Pulse+IT Magazine - November 2010

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.

Subscription Enquiries subscribe@pulseitmagazine.com.au

Advertising Enquiries ads@pulseitmagazine.com.au

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.

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

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

Page 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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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

Print

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

www.pulseitmagazine.com.au

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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phone +61 7 3252 2425 skype skype.totalcare.net.au

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

42 Pulse+IT

www.pulseitmagazine.com.au

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

44 Pulse+IT

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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Pulse+IT 45

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.

46 Pulse+IT

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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.

Pulse+IT 47

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.

www.pulseitmagazine.com.au

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.

www.pulseitmagazine.com.au

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

Pulse+IT 49

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.

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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.

50 Pulse+IT

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.

www.pulseitmagazine.com.au

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