronic illness The National E-Health Transition Authority (NEHTA) was a sponsor of the HealthBeyond expo. NEHTA has been tasked by the governments of Australia to identify and foster the development of the right technology necessary to deliver the best e-health system.

E-health is a revolution in healthcare for all Australians.

It focuses on the electronic communication and storage of health information. E-health initiatives will help all Australians manage their own health and wellness.

Exercise and fat impact your risk

Blood and Guts

John Stubbs’ courageous fight with leukaemia

E-health

Effective healthcare for cancer sufferers

Artist Libby Woodhams overcomes rheumatoid arthritis

mental illness e-health brief

Craig Hamilton

From depression to mania & back again

Up & Down Inside bipolar disorder

Meditation, Hugs & Fish

Joint Pain

The many reasons for sore joints

Latest studies on maintaining a healthy mind

E-health

E-health

Effective management of arthritis

Who is susceptible? How can you recognise it? How to prevent it.

Sun and Skin

Doug Iredale shares a life with melanoma

Cancer Update

Living with

Reasons and remedies for aching, sore joints The National E-Health Transition Authority

State of the art mental illness management

Living with

CanCer

Skin, prostate and breast cancer questions answered

The National E-Health Transition Authority

mental illness.

Living with

The warning signs & the roads to recovery

The Federal Government’s recognition of chronic disease as a major health priority prompted NEHTA to develop the HealthBeyond range of magazines that profiles six chronic health areas – arthritis, asthma, cancer, diabetes, heart disease and mental health. The magazines are designed to raise awareness of e-health and the role of e-health in the management of chronic illness and maintenance of wellness.

You can view electronic copies of the magazines at: www.nehta.gov.au E-health will have a significant impact on the future of healthcare in Australia.

If you are interested in e-health and would like to keep across e-health developments or join our mailing list, please go to: www.ehealthinfo.com.au

Maintaining the buzz One of the major outcomes from the HealthBeyond expo was the commitment to maintain the connections formed by exhibitors and attendees during the event. ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||

Visit: www.thehealthhub.org.au

As well as the Games for Health Special Interest Group established by HISA to continue to drive development in the health games space, there is also a HealthBeyond social networking group being established online - at the Health Hub - an Australian networking site that facilitates innovation and communication in Australian healthcare.

This group will continue to build the consumer e-health community and enhance important innovations in this area through communication and cooperation. ||||||||||||||||||||||||||||||||||||||||||

The SIG agreed on the following guiding themes:

The HealthBeyond expo featured the inaugural Games for Health Special Interest Group (SIG) meeting established

by HISA and bringing together health professionals and video game developers.

This is in response to a growing interest worldwide in the use of video games for health applications and recognition that Australia is well poised to make a valuable contribution to this new and exciting area.

• Enable discussions surrounding open architecture versus existing commercial games consoles.

• Develop mechanisms to protect IP but enable exchange of information within SIG members.

• The SIG should inform government funding agencies like the National Health and Medical Research Council (NHMRC) as well as align its activities with government policy.

• Facilitate engagement between health professionals, games developers and consumers of video game for health technology.

• Consider funding mechanisms through which a national Games for Health research project might be established.

Leader of the group Dr Stuart Smith, Senior Research Officer Prince of Wales Medical Research Institute says:

“Many off-the-shelf games are too difficult for elderly or other patient populations to use so we need to think seriously about how to best map requirements of particular health applications onto video games.

A forum like the Games for Health Special Interest group is an ideal way to start that process.”

• Establish a register of skills of SIG members to further facilitate engagement and discussion.

Further information will be posted on the HISA website and an electronic mailing list established and the SIG is considering further opportunities to drive development in the health games space.

If you would like to receive further information, please contact:

Brendan Lovelock - CEO HISA brendan.lovelock@hisa.org.au

or Dr Stuart Smith s.smith@powmri.edu.au

National E-Health Transition Authority www.nehta.gov.au

Innovation collides with good health at HealthBeyond E-health is about putting the consumer at the centre of their own healthcare. The e–health consumer expo showcased some of the innovative work being done that will see us being able to take greater control of our own health.

Dr Stuart Smith, Senior Research Officer Falls and Balance Research Group, from the Prince of Wales Medical Research Institute in Sydney is using video games to help address the incidence of falls in older people. A slip or trip often results in a fall if people are unable to quickly take a corrective step to regain their balance.

Dr Smith is using a modified version of the popular Dance Dance Revolution (DDR) video game to engage older adults in a step training program. The games involve “players” stepping onto panels of a flexible sensor mat in time with a visual stimulus presented on a television screen.

The beauty of the game is that it can be programmed such that photos of family, pets, or any image of interest can be programmed and any music of a person’s choice can be played in time with the stepping patterns. In time, this simple concept will enable elderly people to participate in physical exercise and train themselves in their own environment to increase their resistance to falling and injuring themselves.

Preliminary results from pilot studies using the system show that older adults really enjoy playing the games. “One elderly participant enjoys Scottish

Dr Stuart Smith and Kieran Young Kieran Young tries the modified Dance Dance Revolution game developed by Dr Stuart Smith.

If you missed the expo or want to watch the presentations again, they can be found at the NEHTA website: www.nehta.gov.au

Highland dancing and immediately saw the potential for her to practice her dancing moves in the privacy of her own home, in her own time,” reports Dr Smith.

Amputees who experience “phantom limb pain” could find relief with such a 3D virtual reality system that creates the illusion that they can once again control their missing limb.

“Once our initial design stage is complete, we will trial the games in a 50 household study which will assess whether DDR gameplay has any effect on reducing fall risk. We are really very excited by the potential for these kinds of exergames to improve health in older people,” concludes Dr Smith.

This research is part of a more general move towards use of video games for health. Other interesting research is in the area of Second Life. Second Life is a 3D virtual world where people can meet, socialise with new friends and even begin a new life.

more productive ways mean that mobile phone platforms are destined to become a central tool in enabling consumers to make better and more informed choices about their health,” said HISA CEO Brendan Lovelock.

These developments are all central to maintaining the ongoing improvement in our quality of life as we transition into an increasingly aged population.

Mandy Salomon, Senior Researcher Faculty of Life and Social Sciences at Swinburne University of Technology in Melbourne, presented what is happening in this field and how the virtual world can encourage patient empowerment and selfcare.

Hot topic at the expo was the use of mobile phones in health care. From fitness monitoring, brain training, relaxation, sleep management to weight loss assistance, mobile phone applications are increasingly being used by consumers.

Explaining how the virtual world can meet the real world in the area of health, she showcased examples of Second Life sites such as the below where the system lets users operate a virtual limb in 3D.

“The fusion of game technology with health applications, the access to almost limitless repositories of medical information and the ability to connect healthcare providers and consumers in new and

University of Manchester http://www.newscientist.com/article/dn10579

Keep up with the latest

If you want to know more about some of the amazing array of advancements in the field of health technology to help individuals manage chronic illness and achieve better well being and good health, the following sites and resources may be a good place to start.

Diversionary Therapy Technologies www.dtt.net.au

Faculty of Health Sciences The University of Sydney www.prometheus.net.au

The Jean Hailes Foundation for Women’s Health http://education.jeanhailes.org.au

Starlight Children’s Foundation www.livewire.org.au

Leukaemia Foundation www.teamrevive.com

TeleMedCare www.telemedcare.com.au

Surgical Multimedia Services http://www.ictechnology.biz

Prince of Wales Medical Research Institute http://www.powmri.edu.au/FBRG/default.htm

UNSW at St Vincent’s Hospital, Sydney www.virtualclinic.org.au

Part of Virtual Medical Centre an approved HealthInsite information partner site www.virtualcancercentre.com

Centre for Mental Health Research ANU www.moodgym.anu.edu.a

Sites and resources listed here are a representative sample only.

CONFERENCE PREVIEW: HIC’09

HIC’09 – Frontiers of Health Informatics Difficult financial times only serve to heighten our need to innovate and adapt. So you won’t want to miss the three day Health Informatics Conference (HIC’09) to be held in Canberra on 19-21 August, being staged by the Health Informatics Society of Australia. Pulse+IT discussed the event with Chair of the HIC’09 organising committee, Professor Peter Croll.

The HIC conference has been an annual event for 15 years now, how has it evolved and what is special about this year’s event?

The HIC conference has always been HISA’s national conference, right from the organisation’s start 16 years ago. In fact, the first conference provided the platform for the formal creation of HISA the following year.

HIC has traditionally been a showcase for excellence in health informatics research, but over the recent past, as health informatics has become more central to the operation of our health system, the conference has developed a balanced program of research and industry presentations, supported by a strong workshop schedule.

This year, while emphasising the cutting edge of technology, we have worked hard to bring this back to current needs in healthcare. The quality of the national and international speakers, the breadth of the workshop program and the emphasising of topical issues such as broadband in health, all make this year’s conference unique and of interest to a particularly broad audience.

How does the HIC conference support the development of e-Health in Australia?

Australia needs a nationally focused agenda to advance eHealth in a consistent and dependable manner. As the premier national conference HIC provides an excellent platform for all the initiatives to be aired. The networking

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opportunities with all the lead players nationally and the many prominent international guests ensures we all have an opportunity to advance our know how and establish new opportunities to exploit effective solutions right across the e-Health space.

Why is the “Frontiers of Health Informatics” such an important theme for this year’s HIC conference?

“Frontiers of Health Informatics Redefining Healthcare” seeks to capture the enormous diversity of achievement that is being driven from the linkage of information technology with science and medicine. At a time when our health system faces not only the existing challenge of an ageing population but also the additional burden of a dramatically weakened economy, there is an urgent need to look to the future. It is unlikely that the solutions to the complex problems we now face will come only from our existing practices, so we have to increase our rate of innovation. HIC’09 has been developed to support this need. We have to accelerate our progress to a safer and more efficient health system.

