Australasia’s First and Only eHealth and Health IT Magazine
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PCEHR ANALYSIS & HIMAA 2012 PREVIEW
A first look inside the PCEHR As the dust settles from the launch of the system, Pulse+IT takes a look at what’s inside the PCEHR.
Roadmap for eHealth journey Department of Health and Ageing secretary Jane Halton outlines the next steps for the PCEHR.
Singapore’s national eHealth record What Australia can learn from a country that has taken a pragmatic approach focused on implementing immediate eHealth goals.
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Inside
Publisher Pulse+IT Magazine Pty Ltd ABN: 34 045 658 171 www.pulseitmagazine.com.au Editor Simon James Australia: +61 2 8006 5185 New Zealand: +64 9 889 3185 simon.james@pulseitmagazine.com.au Advertising Enquiries ads@pulseitmagazine.com.au
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Looking Ahead Pulse+IT welcomes feature articles and guest editorial submissions relating to the nominated edition themes outlined below, as well as articles relating to eHealth and Health IT more broadly. Pulse+IT is produced in print seven times per year with the remaining two editions for 2012 to be distributed for release in: • October 2012 ~ New Zealand eHealth / HINZ Conference Preview • Mid-November 2012 ~ mHealth Edition themes for 2013 will be announced in the next issue of Pulse+IT. Submission guidelines and deadlines are available online: http://www.pulseitmagazine.com.au/editorial Pulse+IT acknowledges the support of the following organisations, each of whom supply copies of Pulse+IT to their members.
About Pulse+IT Pulse+IT is Australia’s first and only Health IT magazine. With an international distribution exceeding 34,500 copies, it is also one of the highest circulating health publications in Australasia. 32,000 copies of Pulse+IT are distributed to GPs, specialists, practice managers and the IT professionals that support them. In addition, over 5,000 copies of Pulse+IT are distributed to health information managers, health informaticians, and IT decision makers in hospitals, day surgeries and aged care facilities. ISSN: 1835-1522 Contributors Bryn Evans, Simon James, Kyle Macdonald, Dr Vincent McCauley, Kate McDonald, David Rowlands, and Louise Schaper. Disclaimer The views contained herein are not necessarily the views of Pulse+IT 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+IT 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, the Rural Doctors Association of Australia, or the Kimberley Aboriginal Medical Services Council, all who produce publications that include the word “Pulse” in their titles. Copyright 2012 Pulse+IT Magazine Pty Ltd 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.
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STARTUP Editor Simon James introduces the 30th edition of Pulse+IT.
Online consumer registration is up and running, so we provide a stepby-step guide to how to sign up.
GUEST EDITORIAL David Rowlands examines the journey Singapore has taken with its national eHealth records system and the lessons Australia can learn.
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GUEST EDITORIAL Kyle Macdonald explains the background to a new campaign to improve the quality of electronic messages and acknowledgements.
A FIRST LOOK INSIDE THE PCEHR
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NEXT STEPS FOR THE PCEHR
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PCEHR IMPLEMENTATION TO BE SLOW AND CAREFUL
MSIA Vincent McCauley argues that while PCEHR standards have taken centre stage, progress has been made in other eHealth standards.
HISA Louise Schaper announces that a mentorship program is being developed by HISA to further assist the health informatics community to achieve professional recognition.
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THE TRANSITION TO ELECTRONIC HIM
NSW to go live with PCEHR compliant clinical repositories
AMA calls PCEHR launch “the softest in history” EpiSoft partners with CSC in eAdmissions rollout
NEHTA has outlined its roadmap for further development of the PCEHR in the next six months and beyond.
DoHA secretary Jane Halton says the development of the PCEHR will be slow, careful and methodical.
SELECTED BITS & BYTES
Communicare to generate eDischarge summaries for GPs
Once you’ve registered, what’s inside your PCEHR? Very little besides the basics at the moment.
GUEST EDITORIAL Bryn Evans reports from the HIC2012 conference, which was inspired by the keynote speech of patient advocate Regina Holliday.
HOW CONSUMERS CAN REGISTER FOR A PCEHR
Deloitte dispels the myths of BYOD in healthcare settings PBS data mapped to AMT in PharmCIS system GP launches free teleconferencing network using Skype
Resources
Activity-based funding and the PCEHR are high on the agenda of October’s HIMAA conference.
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TEST RESULTS NOTIFICATION AND THE ROLE OF HIM
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PULSE+IT DIRECTORY
Joanne Callen is researching how ICT and HIM can improve the follow-up of abnormal test results.
Up and coming eHealth, Health, and IT events.
The Pulse+IT Directory profiles Australasia’s most innovative and influential eHealth and Health IT organisations.
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Editorial
AFTER THE LAUNCH, WHERE TO FROM HERE? Launched at the start of July without a governmental press release in sight, the personally controlled electronic health record system is now allowing healthcare consumers to register for their very own piece of Australian eHealth real estate. However as the dust settles from the soft launch of the service, what’s more apparent than ever is the amount of work software developers, healthcare organisations and consumers will need to undertake before the PCEHR’s proposed healthcare benefits will start to be realised. SIMON JAMES BIT, BComm Editor: Pulse+IT simon.james@pulseitmagazine.com.au
Produced in the weeks following the tentative launch of the PCEHR, this edition of Pulse+IT outlines the process consumers can undertake to register to use the system, provides an overview of what’s currently available, and reports on the government’s expectations of when additional functionality will be added to the system. While there isn’t much for healthcare organisations or consumers to get excited about at this point, it remains prudent – particularly for general practices – to learn more about the system in advance of the release of PCEHR-compatible versions of their clincial software, which is scheduled to start emerging as early as September. Access to Medicare Australia‑held medication data via the PCEHR is also anticipated to be available in a similar time frame, if not before.
Looking ahead
About the author Simon James is the editor of Pulse+IT, one of Australia’s highest circulating health publications of any kind. Prior to founding the publication in 2006 he worked in an IT support capacity for various medical practices, and subsequently for both clinical software and secure messaging developers.
The next edition of Pulse+IT will focus on the New Zealand eHealth landscape and will be released in the weeks leading up to the HINZ annual conference, to be held in Rotorua in November. Despite the difference in their underlying healthcare systems, many New Zealand software developers and health informaticians service clients on both sides of the Tasman and the edition will highlight technologies
and eHealth initiatives that have broad applicability, both throughout New Zealand and in Australia. In the meantime, those interested in keeping abreast of the latest Australian and New Zealand eHealth developments are invited to sign up to our free eNewsletter service, or visit us online at: www.pulseitmagazine.com.au As always, I welcome the input of our readers. If you have any suggestions for future articles, would like to contribute to an edition, or would simply like to discuss your experiences with eHealth, don’t hesitate to get in touch.
Acknowledgements Congratulations are in order for Pulse+IT journalist Kate McDonald, who was the proud recipient of this year’s HISA Media Award. As one observer described, “she does the work of an entire newsroom for Pulse+IT”, which is a sentiment I wouldn’t dare to disagree with. During the same proceedings at the conference gala dinner, Bernie and Yvonne Crowe received honorary life membership to HISA in recognition of their distinguished service to HISA and health informatics. The other award winners from the HIC2012 event are acknowledged within the Bits & Bytes section of this edition.
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Guest Editorial
IMPLEMENTATION OF
SINGAPORE’S ELECTRONIC HEALTH RECORD Singapore went live with its National Electronic Health Record (NEHR) on schedule on July 1, 2011. This article documents Singapore’s eHealth journey up to then and beyond, and highlights the lessons that other countries, including Australia, can learn.
DAVID ROWLANDS B.Ec.(Hons), GBDA, FACHI, AFACHSM Managing director: Direkt Consulting david.rowlands@direkt.com.au
First, some context. Singapore is a small, densely populated and ethnically diverse island. It has 4.6 million people on 707.1 square kilometres (6489 people per sqm). Seventy-five per cent of the population is of Chinese descent, 14 per cent Malay, nine per cent Indian and an array of others make up the remainder. Public hospitals and specialist centres in Singapore have been restructured by the government to be run as private companies, but wholly owned by the government. There are seven restructured hospitals and six specialty centres providing 80 per cent of hospital care. Sixteen private hospitals provide the remaining 20 per cent. Singapore is also a regional centre for the provision of healthcare to international patients.
About the author David is managing director of Direkt Consulting, a management consulting company with offices in Australia, Hong Kong and Singapore and specialising in eHealth, health service improvement, standards and governance. David is heavily involved in health informatics in Australia and internationally.
Eighty per cent of primary care medical services are delivered by private GP clinics or practices, while 17 public polyclinics provide the remainder. Government community hospitals provide intermediate healthcare for the convalescent sick and aged. Other residential and communitybased health services for the elderly are provided by voluntary welfare organisations (70 per cent) or private operators (30 per cent). The Health Promotion Board is the main driver for national health promotion and disease prevention programs.
Singapore has been constantly reforming its health system over the last 25 years, taking an ‘adopt and adapt’ approach to meet changing needs and conditions. A series of major reforms launched around five years ago included the introduction of co-payments and means-testing, and the clustering of services geographically to provide more integrated care. Competition between the clusters provides supply-side incentives for efficiency, service and quality. Singapore’s health system faces similar challenges to those in other highly developed societies. Demand-side factors include an ageing population, greatly increased incidence of chronic and lifestyle-related diseases, and rising public expectations. Supply-side issues include global cost factors (e.g. related to medical technologies), legacy service models that are insufficiently integrated to meet today’s challenges and health workforce shortages.
Health IT – pre-2008 Singapore has a strong platform of health information technology (HIT) across its public sector, although the use of IT for clinical care in other settings is lower, particularly in primary care.
Nationally, there is a range of significant capabilities and initiatives. From the early stages of HIT adoption, the Singapore government adopted a pragmatic approach focused on implementing immediate goals rather than a holistic one that encompassed all foreseeable needs and concerns.
“From the early stages of HIT adoption, the Singapore government adopted a pragmatic approach focused on implementing immediate goals.�
To enable operational interoperability between clusters, the Ministry of Health (MOH) implemented an EMR Exchange (EMRX) system in 2004, enabling secure health information exchange between clinicians in the public sector.
David Rowlands
EMRX was continually enhanced with the sharing of an expanding list of clinical information, including in-patient
discharge summaries, diagnostic reports, medications, immunisation and school health records, operating theatre reports, endoscopy reports, and cardiac and emergency department reports. The EMRX was extended to all
community hospitals in 2008. Another initiative was the development in 2006 of a national repository of critical patient information such as medical alerts and drug allergies. This Critical Medical Information System [CMIS) allowed direct
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reporting by doctors of their patients’ drug allergies and key alerts, such as a patient on anticoagulation therapy, and could be integrated to the e-prescription systems of the respective hospitals/clusters for automated alerts. Adverse drug reaction reports were also generated and routed to the pharmaco‑vigilance unit of the national drug regulatory agency. However, a range of ICT barriers to health reform were also identified around this time. Specific barriers included the inability to include medical images within the EMRX framework due to technical incompatibilities between imaging systems, and the inability to apply decision support because of structural and semantic inconsistencies between EMRX documents.
Health IT – post-2008 In 2008, a new health ICT strategy was developed, with core themes including: • Singapore required a national, integrated eHealth system based on common enterprise architecture, data standards and a privacy and security framework • A shared electronic health record (EHR) could be delivered • Broad stakeholder engagement was needed. The EHR should not be seen as an ICT project, but rather as an enabler of business and clinical transformation • Greater ability for the public to manage their own health, emphasising the public’s access to their own health information as well as improved health system logistics such as appointments, scheduling and notifications • Strong support for clinical and health services research. This strategy was then translated into a five- to 10-year blueprint that clearly spelled out the steps to achieve the goal state. The architecture is reviewed every two to three years to take account of new
trends, developments and learnings and the next set of steps is articulated.
nationally driven health ICT resonate in Australia.
Leaping forward to 2012, what has been achieved?
Singapore’s national eHealth program has been clinically led from day one. The NEHR initiative was effectively launched in mid-2008 at a workshop involving some 160 clinicians who were guided through the vision, issues and approach, and harnessed to help direct the clinical and business transformations which the NEHR would support.
1. The NEHR went live, with limited scope in terms of users, on July 1, 2011. Since then, additional health services have been progressively brought on to the point where today, the NEHR is servicing the restructured hospitals, polyclinics, community hospitals, specialty centres, mental health hospitals, nursing homes and hospices. 2. It is based on a comprehensive, agreed eHealth architecture which is supported by all key health system decision makers and guides the further development of their own information flows and systems as well as those of national infrastructure. 3. An initiative to support the deployment of standardised GP desktop systems has commenced – only about 15 per cent of GPs used clinical systems in 2010. 4. Development of a unified web portal for empowering individuals and their care-givers with health and medical information and preventive or monitoring tools for personalised health management is in progress. 5. A second phase of NEHR (2012-15) is now being architected. This phase will provide extensions to the services provided to clinicians, establish capabilities required for the NEHR to service consumers and other MOH programs and address some architectural lessons learned from the first release in order to provide a truly responsive and evolvable set of healthcare services.
Lessons learned Singapore’s NEHR is an electronic record for health service providers rather than a PCEHR. Nonetheless, some of the learnings from Singapore’s last decade of
A long-term vision is in place, intimately connected to healthcare reforms and other enabling initiatives. It is realised through the development and regular refreshment of national eHealth architecture, including detailed migration planning – meaning the pathways to the long-term vision are clear. Stakeholder engagement is enhanced by delivering meaningful and operationally useful components regularly along the way and evolving them, which is possible because of the architectural approaches taken. A focus on operationalising has been maintained – working through how each component will actually work in practice, with the people who will be affected. Political and bureaucratic leaders and funders were and still are under no illusions that eHealth would be any easier than other structural reforms, and while urging ambitious targets have fully engaged with the philosophy that it’s better to get it right than introduce excess risk. They have provided unwavering and visible support. The implementation of the NEHR system has provided an even stronger spotlight on issues such as standards and data quality, as previously unknown inconsistencies and data defects from a variety of catchments flow into a unified record. Ongoing strategies to address these issues are also now high on the agenda.
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Guest Editorial
COLLABORATIVE CARE: COME TOGETHER, RIGHT NOW Every major conference has a series of themes, but hidden among them are the unexpected jewels that can often be transformative. At HISA’s Health Informatics Conference 2012 (HIC2012), what were these hidden gems, and beyond the PCEHR, where are we heading?
BRYN EVANS Director: JEMS Consulting bryn.evans@ozemail.com.au
At any conference there are always gems of innovation to be found, which at first sight either do not fit neatly into the conference themes or do not grab the headline attention. Three major themes dominated the HIC2012 conference — doing more with less, linking research and evidence with what is working in practice, and future visions and people to support — and these were explored in full. But among HIC’s four days of presentations, workshops, panel Q&A sessions and countless informal discussions, what were the unrecognised gems? In an opening keynote address, Jane Halton, secretary in the Department of Health and Ageing, spoke of the recent launch of the PCEHR. It will help to change how we treat patients and enable consumers to gain personal control over and manage their own health, she said. What a wonderful cue for the very next speaker, Regina Holliday, the patients arts advocate of the Walking Gallery movement in the US. But no cue was needed — the story of her loss transfixed her listeners.
About the author Bryn Evans has many years’ experience as a chief executive of a clinical software supplier, and chief information officer in public hospitals. He is also an author, and writes extensively across a range of categories and genres, notably in the areas of sport, travel, history, information technology and eHealth.
‘We are all patients in the end’ Ms Holliday’s husband, Frederick, struggled through 11 painful weeks of hospital transfers, mis-diagnosis and inappropriate treatment before
succumbing to cancer. Throughout, the couple tried in vain to gain access to medical information on Frederick’s condition, and Regina’s own research was rejected out of hand. When she asked to see her husband’s medical record, which was discovered to comprise volumes of paper documents many inches thick, she was told, “It will cost you 73 cents per page to copy, and take three weeks to do”. This prompted Ms Holliday to paint her now famous mural, named ’73 cents’, and initiate her patients’ advocacy movement. The moving and tragic story of Regina and Frederick’s ordeal shows how patients must be at the centre of healthcare. As Ms Holliday said, “Give us our damned data! We are all patients in the end.” It was an impassioned plea that brought the audience to its feet and would echo throughout the next three days of proceedings. Another story of tragic loss of life showed us the need for collaboration. Nigel Millar, chief medical officer at the Canterbury District Health Board in Christchurch, New Zealand, recounted its response to the city’s devastating earthquake. It was a fascinating glimpse into how the whole spectrum of health services across hospitals, GPs, the community and social services can integrate care under a unified management and governance structure.
Collaboration and sharing of information in response to the Christchurch earthquake were not only literal life savers, in conjunction with the emergency they also drove an acceleration and rapid implementation of initiatives to integrate health systems to meet the most urgent demands for patient care and resourcing. Dr Millar’s revealing story of the healthcare response to the Christchurch tragedy gave me another pointer on where to look for a hidden gem — it must be collaborative care, and where it is working in practice.
