Pulse+IT Magazine - March 2009 by Pulse+IT Magazine

PULSE IT 

AUSTRALIA’S FIRST AND ONLY HEALTH IT MAGAZINE

CONSUMER E-HEALTH

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ISSUE 11: MARCH 2009

Electronic health records Home health monitoring systems Health games and interactive media Online information and community

7 May 2009 Telstra Dome, Melbourne

Invitation to all Healthcare Providers HealthBeyond HealthBeyond is a one-day e-health event looking at how consumers can improve their health and general wellbeing through the better use of information and communication technologies (ICT). The entertaining and information-rich day features plenary speakers, concurrent content presentation streams and interactive demonstrations.

Who should attend? Anyone who influences the health habits and practices of Australians including General Practitioners, Nurses, Allied Health Workers, Psychologists and Carers. HealthBeyond will educate clinicians, care-givers and other healthcare providers and gain commitment to influence their patients around the ways to improve health through the use of ICT. It will also engage with the health consumers who are early adopters of new healthcare technologies. HealthBeyond is being delivered by the Health Informatics Society of Australia (HISA).

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Publisher Pulse Magazine PO Box 7194 Yarralumla ACT 2600

PAGE 28 HEALTHBEYOND Pulse+IT interviews HISA CEO Brendan Lovelock, convener of the forthcoming HealthBeyond consumer e-health conference.

ABN 19 923 710 562 www.pulsemagazine.com.au Editor Simon James 0402 149 859 simon.james@pulsemagazine.com.au Editorial Enquiries editor@pulsemagazine.com.au Advertising Enquiries ads@pulsemagazine.com.au About Pulse+IT

PAGE 26 EVENTS CALENDAR Up and coming Australian and international Health, IT, and Health IT events.

Pulse+IT is Australia’s first and only Health IT magazine. With a national distribution exceeding 40,000 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 12,00 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 Ben Armstrong, Linda Bâgu Batson, Kasey Brunt, Emma Harnett, Simon James, Dr Paul Mara, Dr Andrew McIntyre, Dr David More, Robyn Peters, Kerry Stratton, and Mark Worsman. Disclaimer

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

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, CMP Medica or the Kimberley Aboriginal Medical Services Council, all who produce publications under the title “Pulse”. 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. ISSN: 1835-1522 Subscription Rates Please visit our website for more information about subscribing to Pulse+IT.

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

PRACTICE WEBSITES PAGE 34

COMPUTER MONITORS PAGE 36

EHR LEGAL ISSUES PAGE 41

DIGITAL LIFESTYLE PAGE 44

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

PAGE 12 GUEST EDITORIAL Dr David More contrasts Australia’s “pink batt” recovery plans with those of the Obama administration.

PAGE 30 INTERVIEW: HCN Pulse+IT checks in with Health Communication Network (HCN) CEO, Mr John Frost.

PAGE 08 GUEST EDITORIAL Kerry Stratton discusses the potential for e-health to provide benefits in community care settings.

PAGE 14 BITS & BYTES Pulse+IT’s news section, delivering the latest e-health developments from Australia and abroad.

PAGE 33 NEHTA NEHTA outline the resultant recommendations from their IEHR Privacy Blueprint consultation.

PAGE 10 GUEST EDITORIAL Dr Andrew McIntyre shares his insights into the complexities of modern Health IT.

PAGE 26 EVENTS CALENDAR Up and coming Australian and international Health IT, Health, and IT events.

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

FEATURES Articles PAGE 34 PRACTICE WEBSITES Ben Armstrong discusses the promotional benefits of establishing a website for your practice.

PAGE 38 ACCOUNTING WITH MYOB Robyn Peters discusses interim reports and overviews the process of GST reporting with MYOB.

PAGE 42 BUILD OR BUY Linda Bâgu Batson poses the timeless IT question: “To build or buy”

PAGE 36 COMPUTER MONITORS Simon James provides some advice for practices looking to purchase new computer monitors.

PAGE 41 EHR LEGAL ISSUES Mark Worsman and Emma Harnett overview some of the legal aspects of Electronic Health Records.

PAGE 44 DIGITAL LIFESTYLE Dr Paul Mara shares his experiences with modern audio-visual equipment in practice and home settings.

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

Pulse+IT: 2009.1 Welcome to the eleventh edition of Pulse+IT, Australia’s first and only Health IT magazine. This edition of Pulse+IT is the first to be released under the publication’s new guise as a bi-monthly magazine, with subsequent editions due for release at the start of May, July, September and November. In response to the growing tide of Health IT activity and to further improve the timeliness of our publication, Pulse+IT’s digital offerings have recently been revamped with the launch of a new website. Designed to facilitate timely news updates, the refreshed site retains the online “ePaper” representation of the printed version of Pulse+IT, but offers us the ability to also publish a steady stream of news about Australian-centric Health IT developments. An events calendar and RSS feed have also been established on our new website, the latter allowing website visitors to be alerted to the release of new content within minutes of it appearing on the site. To complement the website, a weekly eNewsletter service has been launched. This free service aggregates new articles published on the Pulse+IT website, and emails them out to subscribers at the start of each week. Up and coming Health and Health IT events are also noted in the eNewsletters, with each instalment rounded out with a humorous Health IT related DocRat comic strip from GP and comic artist, “Jenner”. The eNewsletter sign-up form URL is noted at the bottom of this page — I encourage all to subscribe and promote the availability of the service within your organisation.

HISA FORMALISES MEMBERSHIP-WIDE SUBSCRIPTION Following a positive response to a trial circulation of Pulse+IT to the Health Informatics Society of Australia (HISA) membership last year, I am pleased to report that HISA will be supplying this and future editions of Pulse+IT to their members on an ongoing basis. HISA has been supportive of Pulse+IT since its launch in 2006, and the formalisation of this agreement builds upon this existing relationship. I extend my sincere thanks to the HISA board and CEO for bringing this initiative to fruition, and look forward to any feedback, or indeed editorial contributions, that HISA members may have going forward.

This edition This edition of Pulse+IT features guest editorials from Dr Andrew McIntyre, Dr David More and Kerry Stratton. Each of these gentlemen have spent considerable time in the e-health arena and their insights are well worth reflecting on. Our regular Bits&Bytes news section covers a lot of ground in this edition, featuring a range of articles detailing various Health IT industry staff movements, the launch of several health‑related websites, up and coming Health IT events, and many more other recent developments. “HealthBeyond”, a new e-health conference to be held in Melbourne in May is profiled in detail, Pulse+IT talking about the event with organiser and HISA CEO, Brendan Lovelock. Pulse+IT also interviews John Frost, CEO of HCN, who reveals details about the impending launch of an integrated Easyclaim solution for PracSoft users, in addition to his company’s plans to enhance the interoperability capabilities of its secure messaging platform, MDExchange. NEHTA outline the results of some of their Individual Electronic Health Record (IEHR) privacy work, an article which is complemented by an examination of some of the legal issues relating to electronic health records by co‑contributors Mark Worsman and Emma Harnett. Robyn Peters continues her series on accounting in the medical practice with an instalment outlining GST reporting and interim report analysis, with Linda Batson continuing her own series on project management, posing the time honoured IT question: “To build or buy.” Ben Armstrong commences a series on websites, outlining some of the benefits they can provide for medical practices, while I offer some advice for readers looking to purchase a new computer monitor. Dr Paul Mara rounds out this edition by sharing his recent experiences with modern audio-visual technology and outlining some of the associated applications of the technology in practice and home environments. Simon James, Editor 0402 149 859 simon.james@pulsemagazine.com.au

Pulse+IT eNewsletter Service To receive the latest Australian Health IT news delivered free to your email inbox each week, visit www.pulsemagazine.com.au/enews

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Guest Editorial Kerry Stratton Managing Director, Healthcare for InterSystems Corporation.

Community Care: The New Frontier in Connected Health While most of the talk about the benefits of connected healthcare strategies revolves around a national Electronic Health Record, most of the action has been concentrated in acute care settings. Community healthcare is emerging as a new frontier for connected healthcare strategies and technology is advancing to meet the unique demands of this environment. With ageing populations and increasingly expensive treatment options, governments around the world are asking: How do we start cutting some costs while making things better for patients? One answer is to get patients out of acute care as soon as possible and into their homes and the hands of community care. Psychologically that is better for patients, with less cost and better outcomes. To achieve this, you must share information between acute and community care settings. The local GP needs to know what has happened to their patient in hospital and what their treatment plan is. Other allied health professionals within the community — like the physiotherapist or the home care nurse — may also need to access the treatment plan and other relevant clinical information.

Social care benefits Governments’ desires to cut acute care costs while improving healthcare outcomes also cuts across social care. There is pressure on governments to take more responsibility for social problems that impact acute healthcare costs like child abuse, drug abuse and alcohol abuse. As a result, there is more attention being paid to affected individuals while they are still in the community. In Australia we are seeing IT investments in Community Health agencies through the Victorian HealthSMART program, for example. Most recently, the Victorian Department of Justice signed contracts for an innovative program to supply the InterSystems TrakCare healthcare information system to support both psychiatric and financial counselling to problem gamblers, with further new initiatives expected. While the InterSystems TrakCare healthcare information system was originally developed in Australia for acute care settings, we are seeing a lot of interest in implementing TrakCare in community settings, including clinical settings like primary care clinics. We recently won a contract in Chile for

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primary care clinics across the country as one of two authorised government healthcare solutions providers. These sorts of solutions need to have a small technology footprint and they need to be easily installed with low ongoing maintenance costs. They need to be easy to use and support a mobile workforce. Last, but not least, they need to be easily connected with existing sources of patient information (systems, databases), many of which are owned by larger acute care organisations.

Integrating primary and acute care With all of these community care solutions there is a requirement to integrate with multiple existing systems in multiple sites. A common approach is to use a product like InterSystems HealthShare — a platform that enables the fast creation of an Electronic Health Record for regional or national health information exchanges — to leverage existing IT investments and achieve quick results. This approach allows you to connect multiple systems across multiple sites to provide a single patient view of clinical information in different care settings. The view can be filtered depending on the setting, so a community nurse would see one view and a doctor would see another.

Connecting Australia Australia is in a good position to facilitate connected health strategies. We are better off than many countries because of high IT penetration rates at the primary care level. Around 70 per cent of general practices use systems like Medical Director for practice management and patient administration. Many GPs also use IT systems for recording clinical information, particularly prescribing, so in many cases there is a record of medications. They are also used for lab results and medical history, particularly allergies. The HealthShare approach is proven in scenarios which are similar to Australia’s, such as Sweden where the platform is used to connect hospitals throughout the country. This usually involves deploying appropriate connector software across hospitals to support three or four different vendors’ acute care systems and connectors for common healthcare systems in general practices. Using a Web-based platform means it is easy to make

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Guest Editorial Dr Andrew McIntyre MBBS (Hons), FRACP, is Director of R&D at Medical-Objects and a practicing Gastroenterologist. He is involved in HL7 standards work both in Australia and Internationally. andrew@medical-objects.com.au

Why is Health IT so hard? Every now and again someone decides that Health IT is obviously doing something wrong and they are going to fix it. This is a familiar call, often made by well meaning bureaucracy and it’s part of the problem and not part of the solution. Health IT is hard and it has become much harder with the involvement of well meaning bureaucracy. They often regard (and even refer to!) Health IT people as a bunch of “nerds”. If only there were more nerds and less bureaucracy we may be further ahead. Yes, it is possible for the banks to have ATM machines working in a global sense and interoperating, but they are only adding and subtracting figures from a balance and tolerate a fair bit of fraud as part of the cost. I am sure if all we wanted to do was maintain long term records of patient blood pressure and have this interoperate with low levels of security it could be done quite easily. If we provided this service for the same transaction fees as the banks charge for ATM transactions there would also be a funding model! Health IT is hard because the problem that we are trying to solve is huge, changes rapidly and cannot be modelled completely at any one point in time. It also rightly needs to be done with a very high level of security and even low levels of fraud and security breaches are intolerable and cannot be assigned to an “acceptable level of fraud”, which is what happens in the banking industry. It is also either starved of funds or funds are wasted in large treasure chest sized amounts by giving it to the large corporate software pirates who conduct yet another study or review the “state of the art” and sail on to their next victim. Meanwhile, standards bodies try and pull together workable standards with volunteer labour and laughable budgets. To compound the problem, the standards meetings have been invaded by bureaucracy and modellers with the “nerds” having been left at home. What Health IT needs is an army of smart technical people (i.e. nerds) and smart clinical people who can get together and actually try and pull the technologies needed to make it work in the real world together. As the guardian of a million lines of very technical HL7 orientated source code I am acutely aware of the difficulty of the problem. Medical-Objects has some top class technical brains at its disposal, but you know that even with someone who is exceptional you have to try and partition their problem space off to a small subsection and do a lot of hand holding if you want any useful work done. It takes years to get a top class technical person to see the whole picture as it is all interlinked. They may be a database or Internet or user interface guru, but to make it work together, a lot of balls need to be in the air and aligned at the same time. Any health record model needs to be serialiseable in HL7, security and digital signatures/authorisation appear at all sorts of levels. It has to support not only the HL7 model but also SNOMED CT and then has to be addressable by the GELLO

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code in a standard way. In many cases, the number of patient records may be huge so performance issues are critical and it has to operate in a secure distributed fashion in software environments that are totally uncontrolled and often unreliable. No matter how well you model it it will have to go to systems that are quite basic so it needs to gracefully downgrade to a simple text document on demand. At some point a DICOM image might appear so this needs to be supported as well. Finding people who can function over a landscape dotted with landmarks like HL7, DICOM, PKI, GELLO, SQL, XML, XMLSchema, SOAP, HTTP, HTML, RTF, SNOMED-CT, Archetypes, BNF, RDF etc is no small task. Then of course you have the clinical knowledge that is so vital to build systems that are actually useful. This clinical knowledge is changing and variable, and sometimes contradictory between institutions. Meanwhile the bureaucracy is being wined and dined by the salesmen of the latest wizz bang technology and engaging well dressed consultants to come up with a plan. Working proven scalable technologies must be replaced by new unproven and less scalable technologies. Of course these plans fail, and the whole process restarts with a new bureaucracy who go through the same process yet another time. It is time the bureaucracy actually looked at working Health IT technologies and tried to emulate them. Pathology has been delivering electronic results for over 10 years. The system would not cope if they did not. The quality is patchy but it works and there is lots of room for enhancements. This has been done without any significant government handouts. Australia has standards in place that could be enforced, but no one seems to have the balls to do it. If the government wants to throw money at it then they could reward the use of standards, standards that we know work and not some “almost ready” latest greatest thing that is unproven. It is impossible for the government bureaucracy to come up with their own new “standard” and possibly have it work, it is just too hard to get it right until you have been doing it for 10 years, and even then you get it right a little bit at a time. Organisations such as NEHTA need about 10 years to actually get their finger on the pulse and government can’t see that far ahead. They also need 10 years of actually trying to make it work rather than 10 years of whiteboard scribbling. They need to be highly concerned when “nerds” who are making some things work actually disagree with their plans, but alas, this is not the case! NEHTA needs to become a promoter and enabler of proven standards and a funder of standards work and true R&D. It cannot “solve” the problem on its own and unless they feel totally across all the acronyms above they should not be trying.