The knowledge transfer, networking and inspiration that comes from attending the HIC conferences is an important part of driving that change.

With Senator Stephen Conroy giving the opening speech, is HIC’09 going to have a major focus on broadband as an enabler for e-Health?

The requirement for rapid, secure and

low cost distribution of information is at the heart of building our future health system. The National Broadband Network (NBN) is a key piece of infrastructure to enable that future. As such, it is an important part of HIC’09’s objective of providing a practical vision of new technology. With Senator Stephen Conroy, the Minister responsible for the broadband program and Lawrence Paratz, CEO of Acacia Australia, both giving keynote presentations, we have provided the fuel for what is going to be a very active debate on defining how our information future is best realised.

HIC, with its diverse community of highly skilled health and IT professionals, presents an ideal opportunity to have that important conversation. It is going to be an exciting part of HIC’09.

There are a large number of international and national keynote speakers, could you tell us some of the keynote highlights?

HIC’09 has selected a series of international and local leaders in some on the most innovative areas of informatics to spearhead the discussions at the conference. Pathology and diagnostic imaging are fields which, due to their data intensive nature, have always been at the forefront of innovations in informatics. Bruce Freedman, through both his research and international commentary on the field of pathology informatics will bring a unique insight into this rapidly evolving speciality and how lessons learnt can be applied in other areas. Lawrence Clark

from the National Institute for Health in the US, will bring his extensive experience in successfully delivering innovation in the field of diagnostic imaging to the broader area of innovation in health informatics.

Genomics, is one of the rapidly evolving glamour areas of informatics and here we have Omid Moghadan, from the Harvard Medical School’s Centre for Biomedical Informatics to discuss the impact of advances in this area.

Advancement in genomics along with many other areas of health are generating enormous data sets and the ability to effectively analyse these can provide significant health benefits.

Louise Ryan, the Chief of CSIRO’s Division of Mathematical and Information Science, is an international expert in this area and will be talking to us about the opportunities these technologies present.

Bringing technology into sharp and practical focus will be Peter Fleming, the CEO of the Australia’s National E-Health Transition Authority (NEHTA). Peter will be talking about NEHTA’s leadership in Australia’s e-Health program.

This is only a sample of the keynotes at HIC’09, I would recommend that readers go to the HIC’09 website at www.hisa.org.au/hic09 for more details.

There appears to be strengthening of the workshop part of the conference, how is this changing the event?

The HIC workshops are always popular, they provide an emphasis on the pragmatic understanding of the key

topics and the direct engagement of the audience in a more collaborative learning experience. This year the workshops are an integral part of the conference program and provide an opportunity for personal training across a diverse set of health informatics topics.

The subjects covered include, introduction to health informatics (always popular), implementation of eMRs, bioinformatics, health management informatics, privacy, health data mining, systems modelling and many more. Browse through the program on the HIC’09 website. The workshops are really a very exciting part of the HIC’09 program.

The industry presentation stream was a new addition to HIC last year, could you tell us more about this innovation?

The industry stream helps us provide a balanced program to ensure all aspects are covered and in a format that is reachable to a wider range of participants. The presentations represent a selection based on refereed submitted presentations and will include experiences at applying advanced technologies and recommendations for others seeking to follow their approach.

Could you tell us more about this years exhibition?

Like the presentations and workshops the exhibition provides an important opportunity to learn what is happening in the industry. We are going to have another big exhibition with the leaders in e-Health systems participating. It

provides the opportunity for in depth conversations with experts who have real practical experience in their products.

Are there other meetings that are associated with HIC’09?

There are two major meetings associated with HIC’09. The first is the Nursing Informatics Association’s (NIA) annual conference, to be held on Tuesday, August 18, the day before the workshops, at the same location as HIC’09. You can find out more about the event at the HISA website, www.hisa.org.au/nursing.

The other major event, to be held on Wednesday, August 19, is the Aged Care Symposium. The theme is “Developing & Realising a Vision for Aged Care Informatics for Australia and the Region” and the event highlights the recent growth in the field of aged care informatics and the opportunities and challenges that will present in the future.

You can find out more about the event at the Aged Care website at www.hisa. org.au/agedcare.

How can people find out about the event and register?

You can find out all the details about the conference from the HIC’09 website at www.hisa.org.au/hic09. You can also register online from the website or download a registration form.

If you would like to talk to someone about the conference you can call the HISA national office on +61 3 9388 0555.

Health Informatics Conference 2009 www.hisa.org.au/hic09

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INTERVIEW: MEDISECURE Pulse+IT interviews Phillip Shepherd, CEO of the MediSecure electronic prescribing initiative.

What products and services does MediSecure deliver to the health sector?

MediSecure Pty Ltd was established in July 2008 as a specific purpose company to deliver an e-prescription service. We took this approach because we believed that there was not one single entity in the medical software industry that had the required expertise, market reach and technical and financial capacities to create and deliver a ubiquitous e-prescription service free of baggage from past activities, alignments and arrangements.

While the founding partners of the MediSecure service have a long and successful background in delivering e-health and e-commerce services to both medical practitioners and pharmacies, the key to creating and delivering a universal e-health platform was considered to require multiple partners, an open architecture platform based on existing standards for handling clinical data and an effective and transparent governance structure that accommodated the interests and professional bodies representing both doctors and pharmacists.

Moreover, the founders believed that the ground-breaking solution for e-prescriptions developed by the General Practice Network Northern Territory and sponsored by the eHealthNT stakeholders was a sound basis for a commercial program. Note that much of the technology for the eHealthNT e-prescription solution was developed

by ArgusConnect, one of the founders of MediSecure.

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How is security maintained throughout the MediSecure e-prescribing process?

One of the clear differentiators of the MediSecure e-prescription solution is our recognition and adoption of the existing standards, both international and Australian, for handling patient clinical data. The proposition put by the Royal Australian College of General Practitioners was that a prescription is just another form of clinical data, and as such it should be treated within the accepted standards for electronic handling of clinical data. As a result, the MediSecure e-prescription solution adopts and uses the HL7 international standard as the basis of the e-script message. Note that one of the key roles of the RACGP is to set the standards in general practice across Australia.

HL7 defines the standards for the electronic exchange of health information. MediSecure has implemented the HL7 v2.3 standards in its operating solution and we are ready to adapt to new standards as they emerge from NEHTA. In terms of the process, the Medisecure e-prescription is encrypted using the Medicare PKI location key at the clinic prior to sending to the Medicare Script Vault and remains encrypted throughout its entire journey to a pharmacy.

At a later phase in our program, the individual script will be authorised using the individual PKI keys for signing of the script payload. MediSecure is geared up to work with individual certificates where these are in the possession of the prescribing doctor. In many cases doctors will have applied for their individual keys but will not yet have received them. In the short term doctors will be able to participate in the MediSecure program using location keys for sender authentication and encryption, however they will be encouraged to move to individual keys as soon as possible.

What happens if the patient loses their script?

In the initial period of e-prescriptions,

the e-script will move in parallel to the paper script. So a patient will have a paper script, signed by a doctor, with a barcode on it. When the paper script is presented to a pharmacy, the pharmacy can scan the barcode and download the e-script data from the MediSecure Script Vault, thus avoiding the manual data entry process. This electronic process will improve patient safety (no data entry errors) and save the pharmacy considerable time and therefore cost.

Identification of the electronic script in the initial stages of the MediSecure e-prescription program relies entirely on the paper script barcode. As a result, losing a script has the same consequences as is the present case. So, at least initially, no change for patient, pharmacy or doctor.

We do however see a change in time and this will largely be driven by the removal of paper from the system and the introduction of an electronic token of one sort or another as the media on which the script identifier is carried.

Before this can happen, a number of reforms need to be in place in the health system.

For example, NEHTA is presently working on a range of unique identifiers for broad introduction to the community and to the health sector, and we believe this is the first step in improving efficiency and safety across the primary health care sector. These identifiers will cover individual users of the health system, providers at both an organisation and individual level and there will be a national system of authentication that covers health. We are looking forward to these reforms being available for broad adoption in the community.

How much time do you envisage pharmacists will save per script by using MediSecure compared with existing workflows?

This is one of the key questions in the entire e-prescription solution. What we have found is that pharmacists, particularly pharmacy owners, are very conscious of the time pressures and staff

costs in a busy dispensary. They are also very conscious of the re-work following data entry errors, and of the liability issues associated with data entry errors. Further, they are very aware that any reduction in the time taken for a particular action in the dispensary workflow can result in a significant lowering of their cost base.

Our market proposition continues to be that the 25 cent fee for downloading the MediSecure script data into their dispensing system is a significant saving on the actual cost of the manual system used now. What we have found is that pharmacists almost universally accept the proposition that they will save at least 60 seconds per script by using the MediSecure e-prescription program; about 20% of pharmacists resist the proposition at 90 seconds saved and about 50% of pharmacists resist at 120 seconds.

Given the dramatic rate at which pharmacy owners have signed up to MediSecure Licences since we launched to pharmacy in April 2009, it is reasonable to conclude that pharmacists accept the proposition that the MediSecure e-prescription program will deliver them economic advantage.

How much will pharmacists be required to pay to use MediSecure?

The MediSecure program has two distinct fees. The first is the establishment fee of $250 plus GST; this is payable on signing the MediSecure Licence. The second is the Usage fee of 25 cents plus GST per MediSecure script downloaded.