Participatory and collaborative healthcare In a workshop on the demands for participatory healthcare, session chair George Margelis threw down the challenge: “With an ageing and growing population, and the need to do more with less, how do we help people to improve their lifestyle and better manage their healthcare?” Around 40 per cent of patient visits to GPs relate to chronic disease, while hospitals incur a not dissimilar proportion of their costs in treating chronic disease patients. And these trends are increasing. How do we collaborate to do more with less? The introduction by Dr Margelis gave us the perfect prompt for the next presenter In his presentation on supporting chronic disease patients in the community in an online collaborative care environment, Jon Hilton described how Precedence Health Care is answering these questions. Precedence Health Care, established by Professor Michael Georgeff, has developed and implemented a collaborative web‑based service for managing the entire lifecycle of chronic disease treatment. The chronic disease care model uses the cdmNet system, which enables the patient’s care team to collaborate online in such initiatives as the Diabetes Care Project, the Digital Region Initiative in the Eastern Goldfields, and the PCEHR. Using the ‘cdmNet’ system enables:
“It was an impassioned plea that brought the audience to its feet and would echo throughout the next three days of proceedings. ” Bryn Evans
• Automatic creation of care/ management plans which embody clinical guidelines, co-morbidities, and personalisation for the patient • Online collaboration through integrated processes and workflows and a shared online health record centred on the patient • Patients’ ability to access and update their own record and be reminded of events • Review of the chronic care model and other aspects of online collaboration such as telehealth consultations • Integration of data gathering, Medicare reporting and auditing with clinical workflows. To produce and manage a patient’s care plan, Medicare pays a GP just $550 pa, and an allied health professional only $250 pa. Yet continual review and monitoring of the care plan with the patient, which is where the intrinsic value lies, is not easy, often addresses complex co-morbidities and is very time-consuming. The Precedence chronic care plan and cdmNet system automate the extraction of information from the GP’s desktop practice system, and create a personalised care plan for sharing with the care team and patient. A care team can include practitioners such as a medical specialist, a GP, a nurse, a dietitian, physiotherapist, podiatrist or other allied health professionals. The automated processes enabled by cdmNet for review, updates and follow-up with
the patient, and management of Medicare compliance, have brought a doubling of GP productivity for patient care management. For around 8000 patients participating so far, it is estimated there is a five times improvement in monitoring and follow up of the patient, and an overall increase in collaborative patient care estimated at around 300 per cent.
Can you feel the disease? As I left my seat at one of HIC’s last sessions, the hypnotic beat of a Beatles song poured from the audio system. It was the first track from Abbey Road, their last recorded album, and the lyrics of the last few lines of one verse struck home: ‘Hold you in his armchair You can feel his disease Come together…right now…over me’ Those poignant lyrics seemed uncannily apt, and brought back the impact of Ms Holliday’s dramatic presentation. There can be no better lines to exhort the importance of collaborative care and the challenge we face. Whatever the information systems that may be used — cdmNet, EMR, PCEHR — what is essential is the collaboration of clinicians, exchanging information and sharing it with patients. That is Ms Holliday’s message, and it seems Precedence Health Care is trying to do just that – just like the Beatles implored all those years ago.
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Guest Editorial
MESSAGING QUALITY IS CRITICALLY IMPORTANT TO PAPERLESS HEALTHCARE
Having recently discovered deficiencies in some implementations of clinical messaging in Electronic Medical Record systems, an initiative to improve the quality of such functionality – particularly HL7 message acknowledgements – is being launched by HealthLink.
KYLE MACDONALD B.Eng.(Hons), MBA Manager of Vendor Integration: HealthLink Ltd kyle.macdonald@healthlink.net
There is a great deal of focus on the personally controlled electronic health record (PCEHR) and the implementation of related services at the moment, but we should not forget that a very large amount of patient information is exchanged across the Australian and New Zealand health sectors as an integral part of day-to-day healthcare delivery. For the past 10 years, HealthLink has been advocating for improvements to the quality of electronic messages generated by Australian practice management systems. Three years ago, our campaign to encourage the creation of HL7‑conformant messages and message acknowledgements had a major effect on the quality of electronic communications, with many Australian Electronic Medical Record (EMR) vendors taking steps to improve their systems. However, the time has come to make further progress on this critical problem.
Almost right is not good enough About the author Kyle Macdonald and his team carry out the end to end interoperability integration testing for a large number of information systems used by Australia’s hospitals, laboratories, general practices and allied healthcare providers. Kyle has a B.Eng. (Hons) and a MBA and over twenty years’ experience in the Health IT industry.
To be truly useful, electronic messaging must be at least as reliable as paper‑based information exchange – or preferably even more so. In health sectors all around the world, an increasing reliance on electronic messaging to replace paper-based processes has meant
that it is becoming more urgent than ever to ensure that every electronic message is received by the intended recipient in exactly the manner and format intended. Given the nature of electronic messaging, transference of information across multiple systems and the involvement of literally dozens of EMR system vendors, achieving this very precise and measured outcome requires a very disciplined and well‑managed process. So what has prompted our organisation to raise the issue of messaging quality again? Over the past few months a small number of incidents have come to light which can best be described as patient misadventure near-misses. Examination of these has highlighted the importance of ensuring consistent implementation of messaging standards, in particular the correct and reliable use of HL7 message acknowledgements. HL7 message acknowledgements are automated response messages that tell the sending system that its outgoing message has been received by the recipient’s system and correctly imported into its database. Recently, some problems have emerged. Specialists sending information to their referring general practices have found that lack of standards conformance among some of the EMR systems is reducing the reliability of the process. In the worst
“Over the past few months a small number of incidents have come to light which can best be described as patient misadventure near-misses. Examination of these has highlighted the importance of ensuring consistent implementation of messaging standards.” Kyle Macdonald
cases after successfully arriving at the destination site, messages are failing to be imported and the recipient systems are failing to notify the senders that this has happened. Each of these problems can be traced to one or more deficiencies in the way in which one or more EMR vendors have implemented electronic messaging capabilities within their products.
Quality agenda Our organisation believes part of its role is to assist in ensuring Australian EMR vendors conform with Australian messaging standards and to ensure that their systems are interoperable so that consistently dependable and accurate clinical communications is able to take place across all of the computer systems used within the health sector. Achieving interoperability requires a collaborative approach with participants from each EMR company and providers of secure messaging services all working together to test and update systems so that they will work seamlessly, safely and reliably out in the field. HealthLink takes that responsibility very seriously – our first major public initiative to spur improved messaging quality commenced in late 2009, when we contributed an article to Pulse+IT [November 2009, Issue 15, page 34]
lamenting the poor adherence to HL7 standards within the Australian health sector. Publication of this information created a great deal of interest in the topic. Highlighting the problems was a most effective way of helping medical practices gain a better understanding of the vendors’ capabilities; it also prompted a great deal of activity amongst medical records vendors as they worked together to lift the quality of their messaging interfaces. Since this time, a number of EMR system vendors have made significant strides in implementing message acknowledgements and message tracking capabilities within their systems. However, some EMR systems have not made sufficient progress in this area and a number of new systems have arrived on the scene. In order to encourage continued progress in this important area, we are commencing a new education and engagement campaign to highlight the progress made and to draw attention to any remaining deficiencies. As part of this campaign, HealthLink is contacting approximately 50 EMR software companies to ascertain the exact status of their systems’ messaging capabilities with a particular emphasis on the system functionality that ensures electronic messaging can be safely undertaken
by healthcare organisations using their products. The findings of this research will be published in a future edition of Pulse+IT and it is our intention to present the status of the messaging capabilities of all known EMR systems that have a presence in the Australian marketplace. Additionally we are undertaking to ensure that EMR vendors are given all the help they need to understand where any potential problems and risks lie with their clinical messaging. Approximately 12,000 healthcare organisations throughout Australasia exchange more than 100 million items of clinical information via their electronic medical record systems every year. If even one of those electronic messages fails to import, is deficient, incorrect or incomplete, it could mean life or death for a patient. So it is absolutely essential that as a healthcare IT community we take every possible step to ensure that electronic communication is working perfectly. We hope that the Australian healthcare IT community will work closely with us, just as it did in 2009, to bring each system up to the required level to guarantee quality information exchange and therefore certainty for patients and their carers.
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News
NSW to go live with PCEHR-enabled clinical repositories and Blue Book app
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NSW Health will go live this month with three new clinical repositories it has been building as part of its work as a Wave 2 lead site for the implementation of the PCEHR.
using its clinical and patient portal platform formerly known as Concerto. The technology has also been used to provide the consumer and provider portals for the PCEHR.
“Technically we are across the line and we are starting to switch them on, so by the end of the month all of the deliverables from the lead site project can be ticked off.”
Part of ongoing work that NSW Health has badged as HealtheNet, the repositories include one for electronic discharge summaries, one for shared health summaries and one for an electronic Blue Book for mothers and newborns.
NSW Health demonstrated what a shared health summary will look like when generated by Medical Director at a workshop held at the Health Informatics Conference (HIC2012) in Sydney in early August.
HealtheNet’s lead architect, Tony Lopes, said underpinning all the repositories are new services including an enterprise patient registry for patient ID and demographics information, which is connected to the federal government’s Health Identifier Service (HI Service).
The repositories will store discharge summaries that are already being generated from Cerner’s EMR, which is used in the hospitals taking part in the Wave site, along with shared health summaries being generated by GP desktop software.
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Clinicians will be given a single view of the information held within the repositories through a clinical portal built by Orion Health. Orion has also built the electronic Blue Book,
The repositories have been tested for clinical use in several health services in the Greater Western Sydney region and will start to go live throughout the month, NSW Health’s CIO, Greg Wells, said. “Where we are up to essentially is we are going live with this,” Mr Wells said. “They have been in production but as of [mid August] we will start to switch on in hospitals, in community health and in general practices.
The second is the repository and portal service that is using an enterprise service bus as a messaging gateway to the repositories, along with an external secure messaging gateway that is sending discharge summaries from health services directly to the practitioners’ desktops. Mr Wells said the enterprise service bus is
an internal NSW Health messaging service that is being used to connect general practices and is also being used for its new medical imaging repository, which went live in February. The imaging repository currently holds 200,000 documents – both images and their accompanying reports – and 2200 DICOMstandard documents are being added every day, Mr Wells said. Up to 30,000 views are being recorded every month. He said the new repositories have not yet established connection to the PCEHR but they were built to do so. “Our lead site was to test concepts, standards, infrastructure and identifiers locally and that is what we have got working,” he said. “The patient registry and the ESB are being used in clinical settings already as they are facilitating the imaging repository.
“We are working with NEHTA on opportunities to integrate it with the national infrastructure and we are also looking at how we can leverage or expand our state program to do more of this nationally.”
“We’ve built our business case, we have made sure we have proven it in production so our focus for the next six to 12 months is on change and adoption.” NSW Health also showed its new mobile app for the eBlue Book at HIC. The app, designed by a clinician and developed by Deloitte, will allow new mothers to receive reminders for immunisations and health checks for their babies as well as growth charts with height, weight and head circumference parameters.
Mobile Blue Book (mBB)
The app is for consumers only but providers will have access to the web-based eBlue Book, as will the parents. “We have done all of the technical testing and we are in the final stages of user acceptance testing,” Mr Wells said. “We’ll keep it fairly controlled but again this is not a trial; it is the first phase of what we want to do.” He said the app was NSW Health’s first foray into mobile development and the experience had been very positive. The HealtheNet services are limited to the Greater Western Sydney region at the moment but Mr Wells said the department was working with the Ministry for Health on a state-wide roll out. There is no defined timetable for this, he said. “We’ve built our business case, we have made sure we have proven it in production so our focus for the next six to 12 months is on change and adoption.”
PCEHR call centre overwhelmed at launch The hotline set up to help consumers register for the PCEHR was engaged for most of the first working week following the official launch of the new eHealth records system on July 1.
Pulse+IT made repeated attempts to register for a PCEHR through the 1800 723 471 hotline from nine o’clock on July 2, but was only successful in getting through late in the afternoon, only to be put on hold for 10 minutes before being diverted to another line and then disconnected. Registration for the PCEHR can also be achieved using a 12-page written application, which can be downloaded as a PDF from the ehealth.gov.au website. Written applications require certified copies of identification documents such as a passport, birth certificate or drivers’ licence. Certified copies must be signed by an appropriate person such as a healthcare practitioner, legal practitioner, accountant, police officer, MP, minister of religion or teacher. In its explanatory notes, the document says that applications will be processed by the Department of Human Services, which will notify applicants by phone whether the application has been successful. Online registration capability was not officially available in the first week, although Pulse+IT was able to register on the weekend following the launch. More than 800 people signed up in the first week, mostly online. Several glitches were immediately apparent, including the inability to register if the individual had an apostrophe or hyphen in their name. This glitch was rectified quickly and by the fourth week following the launch, more than 4000 people had registered, over 80 per cent of them online.
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Communicare to generate eDischarge summaries Community healthcare software specialist Communicare eHealth Solutions will add the ability to generate CDA electronic discharge summaries in the next release of its program. Communicare’s operations manager, Heidi Tudehope, said the company had already integrated the ability to receive CDA discharge summaries into its software, but hospitals will now be able to produce them as well. Communicare is predominantly used in the community and Aboriginal healthcare sectors throughout Australia but also by a number of hospitals in Western Australia. Discharge summaries will be able to be uploaded to the My eHealth Record (MeHR), which is managed by the NT Department of Health and has been deployed to communities in WA and SA. Ms Tudehope said WA hospitals are already uploading discharge information to the MeHR, and they will now be able to send electronic discharge summaries to other organisations as well. Discharge summaries will be able to be sent to the PCEHR when its B2B interface has been conformance tested, she said. In addition to the MeHR, hospitals will be able to send discharge summaries to any service that can receive CDA documents, not just those using Communicare, she said. Ms Tudehope said Communicare had also enhanced its documents and results section, which was formerly called the In-tray, as well as developing a completely new user interface. The enhancements to documents and results will allow users to track whether a message has been sent from within Communicare, rather than having to open up a mail client like Argus.
EpiSoft signs with CSC to market eAdmissions secure consumer portal Cloud-based software platform developer EpiSoft has signed an agreement with technology leader CSC to commercialise EpiSoft’s eAdmissions system.
CSC Healthcare has also signed up the Mercy Health & Aged Care group to the eAdmissions portal, with plans for an implementation in its hospitals later in 2012.
It has also signed a recent contract to pilot-test the system at Calvary John James Hospital in Canberra with a view to a wider roll‑out to the private Calvary hospitals network.
EpiSoft’s director of business development, Jenny O’Neill, said more than 1400 patients had used the system at the San with the eldest patient registered so far being 95. “We promoted it through selected private doctors’ rooms to a finite set of patients and there was excellent take up across all types of patients,” Ms O’Neill said.
eAdmissions is a secure consumer portal that allows patients to register their full clinical and administrative details in advance of their admission to hospital. Developed in association with the Sydney Adventist Hospital – better known as the San – the system allows patients to upload data such as their current medications and allergies and helps to reduce time spent on entering data into the hospital’s patient administration system. eAdmissions was first piloted at the San in late 2011 and is now available for use throughout the 352-bed hospital. Following a contract signed recently with the Little Company of Mary (LCM) Health Care group, it is now being pilottested in the maternity unit at Calvary John James before a wider roll-out to other hospitals in LCM Health Care’s Calvary network, subject to the trial’s success.
EpiSoft’s partnership with CSC is a commercialisation and distribution agreement that will see CSC market the eAdmissions portal to both its own customers and those using other systems. eAdmissions is designed around a user selfregistration module that patients can continue to access after they have left hospital and for any return visits. “It saves all of your data online and it is all structured information and fully validated against the patient administration systems in hospitals,” Ms O’Neill said. “There is also a set of structured clinical datasets that the patient steps through. There are different forms and content for
different patient groups – if you are a maternity patient you have a different clinical data capture relative to a paediatric or a general medical or surgical patient.” There are some common modules such as a medication look-up powered by MIMS. For allergies and comorbidities, the system links to SNOMED CT. “The hospital is getting really good quality information in advance of admission,” she said. “eAdmissions has eliminated data entry to the patient administration system and we are gradually eliminating data entry to the EHR. “At the moment only very limited data goes back to the portal from the hospital systems via the HL7 standard preadmission messages but there is the capacity to expand this to establish a more interactive communication between hospitals and patients around their record.” The system also has functionality to allow the patient to upload a set of associated documents, such as the doctor’s referral, any consents associated with the admission, advance care directives, or a birth plan if they are a maternity patient, she said.
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PCEHR launch “the softest in history”: Hambleton
GP launches free teleconferencing network using Skype
AMA president Steve Hambleton has characterised the launch of the PCEHR as “probably the softest launch of a major government initiative in Australian political history”, saying the target of the PCEHR was a noble one but the process in getting there was not. Writing the MJA Insight, Dr Hambleton said confusion still reigned on how the system will work, including questions on the identify verification system, software compatibility, clinical coding and secure messaging. He complained that there had been no information on how the system was supposed to operate at the consulting room level. “Most GPs do not even know if their practice software is compatible,” he said. “I know that my software is not compatible.” He reiterated the AMA’s long-standing call for GPs to be remunerated for work on the PCEHR, arguing there was a long way to go to get a critical mass of GPs interested in the project. The AMA took part in discussions as a member of United General Practice Australia (UGPA) with Health Minister Tanya Plibersek in the week leading up to the launch of the PCEHR. Dr Hambleton said the UGPA had told Ms Plibersek that they wanted the PCEHR to work. “We want it to work for our patients and for ourselves,” he wrote. “We see the electronic health record as a key productivity tool in health. “But we have more than a long way to go to get anything like a critical mass of GPs interested in this scheme, and I doubt that many of them will be prepared to do it for free.”