Source This article has been adapted from a posting from Dr Andew McIntrye’s blog: http://blog.medical-objects.com.au/?p=37

Guest Editorial Dr David G More MB, PhD, FACHI, is an independent Health Information Technology consultant and blogger who has been working in the e-health domain for over twenty years. He is concerned at the lack of clinician and patient focus in much of what is happening in e-health in Australia. davidgm@optusnet.com.au

If we are to have a stimulus, let’s have one that makes a difference! Like many others I have found it quite disappointing that the scope of the Rudd Financial Stimulus Package has essentially ignored the Health Sector (among a large number of others it must be said). What we have seen from the Rudd Government is a one‑off handout combined with major investment in essentially four areas — school education, road black spots, home construction and roof insulation. This approach to be contrasted with the package which is working its way through the US Congress. The most recent draft of this bill in the US Senate shows a different and what I see as a preferred approach. The draft legislation – Senate Version – is available online here: http://online.wsj.com/public/resources/documents/ stimbil2009.pdf Among the major differences are: 1. The stimulus is spread over all arms of government (Health, Education, Road Infrastructure, Agriculture, Housing, Defence). 2. There is a very considerable “High Tech” component to the spending, including research in a wide range of areas from ocean fisheries, information technology to climate change and rural broadband. 3. There are targeted low-income tax cuts of modest size per family — not the rather generous amounts coming in a single lump to families and workers making under $100,000 (which is really getting well into middle class welfare again). However the biggest difference (from my perspective) between Australia and the US is the planned investment by the Obama Administration in Health IT. Although the numbers are not yet finalised it seems the scale of the planned investment is between $15 and $25 Billion US Dollars over 3-4 years. Not surprisingly this very large planned investment has attracted a lot of comment, some favourable and some a little more cautionary. In general the overall flavour of the reaction has had the following broad points: 1. It is universally agreed that the US health care system is overly expensive, financially inefficient, worryingly unsafe and needing to provide greater patient accessibility. 2. It is largely agreed, except by the most extreme sceptics, that moving to a digital health care can contribute to both efficiency and safety of the health system. 3. It is also generally agreed that the issues of information security and privacy need to be carefully considered in any major initiative. 4. Use of appropriate national standards to ensure high levels of interoperability.

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5. Use of the work of the CCHIT and HITSB to maximise conformance and benefits. Where there are a range of views the difference seem to centre around the pace with which implementation should be conducted, what the private/public sector involvement split should be, what role open-source software should be mandated to play and what technology/architectural approaches should be adopted to ensure that following the investment there is a largely interoperable National Health Information Network. It is also of note that the US Congress has been working on bi-partisan Health IT legislation for the last few years. This has meant that the various peripheral issues (such as security, privacy and incentives) have all been debated and discussed in considerable detail. A very recent example of these considerations is discussed here: http://aushealthit.blogspot.com/2009/02/press-releaseon-health-information.html As noted in this posting the privacy provisions that are planned for the Bill (termed the American Recovery and Reinvestment Act of 2009) seem to me pretty sound. The bill’s privacy provisions include the following: • Stronger protections against the use of personal health information for marketing purposes; • Accountability for all entities that handle personal health information; • A federal, individual right to be notified in the event of a breach of identifiable health information; • Prohibitions on the sale of valuable patient-identifiable data for inappropriate purposes; • Development and implementation of federal privacy and security protections for personal health records; • Easy access by patients to electronic copies of their records; and • Strengthened enforcement of health privacy rules. We could sure do with a single federal act of parliament in Australia that provided similar and consistent legislative provisions for the management of health information. Reporting of the Obama package has also considered the employment implications of the planned Health IT initiative. The following extract from a report published on Government Health IT by Nancy Ferris titled “Spending on Health IT would generate 212,105 jobs”, is indicative of what is being said: A $10 billion investment in health information technology as part of a planned economic recovery package would create or retain 212,105 jobs in one year, a Washington think tank has

determined. The Information Technology and Innovation Foundation (ITIF) endorsed health IT spending, along with spending on broadband networks and a smart power grid, as components of a larger economic stimulus package Congress is expected to introduce soon. ITIF President Robert Atkinson said the organization does not necessarily advocate the amounts of spending that it analyzed — $10 billion for each IT component or a total of $30 billion. He said the analysis of the job-creation effects could be extrapolated to a larger or smaller amount of spending. “I think this is a once-in-a-generation opportunity for our country” to position itself for greater competitiveness in a future global economy in which IT will be a major element”, Atkinson said. The full article is found here: http://govhealthit.com/ articles/2009/01/07/spending-on-health-it-would-generate212105-jobs.aspx Additionally, the overall Health IT initiative, as it is planned also includes funds for telemedicine grants and loans, enhanced IT for Indian Health Service facilities, and improved interoperability for first responders. All in all covering all the bases. Lastly we have Rush Limbaugh (the right wing US ‘Shock Jock’) opposing the Health IT initiative — so it must be right! Mr Limbaugh’s commentary is available here: http://thinkprogress. org/2009/02/09/rush-heath-it/ What we have with the Obama package is an already considered, thought out Health IT investment plan that will create jobs and provide adoption incentives while addressing privacy and security. What we have from Mr Rudd is the issue being ignored despite the obvious business case for investment in the area and treatment of Health IT as an infrastructure worth investing in for the long term. This is pretty poor I believe. What is more, I am sure there are many similar “high tech” initiatives that could be identified and brought online reasonably quickly to make a difference both in the short and long term. I just don’t think the planned package has been given enough future orientated thought.

Contributor’s Note This commentary was developed just before the American Recovery and Reinvestment Act of 2009 (ARRA) was finally signed into law on February 17, 2009. The full text of the legislation can be found here: http:// www.whitehouse.gov/the_press_office/arra_public_ review/#TB_inline?height=220&width=370&inlineId=tb_external John Hamalka, CIO of Harvard Medical School has produced a summary of the final Health IT initiatives and associated clinician and hospital incentive package, which is available here: http://ecommons.med.harvard.edu/ec_res/ nt/2470F026-13EF-4685-B5F1-3C599A91C709/stimulusblog.ppt Additionally, very useful detail is available here: http:// wistechnology.com/articles/5523/ All this shows just how much effort has been put in as compared with what we have seen with the planned “pink batt” growth stimulus in Australia. Readers should be aware that there will be continuing coverage of the US Health IT plans on my blog (http:// aushealthit.blogspot.com), necessary given the evolving nature of the story and the inevitable need to freeze the text of this article for print production.

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BitS & BYTES ADVANTECH EXPANDS ONLINE SERVICES Technology supplier Advantech has launched an online discussion forum for its clients. The ADAM forum brings together information and tips on the company’s products and services, which includes point-of-care hardware for the medical sector. The worldwide forum has both discussion and live demonstration capabilities and includes training papers, white papers and installation tips and hints. “Basically, it’s like a cheat sheet for everybody,” Advantech Australia marketing services manager Jasmine Harrison told Pulse+IT. In its first week of operation, the forum registered 700 new members and received around 1200 posts. To join the forum visit: www.adamforum.com Meanwhile, the company has announced that a Live Chat service would be available 24 hours a day, five days a week. The Live Chat service, available via Advantech’s eStore, allows customers to talk to sales engineers 24 hours a day Monday to Friday. The Live Chat service is accessible via the Advantech eStore: www.buy. advantech.net.au

SNOMED CT TRAINING COURSES SCHEDULED FOR MARCH In late March, Health IT software company Medical-Objects will deliver a pair of “SNOMED CT and Decision Support” training courses in Brisbane and Sydney. To be held on 24th and 31st respectively, the one day seminars are broadly pitched and suitable for all health informaticians and Health IT industry participants. The training courses will be delivered by Clinical Terminologist and GP Dr Peter Scott, and Dr Andrew McIntyre, a medical specialist and Director of Research and Development at MedicalObjects. Course participants will receive an introduction to SNOMED CT and its role in the Australian Health IT landscape, SNOMED CT’s application in electronic clinical guidelines and decision support, and guidance on how to create clinician-friendly Archetypes. Full course details are available at: www.medical-objects.com.au

Health Informatician Robyn Cook departs for Qatar A leader in the Australian health informatics industry has taken up a newly created position in the Middle East. Robyn Cook will step down as Chair of the NSW Branch of Health Informatics Society of Australia (HISA) and Chair of Nursing Informatics Australia (NIA) to commence in the role of senior project manager for the implementation of clinical information systems at the yet-tobe-opened Sidra Medical and Research Center in Doha, Qatar. The Sidra Medical and Research Center is the first academic medical centre based on those found in North America to be developed in the Gulf region, and is expected to open in November, 2011. Ms Cook’s duties will encompass the selection of the new clinical systems to

be used by the hospital, right through to the full implementation of the systems. “This is a really exciting opportunity,” Ms Cook told Pulse+IT. “There are not many hospitals in Australia making this level of investment.” Ms Cook said the Gulf region was well placed to be a world leader in Health IT. “The Middle East is gearing up for significant investment in health informatics solutions,” she said. Although Ms Cook, who has been active in the Australian health informatics industry for the past 18 years, has stepped down as Chair of both HISA NSW and NIA, she will remain a member of the NIA board. Dr George Margellis will assume the position of Chair at HISA NSW until elections are held in July.

CMPMedica to supply iSOFT with drug data products CMPMedica has signed a contract to supply iSOFT with evidence-based drug information, in a move iSOFT says will make patient safety a priority. The global contract, which was signed in December, means CMPMedica will supply the information iSOFT needs to operate its decision support tools. iSOFT chief medical officer Michael Dahlweid said the agreement will enable the company to provide its customers with up-to-date information, as well as improve patient safety. "This new service will strengthen the quality of the drug content available within iSOFT products giving our customers ready access to the very latest drug and allergy information," he said. "This will ensure prescribing clinicians have up-to-date and fully integrated drug information to enhance patient treatment and safety." CMPMedica chief executive officer Henry Elkington said the company has a strong relationship with iSOFT, having supplied them with medicine information systems in the past. "The award of this contract

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demonstrates that we are addressing the needs of one of the most dynamic multinational healthcare solution providers," he said. He said CMPMedica works to combine internationally referenced alert tools with local product information, delivered to its clients' IT partners through a common interface. "By providing trusted local data with best-in-class decision support tools we are enabling solutions that will be recognised and welcomed by clinicians," Mr Elkington said. "By delivering data through a common interface we can speed up and simplify deployment for the solution provider." Dr Dahlweid said the agreement would also allow the company improved and real-time access to CMPMedica's knowledge bases. "When interacting with iSOFT products, these decision support tools will provide the capacity to alert clinicians to interactions between medicines, food, health conditions and patient allergies and more," he said.

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World Internet Project quantifies online health seekers Around a quarter of all Australians seek health information from the Internet, new research has revealed. The World Internet Project — the first ever global survey of Internet usage — found 23.7 per cent of Australians went online seeking health information at least once a month, with 13.4 per cent using the Internet to search for health-related information on a weekly basis. The World Internet Project brought together university researchers from across the globe to track the online habits of Internet users in countries including Australia, Canada, China, the United States, the United Kingdom, and New Zealand. Researchers Professor Julian Thomas and Professor Scott Ewing from Swinburne University in Melbourne led the Australian arm of the project. Professor Ewing said the results showed “very large percentages” of Internet users go online regularly for information about health topics. And he said users in other countries also went online to track down health information. “Using the Internet to look for health information at least monthly is particularly

KNOWLEDGE

high in Urban China and Israel,” he said. The research also showed 24 per cent of Australians aged between 18-29 were more likely to look up health information on a regular basis, while the majority of those aged over 50 would only look for health information less than once a month (36.3 per cent). But the research also found 34.6 per cent of Australians did not use the Internet to look for health related information, with 40.7 per cent of participants aged 18-29 claiming they would never use the Internet to look for health information. The researchers expect the statistics would change over time, as more people begin to use the Internet as an information source. “This is the first time there has been a comprehensive survey that has allowed a detailed comparison of Internet use in different countries,” Professor Thomas said. “As the years go by, I have no doubt the results will change dramatically. More information about the report can be found at: www.cci.edu.au/ post/first-world-internet-project-reportreleased.

A web-based reference library.

Communicare appoints new General Manager Health IT software provider Communicare Systems has appointed a new General Manager. Sam Dean joins the team at Communicare after 14 years with UK information technology supplier EMIS. Former general manager Brian Dunstan has transitioned into the position of Product Development Director. The Perth-based company, which has 10 employees on site, specialises in flexible IT solutions for primary health care providers. Ninety-nine per cent of its client base focuses on Aboriginal health care, with the remaining one per cent made up of rural hospitals and clinics.

Its products are mostly used by health workers and nurses, and its customised QuickSmart system features large icons and graphics to assist health workers with limited literacy and numeracy skills. Communicare Systems spokeswoman Heidi Tudehope said Mr Dean’s appointment marks a time of expansion for the company. Mr Dean will be responsible for the day-to-day operations and planning functions of Communicare. His former company, EMIS, is the UK’s leading primary healthcare IT supplier, with 55 per cent of British doctors using its programs.

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BitS & BYTES survey highlights impact of IT outages in health IT outages in healthcare settings compromise patient safety and disrupt clinicians, a survey has revealed. Conducted by Compuware, the survey found the average length of the most severe healthcare information system outages in 2008 was 4.1 hours. However, 39 per cent of survey respondents said their most severe outage was less than one hour, with 19 per cent reporting outages of up to two hours. Survey respondents felt the biggest disruption caused by the system outages was to clinicians and IT staff. Just 38 per cent said the biggest disruption was to patients. 28 per cent of survey respondents felt the system outages compromised patient safety, while 11 per cent said outages did not significantly impact on their service. Craig Little, Compuware vice president of sales operations for Australia, New Zealand and Japan, said the results did little to break down healthcare professionals’ resistance to the adoption of new technology. “Healthcare information systems are expected to play a central role in improving healthcare outcomes and reducing costs as the population ages and skilled healthcare professionals become harder to find,” Mr Little said. “Yet many Australian healthcare organisations lack the basic tools to ensure their major IT applications can be relied upon to deliver.” Mr Little said the survey results reinforced those found in a recent international survey commissioned by Compuware, which found 64 per cent of respondents believed poor application performance resulted in significant financial losses for their organisations. “Australian healthcare organisations need to break the vicious cycle where the poor performance of existing information systems leads to resistance among healthcare professionals towards the adoption of new technology. “IT departments monitor performance from an infrastructure perspective — like network and server uptime — they typically lack visibility into performance actually experienced by end-users. “Without this visibility, IT relies on service desk calls and anecdotal accounts from end-users to understand performance problems.”

Stat Health Systems partners with First DataBank Stat Health Systems has announced a new partnership with First DataBank (FDB), a provider of integrated drug knowledge bases and electronic clinical decision support solutions. Designed with Australian general practice in mind, Stat Health Systems’ product, "Stat", is a fully integrated clinical and practice management solution incorporating electronic prescribing with enhanced clinical decision support and Medicare billing administration. Under the partnership arrangement, Stat's drug data and clinical decision support are being provided by FDB. FDB’s clinical decision support rules are designed to help reduce the risk of medication errors by providing active clinical screening at the point of prescribing. When a doctor wishes to prescribe a medication, FDB’s clinical decision support system checks the patient's electronic health record for drug-todrug interactions, contraindications and precautions, allergies, and duplicate therapy.