We note that the Pharmacy Guild set the market price for usage of e-prescription services when they announced the ScriptX exchange in March 2008. While we accept that 25 cents is now the market fee, we are also very aware that the fee appears to have been set artificially low so that the return on capital deployed is not attractive to commercial investors.

Will prescribers be paid by MediSecure to utilise the service?

In short, no. The MediSecure program does not allow for any incentive, payment or inducement to doctors or other prescribers in any form whatsoever.

We believe such a proposition is improper and contravenes the clear rules around adverse incentives. In any case, acceptance of an inducement by a medical practitioner would be a breach

of their own ethical standards.

The key point here is that doctors prescribe to deliver an improved health outcome to a patient. There is no commercial gain for the doctor at any point in the prescribing process and clearly there should not be. The MediSecure program will not introduce any change in this approach.

What benefits will accrue to GPs that use the MediSecure service?

The main benefits that accrue to doctors who use the MediSecure e-prescription program is in the area of improved patient safety. There are a number of specific points in the process where this is illustrated — at the data entry point in the pharmacy, with the feedback to the doctor on medication persistence and the implied medication compliance data.

Some secondary benefits flow to doctors in the dispense notification process, however, there are some current concerns from the AMA and other advisors that need to be addressed before this process becomes part of the normal operational profile. We are working cooperatively with these groups

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to address these issues before general deployment.

Many doctors recognise that the next step in the e-health process is where major benefits accrue to general practitioners in particular as the primary health care manager for the Australian community. This benefit has been most poignantly summarised by Dr Chris Mitchell, President of the RACGP and rural GP in northern NSW: “As a professional you want to know if your patient has received their medication; you want to know their prescription was dispensed correctly and you want accurate information available at each point of transition in your patient’s care”.

Which pharmacy dispensing vendors have committed to MediSecure?

The MediSecure e-prescription program has received tremendous support in the community pharmacy sector. This has not been a surprise to us as one of the groups that encouraged the founders to take an active role in putting the MediSecure e-prescription program together was a group of large pharmacy owners that were and are keen to see ongoing reform in the community pharmacy sector, particularly in regard to e-health initiatives.

In terms of dispense systems vendors, you will have seen the press announcements in March made by CDC Systems and minfos. We currently have pharmacies operating in the MediSecure pilot program that use PharmacyPro, and we expect to be bringing further pharmacies into our pilot program over the next few weeks that will cover all the major dispense vendors apart from Fred Health.

With the current large number of pharmacy Licence holders that we have, we expect to have a full reach into pharmacy in the next few months.

Our view is that success for the e-prescription protocol requires all e-prescription service providers to interchange. The main aim should be to simplify the process for patients and pharmacists, so that no matter where the patient goes and what exchange the pharmacist is connected to, the scanning of the barcode delivers the e-script into the pharmacy dispense system, similar in concept to the way the EFT and ATM system works. This is our objective and we would welcome any move towards achieving this servicefocused objective.

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Which prescribing vendors have committed to MediSecure?

On the prescriber side, we have a different model for the delivery of scripts into the MediSecure Script Vault.

Because our technical model requires an HL7 message to be delivered to the Script Vault our primary commercial arrangements are with the clinical messaging vendors to deliver the HL7 format script message to the MediSecure Script Vault.

We do have formal cooperative arrangements in place with Best Practice, Genie and Zedmed. But, even in these cases, the clinical software vendor still hands the e–script data set over to a messaging vendor for the HL7 creation and encryption process. The HL7 messaging and protocol is an area of their expertise, having been required to move clinical data in accordance with HL7 standards for years.

Our expectation is that all major clinical applications can or will deliver e-scripts to the MediSecure Script Vault before the commercial program rolls out in July 2009.

Who will provide technical support to practices and pharmacies using MediSecure?

Under the MediSecure program, the medical practices are supported by the clinical messaging system vendor they choose to use for the carriage of the e-prescription message. This is typically an existing relationship and the additional service (MediSecure e-prescriptions) simply adds to the value of the relationship between the messaging vendor and the practice.

I note that MediSecure recognises this potential additional cost for the messaging vendor and accordingly makes a fee payment to the messaging vendor in compensation.

Which technical standards are being used by MediSecure?

The start point for the MediSecure program is that e-prescriptions are just one form of clinical data. We have been led in this conclusion by the work on the eHealthNT program undertaken by GPNNT. The RACGP has strongly supported this approach and has suggested to us that in the interim, before specific e-prescription standards are available from NEHTA, treating the e-script as clinical data is the minimum acceptable requirement for the

profession.

Accordingly, the MediSecure program has adopted the HL7 standards for handling the clinical message of an e-script plus the latest proposals and drafts out of Standards Australia IT-014 committees for issues such as the encryption, authentication and use of PKI infrastructure in this process. These are the same operational standards that have been deployed in the eHealthNT trial. Medisecure also has implemented web services message communication technology in anticipation of the NEHTA desire to move all messaging to SOAPbased web services.

Will script data sent to the MediSecure hub be made available for purposes other than e-prescribing?

No, the MediSecure program has adopted ‘world’s best practice’ privacy recommendations for handling e-scripts so that users of MediSecure can be assured that stored scripts are always encrypted and are unable to be accessed until they are downloaded by the pharmacy for dispensing. The MediSecure Script Vault is secure and the data remains intact and unused, except for the specific purpose of the e-prescription process.

In the mid term, however, we expect that doctors may recruit some patients to a parallel medication management program delivered by MediSecure that is fed by data from the clinical messaging system at the same time as the e-script is delivered to the MediSecure Script Vault.

This service will be a separate patientcentric opt-in service managed by the doctor on behalf of the patient. It will not be able to access the MediSecure Script Vault but it will source data from the message initiation points in the MediSecure program.

When will MediSecure be available?

The MediSecure pilot program is underway now and we expect to be rolling out the commercial operations from July 2009. There are a number of process issues that are under discussion with the RACGP and our Advisory Board, and these matters need to be concluded before the full scale commercial rollout commences.

MediSecure www.medisecure.com.au

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Update: Electronic patient claiming solutions for the medical practice IntRoduction Practices have long had the ability to offer patients the opportunity to claim their Medicare Benefits Schedule rebates electronically from the practice reception, negating the need for the patient to have to send a claim form to Medicare via the post, or present at a Medicare office.

In 2002, Medicare Australia (then the Health Insurance Commission) introduced a suite of billing and claiming solutions now collectively called Medicare Online. Incorporated by practice software developers into their billing solutions, the functionality has allowed Medicare Australia to pay rebates directly into a patient’s bank account.

In 2007, the Medicare Easyclaim solution was introduced, utilising the EFTPOS system to transmit patient claims to Medicare Australia. Rebates are subsequently paid into the patient’s savings or cheque account following a swipe of their bank card through the practice’s EFTPOS terminal.

The number of patient claims transmitted through both Medicare Online and Medicare Easyclaim has steadily increased over the past twelve months, with Medicare Online accounting for 2 million patient claims in the first quarter of 2009, up from 1.35 million in the first quarter of 2008. Starting from a lower base, the volume of patient claims submitted through Easyclaim has tripled over the same period, from 107 thousand in the first quarter of 2008, to 321 thousand in the first quarter of 2009.

In an effort to save time for patients and extract its own organisational efficiencies, Medicare Australia has recently undertaken a range of measures designed to improve adoption of Medicare electronic claiming by practices.

Medicare Australia introduced the Transitional Support Package, which pays practices 18 cents for each patient claim submitted electronically through either claiming channel until the end of 2009. A “sign-on bonus” constituting a single payment of $750 for metropolitan practices and $1,000 for regional and rural practices is also being paid for the first patient claim submitted by the practice. In addition to the funding, around 50 information sessions were held across the country throughout May and June for the benefit of practice staff seeking more information about Medicare electronic claiming.

Having identified the lack of integration between practice software and the EFTPOS terminal as one of the major stumbling blocks for practices interested in offering Easyclaim services, Medicare has awarded $6 million in development and rollout subsidies to software developers and financial institutions that have undertaken to deliver Integrated Easyclaim solutions.

In addition to these supply-side initiatives, Medicare Australia has launched a $2.3 million advertising campaign to increase awareness of the electronic claiming channels amongst patients.

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While these campaign initiatives are purported to be targeted at geographic areas where uptake of electronic patient claiming is low, the use of “niche” nationally distributed publications like the Sydney Morning Herald serves to illustrate just how widespread the lack of electronic claiming adoption is at present. This “No Forms. No Queues. No Worries” advertising campaign has been supported by an extensive direct mail-out to patients, outlining the options that may be available at their medical practice, along with a form that allows the patient to submit their bank details to Medicare Australia directly.

With the exception of the software vendor subsidies — which are targeted specifically at Easyclaim integration and rollout activity — Medicare’s promotion has been largely generic from a claiming channel perspective. That is, patients are being directed by the promotional literature to enquire at their doctor’s surgery about “Medicare electronic claiming” as opposed to either Medicare Easyclaim or Medicare Online Patient Claiming.

Software DEVELOPERS: THE State OF PLAY A comprehensive table outlining software vendor adoption of Medicare Online Patient Claiming and other Medicare Online services is available at the Medicare Australia website: http:// tinyurl.com/me5caj.

With the exception of Best Practice and Direct Control — both of whom are in the process of having their recently completed Medicare Online Patient Claiming functionality certified by Medicare Australia — all software developers referenced in the remainder of this article indicated that they have been shipping Medicare Online Patient Claiming functionality in their products for many years.

Despite the financial support being offered to software vendors to deliver Integrated Easyclaim solutions, some have rejected the opportunity to apply for funding. Other software vendors that did apply received only a fraction of the financial support requested, and others have been overlooked entirely.

