Australia’s First and Only Health IT Magazine
PULSE IT
Issue
November
20 2010
E-health Infrastructure E-health governance: Lack of ownership is the real impediment to e-health progress in Australia. Small initiatives can deliver large benefits: Targeted projects shouldn’t be delayed while Australia pursues national e-health reform. Are you ready for Australia’s e-health revolution? The Medical Software Industry Association overviews the status of Australia’s e-health foundations. National E-Health Transition Authority update: CEO Peter Fleming provides an update on NEHTA’s current activities. Lead implementation sites: Three have been announced with impending tenders for additional e-health rollouts. Healthcare Identifiers: Who can do what with the new patient identification system?
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14 16 17 18 20 22 23
RACGP releases updated GP standards Genie integrates voice recognition NEHTA and MSIA release joint statement Minnow Snomed CT browser launched Panasonic upgrades Toughbook MCA HealthLink and HCN extend networks HL7 Australia to host international meeting
Want to know more about e-health? Whether you are a consumer, healthcare manager, healthcare provider or vendor, you need a central location to quickly find and access e-health information.
Welcome to:
www.ehealthinfo.gov.au Your gateway to the emerging world of modern healthcare. Discover how information technology is delivering a more reliable and efficient health system. Featuring: • The Healthcare Identifiers (HI) Service which commenced operations on 1 July 2010. Access fact sheets for individuals, healthcare providers, healthcare organisations, and medical software vendors • How e-health systems are being designed to maximize security and privacy • Why a national certification capability is an essential foundation for safe, secure and interoperable e-health solutions in Australia • The latest Federal, State and Territory government e-health initiatives • The delivery of a standard clinical language for use across Australia’s e-health implementations and how it is a significant step towards improving the quality and safety of healthcare
www.ehealthinfo.gov.au is jointly brought to you by Australia’s Federal, State and Territory health authorities and the National E-Health Transition Authority (NEHTA) to help you explore the e-health concept and stay in touch with the latest innovations as they unfold.
National E-Health Transition Authority www.nehta.gov.au
“Working for NEHTA gives you an opportunity to see eHealth through to fruition and really make it happen.” Sandy Mills Terminology Lead (Clinical)
Leading the progression of e-health in Australia Join the NEHTA team The National E-Health Transition Authority (NEHTA) was established by the Australian Commonwealth, State and Territory governments on 5 July 2005 to develop better ways of electronically collecting and securely exchanging health information. NEHTA is the lead organisation supporting the national vision for e-health in Australia.
See how NEHTA’s work is helping to enable a better health system and support the Government’s goal of personally controlled electronic health records for all Australians. Go to: www.nehta.gov.au
Use your health, informatics, analytical, project or architecture skills and join the NEHTA team who are making e–health a reality in Australia.
For up to date information on current opportunities see: www.nehta.gov.au “The speed at which medical service is provided will be
faster.
Better information means there is less chance of things going wrong.” Devendra Maisnam Business Analyst, Information Modeller
“ You’ve got to be
open-minded, be able to express your ideas and not be closed to other thoughts.”
Phil Wilford Integration Manager- Reference Platform
NEHTA is an Equal Opportunity Employer. Only people with the right to work in Australia may apply for these positions.
Enquiries and applications can be directed to: careers@nehta.gov.au
PULSE IT +
Publisher Pulse Magazine PO Box 7194 Yarralumla ACT 2600 Australia ABN: 19 923 710 562 www.pulseitmagazine.com.au
Editor Simon James Australia: +61 2 8006 5185 New Zealand: +64 9 889 3185 simon.james@pulseitmagazine.com.au
Pages 8, 28, 32, 34, 38 E-HEALTH INFRASTRUCTURE This edition of Pulse+IT includes a guest editorial, two organisational contributions and two feature articles relating to e-health infrastructure.
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About Pulse+IT Pulse+IT is Australia’s first and only Health IT magazine. With an international distribution exceeding 37,000 copies, it is also one of the higest circulating health publications in Australasia. 32,000 copies of Pulse+IT are distributed to GPs, specialists, practice managers and the IT professionals that support them. In addition, over 5,000 copies of Pulse+IT are distributed to health information managers, health informaticians, and IT decision makers in hospitals, day surgeries and aged care facilities.
ISSN: 1835-1522
Looking ahead The next three editions of Pulse+IT will feature a selection of articles covering the following themes: • March 2011 - Electronic Prescribing • May 2011 - Mobility • July 2011 - Medical Devices Pulse+IT welcomes feature articles and guest editorial submissions relating to these themes, as well as articles relating to e-health more broadly. Submission guidelines and deadlines are available online: http://www.pulseitmagazine.com.au/editorial
Contributors Peter Brown, Peter Fleming, Simon James, Ahmad Jubbawey, Bridget Kirkham, Dr Chris Van Leuvan, Dr Geoffrey Sayer, Jennifer Tetstall, Mark Worsman.
Disclaimer The views contained herein are not necessarily the views of Pulse Magazine or its staff. The content of any advertising or promotional material contained herein is not endorsed by the publisher. While care has been taken in the preparation of this magazine, the publisher cannot be held responsible for the accuracy of the information herein, or any consequences arising from it. Pulse Magazine has no affiliation with any organisation, including, but not limited to Health Services Australia, Sony, Health Scope, UBM Medica, the New Zealand College of General Practitioners, or the Kimberley Aboriginal Medical Services Council, all who produce publications that include the word “Pulse” in their titles.
Copyright 2010 Pulse Magazine No part of this publication may be reproduced, stored electronically or transmitted in any form by any means without the prior written permission of the Publisher.
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Page 8 E-HEALTH GOVERNANCE
Page 34 LEAD IMPLEMENTATION SITES
Page 38 HEALTHCARE IDENTIFIERS
Editorials
Features
News
Page 6 STARTUP Editor Simon James introduces the 20th edition of Pulse+IT.
Page 34 FEATURE ARTICLE With their project plans now submitted to Government, Simon James overviews the Lead Implementation Sites.
Page 14 RACGP expands e-health focus in new Standards for general practice
Page 38 FEATURE ARTICLE Mark Worsman and Jennifer Tetstall ask: “Who can do what with healthcare identifiers?”
Page 16 Genie Solutions releases integrated MedSpeech voice recognition
Page 8 GUEST EDITORIAL Peter Brown discusses the urgent need for improved e-health governance structures in Australia. Page 12 GUEST EDITORIAL Dr Chris Van Leuvan suggests that targeted, small scale e-health projects shouldn’t be overlooked while the development of national e-health systems continues. Page 28 MSIA Bridget Kirkham and Dr Geoffrey Sayer from the Medical Software Industry Association outline the outstanding work that needs to be completed to facilitate “Australia’s e-health revolution”. Page 32 NEHTA Peter Fleming provides an update on the National E-Health Transition Authorities’ implementation approach, Personally Controlled Electronic Health Records, and the Lead Implementation Sites.
Off Topic Page 40 MOBILE HEALTH Ahmad Jubbawey showcases some of the benefits interacting with patients via mobile phone text messages can deliver.
Resources Page 27 EVENTS CALENDAR Up and coming Health IT, Health, and IT events. Page 44 MARKET PLACE The Pulse+IT Directory profiles Australasia’s most innovative and influential e-health organisations.
Medicare releases electronic claiming usage statistics
Page 17 NEHTA and MSIA release joint statement to the software industry Page 18 Free Snomed CT browser launched Nuance releases Dragon Dictate for Mac Page 20 Panasonic updates its Mobile Clinical Assistant, drops price Page 21 Alphastudy acknowledged with NSW Health Award Page 22 HCN and HealthLink collaborate to extend secure messaging network Page 23 HL7 Australia to host international working group meeting in Sydney
EDITORIAL
Pulse+IT: 2010.5 Simon James
BIT, BComm Editor, Pulse+IT Phone (AU): +61 2 8006 5185 Phone (NZ): +64 9 889 3185 simon.james@pulseitmagazine.com.au
Welcome to the 20th edition of Pulse+IT, Australia’s
challenges associated with increasing the frequency
first and only Health IT magazine.
and timeliness of our Health IT reporting via both our
This edition features guest editorials by Peter
new and refreshed online channels. As with Pulse+IT’s
Brown, who overviews Australia’s e-health governance
print editions, our focus online will be the release
arrangements, and Dr Chris Van Leuvan, who highlights
of original stories, produced within the credible
one example of a small e-health project delivering large
independent publishing framework afforded to us by
benefits in both acute and primary care settings.
our diversified subscription and advertising revenue
support base.
This edition’s Bits & Bytes news section includes
articles on the revised RACGP standards, Panasonic’s updated Mobile Clinical Assistant, Snomed CT, a secure
Readership Survey
messaging collaboration between HCN and HealthLink,
In addition to ramping up our online offerings, the
as well as a range of other timely e-health stories.
Pulse+IT team are going to use the Summer months to
As the edition theme, a range of articles focus on
undertake some research into the types of articles the
the underlying national e-health infrastructure that
readership is interested in seeing in future magazines.
is being pursued in Australia, and Ahmad Jubbawey
As part of this process, this edition of Pulse+IT contains
rounds out the edition with some insights into the use
a survey on page 25, which I encourage all readers to
of mobile phone text message reminders for patient
complete. Most of the questions in the survey are
interaction in New Zealand.
simple multiple choice, and I expect that it should only
Looking ahead
Pulse+IT
or online: http://www.pulseitmagazine.com.au
As Pulse+IT does not produce a magazine during the
Christmas period, the next edition will be released
15 December have a chance to win an Apple iPad (RRP
at the start of March 2011, with subsequent editions
$629), which will be dispatched to the lucky winner in
every second month thereafter. With a focus on
time for Christmas.
electronic prescribing, the March 2011 edition will
6
take around five minutes to complete, either on paper All respondents who complete the survey before
provide an update on the state of Electronic Transfer of
Acknowledgments
Prescription (ETP) standards and the current activities
With the production of our 20th edition representing
of the vendors that will ultimately be tasked with
something of a milestone for Pulse+IT, I’d like to take
implementing these standards. A market overview
the opportunity to extend my sincere thanks to all the
of the state of ETP rollout throughout pharmacy and
individuals and organisations that have contributed to
general and specialist practice will also be provided, as
make each edition of the publication a reality. Special
will a selection of articles dealing with prescribing and
thanks must go to the six peak bodies that distribute
medication management innovations in the acute and
copies of Pulse+IT to their respective memberships,
aged care sectors.
the advertisers that make each print run a possibility,
Temporarily free from the rigours of producing a
our ever growing army of editorial contributors, and
printed edition, the run up to Christmas will provide
of course the readership for their continued interest in
us with an opportunity for a website refresh, the
local e-health activity.
resumption of our eNewsletter service, and the
soft launch of a suite of other electronic services to
articles, would like to contribute to an edition, or would
complement the bi-monthly print edition, which itself
simply like to discuss your experiences with e-health,
has a bright future ahead. We’re looking forward to the
don’t hesitate to get in touch.
As always, if you have any suggestions for future
www.pulseitmagazine.com.au
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EDITORIAL
E-health: Lack of ownership is the real impediment Peter Brown
E-health Representative Cancer Voices Australia sealane1@bigpond.net.au
It is clear that at the turn of the century Australia could
customer services and the use of information technologies
realistically claim to be a world leader in the field of
in the health sector. Collaboration also involves entering
e-health. It is equally clear that this is no longer the
into
case, but it is also apparent that no other country — in
particular, the level of participation and ‘ownership’ will
spite of vast levels of investment — is yet to overcome
be threatened without the specific involvement of:
the barriers to meeting their prescribed targets.
• Health consumers and consumer organisations;
• Health care providers and professional health
A national e-health network is akin to establishing
a business. The report of the House of Representatives Committee titled “Health Online,”1 which reported
Author Info
In
(both government and non‑government); States and Territories, and local government); and • The private sector.
Online” in September, 2001.
The first and second edition of this report laid out a
mechanisms that will facilitate collaboration between
governance concept for an e-health network as a piece
the Commonwealth, States and Territories and other
of infrastructure to enable a vastly improved delivery of
key stakeholders in the development, uptake and
health data electronically, rather than manually, which
implementation of new information and communications
required “national collaboration” through “empowering
technologies in the health sector.”
consumers and communities for better health”.
Australian
governments
are
committed
to
It also recommended that this vital national
It continued to make clear however, that this would
project be overseen by a “National Health Information
not be a health product as such, nor would it be just an
Management Advisory Council” (NHIMAC), having
application of information technology.
community inclusion as previously stipulated.
This part of the report headed “Achieving
This challenging proposal has been followed
National Collaboration” was preceded by a dictum,
by endorsing recommendations by eminent global
“Collaboration is essential to success”, by Michael Reid,
consultants, Boston Consulting3, Deloitte4 and Booz &
the then Director General, NSW Health (now Director
Company5.
General of QLD Health).
It went on to advise:
adopted by the Australian Health Ministers’ Advisory
However, whilst the Deloitte report has been
“National collaboration is predicated on the
Council (AHMAC), these critical recommendations
desirability of pursuing a coherent and consistent
about governance and ownership have not yet been
approach to the development of information activities,
implemented.
Peter Brown is an executive member of Cancer Voices NSW and has been seconded to Cancer Voices Australia to engage in national e-health issues. His working life as an executive in freight forwarding included an extensive term as an industry ‘consumer’ representative and Deputy Chair of Tradegate, the community body conceived by customs Australia to overcome the interoperability issues then confronting the introduction of Electronic Data Interchange (EDI) into the complex import/export industry. He sees EDI networking in the health sector as presenting the same governance issues that was holding up progress of data exchanges in his earlier experience.
Pulse+IT
stakeholders.
• The different tiers of government (the Commonwealth,
8
with
organisations;
recommendation and produced “A Health Information Plan for Australia”2 report as the 2nd Edition of “Health
partnerships
• Organisations with an interest in privacy matters
in October 1997, recommended that such a course be followed. An expert committee endorsed this
effective
Deloitte
qualified
their
many
detailed
recommendations with the following admonition:
“It
is
unlikely
that
any
of
the
above
[recommendations] will be achieved unless under-pinned by a governance regime that enables strong coordination and management of national e-health program activities and outcomes.”
The Booz & Company report contains similar
advice.
A major issue associated with this extraordinary
www.pulseitmagazine.com.au
adoption of “recommendation blockage” seems
to
arise
from
a
common
misunderstanding of the actual e-health
each of them jointly having a seat at
that which applies to any other business.
the detail decision-making tables.
It is apparent that e-health planning in
• This would enable their needs to
networking business and the organisational
be
component of the delivery of health
progressively, with any (inevitable)
services that it is intended to enable.
mistakes made to be corrected quickly,
with a full understanding of the
This misunderstanding was picked up
in the recent National Health & Hospitals Reform Commission report6, which stated:
identified
and
incorporated
requirements of other players. • It also assembles a range of all relevant
Outline of Australian National E‑health System structure On 20 November 2009, the Department
competencies
practical
of Health and Ageing (DoHA) and NEHTA
all other industries e.g. banks, in the
advisory body. This would also create
held a stakeholder ‘Update Forum’ in
introduction of its eHealth IT functions.”
a
Canberra. Arising from the input provided
Wrong!
participatory
collaboration.
development of the proposed e-health
This assessment is now common, with
of
a
owner to provide system wide direction.
“Health is the same but lagging behind
situation
within
Australia currently has no responsible
community‑wide teamwork
and
at this meeting, it was revealed that the
this same repetitive exclamation as with
These suggestions would give due
record system in this country, as is now
the unheeded warnings about the ‘break of
recognition to the sound advice given in
proceeding, will continue to be overseen
rail gauge’ and the priority of standards.
2001 by NHIMAC, and not since disputed.
by a partnership between DoHA, NEHTA,
Disagreement with this generally held
AHMAC, and State jurisdictions, as outlined
terms:
E-health implementation: Where do we go from here?
• It arises because the health industry
The Deloitte plan was adopted by AHMAC
as a “private company”, not answerable
varies from most other industries in
but its implementation has not been
to the Federal Government. While ASIC
at least one significant and pertinent
preceded by its insightful and oft repeated
documents refute this characterisation
aspect.
view can be explained in the following
in Figure 1.
NEHTA has recently been described
recommendation to adopt collaborative
of its corporate structure — NEHTA is a
• Whilst most other industries operate
governance, without which, e-health will
Public Company, limited by guarantee —
their daily business on a ‘one-to-many’
remain a project without ownership or
the latter point is true. But the question
basis, health is one of the few that
success. Experience to date, both here and
remains, what is its corporate position?
operate in a ‘many-to-many’ situation.
globally, would seem to verify this.
This is because there is no one player,
Arising out of his wide ranging overseas
the then Director, Clinical Communications,
or small coterie, which dominates a
studies7, Dr Mukesh Haikerwal, NEHTA’s
DoHA eHealth Branch (now Director,
significant part of this very complex
National Clinical Lead, has only been able
eHealth
industry.
to confirm one system wide success story;
and Governance section), described the
Lombardy, a province in Northern Italy. It
e-health business thus:
oversight management of the network
adopted collaborative governance.
needs to provide coverage on an
health service delivery, not an end in
inclusive industry-wide basis.
But
• This means that as a consequence, the
Nominally AHMAC is the local owner. my
interpretation
of
AHMAC’s
In September 2008, Dr Chris Mount,
Systems
Branch,
Framework
“E-health is an enabler of improved
itself.”8
• This would conglomerate all of the
controlling structure relevant to e-health
component sectors and operate with
indicates that this cannot be, as it is unlike
needs to be operated like an infrastructure
E-health implementation, in reality,
Figure 1 - AHMAC’s e-health Confederacy
AHMAC State Jurisdictions
DoHA NEHTA www.pulseitmagazine.com.au
Pulse+IT
9
business, but with accommodation for
our hospitals still do not have effective
targets.
its many-to-many features, as previously
communication about patients between
enunciated.
sectors and functions within the same
United GP Association (UGPA) meeting
hospital.
with DoHA, apparently with a collaboration
agenda, and of NEHTA and the Medical
Many in the community envisage
NEHTA
as
having
ownership
This is not peculiar to the hospital
It is heartening to learn of a recent
responsibilities. In effect, NEHTA is a
sector. GPs who were equipped with
Software
subsidiary funded 50% each by DoHA and
computers some years ago, at the
down at the same table. Hopefully such
Industry
Association
sitting
the State Health Jurisdictions, who are the
behest of the Federal Government are
engagement will become more embracing
members of the unincorporated AHMAC.
today frustrated because there is still no
of the wider community interest.