Ian Threlfall, Managing Director and Software Architect, Stat Health Systems, explains: “Stat is a state-of-the-art physician desktop system which utilises the latest in software development tools to produce an innovative and intuitive application. We wanted to offer our users more than standard drug reference information, so we chose to partner with FDB in order to provide the advanced clinical functionality which is already in use by clinicians around the world.” Speaking about the partnership, David Flavell, President, FDB International, said: “We are proud to be working with Stat Health Systems. As the first system provider in Australia to integrate our electronic clinical decision support, we believe they now have a strong competitive advantage in the region.” During its 25 year lineage, FDB has attracted customers from the UK, North America, the Middle East, Africa, and the Asia Pacific region. Its Australian office, located in Tasmania, provides clinical and technical expertise to customers in the Asia Pacific region.

Continuing medical education website launched A website providing Australian medical practitioners with free virtual access to educational conferences and meetings has recently been launched. Medical Update Pty Ltd director Gary Smith said video and power point slides from events from around the country are uploaded on to the site — www. medicalupdate.com.au — where they are easily accessible by subscribers. “We work by filming educational meetings and conferences doctors would normally attend and then place the material up on line,” Mr Smith said. Mr Smith said the site, which has been live since October, currently includes presentations from local and international clinicians covering a variety of topics including eating disorders, cardiology and ophthalmology. He said the aim of the website was to save doctors’ time.

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“The service was brought about as a time saver,” Mr Smith said. “Some practitioners leave home first thing in the morning and don’t arrive home until late at night because they have to attend educational dinner meetings after work. “The website allows them to watch video of the conferences and meetings online at home or work, instead of spending hours at a meeting.” Mr Smith said the website was attracting positive feedback from rural medical practitioners and said the service would be adding a wider variety of topics in the near future. “We are still fairly new so there will be much more to come,” he said. Access to the Medical Update service is free for Australian medical practitioners who can register via the website.

www.advantech.net.au www.advantech.net.au

Advantech Australia Tel: 1300 308 531 Advantech Australia Tel: 1300 308 531

BitS & BYTES BigPond partners with health information website Telstra has partnered with an online medical site to give consumers easier access to health information. Accessible from the BigPond home page (www.bigpond.com), the Virtual Medical Centre has more than 22,000 pages of medical information and advice from specialists. Patients and medical professionals can become a member of the site for free, with professionals needing to supply their prescriber or provider number to certify their credentials. Telstra media group managing director Justin Milne said thousands of web users had visited the site since it launched in December, ranking it as the number one health site in the country according to the Nielsen NetView ranking system. “An apple a day may keep the doctor away but by also visiting BigPond you can now find a wealth of easy to understand health and wellbeing information,” he said. Mr Milne said the site gives visitors information on diseases, pharmaceuticals and practical remedies, as well as healthy living and diet tips. It also gives users access to a GP directory, educational videos and a medical dictionary, as well as interactive tools including a BMI calculator, a pregnancy calculator and a blood count evaluation tool. Doctors who join the site are given access to “professional members only” tools which allow them to evaluate a patients’ health, including tools to calculate how many migraines a patient may suffer a month, a durogesic dose calculator and a body surface access calculator. There are also separate sections for women, men and children, which group together relevant medical topics such as pregnancy, immunisations and prostate health. More than 1000 medical specialists have contributed to the site. Virtual Medical Centre founder Dr Andrew Dean said linking his site to Telstra to form BigPond Health will give more people access to online medical information. “So many Australians will now have access to this credible and qualitycontrolled health information,” he said.

Facebook-style website launched for Australian doctors An Australian medical practitioner has launched the country’s first social networking website for doctors. Dr Stephen Barnett, a GP practising in Bowral, NSW, is the man behind the brand-new Multimedix site — www. multimedix.com.au — which operates in a similar fashion to online social networks such as Facebook. Dr Barnett’s aim is to have doctors from across Australia join and use the site for both professional and social interaction. The site will have three main uses: to allow doctors to search the database for friends, colleagues and contacts; let them discuss interesting clinical cases or ask clinical questions in a secure

forum‑like setting; and to allow them to form special interest groups with like‑minded colleagues. Dr Barnett, who came up with the idea for Multimedix while trying to track down old university class mates for a reunion, said the site was modelled on similar sites from the USA and Canada, such as www.sermo.com and www. asklepios.ca. “One of the biggest US databases has 80,000 doctors using it, which is a huge amount, so there is value in this as a network,” he said. “There are probably 60,000-70,000 doctors in Australia and the more people that join, the more useful the site becomes. “There are a whole bunch of possibilities.” Dr Barnett said he was hoping 5,00010,000 doctors will join the site in its first 18 months. The site is free to doctors, who sign up for the service online by entering their medical registration details. A section of the Multimedix website homepage, highlighting some of the social networks key functionality.

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Management Advantage and HATRIX integrate aged care software solutions Two aged care clinical software providers will integrate their products to streamline clinical workflow in aged care facilities. Management Advantage and HATRIX say the integration of Management Advantage’s Manad Plus and HATRIX’s MedChart will be an industry first. The integrated solution, currently in the on-site testing stage and set to be launched later this month, will enable the electronic MedChart to link a patient’s doctor, pharmacist and aged care facility nurse to the electronic medical chart in real time through a two-way seamless interface with Manad Plus. Users will be able to move seamlessly from one system to the other as all key resident data will be shared by the two systems. Management Advantage chief executive officer Peter Staples said the move would improve the efficiency of care by allowing users to improve medication management techniques.

“HATRIX and Management Advantage have produced the medication management solution for which the aged care industry has been crying out for,” he said. HATRIX managing director Dr John Ainge said the integration will facilitate better care for aged care residents. “We believe that the integrated solutions will offer aged care facilities a complete package of business and clinical needs,” he said. “This is exactly the direction that e-health needs to move in, ensuring software tools augment better care for the resident.” Features of the web-based MedChart include electronic prescribing and medical administration support. Features of Manad Plus include Claim and Payment statement management and reconciliation, internal and external database benchmarking and care management analyses and profiling.

E-health networking event to be held in Perth in March e-Health professionals are invited to attend a networking event being held in Perth later next month. The Health Informatics Society of Australia (HISA) WA branch and Health Information Management Association of Australia’s (HIMAA) “Hooking up with a Health Informatician” networking evening will be held on Wednesday March 25 from 17:45. The evening is a follow-up event to the 2008 Health Information Technology WA forum held in November 2008, which was attended by more than 150 delegates. Organisers said the networking evening will provide attendees with an opportunity to meet up with colleagues and build on relationships formed at the WA forum and other events. The event is for people who either

work or have an interest in the e-health, health information technology, health informatics or health information management fields. “e-health is a broad field and it is our aim for this even to bring together a wide cross-section of WA-based organisations and individuals,” organisers said. “During the event all attendees will have the opportunity to briefly address their peers and to exchange ideas and interest areas to maximise the networking outcome.” The free event is being held in Seminar Room Three at the Department of Health, Royal St, East Perth on March 25. Refreshments will be served from 17:45 with presentations beginning at 18:00. More information about the event can be found at the HISA WA website: www.hisa.org.au/hitwa08

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MEDICARE LAUNCH MBS SELF AUDIT TOOL Health professionals can now use an online tool that enables them to compare their billing practices with their peers. The Provider Percentile Charts, available on the Medicare Australia website, show the number of services billed for selected MBS items, enabling health professionals to compare their data with the data of other professionals. Minister for Human Services, Senator Joe Ludwig, said the availability of the tool would be a valuable tool for health professionals and urged them to take advantage of the free service. “The posting of the percentile charts on the Medicare website is in response to feedback from doctors and health professionals, who told us it would be a valuable tool,” Senator Ludwig said. “The charts allow health professionals to assess their own claiming patterns in relation to others.” The charts, which will be updated quarterly, include common attendance items and chronic disease management items. Specialist billing data will also to be included in the near future. Senator Ludwig said providing access to the information would help promote a culture of voluntary compliance. “Medicare is developing a range of products and services as part of an education and communication strategy to make it easier for health professionals to comply,” he said. “But it’s important to note, just because a doctor’s claiming pattern falls into a particular percentile, it doesn’t necessarily mean he or she has done anything wrong. “There may be a sound reason for the claiming pattern, whether it is in the first percentile, 99th percentile, or anything in between. “It’s also important to note there is no danger zone in relation to level of services.”

APPLE LAUNCHES SAFARI 4 BETA The updated web browser features a new Java Script engine that Apple claims is four times faster than the previous version of Safari, and thirty times faster than Internet Explorer. Safari 4 also includes HTML 5 support, allowing webbased applications to store information locally when the user doesn’t have access to an Internet connection.

BitS & BYTES HUNTER DIVISIONS TO SUPPORT THE ROLLOUT OF SECURE HOSPITAL MESSAGING A group of NSW hospitals will begin using a secure electronic messaging system from March. Newcastle-based GP Access (formerly the Hunter Urban Division of GPs) and the Hunter Rural Division of Rural Practice are working to connect the 17 hospitals in the Hunter/New England area to the electronic messaging system. GP Access chief information officer Chris Scott said hospital staff would use the electronic messaging system to send out discharge referrals and patient letters. He said the move would benefit both health professionals and patients. GP Access chief executive officer Dr Mark Foster agreed. “Increased reliability in the information sent between hospitals and GPs will mean people will not be sent home from hospital without their GP knowing what has happened during the patient’s stay,” Dr Foster said. “About 25 per cent of a doctor’s time can be spent collecting patient information, so a system that can speed up this process has to be of benefit to the GP.”

NEW FUNCTIONALITY FOR O’NEIL PRINTERS Label printing company Insignia has announced a series of new technical solutions for health sector organisations using O’Neil printers. Wireless 802.11-equipped mobile O’Neil portable printers will be supported within Motorola’s mobility service platform for remote management. The platform can be coupled with remote management software, allowing the printers to be configured, updated and monitored remotely. A spokesperson for Insignia said the portable printers will be equipped to operate within Motorola’s Mobility Service Platform environment, which aims to maximise uptime and utilisation among mobile workers, also allowing the printers to be remotely provisioned, monitored and managed. “This provides a seamless and secure management architecture that is ideal in large networked environments containing a broad set of mobile devices, including portable printers and handheld computers.”

Integrated Easyclaim launch imminent HCN is soon to introduce updates to its PracSoft practice management solution that will enable their customers to provide integrated Medicare Easyclaim services to their patients. When released, the software will be able to interact with EFTPOS terminals supplied by Tyro, a financial institution specialising in merchant services. Representatives from both Tyro and HCN have stressed the differences between “stand-alone” Easyclaim and “integrated” Easyclaim, the former variant having been largely ignored by computerised GP and Specialist practices in favour of entrenched Medicare Online workflows. By developing a communication link between the PracSoft solution and the Tyro EFTPOS terminal, the time consuming elements of the stand-alone Easyclaim system have been eliminated. As demonstrated in a video hosted on the Tyro website (www.tyro.com.au), the

patient’s Medicare card does not need to be swiped and MBS item numbers do not need to be keyed into the terminal, facilitating rapid bulk bill and patient paid transactions. The integrated solution achieved Medicare Australia accreditation in December last year, and has been in live beta testing in selected practices since that time. The impending mainstream launch of the integrated Easyclaim solution builds on previous development work undertaken by Tyro and HCN. In 2008, HCN released functionality in both PracSoft and Blue Chip to integrate and streamline the process of accepting card payments with a Tyro terminal. The terminals, which operate over the practice’s existing Internet connection, negate the need to dedicate a phone line to EFTPOS services, minimising complexity and reducing the costs associated with providing the facility.

SA TAFE selects HealthSolve Care Management for nursing students Starting in February, nursing students at the Panorama College of TAFE will use the HealthSolve Care Management System during their studies. According to Lecturer in Community Services, Melissa Beeston-Nicholls, the decision to expand the teaching syllabus comes in response to requests from students seeking a working knowledge of relevant IT solutions. “Students were asking to be introduced to information systems during their course in order to have some familiarity when they entered the workforce. The health care industry is experiencing a shortage of trained staff at all levels, particularly in aged care,” she said. “With electronic systems used increasingly in aged and community care it is important to provide a credible electronic system for students to utilise within the syllabus.”

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TAFE SA trains almost 4000 graduates in nursing, aged care and community services in South Australia every year. Students undertaking the Certificate IV in Service Coordination will be the primary users of the system, however students enrolled in the Certificate III training programs in both Aged Care and Home Care will also be exposed to the technology. According to a spokesperson for the company, HealthSolve provides affordable academic licenses to tertiary institutions so that nursing students can use their systems for training and project work. HealthSolve, based in SA, provides software systems for hospitals, aged and community care, and medical specialists across Australia. HealthSolve counts Doctors, Nurses, Allied Health Professionals, Clerical Management and Care Staff as users of its solutions.

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BitS & BYTES Global Health deploys e-PAS, signs MHAGIC CONTRACT with ACT Health Two Australian hospitals have implemented Global Health’s patient administration system (e-PAS), the company has announced. The hospitals, based in Victoria and NSW, are upgrading from their current legacy Bourke Johnson System. Global Health said the upgrade will streamline the flow of information through the hospitals, both of which have been long-time clients of the company. The e-PAS system incorporates patient management, administrative functions, medical record management, appointment scheduling and management of emergency patients’ records. The system is also compatible with the ReferralNet Claims service, which can interface with other patient administrative systems or billing systems, to submit claims to Medicare, Department of Veterans’ Affairs and health funds via Medicare’s ECLIPSE system. Meanwhile, Global Health has also announced the signing of a three-year contract with ACT Health for the ongoing development and support of their Mental Health Assessment Generation and Information Collection system (MHAGIC). The system, which is currently used by 20 per cent of GP divisions, utilises templates to collect client information, which can then be automatically published into report form.

NCCH to host 11th annual Coding Rules conference The National Centre for Classification in Health (NCCH) are hosting the 2009 Coding Rules conference from March 11‑13 at Dockside, Cockle Bay, Sydney. The event is designed to “inform, educate and inspire” users of ICD‑10‑AM, Australian Classification of Health Interventions and Australian Coding Standards. Other health professionals involved or interested in health information management or health informatics are also invited to attend. The NCCH says the conference will give attendees the opportunity to learn more about a broad range of core health classification and clinical terminology issues and associated skills, resources, planning, systems and management concepts.

Advantech, Microsoft and Intel team up to demo mobile clinical hardware Advantech Australia will be holding a free mobile clinical computing seminar in Sydney in early March. The Technology in Medicine Roadshow features speakers from Advantech Australia, Intel Digital Health and Microsoft Windows Embedded Division, as well as product displays. Advantech Australia’s medical product manager Brad Waters said the event, which is sponsored by Advantech, Microsoft Windows Embedded and Intel Digital Health, is targeted towards both health professionals, medical OEMs, and system integrators. Speakers include Mr Waters, who will introduce Advantech Australia’s new MICA-101 Mobile Clinical Assistant, and demonstrate several applications where the MICA-101 can assist in improving clinical workflow within a medical environment. Intel Australia Digital Health Group industry development manager Dr George Margelis will also speak at the event, focusing on transforming healthcare using technology. “Intel Digital Health Group has been researching this area for almost a decade,” Mr Waters said. “The Mobile Clinical Assistant

platform, based on this research, is designed to combine the best features of modern information technology and the requirements of clinicians. “George will discuss the research leading up to the development of the MCA and the results of trials from around the world showing its benefits.” Tim Schroder, Microsoft’s embedded channel manager — South Asia Pacific, will present on Microsoft’s strategy of specialised operating systems for specialised tasks. “Depending on the task and needs of the device, Microsoft makes a range of operating systems fully componentised to allow hardware partners to build very focused products, whether it be portable ultrasound, hospital in-ward computing, or test and measure,” Mr Waters said. Products on display at the roadshow will include the new MICA-101 Mobile Clinical Assistant, as well as Advantech’s range of medical grade point-of-care terminals, mini PC systems, and patient infotainment terminals. The free roadshow will be held on Thursday, March 12, in the Microsoft Theatre at 1 Epping Road, North Ryde, Sydney. The roadshow begins at 11:30 and finishes at 14:00, followed by lunch.