Best Practice has indicated that the company did not apply for grant funding, and in the absence of demand for the service by their customers, has no plans to develop Integrated Easyclaim functionality at this time. Similarly, Genie Solutions and Jam Software shunned the funding process, citing Easyclaim’s diminished feature set when compared with their alreadydeployed Medicare Online Patient Claiming services.

Zedmed was awarded funding to undertake integration development, however ultimately the financial assistance was declined, citing the development time frame being offered by Medicare Australia to deliver a completed solution. While the company has indicated that it remains interested in releasing an Integrated Easyclaim solution, Dr Andrew Pascoe, Zedmed’s

Clinical Director said, “We would like to think that if we were to develop a solution, it would cover all the financial institutions, including the new ones coming on-board with Easyclaim.”

Having delivered a working Integrated Easyclaim solution with Tyro in advance of the grant funding being offered, HCN has indicated that it did not receive any financial support from the Medicare process to assist in the deployment of its solution.

It is understood however, that Tyro did receive some financial assistance to support deployment, albeit a fraction of what was requested in its own funding application.

MediFlex applied for financial assistance, however the company’s funding application was ultimately unsuccessful. Phil Kirby, MediFlex’s Managing Director indicated that Medicare Australia cited a lack of information being presented in his company’s application as the primary reason for MediFlex being overlooked for funding, despite the government organisation not providing Mr Kirby with an opportunity to rectify these issues before the submission deadline had passed. Mr Kirby said that while he was interested in providing Easyclaim functionality to his customers, he had, “No intention of self-funding the development of a system that puts money into the banking sector.”

Houston Medical, MediLink, Stat Health Systems, Direct Control and the Practice Management Software Company have all indicated that they have received funding to develop an Integrated Easyclaim solution. It is unclear at the time of writing which banks these software developers are endeavouring to work with to deliver this functionality, however it is understood that Tyro — the only financial institution to have delivered an Integrated Easyclaim solution previously — is focusing on its partnership with HCN at this time. iSOFT was the only organisation contacted by Pulse+IT that declined to be drawn on whether they received funding to integrate Easyclaim into their software, however they did reveal that they have commenced such work with the Commonwealth Bank of Australia (CBA), with plans to incorporate Easyclaim functionality into practiX and Monet.

Beyond simply undertaking the development of their own Integrated Easyclaim solution, iSOFT has also indicated that the company is seeking to deliver a solution that will act as an interface between practice software developed by other companies, and the CBA. Dubbed the Medicare iClaiming Toolkit (iCTK) and developed in conjunction with Touch Networks, the product is slated for release in August.

Conclusion By taking a more proactive approach to the collection of patient bank details, Medicare Australia has commenced a process that will minimise one of the main factors hampering the adoption of Medicare Online Patient Claiming. With this in mind, practices that do not currently offer this service to patients on account of concerns about collecting patient bank details themselves may like to revisit this dormant functionality in their existing software.

The delivery time frame of August 31 afforded by Medicare Australia to Integrated Easyclaim grant recipients would appear to be unrealistic if the two year integration journey undertaken

by HCN and Tyro to deliver the market’s first Integrated Easyclaim solution offers any indication of the challenges associated with such work. As such, for practices using billing software other than PracSoft, the prospect of Integrated Easyclaim being made available to them by their software developers in the near term remains unlikely at this point in time, irregardless of the financial assistance being offered by Medicare Australia.

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FEATURE Dr Paul Mara MBBS, FRACGP, FACRRM, DRACOG, is a rural doctor practising in Gundagai and the Managing Director of GPA Accreditation Plus.

Continuity of care – consultation notes matter In the last edition of Pulse+IT [May 2009, Edition 12, pp44] we discussed the basic domains of continuity of care and identified the core standards requirements for health summaries and typical challenges in current medical records. This article examines these core standards requirements as they relate to consultation notes and how these might be improved to enhance continuity.

Professional requirements for the content of medical records are listed in the Royal Australian College of General Practitioners (RACGP) Standards for General Practices1 and summarised in Table 1. These should also be viewed with reference to state Medical Board requirements, requirements for various billing items in the Medicare Benefits Schedule and recommendations from Medical Defence Organisations. In particular, GPs should take note of the comments in the Professional Services Review: Report to the professions2 and the potential consequences that may arise as a result of failing to meet regulatory requirements.

Meeting these standards to provide complete and contemporaneous notes can be sometimes challenging.

Patients are increasingly presenting with multiple and more complex management problems. Documentation in electronic medical records systems may not reflect this complexity for a variety of practical reasons. Typical issues identified during accreditation visits include time pressure of work and the failure of the MBS to reflect time spent and complexity of the general practice consultation, illegibility of written notes, technical issues with computer literacy or slow typing skills, potential difficulty with written communication where English is not the primary language of the doctor, and clinical software packages that are not user friendly.

According to the RACGP, consultation notes should provide enough information to enable another practitioner to continue the management of the patient. At least in theory, but this requirement discounts the valuable role that relationship continuity plays. Nevertheless, with respect to a patient’s presenting problem, records should include details of the history taken and relevant systems review, relevant positive and negative examination findings, a presumptive diagnosis or differential diagnosis and investigative and management plan.

This plan should include a rationale for investigations ordered and follow up arrangements — will the patient return for results, contact the doctor or will the practice contact the patient?

Symptoms should be fully explored, especially for more complex, unusual or vague symptoms such as headache or dizziness. Pain should include details of site, onset, radiation, duration, precipitating and relieving features, and intensity.

Opportunistic prevention is relevant in each and every

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consultation. Information that core preventative issues have been addressed should be noted. These can be based on the appropriate strategies identified in the RACGP Guidelines for Preventative Activities in General Practice (Redbook)3.

Patient consultation records should also include a positive statement that other problems in the patient’s history have been addressed. For example a patient with diabetes presenting with a laceration should have a review of their notes to check if regular diabetes review has been undertaken and a record made of this.

I have found the SOAP (Subjective, Objective, Assessment, Plan) construct to be a useful framework for the recording of patient encounters. This construct meets minimal criteria and provides a logical framework for addressing medical issues. Each problem can be described and management progressed in a logical and coherent fashion.

GP Management (Care) Plans Care Plans provide an opportunity for doctors and patients to undertake a complete review of the patient’s health, particularly as it relates to chronic illness. Templates should be used with caution as often their use does not adequately contribute to improving health or meeting the regulatory requirements.

Practices need to ensure that information included on the care plan from other areas such as the health summary is accurate and complete. At the time of writing, Care Plans are under review however the Medicare Benefits Schedule4 clearly identifies the current requirements for Item 721 (Table 2).

Summary Improving the quality of progress notes will not only enhance continuity and quality of care but also provide protection for doctors and patients in a more complex medical and regulatory environment. Use of electronic medical records imposes some challenges that need to be addressed and should be supported through an improved Medicare Benefits Schedule that reflects this increased complexity.

References 1 - http://www.racgp.org.au/standards/173 (accessed June 2009).

2 - http://www.psr.gov.au/Publications/ 3 - http://www.racgp.org.au/guidelines/redbook (accessed June 2009).

4 - http://www.health.gov.au/internet/mbsonline/publishing. nsf/Content/Downloads-200905 (accessed June 2009).

Standard 1.7: Content of Patient Health Records

Preparing a GP Management Plan (GPMP): Item 721

Criterion 1.7.3: Consultation Notes

This item is for patients with a chronic or terminal medical condition who will benefit from a structured approach to management of their care needs. A rebate can be claimed once the patient’s usual GP (or another GP in the same practice) has prepared a GPMP by completing the following steps and meeting the relevant requirements listed under ‘Additional Information’. The GP may be assisted by their practice nurse, Aboriginal Health Worker or other health professional in the GP’s medical practice or health service. The service must include a personal attendance by the GP with the patient, as part of Item 721.

Each of our patient records contain sufficient information about each consultation to allow another doctor to carry on the management of the patient.

Indicators

A) Our patient health records document consultations — including consultations outside normal opening hours, home or other visits, telephone or electronic consultations where clinically significant — comprising: • date of consultation • patient reason for consultation • relevant clinical findings • diagnosis • recommended management plan and where appropriate expected process of review • any prescribed medication (including medicine name, strength, directions for use/dose frequency, number of repeats, and date medicine started/ceased/changed) • any relevant preventative care undertaken • documentation of referral to other health care providers or health services • any special advice or other instructions • indication of who conducted the consultation, eg. by initial in the notes, or audit trail in electronic record.

B) Our patient health records show evidence that problems raised in previous consultations are followed up.

The steps in preparing a GPMP must include: (a) assessing the patient to identify and/or confirm all of the patient’s health care needs, problems and relevant conditions; (b) agreeing management goals with the patient for the changes to be achieved by the treatment and services identified in the plan; (c) identifying any actions to be taken by the patient; (d) identifying treatment and services that the patient is likely to need, and making arrangements for provision of these services and ongoing management; and (e) documenting the patient needs, goals, patient actions, treatment/ services and a review date i.e. completing the GPMP document;

Left - Table 1 - RACGP standards for general practices, 3rd edition: Content of Patient Health Records - Consultation Notes.

Above - Table 2 - The Medicare Benefits Schedule for preparing a GP

HealthLink/Medinexus HalfManagement Page 180Plan x 120 - ItemPuse 721. IT Mag

connecting healthcare

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FEATURE Mark Worsman and Nicole Kassis Mark Worsman is a Senior Associate and Nicole Kassis is a Solicitor at DLA Phillips Fox. DLA Phillips Fox has around 800 lawyers across 8 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 28 countries. mark.worsman@dlaphillipsfox.com ~ nicole.kassis@dlaphillipsfox.com

Looking into a Crystal Ball: Genetic Discrimination Overview The ability to collect and analyse genetic information may allow health care professionals (HCPs) to look into a ‘crystal ball’ at a patient’s future to: • determine whether a patient may develop a certain disease; • take preventative action to reduce the chances of the disease developing; and • personalise treatment regimes according to a person’s genetic profile.