Dr Jonathan Brown Melbourne GP Jonathan Brown has set up a new website allowing GPs and specialists to conduct teleconferences through Skype. The Consult Online site is completely free, includes easy steps to show practitioners how to download Skype and then register for ConsultOnline, and includes a list of the Medicare item numbers they need to claim a consult under the MBS. And Dr Brown did it all on the weekend. An admitted geek, Dr Brown said he was frustrated in his own practice that few specialists seemed to know how to use teleconferencing. “I had a patient with a broken nose and I wanted to find a specialist who could
have a look at it over Skype and have a chat with the patient,” he said. “I rang around a few ENT doctors asking if someone could have a look at the patient via teleconsult but there was no way of finding a specialist that could offer this service. “Over the weekend I built a directory of specialists and GPs that offer teleconsulting with a phone number for the GP to call to arrange a consult. You can see when the specialist is online and call them for the teleconsult.” The home page lists seven easy steps to using the service, and also allows users to search for specialists in a directory. It shows who is currently
online on Skype but also the user’s telephone number to ring to set an appointment for a consult. “It shows you who is online but it’s not really to call somebody there and then,” he said. “It has the phone number and says call this number to set up a time for a consult. You can see if they are online at the agreed time.” He acknowledges that there is debate over the use of Skype for teleconferencing due to its perceived lack of privacy settings and resolution, but does not believe that practitioners need to purchase proprietary software for teleconferencing. “You don’t need it,” he said. “Consult Online.com.au works and
is free. We performed a teleconsult today and the system works well. I think it’s great that a rural doctor can ring a specialist quickly and easily and perhaps avoid the need for patients to travel long distances to see specialists.” His opinion echoes that of Gundagai GP Paul Mara, who said he has chosen to use Skype rather than other proprietary packages. “We have investigated a range of solutions and are currently using Skype,” Dr Mara said. “At this stage it is the simplest and to be quite honest the most effective solution that we’ve used. We had a look at a
few other teleconferencing solutions and they were either too expensive or promise the earth but are not much better than Skype for the type of consultation we’re undertaking at present.” Dr Mara dismisses the arguments of many telehealth solution vendors that Skye is not high enough quality, or secure enough. “The notion that you could log accidentally onto any car detailer or housewife or school kid and start having a video medical consultation is a bit rich. It would be nice to have total security and confidentiality and encryption happening,
but as soon as you start putting in encryption algorithms, with the speed of the internet at the moment the whole thing would become untenable.” Dr Brown has signed up with the Australian College of Rural and Remote Medicine’s telehealth service, another free site that allows practitioners to add their names to a registry of active telehealth providers, and has also added a Facebook Like and sharing function to the website. He said GPs and specialists from all over the country had registered for the service since its launch.
iCombat HAIs mobile app launched for hand hygiene audit and compliance A mobile audit app based on the World Health Organisation’s 5 Moments of Hand Hygiene principles that was successfully trialled in two Sydney hospitals is now commercially available. Developed by KimberlyClark Professional and Visibility Solutions, the iCombat healthcare associated infections (HAIs) app is designed for iPads and aims to capture data about hand hygiene compliance in real-time. Anesh Naidoo, category manager Asia Pacific
for Kimberley-Clark Professional, said all public hospitals have been reporting hand hygiene compliance data for several years, mandated by Hand Hygiene Australia (HHA), but many were still using either paper-based forms or inefficient and timeconsuming spreadsheets. “We’ve designed this system to help infection control managers to collate the information from hand hygiene audits in realtime,” Mr Naidoo said. Jon Elcombe, general manager of Visibility
Solutions, which designed the app and the back-end enterprise information portal, said the partners were also working on developing a link directly to Hand Hygiene Australia. “As soon as somebody does the audit it comes through, the administrator will review it, approve it and it then goes into their dashboard for reporting,” Mr Elcombe said. At the moment, the app is being used in the field in Australia and Canada and is currently being trialled in Hong Kong.
How to use social media in general practice While many general and specialist practices continue to prove reluctant to use social media to engage with patients, in the near future they might have to or face being left behind. In contrast to similar markets such as the UK where practices are streets ahead, few Australian medical and healthcare practices are using social media, according to Sam Mutimer, director of social media at Melbourne-based Thinktank Social. Ms Mutimer, who hosted a workshop on social media for the Australian Association of Practice Managers (AAPM) recently, said some practices have websites and a few have set up their own Facebook page, but her research shows most are not using social media to its fullest extent. Practices in the UK, on the other hand, are far more open to embracing social media, she said. “There are a lot of forums out there and specifically designed websites that cater for doctors and the general public in answering and asking questions. “We spend so much time online now that if you haven’t got an online presence then you are not open to engage or value add.” Ms Mutimer advises that practices that do have a website need to work on their search terms. “Any small business or business in general will set up a website but not actually think of how it will rank in Google,” she said. “The way you can increase that is by creating your own blogs and making YouTube videos as well. That’s the second biggest search engine in the world at the moment, so definitely have some video content there. She also encourages the use of online appointment booking for practices due to its ease of use for the consumer.
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Orion Health signs up as reseller for Caradigm Orion Health has signed a letter of intent to become a reseller and services provider for Caradigm, the joint venture between GE Healthcare and Microsoft formed last year. Orion Health will be able to resell Caradigm’s Amalga enterprise health intelligence platform, which aggregates electronic data from multiple sources into one repository, as well as Caradigm’s identity and access management (IAM) products for healthcare, which include expreSSO, an enterprise single sign-on solution, and Vergeance, an integrated single sign-on and context management solution. Orion Health CEO Ian McCrae said access to the Caradigm IAM products will complement Orion’s existing range of clinical workflow and data integration applications, including the Orion Health Hospital Information System (HIS) – which was previously known as Microsoft Amalga HIS and was acquired by Orion Health in October last year – as well as radiology imaging and picture archiving and communications (RIS/PACS) products. Orion Health HIS is a fully integrated hospital information system, including patient management, full electronic medical record, CPOE, end to end medication management, laboratory information system, pharmacy, RIS/PACS and back office functions. Subject to finalisation of a definitive agreement, Orion Health will resell software licenses and deliver implementation and support services to hospitals and health systems in the Australian and Thai markets. Mr McCrae said the agreement would allow Orion Health to offer a comprehensive eHealth solution when allied to its existing electronic health record systems.
Father of HL7 says stars are beginning to align for EHRs When Ed Hammond first began thinking about electronic health records, it was 1970 and he was working on a minicomputer. At the time, he thought EHRs would be something that could be developed in a couple of years, would come into widespread use very quickly and then the healthcare industry could move on to solving other problems. Forty-two years later and we are still struggling with the complexities of EHRs, but according to Dr Hammond, the stars are now starting to align. The EHR is now set to be “the killer app of the future”. Dr Hammond, professor emeritus and director of the Duke Center for Health Informatics at Duke University in the US, is widely considered “the father of HL7”, the organisation responsible for managing standards for electronic messaging and clinical document architecture. Despite those 40-odd years slow progress, Dr Hammond said he believed we are now reaching the point where the EHR can begin to have a significant impact upon an individual’s health and quality of life. “We are expanding the community, starting with
genomics, through clinical trials, through patient care and public health to population health,” he said.
of care, managers and administrators of the importance of healthcare information.
“A killer app is when all of that comes together and we are going to see a much more informed population, a population that is aware of the importance of behaviour changes.
“All of that is coming together and we are beginning to understand that having data collected once but used for many and continuing purposes is extremely important.”
“The killer app for EHRs should accelerate our ability to solve problems and make the use of technology ubiquitous so that it becomes part of how we work as clinicians and manage our own health.” “The killer app for EHRs should accelerate our ability to solve problems and make the use of technology ubiquitous so that it becomes part of how we work as clinicians and manage our own health.” Dr Hammond said better connectivity is part of this momentum, as is an increased awareness from consumers but also other stakeholders such as payers and providers
On a visit to Australia recently, Dr Hammond spoke about new developments in healthcare standards such as the openEHR movement, the Clinical Information Modelling Initiative (CIMI) and FHIR, the fast healthcare interoperability resources developed in the last year or so by Health Intersections consultant Grahame Grieve. FHIR – which former chair of HL7 Australia Klaus Veil calls “the latest trending interoperability technology that has taken the eHealth world by storm” – was developed by Mr Grieve as a new strategy to make using interoperability standards faster and easier. Mr Grieve said FHIR defines a set of “resources” for health which represent granular clinical concepts that can be exchanged. “It’s an IT term which just means a piece of known content that has its own meaning,” Mr Grieve said.
“HL7 has done a lot of past work on figuring out what information is required for exchange within the different parts of the health industry. We just have to figure out the best way of packaging them up.” Mr Grieve believes the real target for FHIR will be in the work being done on mobile applications for healthcare using devices such as the iPad and Android. “Right now there is no standard way for them to talk to the back-end servers in the cloud, so I think ideally that is where we will first make an impact, providing something easy for them to use in developing mobile platforms.” Mr Grieve and his colleagues are organising a connectathon in the US this September to explore the potential of FHIR with vendors. “One of the problems that HL7 has had for 15 years is that the government projects and the academics have become too influential in the specification design. “All of these problems are real problems but you have to solve them with real solutions. If we think we are producing a specification that is easy to use we had better make sure of that by using it. That’s the grounds for having the connectathon. “It is not to prove that we have solved problems, because we haven’t done
that yet, but it is just to prove that the framework is easy to make work. There is a bunch of people around the world who are pretty excited about this and they are coming along to prove whether it is easy or not and we’ll make sure that what we deliver back to the users is what they can easily make to work.”
“All of these problems are real problems but you have to solve them with real solutions...that’s the grounds for having the connectathon.” Another new development is openEHR, which is developing specifications, open source software and tools to develop a knowledge-oriented computing framework for healthcare. Dr Hammond believes the movement is hugely important, particularly for its role in helping to develop a semantically enabled health computing platform in which complex meaning can be represented and shared. “I have long thought that creating a terminology set that really was understood by the people who were
using it was extremely important,” Dr Hammond said. “For example, in 2000 we were trying to create a disease registry for patients at Duke University Medical Centre who had diabetes so that we could make sure they received the appropriate testing, care and control of diabetes. “In 2000 we were finding it impossible to create that registry simply because we didn’t have a common set of terminology for data elements. We are still struggling with making that happen. I think that with openEHR, the major contribution now is a very rich toolset, a very rich model that really begins to allow us to create not only the data elements – they use the word archetypes – but they are beginning to add other attributes to the archetypes that I think make the beginning of interoperability possible. “If we don’t solve the problem we will never have the sort of interoperability that makes the EHR a killer app. I think they have made very good progress and what I’m hoping will happen in the future is that many of us will take advantage of the work that has been done, and openEHR will take advantage of some the other environments created by other groups, and together we can begin to solve the initial problem of language and communication in healthcare.”
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eMental Health strategy opens with consumer portal The federal government has launched a new eMental health portal for consumers called Mindhealthconnect to access a range of information and support services on anxiety and depressive disorders. Part of an overall eMental health strategy, the portal will be boosted by a range of resources for practitioners later this year, including access to online training and development programs, evidence-based practice and clinician-assisted online treatment. It provides a link to Beyond Blue’s directory of mental and allied health practitioners, which allows GPs with postgraduate accredited mental health training to list their services, along with clinical psychologists, occupational therapists, social workers and mental health nurses. Part of the strategy includes the development of a $20 million “virtual clinic” to provide real-time online counselling or phone counselling with a trained cognitive behavioural therapist. The government said the virtual clinic will be delivered by a provider through a select open tender process and will commence in the second half of this year. “The Virtual Clinic will provide a stepped care approach which allows an individual to begin therapy with the Virtual Clinic and be referred to other mental health care services if needed,” the strategy states. The strategy states that the clinic will be designed to help those with mild to moderate depression or anxiety, and it is anticipated that people using the service will require three to five sessions. The government expects the virtual clinic will have the capacity to respond to up to 50,000 people over five years at the current level of funding.
“Mechanics of PCEHR are driving us mad”: AMA Medical groups and indemnity insurers are close to a final agreement with the Department of Health and Ageing (DoHA) for practitioner participation in the PCEHR, but the Australian Medical Association (AMA) is still unhappy with the complexity of the system. AMA president Steve Hambleton said discussions between doctors’ representatives and medical indemnity insurers with DoHA over the final wording of the terms and conditions for participation in the PCEHR had achieved a significant reduction in the “crazy requirements” that medical practices were being asked to sign up to and there were now only a few technicalities that needed to be overcome. “There have been some significant moves although there are one or two definitional issues that are still a problem, but I think the insurers and the AMA are very close,” Dr Hambleton said. “The hard work is done and now we are down to the definitions – it’s not to do with terms and conditions, but we are down to technicalities.” However, he reiterated the AMA’s concerns that the access controls built into the PCEHR were making it unnecessarily complex and there was still a large
amount of scepticism within the GP community over whether or not to participate. Dr Hambleton said that while the AMA supported the vision of the PCEHR, “the mechanics are driving us all mad”.
“The PCEHR has been built with so many controls that can be turned on and off by the patient that they have forgotten that you want to make it easy for doctors and hospitals and other health professionals to use.” “What is driving us mad is that the PCEHR has been built with so many controls that can be turned on and off by the patient that they have forgotten that you want to make it easy for doctors and hospitals and other health professionals to use,” he said. “The more complex you make it, the worse it gets. I had a consumer stand up at a meeting the other day and say ‘I don’t care if I die, I’m not sharing my information with you’. My
response really was, clearly you need to opt out and get out of the way and let the other people who do want to share to gain the benefits … frankly, we just want the rabid consumerists to get out of the way and let’s just get on with it.” Dr Hambleton said one of the implications of the ongoing discussions around provider participation was that general practices will need to ensure they have insurance to cover their responsibilities for the PCEHR in addition to individual indemnity policies for practitioners. “To participate in the PCEHR the practice will need to have a system set up so individuals who interface with the PCEHR are identifiable,” he said. “Say a receptionist accesses the PCEHR and does something, breaks confidentiality for example, that may cause a legal liability that won’t be covered by a doctor’s medical indemnity insurance. It will be in relation to the practice, which will be vicariously liable for the staff. “Most practices have insurance but it was part of the problem as even the insurers were unsure. If it is a practice employee that you are liable for we all recognise that’s a business requirement but what the
original document was going to ask us to do was indemnify for people that the practice didn’t control. “That was part of the original problem so the reality is that this is another reason that practices have to make sure they have appropriate insurance to cover their staff. It’s not completely new but the clarity is there now.” He said that even though several clinical software vendors will have PCEHRcompliant software available in September, it was unlikely it would be used immediately. The software he uses in his own practice, Monet, would not be able to interface with the PCEHR, he said.
“I think there is work happening to retrofit systems like Monet to enable it to interface with the PCEHR but it’s different to a simple upgrade that some of the other products will be doing. There is no doubt in my mind that some practices will have to change software entirely to be able to interface with the PCEHR. “That’s just the practice decision, and then the practitioner will have to make a decision about whether they actually interface with the PCEHR. “We support the end point, but with software upgrades, there are early adopters and late adopters. Whenever you get a significant upgrade,
inevitably – and the software vendors would agree – there are going to be some teething problems. So even if it’s available in September, there may be practices who choose not to apply the upgrade until October or November.” The AMA is not recommending to its members whether to participate or not, but it has devised a checklist to help practices in deciding what they need to do if they want to participate. Dr Hambleton said the checklist would prove a daunting prospect for many GPs. It includes obtaining an HPI-O, HPI-Is for individual practitioners, a secure messaging service, and purchasing or installing PCEHR-compliant software or upgrades. “Then decide how to use it, put in the protocol, train the staff and the practitioners in the practice, check your indemnity cover that practice insurance is included, sign the agreement, review the cost of implementation in the practice and also set fees to cover the visits. You can’t do it overnight.”
Dr Steve Hambleton
Individual practices and practitioners will have to decide for themselves whether it was worthwhile, he said. He said he expected a lot of doctors would just wait and see as the roll out continues.
RDNS chooses HealthShare for systems integration The Royal District Nursing Service (RDNS) will use InterSystems’ HealthShare informatics platform to integrate its client management, HL7 clinical messaging, human resources and finance functions. RDNS, Australia’s largest provider of home nursing services, currently maintains over 50 applications with a substantial effort required to integrate new systems via point-to-point interfaces. The organisation, which also runs a 24hour telehealth nursing service, said it expects automation to reduce this effort by at least 50 per cent. Other systems will be integrated over time. RDNS general manager for solutions services Ainsley Pollock said the purchase was a strategic investment. “HealthShare will help us automate our processes right across the enterprise,” Mr Pollock said. “The business will benefit with workflow improvements and reduced handling of data, and patients will benefit from more accurate service delivery at a lower cost.” He said the organisation will be able to pass data from clinical to financial systems and to automate most of the billing process and create exception reports. “Instead of a finance person struggling for four hours checking data in spreadsheets, HealthShare can create a web portal view as part of the workflow which they can process in 30 minutes,” he said. HealthShare will also be used to deliver information from the triage application used by nurses to provide specialist clinical advice such as catheter management plans. Instead of communicating over the phone and manually updating care plans, information will be automatically inserted as a patient record in the clinical system on their tablet computers. There is potential for it to eventually update the PCEHR.
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HISA board, award winners announced at HIC2012 The Health Informatics Society of Australia (HISA) named its new board members for the next two years along with national award winners at Health Informatics Conference (HIC2012), held in Sydney. Katerina Andronis was re-elected chair of the HISA board, along with vice-chair Jon Hilton and new co-vice chair David Hansen, previously a board director. Phil Robinson returns as treasurer. Returning board directors include Tam Shepherd, Fernando Martin-Sanchez, Jen Bichel Findlay and Lis Herbert. Michael Gill and David Rowlands have also returned to the board. The winner of the Branko Cesnik award for best scientific paper was Jim Warren of the University of Auckland, who spoke about using a general practice EMR for improving blood pressure medication adherence. The student paper award winner was Jaime Garcia of the University of Technology, Sydney, who discussed using “exergames” for the elderly using Microsoft’s Kinect. Livio Ciacciarelli won the Moya Conrick Award at the Nursing Informatics Conference for a paper on a clinical practice support program to support care planning at the beside. IHE Australia advocates Bernie and Yvonne Crowe received a Lifetime Achievement award for their years of service to the field of health informatics. The Don Walker awards for effectiveness, efficiency and access went to Jenny O’Neill of EpiSoft, Alice Freyne of Surgical Multimedia Services and Geraldine McDonald of Arthritis Australia.
Pulse+IT received the HISA media award.
Orion Health details moves towards PCEHR connectivity at HIC2012 Orion Health outlined some of its work with state and territory health departments, including its efforts to connect hospital systems to the national PCEHR infrastructure, at the Health Informatics Conference (HIC2012) in early August. Orion Health, a member of the National Infrastructure Partner consortium that built the PCEHR infrastructure, is currently working with ACT Health on developing the capability to send electronic discharge summaries to the national records system. Orion Health’s solutions director for Australia, Kelsey Grant, said an ACT Health representative was on Orion Health’s stand to provide details on the territory’s progress towards connecting to the PCEHR.