NEHTA’s role is as a provider of IT technical
organised electronic linkage to the many
and standards advice to its financing
other service providers with whom they
all chronic conditions at both Federal and
stakeholders who are the public health
provide vital primary health care teams.
State levels are recognising that whilst
service delivery agencies, and in a vicarious
But let us be cognisant that when the
concentration on their existing issues must
way, to those throughout the community
missing linkage finally is addressed, the
continue unabated, e-health needs are
who are mainly engaged in primary health
sorry tale of historical rail gauge neglect
common to all. These are best advanced
care.
could be repeated. As is the case now,
by collaborating with other sector interests
Consumer representative bodies for
Governance has long been seen as the
we will have a multiplicity of software
and the various government agencies
overriding issue by all advisory groups,
and other technical services installed
involved within a consolidated format.
apparently without demur.
and it will be very expensive to achieve
interoperability as with rail gauges.
initiatives will be successful in creating
been given ownership or responsibility
The principles of data linkage are
inclusive collaboration and be successful in
for
key. They were very well set out within
breaking through the blockages to e-health
complex product in the way that was
the
implementation.
clearly recommended by the Health Online
Infrastructure Strategy in their various
Reports 1997-2001.
issues papers throughout 2007-2008.9
References
1. Health Online. Report into health
However as yet, no single body has national
implementation
of
this
Despite an energetic and expensive
National
Collaborative
Research
This quality work states the keys
search, AHMAC has not been able to locate
to practical e-health implementation.
a consultant to dispute this sound advice.
Foremost will be the systemic ownership
and established standards at all levels.
—
Clinicians, IT vendors and consumers the
engine
room
of
e-health
Hopefully
these
community-based
information management and telemedicine. 1997 2. Health Online. A Health information action plan for Australia. Second
implementation — have not at any
The next step
time had any direct involvement in the
It is clear that inclusive community
Management Advisory Council.
recommended implementation program.
collaboration is widely supported. The
September 2001. ISBN 0 643 73574 3
3. NEHTA Review. 25/10/2007. The Boston
Edition. National Health Information
One disastrous consequence of this, in
barriers to reasonable progress can surely
spite of continuous acknowledgement of
be significantly attributed to a failure
the need for national standards to avoid a
to implement successful collaborative
situation akin to the ‘break of rail gauge’
initiatives.
problem, is the failure to seriously address
standards at all levels in a timely and
time; seemingly their lack of success may be
Reform. 27/11/2008. Booz & Co.
encompassing fashion.
due to them being promoted and designed
6. http://www.health.gov.au/internet/
Such measures have been mooted over
Consulting Group. 4. National E-Health Strategy. 30/9/2008. Deloitte. 5. E-Health: Enabler for Australia’s Health
Consumers and many other players
top-down, on too grand a scale and thus
nhhrc/publishing.nsf/Content/nhhrc-
are greatly concerned that even now,
have become buried by complexity and
report
e-health projects, both public and private,
lack of coal face engagement with those
are proceeding as stand-alone initiatives
whose support would be vital for success.
without
universal
application
of
set
It would seem that taking advantage
7. Engaging the practitioner. Presentation to the AGPN E-health Conference 2010. 17/6/2010.
standards, without which, interoperability
of, and building upon, successful programs
8. eHealth in Australia. Presentation to
cannot be achieved. This is not just a
that were already in place has tended
the Information Technology in Aged
distant global traveller issue, as it is often
to be over ridden by a desire to achieve
Care Conference 2008. 4/9/2008.
portrayed. It is frequently the case that
ambitious long-term or unreal perfectionist
9. NCRIS - http://ncris.innovation.gov.au
10 Pulse+IT
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EDITORIAL
Small, targeted changes in hospital IT can provide disproportionately large benefits Dr Chris Van Leuvan BSc, MBBS chris.vanleuvan@gmail.com
E-health is broad with diverse meanings within the
visible. The domains of automation and changing the
spectrum of healthcare. In general, it appears to
nature of tasks are certainly worthy goals, but are time
encompass the large-scale change that is underway to
consuming and in general more appropriate for larger
facilitate both the digitisation of patient information
scale projects.
and to promote the sharing of this information for the improvement of healthcare delivery.1 There are
Case study in small change
significant efforts in private and government spheres
The Canberra Hospital, a university affiliated hospital,
to continually progress and fulfil this broad vision of
recently introduced a new system for junior doctors to
e-health. Whilst the progress for medium to long term
author electronic discharge summaries. Developed by
change rolls forward to uncertain deadlines, current
a medical software vendor, it is one component being
clinical practice has imminent needs that do not always
used by the hospital to align with the National E-health
require a large time frame or cost. Indeed, focussed
Strategy. It enables delivery of electronic discharge
and inexpensive technical solutions to common clinical
summaries to GP practice management systems
problems can provide disproportionately large short to
utilising HL7 standards in order to phase out paper
medium term benefits.
copies and automatic faxing. When the new system
Pragmatic short to medium term objectives
was initially rolled out, junior doctors viewed it simply as a new system that showed no appreciable benefit over the previous discharge summary system, although
Firstly, the application of any technology to address
clearly GPs in the Canberra region now receiving
a problem requires an element of pragmatism.
electronic discharges had gained. The question was
Appropriate expectations are imperative regarding the
then raised, how can we boost the benefit of this new
potential of technological aids. Technology can:
system more specifically for junior doctors?
1. Provide mental aids but keep the task the same;
2. Make visible the previously invisible;
understand that junior doctors represent the “clinical
3. Automate the task whilst keeping the task
glue� of the hospital, responsible for ensuring
unchanged; and 4. Change the nature of the task.
Those unfamiliar with hospital operations must
mundane tasks required to manage patients can occur. 2
As a result, they need to know: who their patients
The realm of small, targeted changes often
are, where they are, basic information about their
involves providing mental aids and making data more
current clinical state and what tasks need to happen. Previously, junior doctors routinely collected a daily
Author Info
printout of their patients’ locations and used this paper Dr Chris Van Leuvan is a Registered Medical Officer with research interests in patient safety, particularly the recognition of the deteriatoring patient. Chris has 15 years software engineering experience and advises on software solutions in the hospital environment with particular emphasis on usability.
printout to record small notes of jobs to be completed. More diligent doctors created a separate list to record relevant clinical information and jobs needing completion.
From a hospital-wide perspective, a common
pattern of work surrounding patient list and job
12 Pulse+IT
www.pulseitmagazine.com.au
management was identifiable and was
Implementing small change
with varying degrees of interest in IT
replicated on an individual basis with
Creating small IT change with large impact
projects. Recognise these tendencies early
minor variations. With this work pattern
requires four key elements:
in the project and commit to deadlines to
both recognisable and pervading the
1. Identifying high value targets;
ensure delivery.
hospital,
2. Bridging the gap between clinical
enhancing
the
organisation
of patient information within the new
medicine and IT;
Lastly, no amount of technical effort
will change a system if the users do not
electronic discharge summary system had
3. Project diligence and deadlines; and
derive a benefit. Users are exceptionally
the potential for hospital-wide benefit for
4. User uptake.
skilled at avoiding or minimising their
junior doctors.
High value targets are tasks that are
use of any system that does not help
The software vendor was open to
done frequently or require a significant
their daily work. In a worst case scenario,
improving the junior doctor experience
time to perform by a group of individuals.
they will sabotage an unhelpful or poorly
and
together
and
Our high value target was recognising
considered new approach, a topic worthy
enhancements.
that most junior doctors rely heavily on
of a separate article. In the case of a small
The software enhancements included
their patient lists to organise their day
project, ensure that the change provides
minor configuration changes and the
and many doctors duplicate data, which
sufficient benefit to stimulate acceptance
creation of custom patient lists designed
they later enter into a discharge summary
without the need for large scale training.
in conjunction with clinical advice. The
for the GP. Identification of a target is
Since our implementation, there have
improvement
implemented
we system
designed
to
best done from a clinical perspective and
been many positive comments backed by
enter clinical information in the electronic
encourages
doctors
clinicians can typically readily identify
user uptake.
discharge summary early because this
the tasks that occupy their time. Though
same information now populates their
technically skilled, IT staff typically lack
custom patient lists with relevant clinical
medical experience to identify the most
information for daily use. Junior doctors
pressing clinical problems.
Small system changes in parallel with e-health overhauls
are not entering more information than
Incremental
previously on the electronic discharge
challenge is the communication across
IT
summary, but are benefiting from this data
the gap of clinical need and technological
immediate
being entered given the information can
possibility. Its success depends upon basic
practice whilst we await the larger
populate their daily printout of patients.
understanding of the other’s domain.
infrastructure changes to e-health to
Once a target is identified, the largest
gains
improvements
from can
small
scale
provide
enhancements
to
more clinical
Empirically, data is now more visible. A
When experience bridging this gap is
be realised. The onus is on clinicians to
process that already existed was identified
lacking, asking questions from both sides
start with pragmatic aims, identify areas
and supported with the tools that were
and introducing IT people to the clinical
with the potential for improvement and
available. The task was neither automated
space will help open channels and reveal
then instigate small change. Given that
or changed, but improved the manner in
poor assumptions that might otherwise
nationwide e-health program is a project
which doctors could organise their clinical
jeopardise project success. The group
without a firm deadline, smaller short-term
information to guide their work day. By
challenge is finding a technical means
gains should be capitalised on by utilising
supporting the current work practices of
of achieving a solution that is both low
some basic principles for the improvement
doctors, the barriers perceived by junior
technical impact and exhibits excellent
of healthcare delivery today.
doctors for completing the electronic
usability to ensure uptake by the target
discharge summaries were minimised.
audience. Group IT and medical experience
References
Lastly, the junior doctors receive an
combined with a receptive software vendor
1. National E-Health Strategy 2008,
immediate benefit from their efforts.
were essential in our project.
http://www.health.gov.au/internet/
main/publishing.nsf/content/e-health_
Doctors are highly trained individuals
Small projects can often become lost
and any technical solution that places
amongst the larger or seemingly more
additional
responsibilities
important work. They may not be driven
without a personal benefit faces a high
with the same vigour by the IT department
Everyday Things, New York, 1988, pp
probability of failure.
and clinicians are typically busy individuals
193-194
data
entry
www.pulseitmagazine.com.au
strategy_toc 2. Norman, Donald, The Design of
Pulse+IT 13
BITS & BYTES Medicare releases electronic claiming usage statistics Medicare has released its annual report for
RACGP expands e-health focus in new Standards for general practice
the 2009-2010 financial year. The document
The Royal Australian College of General
make specific references to practice
contains an overview of the performance
Practitioners launched their 4th edition
software and electronic referrals.
of the various electronic claiming channels
Standards for general practice at the GP10
available to patients, including Medicare
conference in Cairns in early October.
requires that each patient attending the
Online, Medicare Easyclaim and Electronic
According to the RACGP, the process
practice has their own health record,
Claim Lodgement Information Processing
of developing the 4th edition of the
and that practices using both paper and
Service Environment (ECLIPSE).
Standards was aided by a separate
electronic health record systems indicate
e-health
The report reveals that as of the end
group
in each record where clinical notes
of June 2010, 36 of the 37 health funds
that reviewed all the standards and
are recorded to ensure entries are not
were facilitating claims using the ECLIPSE
their alignment with national e-health
overlooked. Active patient records need
system for in-patient hospital claims.
initiatives, such as patient, provider and
to include multiple pieces of demographic
organisation healthcare identifiers, and
information, including the patient’s full
combined take-up of both Medicare Online
electronic health records.
name, date of birth, gender, and contact
and Medicare Easyclaim had increased by
The working group comprised of the
details. It is understood that the accuracy
6.5% throughout the financial year, with
RACGP e-health working group members
of such details will be important when
over 90% of bulk bill services submitted by
and NEHTA clinical leads, a group of over
the Healthcare Identifier service is usable,
either one of these channels.
50 clinicians engaged by NEHTA to sell the
as such details will be needed to import
organisation’s vision for e-health to their
patient Healthcare Identifiers into clinical
Medicare Online service throughout the
colleagues and the wider community.
software. Criterion 1.7.1 also encourages
year, with Medicare Australia now holding
In a statement, NEHTA’s National
practices to record the contact details of
over three million sets of bank account
Clinical Lead Dr Mukesh Haikerwal, said
the person a patient wishes the practice to
details for consumers.
general practice is well positioned to
contact in the case of an emergency. It also
support national e-health initiatives.
instructs practices to record the details of
Online and Medicare Easyclaim, financial
their patients’ cultural backgrounds.
support was provided to medical practices
computerised healthcare systems for
and software vendors, however this support
clinical purposes and, 117.4 million GP
sets targets for the recording of allergies,
concluded for practices at the end of 2009.
consultations provided each year, GPs will
adverse drug reactions, current medicines,
Over 1200 practices received a one-off lump
be at the forefront of driving e-health in
current
sump payment of $750 (metro) or $1000
Australia. We know that GPs can provide a
past health history, health risk factors,
(rural and remote) for initiating at least one
GP Health Summary for the vast majority
immunisations, relevant family history and
electronic patient claim, however a much
of Australians and this information will
relevant social history including cultural
larger number (5000 practices) were able
form the basis of data for electronic
background. This criterion also requires
to access the 18c per transaction incentive
communication
healthcare
practices to document the “standardised
payment paid for both electronic bulk bill
providers and will be a key component
clinical terminology (such as coding) which
transactions and electronic patient claims.
for electronic health records,” said Dr
the practice team uses to enable data
Haikerwal.
collection for review of clinical practice.”
to support the development and rollout of
integrated Medicare Easyclaim solutions.
RACGP highlights criterion 1.7.1 (Patient
edition of the Standards, much of the
The report claims the “benefits of the
health records), criterion 1.7.2 (Health
computer-related technical detail practices
subsidy, which was paid in June 2009, have
summaries),
started to be felt in the past year”, however
identification)
it is understood that the bulk of this claimed growth can be attributed to HCN customers
of the document including criterion 1.5.3
security guidelines — itself recently
adopting the Tyro solution, which existed
(System for follow up of tests and results)
updated — has been released as an
prior to the announcement of the subsidy.
and criterion 1.6.2 (Referral documents)
accompaniment to the Standards.
Within practices, Medicare announced
More than 11,000 practices utilised a
To incentivise uptake of both Medicare
Over six million dollars was allocated
standards
working
Criterion 1.7.1 (Patient health records)
“With over 98 percent of GPs using
between
In the preface to the Standards, the
criterion
Criterion 1.7.2 (Health summaries)
health
problems,
relevant
As was the case with the previous
3.1.4
(Patient
need to be mindful of has been omitted
containing
e-health
from the Standards document. However a
related material, however other sections
separate document, the RACGP Computer
as
14 Pulse+IT
www.pulseitmagazine.com.au
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Phone:
Email:
BITS & BYTES Telstra enters tablet market Telstra has launched the T-Touch Tab, a diminutive tablet computer priced at $299.
Genie Solutions releases integrated MedSpeech voice recognition
Weighing 500 grams and bundled with
Genie Solutions has upgraded its flagship
the user to skip to the relevant part of the
a stylus pen, the T-Touch features a seven
GP and Specialist practice software,
voice recording by simply placing their
inch screen, which Telstra touts as being
Genie, giving users the option to interface
cursor next to any word that needs to be
around three times larger than a typical
their software with the MedSpeech
corrected.
smart phone screen. The display uses
voice recognition system. The integrated
resistive technology and has a resolution of
solution was officially launched in mid-
is imported into the appropriate part of
800 x 480 pixels.
October with the release of Genie version
the Genie letter template. At this stage
The device runs Google’s Android
Following review, the dictation text
7.7.1 following six months of development
the letter can be cued within Genie for a
operating system, which currently has
and beta testing.
final review by the doctor, printed or sent
over 100,000 apps available in the Android
electronically.
Market. By comparison, Apple’s App Store
engine, which was originally developed by
currently lists over 300,000 apps for devices
Philips but later purchased by Nuance, who
solutions requiring users to undertake a
running iOS, a gap that is expected to
also retail the consumer-oriented Dragon
prolonged period of training, MedSpeech
shrink as more developers embrace both
range of voice recognition products.
has the user dictate just five minutes worth
platforms.
To commence dictating a letter, the
of prescribed text. However, to help the
doctor simply opens Genie’s standard
system rapidly build a vocabulary relevant
Telstra’s 850MHz Next G network, but also
letter-writing
a
to the user, MedSpeech can also import
technically supports networks utilising the
‘MedSpeech’ button. This launches the
and analyse a selection of documents, such
1900MHz and 2100MHz spectrum. The
MedSpeech dictation window, allowing
as previously typed letters. As with other
device can also be used as a mobile phone,
the doctor to construct the body of the
sophisticated voice recognition systems,
and comes bundled with $10 worth of credit
letter using their voice alone. As is the case
the software is designed to learn the
for calls and text messages.
with typed letters, patient demographic
nuances of the user’s voice and vocabulary,
In a statement, Telstra Executive
details are already present in the Genie
becoming
Director Consumer, Ms Rebekah O’Flaherty
letter template, negating the need for this
ongoing usage.
said, “T-Touch Tab will suit Australians’
information to be dictated.
appetite for quick and affordable access to
Doctors can dictate their letters starting
Terminal Services environment across
information, useful apps and digital media
from a blank page, or can create highly
both local networks or the Internet.
wherever they may be.
structured dictation ‘Autotext’ templates
While the software can only be installed
“Created with Australian families in
and recall these as required. Templates can
in a Microsoft Windows environment,
mind, the T-Touch TabTM can be enjoyed
be both opened and populated entirely
Genie Solutions and Speech Solutions
individually or shared together, providing
using speech commands, making this
are working on a solution that will allow
entertainment to all ages. From games that
a very efficient way to generate letters,
Mac OS X users to continue to run Genie
keep the kids amused, reading e-books,
particularly for specialists that routinely
in their preferred operating system, with
checking your email or catching the
perform and report on a limited number of
the software capable of interacting with a
weather on the move, the possibilities are
procedure types.