Healthscope extends iSoft contract Australian private hospital provider Healthscope will continue its roll-out of IBA Health Group’s iSOFT software at 38 of its hospitals, IBA Health Group announced. The agreement, worth $4.2 million over three years, is in addition to a $14 million, seven year agreement announced by the two companies in December 2007. The $14 million deal saw IBA provide Healthscope’s medical and surgical hospitals with a company-wide licence for IBA’s iSOFT hospital information solutions and an ongoing support and

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services facility. Since the December 2007 announcement, IBA Health Group has successfully piloted implementations of iSOFT web-based patient administration solution at two Healthscope hospitals. The latest agreement will see implementation of the software carried out at Healthscope’s remaining hospitals including Knox Private Hospital in Victoria, Allamanda Private Hospital in Queensland and Mount Hospital in Western Australia. Healthscope chief information officer Dougall McBurnie said the initial iSOFT

BitS & BYTES software implementation at two of its hospitals had been a success, leading to the roll-out at all of its Australian hospitals. “Given the marked improvements in feature and function from iSOFT’s web‑based patient administration solution experienced at the two pilot installations, we have elected to roll-out the solution to all of our hospitals,” he said. “[This will] standardise our data sets, configurations and business processes.” Mr McBurnie said implementation services covered under the new agreement include project management, software installation, system configuration, training and

migrating medical records and data from a range of legacy systems. “The ease of implementation of a common group-wide solution and smooth transition to a modern solution with minimal disruption for staff is a huge bonus,” he said. Both agreements will allow Healthscope to standardise its patient and clinical management systems on iSOFT, reducing the cost of managing multiple business systems in individual hospitals and clinics, IBA Health said. It is also expected to reduce the overhead of delivering health information to health professionals operating in a national network of hospitals and clinics.

Church Resources commences aged care IT pilot A group of rural aged care facilities will have access to IT applications through a pilot program being launched by charitable trust Church Resources. The ConnectCare program will see a suite of technology applications and infrastructure rolled out in four not-forprofit rural aged care homes in NSW and Queensland. The four homes are Nambucca Valley Care in Macksville, NSW; Sawtell Catholic Care of the Aged in Toormina, NSW; Churches of Christ Care in Toowoomba, Queensland; and Caloundra Catholic Community Homes in Caloundra, Queensland. Partners in the federal governmentfunded project include Telstra, who will supply the broadband infrastructure that a suite of integrated aged care applications will be delivered over. The IT applications will include an integrated aged care resident health record that can be accessed by GPs, and a suite of integrated residential care management applications including care plans, assessments and financials. Basic IT infrastructure and software will also be implemented including broadband access, network connection, security, firewall, Microsoft applications, mobility, wireless LAN, email and filters, IP phone, VoD and video conferencing. Telstra business group managing

director Deena Shiff said the implementation of infrastructure and software will allow aged care staff to spend less time on administration. “Telstra hopes the pilot will help us create off the shelf solutions, including network-hosted software, making it affordable to roll out similar equipment more widely in rural and regional nursing homes and aged care facilities,” she said. Ms Shiff said the residents will also be able to use the resources to keep in touch with friends and family. “While they may be unable to live independently, our elderly are just as keen to take advantage of social networking as younger Australians,” she said. Nambucca Valley Care chief executive officer Stephen Richards said the project would improve the health of residents by enabling faster and more accurate diagnosis and treatment and easier access to specialists through the use of technology. “People living in aged care facilities are older, frailer and have more complex medical needs than a decade ago,” he said. “With increasing demands on our limited health resources doctors and specialists are being stretched pretty thin, especially in rural and regional areas.”

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HealthBeyond consumer e-health expo launched

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Health professionals and consumers will have the chance to experience technological advances in the management of chronic illness and the pursuit of good health at Australia’s first e-health consumer expo. The HealthBeyond Expo aims to provide a preview of consumer healthcare in the future as it relates to all health professionals, ranging from GPs to specialists, nurses, pharmacists, and allied health workers, as well as health consumers and patients. The one-day event, to be held at Melbourne’s Telstra Dome on May 7, will feature four health and wellness precincts covering home technology, gaming and interactive media, personal health records and virtual communities. The expo, staged by the Health Informatics Society of Australia (HISA), in association with the National E-Health Transition Authority (NEHTA), aims to define the emerging horizon of healthcare and the role technology solutions plays in the health arena. “What technology can do for the management of illness and maintenance of wellness is incredible,” HISA chief executive Brendan Lovelock said. “The role of HealthBeyond is to profile what is available in the marketplace to both consumers and health professionals,

encourage more uptake of the tools available and empower all of us to explore more effective ways of keeping well.” HISA president and information and organisational systems consultant Dr Michael Legg said HealthBeyond would equip health care professionals and consumers with information to allow them to make more informed choices about healthcare. “HISA believes there are opportunities to use information to make significant improvements in both the health of Australians but also their satisfaction with the healthcare services that they receive,” he said. “We believe that the better use of information and information technology is not only affordable but crucial to us having a sustainable health system. “It is important that the community be informed so they are able to engage with Government on the one hand and on the other to take advantage of what is available now to help individuals stay as well as they can.” As well as accepting registrations, in advance of the event the organisers are collecting the personal experiences of consumers and their aspirations for e-health via the HealthBeyond website: www.healthbeyond.org.au

AHML appoints new director The Australian Healthcare Messaging Laboratory (AHML) has appointed Jane Gilbert as its new director. Prior to assuming the lead role at AHML, Ms Gilbert worked as a senior software engineer for the organisation, and has been actively involved with several HL7-related projects and initiatives, including the 2008 IHE interoperability connectathon and showcase. More recently, Ms Gilbert has been appointed to the board of HL7 Australia, and co-chairs a HL7 International Implementation and Conformance working group. AHML develops and supports a sophisticated web-based testing facility specialising in Health Level 7 (HL7) message testing, which is used by

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clinical software developers to test the electronic capabilities of their software’s conformance to healthcare standards. AHML also offers developers the opportunity to have the HL7 functionality of their software certified by the AHML, a process designed to assist purchasers identify software that safely handles electronic clinical messages. AHML has itself recently completed a re-accreditation process conducted by the National Association of Testing Authorities (NATA) to ISO/IEC 17025, an outcome that provides software developers and purchasers with the assurance that AHML supplies accurate and reliable testing results. For more information about AHML, visit: www.ahml.com.au

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Profile: Diagnostic Imaging Pathways website A clinical decision support tool and educational resource for diagnostic imaging has been developed by a team based at Royal Perth Hospital. Diagnostic Imaging Pathways (DIP) presents clinical scenarios for the benefit of diagnostic imaging referrers, providers and patients. Each clinical scenario includes a flowchart giving the appropriate order of imaging, accompanied by referenced text with links to online abstracts. The imaging pathways are broken into categories such as gastrointestinal; neurological; musculoskeletal and trauma; cardiovascular; respiratory; endocrine; urological; ear, nose and throat; obstetric and gynaecological; breast imaging; and paediatrics. Each category includes pathways for individual afflictions, such as suspected bowel obstruction (gastrointestinal); stroke (neurological); head injury (trauma); leg deep venous thrombosis (cardiovascular); acute respiratory illness (respiratory); Cushing’s Syndrome (endocrine); renal colic (urological); vertigo (ear, nose and throat); post menopausal bleeding (gynaecological); breast screening in high risk women (breast imaging); and adolescent scoliosis (paediatrics). The website also includes teaching points, image galleries of pathology and normal anatomy, overviews of common

Queensland Health selects ProVation for electronic Endoscopy Reporting

radiological procedures, and information for patients and carers. DIP editor, Clinical Professor Richard Mendelson, said the site, which can be accessed for free at www. imagingpathways.health.wa.gov.au, is actively maintained. “DIP is continuously updated based on the best-available evidence and consensus opinion after consultation with specialist radiologists and clinicians, general practitioners and our editorial panel,” he said. Prof. Mendelson said the website had been recognised as a valuable tool by many facets of the community. “The website is also being used by the University of Western Australia and Notre Dame University as a teaching resource to educate students on the role of imaging, and as an aid in teaching anatomy,” he said. The site is also further developing its image gallery of normal imaging anatomy, funded by the University of Western Australia, to include normal anatomy and images of disease states. DIP is currently the only clinical imaging web-based resource to have entered into a partnership with the federal government-funded HealthInsite, which aims to improve the health of Australians by providing easy access to information through health professionals and service providers.

Below - A diagnostic imaging treatment flowchart for acute sinusitis, one of around 130 such interactive diagrams available on the Diagnostic Imaging Pathways website.

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Queensland Health is set to install new electronic Endoscopy Reporting software. Global Health IT company, Wolters Kluwer Health, have announced that Queensland Health has licensed ProVation MD for Gastroenterology and ProVation MultiCaregiver. Both products will play a key role in the documentation and reporting required by the National Bowel Cancer Screening Program (NBCSP), which screens people turning 50, 55 or 65 before December 2010. Specifically, the ProVation MD software will electronically capture procedure images taken during a patient’s screening, and will integrate those images and note findings directly into the patient’s report. The MultiCaregiver software will interface with vitals monitors, allowing caregivers, including nurses and specialists, to capture procedure data throughout the duration of the patient’s care. All information will automatically be stored to the ProVation MD database. A company spokesman said the software would integrate seamlessly with other software already operating at Queensland Health by interfacing with current front and back end medical software systems. “ProVation will take front end feeds of patient demographic and scheduling data from Patient Administration Systems and return information to the back end Medical record systems via a HL7 interface language and protocols,” the spokesman said. Site testing of the new software will be undertaken in the first half of 2009, and the company expects the software to be implemented in most Queensland Health sites by December 2009. Queensland’s Health Minister Stephen Robertson said the software will help Queensland Health successfully detect and treat bowel cancer. “Bowel cancer can be treated successfully if detected in its early stages, but currently fewer than 40 percent of bowel cancers are detected early. A critical part of a population screening program is timely data collection and monitoring of quality. ProVation software will allow us to streamline our documentation and data reporting process considerably,” he said.

EVENTS CALENDAR Human Factors in Healthcare Symposium March 3 - March 4 Sydney, NSW P: 02 9080 4307 W: www.informa.com.au Improving Patient Flow Healthcare Conference March 9 - March 12 Sydney, NSW P: 02 9229 1000 W: www.iqpc.com

FEBRUARY The 4th Annual Infectious Disease Control Conference February 23 - February 24 Sydney, NSW P: 02 9080 4300 W: www.iir.com.au IHE Connectathon 2009 - Chicago February 23 - February 27 Chicago, IL, USA W: www.ihe.net HIMSS Asia Pac 09 February 24 - February 27 Kuala Lumpur, Malaysia W: www.himssasiapac.org Inspecht HR Futures Conference February 26 Melbourne, VIC P: 03 9017 1865 W: hrfutures.inspecht.com.au 2nd Annual Hospital Bed Management Conference February 26 - February 27 Sydney, NSW P: 02 9080 4300 W: www.iir.com.au 18th Annual Medico Legal Congress February 26 - February 27 Sydney, NSW P: 02 9080 4300 W: www.iir.com.au

MARCH Australian Health Care Reform Alliance Summit 2009 March 2 - March 3 Melbourne, VIC P: 0438 900 005 W: www.healthreform.org.au

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WASPaLM Satellite Meeting March 12 Sydney, NSW P: 08 9370 5224 W: www.aacb.asn.au Pathology Update 2009 March 13 - March 15 Sydney, NSW P: 02 8356 5858 W: www.rcpa.edu.au National Telemedicine Summit March 16 - March 17 Sydney, NSW P: 02 9080 4300 W: www.iir.com.au 5th Annual Public Private Partnerships In Health Summit March 19 - March 20 Brisbane, QLD P: 02 9080 4307 W: www.informa.com.au 11th Annual Health Congress March 23 - March 25 Sydney, NSW P: 02 9080 4307 W: www.informa.com.au

9th Annual Adverse Events Management Conference April 2 - April 3 Melbourne, VIC P: 02 9080 4300 W: www.iir.com.au HIMSS 09 Annual Conference & Exhibition April 4 - April 8 Chicago, IL, USA P: +1 312 915 9562 W: www.himssconference.org The 6th Annual Future Of The Pharmaceutical Benefits Scheme April 30 - May 1 Sydney, NSW P: 02 9080 4307 W: www.informa.com.au

MAY HIMSS MiddleEast 09 May 5 - May 7 Manama, Bahrain P: +32 2 793 7630 W: www.himssme.org/09 Health Beyond e-Health Consumer Day May 7 Melbourne, VIC P: 03 9388 0555 W: www.healthbeyond.org.au 2nd Annual Green Hospitals Conference May 20 - May 21 Melbourne, VIC P: 02 9080 4307 W: www.informa.com.au

APRIL

ITAC 09 May 21 - May 22 Sydney, NSW P: 08 9409 6870 W: www. itac09.com.au

Hospital Build Asia Exhibition And Congress 2009 April 1 - April 3 Singapore P: +65 6319 2668 W: www.hospitalbuildasia.com

General Practitioner Conference & Expo May 22 - May 24 Sydney, NSW P: 1800 358 879 W: www.gpce.com.au

Med-e-Tel: The International eHealth, Telemedicine and Health ICT Forum April 1 - April 3 Luxembourg City, Luxembourg P: +32 2 269 84 56 W: www.medetel.lu

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

19 - 21 August 2009

National Convention Centre Canberra

“Frontiers of Health Informatics-Redefining Healthcare” captures the exciting achievements in the linkage of science and medicine with information technology. HIC’09 themes •

Preventative Healthcare and Wellness

•

New Models of Healthcare Delivery

•

Next Generation Electronic Health Records

• Personalised Medicine and Bioinformatics The conference delivers an inspiring and practical vision of the future and provides important guidance for all those interested in the fusion of information technology with the provision of care.

www.hisa.org.au/hic09

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

CONFERENCE PREVIEW: HEALTH BEYOND

HealthBeyond — Showcasing the e-health revolution Consumer technology for health and wellness is developing at a spectacular rate. If you are in the business of supporting better health, you won’t want to miss the inaugural one-day HealthBeyond expo to be held at Melbourne’s Telstra Dome on May 7, being staged by the Health Informatics Society of Australia. Pulse+IT discussed the event with HISA Chief Executive Officer, Brendan Lovelock. Pulse+IT: What is HealthBeyond and why is HISA hosting the event? HealthBeyond is a consumer e-health event showcasing the application of e-health technology in the consumer space. The aim of the event is to bring together the major players in consumer e-health under one roof. Healthcare providers will be able to learn and engage with these new options for empowering patients to better support their own health and wellness. HISA is the driving force behind this event because, in a nutshell, it is our mission to improve healthcare through health informatics. Everyone pretty much knows the pathway to being healthy…it's just that the journey can be real tough. Green vegetables don't smell like bacon and getting up early to exercise is easy to avoid! Nothing is going to alter this any time soon...but a lot has changed to help those who have decided to take the journey to better health and convince those who are still wondering about it. This is what HealthBeyond is about...letting everyone know about the new technologies that are available to make good health an achievable goal. Pulse+IT: What are the major areas affected by e-health developments? I think you will be surprised just how far the technology for health and wellness has progressed…the simple tools that are available and the impressive technologies, all providing new options for supporting better health. HealthBeyond will focus on the developments in four areas:

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• Home monitoring and care • Personal e-health records • Health games and fitness systems • Online information and community Home monitoring is a pretty obvious and well-known area. For years we have been putting devices into people’s homes that help consumers to better manage their health. But there have been many significant improvements in this area, particularly in making these systems more engaging and easier for patients to use. There have also been some exciting extensions to this technology in the areas like fitness systems. Take, for example, the new Nokia mobile phone which has an inbuilt GPS. When used in conjunction with a heart monitor, this device will record where you have gone, how far you have travelled, your associated heart rate and keep a record of your training schedule for future reference. Supporting our physical health there is now the emerging segment of ‘exergaming’, which combines highly popular gaming technology with exercise technology to make exercise a more compelling activity. Everyone’s heard of Nintendo’s Wii Fit, but there are many other applications and tools which people probably don’t know about which make it easier to follow the path to better health and well-being. Personal e-health records have been featured regularly in the press, but they are still a fairly abstract concept to consumers. This expo will highlight what is happening in the consumer space and how personal e-health records

can contribute to the improved patient engagement in the maintenance of their health. One of the areas we see as particularly important is the emerging field of interactive media. One of the biggest areas where this technology is having an impact is chronic disease management. There are countless websites which engage children and young adults and help them learn more about their disease and better manage their condition. In Australia, we are also taking a leadership position in the use of online therapy sites where Web 2.0 technology is used to support patients with a range of mental illnesses. There is also the emerging segment of applications which exercise your brain and promote memory retention, these go from enjoyable entertainment right through to serious therapy tools supporting Alzheimer’s patients. The final area the expo will showcase is the opportunities presented through our ever-increasing web-based information resources. Never before have we had access to such an endless stream of knowledge. Of course, this opens up a whole new discussion about the credibility of the material and we will have a number of experts on hand to show you how to find credible, high quality information on the web by using some specific major portals which are safe and approved. Pulse+IT: Who is supporting this expo? HISA is working very closely with our primary sponsor — the National E-Health

Transition Authority (NEHTA) — as well as a multitude of organisations involved in e-health such as the Centre for Health Innovation, the Interactive Entertainment Association of Australia and the Game Developers Association of Australia.

health. People want to be fit. They are interested in what goes into their food and they want to be in control of their own well-being. We will be showing them how to take better care of themselves using information technology.

Pulse+IT: Who is HealthBeyond targeting? Does it have value for the general public as well as medical practitioners? HealthBeyond is for all health professionals who want to learn more about new ways to engage their patients in better managing their health. It is really important for us to engage with them because they are the people who the consumers go to for guidance. But we are also encouraging the general health consumer to come along to gain a better understanding of the new opportunities they have to improve their personal health.

Pulse+IT: What kind of things will people see and will there be opportunities for hands-on experiences? The venue will be divided into four themed areas and in each area there will be pods showcasing the latest e-health developments. At each pod there will be demonstrations and there will be opportunities to have a go and ask questions.

Pulse+IT: What would you like this expo to achieve? There are so many wonderful, leading edge things happening in e-health. Our aim is to educate and engage both health professionals and consumers in these technologies. Hopefully we can expose them to a new set of products and services that will make the journey to better health just that much easier Pulse+IT: Do you think people are taking a more active interest in their own health? There’s a very clear trend which indicates that, more than ever, people are concerned about their own

Pulse+IT: Will there be speakers? HealthBeyond will feature a series of leading industry and academic speakers from around the country. We are also using these new online technologies to help present the conference. We will be having Ben Sawyer, the leader of the Games for Health Initiative in the US as part of a virtual section of the conference along with virtual tours of 3D health spaces on the web. Pulse+IT: When we talk about health we often think only of physical well-being… does this expo have a focus on mental health as well? Yes, mental health is one of the areas where there are a lot of opportunities for information technology. One brilliant example that comes to mind is a fully immersive 3D website called Reach Out, which deals with the particularly

challenging topic of youth depression and suicide. This website gives young people the opportunity to learn how to better deal with stress in their lives. Pulse+IT: Will you be showcasing any real-life experiences from people who have used this type of technology? We are liaising very closely with several chronic disease associations who are helping us identify people already using this technology. These people will be on-hand to talk about their personal experiences and give a personal insight into the benefits of the technology. This will take the concept out of its abstract format and show how it is relevant to the consumer. Pulse+IT: How are you promoting this event and where can people get more information? The event is being promoted in the consumer press, to HISA’s own network of health care associations and through specialist health care publications. We also have a website, which is regularly updated with the latest information about the event: www.healthbeyond.org.au Pulse+IT: How can people register to attend this expo? The best way to register is via the website. This is a national event, so if you’re coming from another state or even another country, the website also features lots of useful information to help with accommodation and travel arrangements.

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INTERVIEW: HEALTH COMMUNICATION NETWORK In our first vendor interview for 2009, Pulse+IT checks in with John Frost, CEO of clinical and practice management software developer, Health Communication Network (HCN). Pulse+IT: What products and services does Health Communication Network (HCN) develop for the health care sector? HCN focuses on improving patient outcomes by providing evidence based software tools to health care professionals at the point of care. Our flagship product, Medical Director is used by over 17,000 doctors including over 1,500 specialists in over 6,000 practices. Medical Director is the leading clinical and prescribing software and is used by doctors to care for their patients during the consultation. HCN is the market leader in practice management software with approximately 3,400 general practice and specialist sites using PracSoft in their practices. It provides appointment book, billing, online claiming, etc for over 16,000 doctors in these practices. Coupled with Medical Director, this suite offers demonstrable improvements in health and healthcare delivery. Blue Chip is Australia’s most comprehensive practice management software solution for specialist practices, It is used by over 2,000 specialists in over 800 practices. Blue Chip Day Surgery, integrates with Blue Chip enabling effective management of patient episodes, statistical reporting and Health fund management for day surgeries. Through its Knowledge Solutions division, HCN is also the national leader in providing Australia’s major hospitals with comprehensive collections of reputable online decision support. HCN’s research division which maintains the General Practice Research Network (GPRN), is a leading electronic provider of research data, relating to GP behaviour. The GPRN Database is the largest and most representative, electronic research network allowing for longitudinal analysis of de-identified doctor/patient records from general practice within Australia. The GPRN is provided to research teams on an

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ongoing basis, delivering data such as: patient demographics; prescribing; reasons for prescribing; reasons for visit; patient history; pathology and radiology requests; and clinical measurements (e.g. BP, height, weight). It contains de-identified records from over 900 GPs, 2.3 million patients, and over 20 million consultations. Pulse+IT: Medical Director 3 contains a feature called MDReference. What benefits does this functionality provide? MDReference is essentially a gold standard Web-based clinical reference library which contains amongst others the John Murtagh series, Harrison’s Online and over 100 other reference texts, online decision support and various popular resources. MDReference is included in MD3 subscription, at no additional charge and is valued at over $1000 pa. A cost saving to practices but more importantly a big time saver by making this information available directly from Medical Director – and being online, it’s up-to-date. MDReference offers MD3 subscribers search capability at the point of care, across all resources. MDReference is powered by HCN’s Unified Search Environment (uSe), which is the underlying technology for National Health Portals like the NSW CIAP portal currently being used by hospital clinicians statewide. Pulse+IT: Which secure messaging products does Medical Director integrate with? MDExchange is a secure messaging system which is a standard component of Medical Director 3. A unique feature of MDExchange is that it delivers encrypted messages directly into Medical Director, rather than into a holding file, making it much more secure. Medical Director can receive messages from most if not all other messaging vendors. Medical Director will very soon

announce interoperability with another reputable messaging vendor. We believe that this will significantly change the current secure messaging environment and assist our customers to reap more true e-health outcomes with better GP to/from specialist to/ from hospital etc communications. We are very excited about this cooperation and believe it will significantly benefit our doctor users. Pulse+IT: How is training and support provided? Customers can receive Technical Support online, via the phone or via the HCN website where they are able to: • Download product updates. • Search for product information. • View online product demos. • Access the HCN Knowledge Base, which contains technical articles relating to the products. • Share user experiences via the HCN forums. • Log Technical Support issues and much more. HCN support operates seven days a week between 8am and 8pm EST and 9am to 5pm EST on weekends. Pulse+IT: In addition to the HCN licences, what other associated costs may practices have to meet? HCN’s software products are licensed on an annual subscription basis or in the case of Blue Chip a license and annual maintenance basis. The products are complete and do not require additional software to operate for most practices. For example, Medical Director includes Australia’s most comprehensive drug and complementary medicines and interactions database as part of the Medical Director subscription. Medical Director, PracSoft, and Blue Chip also include the underlying Microsoft SQL database technology called SQL Express. Note however that larger practices may require a full Microsoft

SQL Server license. Blue Chip users require Microsoft Word. We recommend that all users have broadband internet access to get the most from our software products. Pulse+IT: How frequently does HCN release software updates? Four times a year for Medical Director and PracSoft. Blue Chip updates are released approximately twice a year. Pulse+IT: Is IT assistance required to perform these updates? This comes down to practice choice. Most practices perform updates themselves, however some choose to use IT services to assist. We are currently integrating online update capabilities into Medical Director, PracSoft and Blue Chip. This will further simplify the update process for practices and importantly will give our customers more rapid access to the latest information. Pulse+IT: What new product features should your users look forward to? We are very excited about the new Integrated Medicare Easyclaim feature, which we are launching in PracSoft. This feature will be available very shortly. The main benefit to PracSoft subscribers is the streamlined online claiming functionality, which ensures that the practice workflows are streamlined and

claims are channeled through Medicare Online or Medicare Easyclaim based on patient choice for rebates or the most appropriate and time efficient channel for Bulk Billing. We have a large array of clinical and practice management features in the development pipeline but I prefer not to pre-announce them. Pulse+IT: Does HCN make use of the Australian Healthcare Messaging Laboratory (AHML) HL7 message testing facility? HCN has an ongoing relationship with AHML and I anticipate that with the increased importance of e-health, this relationship and the use of their services will increase. Pulse+IT: Has NEHTA’s work program had an impact on the functional direction of your products, and the strategic direction of the HCN business? HCN is very supportive of key aspects of NEHTA’s work program, e.g. Unique Patient & Provider Identifiers and looks forward to incorporating these initiatives into our products where they benefit our doctor and practice manager customers. However, the rate of progress of many of these and other government initiatives is such that we must forge ahead with our own strategy to meet and hopefully exceed our customers’ expectations.

Pulse+IT: How will the prevailing economic conditions impact on HCN? Overall the healthcare industry is not affected by economic conditions as much as other industries may be. HCN is, and remains, a stable commercial entity and continues to grow in revenue and subscriber numbers year on year — it all comes down to ensuring continuous value add in the products that we develop. A case in point for example is the launch of the PracSoft Integrated Easyclaim solution. It offers our customer base the facility to provide patients some economic relief by assisting Medicare to facilitate real time rebates and a cost saving for the practice. Most clinicians that use our software participate for example, in government PIP incentive programs. HCN endeavours to work with government to incorporate such programs into the software, facilitating automated, streamlined functionality which allows the clinician to participate as part of their workflow — again easing the burden that clinicians might bare. An example being Streamlined Authorities — Medical Director was first to market with this functionality.

HCN www.hcn.com.au

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NEW

2009 EDITION

NEHTA

NEHTA puts privacy on the agenda The federal, state and territory governments of Australia recognise that electronic health (e-health) is vital to the achievement of major health reform over the next decade. E-health has the capacity to benefit all Australians — and in the process improve standards of care. In 2008, NEHTA sought submissions from stakeholders to ensure community expectations around privacy protection are clearly understood.

privacy. Underpinning the IEHR platform is a requirement for a strong privacy foundation. Given that, it should be noted that privacy is not an absolute right and must be balanced against a number of other important public policy objectives. Importantly, NEHTA believes that the IEHR can encompass both appropriate privacy protections and deliver critical benefits such as improved safety and quality outcomes.

The IEHR (Individual Electronic Health Record)

The Privacy Blueprint consultation process took place during a period of considerable change in the e-health landscape and the feedback received on some of the key issues is as follows: • Governance — there is general agreement that strong governance arrangements are important for over seeing and managing an IEHR. • Sensitivity labels — the submissions revealed overwhelming support for a ‘sensitivity label’ function. It is envisaged that greater risks will arise if there is no sensitivity label function in place as individuals may withhold vital information when accessing healthcare. • Individual control over health information — voluntary participation is viewed as a key to success of the IEHR. • Authorised and nominated representatives — how an IEHR might implement representative mechanisms, including those relating to the needs of carers, children and young people. • Audit functionality — it was widely agreed that an effective audit function was needed to ensure consumer confidence in the IEHR system. • Secondary uses — the need for support for certain types of secondary use such as research and improved public health and safety. The support did not extend to other types of secondary use such as direct marketing and use of health information by employers or insurers. • Other issues — several other key issues emerged including data integrity and control, provider participation in the IEHR and the importance of training and community education. It is evident from the submissions received that there is a strong desire to advance an IEHR in Australia. While privacy remains a key challenge, the overwhelming message is that this is a challenge that can be met as a matter of priority. NEHTA will build on the outcome of this consultation process to ensure that a strong privacy foundation is established for the IEHR and other related e-health initiatives.

A key initiative of e-health is the development of an IEHR (Individual Electronic Health Record) which is a secure, electronic record of an individual’s medical history, stored and shared in a network of connected systems. An IEHR will give someone the opportunity to look at their health information electronically. The IEHR will bring key health information from a number of different systems together and present it in a single view. Information in the IEHR will be able to be accessed by the individual and their authorised healthcare providers. With this information available to them, healthcare providers will be able to make better decisions about their treatment advice. Over time the individual will be able to contribute to their own information and add to the recorded information stored in their IEHR.

Privacy NEHTA is committed to developing the national foundations for the electronic exchange of information for healthcare purposes in a way that ensures that individuals’ privacy is protected. Australia’s privacy law framework is complex and fragmented. Depending on where and how national e-health infrastructure is delivered, it may be subject to a different privacy scheme. Currently, NEHTA is working with a set of common privacy principles based on the National Privacy Principles (NPPs) found in the Privacy Act 1988. These common privacy principles seek to capture the major requirements found in the various privacy laws, administrative instructions and standards in place across Australia and apply them to the IEHR. The IEHR Privacy Blueprint was released for public comment in July last year and was designed to elicit feedback on

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FEATURE Ben Armstrong Ben Armstrong is a business executive with Telstra Business, a non-executive director of AMPCO, the AMA’s publishing company and acts as the webmaster and IT manager at Obstetrics & Gynaecology Consulting Group — www.ogcg.com.au. The views in this article are his own and do not necessarily represent any organisation with which he is associated. ben@ogcg.com.au

A doctor's website — a growing necessity? Introduction This article talks about how your colleagues are currently using websites and the potential for you to have richer communication with the public and your patients. A subsequent article will focus on the techniques you can use to promote your website online to attract new patients and/or referral sources. A website can be a vital resource for patients and potential patients and may even become a business management tool for doctors. All businesses need to consider at some point in their lifecycle the issue of how to promote themselves to get their message out to potential customers. Maybe it is because they are newly established, there has been a change in ownership, a move of office location, a change to office hours, new partners or associates joining the firm or new products and services have become available. A medical practice is a business regardless of whether it has broader social and charitable aims: it employs staff, rents business premises, and must pay business taxes. I write this article from first hand experience: I have helped my wife, a medical specialist, and her colleagues establish a new medical practice and have been given latitude to assist particularly with the online marketing and advertising activities. Their experience is that approximately 30% of new patients have come from the Internet to some degree — others quote as many as 80%. This has certainly helped to defray some of the high start up costs of establishing a practice. The website has also become a useful resource for patients and reduced the need to distribute information in a printed form.