ACT Health is using Orion Health’s Rhapsody integration engine to build the infrastructure required to connect to the PCEHR, he said. Rhapsody will allow ACT Health to integrate its disparate clinical and patient management systems and translate the information contained to the national system. “Rhapsody is used within the organisation to connect and integrate their existing systems and is being used as what we term a PCEHR connector,” he said. “The real advantage is that ACT Health does not have to change existing systems to contribute information to the PCEHR. Rhapsody can sit at the edge, translate and contribute.”
Orion is also working with NSW Health on two components of the Greater Western Sydney Wave 2 lead site, including the creation of its clinical repository for sharing information between NSW’s local health districts and on its electronic Blue Book. Several jurisdictions are building PCEHR conformant repositories to receive and store clinical information and then link it to the PCEHR. The national infrastructure has been built to receive both information uploaded directly and from repositories, Mr Grant said. “The PCEHR supports both environments,” he said. “You can send information
“ACT Health are quite advanced and are already doing electronic discharge summaries,” Mr Grant said. “They have been working on Individual Healthcare Identifiers for quite some time so they have a lot of the groundwork already laid. What the work is about now is doing the translation and to generate CDA documents and send out discharge summaries to the national PCEHR infrastructure.”
Kelsey Grant
How do I do it? to the national repository and you can build your own conformant repository. To put information into the national repository is probably a bit easier because you don’t have to build your own – just send the information across. “However, some organisations may wish to avoid duplication of information, and keep a higher degree of control. By having your own repository you are able to do this. “Over time, more organisations will connect and you will start seeing private organisations
such as private pathology providers who might not want to duplicate all of their data into the national infrastructure; they might want to retain control of it.” Mr Grant said the other focus for Orion Health was its clinical portal product, which has been deployed to build the consumer and the provider portals for the PCEHR. Formerly known as Concerto, the clinical portal is able to aggregate information from existing clinical systems into a single patient view. “Orion Health has two portals – Orion Health
clinical portal and Orion Health patient portal Both of those portals are deployed in the national infrastructure and so when the provider portal becomes available it will have a very similar look and feel to the consumer portal.” Mr Grant said the PCEHR had been built to support the ability for healthcare practitioners to be able to import information into their desktop software from the PCEHR, although this has yet to be deployed by the software vendors. The PCEHR had also been designed to support future mobile applications.
Victoria begins product catalogue build Health Purchasing Victoria (HPV), the organisation responsible for collective procurement for Victoria’s public hospitals and healthcare services, has started building its state product catalogue system, with a production build due at the end of the year and a rollout to hospitals beginning in 2013. The Victoria Product Catalogue System (VPCS) will maintain the Victoria Product Catalogue (VPC), which will receive product and pricing information from the National Product Catalogue (NPC), the standardised data repository that identifies medicines, medical
devices, equipment and consumables. The NPC is hosted on GS1 Australia’s GS1net datapool and uses GS1’s standard identifier, the Global Trade Item Number (GTIN), as the unique primary product identifier for every NPC record. More than 90 per cent of pharmaceuticals and 50 per cent of medical devices and consumables worldwide have a GTIN assigned to them. To populate the VPC, the system will match and merge product and pricing information from the NPC with HPV contract information. The data loaded into the NPC by
suppliers will feed into the VPC regularly, meaning suppliers do not need to provide data to both. ACT Health was the first to build a jurisdiction-wide product catalogue, called the Master Catalogue Information Service (MCIS), and the other states and territories are working on theirs. An HPV spokesperson said the VPCS project team had this month started loading data for suppliers from the NPC into a basic, test version of VPC. Once quality assurance testing has been completed, the VPCS will be rolled out to all Victorian public hospitals.
nd eReferralsmamaries... u Discharge S
h ealtnce... H ed de Alli spon re cor Ra dio log yR ep ort s...
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...ALL SECURELY and ELECTRONICALLY? The questions are tough, but the answer is easy.... Better Communication, Better Care www.healthlink.net
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AMA launches desktop tookit for GP resources
The fear factor: dispelling the myths about bring your own device
The Australian Medical Association (AMA) has developed a GP Desktop Practice Support Toolkit for members to provide easy access to over 300 commonly used administrative or diagnostic tools. The toolkit, which is free to members, can be downloaded from the AMA’s website. It will sit on the GP’s desktop computer as a separate file and is not linked to vendorspecific practice management software, a spokesman for the AMA’s member services division said. New or updated documents or tools will be automatically linked through the toolkit, the spokesman said. It has been designed on the Google Doc platform to allow easy access to the tool, which include state and territory specific documents such as forms for WorkCover and S8 prescribing. The toolkit is divided into five categories, including online practice tools that are accessible or can be completed online; checklists and questionnaires that are available in PDF format and can be printed; and commonly used forms that are available in PDF and can be printed. Relevant administrative and clinical guidelines and references and other resources are also included. The spokesman said members can download the toolkit by dragging it onto their desktop. “When you need a document, you just click on the link and the latest version will be there,” he said.
Katerina Andronis Consulting firm Deloitte has released a report dispelling what it says are the top 12 myths about technology use in digital hospitals now and in the future. The Untangling the Truth report dismisses some of the myths surrounding the concept of the digital hospital, including that it means the same as a “paperless” hospital.
“We’ll be checking it once a week to make sure all the links work and the latest versions are uploaded.”
Deloitte predicts that hospitals will use a mixture of paper-based and electronic information for the foreseeable future, including new hospitals that are opening with the latest technological advances.
The AMA will add new links or tools as they are identified and members are welcome to suggest other tools.
The report covers topics such as clinician access to information, finding
that while some believe clinicians require access to all available information on a particular patient, this is not necessarily true. The reality is that clinicians only require access to information needed to support clinical decisions in the context of the task. It also covers the very topical issue of the bring your own device (BYOD) movement, dispelling the myth that clinicians will only access patient information through a hospital's own systems and devices. “Clinicians want to be able to bring their own devices to work and to access patient information this way,” the report states.
Katerina Andronis, Deloitte's director of consulting for healthcare, said there is a myth that if clinicians bring their own devices to work, hospital CIOs will have problems with security and network connections and “all hell will break loose”. “In reality, that is not the case,” she said. “Our world has changed – we have the technology, we have the capability, and the challenges we have are around processes and adoption. That's really what our problems are.” Ms Andronis said clinicians were driving the uptake of mobile devices and while some CIOs are still nervous about the security implications, if BYOD
policies are implemented appropriately, it is a way to get clinicians on side. She gave the example of her time as CIO at the Peter MacCallum Cancer Centre when Apple first launched the iPhone. “Doctors were queuing up at four o'clock in the morning at Optus, and by nine o'clock that morning they came into my office and said ‘we want you to enable our iPhone on the Wifi’,” she said. “Two weeks later we did. “And that is what I love about BYOD – a lot of the hospitals that we are working with are incorporating that strategy
because a doctor wants to bring in his mobile device, whether it's a tablet or a phone, they don't want to be changing devices. They want to be going through the patient's journey in and out of the hospital in a secure way.” She said Deloitte was working with a number of hospitals throughout Australia that were implementing BYOD policies safely and securely. One has set up a system in which clinicians' devices are automatically linked to the hospital's clinical system as soon as they walk in the front door. When they leave, they remain
connected through a virtual private network.
Secure health record sharing with no big build
“You are not holding information on the device – it is a thin client device,” she said. “Eventually, mobility and the cloud will be a normal thing for us. The private cloud for health will be the future; they will all work together in conjunction as a family.
Emergency department doctors in the north of New Zealand who are trialling a new service allowing access to GP medical records are using the program up to 20 times a night, the developers say.
“I think we have to take away the fear factor, which is what it really is, because you can still hack into the computer of someone sitting in the locked room of a hospital. With the cloud and mobility, you just have to set it up properly, and some do.”
Privacy Commissioner reveals investigative powers over PCEHR The Office of the Australian Information Commissioner (OAIC) has released details of the powers it has been awarded under the PCEHR Act to investigate breaches of the new system.
undertakings, and to use its existing Privacy Act investigative and enforcement mechanisms.
The OAIC was appointed as the independent privacy regulator of the PCEHR under the new Act. It will have a range of enforcement powers, including the power to seek civil penalties or an injunction to prohibit or require particular conduct.
The Australian Privacy Commissioner, Timothy Pilgrim, said consumers should ensure they understand how their personal and health information will be collected, used and disclosed. “You can decide which healthcare providers can see your record and what information they can access,” he said.
It can also require people to accept enforceable
“Have a conversation with your healthcare provider
Developed by NZ companies HealthLink and Dr Info, the Care Insight service allows ED doctors to access patient records, recent prescriptions, diagnoses and medical alerts, held in practice systems. The service, which is being trialled in the Hawke’s Bay region, Gisborne and Northland, requires both the patient’s and the GP’s consent to access the records by ED doctors. All access to the patient record is tracked, so GPs are notified when their patient is checked at ED and a record is requested. GPs keep full control of patient data since Care Insight runs securely on the practice’s HealthLink server, the company’s CEO, Tom Bowden, said.
about what will be uploaded and accessed from your eHealth record.”
“The primary thing it does is allow the person going into an emergency department as a patient to have their primary care and pharmacy records looked up,” Mr Bowden said.
Mr Pilgrim encouraged healthcare providers to understand their obligations under the new laws, which impose extra obligations to those existing under the 1988 Act.
“If you go into emergency care they will immediately use a Care Insight system to scan all of the GP records in the region to find out where you have been and then go and get a chart. It solves a lot of time spent in hospitals chasing around trying to find out what medications they are on.”
“Healthcare providers’ obligations include not collecting more information from a patient’s eHealth record than is necessary, and making sure their staff are trained in how to handle eHealth records correctly,” Mr Pilgrim said.
He said that in contrast to national systems such as Australia’s PCEHR, this sort of system is cheaper, simpler, easier to use and doesn’t require large centralised infrastructure. “It is browser-based from the hospital system but the actual software is on the GP’s site,” he said.
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InterSystems adds to HealthShare portfolio InterSystems has won two contracts to install its HealthShare health informatics platform in the US. One contract, for the New York eHealth Collaborative (NyeC), will see the company link up regional health information organisations (RHIOs) to create a state health information network covering the whole of New York state, which at 19 million has a total population similar in size to Australia. NYeC will implement a set of core services that will be used by participants in the Statewide Health Information Network of New York (SHIN-NY) to exchange information across organisational boundaries. More than $US300 million in federal and state funds have been allocated to accelerate health information exchange (HIE) and the use of health information technology in New York over the next three years, NYeC executive director David Whitlinger said. “NYeC’s success will depend on its use of federal and state grant dollars to create a sustainable HIE infrastructure that supports widespread initiatives to improve health care quality and reduce health care costs,” Mr Whitlinger said. InterSystems’ group commercial director, Steve Garrington, said HealthShare supports a set of standards and protocols that will enable sharing of critical health information across New York and will provide a health information exchange model for national initiatives. “We also anticipate that existing and potential customers will use HealthShare to provide secure and consistent access to regional and national infrastructure such as the PCEHR in Australia,” Mr Garrington said.
PharmCIS PBS system to include medicines terminology The federal government will introduce its longpromised Pharmaceutical Consolidated Information System (PharmCIS) in December, with Pharmaceutical Benefits Scheme data now referencing NEHTA’s Australian Medicines Terminology (AMT). Updated PBS data will now be delivered to users in XML format, rather than the previous plain text format. PBS data is managed by DoHA’s PharmBiz division, which collects and disseminates data from a range of internal and external sources. The PBS is updated every month. According to DoHA, PharmCIS is designed to improve the efficiency of submission processing by consolidating existing systems and processes into a single authoritative source of information about the PBS. For prescribers and dispensers, PharmCIS aims to improve the specification and management of restrictions by increasing clarity for prescribers and dispensers and introducing machine encoding. It will also support broader eHealth initiatives by mapping to NEHTA’s AMT codes, which is necessary for implementing
developments such as the electronic transfer of prescriptions (ETP).
reference product, there will be no difference. It will be business as usual.”
PharmBiz will not produce a schedule in November to allow the introduction of AMT descriptors in the PBS data, with the December 1 2012 schedule the first to reference the AMT. The October 1 PBS schedule will remain current until November 30.
MIMS editors have been mapping MIMS data to the AMT for last two years, so that will make no difference either, she said.
“In terms of us bringing the PBS into our reference product, there will be no difference. It will be business as usual.” Margaret Gehrig, national business manager for medicines information provider MIMS, said the introduction of the new system would have no effect on MIMS processes as MIMS already receives and can handle both XML and text formats. “We take the PBS as a file and we incorporate the PBS information into all of the drug-related information, and we bring that information in (to MIMS) every month,” Ms Gehrig said. “In terms of us bringing the PBS into our
The director of strategy and operations at Health Communication Network (HCN), Tania Taylor, said HCN saw the move towards an XML feed as a positive step. HCN has its own drug reference product, MDRef, while many other software packages use MIMS. “There is no impact on HCN products and besides some testing on our side, we do not have to make changes to Medical Director,” Ms Taylor said. Frank Pyefinch, CEO of Best Practice, said his company is prepared to incorporate AMT as soon as MIMS has completed the mapping. “We are including it in the MedView project, one of the Wave 2 projects, so in the XML that we send up to MedView we are including AMT codes that MIMS have given us,” he said. “We are pretty much ready to go as soon as they are.” He said the move to XML in the PBS data would make processes faster as the text files require some manual correction, such as fixing
fields that have commas in the text. Best Practice will need to rewrite some of its routines to process the XML files but Dr Pyefinch said it would mean a more reliable import in the long run. “We’ve had access to the XML files for quite some time and we theoretically could have been working
on that but we haven’t had time,” he said. He said one benefit of the XML files is that they include notifications of streamlined authority for repeat prescriptions that no longer require telephone approval from Medicare. End users will see no difference, he said.
A DoHA spokeswoman said DoHA was working with software vendors on the technology and system needs for the transition to the new system. “Further details on the look and feel of the new system will be provided to all stakeholders over the coming months,” she said.
Operational lessons from CareTrack The team behind the landmark CareTrack study into the level of appropriate care in healthcare provision in Australia, published recently in the Medical Journal of Australia, is hoping to develop a set of agreed tools for data extraction and to set up expert groups to develop clinical standards for common conditions using a Wiki-like approach. CareTrack, which highlighted disparities in the standards of care provided by medical practitioners for 22 conditions, proved to be a difficult study to undertake due to problems in gathering population-based data from multiple sources, the researchers said. In a Perspectives piece accompanying the study, the CareTrack authors outline the difficulties they faced in gathering information to conduct the project, pinpointing the lack
of easy access to healthcare data as one of the main barriers to making similar studies more routine and prospective. One of the main barriers to such population-based studies is the difficulty in accessing medical records, the researchers said. The study required a large amount of manual data extraction, several rounds of ethics approval and a lot of paper-based forms. Two reasonably simple ways to overcome these barriers are the wider use of commercially available tools to extract data from general practice and hospital-based medical records, and the creation of expert groups to set up clinical standards using a Wiki-like approach. One of the study authors, Enrico Coiera, director of the Centre for Health Informatics at the University of NSW’s
Australian Institute of Health Innovation, said a shorter-term approach should be considered to develop tools that permit extraction of key data fields from local electronic record systems. “There are many models for such monitoring tools on a selected sample of practices to get this kind of high level data. If it was thought useful, and individual practices wanted to see how well they tracked against standard, then they could elect to report, and would make sure the record system they used was conformant with standards for extraction.” The researchers said some of these difficulties might be overcome if they could be carried out over a national shared electronic health record system. However, national systems like the PCEHR are not likely to be able to allow this for many years, if ever.
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mHealth helps patients stick with the program The federal government has launched an online cognitive behaviour therapy (CBT) program with a difference – it’s mobile. Developed by researchers at the Black Dog Institute and the University of NSW, myCompass is a web-based program offering a range of modules to help people with moderate stress, anxiety and depression to identify triggers for their conditions and clinically validated methods to overcome them. However, two of the main problems with online programs – or face-to-face therapy for that matter – is motivating people to stick with the program and recording moods and triggers in real time. The myCompass program aims to overcome those barriers by using that most ubiquitous of devices, the mobile phone. According to one of the program’s developers, the Black Dog Institute’s Judy Proudfoot, myCompass is one of the few in the world that is using mobile phones to provide real-time monitoring for people undertaking web-based CBT. “Mobile interventions are just starting to take off internationally, so we were at the forefront,” Associate Professor Proudfoot said. “I think our program is one of the few in the world, if not the first in the world, that is for adults with depression, anxiety or stress. “myCompass is a self-help program and can also be used by GPs with their patients. It has the dual functionality.” myCompass has two “active ingredients” that together improve outcomes for people using the program. The first is a series of web-based modules, which use a variety of evidence-based therapies in addition to CBT, and the second is the real-time monitoring element utilising mobile phones or other hand-held devices.
NPS RADAR added to Best Practice and Medtech32 The NPS RADAR decision support tool will shortly be available to users of Best Practice and Medtech32 clinical software.
NPS patient information leaflets for some years now but the RADAR documents are more aimed at the prescriber,” he said.
NPS RADAR reviews new drugs as they become available on the PBS and alerts the GP with a pop-up summary of key information the first time he or she prescribes the drug.
“We’ve integrated them into our prescribing wizard so that where a drug is selected that has an NPS RADAR entry, that will be displayed as part of the step-wise sequence that users go through in generating the script.”