MedSpeech installation running within a
virtually endless,” she said.
Windows virtual machine installed on the
The device is capable of running on
MedSpeech utilises the SpeechMagic
screen
and
clicks
Corrections can be made by the doctor
Unlike
other
voice
increasingly
recognition
accurate
with
MedSpeech can be run within a
Bundled with 3GB of data, the T-Touch
during the dictation process if required,
same system.
Tab is currently only available on a pre-paid
or optionally, any errors can be left for a
basis, however Telstra has indicated that
practice staff member to rectify. During
software — which comes with a Philips
post-paid plans will be available towards
the correction process, the MedSpeech
microphone — retails for a considerable
the end of November. For ongoing data
software makes both the original speech
$5500+GST for each user needing to
usage, Telstra has a range of plans starting
recording
text
dictate. An annual fee of $856+GST is
from $20 for a miserly 250MB (21 day
available to the reviewer. These visual and
also charged after the first year to cover
expiry), through to $150 for 10GB that can
audio representations of the dictation are
ongoing software upgrades and support.
be utilised during a 365 day period.
synchronised by the software, allowing
Typists and other practice support staff
and
16 Pulse+IT
the
interpreted
Distributed by Speech Solutions, the
www.pulseitmagazine.com.au
BITS & BYTES are able to install a free version of the
five paragraphs in length. Dr Macdessi
software, which allows them to review
estimated that he self‑corrects around half
and edit dictations, but not dictate notes
of his letters, with the rest of his letters
themselves.
being assigned to his typist to review in
advance of the letters being signed.
Dr Joseph Macdessi, a product beta
tester turned evangelist for the solution
historically used a handheld digital voice
perfect level of accuracy for Dr Macdessi,
Despite the system not operating at a
recorder, with dictations transcribed by
he indicated the solution was delivering
an in-house typist. A paediatrician at
significant time savings for both himself
the Children’s Hospital at Westmead, Dr
and his practice staff.
Macdessi typically generates around 150
letters per week, which he described as
efficiency and not having to review letters
having a high level of variability when
several days after dictating them is an
compared to the types of reports his
absolute blessing. Letters can be turned
proceduralist colleagues typically produce.
around in a day, meaning I don’t have
He indicated that the system typically
to spend time recalling each patient
requires three to four corrections for each
encounter days after seeing them as part
of his letters, which are generally four to
of the letter review process.”
“ I am handling messages with extreme
NEHTA and MSIA release joint statement to the software industry The
National
E-Health
Transition
Tensions
relating
to
competitive
Authority (NEHTA) and the Medical
behaviour emerged during the Secure
Software Industry Association (MSIA)
Message Delivery (SMD) specification
have released a joint statement to address
design
some concerns software developers have
industry was helping NEHTA to develop
expressed regarding the way industry has
SMD specifications, while at the same time
been engaged by the government-funded
NEHTA was aiding the Northern Territory
organisation. NEHTA has been undertaking
Department of Health and Families to
its e-health work program for over five
develop an early form of SMD designed
years, however its shifting focus from
to unseat an existing secure messaging
specification design to implementation
provider.
has seen increasing amounts of interaction
with industry throughout 2009 and 2010.
is not NEHTA’s intention to interfere
phase,
raising
concerns
that
The statement assures industry: “It
Signed by MSIA President Dr Geoffrey
in commercial market processes nor
Sayer and NEHTA CEO Peter Fleming
provide information and support to
and distributed at the start of October,
individual companies that provides an
the letter is the second joint statement
unfair competitive advantage; rather it is
released by the organisations, the first
NEHTA’s intention to offer the same level
being a memorandum of understanding
of information, support and conditions to
relating
all companies.
to
NEHTA’s
Compliance,
Conformance and Accreditation (CCA)
activity. In-line with the thrust of the CCA
developing guidelines and specifications
agreement, the latest letter to industry is
defining core elements of our national
designed to allay concerns that NEHTA
e-health infrastructure, it is the ICT
is, or has the potential to become, a
industry that will take the vision to market
competitive force in the e-health space.
through its products and services.”
www.pulseitmagazine.com.au
“While NEHTA is responsible for
Pulse+IT 17
BITS & BYTES Nuance releases Dragon Dictate for Mac
Free Snomed CT browser launched
In late September, Nuance Communications
The Australian e-Health Research Centre
systems, such as ICD, which primarily aim
announced the release of Dragon Dictate
(AEHRC) has released Minnow, a free
to capture information for mortality and
for Mac 2.0, a voice recognition system for
browser for both SNOMED CT AU and the
morbidity reporting.
MacOS X users running the latest version of
Australian Medicines Terminology (AMT).
the operating system, Snow Leopard.
CSIRO Principal Research Scientist, Dr
CT-based termsets, such as the Emergency
The product is the successor to
Michael Lawley, said that the browser is
Department Reference Set, which will
MacSpeech Dictate 1.5, software acquired
designed to provide a simple and intuitive
be used in clinical information systems.
by Nuance in February 2010. At the time of
means to explore both SNOMED CT and
Minnow highlights SNOMED CT concepts
the acquisition, Nuance announced that any
the Australian Medicines Terminology.
which are part of these specialist Reference
subsequent versions of the product would
Sets,” said Dr Lawley.
be released under the Dragon moniker,
features which people have come to
bringing the product into alignment with
expect in software tools, such as a dynamic
the components that were developed
Nuance’s voice recognition software for
graphical view of the SNOMED CT
and refined for Snapper, another tool
Microsoft Windows.
hierarchy and drag and drop functionality.
developed by AEHRC. Snapper is being
The
new
used to assist migration from other
release incorporates the voice recognition
diagramming standard for SNOMED CT
terminologies to SNOMED CT by building
engine used in Dragon Naturally Speaking
content, which illustrates how a concept
semantic mappings between these existing
11 for Windows, features an improved
is defined in terms of other concepts. For
terms and corresponding SNOMED CT
user
proofreading
example, for fracture of femur it displays
concepts.
functionality, and supports a wider range
the relationships to the morphology
of voice activated shortcuts. Nuance also
of fracture and the finding site of bone
be recorded using SNOMED CT is vital
claim Dragon Dictate for Mac is better
structure of femur.”
to improve our ability to use existing
able to adapt to the user’s voice than the
SNOMED CT is designed for recording
knowledge, such as that about drug
product line it replaces.
clinical information about patients in a
contra-indications, to improve the safety
In addition to the name change, the
interface,
includes
“Minnow offers many of the interactive
tool
also
supports
the
“NEHTA are now releasing SNOMED
Minnow is based on a subset of
“Migrating existing patient data to
In a statement, Peter Mahoney, senior
fully machine processable way, assisting
and quality of our heathcare system,” Dr
vice president and general manager for
to advance clinical decision support and
Lawley said.
Dragon at Nuance said, “We’ve maintained
aid interoperability of clinical information
the elements of Dictate that are most
systems. This differs from other coding
download from http://snipurl.com/minnow
important to our Mac customers, such as the native Mac interface, and integrated many
features
of
Dragon
Naturally
The Minnow browser is available for
Below – A screen capture of the Minnow Tool showing the graphical view of the SNOMED CT hierarchy; the search box and results; the diagrammatic representation of the “fracture of femur” concept and the concept properties.
Speaking 11 to bring improved accuracy as well as smarter command and control capabilities to this discerning audience of new Dragon customers.”
Dragon Dictate for Mac is available
starting at $219.95 for the software only, $249.95 for the software and a bundled USB headset, or $349.95 for the software bundled with a wireless Bluetooth headset. Upgrades are available to current users of MacSpeech Dictate 1.5, which start at $69.
Nuance also produces a version of
Dragon for iOS devices including the iPhone, however they do not currently support Australian dialects at this time.
18 Pulse+IT
www.pulseitmagazine.com.au
iSOFT Enterprise Scheduling Solution iSOFT is pleased to announce the launch of our Enterprise Scheduling Solution into the Australian and New Zealand market. With hospitals managing several hundred thousand appointments per year, across fragmented hospital environments, iSOFT understands the complexities and inefficiencies caused with regard to each department managing their own appointments across various different systems. To assist the Australian and New Zealand Region to better manage the scheduling process, improve efficiency and reduce costs, iSOFT has joined with Ultragenda to provide a robust Enterprise Scheduling Solution to the region. iSOFT Enterprise Scheduling Solution (UltraGenda) is a proven booking and referral solution that enables hospitals to manage the scheduling process across entire hospitals and healthcare communities. UltraGenda is a best of breed solution, currently implemented in 9 countries, with more than 100 customers managing over 75 million appointments per year. Key Features • Ensures accurate and up-to-date scheduling information is accessible at any time • Supports optimisation of resources and regulates cross activities • Rules-based and extremely configurable • Intuitive user interface • Highly secure with sophisticated access rights • Seemless integration with other hospital solutions (iSOFT & 3rd party), ensuring appointments can be sent to existing systems • Uncomplicated integration with GP systems • Referral portals for existing clinicians • Enabled for eTransactions • Functionally rich product features
Find out more about the iSOFT Enterprise Scheduling Solution: www.isofthealth.com/scheduling.aspx Tel: +61 2 8251 6700
BITS & BYTES
Panasonic updates its Mobile Clinical Assistant, drops price
OPTALERT driver fatigue monitoring system wins InterSystems Award InterSystems Corporation has announced
Panasonic
that
Australia-based
OPTALERT
has
updated
its
CF-H1
has a resolution of 1024x768 pixels and is
has
Toughbook, a tablet computer designed
designed to be viewable in direct sunlight.
been recognised with an InterSystems
specifically for clinical settings. As with
Award for Breakthrough Applications. The
its predecessor, the CF-H1 MkII has been
sports an integrated handle for easy
award program honours developers who
built upon Intel’s ‘Mobile Clinical Assistant’
transportability.
“create game-changing applications using
(MCA) reference design, which specifies
InterSystems’ advanced technologies”.
the
hardware functionality
batteries, both of which can be swapped
The web-based OPTALERT system
types
of
The device weighs around 1.5kg and
The CF-H1 MkII is powered by two
that can be leveraged in healthcare
out of the device without it having to be
is the only real-time safety system in
environments.
shut down or put in sleep mode. With its
the world that detects the early onset of
As with other devices in the Toughbook
fanless construction and the low power
drowsiness during a journey by accurately
range, the CF-H1 MkII sports a ruggedised
requirements of its Intel Atom processor
measuring a person’s level of alertness.
construction. The crash resistance of
(running at 1.86GHz), Panasonic claim
This information is quantified into a fatigue
the device is tested to military standard
the device is capable of operating for six
risk profile and supplied to both driver and
MIL-STD810G, which requires that it be
hours before a recharge or battery swap is
their company. Vehicle operators wear
capable of withstanding a drop of 180cm
required.
specialised OPTALERT driver glasses that
while operational, a height double that of
measure the velocity of the wearer’s eyelid
the first iteration of the product.
way as to make it conducive for disinfection
500 times per second using tiny infrared
to clinically acceptable standards using
emitters and receivers built into the frame
recently
computer
typical cleaning products commonly found
of the glasses.
market, the CF-H1 MkII does not feature
in healthcare settings. To assist the user
InterSystems
a keyboard, with users instead interacting
to do a thorough job of disinfecting the
CACHÉ®, a high performance object
with the device via its 10.4 inch touch
device, a packaged software application
database
the
screen using either a stylus pen or their
can be run on the CF-H1 MkII that works
companies involved, by using CACHÉ,
finger. Like its predecessor, the screen
in conjunction with its touch sensitive
OPTALERT
uses
the
solution. According
to
As is increasingly common in the revitalised
tablet
The device has been designed in such a
OPTALERT was able to move to a Software as a Service (SAAS) business model and develop an online service that can be tailored to meet the varying requirements
Below – The Panasonic Toughbook CF-H1 MkII Toughbook Mobile Clinical Assistant. One of two battery slots is visible on the right hand edge of the device, with the finger print reader and function shortcut buttons shown to the right of the screen.
of its mining and transport industry clients.
“This application successfully addresses
a serious problem that affects many people in industrial environments and along with increasing productivity and mitigating risk, it can contribute to saving lives,” said InterSystems Vice-President of Strategic Planning Paul Grabscheid.
In accepting the award, OPTALERT
Chief Executive Officer, John Prendergast said, “It’s tremendously gratifying to be recognised for creating a game-changing solution. Journey management and control is becoming the norm amongst business leaders and they are turning to OPTALERT to enable them to quantify their fatigue risk profile.”
20 Pulse+IT
www.pulseitmagazine.com.au
BITS & BYTES screen to visually demonstrate which parts
be dependent on the ability of the
of the screen have been wiped down, and
organisation’s clinical software to integrate
more importantly, the areas that haven’t.
with MCAs.
Alphastudy acknowledged with NSW Health Award
Software can also remind the healthcare
In its default configuration, the CF-H1
Emergency department staff at Royal
facility’s staff to disinfect the device at
MkII ships with 2GB RAM (up from 1GB)
Prince Alfred Hospital, in collaboration with
regular intervals.
and an 80GB 1.8 inch hard drive, however
Alphastudy, have been awarded a NSW
The CF-H1 MkII integrates both a
the device can be customised to include
Health award in the ‘Making Smart Choices’
finger print reader and a contactless smart
solid state drive (SSD) technology to
category. The award recognised the team’s
card reader, both of which can be used to
improve performance and add further
work on a project designed to improve
authenticate healthcare professionals to
robustness to the MCA.
emergency department training and quality
clinical systems and desktop environments
Assisted by the strong Australian dollar,
improvement capacity through the use
that support such access controls.
the device features a RRP of $3899AUD,
of the Alphastudy collaborative learning
Also included in the CF-H1 MkII is
which is $1100 cheaper than the debut
system. Accessible via a web browser,
RFID technology for wireless interaction
price of first version of the CF-H1, which
Alphastudy
with compatible tags, a technology
was announced in June 2009.
tools with the ability to share educational
increasingly being used for both patient
material within an organisation.
record management, and management
which retails from $629AUD, are inevitable,
of patients themselves. The device can be
particularly after some high profile bulk
of learning activities and quality initiatives
configured with an optional 2D barcode
purchases of the device by healthcare
were generated including evaluation of
reader, making it suitable for the majority
organisations in Australia, against the
emergency department clinical handover,
of Australian healthcare facilities that have
backdrop of worldwide sales of over seven
training
not yet widely deployed RFID systems.
and a half million units in just six months.
dissemination and discussion forums.
Comparisons with the Apple iPad,
combines
online
learning
Over a nine month period, a wide range
needs
analysis,
knowledge
The CF-H1 MkII includes Bluetooth
And Apple is far from the only other
technology for wireless communication
vendor that retails products healthcare
held on 15 October at the Australian
with peripheral devices, and wireless
organisations looking to mobilise their
Technology Park by Director‑General of
network technology (a/b/g/n) to allow users
clinical and nursing workforce need to
NSW Health and NEHTA board member,
to remain connected to their healthcare
consider. A plethora of tablet computing
Professor Debora Picone.
facility’s network whilst moving between
devices have been announced in recent
patients
areas.
months, including the HP Slate 500 (RRP
Health “Baxter” Award, the project team
Wireless 3G broadband technology can
$799USD) and the diminutive Telstra
also collected a Quality Improvement
also be integrated into the device, allowing
T-Touch (RRP $299AUD), which were both
Award, presented by the South Sydney
healthcare
and
administration
The award was presented at a ceremony
On their way to winning the NSW
launched in the last week of October.
Western Area Health Service.
Internet connectivity anywhere mobile
phone reception is available. The device
recent emergence of these devices will
edged out two other finalists, including a
can also be configured with an integrated
have on Panasonic’s plans for its CF-H1
telehealth project that links the emergency
GPS unit, which can be used, for example,
MkII, Mark Wallis, Toughbook Group
departments of base and regional hospitals
to assist the user when conducting home
Manager
within the North Coast Area Health Service.
visits, or to allow healthcare facilities to
targeted focus on healthcare environments
dynamically track the location of their
and the positive impact Apple’s marketing
interest in the awards has seen them
MCAs.
clout
developed into a two-stage selection, with
professionals
to
achieve
When asked about the impact the
will
highlighted
deliver
the
the
product’s
entire
tablet
At the state level, the collaboration
Since their establishment in 1999,
computing sector.
over 170 submissions made in 2010.
the opportunity to quickly take photos
and include them in patient records, the
to us and we have had this technology for
from a range of positions including board
device features an integrated 2 megapixel
some time. Apple, by virtue of their size
members,
camera and two LED lights to maximise
and nature, will yell to the crowds that
managers and directors, health researchers,
picture quality. However along with many
touchscreen is great technology, and that’s
quality managers, patient advocates and
of the CF-H1’s other value added features,
a good thing for all of us. In terms of actual
policy advisors. A judging panel of up to
the ability for photos to be seamlessly
usage, you’ll only need to drop a couple [of
eight members is assigned to each award
integrated into a patient’s record will
iPads] and perceptions will change.”
category.
To
give
healthcare
professionals
www.pulseitmagazine.com.au
“Touchscreen technology is not new
Pulse+IT 21
Judging panels comprise volunteers chief
executives,
general
BITS & BYTES AMA negotiates IT discounts for its members The Australian Medical Association (AMA)
HCN and HealthLink collaborate to extend secure messaging network
has released the details of a new crop
HCN and HealthLink have connected
acknowledgements that the referral has
of IT-related discounts available to its
their
messaging
safely reached the hospital, the referrer
members.
infrastructures, allowing customers of both
can also be notified that their patient has
Companies enlisted in the ‘PowerBuy’
respective
secure
companies to communicate with a greater
had an appointment scheduled by the
program include Apple, Dell, APC, Lenovo,
number
relevant hospital department.