Traditional promotion techniques The traditional focus of promoting medical services is based on physical location, print advertising and networking. Locating a medical practice on a busy corner, near a shopping centre or other location with high visibility combined with clear signage is a simple way to ensure that people know where to find you. Print advertising may take the form of a listing in the White Pages, Yellow Pages or other printed directory, advertising in local papers and specialist publications such as medical journals, college newsletters or AMA publications. Building a good reputation amongst medical colleagues, friends and other businesses is also important. In the case of specialists, they need to establish a reputation amongst general practitioners to attract referrals. In the case of a new medical practice, networking might involve approaching

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nearby overworked colleagues who may be all too eager to reduce their workload, or these colleagues may simply remember their own experience in establishing a practice. All these traditional (off line) techniques remain important however in an increasingly online world their relevance is gradually diminishing.

Why do doctors establish websites? There is no doubt that an increasing number of patients are using online mediums for entertainment, education, communication, and indeed, as their first point of call to find information. So much so that the verb “Google” has entered popular language, and even the dictionary, and has become synonymous with searching on the Internet. With over a trillion pages available on the Internet as of July 2008, there exists a substantial amount of information and misinformation about even the most arcane and niche topics. A website gives a doctor a relatively economical way (at nearly zero variable cost) to reach the estimated 75% of the Australian population that uses the Internet. A recent World Internet study shows that nearly a quarter of Australians seek health information online at least once a month, and nearly one in eight people search for health information on a weekly basis. This is a big change to the traditional methods of finding answers to health questions and concerns. In addition to being nearly ubiquitous, the medium has a number of other advantages: • It can be searched readily. • It allows a practically unlimited amount of space and time to communicate a message. • It is available 24/7. • It can be readily updated as things change. • It supports rich forms of communication like video and graphics. • It can support a two-way conversation/dialogue. This is the potential of the online medium — rarely is this potential fully exploited by doctors.

The patients' perspective Although the subject of a doctor's website is the doctor and their practice, the audience of a website is the public and other doctors. The public and your patients benefit if you have a website as you are opening up another communication channel. Accessing your website gives a patient the opportunity to

find out more about you, your style of practice and treatment philosophies before deciding to make an appointment. A patient may more readily make an appointment with someone who they have read about rather than someone who is just a name and phone number. If you don't have a website or your website doesn't make a favourable impression then you may never get the opportunity to demonstrate to the person the caring experience you provide, your proficiency or skills. There are a variety of ways you can make an unfavourable impression — these may arise from how the potential patient perceives the tone or purpose of your website (e.g. maybe too aggressive or pushing surgical intervention) or may be as simple as the presence of out of date information (e.g. where you now practice or a phone number that doesn't work), a slapdash attitude to grammar and spelling, or a hard to navigate website.

Do you have a website? There is no definitive list of websites maintained by doctors in Australia, however based on my best estimates there are only a few hundred medical practices with a website today out of a practising medical practitioner population of roughly 60,000. The standard varies: some are no more than a brief one page biography with contact information; others have obviously been lovingly put together over a long period of time with professional graphics, multimedia, and include extensive patient educational information. Setting up a website need no longer be a complex undertaking. There are many options ranging from doing it yourself using freely available tools to hiring a professional web developer to provide a complete solution. You can spend a few hundred dollars or a few thousand. The key to an effective website is to have a clear purpose and vision for what you want to achieve and to spend time providing quality content. It is difficult to find someone else who has the skills, understanding of your discipline, and passion to write effectively about you and your style of practice.

WEBSITE CONTENT There is a great diversity in the kind of information and resources provided on doctors' websites today. A summary of some of these categories is provided in Table 1. If you have a website or are thinking of establishing one you can use this information as a checklist to determine what you regard as appropriate information and content. You should carefully consider what your patients would value and what you are comfortable in providing. Some practitioners opt for providing basic information and some towards very detailed information including personal information, declarations of (potential conflicts of) interests and surgical complication rates. You can see from the list while many of the types of information have simple analogs off the Internet, others involve a new way of having a relationship and dialogue with a patient outside the traditional doctor-patient consultation. These provide you with a way of delivering rich and detailed information to patients at their own convenience however they also represent challenges in ensuring the information you communicate is clear and will not be acted upon without proper medical supervision or regard for their particular circumstances.

Conclusion Having your own website gives you complete flexibility to determine how you wish to present yourself on the Internet rather than being limited by the space and format restrictions of others. It also gives the public a focal point with up to date information for your practice and where you can begin to establish a virtual rapport prior to any consultation.

Further Information If you would like further information about some of the themes discussed in this article, or would like to make a comment or ask a question of the author, visit the author’s AusMedWeb blog, which is located at: www.ausmedweb.blogspot.com.

Table 1 - A selection of the types of information that may be suitable for use on a medical practice website. While some types of information may replicate information promoted via traditional means, others provide new ways of engaging with both patients and other clinicans.

Contact information

Educational links or content about conditions and treatment

Blogs about medical and non-medical subject matter

Area of practice or specialty

Published articles

Health news and updates from journals and the media

Doctor’s biography

Downloadable patient forms e.g. registration forms for new patients

Subscription to practice newsletters

Location, map (possibly interactive) and directions

Presentations delivered at conferences

Pictures and/or videos/animations of procedures

Pictures and qualification of staff

Declarations of interest

Audits of outcomes of surgery/surgical complication rate

Email address

Online credit card billing

Awards, newspaper articles and TV appearance

Pictures of the practice

Online satisfaction surveys

Printable patient self management forms and diaries e.g. food diaries

Available services and or equipment

Online tools e.g. to calculate an estimated due date for pregnancy

Links to Personal Health Record systems

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FEATURE Simon James BIT, BComm Editor, Pulse+IT simon.james@pulsemagazine.com.au

Computer monitors — bigger is better and so is more Introduction Many white collar professionals routinely spend at least eight hours of every working day gazing, or at least periodically glancing, at a computer screen. As such, it makes sense that this pervasive piece of technology be properly matched to the user’s environment, software requirements, and indeed the computer user themselves. This article outlines some of the characteristics of modern LCD computer monitors that should be considered when purchasing a new monitor.

RESOLUTION and SCREEN SIZE The first thing to consider when purchasing a new computer monitor is the devices’ native resolution. This term refers to the number of pixels (dots) built into the screen, and directly impacts the amount of information that can be displayed on the monitor at any one time — the higher the pixel count, the greater the amount of information that can fit on the screen. Older monitors touted resolutions of 640x480, 800x600, and 1024x768 (the first number being the pixel count from left to right and the second number being the pixel count from top to bottom). The mathematically inclined may note that all of the above resolutions yield an “aspect ratio” of 4:3, which yielded screens that were only slightly wider than they were high. More recently, most computer monitors have transitioned to a 16:10 aspect ratio, with a range of native pixel resolutions as outlined in Table 1. As a result, most computer monitors have taken on a wide-screen appearance in recent years, presumably to better accommodate modern wide-screen video formats. While the number of pixels in a screen generally increases in line with the size of the monitor, this increase tends to happen in “steps”. As outlined in Table 1, 17 inch and 19 inch monitors are typically built using 1440x900 pixel panels. Similarly, 24 inch and 27 inch monitors are typically built using 1920x1200 pixel panel technology. It follows therefore, that a 19 inch monitor is only capable of displaying the same amount of information as a 17 inch monitor, but the image will appear slightly larger to the user, which may be an important characteristic to take into account alongside the capacity of the user’s eye balls! As many would already be aware, it is possible to decrease the resolution displayed by an LCD monitor, which has the net effect of increasing the size of the image the user views on the screen. As the number of pixels in an LCD monitor is fixed, this resolution change needs to be simulated by the computer. The trade-off of this visual trick is that the screen image will appear somewhat blurred. Accepting that being able to read what is on the screen

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is generally regarded as important by most users, people whose vision requires that a computer monitor’s resolution be decreased to allow for comfortable viewing will benefit from a large screen. While the native resolution of such monitors may in fact make text and images appear even smaller than on a smaller monitor, when the resolution is decreased on the larger screen, the resultant image will be somewhat crisper (yet still larger) than what can be achieved on smaller monitors. The principle reason computer users elect to purchase large monitors over smaller screens is that they allow the user to display relatively more information on the screen at any one time. By decreasing the amount of application and window toggling needed to be performed by the user to interact with their various applications, observable efficiency gains can be achieved. In line with this rationale, some clinical software developers are taking advantage of the increasing use of higher resolution monitors by their users, with some clinical software featuring interfaces specifically designed to support wide-screen monitors. If such software detects that a wide-screen monitor is present, a more feature rich interface is displayed, allowing the user to access more functionality with fewer mouse clicks than would otherwise be possible.

Is one Monitor enough? While multi-monitor setups were historically found only in niche settings such as desktop publishing, video editing and finance, the functionality has been available to all computer users for some time. Indeed, Apple introduced support for the concept in 1987, with Microsoft introducing multi-monitor support as a standard component of its operating systems starting with Windows 98. Driven by the power of modern graphics cards, falling monitor prices, and the increasing use of laptops (most Table 1 - An overview of the LCD monitor screen sizes available on the market, along with their respective typical native screen resolutions. Screen size

Native resolution (pixels)

17 inch

1440 x 900

19 inch

1440 x 900

20 inch

1680 x 1050

22 inch

1680 x 1050

24 inch

1920 x 1200

27 inch

1920 x 1200

30 inch

2560 x 1600

of which have video-out capabilities), the number of computer users adding a second or even third monitor to their computer has risen rapidly in recent times. It should be noted that extending the image across multiple screens is the intention, not simply mirroring the same image on both screens. By doing so, the physical size and number of pixels on the computer desktop can be dramatically expanded. Beyond just providing the user with more desktop “real estate”, having separate monitors allows for easier segregation of various applications, increasing the amount of information available at a glance and dramatically reducing the amount of switching required to interact with multiple applications simultaneously. For example, a doctor may use their primary monitor for their clinical software, but position a web browser with links to online clinical resources on the second screen for convenient access. Similarly, a practice staff member may wish to have the practice appointment book permanently open on one screen, but use the second screen for scanning, transcribing letters, or performing other administrative tasks. Accepting that in some cases, having multiple monitors attached to each computer in a medical practice or hospital environment may not be feasible due to a shear lack of space or other ergonomic considerations, such environments are the exception and not the rule.

Convergence is king As prices fall and hardware manufacturers seek to differentiate themselves, various additional features have been incorporated into selected monitors. In response to the increasing number of devices that rely on the USB interface for connectivity, many monitors now incorporate USB hubs to increase the total number of USB ports available on a system, while at the same time making the ports more accessible. Other monitors feature a multi-format media card reader, allowing clinicians to rapidly transfer photos from their digital camera to their computer without the need for a USB cable or a separate media card reader. For clinicians with older digital cameras, the use of such a feature is likely to improve photo transfer speeds dramatically. Other monitors incorporate a microphone and web camera, which could be used for enhanced internal office communication, video conferencing with colleagues, friends and family, and presumably in the not too distant future, video teleconsultations with patients. Of course all of these optional extras come at a price, however when compared with the costs of adding such functionality at a later date using aftermarket componentry, the additional up-front expenditure is likely to be easy to justify.

Conclusion Given the amount of time professionals spend in front of computers, purchasing a monitor (or monitors) that suit one’s eye sight, available desktop space, and takes full advantage of their clinical software is highly recommended. With the cost of quality 24 inch monitors having dropped below $500, the author proposes that this dimension should now be seen as the default monitor option for medical practices, with monitors no smaller than 20 inches being deployed where budgetary or ergonomic restrictions exist. For those looking to maximise their computing efficiency, a multi-monitor setup is definitely worth considering.

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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

GST reporting and interim report analysis Introduction This article was preceded by another dealing with End of Financial Year reports [Pulse+IT, Issue #10, page 29]. If your financial reporting entries are up‑to‑date in your accounting package, these reports can be generated at any stage throughout the year, giving you an accurate snapshot of your business at any point in time. Thanks to GST reporting requirements, you can now access this analysis much more regularly than would typically have been possible prior to the year 2000.

Focus on GST Reporting First Most businesses choose to submit GST/Business Activity Statements(BAS) each quarter. Some choose to submit monthly. Others can do installments throughout the year and reconcile at the end. There are two types of GST: 1. GST Collected — being the 10% you collect from your customers. 2. GST Paid — being the 10% you pay to your suppliers. It is the difference between the two amounts that you either pay to the Australian Taxation Office (if you collect more than you pay) or the Australian Taxation Office refunds to you (if you pay more than you collect). Of course, all Medicare Items (MBS) are GST-free, so it is typical for most

Medical Practices to receive a GST refund from the Australian Taxation Office (ATO). Practices that carry out a high number of non-MBS rebateable procedures may find themselves making GST payments to the ATO. There are also two types of GST Reporting: 1. Cash Reporting — recording expenses when you actually pay your supplier and income when you actually receive the payment (excluding prepayments). 2. Accrual Reporting — recording expenses when you have a legal obligation to pay and income when you have legal right to claim payment. The recording date is usually when you receive an invoice or generate one i.e. the date the transaction occurred. In the medical practice context, it is often best to base your GST reporting on the date you actually provide the service. Just as your patient cannot claim from Medicare or their Health Fund until after the service has been provided, then you should not pay to the ATO any GST involved. This is particularly the case for plastic surgeons who often receive payment for cosmetic procedures well in advance of the procedure date. Often patients may not go ahead and their payment needs to be refunded. You need to ensure you manage prepayments correctly.

Below - Figure 1 - An example of a GST Summary Cash report generated by MYOB.

Figure 1 presents an example of the GST Summary Cash report generated by MYOB. In the report: • The value against the Code FRE would be for MBS (Medical) Services. • The value against the Code GST would be for Non-MBS services (eg: Cosmetic). • The value against the Code N-T would be for any internal transfers of money and not sales or purchases. As the GST Collected is more than the GST paid the amount of $8,920 is payable to the ATO. Here is how to record the payment to the ATO or a Refund from the ATO. Your Chart of Accounts would have under Current Liabilities the following accounts that are used for GST Collected and GST Paid.

Let us reference the GST Report in Figure 1. Take the total values (it would be made up of individual transactions) and let us assume for this example that they are all Cash. On recording a Cash Sale with GST, these accounts are affected: Account 1-1000 Bank

Debit

Credit

228,444

2-2310 GST Collected

19,037

4-1000 Sale

209,407

On recording a Cash Purchase with GST, these accounts are affected: Account

Debit

1-1000 Bank

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Credit 121,395

2-2320 GST Paid

10,116

6-xxxx Expenses

111,279

In this example, the ATO need to be paid $8,920. On processing this transaction, it is recorded as demonstrated in Figure 2 and Figure 3. On processing a refund from the ATO, just do the reverse.

PAYG Included with the GST Reporting/BAS is any employee tax you have withheld during the same period (Pay As You Go – PAYG). Generating the Payroll Activity Summary Report in MYOB will give you this detail.