The tool is currently available in Medical Director and Genie, but is now being added to Best Practice and Medtech32, with an updated version integrated into Genie. Best Practice founder and CEO Frank Pyefinch said it would be available to users in the next release of Best Practice. “We’ve had
Rama Kumble, chief technology officer with Medtech Global, said his company had begun integration into Medtech32 in August. “It will be available this month for beta customers and usually once the beta is complete it will be available
for everybody,” Mr Kumble said. “We expect an AugustSeptember timeframe. “The implementation is pretty straight forward and the doctors will see a button whenever there is an alert available, and they can take a look at it and take any action they need.” NPS CEO Lynn Weekes said alerts are activated if there is current RADAR information available on a selected drug. The alerts highlight safety, dosing and patient counselling points that are relevant at the time of prescribing. “The RADAR alert messages are designed to be clear, concise, and easily scannable,” Dr Weekes said. “Each alert
Tele-eye care teams up with EHRs for diabetic retinopathy The University of Melbourne and the Fred Hollows Foundation have launched a $3 million partnership to introduce low-cost eye exams for indigenous Australians using proven telehealth technologies. The Telehealth Eye and Associated Medical Services network (TEAMSnet) aims to increase the access of people in remote areas of Australia with diabetes. The program will include a clinically validated protocol that has proven to work not just for diabetes-related blindness but for age-related macular degeneration, hypertensive retinopathy and glaucoma, the project’s lead, Sven-Erik Bursell, said.
is reviewed by a panel of GPs to ensure it aligns with day-to-day clinical practice, so it’s relevant information available at the GP’s fingertips.”
“As soon as a new drug has information available, we will have it within Best Practice automatically. We have a little server in the background that is checking at random times,” he said.
“We’ve integrated them into our prescribing wizard so that where a drug is selected that has an NPS RADAR entry, that will be displayed as part of the step-wise sequence that users go through in generating the script.”
“If a new drug is available on the market, when the doctor tries to prescribe it for the first time they’ll get an NPS RADAR alert come up in the course of the prescribing process.”
Dr Pyefinch said users can elect to turn it off after it has popped up – by default it will only pop up three times, the first three times a drug is prescribed.
Dr Pyefinch said Best Practice will scan the NPS server every 24 hours to see if there is any updated material.
“So if a doctor wants to turn it off after the first time they can turn off that individual drug information without turning off the whole NPS RADAR system,” he said. “From the little pop-up, which is usually just three or four dot points of major information, such as ‘this should not be used in renal failure or is contraindicated in a patient with asthma’. “They also have a hyperlink to a full monograph of the drug, and that’s available forever afterwards.” Links to NPS RADAR are also integrated in eMIMS and MIMS Online, and all NPS RADAR articles, including in-brief news items, are freely available on the NPS website.
It will also use Associate Professor Bursell’s Chronic Disease Management Program (CDMP), an open source software program that actively incorporates eye care management into mainstream chronic disease management functions such as electronic clinical decision support, risk assessments, collaborative care planning, nutrition counselling and physical activity coaching. The software can operate in a mobile health environment using CDMP’s patient portal, and the team is in discussions with Communicare, the WA-based clinical software vendor that specialises in Aboriginal healthcare and which was recently acquired by DCA, to set up an interface between Communicare’s electronic health record and CDMP. As part of the TEAMSnet project, nonmydriatic retinal cameras will be purchased and sent to participating communities, with Aboriginal health workers taking the images. These will be sent via a secure virtual private network to a team of trained readers at the Centre for Eye Research in Mebourne, who will do a retinal assessment and relay an encrypted PDF report back to the originating site.
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Events
August 29-30 AUGUST
27-28 SEPTEMBER
14
AUSTRALIAN TELEHEALTH CONFERENCE Melbourne, VIC p: +61 3 9326 3311 w: www.hisa.org.au/telehealth2012
INTERNATIONAL HL7 IMPLEMENTATION CONFERENCE Vienna, Austria w: www.ihic2012.hl7.at
QUEENSLAND HIC REPRISAL AND WORKSHOP Brisbane, QLD p: +61 3 9326 3311 w: www.hisa.org.au
September
October
5-7 SEPTEMBER
11
ROYAL AUSTRALASIAN COLLEGE OF MEDICAL ADMINISTRATORS Perth, WA p: +61 3 6234 7844 w: www.racmaconference.com.au
PROGRESS OF PCEHR WAVE EVALUATIONS Sydney, NSW p: +61 3 9326 3311 w: www.hisa.org.au
10-14 SEPTEMBER SUPPLY CHAIN WEEK HEALTHCARE Melbourne, VIC and Sydney, NSW p: +61 3 9558 9559 w: www.gs1au.org
14-16 SEPTEMBER THE GENERAL PRACTITIONER CONFERENCE & EXHIBITION - BRISBANE Brisbane, QLD p: +61 2 9422 2007 w: www.gpce.com.au
NOVEMBER
OCTOBER
16-19 OCTOBER AAPM NATIONAL CONFERENCE Brisbane, QLD p: +61 3 6231 2999 w: www.cdesign.com.au/aapm2012
17
OCTOBER
DISCUSSION AND ANALYSIS OF PCEHR WAVE SITES Melbourne, VIC p: +61 3 9326 3311 w: www.hisa.org.au
19
OCTOBER
HEALTH INFORMATION TECHNOLOGY WA Perth, WA p: +61 3 9326 3311 w: www.hisa.org.au/page/hitwa2012
29-31 OCTOBER HIMAA 2012 NATIONAL CONFERENCE Surfers Paradise, QLD p: +61 2 9887 5001 w: www.himaa.org.au/2012
November 17-19 SEPTEMBER
7-9
HIMSS ASIAPACIFIC 2012 Singapore p: +65 9299 0802 w: www.himssasiapac.org
HINZ 2012 Rotorua, NZ p: +64 4 389 8981 w: www.hinz.org.nz
20-21 SEPTEMBER
8-10 NOVEMBER
16TH ANNUAL CHRONIC DISEASES NETWORK CONFERENCE Darwin, NT p: +61 8 8981 2010 w: www.cdnconference.com.au
THE NATIONAL PRIMARY HEALTH CARE CONFERENCE 2012 Adelaide, SA p: +61 2 6228 0846 w: www.agpn.com.au
NOVEMBER
16-18 NOVEMBER THE GENERAL PRACTITIONER CONFERENCE & EXHIBITION - MELBOURNE Melbourne, VIC p: +61 2 9422 2007 w: www.gpce.com.au
19-21 NOVEMBER 4TH AUSTRALIAN RURAL & REMOTE MENTAL HEALTH SYMPOSIUM Adelaide, SA p: +61 7 5502 2068 w: www.anzmh.asn.au/rrmh
22-23 NOVEMBER 5TH HOSPITAL IN THE HOME CONFERENCE Melbourne, VIC p: +61 2 8204 0770 w: www.hithsociety.org.au
26-28 NOVEMBER GLOBAL TELEHEALTH 2012 Sydney, NSW p: +61 7 3876 4988 w: www.icebergevents.com/gt2012/
December 3-5 DECEMBER 2012 MHEALTH SUMMIT Washington DC, USA p: +1 703 562 8809 w: www.mhealthsummit.org
the fabric of a sustainable health system 29 - 30 AUGUST
Primary Care Acute and Emergency Mental Health Broadband Behaviour and Consultation Skills in a New Environment Chronic and Aged Care www.hisa.org.au/telehealth2012
HealthLink/Medinexus Half Page 180 x 120 Puse IT Mag Telehealth_PulseIT_JULY_0.indd 1
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connecting healthcare
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MSIA
AN EHEALTH SOFTWARE STANDARDS UPDATE A MEDICAL SOFTWARE INDUSTRY VIEWPOINT
In the last few months there have been a number of significant, and for the standards community at least, exciting, developments in the health software standards arena. Before launching into that, it is worth summarising some of the goals of standardisation and the main bodies involved in the eHealth standards landscape, both in Australia and internationally. DR VINCENT MCCAULEY MB BS, Ph.D MSIA National eHealth Implementation Coordinator implementation@msia.com.au
About the author Dr Vincent McCauley is an acknowledged national and international expert in eHealth standards. He leads MSIA’s team assisting its membership of more than 120 leading eHealth software vendors and the wider vendor community in creating a richly interconnected, semantically interoperable eHealth environment.
Software standards in general and eHealth software standards in particular provide a methodology and governance framework to encapsulate community agreed best practice in a readily accessible and stable specification. The wide stakeholder engagement, public comment processes and concentrated expert input are a proven and trusted path to high quality documents. Standards provide stability for industry and building blocks towards interoperability that are vendor neutral. International standards aim to provide capabilities that can be built once and deployed across international boundaries. eHealth standards in Australia are governed by Standards Australia and managed by the IT-014 Technical Committee (www.e-health.standards.org. au). There are sub-committees of IT-014 for specific domains including Health Concept Representation (IT‑014-02), Electronic Health Record Interoperability (IT-014-09), Information Security (IT‑014‑04), Telehealth (IT-014‑12) and Messaging and Communication, including clinical documents (IT‑014‑06). IT‑014‑06 in turn has Working Groups (WG) responsible for Patient Administrative Messaging (IT-014-06-03), Prescription Messaging (IT-014-06-04), Diagnostic Messaging (IT-014-06-05) and Collaborative Care Communications (IT‑014-06-06). The Medical Software
Industry Association (MSIA) has members who attend all IT-014 committee meetings on a regular basis. Recent developments at IT-014 have included: a) Formation of a Conformity Assessment Task Force looking at how standards should specify conformance requirements and how conformance requirements and test cases should be documented. b) Formation of a Clinical Decision Support sub-committee (IT-014-13) with the inaugural meeting taking place on June 12, 2012. c) A large and complex work program of approximately 72 projects to provide standards support for the PCEHR project and National Health Identifiers in existing and new standards. d) Major current work items include topic areas such as: (i) a new CDA based ETP standard; (ii) standardising the CDA documents specified for the PCEHR (shared health summary, event summary, referral, discharge summary and specialist letter) and extending their applicability for point-to-point exchange; (iii) Profiling the HL7 V2 referral standard to carry the same content as the CDA Referral document; (iv) Updating the diagnostics implementation handbook and standard to incorporate National Healthcare identifiers and terminology;
and (iv) Updating the patient and provider identification standards and patient administrative messages to include support for National Health and other identifiers. The Department of Health and Ageing (DoHA) provides significant financial support for IT-014 administrative functions but the members of the IT-014-subcommittees and working groups are all unpaid technical experts. In the Australian context, the majority of eHeath international standards work occurs at HL7 International and at the International Organization for Standardisation (ISO) eHealth Committee (ISO/TC215). Related bodies are the European Economic Community (EEC) eHealth standards Committee (TC251) as well as other Standards groups with eHealth work programs such as the Object Management Group (OMG), CDISC, IEC and IEEE. Increasingly there are cross standards organisations and joint standards development between these groups. Examples include HSSP (collaboration between HL7 International and OMG) and the various Joint Working groups such as JWG7 which is a collaboration between ISO/TC215 and IEC. Internationally, Australia is well represented at HL7, with six co-chairs of influential HL7 International committees, as well as input to the board advisory panel and has a strong team representing Australia’s interests at ISO/TC215. Both of these teams receive DoHA support for costs (administered by Standards Australia) but volunteer their time to attend working meetings and weekly or fortnightly teleconferences. For the eHealth software industry, a significant development at ISO/TC215 over the last few years has been the move to develop a prescriptive approach to eHealth software system safety in a standards framework. Initial attempts promoted by the healthcare devices groups proved too inflexible and were not accepted by TC215. However, two new work items have recently been proposed to develop both a catalogue of international standards that may be useful for developing safe eHealth software and a renewed attempt to standardise concepts and behaviour that are requirements of safe eHealth software. Many regulatory bodies are watching these developments carefully. Achieving a balance between cost effective, practical standards and the ability to support a prescribed level of safety and certainty will be difficult – doing so in a manner that is acceptable to a broad spectrum of the international eHealth community will add an additional level of challenge. The formation of IT-014-13 as an Australian Standards focus for Clinical Decision Support (CDS) is a welcome development. In recent years there has been general agreement that standards for this rapidly developing area are necessary to underpin safe, reproducible, traceable clinical outcomes, but there was no local
body tasked with their production. The imminent delivery of the national PCEHR for the first time provides the potential for a rich source of data to facilitate Clinical Decision Support systems. The IT-014-13 sub-committee will act as a local mirror committee to the HL7 International Clinical Decision support committee and is co-chaired by representatives from two MSIA member companies. The sub-committee’s work plan will include localisation and support for the HL7/OMG Service Oriented Architecture (SOA) Clinical Decision Support Service as well as standardisation of data inputs to CDS systems – the HL7 Virtual Medical Record (VMR). At the last HL7 International meeting, frustration with the complexities of HL7 V3 implementation led to a proposal by local HL7 Standards guru and MSIA member, Grahame Grieve, for the next step – Fast Health Interoperability Resources (FHIR). This proposal is being loosely referred to as HL7 V4! It connects the strong data modelling of the HL7 V3 Reference Information Model (RIM) to the easy to implement world of RESTful service oriented architecture. FHIR has been endorsed by many of the HL7 V3 stalwarts though there are many details still to be finalised. Work on FHIR has attracted an enthusiastic, highly motivated community of people and is being progressed at a pace that is likely to see some mature outcomes in unprecedented short timeframes. Whilst the standards support for the PCEHR has been a prominent focus for the federal government over the last two years, there have been many other areas of progress in eHealth standards development. Australian expertise is playing a significant role in international standards initiatives and this is being reflected in local standards developments across a broad spectrum. A major limiting factor at present is availability of expert volunteer time. NEHTA has made a number of significant resource contributions to major specifications that are now being passed to Standards Australia to develop and progress through the standards development process. However, the current capacity is being challenged by large sets of documents comprising many thousands of pages, produced over many years which are now inputs to new standards and are to be processed by small numbers of volunteers in relatively short timeframes. A few years ago IT-014 received an award as the most productive committee within Standards Australia. Refinements of process and resources are being undertaken to address the current challenges so that the same efficiencies can be reached to achieve the required outcomes in quantity whilst maintaining quality. The prospect of a cutting edge, richer eHealth standards landscape is tantalisingly close. However, it will require the eHealth community in general, the eHealth software industry and MSIA members in particular, to provide significant support in order to build effectively on the foundations provided by NEHTA and DoHA.
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HISA
WORKFORCE DEMANDS, EMPLOYERS AND EMERGING
HEALTH INFORMATICS PROFESSIONALS Of the 482 unique job titles that HIC2012 delegates listed as their occupation, 19 of them had the term informatics in them. Amongst them were academic titles, clinical roles and some managerial titles such as Director of Health Informatics, Director of Nursing Informatics and Manager Health Informatics. Is this good enough in raising the profile of our profession?
DR LOUISE SCHAPER BSc(OT)HONS, PhD CEO: HISA ceo@hisa.org.au
Considering the audience at HIC, out of the 900 or so people who attended, should we expect more than 22 of them to have the term ‘informatics’ in their title? Does it matter? In the final panel session of the conference, we asked panellists about the role of health informatics and its professionals. It was the final session of an exciting but tiring four days. I started by asking delegates if they would describe themselves as a health informatics professional: how many have informatics somewhere in their job description and how many of them work for organisations that employ someone who practices informatics? There was a strong raising of hands in response to all of these questions, giving encouragement that we are making progress in raising the profile of health informatics and its professionals.
An insatiable demand
About the author Dr Louise Schaper is CEO of the Health Informatics Society of Australia, Australia’s health informatics organisation. Louise has over 10 years of experience in eHealth and health informatics, a degree in occupational therapy and a PhD on technology acceptance in healthcare.
While progress may be occurring, it is not happening fast enough. The need for a health informatics-literate workforce and the need for health informatics professionals across the health sector will be an insatiable workforce demand for many years to come. The opportunities for you as part of the health workforce are great. The demand
will come from the many burgeoning issues that are influencing the way healthcare is delivered, where it is delivered, and how the information is created, stored, managed, accessed and used – all of which affects the demand for health informatics. These influencers include analytics and big data; genomics; data, devices and sensors; telehealth; workforce mobility and technologies that enable the mobility of data; clinical terminology, implementation and use; decision support and artificial intelligence; consumer informatics; and the changing nature of care delivery models.
Employers’ needs Employers who are looking for and need health informatics professionals include health providers, technology companies, research and education organisations and government. During HIC I heard from many employers across these sectors of our industry who voiced their frustration at not being able to find the people they need. Many of them have work-arounds and techniques they have developed to train from within. Others said they recruit people with a health background as it is easier to teach informatics to people with a health background than to try and teach
health to people with IT or technical backgrounds. Others have had success hiring for attitude and aptitude and teaching them healthcare.
Emerging health informatics professionals and students During the networking reception at HIC we had a very good, albeit informal, gathering of health informatics students and emerging professionals. This group of people is interested in learning, finding a job, learning (purposefully repeated for emphasis) and establishing relationships with others who can give them sage advice about the next steps in their career. They wanted advice on how they can frame their long-term career strategy to have a long and successful career in this industry. HISA has a mentorship program on the ‘to do’ list and thanks to input from these emerging professionals and a few experienced people who have put their hands up, this new offering is in train. Over the next few months we will be formulating how this program will work. If you would like to be involved – either as an emerging health informatics professional or as someone ‘older and wiser’ who is interested in nurturing the future of our profession – please let me know.
How can HISA help you? Professor Enrico Coiera expressed in 140 characters or less this question to the twitterverse: “Is health informatics a body of
“Is health informatics a body of knowledge or a body of people that get special things done that no one else can do?” @enricocoiera
knowledge or a body of people that get special things done that no one else can do?” Prof Coiera’s question reverberated with me and other tweeps, as for most of us it is both. The health informatics community knows this, but there is still a ways to go in achieving recognition of the uniqueness and specialness of what we do across the healthcare system. As Australia’s health informatics organisation, it is HISA’s job to provide programs and opportunities to advocate for and support our community – you! You may not identify as a health informatician, but if you are reading Pulse+IT, then this applies to you. I invite you to contact me with your ideas and suggestions on how we can help you and others in the community. We have some things in the pipeline, but I’d love to incorporate your contributions to our strategy. I look forward to turning your suggestions into reality!