Netgear, CISCO and Fuji Xerox, each of
The development means doctors using
whom are offering discounts to AMA
HCN’s Medical Director software will be
Health Chief Executive said, “For GPs,
members that purchase selected products.
able to send clinical information to any
the ability to send referrals by secure
While the terms and conditions attached
healthcare provider on the HealthLink
messaging direct from the patient’s
to the reduced pricing varies between IT
secure
This
electronic medical record, is not only time
vendors, in many cases customers are able
‘interconnectivity’ has been made possible
and paper saving but allows the GP to
to purchase products from their existing
via an agreement that has seen the HCN’s
receive acknowledgments that the referral
suppliers and seek a cash back rebate from
MDExchange messaging hub connected
has been received and to be informed in a
the PowerBuy system. Discount coupons
with
timely and reliable way about scheduled
for use on selected online stores are also
infrastructure.
appointments.”
administered by PowerBuy.
of
healthcare
messaging
HealthLink’s
organisations.
network.
communications
In announcing the development, the
In a statement, Dr Peggy Brown, ACT
This electronic referral workflow has
Discounts available through PowerBuy
companies touted their respective market
been available to practices in the ACT
typically range from 10% to 20%, however
shares, HCN claiming “Medical Director
region using the Medtech32 practice
some vendors have elected to offer flat
is used by more than 17,000 medical
software solution since 2009, however the
rate discounts of between $100 and $150.
professionals”, with HealthLink indicating
participation of HCN dramatically extends
Further details are available from the
“5300 practices, hospitals, laboratories and
the reach of the Canberra hospital’s
AMA
acute care facilities in Australia” are using
electronic referral catchment, John Frost
their messaging solutions.
revealing that HCN has over 50 practices in
the ACT using MD3.
website:
http://www.ama.com.au/
memberservices
Bigpond releases faster mobile broadband modems
John Frost, CEO of HCN said, “There
is a very real requirement for information
Dr
Geoffrey
Sayer,
HealthLink
flowing securely between acute care and
Australia’s General Manager, indicated
Telstra’s consumer division has begun
primary care. Medical professionals want
that there are around 130 practices
retailing its ‘Ultimate’ wireless broadband
to exchange reports, referrals, hospital
in the Canberra Hospital region, with
modem, which has a theoretical download
discharge summaries and similar electronic
approximately 20 of these expected to be
speed of 42Mbps, twice that of the
messages today. Market leaders, Medical
up and running within a few weeks.
company’s previous fastest offering. As with
Director and HealthLink, have taken
all wireless broadband services however,
this important step towards widespread
upon
real-world performance using the device is
interoperability.”
undertaken by HealthLink and Orion
likely to vary greatly, the company advising
The coupling of HCN’s and HealthLink’s
Health, one of the key software suppliers
that speeds of anywhere between 1Mbps
messaging capabilities is already being
to the Canberra Hospital. Chris Stephens,
and 20Mbps are realistic.
showcased in the ACT, where GPs running
Orion Health’s Regional Director for
The electronic referral project builds a
discharge
summary
project
The modem has a RRP of $299, however
MD3 are now able to send referrals to the
Australia and Southeast Asia said, “This
it can be bundled with a 24-month contract
Canberra Hospital’s outpatient service.
initiative will further enhance the ACT
at no charge. Plans start at under $10 for
GPs referring to the hospital select a
Health eReferrals solution by increasing
400MB, with 7GB and 12GB plans available
customised template from within Medical
the number of general practitioners
for around $40 and $70 respectively. To
Director, which contains relevant data
and specialists having access to timely
access these prices however, Bigpond
that can be seamlessly integrated into
and accurate information. It is another
requires that the purchaser have a fixed
the hospital’s various systems, minimising
improvement to health interoperability
line service, in addition to at least one other
the need for manual transcription from
between primary and secondary care
eligible service with the company.
paper referrals. In addition to electronic
providers.”
22 Pulse+IT
www.pulseitmagazine.com.au
BITS & BYTES
Due to the number of disparate
Sayer.
software systems running in the hospital,
not all departments within the hospital
workflow enabled as a result of HCN’s
In addition to the new referring
are currently able to accept such electronic
collaboration with HealthLink, Dr Sayer
referrals, however Dr Sayer indicated the
noted that, for the first time, a secure
service will be expanded in time, with extra
messaging company is now able to
capabilities added at both the hospital
transport HL7 messages generated by
and to referring practices. It is expected
MD3, without the need for an intermediary
that additional general practice software
to create HL7 messages on MD3’s behalf.
will also be capable of sending electronic
referrals to the Canberra Hospital in the
practices wanting to communicate with
near future.
their
“HealthLink is seeking to enable
software and a HealthLink messaging
practices running other clinical software to
capability can now add the recipient’s
participate in the Canberra Hospital referral
HealthLink EDI to the MD3 address
project, with developers of other popular
book, a one-off process that provides the
practice software solutions undertaking to
HealthLink messaging system with the
perform the necessary upgrades to their
information it needs to direct the message
systems to enable this to happen,” said Dr
to the appropriate recipient.
John
Frost
colleagues
explained using
that
other
MD3 clinical
Feel like you’re going under with increasing costs & lack of service from your current practice software provider? You put up your hand for help but there’s no-one there? Stop feeling like a very small fish in a very big corporate sea. Here’s why you’ll feel right at home when you jump over to Best Practice:–
HL7 Australia to host international working group meeting in Sydney HL7 Australia will host the January meeting
Standards for Clinical Trial Research”, and
of the “HL7 International” healthcare
an “Academic Summer School” e-health
interoperability standards organisation in
program presented by globally recognised
Sydney from 9 January to 14 January 2011.
experts Ed Hammond and Bernd Blobel.
The HL7 International Standards and
Special
sessions
are
devoted
to
• We have MIMS – Australia’s most trusted drug database
Education Meeting will provide a forum
medicines and medical device regulatory
• Support professionals who are truly supportive
for more than 50 work groups, committees
activity,
and task forces designed to progress
for clinical trial research and health
• Speed and superior stability of 100% SQL performance
standards including HL7 version 2, HL7
information exchange in military and
version 3, Clinical Document Architecture,
humanitarian operations.
as well as standards available for electronic
health record implementations.
Healthcare Enterprise (IHE) initiative will
In
addition
development
to
the
meetings,
a
data
exchange
An introduction to the Integrating the
standards
also be presented at the event.
range
of
standards
Klaus
Veil,
event
organiser
and
• Converting your data from MD2, MD3 and MedTech32 virtually automatic • No ads, bolt ons or mixed file formats to compromise performance • Great value – subscription $907.50 for both Clinical & Management • Discounts for practices larger than 3 GPs
courses, tutorials and work-shops provide
immediate past Chair of HL7 Australia said,
attendees with an opportunity to learn
“We are delighted to welcome the e-health
about the latest developments in electronic
standards world to Sydney in January and
• No downtime for updates or time- consuming maintenance
health records, clinical messaging and
are looking forward to an exciting and
• More GPs voting for Best Practice with their feet
terminology, and to meet global experts
productive meeting. We are dedicated to
and leaders in e-health.
making the Sydney WGM a success — both
Some
of
the
education
events
in terms of attendance and the quality of
targeted at the Australasian participants
the sessions presented.”
include an extensive three day “CDA
Masterclass”, an introduction to openEHR
available from the HL7 Australia website:
and HL7 standards, a tutorial on “Data
www.HL7.org.au/Sydney2011.htm
www.pulseitmagazine.com.au
• Half price for part time practitioners – $453.75
More information about the event is
Pulse+IT 23
Go to the Best Practice website at www. bpsoftware.com.au to order your FREE Evaluation DvD, email sales@bpsoftware.com.au or phone (07) 4155 8800
Plug into a world where size doesn’t matter.
When the what is Cloud computing the who is NEC.
Productive
Collaborative
Inventive
Ask your tech leader to speak to NEC. Visit NEC.com.au/Cloud
Proactive
NEAUST0043_275x420_PulseMag.indd 1
8/06/10 11:00 AM
2nd Annual Clinical Leadership and Change Management Conference Human factors behind the management of clinical redesign 22nd & 23rd of November, 2010 | Hilton, Brisbane Themes include: • Engaging and motivating your staff • Increasing staff efficiency and patient care simultaneously • Building change capability in your organisation • Diagnostic tools to support change • Learn to effectively implement accountability in your team • Develop and engage your staff to have greater responsibility • Effective communication strategies to foster change
• How to manage complaints effectively in the clinical setting • Engaging stakeholders in the change process • Implementing change processes to facilitate e-health • Strategies to engage, retain and build staff • Developing a change culture in your organisation • Effectively use values to communicate effectively
Wednesday 24Th november, 2010 Workshop a: 9:00am-12:00pm staff retention: Facilitated by Robyn Williams, Education & Recruitment Manager, st George Private hospital Workshop b: 1:00pm-4:00pm developing Clinical Leadership to implement change in your organisation: Facilitated by Fiona Rawson, Fiona Rawson, Communications Consultant, momentum
PlusREGISTER much more...CALL NOW! TO T: +61 2 9080 4090 F: +61 2 9299 3109 E: info@iir.com.au
VISIT: www.iir.com.au/clinicalleadership
24 Pulse+IT
www.pulseitmagazine.com.au
READERSHIP SURVEY: 2010
Win an Apple iPad!
Online:
www.pulseitmagazine.com.au
In preparation for the new year, Pulse+IT is seeking feedback from its readers to assist with the development of its editorial framework for 2011 and beyond.
Fax:
+61 2 9475 0029
The Pulse+IT Readership Survey can be completed online at www.pulseitmagazine.com.au/survey2010, or by filling out both sides of this page and returning it by mail or fax.
Mail:
Pulse+IT Magazine PO Box 7194 Yarralumla ACT 2600 Australia
All respondents that complete this survey online before 15 December 2010 will be entered into a draw to win an Apple iPad (RRP $629AUD).
1. What type of organisation do you principally work for?
5. Briefly describe the types of articles or subject areas you would like to see in future editions of Pulse+IT?
2. What is your role at this organisation?
3. From a Health IT perspective, what parts of the health sector would you most like to see covered in future editions of Pulse+IT (rank 1 to 6)?
Aged Care Allied Health General Practice Pharmacy Public and Private Hospital Specialist Practice 4. Each edition of Pulse+IT features the following types of articles. Please rank these in order of importance and interest to you (rank 1 to 3):
6. Do you review the Pulse+IT calendar (see page 27)?
Yes
No
7. Do you review the vendor listings in the Pulse+IT Directory (see pages 44-50)?
Yes
No
8. Do you retain copies of Pulse+IT after reading?
Yes
No
9. How long does it usually take you to read each edition of Pulse+IT?
Guest editorials and opinion pieces (see pages 8-13). A week or less. Health IT news as presented in the Bits & Bytes Longer than a week but less than a fortnight. section of the magazine (see pages 14-21). Longer than a fortnight but less than a month. Longer feature articles of a more technical or instructional nature (see pages 28-43). A month or longer. Please continue survey overleaf www.pulseitmagazine.com.au
Pulse+IT 25
From previous page 10. How many people do you expect will read your copy of the November edition of Pulse+IT?
Just me 2 3 4 5+
Yes
No
Please specify
17. Other than Pulse+IT, do you refer to any other printed Information Technology / Computer magazines?
11. Given the choice, would you prefer to read Pulse+IT online or in print?
Online
16. Other than Pulse+IT, do you refer to any other e-health publications or websites?
Yes
No
Please specify
12. Would you be interested in writing articles for Pulse+IT?
Yes
No
Please provide your contact details
13. If you work for a General or Specialist practice, which clinical and/or practice management software does your practice use currently?
AAPM
Clinical Software
Practice Management / Billing Software
14. If you work for a General or Specialist practice, does your organisation intend to change either clinical or practice management software in the next 12 months?
Yes
18. In addition to other channels, Pulse+IT is distributed to the memberships of the following organisations. Are you a member of any of these organisations? (tick all that apply):
No
ACHI
AMA
HIMAA
HINZ
HISA
19. Do you have any feedback that may assist the publisher to improve future editions of Pulse+IT?
N/A
Please specify
15. If you work for a General or Specialist practice, does your organisation send prescriptions to community pharmacies electronically?
Yes, using eRx Script Exchange (www.erx.com.au) Yes, using MediSecure (www.medisecure.com.au) No OPTIONAL: To enter the draw to win an Apple iPad, please supply your contact details below (personal details will not be disclosed to any third party): Name:
26 Pulse+IT
Email address / Phone:
www.pulseitmagazine.com.au
EVENTS
Health
2nd Annual Reducing Medication Errors Conference 2010 28 October - 29 October Melbourne, VIC P: +61 2 9080 4300 W: www.iir.com.au
NOVEMBER
HIT
HINZ Conference 2 November - 4 November Wellington, NZ P: +64 9 373 7599 W: www.hinz.org.nz
www.pulseitmagazine.com.au
2nd Annual Leadership and Change Management 22 November - 23 November Brisbane, QLD P: +61 2 9080 4300 W: www.iir.com.au AAPM Victoria Staff & Expo Day 27 November Melbourne, VIC P: +61 1300 651 334 W: www.aapm.org.au
HIT HIT
HIMSS 20 February - 24 February Orlando, USA P: +1 312 915 9285 W: www.himss.org
HIT
Health Informatics: International Perspectives February 24 - February 27 Victoria, BC, Canada P: +1 250 721 8581 W: www.itch.uvic.ca
HIT
3rd Annual National Telemedicine Summit 21 March - 22 March Sydney, NSW P: +61 2 9080 4300 W: www.iir.com.au The 2nd Annual National Disability Summit 4 May - 5 May Melbourne, VIC P: +61 2 9080 4300 W: www.iir.com.au Health
HIT Health HIT HIT
Technology in Healthcare Summit 2010 16 November - 18 November Melbourne, VIC P: +61 2 8908 8555 W: www.acevents.com.au
HL7 International Standards and Education Meeting 9 January - 14 January Sydney, NSW P: +61 412 746 457 W: www.hl7.org.au/Sydney2011
HISA Health Informatics Conference (HIC2011) 1 August - 5 August Brisbane, QLD P: +61 3 9388 0555 W: www.hisa.org.au/hic2011 HIT
Health
3rd Annual Hospital & Healthcare Security & Safety Conference 28 October - 29 October Brisbane, QLD P: +61 2 9080 4300 W: www.iir.com.au
General Practitioner Conference and Exhibition 12 November - 14 November Melbourne, VIC P: +61 2 9211 7454 W: www.gpce.com.au
2001
HIMSS AsiaPac 2011 20 - 23 September Melbourne, VIC P: +65 9848 5259 W: www.himssasiapac.org HIT
Health
Correctional Services Healthcare Summit 27 October - 28 October Melbourne, VIC P: +61 2 9080 4300 W: www.iir.com.au
Global Telehealth 2010 10 November - 12 November Fremantle, WA P: +61 2 9372 4493 W: www.aths.org.au/GT2010/ HIT
HIM
HIMAA National Conference 27 October - 29 October Sydney, NSW P: +61 2 9887 5001 W: www.himaa.org.au
Health Information Technology WA Forum 9 November Perth, WA P: +61 8 6304 5039 W: www.hisa.org.au/wa
Health
HIT
HIMSS Asia’10 Health IT Congress & Leadership Summit 26 October - 29 October Daegu, South Korea P: +65 9848 5259 W: www.himssasiapac.org
HIMSS Middle East 2010 8 November - 10 November Dubai P: +65 9848 5259 W: www.himssME.org
HIT
HIT
International Conference on the Implementation of Electronic Health Records 26 October Edinburgh, UK P: +44 131 651 3001 W: tinyurl.com/35s2qfv
Australian General Practice Network National Forum 3 November - 6 November Perth, WA P: +61 2 6228 0835 W: www.gpnetworkforum.com.au
Health
Health
The National Forum on Safety and Quality in Health Care 25 October - 27 October Canberra, ACT P: +61 8 8274 6050 W: www.sapmea.asn.au
mHealth Summit 2010 8 November - 10 November Washington DC, USA P: +1 301 402 5311 W: www.mhealthsummit.org
PM
OCTOBER
Health
Health
HIT
Health IT
HIM
Health Information Management
PM
Practice Management
Pulse+IT 27
MSIA
Are you interested in being part of Australia’s e-health revolution?
Bridget Kirkham Dip FAA, MBA CEO, MSIA ceo@msia.com.au
Dr Geoffrey Sayer BSc(Psychol), MCH, PhD President, MSIA president@msia.com.au
This question, posted on a Department of Health and
and diagnostic imaging), medications management,
Ageing (DoHA) website1 for the pre-registration for
as well as all that is included in the Continuity of Care
notification of e-health tender documents, suggests
grouping (discharge and referral, care planning and
the e-health revolution is underway. The Health
co-ordination and the PCEHR).
Minister, Nicola Roxon, has made a promise that all
Australians will be able to have access to a Personally
members of the Minister’s department suggested
Controlled Electronic Health Record (PCEHR) by 1 July
that industry would only be able to access the final
2012. Perhaps we are at a real turning point and will see
specifications and test their developments for using
marked differences in healthcare in the future — upon
the Healthcare Identifier Service in March 2011.3 This
the e-health foundation stones that will underpin the
leaves 15 months to implement access to the HI Service
revolution. So where are we at the time of writing —
in every healthcare site across Australia whilst the
revolution, pre-revolution or turning point?
much more challenging PCEHR is also being prepared.