Certain obligations are imposed on HCPs who handle genetic information in Australia under various Federal, State and Territory discrimination and privacy laws. If a HCP breaches these laws then not only will the HCP be liable, but in certain circumstances a supplier such as an IT supplier may also be liable for ‘aiding and abetting’ the HCP’s unlawful discrimination.

Genetic discrimination appears to be unlawful under different Federal, State and Territory laws. Discrimination laws in Australia are broadly drafted and the courts may adopt an expansive approach in dealing with such cases.

If a person considered that he or she was discriminated against on the basis of their genetic information, that person could seek redress under Federal, State or Territory law. The consequences of discriminatory conduct, including the imposition of ancillary liability, will vary depending upon the legislation involved and the jurisdiction in which the claims are being made. Both civil and criminal sanctions may be imposed by a court including damages, determinations and fines.

In addition to the existing laws on discrimination (discussed below), the law in this area may change to include certain express prohibitions against specific forms of genetic discrimination. Currently, the Federal government is considering the recommendations of the Australian Law Reform Commission’s 2003 report into the regulation of genetic information.

What is genetic discrimination?

There is currently no definition of genetic discrimination under Federal law. There is, however, a Bill to change the Disability Discrimination Act 1992 (Disability Discrimination Act), which would prohibit discrimination based on an individual’s genetic predisposition to a disability.

In addition, the definition of genetic discrimination proposed under the Genetic Privacy and Non-Discrimination Bill 2004 (Genetic Privacy Bill) is extremely broad. Essentially, under this Bill, any act involving a distinction, exclusion, restriction or preference based on genetic information which has the purpose or effect of nullifying or impairing the recognition or enjoyment of any human

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right will be considered to be genetic discrimination. The right to the ‘highest attainable standard of physical and mental health’ is recognised as a fundamental human right in the International Covenant on Economic, Social and Cultural Rights to which Australia is a signatory. This means, any act that impinges on that right might potentially offend the Genetic Privacy Bill.

Accordingly, it appears that genetic discrimination by a HCP in the administration of medicines may be prohibited under the Genetic Privacy Bill , if it is passed into law. This Bill does not appear to contemplate that there might be legitimate acts of genetic discrimination by HCPs. The result, which may be unintentional, is that any form of discrimination could be unlawful.

Is genetic discrimination unlawful?

Certain kinds of genetic discrimination are already likely to be unlawful under existing laws. For example, if a HCP refused to provide a certain medical service to a woman on the basis of her genetic predisposition to breast cancer (breast cancer occurs in men, but is uncommon), that refusal may amount to treating the woman in a less favourable manner than a person of the opposite sex, and may therefore constitute unlawful discrimination in breach of the Sex Discrimination Act 1984 (Cth) (Sex Discrimination Act). Similarly, a refusal to provide certain medical treatment to an individual or group of individuals from a certain ethnic background because of a genetic predisposition to a disease may amount to racial discrimination which is prohibited under the Racial Discrimination Act 1975 (Cth) (Racial Discrimination Act). It is also possible that the Disability Discrimination Act prohibits discrimination against an individual on the basis of their relative’s genetic information, because that Act prohibits discrimination against an individual on the basis of their being an ‘associate’ or more specifically, a relative of another person.

IT supplier LIABILITY An IT supplier may also be liable under these laws for: • inciting, assisting or promoting the discriminatory conduct under the Racial Discrimination Act; or • causing, instructing, inducing, aiding or permitting the discriminatory conduct under the Sex Discrimination Act and Disability Discrimination Act. In most instances, liability for aiding or permitting discriminatory conduct has rested upon the ‘permitter’ having some level of knowledge of the circumstances that could lead to discriminatory conduct. For example, it is arguable that an IT supplier that knowingly provides a medical device or system (including software) which allows for ‘pooling’ or ‘searching’

through genetic information may have ‘permitted’ or ‘aided’ a HCP to engage in unlawful discriminatory conduct. The more closely that the medical device’s or system’s function is related to the discriminatory decision or action by the HCP, the more likely it is that an IT supplier will be liable for unlawfully aiding and abetting the HCP’s unlawful discrimination.

The fact that a generic tool allows discrimination is unlikely to constitute unlawful conduct by the IT supplier on its own. If, however, a medical device or system (including software) is made for the specific purpose of enabling a HCP to assess the genetic disposition of a population group, then there is risk that the IT supplier will have breached one of the Discrimination Acts referred to above.

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Practical implications The practical implication of this is that where an IT supplier is involved in developing or customising a medical device or system and the purpose of that development or customisation is to enable or create a discriminatory function (for example, segmentation of a specific population or patient group on a genetic basis), the IT supplier needs to consider whether it is creating a risk for itself that the HCP will be able to unlawfully discriminate against a specific patient population. The supplier’s involvement with the development or creation of the discrimination functionality increases its proximity to any unlawful HCP discrimination. This increases the risk that the supplier would also be liable for the unlawful discrimination.

If the discrimination functionality is on the basis of sex or disability (for example, a genetic disorder and predisposition), the IT supplier should be particularly cautious. This is because merely permitting unlawful discrimination may attract secondary liability under the Sex Discrimination Act and Disability Discrimination Act. The penalties for breach of these laws may include the award of damages, criminal sanctions and fines. There is also a public relations risk for an IT supplier if it is seen to be involved in unlawful discrimination of any kind.

Under the Genetic Privacy Bill, there does not appear to be an equivalent ancillary liability or ‘aid and abet’ provision.

However, the Bill may be amended before it is passed to provide for ancillary liability. Regardless, an IT professional or supplier may be found liable for discriminatory conduct by way of the Sex, Race and Disability Discrimination Act ‘aid and abet’ provisions described above if the concerned individual chooses to bring an action under this legislation.

Privacy IT suppliers and HCPs should also be aware that privacy laws (again, at a Federal, State and Territory level) also apply to the storage and handling of genetic information. For example, the Federal Privacy Act 1988 expressly defines health information (to which the Act applies) as genetic information about an individual in a form that is, or could be, predictive of the health of the individual or a genetic relative of the individual.

Because we don’t just take away your IT Pain, we enhance the quality of the way you do business.

Conclusion If an IT supplier provides products designed to allow or enable genetic discrimination, then depending on the nature of the product (such as its specificity and purpose), the supplier should consider taking steps to minimise any potential risk that it may be found to breach discrimination laws by aiding and abetting unlawful discriminatory conduct by HCPs.

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43 P 1300 300 471 | E info@isnsolutions.com.au | W www.isnsolutions.com.au

FEATURE Robyn Peters Robyn Peters is the Managing Director of CONNECT DIRECT Pty Ltd, developers of Direct CONTROL a business management software solution for the health sector. robyn.peters@directcontrol.com.au

Good billing practices and avoiding bad debts Introduction An efficient business has systems and processes in place to ensure: • all invoicing is accurate; • all customer accounts are paid in a timely manner; and • all supplier accounts are also checked for accuracy and paid according to supplier terms.

The practice’s policy regarding payment of accounts and any associated terms and conditions should be clearly displayed.

It is common practice to have patients complete a Patient Details form when they first visit your practice. This form should make reference to your practice payment policy. An example is included in Figure 1. If the practice raises accounts and allows patients to pay after their service is provided, a reference to the payment policy should be included on all invoices.

You can assist your patients to make payments by providing them with a number of payment options and detailing these in a remittance advice section on your invoice. This section outlines your bank details if you accept direct deposits, credit card payment information, and the appropriate postal address if you accept cheques or payment via other methods. An example of a typical remittance advice extract is provided in Figure 2.

Payment Options EFTPOS With the majority of patients having a debit or credit card, bad debts are not as common as they once were. If you do not have an EFTPOS terminal, you should consider installing one. There are merchant fees associated with offering this service, so ensure your billing fees cover any of these costs. The obvious benefit of EFTPOS is immediate payment resulting in improved cash flow.

On processing the EFTPOS payment your staff must be trained to take note of the printout ensuring that the payment has been approved and not declined. Circle the word “approved”.

Check the amount processed is correct, circle it too, and write the patient’s name on the slip if it is not already printed (some EFTPOS terminals do not print the patient’s name).

“I understand that payment of my account, in full, is my responsibility and that my health fund / insurer might not cover the total amount invoiced. I am responsible for any further costs that might be incurred resulting from my not paying my account, in full, by the due date.”

Patient Signature: _______________________ Date: ___/_____/________

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Cash Cash payments are fine as long as you get the money into the bank and do not allow staff to use it for other expenses. It is bad practice to utilise cash received for business expenses or loans.

Instead, establish a petty cash system for these miscellaneous cash expenses.

Cheque Not many businesses accept cheques today. If your practice does, record all of the cheque details (BSB, account number, and the name on the cheque). Also insist on recording the patient’s residential address. You will need this information, if the cheque is dishonoured. Your practice policy should include reference to the fact that any dishonour fee you are charged will be billed to the patient.

Direct Deposit With many patients now familiar with Internet banking, receiving payments by direct deposit is an increasingly popular option.

However reconciling such payments can be frustrating and time consuming if the payer is not reminded to include the patient’s name and invoice number in the relevant deposit transaction fields.

BPay You may have set up a BPay facility. If not, talk to your bank about the possibility of offering this service. You will be allocated a Biller Code which is to be printed on invoices and used by the patient when making payments to your practice.

What if they do not pay?