Superannuation

Above - Figure 2 - GST payment to the ATO using MYOB Spend Money. Below - Figure 3 - Edit - Recap Transactions to view accounts to be allocated.

The Payroll Activity Summary also details any superannuation due and payable to the employees’ superannuation funds. Employees who don’t earn above the threshold of $450 in any of the three months of a BAS reporting quarter are not eligible for employer-contributed superannuation payments.

Other Interim Reports The ideal objective for medical practices is to have a weekly meeting at lunch time, early in the week if possible. This should be planned and organised — there should be an agenda that includes a clinical component as well as business matters. The agenda should have been circulated at the end of the previous week for consideration and input. At these weekly meetings, the following reports should be generated: • Bank Reconciliation. • Actual Income and Expenditure for

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Above - Figure 4 - Example of a Cash Flow in Excel Below - Figure 5 - Business Ratios Ratio

What does it do?

How to calculate

Current

Measures the financial health of your business. A Healthy Business results in 2+

Divide your Total Assets by your Total Liabilities

Quick

Measures your business liquidity. The optimal result is 1+

Divide your Current Assets (less stock) by your Current Liabilities

Stock Turnover

Many Practices are now selling products and often cash can be tied up in unsold stock.

Cost of goods sold divided by the average value of stock

Average Fees Earned by Practitioners

Individual Practitioners can compare their fees earned with average fees earned

Total Fees earned in a given period divided by the number of Fee Earning Practitioners

Average Fees Earned by all Personnel

Staff members can see a result from their efforts and share in the rewards

Total Fees earned in a given period divided by the number of Personnel

Average Hourly Income

Calculates the average hourly income

Total Fees earned in a given period divided by the total Working Hours of Fee Earning Practitioners

Average Hourly Expense

Calculates the average hourly expense

Total Expenses in a given period divided by the Total Working Hours

Average Daily Expense

Calculates the average daily expense for running your business

Total Expenses in a given period divided by the Total Working Days

Break Even

Take the Average Hourly Income and see how many hours you need to work to cover the expenses for the day. Once the expenses are covered, the income to end of day is then profit. Calculate this for the week instead of the Day and you might be more relaxed about having a day off.

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the previous week. • Cash Flow and Forecast. • Necessary Expenditure for the week to be approved. • Number of patients seen in the Practice. • Number of patients seen per Practitioner.

You have to have Cash flow Reporting on the actual income and expenses of the business and forecasting future income and expenses is a necessity. Have this report available at least once a week replacing the previous weeks forecast with actuals. If you would like an Excel template of a Cashflow table as outlined in Figure 4, feel free to email me.

Business Analysis Now that you have available all this detail, you should carry out some calculations to analyse the “health” of your business. Figure 5 details a number of Business Ratios that can assist with this process.

Looking Ahead In the next edition of Pulse+IT we will look at Payroll using MYOB.

FEATURE Mark Worsman and Emma Harnett Mark Worsman is a Senior Associate and Emma Harnett is a Summer Clerk 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 ~ emma.harnett@dlaphillipsfox.com

Electronic Health Records — Legal Issues What are electronic health records?

Storage

Electronic health records are potentially any and everything recording a patient’s health information. They can be any medical event, such as a prescription, check-up report, surgery report or vaccination record, that would usually be recorded on paper, but is instead recorded electronically. It is possible that in the future, a patient file will be composed entirely of electronic health records. Assuming that access rules can be established and adhered to, such a record could be made accessible to all health care providers and the concerned patients.

Medical practitioners must take all reasonable steps to ensure that all records are kept in a way that preserves the confidentiality of the information contained within and prevent them from being damaged, lost, stolen or accessed by an unauthorised person. In other words, to ensure that the records are kept in a secure environment. It is important to remember that where an off-site backup of electronic health records is made, that backup facility must likewise prevent the records from being damaged, lost, stolen or accessed by an unauthorised person. In other words, the backup facility should also possess all of the necessary security and privacy measures as required for the primary location of storage. Care should also be exercised when transmitting records and disposing of hardware on which such records were stored.

Ownership Contrary to popular belief, patients do not own their individual medical records. Rather, the record generally belongs to the medical practitioner who created it or caused it to be created. The same applies to medical reports. Items such as pathology reports and X-ray reports that are obtained at the request of the medical practitioner usually remain the property of the medical practitioner.

Access Although a patient does not own his or her records, this does not mean that he or she does not have a right to access their medical records. This is addressed under different legislation in each State and Territory (and Federally) that provides patients with certain access rights to their medical records. For example, in NSW the relevant legislation is the Health Records and Information Privacy Act 2002. At a Federal level, this is dealt with under the Privacy Act 1988. Put simply, the record belongs to the medical practitioner but the patient is entitled to view and copy his or her record. There are exceptions to this, for example if the practitioner or hospital decides that it would be harmful to a patient to allow him or her access to a record, they do not have to provide the patient with access. In August last year the Australian Law Reform Commission (ALRC) recommended significant changes to the regulation of health information handling. If the ALRC’s recommendations are implemented in Australia, we can expect to see the current complex mix of Federal, State and Territory laws replaced by a uniform set of national law on health privacy. Apart from a patient’s treating medical practitioner, the patient’s medical record can only be accessed by others with the consent (including implied consent) of the patient or by a court subpoena. Generally, no access can be given to a third party, for example an insurer, pathologist or other medical practitioner unless the individual’s consent has been obtained.

Offshore storage and “cloud computing” Another interesting issue is the possibility of storing medical records off-shore or via “cloud computing” — that is, where data and software applications are on the Internet. While cloud computing technology is developing rapidly, the concept of hosting data off-site and off-shore raises a number of issues. From a privacy point of view, cross border data flows are regulated differently to “Australia only” data flows. Also, different countries protect confidential information differently, so what is not allowed in Australia may be allowed in the “recipient” country. The paucity of privacy protection in countries like India and China will be an issue if health records are to be stored in those countries.

Retention In NSW the medical records must be kept for at least 7 years from the date of the last entry made in the record. If the patient is less than 18 years old at the date of the last record, the record must be kept until the patient turns 25 or would have turned 25. If a patient has been consulting a medical practitioner for more than 7 years, the whole record must be kept until such time as the medical practitioner has not consulted with that patient for at least 7 years. The requirements of the other States and Territories are similar to this.

Hard copies In NSW records can be made and kept in electronic form (such as a computer database), provided that the record is capable of being printed on paper. There is currently no legal responsibility for medical practitioners to integrate existing paper records into an electronic format.

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FEATURE Linda Bâgu Batson B Comm, MACS, PCP, is an information systems manager with experience in many sectors, such as manufacturing, education, utilities, mining and is currently working in health. Linda is a member of the Australian Computer Society and a member of the Advisory Board, School of Information Systems, Deakin University. linda.batson@acslink.net.au

To build or buy? That is the question Happy days have arrived when you finally get to choose your new software system. Having been through the meticulous work of developing functional requirements, writing and releasing your Request for Proposal [Pulse+IT, Issue #10, page 34] and evaluating responses, you are now in the envied position of making your selections for demonstration. Let’s have a look at the types of proposals you may have received from software vendors keen to meet your need. They will fall into basically two categories, “bespoke” or “packaged” software (also known as “shrink-wrap” or “off the shelf”). Gaining an understanding of the differences between these is crucial to assist with your decision making. Bespoke software is exactly what it sounds like — software, tailor-made to fit with your existing systems and give you an exact solution to your requirements. A talented, experienced software analyst/programmer won’t have any trouble designing a system to your functional specification, using the most appropriate IT platform and technology. Packaged software, on the other hand, could be thought of as the exact opposite to bespoke. This type of system is often a “one size fits all” solution, designed to be customised to fit your particular site. “But, one size doesn’t fit all!”, I hear you cry. Relax — there are some advantages to this approach, which we shall uncover in a moment. But first, let’s discuss a particular type of installation unique to packaged software, commonly known as the “Vanilla” or “Clean” install. A system implementation is referred to as “Vanilla” if it is extremely plain and has none of the customisations that one would desire from a truly elegant system. Don’t bother looking for the added extras, like chocolate shavings, rainbow sprinkles or honeycomb ribbons, ‘cause they ‘aint there. A vanilla install works like this: 1. Remove software from package. 2. Install software. 3. Start using software. That’s it! Sounds simple, right? It’s really simple — until you get to step 3 and find out that the vanilla implementation the vendor promised is unusable and you have to delay the rollout by several weeks, whilst some hasty customisations are retrofitted. Avoiding this situation completely is your best approach. An advantage that comes with the choice of packaged software is the promise of getting a system up and running more quickly than a bespoke system. This is unlikely to happen, however, unless you already know of another site that has implemented the same system on the same IT platform, with

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the exact same interfacing that your agency is planning. There are always unknown factors in any implementation that could potentially increase the time to “go-live” — and often do. One of the factors that could significantly extend your implementation time is under-resourcing. No matter what type of implementation, you will need to allocate dedicated staff to manage and implement it. Leaving this up to the vendor alone — even though the cost of it is covered in your contract — can be problematic and dangerous. No one likes a halfbaked implementation! Do it properly and match the vendors resources, staff member for consultant. If you have a multi-campus or partner Agencies that will also be implementing the same system, this is where packaged software comes into its own. Being able to roll out an almost identical system across all sites, will often be faster and more cost-effective than a fully bespoke system. It will also have advantages for the broader picture of e-health, such as a multi-site electronic medical record implementation. However, a major drawback of packaged software is inheriting functionality that you don’t need. Many packages come with masses of functionality above and beyond what the average user requires. For example, a specialised clinical system that also incorporates a medical record, scheduling system or financial module. More often than not, your organisation already has these functions up and running in other specialised applications. In these cases, you will be paying for functionality — and the annual maintenance of that functionality — that will never be used. Apart from the cost, workflow aspects also need to be discovered. If the unused modules of the package are vital to the workflow inherent in the system, you may find the functional part of the system that you need is negatively affected by the non-use of the other modules. A critical consideration of your “buy vs build” dilemma, is the schema of your existing systems. It is absolutely essential to do your homework here. It is all very well to select and purchase a great piece of software, but if you discover — during implementation — that vendors of your existing systems are not amenable to interfacing, you will soon find yourself in deep trouble.

Cost, Contract and Negotiation Generally, software costs are divided into an up-front fee and an annual fee. The up-front fee often includes the cost of the software licence, installation and interfacing by consultants,

and user training. The annual fee includes technical support, upgrades and bug fixes. However, there can be many hidden costs, such as additional user licences, additional server, CPU or core licences if you change or extend your hardware platform, further interfacing development, fees from other vendors for interfacing modules to their systems or possibly an annual thirdparty licence fee, if, for example, your system has an in-built MIMS link. Obtaining new software can be quite an expensive exercise, yet it never ceases to amaze me how differently people perceive the cost of bespoke and packaged software. It’s not unusual to spend, for example, $200 - 500K on a software package for a reasonably small or specialised system. However, think about how you would treat a quotation of the same amount for a custom built solution. Whilst the bespoke solution would invariably be of a higher quality (less bug fixing) and designed to meet your need (not retro-fitted), there can be a severe lack of trust in handing over a fee that size to the small or medium size business owner. The shrink-wrapped version always seems more credible. Don’t forget to have IT maintenance included in your agency’s annual budget, not just the annual vendor fee, but the internal support costs as well. As for contracts, don’t hesitate to get your agencys’ legal representative and CIO involved. In IT terms, there is no such thing as a “standard” contract and they do vary wildly between vendors. Be prepared to have your legal representative negotiate directly with the vendor on any points that are of concern. If the contract needs to be modified to suit

your site, but the vendor is not willing to bend, it will most likely be an unhappy marriage that results from any union of this type. In other words, look elsewhere!

Getting Something for Nothing From time to time, you may feel very privileged to be offered a shiny, brand-new software system for free. This is likely to be an untested system, with a vendor or developer looking for a “live” healthcare site in which to test and refine the workings and functionality of the software. In these situations, yes, the software is free, but there is always a cost to the agency. That is not to say it’s a bad idea, but you must know what you are getting yourself, your IT team and your users into. The development team for the new software will need either on-site or off-site access (or both) to their system, in order to carry out testing and bug fixing. There will also be healthcare agency resources needed to contribute time and energy to the new system. For example, a dedicated project manager, a system administrator, as well as clinical and administrative users to participate in testing, will be required. Even on a part-time basis, this will put a strain on the normal healthcare activities. Also, you will not be able to “go-live” with the new system until you can be certain it is secure and robust enough, so your resources will be well and truly spending time outside of their designated duties. However, being part of a new development can be exciting and rewarding, particularly if it is a ground-breaking design and will make a real difference to your healthcare operations, so keep an eye out for those special gems that may come your way!

Introducing HealthLink’s Partner Systems

HealthLink focuses on integration with its partners’ systems and works together with them to implement and test new communications services. HealthLink’s key concern is ensuring that HealthLink enabled systems are both easy to use and 100% reliable. HealthLink believes that compromising service quality is not acceptable in today’s healthcare environment.

Tel 1800 125 036 enquiries@healthlink.net

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FEATURE Dr Paul Mara MBBS, FRACGP, FACRRM, DRACOG, is a rural doctor practising in Gundagai, NSW.

Digital lifestyle or digital nightmare? The past five years has seen a rapid convergence of television, video and computer technology. While new technology generally delivers benefits, it can also bring complexity. Purchasing and setting up new computers or other electronic equipment can be a nightmare for the uninitiated with a multitude of cables, plugs and sockets. Recently I purchased a new high definition television for the surgery. Our aim was to use if for teaching purposes. I wanted to be able to play videos and attach it to a computer for presentations and viewing online media.

Television and CONNECTIVITY Standards When I connected my new digital TV to a DVD/Personal Video Recorder (PVR) confusion reigned. It should be quite simple really — plug a cable into the video input on the TV and connect this to the video output on the DVD unit. But on the back of both devices was a range of plugs with various names, including Composite, S-Video (Separate/Super Video), Component, VGA (Video Graphics Array), and HDMI (High Definition Multimedia Interface). What I didn’t know was that most of these ports were for legacy reasons and by connecting the familiar red, white and yellow cables for audio and video, I was actually selling myself short. A few days later, my son showed me the HDMI ports present on both the TV and DVD player and I was persuaded that using this interface would yield better results. HDMI is a digital interface that carries both audio and video signals down

a single cable. In addition to reducing “cable clutter”, the improvement in picture quality was amazing. Having connected the DVD player, the next step was to connect a computer to facilitate the playback of other material, such as presentations or multimedia sourced from the Internet. Here, connectivity standards continue to change rapidly. Whereas previously, computers were typically connected to a monitor using a VGA cable, this connectivity option was later augmented with DVI (Digital Video Interface) technology. In the absence of a HDMI port on your computer, it would be typical to use the computer’s DVI port to connect to a modern television using a DVI to HDMI cable. Other combinations are achievable using a range of adapters, however attempting to make an “all digital” connection is advisable to preserve video quality. Progress does not appear to have stopped with the HDMI format. DisplayPort, a new standard that is starting to gain traction in the computer market may soon be adopted in the audio-visual segment also. As with HDMI, the interface is designed to carry both audio and video signals, however DisplayPort is also capable of carrying other data, facilitating USB connectivity.