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Feature
HOW TO REGISTER FOR A PCEHR More than 4500 consumers have registered for a PCEHR since its launch date on July 1, and over 80 per cent of those have registered online. Consumers can also apply in writing, by phone or in person at a Medicare office, but while the steps are relatively easy, identity verification can be difficult.
KATE MCDONALD Journalist: Pulse+IT kate.mcdonald@pulseitmagazine.com.au
About the author Kate McDonald is a senior staff journalist for Pulse+IT. Formerly the editor of Australian Life Scientist magazine, she has also edited industry titles Hospital & AgedCare and Nursing Review. Her interests cover health ICT, biotechnology and translational research.
It is probable that the launch of the PCEHR was most eagerly awaited by the few people who had even heard about it, but in the month since its official launch on July 1, more than 4500 people have registered. The online registration system was not functioning in the first several days, and instructions on how to register online were not released until late in the second week, but several hundred people were still able to work out how to register online in launch week. DoHA figures show that over 80 per cent of registrations have been completed online. There are four ways that consumers can register for a PCEHR: in person, by telephone, by writing and online. NEHTA and the DoHA are preparing brochures outlining the steps to registration, which will be distributed through GP surgeries initially in the Wave 1 and 2 sites, but in the meantime, if your patients request information on how to register, it is best to direct them to the www.ehealth.gov.au site, which explains the background to the PCEHR, privacy information and outlines the steps to registration.
In person and by telephone Consumers can register for a PCEHR in person at a Medicare office as long as you have photo ID and a Medicare card. Medicare staff will verify your identity and
provide a wallet card which shows your identity verification code. They will help you to set up an australia.gov.au account and a PCEHR. The first time a consumer wants to access their PCEHR online, they will be asked to enter the identity verification code. Registration by telephone (1800 723 471) is a similar process, although tailored to identity verification from a distance. The call centre will ask you a series of questions about your most recent visit to a doctor or any medicines prescribed in order to ensure you are who you say you are. If your identity is verified, the operator will give you your identity verification code over the phone and you can then register for australia.gov.au and set up your PCEHR online.
In writing Critics of the PCEHR registration process have made much of the 12-page document that consumers must complete for written registration. The reality is that if you are registering for yourself, you only need to fill out three pages of details. The rest of the document relates to other people you would like to register for – either as an authorised representative for your children or as a nominated representative for those who are happy
to give access to an individual PCEHR to other people, such as family members or carers. Up to four other people can be listed on the form. The application form is available for download at the ehealth.gov.au site or from Medicare shopfronts, but you will need to read the accompanying information booklet, as this details the documents you must submit with the application form. Again, this is necessary to verify your identity. You must submit certified copies of a primary identity document such as a passport or birth certificate, or two secondary documents such as a drivers licence and a credit card. Certified copies are those made in the presence of an authorised person such as a justice of the peace, medical or legal practitioner, police officer or accountant. You then must post these to the Personally Controlled eHealth Record Program, GPO Box 9942 in your capital city, or drop them in to a Medicare office. If you are submitting an application for a child, they will in most cases be listed on your Medicare card, so you need only fill out the form with their basic details. If you are submitting an application
for someone over 18 – for instance, an aged relative or a family member with a disability for whom you are a carer or have power of attorney – you must submit a statutory declaration. Statutory declaration forms are available at www.ehealth.gov.au. An identity verification code will then be posted to you and you can proceed to set up a PCEHR.
Online Despite the bugs that the system experienced in the first week, online registration is relatively easy if you take a few steps beforehand. The first step is to create an australia.gov.au account, or if you already have one, log in to that account. australia.gov.au acts as a single sign-on system for a range of government departments, including Medicare, Centrelink and the new eHealth records system. It also helps to have registered with Medicare Online as your identity is then much easier to verify, and you can also find out what your Individual Healthcare Identifier (IHI) is.
The australia.gov.au is a single-access system to a number of government departments, including the National eHealth Record System.
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There are several steps you must take to verify your identity online, so it helps to have registered with Medicare Online beforehand as doing so streamlines the PCEHR registration process considerably.
If you first apply through ehealth.gov.au, you will be directed to australia.gov.au, where you must either register or log in. Registering for australia.gov.au requires you to write a series of security questions, one of which pops up every time you log in. You will be given a random log-in and password, which you should write down somewhere safe. If you lose your log-in, you must reapply for a new account. Once that is done, you can click on the link to the National eHealth Records System, which will take you back to ehealth.gov.au to set up your PCEHR. If you also click on the link to Medicare, this will allow the verification system to check your identity and the process is very smooth. If you do not, you will be asked a similar number of questions concerning your last interaction with Medicare, much the same as is asked when registering by phone. Pulse+IT readers have indicated this can be a very slow process unless you have kept written records of your last doctor’s visit or script.
We suggest that you first register for Medicare Online, which means a wait of a couple of days for Medicare to send a password in the post to the address linked to your Medicare card. While you are waiting, sign up for australia.gov.au. When you have signed in to australia.gov.au, remember to link your account to both Medicare and to the National eHealth Record System. Once you have verified your identity, you will be invited to create your PCEHR at ehealth.gov.au. You can then continue to access your PCEHR through australia.gov.au. For those who have encountered difficulties filling out the security questions at australia.gov.au, or filling out the Medicare identity verification questions, australia.gov.au suggests this might be due to leading and trailing spaces at the start or end of a sentence in the online fields. It suggests you do not copy and paste your answers, and to check that each question starts and ends with a regular text character.
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Feature
A FIRST LOOK INSIDE THE PCEHR Once you have registered for a PCEHR, what exactly does it look like? On first view, it is a utilitarian document that at the moment contains very little, but NEHTA and DoHA have promised a second round of functionality, including Medicare details such as MBS and PBS history, will be added later this month. Clinical documents will be able to be uploaded reasonably soon as well.
KATE MCDONALD Journalist: Pulse+IT kate.mcdonald@pulseitmagazine.com.au
On first view, the PCEHR is exactly what is described on the tin – it is personally controlled. While healthcare professionals will soon be able to upload a shared health summary and other clinical documents, it is the consumer who controls what goes in and what other people can see. A slight criticism is that on the individual PCEHR home page, quite a lot of space at the top of the screen is taken up with logos: the Department of Health and Ageing, eHealth, the National eHealth Record System and National Health Reform logos all make an appearance, meaning you have to scroll down to view your record in its entirety. This might prove annoying to those who are unfamiliar with web pages, such as the elderly, one of the government’s prime targets for the PCEHR. When you first enter your record’s site, it gives you a ‘Health Record Overview’, also known as the consolidated view. This is not functional at present, but according to Andrew Howard, head of the PCEHR at the National E-Health Transition Authority (NEHTA), specifications for a revised consolidated view will be released this month, along with a range of new functions that consumers should be able to see in their personal record.
The Health Record Overview will present shared health summaries along with information from other clinical documents received since it was created. The PCEHR also includes a Medicare Information view, which is not functional as yet but which will integrate information such as PBS and MBS history and Australian Organ Donor Register and Australian Childhood Immunisation Register status. Mr Howard told a software vendors’ meeting recently that this information should be available in August, following final testing of the PCEHR’s Medicare interface with Medicare Australia. It also appears there will be a section allowing you to see “Recent documents sent to the PCEHR in the last 12 months”, but again this is not yet functional and will presumably only go live when clinical software has been rolled out to GPs. This is likely to begin in September. On the left-hand side of the screen as you view your PCEHR is a menu divided into four sections: • • • •
Clinical Documents Personal Medicare Records Restricted Settings
Clinical Documents will contain the promised shared health summary, which will be compiled by healthcare providers and uploaded. There is no word as yet on when this will be available, although under the PCEHR’s Concept of Operations, it will be a ‘point in time’ clinical summary of your healthcare status. Under the Personal heading, a drop-down menu lists: • • • • •
Personal Health Notes Personal Health Summary Advance Care Directive Custodian Your Personal Details Emergency Contact Details
If you click on Personal Health Notes, you are invited to add a new note. The notes look a little like the comments section of a news website, with a title and description, although you are not limited in the amount of words you want to write. This is the promised personal diary section and it is up to the consumer whether they use it or not. It doesn’t appear that a limit will be placed on how
many personal notes are created, although it is not as userfriendly as some online health diaries. Notes are then listed under the Personal Health Notes section in the menu by date and title. There is a delete button available, and when you click on the note a little pop-up appears telling you when the note was written and by whom. Healthcare practitioners do not have access to this section of the PCEHR. Then there is the Personal Health Summary, which lists your allergies or adverse events, along with your current medications. Users are asked to list allergies or adverse reactions by substance/agent and reactions. For current medications, you are asked to list them by medication, dose information, reason for taking medication, and additional comments. This section of the PCEHR will prove very useful in emergencies, and also for the chronically ill or elderly who take several medications and have trouble keeping track of them. Healthcare practitioners do have access to this section.
The Health Record Overview of the PCEHR, also known as the consolidated view. This is homepage of each individual record.
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What is missing perhaps is the ability to say you have no allergies or are on no medications, as otherwise it could look like this section has not been completed correctly. Next is your Advance Care Directive. This allows you to enter the name, address and contact details of the custodian of your Advance Care Directive, should you have one. This will prove extremely useful in the future for people entering residential aged care as they will then be confident that their wishes for treatment in the last years of their lives will be respected. Your Personal Details lists your name, IHI number, date of birth, age, sex and address, although the last element cannot yet be displayed. Then there is Emergency Contact Details, which allows you to add several different contacts including next of kin and carer. As it should be, this is a very easy to read section of the record. Next is Medicare Records, which will provide information on the last two years of Medicare and Pharmaceutical Benefits Shceme services, which the Department of Health says will be available soon.
Now comes the interesting part of the PCEHR as it stands. Much of the debate over the design of the PCEHR from consumer and privacy groups centred around who has access to what on your record. The last heading in the main menu is Restricted Settings, which lists:
have to your documents below by selecting the access level from the drop down menu on each document. You can effectively remove a document from view by clicking on the “Remove” button. Removing a document will result in it being hidden from your healthcare professionals.”
• Medicare Information Preference, which allows you to choose whether or not your PBS, MBS, organ donation and childhood immunisation register information is available to be seen by others • Notification Settings, which allows you to be notified by email or SMS if your PCEHR has been accessed • Manage Access to this Record, which allows you to list your authorised or nominated representatives if you have them; and • Manage Document Access, which allows you to nominate certain documents that you do not want other people to see.
In other words, the document has been removed from everyone else’s view, but is still contained within the PCEHR and the consumer can still look at it. To delete a record permanently from your PCEHR, you must contact the Department of Health.
The PCEHR has been designed with general access as the default, but if you do have a document you don’t want someone to see, you can block them from doing so. As the site explains: “You can manage the level of access healthcare organisations
Consumers can add personal notes to their health diary. Practitioners do not have access.
If you do want to restrict access to your record, or to specify that one healthcare organisation or provider can access it but another can’t, you must create a Record Access Code (RAC). You then give this code to the organisation or professional to whom you do want to provide access. The site does specify that even if you have a record access code, all information in your record will be available in a medical emergency. Finally, the PCEHR has an Audit Log, which contains the details of all the activity on your record. The log includes approval date/time, operation performed, organisation name, role, access condition, action type, subject type and subject. In summary, the PCEHR is a utilitarian but reasonably intuitive record and will make much more sense once it becomes populated with useful information. It has not been designed with the bells and whistles of other online health records, such as those offered by Microsoft through HealthVault or private health insurers. Once you have gone through the steps of setting up your PCEHR, it is a reasonably easy system to navigate for those used to entering and maintaining information online. For those unfamiliar with the internet, it would be useful to have a family member or carer present to assist.
The Manage Document Access view. Users can restrict who has access to specific documents held on their PCEHR.
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Feature
THE NEXT STEPS FOR PCEHR FUNCTIONALITY While the PCEHR does not contain much information as yet, new functionality will begin rolling out from the end of this month, including upgrades to GP clinical systems. The next steps in the development of the PCEHR were recently outlined by NEHTA at a webinar for software vendors.
KATE MCDONALD Journalist: Pulse+IT kate.mcdonald@pulseitmagazine.com.au
Andrew Howard, NEHTA’s head of the PCEHR, told the meeting that launching the consumer portal had been the organisation’s priority in order to meet the federal government’s commitment that every Australian could register for a PCEHR from July 1. The priority given to the consumer launch date had held up other aspects of the build, including fixing the glitch that slowed down vendor testing earlier this year, he said. NEHTA has not yet made public a specific date for the launch of PCEHR-enabled clinical software as contracts were still being negotiated with Accenture, the lead National Infrastructure Partner, to agree on an exact date, he said. However, the Department of Health and Ageing told a Senate hearing in May that September was the most likely timeframe, a statement reiterated recently by DoHA secretary Jane Halton (see our interview on page 52). Mr Howard said a fix had been prepared to correct defects in NEHTA’s PCEHR software developer test environment to allow vendors to continue testing their software’s ability to connect to Medicare to access the HI Service. “There is a set of defects in the software development environment that have not allowed some of the vendors to proceed
through the final steps for the notice of connection (NOC),” Mr Howard said. “Our priorities have been around the production system at this point in time, but we are aware of the defects, those defects have been corrected but we just haven’t had time to move the fixes into the software environment for you to complete the testing.” He said the updates would allow vendors to continue with notice of connection testing so they would be in a position to have PCEHR-compliant software on the market for the provider release in late August. To date, 25 software vendors and three state health systems had connected to the software vendor testing environment, with three vendors having conducted formal NOC testing. Frank Pyefinch, CEO of clinical software provider Best Practice, said it would more likely be September before PCEHR functionality would be ready to roll out to users of his software. Dr Pyefinch said Best Practice had achieved its notice of connection for the HI Service. Paul Carr, managing director of Genie Solutions, said his company had also successfully completed its NOC for HPI-Is and HPI-Os.
A spokesperson for clinical software provider Zedmed said its software development for PCEHR connectivity was well advanced. “We are waiting on the software vendor environment to be upgraded to allow NOC and other conformance testing to be completed,” the spokesperson said.
“That will it apply to the point-to-point world and to the PCEHR but it has been driven by a desire to get discharge summaries onto the PCEHR over the next 12 months, to get that information sharing happening and with jurisdictions ready to deploy that solution.”
“In preparation for our PCEHR connected release, we have prepared and will shortly place on our website a series of documents summarising how practices can prepare themselves and their patients for the PCEHR, and what doctors can expect to be able to do in Zedmed to utilise the PCEHR for their patients.”
For the consumer view of the PCEHR, a revised consolidated view – known on the PCEHR as the Health Record Overview – will also be launched this month, as will the Medicare Information view, which consolidates the consumer’s MBS, PBS, organ donor and childhood immunisation registry information into one list.
Rama Kumble, chief technology officer for Medtech Global, said work on enabling connections to the PCEHR through his company’s Medtech32 software was also well on its way.
The ability of vendors to integrate and display this information in their clinical software is slated for December. However, individual documents will be able to be displayed shortly, with specifications to be released shortly, subject to final testing of the PCEHR’s interface with Medicare.
Mr Howard also told the seminar that rules on conformance to allow discharge summaries to be created and loaded into the PCEHR might be relaxed to allow discharge summary functionality within the next 12 months. A state-based identifier will probably be used instead of the Healthcare Provider Identifier – Individual (HPI-I) on the discharge summary until the use of HPI-Is becomes more widespread. “We will still have an identifier but it will be a local identifier provided by the jurisdiction or a private hospital sending us that discharge summary for probably the first year of operation,” Mr Howard said.
Mr Howard confirmed that IBM, which is building the National Authentication Service for Healthcare (NASH), had not met its contractual commitment to deliver the solution by June 26. “[NEHTA is] in negotiations with IBM around a firm commitment from them, on a plan for a final delivery date for NASH,” he said. “In the interim DoHA is working with Medicare Australia on a gateway compliance certificate which encompasses the NASH requirements for HPI-Is and HPI-Os for both individuals and organisations for the use of connectivity with the PCEHR.
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“NASH isn’t there but we do have a solution for vendors that will be in place for the August release.” Andrew Howard
“NASH isn’t there but we do have a solution for vendors that will be in place for the August release. A number of vendors have tested that solution for us, so with respect to secure connectivity to the PCEHR we are still on schedule for delivery in August.” He said information for consumers and providers was being prepared to guide them through the process of accessing the PCEHR online. NEHTA has also prepared an implementation guide, one that is being used in the lead sites for GP use and one for software vendors.
Aged care and pharmacy The progress to date made by the members of the GP desktop software panel was outlined in the July issue of Pulse+IT. Progress to allow other software vendors for the aged care, pharmacy and pathology sectors to interface with the national infrastructure is moving slowly, but according to DoHA secretary Jane Halton, the lessons learned from the GP software panel is expected to smooth the way for other sectors. The members of the aged care software vendors panel were announced in early June, comprising Autumncare, Database Consultants Australia (DCA), iCare, Leecare Solutions and the WA-based nursing service Silver Chain, which has developed the ComCare software under its subsidiary EOS Technologies. Through the panel, NEHTA will work with vendors, the Aged Care Association Australia (ACAA) and the Aged Care Industry Information Technology Council (ACIITC) on the changes that vendors will need to make to their products to meet the requirements for PCEHR implementation, NEHTA CEO Peter Fleming said. Caroline Lee, CEO of Leecare Solutions, said the panel members will be developing capability to access the HI Service and link to the PCEHR so that clients can download and upload clinical information through event summaries, discharge summaries, transfer documents and shared health summaries.