Your terms of payment should be specified clearly as XX days from the date of the invoice. If the patient has not paid within this time frame, here are some suggested steps to follow: • Step one: Send the patient a statement reminding them that their account is overdue and politely request payment by dd/mm/yyyy.

Left - Figure 1 - A practice payment agreement, which could be included on a practice’s Patient Details collection form. Below - Figure 2- Remittance advice extracted from a practice invoice.

INV:521

Mr James Hutton

• Step two: Should the date on the statement pass, you can then send out a copy of the invoice along with a friendly worded covering letter requesting payment by a specific date.

• Step three: If the date on the letter sent in step two passes, you then send out another copy of the invoice along with a letter of final demand.

• Step four: In the absence of payment, hand it over to your debt collector and move on.

Note that some practices do not worry about step one and move straight on to step two. Sample reminder letters can be found at: www.directcontrol.com.au/accounting.

Invoicing Procedures You can avoid bad debt by having in place proper invoicing procedures. These will depend on several factors including: • your specialty; • how established your business is; • your patient demographics; and • your expertise.

Practices have a number of invoicing choices, including various private and direct billing options: Private Billing Set your fees as you see best. This can be based on an existing fee schedule (AMA, Medicare, AHSA, etc) or a percentage of or you can simply decide on what you are going to bill per item number. It is your choice to offer discounts as an incentive for quick payment or not.

It is accepted practice that if billing for medico-legal services (MBS non-rebateable and GST inclusive), you raise the invoice and receive payment before you carry out the service.

With “In-Room” services, Medicare Australia is encouraging practices to use electronic Medicare claiming. This is not bulk billing. You can charge your full Private In-Room fee and you can lodge patient claims electronically by using Medicare Easyclaim, which uses the practice EFTPOS terminal (debit card only), or via your practice management software if it integrates with Medicare Online Patient Claiming. Either way the patient is invoiced for your full fee.

If they pay in full, the claim is submitted to Medicare Australia in real time, processed, and the rebate is paid into the patient’s bank account within a few seconds (Easyclaim) or a few days (Medicare Online).

If you choose to accept the gap, Medicare raises a cheque made out to you but posts it to the patient, relying on the patient to send this cheque to you. Medicare has now extended the Pay Doctor Via Claimant 90 day rule for specialists, having only been available to general practitioners until recently. What this means is that if the patient does not send the cheque to your practice, after 90 days, Medicare will cancel the cheque and direct deposit the monies to the practice bank account.

For In-Hospital procedures, for some Specialists, it is also accepted practice to have the patient pre-pay for the entire procedure. However issues can arise if the procedure changes and you will need to decide to either wear the difference or, on converting the IFC, amend the invoice or issue a refund.

Direct Billing You have the choice of direct billing to Medicare for bulk billing and Department of Veterans Affairs. This means that you accept what Medicare pay and you do not charge the patient any fee over and above this. These claims can be sent in manually, but many practice management software solutions facilitate electronic batching and processing.

For In-Hospital procedures for privately insured patients, you can direct bill to health funds. If you accept the fund rulings, their schedule fee is usually higher than the Medicare Benefits Schedule. Some funds allow you to also charge the patient a gap (out-of-pocket or known gap) and some do not (no gap). If you charge the patient more than the known gap allowed, then the rebate will only be 100% of the Medicare Benefit Schedule resulting in the patient being very much out-of-pocket.

To direct bill health funds, doctors have to register with each fund. To do business online with Medicare, you must also be registered. To register, visit http://www.medicare.gov.au/ provider/business/online/register/ Invoices can be lodged for services provided up to two years in the past. If services were before that time, an application for late lodgement form must accompany the invoice.

ecurity IT security in a medical practice is critical to your practice and business data integrity; and of course patient confidentiality.

Effective measures include: Effective antivirus solution; we recommend Kaspersky Effective backup solution to protect patient and practice data Proactive monitoring of your backup and Antivirus Regular server operating system updates Strict firewalling procedures that protect your practice and still allow you access remotely P 1300 300 471

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E info@isnsolutions.com.au

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W www.isnsolutions.com.au

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Computer Initiatives P: 1300 85 39 39 (VIC) P: 1300 85 39 85 (QLD) F: 03 9768 9058 E: tim@cinet.com.au W: www.cinet.com.au

AHML AAPM

P: 1800 196 000 or 03 8414 8225 F: 03 9685 7599 E: national@aapm.org.au W: www.aapm.org.au The Australian Association of Practice Managers (AAPM) represents Practice Managers and the profession of Practice Management. Founded in 1979, AAPM is a non-profit, national association recognised as the professional body dedicated to supporting effective Practice Management in the healthcare profession.

The Australian Association of Practice Managers: • Represents and unites practice managers and the profession of Practice Management throughout the healthcare industry.

• Promotes professional development and the code of ethics through leadership and education.

• Provides specialised services and networks to support quality Practice Management.

P: 03 5327 9142 F: 03 5327 9289 E: info@ahml.com.au W: www.ahml.com.au AHML is a globally accredited online testing laboratory for the technical evaluation and certification of conformance to standards in healthcare technologies. AHML is a nonaligned, not-for-profit organisation with over 450 users from 36 countries, whose mission is to facilitate the conformant usage of healthcare standards.

AHML’s services include online testing and certification against International and National Standards and implementation of client specifications for testing.

AHML is accredited by the National Association of Testing Authorities (NATA) to ISO/IEC 17025 2005 in the field of Information Technology and with NATA’s mutual recognition arrangement with the International Laboratory Accreditation Cooperation (ILAC) their accreditation is recognised by 47 countries.

ArgusConnect Advantech Australia P: 1300 308 531 F: 03 9797 0199 E: info@advantech.net.au W: www.advantech.net.au

Advantech’s medical computing platforms are designed to enhance the quality and efficiency of healthcare for patients and users alike. All products match the performance of commercial PCs and tough medical safety ratings like UL606011 and EN60601-1; adding to this they are all IPX1 certified dust resistant and come with water drip-proof enclosures. Advantech offers long term support and a proven track record of reliability.

The medical range extends through: • Point-of-Care Terminals.

• Mini-PC and Medical Imaging Displays.

• Mobile Medical Tablets.

• Patient Infotainment Terminals.

Advantech is also an official distributor of Microsoft Windows Embedded software across Australia & New Zealand.

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P: 03 5335 2220 F: 03 5335 2211 E: argus@argusconnect.com.au W: www.argusconnect.com.au ArgusConnect provides and supports Argus secure messaging software that enables doctors and healthcare organisations to exchange clinical documents securely and reliably.

Argus can be used to send specialist reports to referring doctors but it can also exchange pathology and radiology reports, hospital discharge summaries and notification between healthcare providers. Healthcare practitioners can use any of the popular clinical software packages to send reports and other clinical correspondence via Argus.

Argus is the messaging solution chosen by over 50% of all Divisions of General Practice across Australia through the ARGUS AFFINITY DIVISIONS program.

Keep a watch out for the AFFINITY DIVISIONS ‘Buddy Practice Initiative’, a program promoting the adoption of Argus by specialists and allied health practitioners.

Best Practice

P: 07 4155 8800 F: 07 4153 2093 E: sales@bpsoftware.com.au W: www.bpsoftware.com.au Best Practice sets the standard for GP clinical software in Australia offering a flexible suite of products designed for the busy GP practice, including: • Best Practice Clinical (“drop-in” replacement for MD2) • Integrated Best Practice (clinical/management) • Top Pocket (PDA companion software for Pocket PC)

Cerner Corporation Pty Limited P: +61 2 9900 4800 F: +61 2 9900 4990 E: AsiaPacific@cerner.com W: www.cerner.com.au

Cerner is a leading supplier of healthcare information systems and our Millennium suite of solutions has been successfully installed in over 1200 sites across the globe. Cerner’s technology has been designed so that it can be adapted to meet the needs of the very different healthcare delivery systems that exist, with a universal framework which allows clinician workflow to seamlessly span role and venue.

Our innovative leadership is allowing us to push boundaries by: • Leveraging clinical and pharmaceutical data for new discoveries in Condition Management and Personalised Medicine • Connecting the community with personal and community health records • Seamlessly connecting the patient record across the continuum of care

Computer Initiatives has been supporting the medical profession for over 15 years. Providing IT consultancy services, quality hardware, professional support with qualified engineers to our large customer base in Melbourne and now in Brisbane and the Gold Coast.

Recommended and preferred by a number of Divisions of General Practice and specialist software providers we are well versed in providing the following services to the professions: • Supply and install of hardware/ software and peripherals • Disaster recovery and replication plans to minimise downtime to a number of minutes • Remote monitoring and diagnosis of crucial information systems • Advanced networking deployment and support • Prompt and competitive on site support • Internet configurations and content filtering services • Security audits, configurations and monitoring • Regular maintenance services We pride ourselves in our accreditations and levels of certification. We are a Microsoft Gold Partner – the highest level of MS certification and a Microsoft Small Business Specialist.

200,000:

The number of copies of Pulse+IT that are produced each year.

$900:

The cost of participating in the Pulse+IT Directory in all of these copies.