Networking So now we have our digital TV connected to a DVD player and a computer. Strictly speaking we didn’t need to involve the DVD player as most computers can fill this role, but such

Below - Audio-visual cables shown in increasing quality from left to right 1. A yellow composite video cable, pictured with red and white stereo audio cables. 2. A separate/super video (S-Video) cable 3. Component video cables. 4. High Definition Multimedia Interface (HDMI) cable. Both sound and video signals are transmitted digitally over HDMI cables, reducing cable clutter and providing optimal image quality.

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devices are inexpensive and provide added convenience. The next step was to facilitate streaming of video and music, either to or from the new setup. Such an arrangement allows the user of any computer in the practice to view presentations or listen to music or audio presentations such as educational podcasts. I use Apple iTunes to categorise, store and stream most digital media, a process that works well even when connecting a laptop to the wireless segment of our network. The open source and cross platform VLC media player software is also useful for playing video formats that iTunes has difficulty with. A range of simple networking and communications technologies are now available. Most computers come standard with an Ethernet port for use with a cabled network, and almost all portable devices additionally include wireless networking capabilities. While wireless network performance has steadily improved, from 11Mbps (802.11b) to 54Mbps (802.11g) to over 300Mbps (802.11n), these speed ratings are theoretical maximums and not sufficient in practice for carrying the more network‑intensive flavours of high definition video which you may start to encounter, both at home and in the practice. It is preferable therefore, to use Ethernet to connect a “media server” to your network if at all possible. Another networking option exists for home environments called Ethernet over Power (EoP). As the name implies, the network is created using the cables that carry the power supply through the walls of the building. While EoP networks are theoretically less secure than wireless networks due to the fact that anyone can gain access to your network by simply

plugging a compatible device into a nearby powerpoint, the technology is ideal for large homes where a single wireless access point does not provide sufficient coverage, and where retrospectively laying Ethernet cable through the home is not a desirable option. Creating an EoP network is relatively straight forward. After purchasing two or more EoP adapters, one is plugged in to a powerpoint adjacent to the home’s Internet router with the devices connected with a short Ethernet cable, and the second is plugged into a powerpoint next to the computer to be “cabled” to the network, again, with the devices connected using a short Ethernet cable. As with wireless networks, the performance of an EoP network will vary depending on a range of factors, however I have found them to outperform wireless networks for the purpose of streaming video across a network, regardless of the theoretical maximum speeds of both technologies.

Putting it all together Having now been through the process of setting up TV‑connected media servers in both my practice and home, I am surprised at how seamless this arrangement has become. In my practice, I now have an iTunes library with movies and other educational videos networked to a television in our resource centre, and also to a stereo sound system for the playback of easy listening music in the practice waiting room. All of these technologies can be remotely controlled through my iPhone using free software from the iPhone Apps store called “Remote”. But that’s another story.

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ArgusConnect 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 non-aligned, not-forprofit 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.

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 nearly 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.

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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AMA

P: 02 6270 5400 F: 02 6270 5499 E: ama@ama.com.au W: www.ama.com.au The Australian Medical Association (AMA) is an independent organisation which represents more than 27,000 doctors, whether salaried or in private practice, whether general practitioners, specialists, teachers and researchers, or doctors in training. The AMA exists to: • promote and advance ethical behaviour by the medical profession and protect the integrity and independence of the doctor/patient relationship; • promote and advance the public health; • protect the academic, professional and economic independence and the well being of medical practitioners; and • preserve and protect the political, legal and industrial interests of medical practitioners.

Best Practice

P: 07 4155 8800 F: 07 4153 2093 E: sales@bpsoftware.com.au W: www.bpsoftware.com.au Contents: 7 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)

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

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Emerging Health Solutions

P: 02 8853 4700 CMY F: 02 9659 9366 E: Arthur.Harris@emerging.com.au K W: www.emerginghealthsolutions. com.au

DIRECT CONTROL

P: 1300 557 550 F: +61 7 5478 5520 E: support@directcontrol.com.au W: www.directcontrol.com.au Contents: 9 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. Direct CONTROL lets you get on with earning a living doing what you enjoy most … patient care.

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. Emerging has four teams: Application Development, Network Security and IT Infrastructure C Management, Helpdesk & Support and Management Services. M Emerging’s core clients include Y St. Vincent’s, Mater Health service, and the South Australian CM Government Department of Health. MY

P: 02 8883 4425 F: 02 8883 4426 E: info@docstock.com.au W: www.docstock.com.au DocStock is an exclusively-online store retailing quality medical equipment to Australian doctors. As a quality medical equipment supplier, we offer you the following benefits: • Known and reliable brand names • Safe and secure payment methods • Easy access to full product information and pricing • Efficient order turn-around and delivery times • AND ALL AT DISCOUNTED PRICES!

“Innovative Data Storage”

FILE PTY LTD

P: 1300 306 407 F: 02 9317 0999 E: info@file.com.au W: www.filegroup.com.au The FILE GROUP offers a comprehensive suite of records storage and management services: • FILE Pty Limited specialises in open-shelf offsite storage and management of records. • FILE Technology Pty Ltd supplies a turnkey RFID tracking system for the movement of records, assets and people. • FILEVault offers a comprehensive on-line backup service using 448 bit military strength encrypted technology for desktops, laptops and servers. FILE Logos - 42mm.pdf 25/07/2008

CMY

Equipoise International

Equipoise International Pty Ltd (EQI) is the developer and supplier of the ‘Totalcare’ clinical health and management information system. Used by health care facilities across Australia, clients include GP’s, specialist practices, day surgery facilities and hospitals. A fully integrated suite of software modules, Totalcare has been developed in close working relationships with clinical specialists, healthcare administrators and hospitals and has been designed to suit and follow the particular needs and processes of healthcare providers. Totalcare is a complete clinical, front office, financial & management solution designed to give you everything you need to run your specialist practice, day surgery and hospital.

GENIE solutions

P: 07 3870 4085 F: 07 3870 4462 E: info@geniesolutions.com.au W: www.geniesolutions.com.au Contents: 11 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 1400 sites, it is now the number one choice of Australian specialists. 12:55:38 PM

The availability of these services makes the FILE GROUP the partner of choice for forward looking organisations desirous of achieving the best possible outcome in records storage and “Innovative Document Management” management. Sydney - Brisbane - Melbourne - Perth “Innovative RFID Tracking”

P: 07 3252 2425 F: 07 3252 2410 E: sales@totalcare.net.au W: www.totalcare.net.au

DOCSTOCK

“Innovative RFID Tracking”

“Innovative Data Storage”

FILE VAULT

P: 1300 306 407 F: 02 9317 0999 E: info@file.com.au W: www.filevault.com.au Secure Backup: Protection for your priceless medical data What can you do to protect your irreplaceable medical data and more? FILE Vault Secure Backup offers a best-in-class security to backup your valuable data files continuously on-line. • Automatically back up your medical data, administration records and more. • Protects files against hard drive crashes, fire, theft and even accidental deletion. • Multiple layers of security are used to ensure your files are protected during online backups. • Easy to use Sydney - Brisbane - Melbourne - Perth

GLOBAL HEALTH

P: 03 9675 0600 F: 03 9675 0699 E: sales@global-health.com W: www.global-health.com Global Health is a premier provider of technology software solutions that connect clinicians and consumers across the healthcare industry. ReferralNet takes advantage of email and the internet to provide a practical and secure infrastructure for delivering healthcare information efficiently to industry professionals. 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.

PULSE + IT

HEALTH SOLVE Health Communication Network - HCN P: 02 9906 6633 F: 02 9906 8910 E: hcn@hcn.com.au W: www.hcn.com.au Contents: 15, 23, 29, 39

GPA

P: 1800 188 088 F: 1800 644 807 E: info@gpa.net.au W: www.gpa.net.au Contents: 21 GPA ACCREDITATION plus has given general practices a reliable alternative in accreditation. GPA is committed to offering a flexible accreditation program that understands the needs of busy GPs and practice staff. GPA assigns all practices an individual quality accreditation manager to support practices with their accreditation. Choose GPA for more support, improved service and greater choice.

Health Communication Network (HCN) is the leading provider of clinical and practice management software for Australian GPs and Specialists. HCN supplies Australia’s major hospitals with online Knowledge resources. HCN employs the industry’s largest software and customer services teams, dedicated to delivering new and enhanced products for Australia’s health care sector.

PULSE + IT

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.

HIMAA

P: 02 9887 5001 F: 02 9887 5895 E: himaa@himaa.org.au W: www.himaa.org.au Contents: 31 The Health Information Management Association of Australia (HIMAA) is the peak professional body of Health Information Managers in Australia.

P: 1800 125 036 F: 07 3870 7768 E: enquiries@healthlink.net W: www.healthlink.net Contents: 43, 52 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.

P: 03 9388 0555 F: 03 9388 2086 E: hisa@hisa.org.au W: www.hisa.org.au Contents: 2-3, 27 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.

P: 1800 420 066 or +61 2 9669 1844 F: +61 2 9669 1791 E: houston@houstonmedical.net W: www.houstonmedical.net Contents: 37

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

HEALTHLINK

HISA

Houston Medical

Market snapshot:

GPComplete

GPComplete is the first software explicitly geared to reducing the time taken to perform common tasks in your practice, and has been shown to increase workflow by as much as 50%. It combines electronic health records, practice management and Medicare Australia Online functionality, all built on a single, open source database.

HealthSolve provides solutions across the continuum of care with solutions for all sectors.

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

Visit our website to learn more about our complete offering which includes MDPlus advanced tools, GPRN data and iRIS for radiology practices.

P: 1300 794 471 F: 07 5569 2648 E: sales@gpcomplete.com.au W: www.gpcomplete.com.au

P: 1800 803 118 F: 08 8203 0595 E: info@healthsolve.com.au W: www.healthsolve.com.au

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.

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!

INTERSYSTEMS

NEHTA

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 organizations 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.

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.

P: 02 9380 7111 F: 02 9380 7121 E: anz.query@intersystems.com W: www.InterSystems.com Contents: 13

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.

P: 02 8298 2600 F: 02 8298 2666 E: admin@nehta.gov.au W: www.nehta.gov.au Contents: 2-3

JABBAWOKI

P: 1300 667 685 F: 02 9211 0640 E: info@jabbawoki.com W: www.jabbawoki.com Hosting - IT Support - Programming Customised medical solutions. Our goal is not to meet customers expectations, but to exceed them. WE SOLVE PROBLEMS

JOSE & Associates IT/IM ConsultaNTS P: 03 9850 1350 F: 1300 889 012 E: news@jose.com.au W: www.jose.com.au

iSOFT

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

Medical-Objects

P: 07 5456 6000 F: 07 3221 0220 E: info@medical-objects.com.au W: www.medical-objects.com.au Medical-Objects are a software company with a vision of a tightly connected integrated health platform. Built on open standards and strong architectural solutions, Medical-Objects provides rich messaging between all sectors of the health sector and tools that build on that messaging such as Clinical Tools for Specialists and Hospitals, Decision Support and Executable forms of Clinical Guidelines. Medical-Objects is committed to agile software methods to deliver the highest of IT standards. Belief in the exclusive use of standards based messaging has developed our expertise and profile in standards implementation in Australia, and enables interoperability with most common clinical software including desktop and hospital systems.

JOSE and Associates are IT/IM Consultants working exclusively with General Medical Practices and other allied health organisations. Service Model Outcomes: • Satisfying IT Accreditation Standards. • Network standards protocols are used to ensure optimum uptime of network. • Total ownership of all IT related problems (from Clinical s/w updates to a faulty mouse) • Disaster Recovery and Business Continuity plans and monthly reviews and test restores. • The entire IT/IM business infrastructure is documented and updated monthly (similar to a patient record). • Support is available 24/7 and the response in most cases is immediate. Most scheduled work is completed after the practice is closed. • Server Maintenance on a monthly basis which includes full monthly reporting. • Initial consultations are complementary until a detailed road map is established. • References available on request.

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

To cope with the demands of practicing 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 being up-to-the-minute 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.

NTS Transcription Services

P: 1300 305 998 F: 03 5722 9388 E: info@ntstranscriptions.com W: www.ntstranscriptions.com NTS provides the very latest in secure Digital Dictation and Transcription systems and couples this technology to deliver highly accurate transcriptions within 24 hours. NTS’s technology allows you to link with your Practice management systems including, but not limited to, Direct Control, Genie, Shexie, CCOS, Blue Chip, Practix, Medical Director, Profile, Zedmed, Medical-Objects, Argus and Healthlink. With 98.5% accuracy and 24hr turnaround, our service will ensure your patient's letters arrive at their GP’s and other interested parties, sooner. Our fully secure web based systems allow Drs to dictate via hand held recorders, telephone, PDA’s or direct from the PC. We accept voice files from many of the large dictation platforms. Letters can be viewed, edited and printed from any web connected PC and filed back to your own systems patient files. An electronic copy can also be sent to the GP through our HL7 delivery system or via third party systems like Medical Objects. NTS will tailor the service and system to your current practice processes and requirements without compromising security and confidentiality. We are the leaders in our Field.

PULSE + IT

Pulse+ IT PULSE 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 C management) and PDF Converter Professional (PDF creation andM conversion).

P: 0402 149 859 F: 02 9475 0029 E: info@pulsemagazine.com.au W: www.pulsemagazine.com.au

THE SPECIALIST

Pulse Magazine is the publisher of Pulse+IT, Australia’s first and only Health IT magazine.

“The Specialist” is an intuitive and truly sophisticated tool that allows management of patients within:

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

• specialist medical practices • private hospitals • day surgeries.

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 SR highest Logo_65x42mm.pdf as Australia’s circulating health publication of any kind.

P: 1800 803 118 E: info@healthsolve.com.au W: www.clintelsystems.com

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

20/02/09

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.

14:50:20

Current installations range from single stand-alone computers to networks connected to either Macintosh™ or Windows™ file servers. The Specialist is industry standard, and readily interoperable with other systems.

Zedmed

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

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

PULSE + IT

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

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

STAT HEALTH SYSTEMS

CMY

SMARTROOMS By DOCTORWARE

P: 03 9499 4622 F: 03 94991397 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).

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 AAPM 2009 Australian Association of Practice Managers National Conference will be hosted by AAPM Victoria. As October 2009 draws near, the Victorian conference committee is excited to be playing host to the AAPM National conference ‘The Edge of Practice Management.’ With a state-of-the-art facility, the new Melbourne Convention Centre is in the heart of Melbourne on the banks of the Yarra. This exciting venue will take our conference on to a new level of technology and event facilitation. The conference committee took a ‘hard hat’ tour of the facility in January and were amazed by the attention to detail; it combines the features of all the best conference centres from around the world. Our dedicated conference committee is working alongside our conference partners, Conference Design to bring an exciting program and opportunities to make an experience for the entire healthcare practice management sector. It is with great pleasure that on behalf of the conference committee, I invite you to take part in AAPM 2009: The Edge of Practice Management. Linda Osman Conference Convenor

David & da, Penny, Brett, ce Committee Lin en er nf hren. Co : Mo ht nk rig Left to director Fra EC with operations MC w ne e th g in Lis tour

Invited Speakers include: Ms Amanda Gore Mr Jeff Kennett Mr Alan Pease Mr Simon Thiessen

Mr Steve Herzberg Ms Angela Mason Leh Simonelli Ms Sue Watt

Please check the website for topics and additional speakers. Conference Design Pty Ltd 228 Liverpool St Hobart Tasmania 7000 w: www.cdesign.com.au e: info@cdesign.com.au p: 03 6231 2999 f: 03 6231 1522

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