The word revolution itself has a number of
Attaching Individual Healthcare Identifiers to all of an
meanings but all have a degree of urgency, if not
individual’s relevant clinical information is critical if we
sudden, complete and marked change. To achieve
are to have PCEHRs.
the target there will need to be urgency as no country
in the world has achieved a national EHR system in
Foundations and E-Health solutions are ready, and
20 months. Has the revolution already started with
the extent to which they are interdependent is
the essential building blocks in place? Let’s review
shown in Figure 1. While personal numbers have been
the current status and progress of the infrastructure
allocated to 23.5 million individuals, we are not sure
required for the “e-health revolution” to deliver on the
who the phantom million are — the Australian Bureau
Minister’s promise.
of Statistics population clock indicates there are not
At Senate Estimates on 20 October 2010, senior
The
degree
to
which
the
other
E-Health
As described by the National E-Health Transition
yet 22.5 million Australians. Numbers have also been
Authority (NEHTA) Blueprint v12, the E-Health
assigned to 390,000 healthcare professionals and
Foundations
Service,
just two organisations,4 however not a single one
Authentication, Secure Messaging, Clinical Terminology
of these numbers is being used in a live setting to
and Supply Chain) provide the “common infrastructure
increase patient safety and to improve patient care.
and standards crucial to enabling a consistent
The reasons are simple: there are no agreed test
approach to interoperability across the healthcare
cases, no operational Compliance, Conformance and
sector.” However, the NEHTA document goes on to
Accreditation (CCA) process, no specifications for the
say “these will not be of value” unless individuals and
Contracted Service Providers (CSPs) — those most
providers have access to a wide range of solutions that
likely to be providing PCEHRs — and no final Healthcare
leverage the foundations. For NEHTA, the E-Health
Identifier specifications for the software industry to use
Solutions include the diagnostic services (pathology
to allow the “revolution” to start. The organisations
(Healthcare
Identification
Author Info
that are integral to the process — from Hospitals, to Bridget Kirkham has been a senior executive in a range of not-for-profit health settings in Australia, UK, USA and New Zealand. These include the MDU (London) and in Australia, Breastscreening, Arthritis, IVF, and The Simpson Centre. As well as being President of MSIA, Geoffrey is General Manager - Australia of HealthLink. He has spent the past 20 years working as an epidemiologist. For the past 10 years Geoffrey has occupied senior management positions in medical software companies.
28 Pulse+IT
GP clinics, to specialists, to pathology and radiology Figure 1 - The NEHTA Foundations and E-Health Solutions are shown in yellow. The other boxes represent the work that needs to be completed to be "fit for use", "go live", or to optimise the benefits of each "Foundation" in terms of patient safety and quality of care. The NEHTA Foundations and E-Health Solutions can be found on page 21 of the NEHTA Blueprint v1.
www.pulseitmagazine.com.au
Outstanding work necessary to complete Foundation Blocks and E-Health Solutions
Foundation Blocks and E-Health Solutions
Outstanding work necessary to complete Foundation Blocks and E-Health Solutions
Tender Process
Specify and Build CSP component
CCA
Interim PKI until NASH ready
NASH
“Fit for use” in community setting
Notices of Integration (NOI)
CCA & NOIs
“Fit for use” in community setting
Foundation Blocks and E-Health Solutions
Clinical Terminology
Map to decision support systems
Healthcare Identifiers Service
Indemnity, software update schedule and other issues
Developer’s Agreement
Completed?
Service levels, 24/7 and response times
Third Party Accreditation of HI Service
CCA
Supply Chain
Continuity of Care Agreed implementation plan
Full HI Service
Tender Process
CCA NASH
Build, test and deliver
AMT “fit for use” in all settings
CCA
AMT
NASH
Medication management
Mapped to decision support
CCA Secure Messaging
HI Service fully functional
Pathology
ELS or alternate
Imaging
www.pulseitmagazine.com.au
Diagnostic services
Pulse+IT 29
Figure 2 - List of key events and decision points relating to e-health 2005-2012
National E-Health Strategy released NEHTA established by Commonwealth, State and Territory Governments
2005
NEHTA CEO Peter Fleming appointed
2006
2007
2008
services — haven’t seen any business case
of medication misadventures, but AMT
to encourage them to “sign up.” Just two
is critical for supporting interoperability
fundamental problem that needs to be
jurisdictions, members of NEHTA’s Board,
for sharing medication information using
resolved to achieve a PCEHR: the scope
have sought to have access to the Hi
a common terminology. With the current
of what clinical and health information
Service and HI-O access to “purge” their
Electronic Transfer of Prescription (ETP)
the PCEHR will actually contain has not
records and do other preparatory work.
suppliers not using a common standard
been agreed. The idea of dumping or
There are still outstanding issues
for the medication payload in their
sourcing anything and everything without
with the Healthcare Identifier Service
messages, and no agreement on the
provenance and other controls will most
Developer’s Agreement, the prime issue
correct messaging standard to use for
likely make it unworkable if required at
being a requirement those software
the AMT, there is much to do. Even when
point of care.
vendors take on liability for the Medicare
it is agreed the vendors have two years
Australia-operated infrastructure. It is not
to comply under the payment incentive
a summary of key data is what will be
possible to buy the insurance coverage
for ETP, the ETP is unlikely to be able to
achieved in time for the PCEHR deadline.
the Healthcare Identifier Service requires,
contribute optimally to the PCEHR taking
Things like next of kin, preferred GP,
leaving vendors to shoulder potential
into account the current timelines.
drug allergies, current medications and
liability for actions taken by others.
Even in the absence of a PCEHR and
significant medical conditions are obvious
Unless resolved, the current developer’s
the shared medication information it could
starters. This can then serve as a basis for
agreement will prevent software vendors
provide, the AMT could go a long way
pointing to other information that can
from utilising the service — this has been
towards helping electronic prescribing
be sourced. Some would argue you are
an issue for many months without a
and dispensing if it is to achieve its full
after a patient summary that can serve as
resolution to date. This problem alone will
potential in terms of patient safety at the
a universal referral for all occasions. We
kill the revolution before it has even had a
point of prescribing and dispensing. The
can get more detailed over time and allow
chance to begin.
AMT is constantly updated, with Cerner
innovation and flexibility to grow as the
What of the other building blocks? The
and NEHTA claiming it had gone “live”
systems get the fundamentals right.
Australian Medicines Terminology (AMT)
(10 August 2010) in one setting. The
is a key part of the Clinical Terminology
Medical Software Industry Association
create a view of the PCEHR on the fly;
Foundation and will be critical for
(MSIA) understands that the AMT will
imagine doing a search for all information
establishing a current medication list from
not be ready for months for wider use
about a patient across the many healthcare
disparate systems for a PCEHR. Most of
and that there will be further delay while
facilities in Australia. It would be a lot
the proposed benefits to be gained from a
the software vendors map AMT to their
easier if there was an indexing service
PCEHR system accrue from the prevention
Decision Support systems.
and everything connected up of course.
30 Pulse+IT
5
There is one other outstanding and
More realistically, it is likely that
It has been suggested that we could
www.pulseitmagazine.com.au
NHHRC recommends PCEHR
$466.7 million announced for PCEHR
SMD Technical Specification
Software vendors get final Healthcare Identifiers specs Healthcare and test software Identifiers Legislation passed
2009
2010 FOUNDATION DELIVERY *
2011
ENHANCED DELIVERY
PCEHR available for “all Australians”
2012 IMPLEMENTATION *
phases outlined in *theProject NEHTA Annual Report
*
(2008-2009)
This has not been agreed to or designed,
Information Industry Association (AIIA),
the previous battles in recent history to
let alone built. So are there easier ways
MSIA, NEHTA, the National Association of
avoid the mistakes of the past. Let’s deliver
to achieve a PCEHR, which works with
Testing Authorities (NATA), and the Joint
activities that take the e-health revolution
trusted parties who hold the information
Accreditation System of Australia & New
forward — and build momentum. While it
on your behalf? Yes there are, and they are
Zealand (JAZ-ANZ) signed an agreement
appears a lofty ambition to have a PCEHR
currently available in the market.
in December 2009 outlining how this
by 1 July 2012 — there are many things
While there are existing offerings
should be done to mitigate risk in clinical
that can be achieved with this goal in mind
in the market place, there has been no
settings and to ensure patient safety, but
that will affect all of us, whether we want a
agreement on what consent and access
NEHTA has not yet provided a draft plan
PCEHR or not.
controls should be established for the
as to how this may work.
“Personally Controlled” part of the system.
growing chorus of determination with the
Furthermore, while many would be making
before us and many will throw their arms
use of standards in various forms that
up in the air about lost opportunities,
could facilitate sharing of data, there has
failures of others and lack of progress to
References
been no harmonisation or CCA to ensure
date — the time is now. Steely resolve,
1. http://www.health.gov.au/internet/
that interoperability can take place.
an uprising of allies and well-executed
main/publishing.nsf/Content/
CCA is a key part of software
While we have a bleak picture painted
Do we hear a change in the wind and a
call to arms? “Vive la Revolution!”
strategies will make the difference for
Listing+of+Tenders+and+Grants-
achieve
success. We need to ensure that there is
1#eHealthTender [Accessed:
interoperability, especially for large roll
a united front storming the barricades
outs in health such as the Healthcare
before us to ensure that change does
Identifier Service. This acts like the
occur. The change we are seeking needs to
ISO9000 standard does for management
be manageable and achievable, otherwise
systems to ensure quality. This process
we will lose the battle. We need to select
Estimates, 20/8/2010, p.103-104
has not yet been clarified for the software
strategic targets that deliver improved
4. Community Affairs Transcript Senate
vendors for any of the Foundations or
patient outcomes and safety. Let’s work
E-Health Solutions or the Healthcare
with existing standards, existing vendor
5. http://www.nehta.gov.au/media-
Identifier Service itself. The Australian
offerings and show we have learnt from
centre/nehta-news/677-amt-i
implementations
looking
to
www.pulseitmagazine.com.au
27/10/2010] 2. NEHTA BluePrint v1, 10/8/2010, p.21-22 3. Community Affairs Transcript, Senate
Estimates, 20/8/2010, p.103
Pulse+IT 31
NEHTA
Q&A with NEHTA CEO, Peter Fleming 2010 has been a significant year for e-health in Australia. NEHTA CEO Peter Fleming explains why it is all systems go for the body set up to lead the progression of e-health in Australia. Healthcare Identifiers (HI) Service When the HI Service launched on 1 July 2010 approximately
23
million
individual
healthcare
identifiers were created by our contracted service operator, Medicare Australia, for people with a Medicare Card or a Department of Veterans’ Affairs Card. The HI Service will also allocate 500,000 healthcare provider identifiers through the newly created Australian Health Practitioner Regulation Agency (AHPRA) process and 200,000 to other healthcare providers outside of the national registration process.
These numbers will eventually populate the data
systems and health records of all Australians in a “behind the scenes” technology able to transform the efficiency of the health system.
Medicare Australia is the initial operator of the HI
Service and in 2010-2011 we will be jointly focused on
has been developed to give information to healthcare
supporting the early adopter sites to ensure healthcare
sector stakeholders who are going to be impacted by
identifier numbers are seamlessly integrated. We are
the HI Service. While it contains approximate time
engaging with Australia’s medical software vendors,
frames, this is to provide context only. Actual project
who are updating their GP software and other products
plans will be managed by jurisdictions, private sector,
to incorporate identifier numbers before the clinical
aged care, primary care and many other participants
sector can start to use them for sending discharge
involved in the roll out of the service. More detailed
summaries or referrals electronically.
sector plans are being prepared and their progression
Implementation approach In October the finalised HI Service Implementation
Author Info
Approach was published on the NEHTA website. It
The National E-Health Transition Authority was established by the Australian Commonwealth, State and Territory governments on 5 July, 2005 to develop better ways of electronically collecting and securely exchanging health information. For more information about NEHTA visit: www.nehta.gov.au, for more information about e-health visit: www.ehealthinfo.gov.au
will be able to be monitored through the NEHTA web site.
Personally Controlled Electronic Health Records NEHTA welcomed the Federal Budget announcement on 11 May of this year for a $466.7 million investment over two years to fund the start of personally controlled electronic health records (PCEHR) for all Australians. We are now revising our Strategic Plan to ensure it reflects the changing expectations of the health sector including the introduction of electronic health records.
32 Pulse+IT
www.pulseitmagazine.com.au
Lead Implementation Sites
lead sites will use the identifiers for health services
A Federal Government announcement was made
including electronic discharge summaries, prescriptions
in August about the three trial sites that will be the
and referrals and, personally controlled electronic
first in Australia to benefit from national e-health
health records. We are now in deep dialogue with the
advances. Brisbane, the Hunter Valley and Melbourne’s
three sites and more importantly, we’re bringing in
eastern suburbs will be the first areas in Australia to
external parties to that dialogue now.
These three sites will help lead the way in developing and informing future planning of e-health in Australia.
Next steps The three sites mentioned will serve as the catalyst for kicking off e-health around the country. The focus for NEHTA is now heavily on implementations. Firstly around implementation of the HI Service then around implementation of the next level of our work program, including discharge and referrals. This will ultimately
use national healthcare identifiers and eventually an
lead to electronic health records. The government
electronic health record. These three sites will help lead
has set a 2012 deadline for electronic health records.
the way in developing and informing future planning of
We’re excited abut working towards that, it’s a tight
e-health, improving technology and identifying what
schedule but what you will see is a series of incremental
works well and what could work better. These early
deliveries to get to that point.
Healthcare Complaints Management Conference 29th–30th November 2010 | Brisbane Marriott Hotel A Comprehensive Conference Addressing: • National RegistrationNational Significance • Where Does Accountability Rest When Things Go Wrong? The Patient, the Clinician or the ‘System of Care’? • Integrating Complaints Management and Incident Disclosure
• Triage of Staff Complaints About Senior Clinician Competency Concerns: A Case Series • Professional Indemnity and Negligence Claims: When a Patient Sues for Damages • Code Dread: Responding When The Media Goes Critical
Case Study from Across the Tasman: A Simple and Practical Approach to Complaint Management at Auckland District Health Board (ADHB)
Practical Workshop: Frontline Conflicts and Complaints Resolution Led by Caroline Rose, BA, BSW, Consumer Advocate, Royal Women’s Hospital, Victoria
Plus much more… PlusREGISTER much more...CALL NOW! TO T: +61 2 9080 4090 F: +61 2 9299 3109 E: info@iir.com.au
VISIT: www.iir.com.au/complaints www.pulseitmagazine.com.au
Pulse+IT 33
FEATURE
Lead Implementation Sites prepare to commence PCEHR development Simon James
BIT, BComm Editor, Pulse+IT simon.james@pulseitmagazine.com.au
On 11 May 2010, Minister for Health and Ageing,
Nicola Roxon announced that $466.7 million would be
with $100,000 to produce a detailed Project Plan to
Each of the lead implementation sites was provided
allocated to the development of Personally Controlled
guide their PCEHR implementation, with these plans
Electronic Health Records (PCEHR) over a two-year
required to be submitted to DoHA by 18 October 2010.
period concluding at the end of June 2012.
The Minister’s announcement of 17 August 2010
Additional details were released by the Minister in
indicated that up to $12.5 million will be expended on
a subsequent announcement on 17 August 2010, which
the three sites over the two year period, an amount
revealed that three “lead implementation sites” had
boosted by some states’ additional commitment of
been selected to receive funding to pilot the e-health
financial or in-kind support.
foundation services developed by the National E-Health Transition Authority (NEHTA), and upon these
The Lead Implementation Sites
services, build operational PCEHR infrastructure.
At the time of writing, scanty prospective information
The three lead implementation sites mentioned
is available from the three lead implementation sites.
in the announcement were all divisions of general
Bound by confidentiality agreements and justifiably
practice, namely GPpartners (North Brisbane, QLD), GP
not interested in jeopardising their recently bestowed
Access (Hunter Valley, NSW), and the Melbourne East
funding, division representatives did not reveal
GP Network (VIC). According to a statement released
any details about their future plans or their funding
by the Minister, the sites were “...chosen because they
arrangements. Notwithstanding the lack of readily
already have strong e-health capability and support
available information about the projects the three sites
within their communities.”
are seeking to undertake going forward, the following
information was gathered to provide readers with
NEHTA CEO Peter Fleming clarified to Pulse+IT
that the Department, in consultation with NEHTA,
some historical and current day context.
had selected the sites based on their proven track record with e-health implementations and change
GP Access (Hunter Valley, NSW)
management, and their preparedness and eagerness
GP Access (formerly the Hunter Urban Division of
to be involved in the project.
General Practice) has around 400 member GPs working
from 150 practices.
The Department of Health and Ageing’s (DoHA)
considered justification for the selection of these
particular sites as reported to Pulse+IT was: “...based on
Healthelink centralised health record project, but their
Historically, the division supported the NSW
criteria that informed the selection including scalability;
active involvement with this initiative concluded some
e-health maturity; strong clinical governance; and
time ago according to GP Access CEO, Dr Mark Foster.
population coverage.”
Around five years ago, the division negotiated a
package of broadband-related services from Pacnet on
Author Info
behalf of member practices, which lead to a high take Simon James is the editor of Pulse+IT, Australia’s highest circulating health publication of any kind. Prior to founding the publication in 2006 he worked in the statistics division of a clinical research organisation, in an IT support capacity for various medical practices, for a clinical software developer, and subsequently for a secure clinical messaging developer.
up of broadband by practices. Dr Forster indicated that many of the practices continue to utilise the services.
GP Access has facilitated the rollout of secure
messaging throughout its catchment, with around 95% of practices now able to receive messages from several of the after-hours services available to patients
34 Pulse+IT
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DISCO VER SOMETHING NEW
iPhone app coming soon to the App Store
Call 1800 800 629 to be notified when available
in the region. Having gained permission to utilise the
Based Organisation. The division is alslo involved with
Hunter New England Area Health Service’s network
hospital discharge summary projects and electronic
infrastructure — no small feat in itself — the division
referral initiatives.
has been able to network its after-hours services, which run a unified practice management system.
Melbourne East General Practice Network (VIC)
The Melbourne East General Practice Network has
GP Access boasts four full time IT support staff as
well as management-level IT oversight. In addition to
around 627 member GPs working from 142 practices.
supporting the division’s own internal systems, these
personnel provide help desk support to around 80%
and historical initiatives, Adam McLeod, an IT
of member practices, with 20% electing for a fully
professional who recently joined the MEGPN to
managed service.
coordinate their PCEHR project, said the Practice
The division has had a long history with decision
Health Atlas and the PEN Clinical Audit tool have been
support initiatives, and currently supports data
used extensively and are supported by two division
extraction using the Canning Data Extraction Tool
project officers.
and the Practice Health Atlas, which is used by 65% of
member practices.
general practices and aged care facilities has been
Outlining the division’s current e-health capacity
Support for Virtual Private Networking between
provided, enabling GPs to access their own practice
GPpartners (North Brisbane, QLD)
record systems remotely. The MEGPN also conducts
GPpartners has over 800 member GPs working from
IT security audits for practices, and has made a
200 practices, who service a population of 600,000
“significant investment in secure message transfer
people. The division is the largest in the country.
between GPs and specialists”.