She said the panel will not have many different requirements to the GP software vendors panel as all members will be required to link to the Healthcare Identifier Service and access and upload documents from the PCEHR so that the data present on an individual’s site is useful. Both Leecare Solutions and iCare have already integrated HI Service functionality into their software. Dr Lee said her company had been working on the building blocks of integration with the PCEHR since last year. AutumnCare managing director Stuart Hope said the time frames negotiated are “very achievable”. “We will be working with some of our key clients to ensure the required functionality is what is needed in aged care and also accommodates the aged care processes. We will be incorporating the eHealth functionality into our standard product releases over the next 12 months.” He said AutumnCare will be taking the lead role in defining an “aged care transfer” event to ensure all the necessary information is available when a resident or community client is moved into an acute setting. In June, NEHTA issued a call for expressions of interest from community pharmacy software vendors to join a panel to work on incorporating PCEHR specifications into their software. Successful members were to have been announced in July, although they still had not been released in early August. Pharmacy vendors will have to integrate a number of products and specifications into their software, including HI Service functionality, secure messaging delivery (SMD) and endpoint location service (ELS) specifications, the NASH software development kit (SDK), connectivity to the PCEHR, and the ability to generate and send a CDA event summary to a PCEHRconformant repository. They must also have electronic transfer of prescriptions (ETP) capability and the ability to incorporate Healthcare Identifiers and standardised medications terminologies including SNOMED CT-AU and the Australian Medicines Terminology (AMT) for the medication history list. It is expected that the pathology sector will begin work towards including pathology results in the PCEHR next year. National standards for electronic reporting of pathology results are promised by June 30 2013, with funding for this measure already secured through the Pathology Funding Agreement between the government and the pathology sector.
Moving to Best Practice, easy as Like eating brussels sprouts – you know that changing your clinical software will be good for you – but not something you want to face. Best Practice is different. Best Practice makes the changeover so easy you can try it out with all your practice data (the backup version of course) without committing. Sweet! • We have MIMS – Australia’s most trusted drug database • Support professionals who are truly supportive • Speed and superior stability of 100% SQL performance • Converting your data from MD2, MD3 and MedTech32 virtually automatic • No ads, bolt ons or mixed file formats to compromise performance • Great value – subscription $948.75* for both Clinical and Management • Discounts for practices larger than 4 Equivalent Full time GPs • Half price for part time practitioners - $474.38* • No downtime for updates or time-consuming maintenance • More GPs voting for Best Practice with their feet *(includes GST)
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PCEHR IMPLEMENTATION: SLOW AND METHODICAL The secretary of the Department of Health and Ageing, Jane Halton, has defended the progress of the PCEHR since its July launch, dismissing concerns the program would be cancelled by a Coalition government. In an interview with Pulse+IT at HIC in Sydney, she also put to bed concerns over the future of NEHTA, memorably describing the organisation as “the lovechild of COAG”.
KATE MCDONALD Journalist: Pulse+IT kate.mcdonald@pulseitmagazine.com.au
NEHTA and the Department of Health and Ageing will roll out the PCEHR in a slow, careful and methodical way with further functionality to be added later this month, DoHA secretary Jane Halton told the Health Informatics Conference (HIC2012) in Sydney recently.
now register for the PCEHR. Without any fanfare at all, over 4000 people have registered for the PCEHR. Registration is only the very first and very preliminary step. We have always said we will roll out the PCEHR in a very careful, staged and methodical way. It won’t happen overnight.
Ms Halton reiterated the department’s and the federal government’s intention to aim for consumer registration capability first with real functionality to be added later in a careful manner. In her keynote address at the conference, she said the government had only begun to roll out the national system but its potential was clear.
“One of our challenges [is] we want to deliver to people who are interested in a way that doesn’t lead to disappointment, but we have to do it in a careful and methodical way. We will add functions over time.
“We will focus in the first instance on registration and on consumer and personal controls,” she said. “We will continue working through the national frameworks and we will bring, fairly soon, late in August, the next phase of roll out of the PCEHR.” She said she was pleased but surprised that over 4000 people had registered for a PCEHR despite its launch with little fanfare, noting that the ehealth.gov.au website had received tens of thousands of unique website visitors. “We took a huge step forward on the first of July, because people actually can
“The ability to view information held by Medicare will be early and then the uploading and viewing of discharge summaries and medication management and eventually, pathology and diagnostic imaging. The commitment is rock solid and progress will be – and I use this as a positive – methodical and deliberate.”
Wave sites Greater consumer adoption is not yet on the agenda, with the focus still on the 12 Wave sites to test functionality in healthcare settings, she said. “There are a number of extra pieces of functionality that we need to have and we need to be clear: our priority has always been to roll out in the Wave sites first.
to be a bit later than that – probably the following month – and we are working with all of those providers. Again, we have to do this in a methodical way and it has to be right ... IT in particular doesn’t get delivered according to the fact that someone has put a deadline on it.” Ongoing funding for the Wave sites was still being considered, as was the role of the Change and Adoption partner, funding for which ceased on June 30. “The Wave sites will not disappear and they will continue work,” she said. “Now that we’ve got Medicare Locals, they are getting money as well to assist with adoption so you will see some of the focus shift a little bit.” She would not reveal details of the $50 million in funding recently awarded to Medicare Locals to help with the implementation of the PCEHR, saying some would be in the vanguard and some would be at the tail. “Until we’ve got the GP desktop software up and running and we’ve had some of those early experiences in the Wave sites, we don’t want to get everyone running around the country recreating the same experiences. We want those experiences to inform how they have been helping others roll out.”
Jane Halton
“Those Wave sites are our opportunity to test in a real environment, how things are going to work, how consumers are going to react, working with the clinical community.” She also said both DoHA and NEHTA agreed with the launch date of July 1, saying a delay was not considered. “You’ve got to have a date that you are aiming for, and we have aimed for the first of July for registration, which we delivered. “Then we always said we would sometime later go with electronic registration. All of that enabled us to really focus our efforts; being able to do that first – really work out how it works, knock any bugs out of it – and then be able to move on in a methodical way was actually the right thing to do.” Additional functionality available later this month will include access to Medicare data, she said. This will include MBS and PBS information, along with childhood immunisation and organ donor status. The medicines information will only be that held by Medicare, including scripts that are below the co-pay, although privately issued scripts will not yet be included, she said. This functionality will come when electronic transfer of prescriptions is more widespread. “What will be available in late August will be access to Medicare data,” she said. “The beginnings of the GP software we anticipate
The role of GPs Ms Halton reiterated the importance of the role of general practitioners in the new system, telling the Q&A panel that the government had invested heavily in providing incentives to the sector to invest in upgrading their IT capabilities. “Let’s stand back and remind ourselves that we have been on the journey to an electronic health record for a long time. It is no accident that almost all GPs have access to computers because we have been investing in them, we have been crossing their palms with silver for a long time … We know that 34 per cent of GPs say that they see at least one person a week where they have no information about them and more than one in five doctors face that situation every day. A similar proportion of GPs will see a patient without complete information. “It is in this day and age an anachronism that GPs handwrite or type a referral to a specialist that they then give you in an envelope, which you then carry yourself to that visit. Where else in the modern world do we use that form of communication? It is important that we don’t duplicate existing systems and it’s important that we connect the existing treasure troves of information.” She clarified the position of GPs as curators rather than custodians of their patients’ PCEHR, saying doctors should work with their patients on what should be uploaded and how. If there are errors in the information, doctors and patients should also work together to resolve them.
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“NEHTA is much more than just the PCEHR – it is the electronic shared agenda between us and the states and the states and territories.” Jane Halton
“Essentially, you will be able to work with your doctor to curate the information. This is the role of the patient. The doctor should talk to you about what it is they are going to curate and put up as a summary on your record. That does enable you to say, hang on a second, that seems to contradict what someone else has curated into the record. “The advantage of course is that a number of other clinicians who are looking at it will be able to see who those clinicians are. If they are worried about the care of that patient, they can have a dialogue with those clinicians. Think about the current world – you see a patient and you don’t necessarily know who they have been to see. “If there is a conflict, say in a matter of observable fact, in which case they are going to check it. In one case it says your blood type is A positive and in another case it says it is B. Well, you check.” She used the example of the Northern Territory shared electronic health record, which shows all of the interactions the patient has had with different healthcare providers. “[That] then forms input into the care that the clinicians they are sitting in front of is actually going to deliver to you. That is a much more sophisticated approach than we currently have.”
The future of NEHTA She also dismissed claims that NEHTA’s ongoing funding was in peril, responding to some media claims that as eHealth was not discussed at the recent COAG meeting, which failed to come to an agreement about the National Disability Insurance Scheme, both NEHTA and the PCEHR itself had not been provided with the security of ongoing funding. “eHealth wasn’t even on the COAG agenda,” she said. “That last COAG meeting had nothing to do with this particular agenda. This agenda has to do with a forward momentum, it has a structure
and a framework and we are working cooperatively with the states. We’ve all made funding commitments. “NEHTA is much more than just the PCEHR – it is the electronic shared agenda between us and the states and territories. There is a lot of work that still needs to be done on creating those foundations and they have a role in delivering the PCEHR. The Department has a role in operating it. NEHTA has some very important work to do that does not finish with the current wave of changes with the PCEHR. Memorably describing NEHTA as “the lovechild of COAG”, Ms Halton said she did not predict that the PCEHR would be scrapped under a new government. In a Q&A session hosted by Tony Jones, Ms Halton pointed out that NEHTA was first established by a Coalition government, with Tony Abbott as health minister.
The future The delay in establishing the National Authentication System for Health (NASH), being built by IBM, would not halt the roll out of the system, she said. An interim NASH has been established using exiting technology developed by Medicare Australia. “Essentially what we’ll do is leverage technology that is available through Medicare Australia. It is fair to say that some of that technology has now been able to be deployed in ways that perhaps we didn’t always understand it could be and certainly wasn’t able to be some time ago. That’s because of continuing work with Medicare Australia and their technology partners. “So we have deployed interim NASH and contractual details between NEHTA and other parties are a matter for them and not for me.” She said she was unsure if the budget target of 500,000 consumers signing up for the PCEHR in the first year would be met, as the figure was set only as an estimate for operating costs in the budget. “We have to have an estimate of PCEHR registration, because we have to estimate what the operating costs are. We are being quite careful to say this is about a careful and staged roll out … What we do know is that we have well over 4000 people without any publicity. I’m astonished by the number of people we have – we haven’t even raised this out there in the Wave sites. “Can we say confidently that there will be a lot more than now? Absolutely. The 500,000 was an estimate based on some international evidence, but every country is different. We’ll see. I think the important thing is that what we do roll out we roll out successfully, and that we deliver the kind of functionality that people want and they are going to use.”
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THE TRANSITION TO ELECTRONIC HIM The introduction of activity-based funding (ABF) and the PCEHR are high on the agenda at the 2012 Health Information Management Association of Australia (HIMAA) conference, being held on the Gold Coast at the end of October. For the first time, there will also be a clinical coding stream running throughout the conference.
KATE MCDONALD Journalist: Pulse+IT kate.mcdonald@pulseitmagazine.com.au
Next year, the University of Western Sydney is expected to offer a major in health information management as part of its general information technology course, probably the first time this has been offered in Australia and a pointer to the demand for HIM professionals that is forecast to grow as new initiatives such as ABF and the PCEHR come on stream. Allied to the relaunch of Queensland University of Technology’s bachelor of health science – health information management degree, which took a breather for a year before being offered again next year, the new UWS course shows there is not only a demand for education and professional skills from undergraduates but a need for well‑qualified HIM professionals with a grounding in basic IT as well. For Sallyanne Wissman, president of HIMAA and director of information management in the information and infrastructure division at Mater Health Services in Brisbane, the new courses are part of a growing recognition from industry that there is an increasing need for people well-grounded in health information management and IT. “There has been a history of HIM courses grounded in a number of discplines,
whether it is business management or public health or health science or health services management, so this is the first one that is offering it within the IT area,” Ms Wissmann says. “I think the IT degree will be a really good foundation upon which to then build the health information management knowledge base, particularly given where things are progressing. IT fundamentals permeate health information management now.” At HIMAA 2012, Vera Dimitropoulos from the National Centre for Classification in Health (NCCH) at the University of Sydney will discuss the new course, which Ms Wissmann and other colleagues from HIMAA have been involved in helping to develop. Ms Wissmann says she expects it to prove very attractive to new entrants to the field. “IT and information management really needs to have a strong partnership, so that offering will be attractive, or potentially more attractive than historical courses as a lot of people are interested in IT as a basis and being able to specialise in the application of IT into health.” Health Workforce Australia’s (HWA) CEO Mark Cormack will also address the conference, presenting the results of a recent study into workforce requirements
that HWA has completed. Ms Wissmann says drivers such as the introduction of ABF and the PCEHR and a progression towards more electronic capture and management of health information at all levels will see workforce demand continue to grow. This is something that is happening internationally as well. As part of her role as HIMAA president, Ms Wissmann will attend the American Health Information Management Association (AHIMA) convention in September, and she also represents the western Pacific as an executive member of the International Federation of Health Information Management Associations (IFHIMA). She is preparing a briefing paper for the IFHIMA board on the transition to “eHIM”, or the move into the digital world and what that journey might look like. In her opening address, Ms Wissmann is hoping to draw together what she sees as the main challenges facing the profession both here and overseas. “I want to highlight the role that health information management plays in the healthcare environment and how it’s really important that we partner and collaborate in the space,” she says. “Collaborating with our peers in health informatics and clinicians and administration and management at all levels, whether in your workplace at a healthcare provider or at a state or national level, is so important, particularly with the national health reforms. “The PCEHR and activity based funding are large changes to the healthcare system but they are spaces that traditionally health information managers and health information management professionals have played a part in; in historical records management, record content, information privacy, coding, counting and reporting. “This is a critical role. It’s okay for the policymakers but at the end of the day we are the people who are on the ground and doing the work so we need to be involved in an advisory capacity in the policy-setting space and the process space in terms of establishing the processes. Health information managers need to have a say in that environment, to share the knowledge. “I really want to encourage the attendees and more broadly the HIMAA membership to think about their role and what that means in terms of networking, stakeholder engagement, where’s the real value in terms of tasks and functions and being involved in projects. If you sit back and wait to be asked it might not happen. Why not say ‘we have something to offer and leverage our knowledge and contribute’?” Other speakers include a representative from Ms Wissmann’s organisation, Mater Health Services, which has been heavily involved in the development of the PCEHR through its role as a
“It’s OK for policymakers but at the end of the day we are the people who are on the ground doing the work...” Sallyanne Wissmann
Wave 2 site. The representative will discuss what Mater Health Services has been able to deliver through its Mater Shared Electronic Health Record for new mothers, Ms Wissmann says. “We are currently in a transition phase through to the end of January next year about how we hook what we’ve done up with the national PCEHR system. That’s the approach that is being taken with the Wave sites in general. From a healthcare providers’ perspective, we’ll look at what their journey has been and how we’ve been able to partner with the Commonwealth to deliver some of their vision in terms of the PCEHR. Also on the agenda is activity based funding, with keynote presentations from Tony Sherbon, CEO of the Independent Hospital Pricing Authority (IHPA), and Ric Marshall, who leads the team responsible for the ABF system reforms in hospitals. Health information management professionals will be responsible for a lot of the hard yards in introducing this national funding model for public and not-for-profit hospitals, Ms Wissmann says. “ABF is a model of payment for healthcare provision and that needs to be measured, so obviously the activity needs to be counted, it needs to be counted consistently and to meet consistent definitions, because now it will be reported to IHPA.” HIMAA 2012 will also feature for the first time a clinical coding stream throughout the conference, she says. “We’ve identified that a number of our members work in the clinical coding space, either in the management of the clinical coding function or in clinical coding itself, and historically there have been coding conferences that are no longer happening, so we have identified a need to continue to explore and present information around coding and classification themes and issues that are happening.” Coding standards for diabetes were changed in July, so a clinical update will be provided from both a clinical and a classification viewpoint. Workshops will also cover DRG classifications and their role in ABF, performance indicators for coding quality (PICQ) analysis, and changes to ICD-10-AM/ACHI/ACS and ICD-11.
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TEST NOTIFICATIONS AND THE ROLE OF HIMS Missed or delayed test results are a significant safety problem, particularly in ambulatory and emergency department settings. Dr Joanne Callen is researching how ICT and health information management can improve the efficiency of test results follow up by both clinicians and patients.
KATE MCDONALD Journalist: Pulse+IT kate.mcdonald@pulseitmagazine.com.au
Last year, researchers from The Centre for Health Systems and Safety Research (CHSSR) at the University of NSW’s Australian Institute of Health Innovation published a review in the Journal of Internal General Medicine of studies into the failure of clinicians in following up test results for ambulatory patients, along with a review of the safety implications of missed test results for hospitalised patients, published in the British Medical Journal Quality and Safety. Joanne Callen, senior research fellow at the CHSSR and a lead author on those papers, will present some of her new research into the efficient and safe management of test results at the HIMAA conference in October. Her current study is part of her broader interest in patient perspectives and her belief that it is crucial to involve consumers if we are to realise the potential of health ICT. In the paper she will present at the HIMAA conference, Dr Callen will discuss the results of her study into what clinicians think about the direct notification of significantly abnormal test results. These results are those that are not lifethreatening but need short-term follow up, such as chest x-rays showing a new shadow or an abnormal prostate specific antigen (PSA) test.
Dr Callen’s research showed mixed attitudes to patient notification, she says. “Preliminary results showed physicians’ key concerns related to perceptions of patient anxiety (89.5 per cent) and lack of expertise necessary to interpret test results (84.2 per cent). Test result notification directly to patients, using electronic systems, requires further study and evaluation.” Dr Callen believes health information managers play a key role in this sort of research and its potential outcomes. “Health information managers have a unique set of knowledge and expertise centred on health information management and the design, evaluation and implementation of clinical information systems. They are often employed as critical members of healthcare teams which are responsible for implementation of, and training in the use of, clinical information systems.” She believes HIM professionals are ideally placed to undertake evaluation research related to the efficient and safe use of clinical information systems in all healthcare settings. “This study will assist those who are exploring ways of improving the management of test results across all health care settings to reduce the incidence of missed results.”