For more information about advertising in Australia’s first and only Health IT magazine, call Simon James on 0402 149 859

FILE Pty Limited

VAULT

DIRECT CONTROL

P: 1300 557 550 F: +61 7 5478 5520 E: support@directcontrol.com.au W: www.directcontrol.com.au Listening to what people want has resulted in the birth of a fully integrated business solution for Practitioners. The aim was to develop an affordable, intuitive, easy to use, educational business solution for Practitioners of all Disciplines that eliminates the need for double entry of data. This has been achieved with seamless integration with Outlook and MYOB. Direct CONTROL facilitates medical billing Australia wide and overseas. Included is all Medicare, DVA, WorkCover, Private Health Insurance and other billing with the latest rules and fees relevant to each medical discipline (general practice, surgeons, physicians, allied health, anaesthetists, pathologists, radiologists and day surgeries/hospitals). Ideal for both the single practitioner and the multi-disciplinary Practice.

powered by FILE Vault

FILE GROUP

P: 1300 306 407 F: 02 9317 0999 E: info@file.com.au W: www.filegroup.com.au

GLOBAL HEALTH

P: 03 9675 0600 F: 03 9675 0699 E: sales@global-health.com W: www.global-health.com

FILE GROUP is an independent, wholly Australian-owned group of companies, a leader in the field of secure information storage and management.

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

At FILE GROUP, we tailor our solutions to match your business requirements, by a comprehensive offering including:

ReferralNet takes advantage of email and the Internet to provide a practical and secure infrastructure for delivering healthcare information efficiently to industry professionals.

• open-shelf, offsite records storage and management; • leading edge RFID tracking systems for patients or residents, records and assets; and • our tailored, online, secure data backup facility, MEDI Vault.

FILE GROUP can help you to meet all your critical information management compliance needs.

Direct CONTROL lets you get on with earning a living doing what you enjoy most … patient care.

ReferralNet Claims offers real time submission of claims from practices, public and private hospitals and billing agents to Health Funds, Medicare and Department of Veterans’ Affairs.

MHAGIC is the latest and most comprehensive Mental Health Assessment Generation and Information Collection system in Australia.

Locum replaces traditional paper records with a robust electronic filing system that manages patient information and improves the efficiency of medical practice.

Health Communication Network - HCN P: 02 9906 6633 F: 02 9906 8910 E: hcn@hcn.com.au W: www.hcn.com.au

Health Communication Network (HCN) is the leading provider of clinical and practice management software for Australian GPs and Specialists and supplies Australia¹s major hospitals with online Knowledge resources.

HCN focuses on improving patient outcomes by providing evidence based software tools to health care professionals at the point of care.

Market snapshot: • 17,000 medical professionals use Medical Director • 3,600 GP Practices use PracSoft • 800 Specialist Practices use Blue Chip and • 2,100 Specialists use Medical Director • Leading suppliers of Knowledge Resources to Australia¹s major hospitals

HEALTHLINK

P: 1800 125 036 F: 07 3870 7768 E: enquiries@healthlink.net W: www.healthlink.net

Emerging Health Solutions

P: 02 8853 4700 F: 02 9659 9366 E: Arthur.Harris@emerging.com.au W: www.emerginghealthsolutions. com.au Emerging Health Solutions (EHS) provides next generation electronic health records. A Clinical Information System that is patientcentric & web-based that captures and provides appropriate, timely, clinical information in a secure and auditable environment to assist clinicians deliver effective, quality care.

EHS is currently live in Australian hospitals and has been assisting the Australian health industry for over a decade. Emerging is a specialist I.T. health provider acutely aware of the privacy and security issues that rightfully exist when dealing with patient records.

GENIE solutions

P: 07 3870 4085 F: 07 3870 4462 E: info@geniesolutions.com.au W: www.geniesolutions.com.au Genie is a fully integrated appointments, billing and clinical management package for Specialists and GPs. Genie runs on both Windows and Mac OS X, or a combination of both. With over 1500 sites, it is now the number one choice of Australian specialists.

GPA

P: 1800 188 088 F: 1800 644 807 E: info@gpa.net.au W: www.gpa.net.au GPA ACCREDITATION plus has given general practices a reliable alternative in accreditation. GPA is committed to offering a flexible accreditation program that understands the needs of busy GPs and practice staff. GPA assigns all practices an individual quality accreditation manager to support practices with their accreditation.

Australia’s largest effective secure communication network.

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

Choose GPA for more support, improved service and greater choice.

Emerging’s core clients include St. Vincent’s, Mater Health service, and the South Australian Government Department of Health.

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Houston Medical

HEALTH SOLVE HEALTHENGINE

P: 0419 091 170 F: 08 9467 6150 E: info@HealthEngine.com.au W: www.HealthEngine.com.au HealthEngine.com.au is a comprehensive online directory of GP’s and Specialists, offering free doctor and practice listings to any Medical Practitioner registered in Australia.

Find a Doctor: Doctors can be searched Australia-wide by name, specialty, gender, and geographic location.

Find a Service: GP and specialist medical practices, public and private hospitals, day surgeries and medical test centres across Australia.

P: 1800 803 118 F: 08 8203 0595 E: info@healthsolve.com.au W: www.healthsolve.com.au HealthSolve provides solutions across the continuum of care with solutions for all sectors.

Care Management Systems for: • Acute Care • Aged Care • Community Care HealthSolve RiGHTPEOPLE is our Staff Management system for any health organisation. Use in conjunction with the HealthSolve CMS or stand alone.

HealthSolve solutions are industry standard, and readily interoperable with other systems.

HISA

P: 03 9388 0555 F: 03 9388 2086 E: hisa@hisa.org.au W: www.hisa.org.au The Health Informatics Society of Australia (HISA) aims to improve healthcare through health informatics.

HISA: • Provides a national focus for health informatics, its practitioners, industry and users.

• Advocates on behalf of its members.

• Provides opportunities for learning and professional development in health informatics.

Find Information: seeks to demystify the maze of specialty qualifications, subspecialty interests, medical tests and procedures.

P: 1800 420 066 or +61 2 9669 1844 F: +61 2 9669 1791 E: houston@houstonmedical.net W: www.houstonmedical.net Houston Medical, formed 1988, leading supplier of software for Ophthalmology and Retinal Diabetic screening, installed in hospitals and practices of all types throughout New Zealand, Australia, Fiji, Dubai and Hong Kong.

After a complete re-write, Houston VIP.NET using Security Groups with User Defined Forms, allows different specialities their own desktop and workspace on a common database. Billing, appointments TXT and RSD messaging, word processing, prescribing, operating lists all integrated but separate.

Whether for day surgery, ophthalmology, cardiology, dermatology, urology, general practice, allied health, or any combination in a mixed practice, in once, out in a 1000 different ways, a truly unique concept for 2009!

We do not sell search position, and Sponsored Links are clearly labeled as such.

Doctors or Practice Managers may enhance their doctor or service listing by purchasing a Custom Profile: • Display your photo or business logo • Showcase your areas of interest with specific, detailed information • Custom web address (URL): HealthEngine.com.au/dr/ YourName • Enhance your web presence: effectively a micro-website on HealthEngine.com.au benefitting from our pagerank and Search Engine Optimisation.

Link to your own website, and increase traffic to your profile by sharing informative healthrelated articles.

HealthEngine.com.au - Getting the Right Patient to the Right Doctor For further information, please contact Mike: 0419 091 170

INTERSYSTEMS HIMAA

P: 02 9887 5001 F: 02 9887 5895 E: himaa@himaa.org.au W: www.himaa.org.au The Health Information Management Association of Australia (HIMAA) is the peak professional body of Health Information Managers in Australia.

HIMAA aims to support and promote the profession of health information management.

HIMAA also conducts, by distance education, "industry standard" training courses in Medical Terminology and ICD-10-AM, ACHI & ACS clinical coding.

HL7 AUSTRALIA P: 0412 746 457 F: 02 9475 0685 E: chair@hl7.org.au W: www.hl7.org.au

HL7 Australia is the local representative of the global Health Level 7 standards organisation. The HL7 standards are widely used in Australia to interconnect computer systems in hospitals, laboratories as well as GP and specialist practices.

HL7 Australia supports the local user and implementer community with standards, education and implementation support.

P: 02 9380 7111 F: 02 9380 7121 E: anz.query@InterSystems.com W: www.InterSystems.com InterSystems provides innovative software products that enable you to create, deploy, run, and connect healthcare applications faster. InterSystems Ensemble®, our rapid integration platform, can cut IT project times in half for enterprises that need to connect applications, processes, and people. Our health information exchange platform, InterSystems HealthShare™, enables the creation of electronic health records that share clinical data across multiple organisations on a regional or national level.

InterSystems TrakCare™ is an advanced Web-based healthcare information system that rapidly delivers the benefits of an Electronic Patient Record.

Ensemble, HealthShare, and TrakCare all leverage the lightning speed, massive scalability, robust reliability, and rapid development capabilities of InterSystems Caché®, the world’s fastest object database.

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MEDTECH GLOBAL

P: 03 9690 8666 F: 03 9690 8010 E: salesAU@medtechglobal.com W: www.medtechglobal.com

ISN SOLUTIONS PTY LTD P: 1300 300 471 F: 02 9280 2665 E: info@isnsolutions.com.au W: www.isnsolutions.com.au

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

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.

Some of our solutions include but 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

JAM SOFTWARE

P: 02 9799 1888 F: 02 9799 4042 E: enquiries@jamsoft.com.au W: www.jamsoft.com.au MED™4i (Medical Electronic Desktop™) streamlines Health Care with easy-to-use customisable interfaces, modular versatility & connectivity backed by friendly expert engineers.

Comprehensive Patient database with multiple-format billing including electronic Online Patient Verifications & Claiming to Medicare, DVA & Health funds (paperless) MS Office integration, Orders, e-Results, Prescriptions (including MIMS) & Customisable databases including surgical audits.

Your specific needs can be easily accommodated. Fully supported with on-going upgrades to meet the ever-changing health environment.

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.

iSOFT aims to create virtual health networks that promote clinical and corporate governance, quality, efficiency and consent in healthcare, enhancing the experience for all participants.

MIMS is the premier supplier of medicine information to Australian healthcare professionals.

To cope with the demands of delivering healthcare in the real world, you need fast access to a pure source of knowledge.