Citing
the
restrictions
associated
with
the
More recently, the MEGPN has deployed the
confidentiality agreement, GPpartners were not
Extensia RecordPoint system to provide access to
forthcoming with any information about their intended
a centralised electronic health record from general
project, nor were they able to provide any information
practices and aged care facilities, however Mr McLeod
about their historical e-health activities or current
indicated adoption of the system was representative of
capabilities prior to publication. However their website
the implementation’s pilot status.
lists a range of e-health capabilities, including the Health Record eXchange, a rebranded implementation
The next steps
of Extensia’s RecordPoint solution.
While visible work is yet to commence on the ground in
GPpartners has also been an active supporter of
the three lead implementation sites, DoHA has already
secure messaging and the Canning Data Extraction
invited registrations for a forthcoming tender round to
Tool. The division provides regular low cost software
select from a pool of “organisations, partnerships and
training for selected software products, and Medicare
consortia” capable of rolling out e-health at additional
Australia claiming channels.
sites. Pre-registrations opened on 22 October 2010,
with a wide-scale email broadcast taking place on 27
GPpartners is an active supporter of the iHealthcare
Directory, a provider directory coordinated by General
October 2010 to promote the impending tender.
Practice Queensland, the local division network’s State
There are currently no identifiable commercial
Pulse+IT eNews & Twitter Service To receive the latest Australian Health IT news delivered free to your Email inbox or Twitter client, visit www.pulseitmagazine.com.au
36 Pulse+IT
www.pulseitmagazine.com.au
imperatives for software vendors to interface their
Integration from Medicare Australia, a process
solutions with any of the existing or proposed
that allows them to deploy software capable of
centralised health record systems at the lead sites, or
interacting with the Healthcare Identifier Service.
even the Healthcare Identifier Service for that matter.
• A Compliance, Conformance, and Accreditation
However it is understood that a tender process will
(CCA) process needs to be brought to fruition
open in the near term, which will provide funding for
rapidly, so that healthcare providers and consumers
the development of the requisite software interfaces
have at least some level of third-party assurance
needed to interact with the PCEHR infrastructure.
that
healthcare identifiers won’t inadvertently lead to
Before such funding can be put to use however,
there are several outstanding pieces of business that
software
implementations
that
utilise
patient harm or provider liability.
will need to be resolved, including:
• The Medicare Australia-run Healthcare Identifier
seem to be the bare minimum set of conditions
Service specifications need to be finalised and
required before software vendors are able to support
made available to software developers.
the Government’s vision for the national rollout of
• Software developers need to be presented with
Far from being an exhaustive list, this would
healthcare identifiers, much less the greatly more
a Healthcare Identifier Service agreement that is
ambitious PCEHR.
palatable and won’t burden them with undue legal
liability.
personnel involved in the projects, with one source
Such sentiments are not lost on the division
• Software developers need to undertake the
summing up the situation candidly: “Our game is
necessary development work that will allow their
change and adoption. If software vendors don’t
products to utilise healthcare identifiers.
upgrade their software, we will have nothing to change
Half Page 180 xto 120 Puse • Software developers need to HealthLink/Medinexus receive a Notice of and nothing for practices adopt.”
IT Mag
connecting healthcare
www.pulseitmagazine.com.au
Pulse+IT 37
FEATURE
Who can do what with HIs? Mark Worsman
Senior Associate DLA Phillips Fox mark.worsman@dlaphillipsfox.com
Jennifer Tetstall
Paralegal DLA Phillips Fox jennifer.tetstall@dlaphillipsfox.com
Introduction
information or as part of providing healthcare to a
The use, assignment and maintenance of healthcare
patient;
identifiers (HIs) is governed by Commonwealth
• a HCP’s IT supplier provided that the HCP has
legislation and Regulations. These stipulate, among
notified Medicare Australia beforehand that the
other things, significant penalties for unauthorised use
IT supplier has entered into a contract with the
or disclosure of a HI by any person, including healthcare
HCP (the contract must be for the purpose of
professionals (HCPs) and IT service suppliers dealing
communicating or managing health information
with HIs.
as part of providing healthcare to the healthcare
For an individual criminal liability, these penalties
include up to two years imprisonment and fines of up to $13,000. A body corporate can be fined up to
recipient); and • the patient to whom the HI relates.
$66,000 if it misuses a HI or discloses a HI improperly.
HCPs
Because these fines apply to each HI that is misused
HCPs and healthcare providing organisations can
or unlawfully disclosed, if a disk or other media that
use and disclose HIs in certain circumstances. The
contains numerous HIs was lost or disclosed, the
legislation provides a significant amount of flexibility
potential risk is quite significant.
for HCPs and the permitted uses and disclosures are
It is therefore quite important to understand who
potentially quite broad. Given the criminal sanctions
can use and disclose HIs and the purposes for which
imposed on HCPs, HCPs should nonetheless check that
they can be used and disclosed. It is also important to
their uses and disclosures fall within the permitted uses
bear in mind that these penalties (and the permitted
and disclosures listed.
uses and restrictions discussed below) only relate to
the identifier, not electronic health records. Other
• lessening or preventing a serious threat to the
restrictions (and penalties) do (and will) apply to those records.
The legislation authorises use as disclosure for: individual’s life, health or safety;
• lessening or preventing a serious threat to public health or public safety;
The Service Operator
• managing or communicating the provision of
The current Healthcare Identifier Service Officer is Medicare Australia. The Service Operator can disclose
healthcare; • the management (including the investigation or
a HI to:
resolution of complaints), funding, monitoring or
• a HCP if the disclosure is in relation to
evaluation of healthcare;
communication
or
management
of
health
• managing or communicating the provision of indemnity cover for healthcare provider; and
Author Info
• managing or communicating the conduct of Mark Worsman is a Senior Associate and Jennifer Tetstall is a Legal Clerk at DLA Phillips Fox. DLA Phillips Fox has around 700 lawyers across eight offices in Australia and New Zealand. It has an exclusive alliance with DLA Piper, one of the largest legal services organisations in the world, with lawyers in 30 countries.
research approved by Human Research Ethics Committee.
Unsurprisingly, the HCP is also authorised to
disclose a patient’s HI to the patient.
It is noteworthy that the definition of ‘healthcare’
in the legislation is quite broad and can include any
38 Pulse+IT
www.pulseitmagazine.com.au
activity that the HCP intends or claims to
come into contact with a HI. This means
Territory legislation). The legislation does
be for the purpose of:
that IT suppliers that provide services to a
not envisage a clear or transparent process
• assessing, recording or maintaining an
HCP or healthcare providing organisation
for such other uses and disclosures.
individual’s health;
need to ensure that their conduct is
• diagnosing an illness or disability; or
properly authorised, in order to avoid
Security
• treating an illness or disability.
criminal liability and the fines referred to
Under the legislation, all entities that deal
above. As the old saying goes, “ignorance
with a HI are to take reasonable steps to
of the law is no defence”.
protect the HI from:
IT suppliers IT suppliers that are properly authorised to provide IT services related to the communication of health information or
The legislation provides that if another law
health information management services
specifies a HI use or disclosure, that other
suppliers need to take appropriate security
to a HCP, in connection with the HCP’s
use or disclosure will be permitted. This
measures in relation to the HIs. Given the
proper purpose.
means that, in time, the uses described
usual security measures that HCPs and
above may change and may be different
their IT suppliers take in relation to health
providing
on a State‑by‑State basis (since ‘another
records, this additional requirement may
Pulse.pdf 1 19/10/10 PM organisations and other people that7:34 may
law’ may include regulations and State and
not have much of a practical impact.
The penalties do not distinguish
between
HCPs,
healthcare
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Pulse+IT 39
OFF TOPIC
Constraining costs and improving health outcomes with mHealth Ahmad Jubbawey
CEO, Vensa Health BSc ajubbawey@vensahealth.com
It is no secret that public health systems in Australia
exist to reduce the reliance on traditional ways of
and New Zealand are facing greater demand. In fact it
engaging with patients.
has been a theme recently. This is due to the increase
in health services being offered, population growth,
developed the ‘TXT2Remind’ mobile text-messaging
ageing population, high prevalence of chronic diseases,
system, which interfaces with patient management
increasing demand for personalised care, and advances
systems. Vensa Health currently supports over 500
in technology.
primary care providers and a number of hospitals.
The challenges facing the health sector are
Vensa Health, a mobile health provider, has
motivators for the emergence of mobile health
mHealth in primary care
(mHealth), which uses mobile phones and other devices
The TXT2Remind system can be used to engage with
for health services delivery. Amongst the population,
patients via mobile phone text messages. The system
the utilisation of mobile phones is near universal,
interfaces with the practice patient management
fundamentally changing the way businesses and
system to allow two-way text message exchanges
individuals communicate. Voice and text‑messaging
between health providers and patients. The service has
provide a significant opportunity to leverage this media
increased health outcomes (particularly for high-needs
for healthcare delivery. The mobile phone is personal
groups), by improving access and reducing costs.
and very responsive.
Specifically, this includes:
1. Improved efficiency in how healthcare is delivered
mHealth has emerged as a sub-segment of
e-health, with its applications being delivered hand
by GPs.
in hand with patient management systems and the
2. Improved healthcare outcomes by optimising
clinical software used by health providers. While the
patient appointment attendance through the use
definition of mHealth and its applications is broad, the
of mobile text-message appointment reminders.
use of mobile phone text messages for appointment
3. Improved patient satisfaction and perception of
reminders, medication reminders, recalls for services
service through timely alerts both before and after
(such as childhood immunisations and Screening
healthcare delivery, e.g. appointment reminders
services), and laboratory results have demonstrated
before a service and lab results alerts after the
improved access with workflow efficiency gains in
service.
practices and hospitals.
In March 2009, Vensa Health surveyed 27 practices
Traditional forms of communication, such as
that had been utilising the TXT2Remind system for
physical mail and telephone calls, are relatively high
over 12 months. The survey was designed to quantify
in cost and often do not achieve desired outcomes.
the practices’ experience with the system with the key
Mobile text-messaging technology is the most popular
finding from the survey outlined below.
method for communication and opportunities now
Author Info
Missed appointments Ahmad Jubbawey is the CEO of Vensa Health, which he founded in 2005 as a mHealth provider specialising in provider-to-patient mobile communications. Ahmad aspires to creating a global brand that will assist people to achieve what they want to achieve in their day-to-day life with improve health outcomes. He was a keynote speaker in the recent Global mHealth Conference Dubai 2010 and mHealth World Congress Singapore 2010.
Of the 27 practices polled, 15 reported reductions of at least 50% in missed appointments, two indicated there was no change, three practices had not quantified this metric, and seven of the practices used the service for recalls and don’t remind their patients of impending appointments.
40 Pulse+IT
For those practices that did report a drop in
www.pulseitmagazine.com.au
missed appointments, at least a 50% reduction was demonstrated.
mHealth in hospital outpatient clinics There needs to be a better way of managing outpatient
Ministry of Heath immunisation targets in Whanganui District Health Board
scheduling, missed appointment rates, waiting lists
In January 2010, Vensa Health worked with the
all public hospitals in New Zealand and the United
Whanganui Regional Primary Health Organisation
Kingdom National Health Service (NHS), the issue of
to undertake a regional TXT2Remind rollout across
missed appointments is resulting in their respective
their registered general practices. Introducing mobile
health system wasting:
messaging in primary care to assist with immunisation
1. New Zealand: NZ$60 million (AUD$46.7 million)
recalls has resulted in impressive improvements. The
across all public hospitals in missed appointments.1
target was to bring the immunisation rates for eligible
2. NHS: £600 million (AUD$978 million, NZ$1.26
and staff rostering (clinical and administration). Across
children to over 90%. The Ministry of Health National
billion)2
Immunisation Register shows improvement to the the rates for Maori and very ‘low deprived’ areas. This
Trial of text messaging in Counties Manukau District Health Board
data is presented in Figure 2.
Missed appointments mean wasted resources and
Nearly all general practices in the region installed
patients failing to receive care that may improve their
the TXT2Remind system and had specific training on
health and quality of life. In many cases these patients
how to generate text messages within their patient
may present later with significantly worse health
management system. The nurse staff usually champion
problems that can require more resources than would
the recall process in general practice and were provided
have been required previously.
with on-site training and ongoing support.
national targets over the last three quarters, along with
Missed appointments occur due to many reasons
The positive outcomes showcased how mHealth
including patients forgetting the appointment, patient
can be used to improved access to immunisation
perceptions that they do not require the service, and
services, particularly for those groups who live in
location issues such as people not finding the clinic
high deprived areas where the 90% target (one of six targets) set by the Ministry of Health is close to being achieved. The transient nature of some residents’ living
Figure 1 - Text message appointment reminder impacts
arrangements in these areas makes mobile phone
Yes
technology more conducive to reliable communication than traditional channels, such as the postal service. Figure 1 (right) - Results of a survey conducted by Vensa Health showing the number of practices that were able to reduce the number of appointment “no shows” by sending appointment reminders via text message.
N/A
Figure 2 (below) - Immunisation rates over three quarters for the Whanganui District Health Board catchment for 24 month old children, which were progressively improved following the introduction of a text message recall system. 1 October 2009 and 1 January 2010
Don’t know
No
1 January 2010 and 1 April 2010
1 April 2010 and 1 July 2010
Total % Immunised
Coverage % Maori Immunised
Coverage % Dep 9-10
Total % Immunised
Coverage % Maori Immunised
Coverage % Dep 9-10
Total % Immunised
Coverage % Maori Immunised
Coverage % Dep 9-10
83%
78%
84%
88%
86%
90%
87%
91%
89%
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Pulse+IT 41
or being unable to attend due to a lack of transport
GP provider. The author believes traditional models of
options. The combination of using text message
servicing patients across primary and secondary care
reminders along with resources accessible from a
are proving untenable, particularly when emergency
mobile phone, such as outpatient clinic information,
attention is required or in areas where there is a
maps and directions, provide the patient with all the
shortage of specialists and GPs.
information they require to “act there and then”.
Counties Manukau DHB trialled a text message
patient in their home while encouraging them to be
solution in an attempt to reduce the number of missed
more aware of their own symptoms to effectively
appointments. As a result of the introduction of text
manage chronic conditions. International trends
message reminders, the DHB’s non-attendance rate
suggest this can be achieved through consumer-based
of 12% dropped by 10% immediately, despite only
mobile phones and wireless smart home devices.
50% of patient records having a mobile phone number
Telehealth‑based wireless devices have demonstrated
recorded. The non-attendance rate is expected to
potential in effectively monitoring and managing
continue to decline as more mobile phone numbers
long‑term
are added to the patient administration system. This
congestive heart failure, diabetes and COPD, allowing
equates to 6000 more patients presenting for their
for reduced hospitalisation and emergency care
appointments each year, which is in-line with improving
business cases in some studies.
access to elective surgery by 4000 discharges as one of
the six Ministry of Health targets for each DHB.
by a group of professors led by Guy Pare to evaluate an
3
There is a need to provide quality care to the
conditions
such
as
blood
pressure,
A systematic review of the literature was conducted
existing research base of 23 case studies on the effects
National adoption of mHealth in outpatient clinics
of home telemonitoring for respiratory conditions.
Mhealth can support the public hospital outpatient
approach that is well received by patients, which
services at a national level by:
supports early identification of deterioration in patient
1. Improving efficiency in how healthcare is delivered
condition and symptom control. Despite minimal
The study found a promising patient management
by hospitals.
evidence on its economic viability, early analyses show
2. Improving healthcare outcomes by optimising
promising results and affordability of this approach.4
patient appointment attendance through the use
of mobile text message appointment reminders.
to a remote medical centre to be analysed by health
3. Allowing patients to respond to their appointment
professionals. The United States of America and
reminders, allowing the hospital to reassign the
United Kingdom have emerged as early adopters of
appointment slot to another patient.
Telecare and Telehealth solutions. Numerous trials
4. Reducing waiting lists.
Telehealth can involve the transmitting of results
have been undertaken in both countries with positive
5. Better management of staff rostering. 6. Better
management
of
patient
triage
and
administration staff.
At a national level, the sector can get a better ‘bang
for the buck’ of allocated spending by seeing more people attend their appointments. The author believes the success found in the primary healthcare sector can be replicated.
Future trends of mHealth — Telehealth The other opportunity mHealth presents is the capability to manage acute hospitalisation of the aged and long term chronically ill population. Long term condition groups often do not comply with their medication and are not optimally managed by their
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outcomes. The UK Department of Health’s Whole System Demonstrator program aims to evaluate how telehealth systems affect the quality of life for users and caregivers. These governments are set to place increased reliance on this technology, given that health system costs are on track to double over the next 15 years. The aim is to evaluate the business case through recruiting 6000 participants in a two year trial. So far 2000 participants have been recruited with trials set to begin in the next two months.5 Telehealth is allowing health organisations to do more with less and support a greater number of patients. The phenomenon is helping to improve health outcomes and ensure the best use of the healthcare resources.
Telehealth brings a win-win situation for all
stakeholders involved in the journey of care, including hospitals, GPs, community providers and patients. For the patient, improving their health includes: more accurate titration of medication, improved medication compliance, increased understanding and responsibility of their condition, and reduced travel barriers.
In the United States of America, the annual
healthcare spending is $2.2 trillion dollars, of which $1.4 trillion is spent on treating long term chronic diseases. The United States government is placing a lot of emphasis on leveraging consumer devices and telehealth solutions, estimating a $21.1 billion dollar saving per year in emergency care, hospitalisation and nurse home costs if these are adopted nationally.6
References 1. Unhealthy figures. NZ Herald. 20 September 2007. http://www.nzherald.co.nz 2. Outpatient appointment no-shows cost hospitals £600m a year. 2008. http://www.drfosterhealth. co.uk 3. Jubbawey A. The Potential of Person Centric Wireless Mobile Devices and Telehealth solutions. 2009. HINZ. http://www.hinz.org.nz 4. Jaana M, Pare G, Sicotte C. Home Telemonitoring for Respiratory Conditions: A Systematic Review. The American Journal of Managed Care. 7 May 2009. http://www.ajmc.com 5. Everett C. Testing telehealth and telecare. Smart Healthcare. http://smarthealthcare.com. 3 June 2009. 6. Walls J. mHealth Solutions Play Important Role in Healthcare Reform. CTIA – The Wireless Association. 24 June 2009. http://www.ctia.org
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Pulse+IT 43
Advantech Australia AAPM
P: 1800 196 000 or +61 3 9095 8712 F: +61 3 9329 2524 E: headoffice@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 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.
Advantech’s medical computing platforms are designed to enhance the quality and efficiency of healthcare for patients and users alike. All products match the performance of commercial PCs and tough medical safety ratings like UL60601-1 and EN60601-1; adding to this they are all IPX1 certified dust resistant and come with water dripproof enclosures. Advantech offers long term support and a proven track record of reliability. The medical range extends through: • Point-of-Care Terminals. • Mini-PC and Medical Imaging Displays. • Mobile Medical Tablets. • Patient Infotainment Terminals. Advantech is also an official distributor of Microsoft Windows Embedded software across Australia & New Zealand.
P: +61 3 5335 2220 F: +61 3 5335 2211 E: argus@argusconnect.com.au W: www.argusdata.com.au
P: +61 412 746 457 F: +61 3 9569 9449 E: Secretary@ACHI.org.au W: www.ACHI.org.au
The Australasian College of Health Informatics is Australasia’s Health Informatics professional body, representing the interests of a broad range of clinical and non-clinical e-health professionals. ACHI is the community of Health Informatics thought-leaders in Australasia. ACHI is committed to quality, standards and ethical practice in the Health Informatics profession. More information is available at: www.ACHI.org.au Join the ACHI Info email list at: www.ACHI.org.au/List
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P: 1300 720 274 F: 1300 364 008 E: marketing@ch2.net.au W: www.ch2.net.au
Clifford Hallam Healthcare (CH2) is today Australia’s largest pharmaceutical and medical healthcare service provider with a catalogue of over 15,000 products servicing metro, regional and rural customers across Australia.
Best Practice
P: +61 7 4155 8800 F: +61 7 4153 2093 E: sales@bpsoftware.com.au W: www.bpsoftware.com.au Best Practice sets the standard for GP clinical software in Australia offering a flexible suite of products designed for the busy GP practice, including: • Best Practice Clinical (“drop-in” replacement for MD) • Integrated Best Practice (clinical/ management) • Top Pocket (PDA companion software for Pocket PC)
Cerner Corporation Pty Limited P: +61 2 9900 4800 F: +61 2 9900 4990 E: AsiaPacific@cerner.com W: www.cerner.com.au
Argus
Australasian College of Health Informatics
CH2 (Clifford Hallam Healthcare)
P: 1300 308 531 F: +61 3 9797 0199 E: info@advantech.net.au W: www.advantech.net.au
Argus provides and supports Argus secure messaging software that enables doctors and healthcare organisations to exchange clinical documents securely and reliably. Argus can be used to send specialist reports to referring doctors but it can also exchange pathology and radiology reports, hospital discharge summaries and notification between healthcare providers. Healthcare practitioners can use any of the popular clinical software packages to send reports and other clinical correspondence via Argus. Argus is the messaging solution chosen by over 50 percent of all Divisions of General Practice across Australia through the ARGUS AFFINITY DIVISIONS program.
Cerner is a leading supplier of healthcare information systems and our Millennium suite of solutions has been successfully installed in over 1200 sites across the globe. Cerner’s technology has been designed so that it can be adapted to meet the needs of the very different healthcare delivery systems that exist, with a universal framework that allows clinician workflow to seamlessly span role and venue. Our innovative leadership is allowing us to push boundaries by: • Leveraging clinical and pharmaceutical data for new discoveries in Condition Management and Personalised Medicine • Connecting the community with personal and community health records • Seamlessly connecting the patient record across the continuum of care
Supported by a National Network, CH2 utilises local knowledge and local people to provide pharmaceuticals, medical consumables and equipment products to the healthcare market. CH2 is represented by a National Sales Force as well as a local Customer Service team in each state. CH2 understands the value of quality data and are committed to implementing the GS1 system throughout our business and with our partners. The use of EANCOM standard messages, Global Trade Item Numbers (GTIN) for product identification, Global Location Numbers (GLN) for location information and Serial Shipping Container Code (SSCC) labels are paramount to our industry moving forward. CH2 are passionate supporters of these philosophies and believe the uplift in quality systems will result in improved patient safety. CH2 are currently working with partners to implement the National E-Health Transition Authority (NEHTA) National Product Catalogue. “Our aim is to be a great company to do business with. The right product, at the right price, at the right time.” WardBox® is CH2’s direct to ward distribution system. It is a just in time replenishment system where orders are created in a theatre or ward area and then transmitted electronically to one of CH2’s warehouses using SOS or an EDI interface. The service incorporates barcode scanning technology, direct delivery to individual wards or departments, monthly invoicing and comprehensive reporting. WardBox® is designed to assist our customers in reducing purchasing and supply operating costs. This valuable service increases supply chain efficiencies, improves service delivery models and assists in achieving economies of scale. WardBox® distribution is used for pharmaceuticals, medical, surgical and general supplies at numerous healthcare facilities. In 2009 CH2 won the ASCLA Information Management Award and are gold sponsors for the ASCLA Awards 2010.
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Extensia
Cutting Edge Software Communicare Systems P: +61 8 9332 2433 F: +61 8 9310 1516 E: info@ccare.biz W: www.ccare.biz
Established in 1994, Communicare Systems have built an enviable reputation for delivering results, supported by excellent service based on mutual respect, mutual trust and mutual benefit. Communicare is the electronic medical records and practice management system of choice for Aboriginal Health Services employing multidisciplinary holistic healthcare, featuring: • Ease of use for all providers • Shared electronic health records • Standards based electronic messaging • Comprehensive easy to use automated reporting • Scalable from small service to multi organisational enterprise • Multi axial security and access logging
Computer Initiatives
P: 1300 237 638 F: +61 3 9787 8210 E: enquiries@cesoft.com.au W: www.cesoft.com.au Cutting Edge produces affordable, intuitive billing solutions for Mac, Windows, Linux and iPad. Cutting Edge is ideal for practitioners who prefer to maintain control of their own billing from a number of sites. Cutting Edge Software is approved by Medicare Australia to manage your electronic: • Verification of Medicare and Fund membership • Bulk Bill and Medicare claims • DVA paperless claims • Inpatient claims to Health Funds We have solutions tailor-made for • Anaesthetists • Surgeons/Surgical Assistants • Physicians • GPs • Allied Health The software comes with up-to-date schedules for MBS/Rebate, Gap Cover (all registered health funds), Workers’ Compensation, Transport Accident authorities and DVA.
Direct Control
P: 1300 85 39 39 (Melbourne) P: 1300 85 39 85 (Brisbane / GC) E: tim@cinet.com.au W: www.cinet.com.au
P: 1300 557 550 F: +61 7 5478 5520 E: support@directcontrol.com.au W: www.directcontrol.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.
Direct CONTROL is an affordable, intuitive and educational Medical Billing and Scheduling application for Practitioners of all Disciplines. Seamless integration with Outlook, MYOB or Quickbooks. Direct CONTROL’s Clinical Module manages Episodes of Care and includes State, Federal and Health Fund Statistical Reporting for Day Surgeries/Hospitals.
Recommended and preferred by a number of Divisions of General Practice and specialist software providers we: • Supply and install of hardware/ software and peripherals • Implement disaster recovery and replication plans • Remote monitoring and diagnosis • Advanced networking deployment and support • Prompt and competitive support • Internet configurations and content filtering services • Security audits, configurations and monitoring • Regular maintenance services • Microsoft Gold Partner and a Microsoft Small Business Specialist
Direct CONTROL facilitates Medical Billing Australia-wide and overseas. Included is all Medicare, DVA, Work Cover, Private Health Insurance fee schedules with built in rules relevant to each medical discipline (allied health, general practice, surgeons, physicians, anaesthetists, pathologists, radiologists, day surgeries/hospitals). Ideal for the single practitioner or the multidisciplinary Practice.
Digital Medical Systems P: +61 3 9753 3677 F: +61 3 9753 3049 E: inform@dgs.com.au W: www.dgs.com.au
Easier ICT is a technology partnership with DMS — we make I.T. work for you. DIGITAL MEDICAL SYSTEMS has provided ICT solutions and services to medical practice clients across Australia since 1990. We have specialist expertise and experience in the installation and support of leading medical software applications. DMS is a Business Partner for IBM, Lenovo, HP and Microsoft. Other leading ICT brands include Trend Micro, Symantec, CA, Cisco, Toshiba, Canon, Epson, Kyocera, Fujitsu and Brother. Accreditation is easier with the customised DMS IT Systems Documentation. Ensure your practice has the best quality IT policy, security and maintenance program that meets and exceeds the standards guidelines from the RACGP and AGPAL and GPA. World leading DTech provides 24x7 near Real-Time Monitoring and Management that alerts and enables our engineers to quickly troubleshoot and solve problems of security, network, Internet, Server and software remotely on almost any client computer system or device. Medical IT systems are automatically maintained by DTech to the most highly available status to minimize downtime by preventing problems from occurring or reducing their impact. Proactive, Flexible, Consistent, Reliable, Audited, and Affordable — for even the smallest practice. Call DMS for: • Systems Analysis & Consulting • Solutions Design • Procurement & supply of hardware, software, network and peripheral products • Installation & Configuration • Support Services inc Help Desk • DTech Monitoring, Maintenance & Management • Disaster Recovery solutions • Fully managed & automated Online Backup customised for clinical data
P: +61 7 3292 0222 F: +61 7 3292 0221 E: enquiries@extensia.com.au W: www.extensia.com.au Extensia links healthcare providers, consumers and their communities to deliver better and more efficient health care outcomes. The products used to do this can be custom branded for all Organisations and include: • RecordPoint – a proven Shared Electronic Health Record that links all clinical systems, hospital settings, care plan tools and any other sources of information available. It provides a secure means of sharing critical patient data in a privacy compliant and logical structure. • EPRX – an Electronic Patient Referral Exchange and Directory. It streamlines the process of selecting a provider and completing a referral. Patient information is transferred seamlessly from clinical software, then the most relevant providers, services and products are presented instantly and referral documents are created automatically and sent electronically.
Equipoise (International) Pty Ltd Totalcare P: +61 7 3252 2425 F: +61 7 3252 2410 S: skype.totalcare.net.au E: sales@totalcare.net.au W: www.totalcare.net.au
Equipoise International Pty Ltd (EQI) is the developer and supplier of the ‘Totalcare’ clinical and office management system. Used since 1995 by health care facilities across Australia including General and Specialist practice, Radiology, Day Surgery and Hospitals. Totalcare is a fully integrated Clinical, Office and Management software suite. Totalcare is stable, scalable, customisable and easy to learn and use. From a small practice to a distributed, multi site, multi disciplinary corporate entity or hospital, Totalcare can provide a solution for your needs.
Easier IT — we make I.T. work for you.
Direct CONTROL supports ALL your Business needs letting you and your staff get on with earning a living doing what you enjoy most … Patient Care.
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GE Healthcare Australia Pty Ltd eHealth Education Pty Ltd
P: +61 3 9653 9433 F: +61 3 9653 9307 E: info@ehealtheducation.net W: www.ehealtheducation.net • The Registered Training Organisation specialising in quality Health Informatics education provided by senior, education qualified HI professionals. Educational programs are designed to up-skill clinicians, technical staff, consumers and administrators in healthcare. • Delivery options include focused workshops, single subject courses or fully integrated programs delivered face to face or online through our extensive and quality assured online education delivery infrastructure. • Servicing professional and education organisations, we also aim to support professional and healthcare education providers. You can deliver your material using EHE infrastructure, or we can help you develop and/or deliver quality educational material.
P: +61 2 9846 4000 F: +61 2 9846 4001 E: GEHCinfo@ge.com W: www.gehealthcare.com
GE Healthcare is a $17 billion business of General Electric Co. and provides a broad portfolio of healthcare technologies and services. GE Healthcare’s ‘Healthymagination’ initiative is a $6 billion commitment to improve healthcare through innovation - reducing costs, improving quality and expanding access for millions of people. A leader in solutions for the entire healthcare enterprise. GE Healthcare has extensive global experience in successful ehealth implementations and offers a broad ehealth solution portfolio including Personal Health Manager, Provider Portal, Master Patient Index and Health Information Exchange Solutions. GE Healthcare also provides the Centricity® suite of integrated information technology for enterprise hospital information systems and specialist clinical information solutions, for theatre, anaesthesia, intensive care, cardiovascular, radiology and maternity.
Global Health
Health Communication Network
P: +61 3 9675 0600 F: +61 3 9675 0699 E: sales@global-health.com W: www.global-health.com
P: +61 2 9906 6633 F: +61 2 9906 8910 E: hcn@hcn.com.au W: www.hcn.com.au
Global Health is a premier provider of technology software solutions that connect clinicians and consumers across the healthcare industry.
Health Communication Network (HCN) is the leading provider of clinical and practice management software for Australian GPs and Specialists and supplies Australia’s major hospitals with online Knowledge resources.
ReferralNet Messaging is a secure message delivery system for sending healthcare information efficiently to industry professionals. MHAGIC is the most comprehensive mental health electronic medical record (EMR) system in Australia. MasterCare EMR is an electronic medical record system for specialists and allied health professionals. Locum is a clinical information management system for GPs.
HCN focuses on improving patient outcomes by providing evidence based software tools to health care professionals at the point of care. Market snapshot: • 17,000 medical professionals use Medical Director • 3,600 GP Practices use PracSoft • 800 Specialist Practices use Blue Chip and • 2,100 Specialists use Medical Director • Leading suppliers of Knowledge Resources to Australia’s major hospitals
GPA
P: 1800 188 088 F: 1800 644 807 E: info@gpa.net.au W: www.gpa.net.au
Emerging Health Solutions P: 02 8853 4700 F: 02 9659 9366 E: mail@emerging.com.au W: www.emerging.com.au
Emerging Health Solutions (EHS) is a web-based Clinical Information System for hospitals that is patientcentric capturing and providing appropriate, timely, clinical information in a secure and auditable environment. to assist clinicians deliver effective, quality care. Our prestigious clients include St Vincents & Mater Health Sydney and the Government of South Australia Department of Health. EHS has integrated Sabacare’s Clinical Care Classifiaction (CCC) System, a diagnosis framework integrated in SNOMED CT. EHS’ extensive list of modules work seamlessly with other systems via our integrated interface engine which accepts HL7 and other accepted Health IT standard protocols complying with the Australian Technical Specification: ATS 5822:2010 eHealth Secure Message Delivery.
Genie Solutions
P: +61 7 3870 4085 F: +61 7 3870 4462 E: info@geniesolutions.com.au W: www.geniesolutions.com.au Genie is a fully integrated appointments, billing and clinical management package for Specialists and GPs. Genie runs on both Windows and Mac OS X, or a combination of both. With over 2000 sites, it is now the number one choice of Australian specialists.
HealthEasy
GPA ACCREDITATION plus has given general practices a reliable alternative in accreditation. GPA is committed to offering a flexible accreditation program that understands the needs of busy GPs and practice staff. GPA assigns all practices an individual quality accreditation manager to support practices with their accreditation. Choose GPA for more support, improved service and greater choice.
P: +61 7 5665 7995 F: +61 7 5502 6543 E: info@healtheasy.com.au W: www.healtheasy.com.au HealthEasy is a 100 percent web‑based “Cloud Computing” solution as used by leading Web 2.0 apps like BaseCamp and SalesForce. • • • • • •
No hardware upgrades No local Server needed No manual software upgrades No local backups required No contracts (pay monthly) Runs on Windows, Mac & Linux
eHealth Initiatives Support: • Electronic Prescribing (eRX) • Personal Health Record (IEHR) • Unique Health ID (UHI) Built using Open Source tools with source code available. We invite expressions of interest from all sectors of the industry. Demonstrations available under NDA due to late 2010 release.
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HealthLink
P: 1800 125 036 E: enquiries@healthlink.net W: www.healthlink.net
Health Informatics New Zealand E: admin@hinz.org.nz W: www.hinz.org.nz
Health Informatics New Zealand (HINZ) is a national, not-for-profit organisation whose focus is to facilitate improvements in business processes and patient care in the health sector through the application of appropriate information technologies. HINZ acts as a single portal for the collection and dissemination of information about the New Zealand Health Informatics Industry. Membership is for anyone who has an interest in health and informatics.
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 percent of GPs use for diagnostic, specialist and hospital communications.
HealthSolve
P: +61 8 8203 0500 E: info@healthsolve.com.au W: www.healthsolve.com.au HealthSolve provides Care Management systems for aged, acute, and community care that can be shared across all health care sectors. Features: • Web-based. • Flexible, dynamic, and highly configurable. • Mirror your specific work flow and document style. • Resident/client centric with a focus on the whole “journey.” • Brings together administration, staff, providers, and facilities.
Health Informatics Society of Australia P: +61 3 9388 0555 F: +61 3 9388 2086 E: hisa@hisa.org.au W: www.hisa.org.au
The Health Informatics Society of Australia is a membership based not-for-profit organisation which has been supporting and representing Australia’s health informatics and e-health community for almost 20 years. HISA aims to improve healthcare through the use of technology and information. We: • Provide a national focus for e-health, health informatics, its practitioners, industry and a broad range of stakeholders • Support, promote and advocate • Provide opportunities for networking, learning and professional development • Are effective champions for the value of health informatics HISA members are part of a national network of people and organisations building a healthcare future enabled by e-health. Join the growing community of organisations and individuals who are committed to, and passionate about, health reform enabled by e-health.