MIMS is essential knowledge that Australian health professionals can trust, distilled down to crucial facts and easy to use.

Because of the rapid flow of information today, you can count on MIMS information being current with regular updates through print, CD ROM, PDA, online or integrated into your clinical software.

And because it is generated by a local Australian editorial team and backed by global resources, you can be sure MIMS is always relevant to your needs.

P: 02 8298 2600 F: 02 8298 2666 E: admin@nehta.gov.au W: www.nehta.gov.au

P: +61 2 8251 6700 F: + 61 2 8251 6801 E: company_enquiry@isofthealth. com W: www.isofthealth.com

Our solutions facilitate cooperation and communication between doctors, nurses, pharmacists and lab technicians by allowing unified patient management, electronic ordering, results reporting and transfer of data between different care settings.

P: 02 9902 7700 F: 02 9902 7701 E: info@mims.com.au W: www.mims.com.au

NEHTA

iSOFT

iSOFT is one of the world’s largest providers of healthcare IT solutions.

We design, build and deliver industry-leading software systems that serve the entire health sector, ranging from GP surgeries to specialist departments and across entire hospitals.

MIMS AUSTRALIA

MEDILINK

P: 1800 623 633 F: 07 3392 1108 E: support@medilink.com.au 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.

Medical-Objects

P: 07 5456 6000 F: 07 3221 0220 E: info@medical-objects.com.au W: www.medical-objects.com.au

The National E-Health Transition Authority identifies and fosters the development of the best technology necessary to deliver a e-health system for Australia. This includes national health IM and ICT standards and specifications.

Medical-Objects has provided secure messaging to over 10,500 health professionals with referrals, reports, letters and discharge summaries. Delivering directly into leading practice software, removing the need for scanning and faxing.

Referrals are digitally signed and encrypted, moreover, compatible with Medicare’s requirements and in line with NEHTA’s eHealth PIP direction. Using Medicare supported PKI, you can trust that referrals are digitally signed with PKI and we are working with NEHTA as an eHealth PIP eligible secure messaging vendor.

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Pulse+ IT PULSE MAGAZINE

P: 0402 149 859 F: 02 9475 0029 E: info@pulsemagazine.com.au W: www.pulsemagazine.com.au Pulse Magazine is the publisher of Pulse+IT, Australia’s first and only Health IT magazine.

NUANCE COMMUNICATIONS

P: 1300 550 716 F: 02 9434 2301 E: Kerry.Young@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).

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 40,000 printed copies ranks it as Australia’s highest circulating health publication of any kind.

THE SPECIALIST

P: 1800 803 118 E: info@healthsolve.com.au W: www.clintelsystems.com “The Specialist” is an intuitive and truly sophisticated tool that allows management of patients within: • specialist medical practices • private hospitals • day surgeries.

The Specialist includes 5 modules: • Accounting • Correspondence • Time Manager • Medical Records • Mobile Data Facility “The Specialist” runs on both Macintosh™ and Windows™ platforms.

Current installations range from single stand-alone computers to networks connected to either Macintosh™ or Windows™ file servers.

In addition to printed magazines, Pulse+IT offers a number of digital products including a weekly The Specialist is industry standard, eNewletter service, Twitter and RSS and readily interoperable with feeds, an online events calendar, 20/02/09 SR Logo_65x42mm.pdf 14:50:20 other systems. and an interactive website.

C

M

STAT HEALTH SYSTEMS

PEN COMPUTER SYSTEMS P: 02 9635 8955 F: 02 9635 8966 E: enquiries@pencs.com.au W: www.pencs.com.au

CM

MY

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

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

CAT delivers enhanced data quality and patient outcomes in general practice.

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P: 07 3121 6550 F: 07 3219 7510 E: carla.doolan@stathealth.com.au W: www.stathealth.com.au

Y

SMARTROOMS BY DOCTORWARE

P: 03 9499 4622 F: 03 9499 1397 E: sales@doctorware.com.au 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.

Stat is an integrated clinical and practice management application which has embraced the latest Microsoft technology to build a new generation solution.

Stat Health Systems have formed partnerships with Ocean Informatics and First DataBank who will supply tools for clinical database management and the drug database respectively.

Fully scalable and the only medical software application to incorporate a multi-functional intuitive interface, Stat is at the forefront of computing technology.

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).

WACOM

P: 02 9422 6700 F: 02 9420 2272 W: www.wacom.com.au Wacom is the worldwide market leader in graphic tablet technology and interactive pen displays.

For practices looking to move toward a paperless office system, Wacom has a number of solutions that are intuitive and easy to use.

ZEDMED

P: 03 9284 3300 F: 03 9284 3399 E: sales@zedmed.com.au 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.

From a single Specialist to a multisite GP Practice, we are renowned for our superior customer service and products that provide stability, security and ease of use. We also provide comprehensive data conversions from most software packages on the market today.

Zedmed is proud to be one of the longest serving Australian medical software solution providers, with clients nationwide.

AAPM2009 National Conference

‘The Edge of Practice Management’ Tuesday 20 – Friday 23 October 2009 Melbourne Convention and Exhibition Centre

PROVISIONAL PROGRAM Tuesday 20 October 2009 UNE Partnerships Workshop 1 – Emotional intelligence – the difference it makes to leadership UNE Partnerships Workshop 2 – Project management – the ‘Essentials’ Leh Simonelli, Academic Director, UNE Partnerships Corporate Governance AAPM AGM Welcome Reception in the Exhibition Area First Time Attendees’ informal dinner

Wednesday 21 October 2009 Official Opening:

Keynote Speaker: Mr Alan Pease – It’s not what you say – body language Keynote Speaker: Mr Jeff Kennett – Leading your way to success Concurrent Sessions: SED, Vicki Hayward and Lisa Phelps – Consulting Practice Management Services – investing in people matters David Osman and Simon Thiessen – Myers-Briggs™ Introduction to Type NEHTA, Dr Mukesh Haikerwal – E-Health: shaping the future of healthcare Brett McPherson – Financial management reporting – simplifying the myth Gail Raw – Are we providing the BEST service for our clients? Are we hearing what they really want?

Claire Johnston, Facilitator – The Medical Specialist – a forum of speakers and an interactive panel focussing on the circle of management topics Danny Haydon – The Big 5 challenges for practices Fiona Galloway – Making the most of your staff recruitment and retention program Happy Hour in the Exhibition Area to celebrate AAPM’s 30th Birthday UNE Partnerships’ Cocktail Reception, Graduation and Awards Ceremony

Thursday 22 October 2009 Cooking with CAT: Recipes for success in your practice (RACGP) Key Industry Leaders Forum – Big issues in Practice Management Concurrent Sessions: Dr Stephen Clark, CEO AGPAL – Future quality in General Practice Avant, Dr Liz Mullins – Medico-legal risk APNA, Belinda Caldwell – The Practice Nurse of the future Avant, Marianna Kelly and Di Preen – Myth busters Sue Gordon – Quality systems working for you Plenary Speaker: Simon James – The Practice Manager’s role in driving eHealth adoption Plenary Speaker: Mark Brommeyer, iSOFT – On the edge of the precipice – managing practice change in uncertain times Keynote Speaker: Steve Herzberg – Dealing successfully with Gen X, Y and baby boomers – practical strategies for Practice Managers Keynote Speaker: Amanda Gore – Transforming people and cultures from the inside out Optional Function – Melbourne Aquarium Party with the Penguins

Friday 23 October 2009 EXPEDITION – Simon Thiessen (Optional workshop – see registration details on www.cdesign.com.au/aapm2009) Concurrent Sessions: HCN – Margaret Windsor and Katrina Otto – Preparing for the paperless office Dr Gordon McLean – The relationship between oral and system health Marina Fulcher – How to manage difficult patients at the front desk John Boyle– Zero Tolerance GPA – New online accreditation program A+ Samantha Smorgon and Olga Maripoulias – The Practice Team and QA&CPD – RACGP Paula Robinson – Fair Work Act – Modernisation of awards and the new employment standards Tracy Penn – Managing your recalls, marketing your practice and welcome kits for the dental practice APCC – Improve, building the practice team Plenary Speaker: Adam Priddle – Debt management and recovery – some perspectives Plenary Session – AAPM National Angela Mason, Management Consultant – Surviving a battle: The Kokoda track Sue Watt, Nurse Comedian Prizes from Sponsors and Exhibitors, details of next conference and official closing of AAPM 2009 Pre-dinner drinks followed by AAPM Gala Conference Dinner at Peninsula, Central Pier, Docklands

Conference Design Pty Ltd P: 03 6231 2999 www.cdesign.com.au/aapm2009

WHEN EVERY HANDOVER IS MISSION CRITICAL.

Using electronic communications for the transfer of care between healthcare providers is a complex and exacting process. Very few organisations have demonstrated the ability to do so on any scale.

The stakes are extremely high. Every electronic referral that you send is mission critical and there is absolutely no margin for error.

Every month HealthLink is responsible for the sending of more than 36,000 electronic patient referrals, 81,000 specialist letters and the delivery of 110,000 electronic discharge summaries. HealthLink’s services are used by more than 8,000 individual Australian and New Zealand healthcare organisations. We employ a highly skilled team of staff and employ and/or contract local support staff in many areas of Australia and New Zealand.

HealthLink has demonstrated a solid track record as a manager of clinical information exchange and during the past twelve years has become a world leader in clinical messaging and health system integration.

HealthLink has a deep understanding of what is needed to support its partners’ use of electronic communications. When you are ready to commence electronic ‘Transfer of Care’ we are ready to help you to do it.

Tel 1800 125 036 enquiries@healthlink.net Integration

Standards

www.healthlink.net Scalability