HIMAA is also a Registered Training Organisation conducting, by distance education, “industry standard” training courses in Medical Terminology and ICD-10-AM, ACHI and ACS clinical coding.
HL7 Australia
P: +61 420 306 556 F: +61 2 9475 0685 E: Admin@HL7.org.au W: www.HL7.org.au HL7 Australia is the representative of the HL7 International standards organisation in Australia and supports the user and implementer community with standards, training, professional certification and implementation support. HL7 Australia is hosting the HL7 International Standards and Education Meeting 9-14 January 2011 which will provide the forum for more than 50 Work Groups, Committees and Task Forces to progress the HL7 V2.x, CDA, V3 and EHR Standards. More information is available at: www.HL7.org.au/Sydney2011
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INTEGRATION ACROSS THE PRACTICE Houston Medical delivers one streamlined system integrating medical equipment with financial, claiming and administrative areas that works reliably and securely for small practices through to large multi‑disciplinary practices. GREATER ROI VIP.net for medical specialists and VIP Allied for General practice/Allied Health delivers great ROI through smoother workflow, improved data quality, boosted productivity and reduced costs. FLEXIBLE Individually configurable, Houston’s systems support you in the way you work and deliver better results. TRUSTED Houston delivers software that you can trust - built on 20 years experience and used by many hundreds of leading practices across Australasia and beyond. Our first customer is still a customer.
P: +61 2 9380 7111 F: +61 2 9380 7121 E: anz.query@InterSystems.com W: www.InterSystems.com
P: +61 2 9887 5001 F: +61 2 9887 5895 E: himaa@himaa.org.au W: www.himaa.org.au
HIMAA aims to support and promote the profession of health information management.
P: 1800 420 066 or +61 2 9669 1844 P: 0800 401 111 or +64 7 834 9354 F: +61 2 9669 1791 E: houston@houstonmedical.net W: www.houstonmedical.net
InterSystems
Health Information Management Association Australia
The Health Information Management Association of Australia (HIMAA) is the peak professional body of Health Information Managers in Australia.
Houston Medical
InterSystems Corporation is the worldwide leader in software for connected healthcare. With headquarters in Cambridge, Massachusetts, and offices in 24 countries, InterSystems provides advanced software technologies for breakthrough applications. InterSystems TrakCare™ is a Web‑based healthcare information system that rapidly delivers the benefits of an Electronic Patient Record. InterSystems CACHÉ® is a high performance object database that makes applications faster and more scalable. InterSystems Ensemble® is a seamless platform for integration and the development of connectable applications. InterSystems HealthShare™ is a platform that enables the fastest creation of an Electronic Health Record for regional or national health information exchange. InterSystems DeepSee™ is software that makes it possible to embed real-time business intelligence in transactional applications.
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MEDITECH Australia
P: +61 2 9901 6400 F: +61 2 9439 6331 E: sales@meditech.com.au W: www.meditech.com.au
ISN Solutions
P: 1300 300 471 F: +61 2 9280 2665 E: info@isnsolutions.com.au W: www.isnsolutions.com.au ISN Solutions is a medical IT company that specialises in the design, setup and maintenance of computer networks for medical practices. Our consultants and engineers are dedicated to the medical industry, understand your business needs and know what is required to run a practice. We strive to take away the pain from you, on managing the day to day IT issues regardless of which medical application you use. Our claim is supported by strong industry references. Some of our solutions include but are not limited to: • A paperless practice • Speech Recognition • Capped cost medical support & maintenance plan • Ability to consult remotely • Linking your imaging equipment to your network • Medical application Support
Jam Software
P: +61 2 9799 1888 F: +61 2 9799 4042 E: enquiries@jamsoft.com.au W: www.jamsoft.com.au MED™4i (Medical Electronic Desktop™) streamlines Health Care with easy-to-use customisable interfaces. Modular Versatility & Connectivity backed by friendly expert engineers. Comprehensive Patient database with multiple-format billing including electronic Online Patient Verifications & Claiming to Medicare, DVA & Health funds (paperless), Letters, Prescriptions (including MIMS), Orders, e-Results, MS Office integration & CustomDB including surgical & other audits. Now with HL7 Secure Messaging. Your specific needs can be accommodated easily, onsite & remote installation, training, ongoing support including upgrades to meet the ever‑changing health requirements.
A Worldwide Leader in Health Care Information Systems
Medical-Objects
P: +61 7 5456 6000 F: +61 7 3221 0220 E: info@medical-objects.com.au W: www.medical-objects.com.au Medical-Objects has provided secure messaging to over 10,500 health professionals with referrals, reports, letters and discharge summaries. Delivering directly into leading practice software, removing the need for scanning and faxing. Referrals are digitally signed and encrypted, moreover, compatible with Medicare’s requirements and in line with NEHTA’s eHealth PIP direction. Using Medicare supported PKI, you can trust that referrals are digitally signed with PKI and we are working with NEHTA as an eHealth PIP eligible secure messaging vendor.
Medtech Global
P: +61 3 9690 8666 F: +61 3 9690 8010 E: salesAU@medtechglobal.com W: www.medtechglobal.com
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 work with healthcare professionals to design, develop and implement healthcare solutions that deliver administrative, clinical and diagnostic services to ensure continuity of care across all care settings. iSOFT provides flexible and interoperable solutions to the whole spectrum of providers, from single physician practices through to integrated national solutions supporting thousands of concurrent users. Our capacity to embrace change and keep abreast of emerging new directions in healthcare has allowed our clients to explore the exciting potential of new technologies while securing their existing investments.
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For 25 years, Medtech Global has been enhancing the quality of patient care by working with healthcare professionals in developing and delivering award-winning industry‑proven technology products. Our technology solutions are both sophisticated and user-friendly, designed for the comprehensive management of patient information throughout all aspects of primary and secondary healthcare, mental health and corporate health.
JOSE & Associates
P: +61 3 9850 1350 F: 1300 889 012 E: news@jose.com.au W: www.jose.com.au JOSE and Associates – IT Management and Support for Medical Practices • Complete IT support for medical practices: • Support for most clinical and practice management software àà Support for all network topology àà Dedicated help desk àà 24/7 support - response in most cases is immediate • New practice installation • Server maintenance on a monthly basis which includes full monthly reporting • Satisfying IT accreditation standards • Data conversions • Disaster recovery and business continuity plans – monthly data restores • Australia Wide coverage • References available on request
MEDITECH today stands at the forefront of the health care information systems industry. Our products serve well over 2,300 health care organisations around the world. Large health care enterprises, multi‑hospital alliances, teaching hospitals, community hospitals, rehabilitation and psychiatric chains, long-term care organisations, physicians’ offices, and home care and hospice agencies all use our Health Care Information System to bring integrated care to the populations they serve. Our experience, along with our financial and product stability, assures our customers of a long-term information systems partner to help them achieve their goals.
Medical Software Industry Association P: +61 427 844 645 E: ceo@msia.com.au E: president@msia.com.au W: www.msia.com.au
With the increase in government e-health initiatives, the MSIA has become increasingly active in representing the interests of all healthcare software providers. The MSIA is represented on a range of forums, working groups and committees on behalf of its members, and has negotiated a range of important changes with government and other stakeholders to benefit industry and their customers. It has built a considerable profile with Government and is now acknowledged as the official ‘voice’ for the industry.
Some of our products include: • Medtech32 and Medtech Evolution – practice management and clinical software packages • Manage My Health – an online patient portal that holds electronic health records • MDAnalyze – a surgical audit/ clinical outcomes software • We are also able to provide training, data services and consultancy.
Join over 100 other companies across all areas of medical IT/IM so your voice can be heard.
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MIMS Australia
NEHTA
P: +61 2 9902 7700 F: +61 2 9902 7701 E: info@mims.com.au W: www.mims.com.au
P: +61 2 8298 2600 F: +61 2 8298 2666 E: admin@nehta.gov.au W: www.nehta.gov.au
MIMS Australia is built on a heritage of local expertise, credibility and adaptation to changing healthcare provider needs. Our information gathering, analysis and coding systems are proven and robust. MIMS information is backed by MIMS trusted, rigorous editorial process and constantly updated from a variety of sources including primary research literature. Our database and decision support modules are locally relevant, clinically reviewed and updated monthly and compatible with a host of clinical software packages. Indeed, the majority of Australian prescribing packages and many dispensing applications are supported by the MIMS medicines data base.
The National E-Health Transition Authority identifies and fosters the development of the best technology necessary to deliver an e-health system for Australia. This includes national health IM and ICT standards and specifications.
MIMS is delivered all the ways you need – print to electronic, on the move, to your patient’s bedside or your consulting room desk. Whatever the format, MIMS has the latest information you need.
P: 1300 550 716 F: +61 2 9434 2301 E: Vicki.Rigg@nuance.com W: www.nuance.com/au
Mouse Soft Australia Pty Ltd
P: +61 3 9888 2555 F: +61 3 9888 1752 E: sales@medicalwizard.com.au W: www.medicalwizard.com.au Medical Wizard saves time and money through greater efficiency and comprehensive integration.
Software of Excellence
Pen Computer Systems
P: +61 3 8872 5500 F: +61 3 8872 5524 E: sales@oasis-software.com.au W: www.oasis-software.com.au
P: +61 2 9635 8955 F: +61 2 9635 8966 E: enquiries@pencs.com.au W: www.pencs.com.au
Developed in Australia by the leading practice management provider in the Dental Market, OASiS Software has now released OASiS Health. Already used by Medical Specialists, Physiotherapists, Chiropractors, Podiatrists, Physiologists and a variety of other Allied Health Professionals.
Established in 1993, Pen Computer Systems (PCS) specialises in developing information solutions for National and State eHealth initiatives in Primary Health that deliver better Chronic Disease outcomes.
With full appointment book and clinical functionality, many customers have used OASiS Health to create the paperless practice by taking advantage of OASiS Health powerful document and image handling features.
Nuance Communications
Nuance (NASDAQ: NUAN) is a leading provider of speech and imaging solutions for businesses and consumers around the world. Its technologies, applications and services make the user experience more compelling by transforming the way people interact with information and how they create, share and use documents. Every day, millions of users and thousands of businesses utilise Nuance’s proven range of productivity applications which include Dragon NaturallySpeaking (speech recognition), OmniPage (OCR), PaperPort (document management) and PDF Converter Professional (PDF creation and conversion).
Throughout its 17 year history, Medical Wizard has led the way with innovative solutions. We are constantly evolving Medical Wizard to meet the challenges of the medical profession for today and tomorrow. A software of choice for discerning Specialist practices, notably Gastroenterologists, Cosmetic Surgeons, Ophthalmologists, General Surgeons, IVF Centres and Day Hospitals amongst others. All aspects of practice management from appointments, billing, clinical, theatre management and compliance reporting are covered and backed by a dedicated local support team. Feature Rich. Dynamic. Innovative.
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Described as the most flexible practice management system available, OASiS Health specialises in Multi-Branch, Multi-Practitioner and Multi-Discipline practices. OASiS Health is designed to create a Healthy, Profitable business.
PCS expertise extends to: • Chronic Disease Prevention and Management • Population Health Status, Reporting and Enhanced Outcomes • Decision-Support tools delivered LIVE into the clinical consult • Web-based Electronic Health Records (EHRs) • SNOMED-CT and HL7 Standards Frameworks Our Clinical Audit Tool (CAT) for example delivers an intuitive population reporting and patient identification extension to the leading GP systems in Australia. CAT delivers enhanced data quality and patient outcomes in general practice.
Orion Health
P: +61 2 8096 0000 / +64 9 638 0600 F: +61 2 8096 0001 / +64 9 638 0699 E: enquiries@orionhealth.com W: www.orionhealth.com Orion Health is a global leader in integrated healthcare IT solutions. We specialise in electronic health records solutions, disease management, clinical decision support, and hospital administration tools. More than 200,000 clinicians in more than 20 countries use Orion Health products. Using our solutions, Orion Health’s customers have reduced operational costs, reduced risk and improved patient safety, improved communications across their organisations and between primary and secondary care. Our solutions are designed to support emerging health IT trends and standards, we work closely with our customers, clinicians, government bodies and other industry leaders to deliver elegant and intuitive solutions to meet your organisation’s current and future needs.
Practice Services P/L
P: +61 3 9819 0700 F: +61 3 9819 0705 E: Sales@practiceservices.com.au W: www.practiceservices.com.au 15 years as Authorised Medilink Dealer selling, installing, training and supporting Medilink Practice Management Software • Fixed Cost Onsite and Remote Support • Medilink = Intuitive ease of use • Solo Drs up to Hospitals in size • Cut debtors and boost cash flow with Online Claiming via EFTPOS or Medicare Online for Funds, Patients, DVA & bulk billing • Many optional modules • Links to many third party packages and services Our Users are our best Salespeople
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Pulse+ IT Pulse Magazine
P: +61 2 8006 5185 / +64 9 889 3185 F: +61 2 9475 0029 E: info@pulseitmagazine.com.au W: www.pulseitmagazine.com.au Pulse Magazine is the publisher of Pulse+IT, Australia’s first and only Health IT magazine. Pulse+IT is distributed to all corners of the health sector and is enjoyed by General Practitioners, Specialists, Practice Managers, Hospital and Aged Care decision makers, Health Informaticians, Health Information Managers and Health IT industry participants. Having grown rapidly from its launch circulation of 10,000 copies in August 2006, Pulse+IT’s current bi-monthly distribution of 37,000 printed copies ranks it as Australia’s highest circulating health publication of any kind. In addition to printed magazines, Pulse+IT offers a number of digital products including a weekly eNewsletter service, Twitter and RSS feeds, an online events calendar, and SR Logo_65x42mm.pdf an interactive website.
The Specialist
P: +61 8 8203 0500 E: info@clintelsystems.com W: www.clintelsystems.com “The Specialist” is an intuitive and comprehensive tool that allows management of patients within specialist medical practices and day surgeries. The Specialist includes 5 modules: • Accounting • Correspondence • Time Manager • Medical Records • Mobile Data Facility Key features: • Runs on both Macintosh™ and Windows™ platforms. • Scales easily from stand-alone users, to multi-site networks. • Industry standard, and readily interoperable with other systems. • Comprehensive data migration tools for most systems. • Unlimited training and support. • Designed with the future in mind. 20/02/09
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Stat Health Systems (Aust)
P: +61 7 3121 6550 F: +61 7 3219 7510 E: carla.doolan@stathealth.com.au W: www.stathealth.com.au Stat Health Systems (Aust) has built a progressive and resilient system that introduces a new level of stability and flexibility to the medical software market. Stat is an integrated clinical and practice management application which has embraced the latest Microsoft technology to build a new generation solution. Fully scalable and the only medical software application to incorporate a multi-functional intuitive interface, Stat is at the forefront of computing technology. Stat Health provide a premium support service, clinical data conversion from existing software and tailor made installation and training plans for your practice.
Real Outcomes Real Productivity Minimising Waste
Spellex
P: +61 2 8014 4573 E: info@spellex.com.au W: www.spellex.com.au
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SmartRooms by Doctorware P: +61 3 9499 4622 F: +61 3 9499 1397 E: sales@doctorware.com.au W: www.doctorware.com.au
SmartRooms provides a comprehensive software solution for specialist practices for both Mac and Windows. Comprising both practice management and clinical software, our all-in-one patient record and superior after-sales support provides the basis for a stable and time effective software solution for specialist practices of all sizes. SmartRooms is available in an appointments and billing-only version for practices with uncomplicated software needs.
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Spellex has been the leading provider of comprehensive medical dictionary enhancement software to thousands of the world’s most prominent healthcare companies for 21 years. Our easy-to-use Australian medical spell checking software integrates fully with all Microsoft programmes, Web-based applications, and popular platforms. Spellex Medical is available for end-users to ensure the medical accuracy of documents and to enhance their productivity. Spellex software development kits can also be integrated with developer’s custom programmes and Web sites. Whether you’re an individual transcriptionist or you need to provide greater medical documentation accuracy across an entire hospital or campus, Spellex has a solution that’s right for you. For a free trial of Spellex software, go to spellex.com.au and click the Free Trial tab.
Vensa Health
P: +64 9 522 9522 F: +64 9 522 9523 E: website@vensahealth.com W: www.vensahealth.com The next time you receive a text message mobile reminder or an alert from your doctor, hospital or physio you now know its done by Vensa. Vensa Health is a mobile health (mHealth) provider in the health care sector offering eHealth integrated mobile solutions, enabling text-messaging for patient communications for applications such as appointment reminders, medication reminders, test results alerts, recalls for screenings such as mamograms, immunisations and more. Vensa has invested substantially into developing products and services that offer communication solutions to better content providers with patients, including mobile text-messaging, voice, mobile sites and Telehealth services delivery.
Trend Care Systems
P: +61 7 3390 5399 F: +61 7 3390 7599 E: support@trendcare.com.au W: www.trendcare.com.au
Zedmed
A national and international award winning solution recognised for its ability to provide real benefits in the acute and sub-acute health care settings. TrendCare is an international leader for e-health solutions excelling in all of the following: • Patient dependency and nursing intensity measures. • Projecting patient throughput and workforce requirements. • Rostering and work allocation. • Efficiency, productivity and HRM reporting. • Discharge analysis, bed management and clinical handovers. • Allied health registers with extensive reporting. • Clinical pathways with variance reporting. • Patient assessments and risk analysis. • Diet ordering and reporting. • Staff health tracking and reporting.
P: +61 3 9284 3300 F: +61 3 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. Zedmed would also like to introduce to you Zedmed eXchange – a simple solution allowing Doctors to send patient’s medical information to insurance companies electronically. Using the latest in data extraction technology and fully encrypted, this is a secure, time-saving solution to one of the most dreaded requests Doctors receive on an almost daily basis.
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GPA thinks a change would do you good‌ When it comes to accreditation, GPA’s new online program
A+
is guaranteed to change your life!
We invite general practices to trial this latest advancement in accreditation. Call us today to find out more about A+ and the 7 day no-obligation free trial. 1800 188 088 or go online at www.gpa.net.au