Supporting the conference are our sponsors and trade exhibitors. The extensive trade exhibition will allow you to investigate the latest innovations and solutions for the healthcare industry. Thanks to our Gold sponsors: • NEHTA (National E-Health Transition Authority), • AGPAL (Australian General Practice Accreditation Limited and (QIP) Quality in Practice And also to our Silver sponsors: •
MEDIPROTECT
• Stat Health Systems (Aust). PAL AG
QIP
Where do you work? In allied health, dental, general practice, a medical specialty or a multidisciplinary practice? Or, perhaps you are in a supporting industry such as a Medicare Local or Division of General Practice, then the AAPM 2012 National Conference ‘Surfing the Waves of Change’ is your professional conference for 2012.
NATIONAL CONFERENCE Brisbane Convention & Exhibition Centre
Tuesday 16 – Friday 19 October 2012
www.aapm.org.au
Visit www.aapm.org.au to download a registration brochure or a prospectus
EARLY BIRD REGISTRATION CLOSES 17 AUGUST 2012
Advantech
3M Health Information Systems P: +61 2 9498 9499 F: +61 2 9498 9377 E: gharris@mmm.com W: www.3m.com.au/his 3M Health Information Systems is a leading provider of software solutions to help healthcare organisations capture, classify, and utilise data — accurately and efficiently. With more than 28 years of experience in health information management, 3M offers integrated solutions for: • Coding, Grouping and Reimbursement • Document Management and Scanned Medical Records, providing: ◊ Access anytime to complete patient history ◊ Intuitive, customisable document viewing ◊ Automated worklists ◊ Electronic signature • Dictation and Transcription, providing: ◊ Reduced dictation time ◊ Increased accuracy ◊ Lower transcription turn‑around‑time ◊ Seamless integration with PAS and EHR systems
ACIVA E: j.edgecumbe@ehealtheducation.net W: www.aciva.org.au The Aged Care IT Vendors Association (ACIVA) was formed in early 2010, a not-for-profit organisation, incorporated in NSW. ACIVA represents the residential aged and community care sectors and vendors at various national forums regarding strategic developments and eHealth. ACIVA members are residential aged and community care software vendors, industry benchmarking software, financial software, call-bell, hardware, networking, infrastructure and industry partners. Members are committed to furthering the interests of residential aged and community care in national forums to ensure eHealth and access to the personally controlled health record (PCEHR) becomes a reality for the aged care industry in the very near future. Contact: Secretariat Joan Edgecumbe j.edgecumbe@ehealtheducation.net
P: 1300 308 531 F: +61 3 9797 0199 E: info@advantech.net.au W: www.advantech.net.au Advantech’s medical computing platforms are designed to enhance the quality and efficiency of healthcare for patients and users alike. All of Advantech’s medical PCs match the performance of commercial PCs but are medically rated to UL/EN 60601-1 third revision, IPX1 drip‑proof enclosures and are designed to suit ward and theatre based applications. Advantech offers long term availability and support plus a proven track record of reliability. The medical range extends through: • Point-of-Care Terminals. • Mini-PC and Medical Imaging Displays. • Mobile Medical Tablets. • Computerised Medical Carts. • Patient Infotainment Terminals. Advantech is also an official distributor of Microsoft Windows Embedded software across Australia & New Zealand.
Australasian College of Health Informatics 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
Argus ACSS
AAPM P: 1800 196 000 / +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) is a not for profit, national peak association founded in 1979, dedicated to supporting effective practice management in the healthcare sector. 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 to support quality practice management including advocacy, education, resources, networking, advice and assistance.
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P: 1300 788 005 / +61 2 9632 0026 F: +61 2 9632 0096 E: sales@acsshealth.com W: www.acsshealth.com ACSS provides innovative and customisable patient management software streamlining day-to-day operations for GPs, Allied Health, Specialists, Radiologists, Pathologists, Private and Public Hospitals. eClaims® — Comprehensive and robust appointment and billing system with digital/voice recognition capabilities, electronic reporting transmissions and HL7 PACS system integration. eClaims® Hybrid — A solution tailored to Hospitals and other health service providers including billing agents who lack online capabilities. eClaims® Hybrid is the interface solution for connecting you to Medicare and health funds through ECLIPSE. SimDay® — Proven PAS (Patient Administration System) specifically designed for day surgeries and private hospitals – Now with ECLIPSE integration.
P: +61 3 5335 2220 F: +61 3 5335 2211 E: argus@argusconnect.com.au W: www.argusdca.com.au Argus provides and supports Argus secure messaging software; a popular electronic solution that enables healthcare practitioners to exchange pathology, radiology and specialist reports, hospital discharge summaries, referrals and clinical data securely and reliably. Argus interfaces with most clinical software applications sending directly from within your letter writing facility or word processor and runs virtually invisibly in the background. Documents sent using Argus can be automatically added to electronic patient records; thus avoiding the need to scan or manually file them. Argus is the messaging solution chosen by 65 Divisions of General Practice through the ARGUS AFFINITY program. With over 12,800 users Argus continues to grow in popularity by delivering a highly secure message, reliable product, backed by outstanding customer service all at the lowest cost possible.
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) • Best Practice Automatic SMS reminders Visit us at the following conferences throughout the year: • GPET Melbourne, 5 - 6 September • GPCE Brisbane, 14 - 16 September • AAPM National Conference Brisbane, 23 - 26 October • ACRRM Fremantle, 25 - 28 October • AGPN Adelaide, 10 - 14 November • GPCE Melbourne, 16 - 18 November
cdmNet P: +61 3 9023 0800 F: +61 3 9614 2650 E: info@precedencehealthcare.com W: www.precedencehealthcare.com cdmNet is an online service specially designed to manage the entire life cycle of a patient’s chronic disease. cdmNet delivers best practice chronic disease management, including creation of GPMPs, TCAs and Reviews. In addition, collaboration with your care team is quick, easy and ongoing. cdmNet minimises the bureaucracy, eliminates the paperwork, and ensures compliance with Medicare requirements for chronic disease management.
Clintel Systems P: +61 8 8203 0555 E: info@clintel.com.au W: www.clintel.com.au The Specialist: A complete solution for your Appointments, Billing including Online Claiming and Clinical requirements in an intuitive scalable solution. Clintel provides systems to Specialist and Day Surgeries nationally. Powerful, highly configurable and easy to use, our systems mirror the needs and workflow of your practice and individual specialty.
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cdmNet optimises patient care, simplifies care team collaboration and reduces administration & paper work.
Cerner Corporation Pty Limited P: +61 2 9900 4800 F: +61 2 9900 4990 E: AsiaPacific@cerner.com W: www.cerner.com.au Cerner is one of the leading global suppliers of health care information technology solutions. Cerner’s mission is to contribute to the systematic improvement of health care delivery and the health of communities. Our vision of proactive health care management drives innovation in the development of effective solutions for today’s health care challenges, while creating a foundation for tomorrow’s health populations. Working with more than 4000 clients worldwide, Cerner is solving health care’s many challenges making sure the right people have the right information at the right time. Our innovative leadership is allowing us to push boundaries by: • Leveraging clinical and pharmaceutical data in Condition Management and Personalised Medicine • Connecting the community with personal and community health records
CSC’s HealthCare Group P: +61 2 8035 6700 F: +61 2 8035 6801 E: healthsolutions@csc.com W: www.csc.com/healthsolutionsAPAC Healthcare is key part of CSC’s global business. It has a strong track record of delivering successful government health programs across Europe and in both the public and private healthcare sectors in the US. Focused on eHealth, CSC’s Healthcare Group provides an end-to-end service combining technology innovation, world-class consulting and system integration services with proven healthcare software. In the Asia Pacific region, CSC provides localized solutions to improve: patient flow, access to clinical information, medication safety and pathology diagnostics. CSC participates in regional government health information exchange initiatives to connect care across care environments and to enable clients to leverage existing e-health investments. For more information, visit the Healthcare Group’s Asia Pacific website at www. csc.com/healthsolutionsAPAC
Cutting Edge Software P: 1300 237 638 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 557 550 F: +61 7 5478 5520 E: support@directcontrol.com.au W: www.directcontrol.com.au 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. 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: 1300 865 977 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 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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Emerging Systems P: +61 2 8853 4700 F: +61 2 9659 9366 E: sales@emerging.com.au W: www.emerging.com.au/ehealth
Doctors Control Panel E: www.pracsoftutilities.com W: PSU_admin@pracsoftutilities.com • Download and trial DCP software for GP’s and health teams. • DCP is your digital PA and guidelines advisor. • DCP facilitates TCA, GPMP and MHCP creation and tracking. • Contains guidelines licenced from RACGP. • Low annual subscription. • The best preventive care add-on software in Australia. • Compatible with MD3 and BP. • Achieve new heights in preventive care performance. • Significant benefit for patients. • Increase your revenues. • Streamline your workflow. • 3000 current users. • Several research projects based on DCP. • Try it today.
eHealth Security Services P: 1300 399 116 / +61 2 9016 5378 F: +61 2 9016 5379 E: info@ehealthsecurity.com.au W: www.ehealthsecurity.com.au eHealth Security Services (eHSS) specialises in the provision of security as a service and offers an extensive range of Managed IT Services including IT Support for small to medium businesses in the health sector. eHSS’ MediAccess® service provides comprehensive and cost-effective managed security and remote access solutions. eHSS has thorough knowledge and understanding of IT matters in the health industry and its regulatory aspects. eHSS has extensive experience reviewing and assisting with organisational policies and procedures and technical implementations against applicable standards.
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Emerging Systems EHS web-based Clinical Information System records the clinical care delivered to a patient from pre-admission through to discharge. EHS interfaces with the hospital’s PAS system, capturing and providing all of the information Clinicians require during a patient stay to support the delivery of effective, appropriate, quality care outcomes in a secure and auditable environment. Information is displayed in a user friendly single pageview for easy access by to information by clinicians. Importantly, EHS links Clinical Care with Workforce Rostering and Staff Allocation allowing for predictive Resource Allocation based on the care required, enabling valuable productivity improvements. EHS is a proven and highly useable electronic medical record (EMR) developed within Australia and operating successfully in St Vincents & Mater Health, Sydney and Government of South Australia, Department of Health Hospitals. EHS provides:• Pre-Admission • Patient History • Orders & Results • Clinical Care Guides • Assessments • Progress Notes • Referrals • Labour & Birth • Medications Reconciliation • Clinical and Non Clinical Messaging • Discharge Summaries • Appointments • Rostering & Allocation • GP Connect • Workforce Resource Calculation • Document Management System • Clinical Dashboard and more EHS supports interactions with the health identifier service and PCEHR. The 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. Accessibility: EHS is accessible on a range of devices according to user preference including our latest iPad application.
Extensia 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 for better and more efficient health care. 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. The most relevant providers, services and products are presented instantly and referral documents are generated and sent electronically.
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 2400 sites, it is now the number one choice of Australian specialists.
GPA P: 1800 188 088 F: 1800 644 807 E: info@gpa.net.au W: www.gpa.net.au GPA ACCREDITATION plus (GPA) is the only independent accreditation program for general practice in Australia. Established in 1998 and run by a team of committed general practitioners, business leaders and experienced administrators, GPA has developed a program that continuously evolves in order to set new standards in general practice accreditation, while offering full support to practices to make accreditation both achievable and rewarding. GPA is committed to providing an accreditation program, which is flexible and understands the needs of busy GPs and practice support staff. Whilst accreditation gives practices access to the Practice Incentive Program (PIP), GPA believes it should offer benefits that go well beyond the PIP. Our program provides practices with a pathway to enhanced patient care, continuous professional satisfaction, improved practice efficiency and superior risk management. GPA ACCREDITATION plus certificates and signage remind patients that their practice has achieved a level of care and service above and beyond essential general practice standards. GPA provides a system designed to accommodate busy general practices. Among our services, we offer practices the opportunity to use technologicallyadvanced, environmentally-friendly online programs, allowing staff to upload documentation at their own pace; individually assigned client managers, supporting practices through accreditation from start to success and beyond; highly-trained and sensitive surveyors, with extensive experience in all facets of general practice; and interactive training seminars, bringing practices the latest information in standards and innovation. At GPA, we believe that accreditation should be an accomplishment, not a test, and we uphold that belief in our approach and service. For an accreditation program that will offer you assistance, support, information and satisfaction…the choice is yours.
Global Health
Health Communication Network
P: 1300 723 938 F: +61 3 9675 0699 E: marketing@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 leading provider of e-health solutions that connect clinicians and consumers across the healthcare industry. Global Health’s portfolio consists of: • ReferralNet - a cloud-based secure message delivery system for the exchange of information between healthcare providers. • MasterCare® - a suite of health information systems that provides tools to collect, manage and access clinical and patient information at the point of care. • LifeCard® - a personal health management system for keeping all your important medical information in ONE secure location. With LifeCard® you can maintain a personal health record, access emergency health information and be rewarded for looking after your health.
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. 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
Health Informatics Society of Australia P: +61 3 9326 3311 F: +61 3 8610 0006 E: hisa@hisa.org.au W: www.hisa.org.au HISA is Australia’s health informatics organisation. We have been supporting and representing Australia’s health informatics and eHealth community for almost 20 years. HISA aims to improve healthcare through the use of technology and information. We: • Provide a national focus for eHealth, 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 eHealth. Join the growing community who are committed to, and passionate about, health reform enabled by eHealth.
HealthLink P: 1800 125 036 (AU) P: 0800 288 887 (NZ) E: enquiries@healthlink.net W: www.healthlink.net Australia’s and New Zealand’s largest effective secure communication network. • Referrals, Reports, Forms, Discharge Summaries, Diagnostic Order and Reporting • Provider of Secure Messaging Delivery (SMD) services • Fully integrated with leading GP and Specialist clinical systems • Robust; Reliable and Fully Supported Join the network that more than 70 percent of GPs use for diagnostic, specialist and hospital communications.
Houston Medical P: 1800 420 066 (AU) P: 0800 401 111 (NZ) E: info@houstonmedical.net W: www.houstonmedical.net “We provide time to health professionals through efficient practice management software”
Healthbank Consult P: 1300 856 722 F: 08 8301 4001 E: support@healthbankconsult.com.au W: www.healthbankconsult.com.au Healthbank Consult is a telehealth system developed in Australia for Australian healthcare providers. Secure, fully encrypted and HD capable, Healthbank Consult is designed to be compatible with your clinical desktop for easy integration with your practice’s workflow and retains an audit trail for Medicare. Compliant with RACGP telehealth guidelines, Healthbank Consult will qualify Rural GPs, Specialists, Aged Care Facilities and Aboriginal Medical Services for a $4,800 Medicare telehealth rebate plus ongoing fees.
Our multidiscipline software provides interfaces to every major manufacturer, enabling many clinics to save space by becoming completely paperless!
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. The Executive Committee works to maintain the purpose and service for the members, through dynamic goals of improved healthcare outcomes through the dissemination and utilisation of information, knowledge and technology. HINZ acts as a single portal for the collection and dissemination of information and about the New Zealand Health Informatics Industry. Membership is for anyone who has an interest in health informatics.
Health Information Management Association Australia P: +61 2 9887 5001 F: +61 2 9887 5895 E: himaa@himaa.org.au W: www.himaa.org.au The Health Information Management Association of Australia (HIMAA) is the peak professional body of Health Information Managers in Australia.
We are a progressive medical software company and take pride in working with our health care clients to deliver tailored EMR and PMS packages based on each unique situation and practice requirements. We’re focused on helping to make their businesses more efficient and productive as well as delivering measurable improvements in customer satisfaction and market share. You can arrange a free demonstration of our software by visiting: www.HoustonMedical.net
HIMAA aims to support and promote the profession of health information management. 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.
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InterSystems P: +61 2 9380 7111 F: +61 2 9380 7121 E: anz.query@InterSystems.com W: www.InterSystems.com InterSystems Corporation is a global leader in software for connected care, with headquarters in Cambridge, Massachusetts and offices in 25 countries. InterSystems TrakCare™ is an Internet-based unified healthcare information system that rapidly delivers the benefits of an Electronic Patient Record. InterSystems HealthShare™ is a strategic healthcare informatics platform for information exchange and analytics within a hospital network, and across a community, region or nation. HealthShare leverages InterSystems iKnow and DeepSee technologies to unlock all patient information, including unstructured data, and to enable real-time analysis. InterSystems Ensemble® is a platform for rapid integration and the development of connectable applications. InterSystems CACHÉ® is the world’s most widely used database system in clinical applications.
MEDITECH Australia P: +61 2 9901 6400 F: +61 2 9439 6331 E: sales@meditech.com.au W: www.meditech.com.au A Worldwide Leader in Health Care Information Systems 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.
Medtech Global Ltd
MIMS Australia P: +61 2 9902 7700 F: +61 2 9902 7701 E: info@mims.com.au W: www.mims.com.au MIMS Australia is built on a heritage of local expertise, credibility and adaptation to changing healthcare provider needs. Our information gathering, analysis and coding systems are proven and robust. MIMS information is backed by MIMS trusted, rigorous editorial process and constantly updated from a variety of sources including primary research literature. Our database and decision support modules are locally relevant, clinically reviewed and updated monthly and compatible with a host of clinical software packages. Indeed, the majority of Australian prescribing packages and many dispensing applications are supported by the MIMS medicines data base. MIMS is delivered all the ways you need – print to electronic, on the move, to your patient’s bedside or your consulting room desk. Whatever the format, MIMS has the latest information you need.
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. Join over 100 other companies across all areas of medical IT/IM so your voice can be heard.
P: 1800 148 165 E: salesau@medtechglobal.com W: www.medtechglobal.com
ISN Solutions P: +61 2 9280 2660 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 and private hospitals. We manage IT services, we are dedicated to the medical industry. We know that if you are consulting then you need a quick response. Our support model is designed to minimise the interruptions to the doctor specially. We are familiar with most medical software applications in Australia. We have strong industry references. Some of our solutions include, but are not limited to: • Cloud based computing tailored to medical industry • Medical voice recognition • Capped cost medical support and maintenance plan • Ability to consult remotely • Medical application support
For over 28 years, Medtech Global has been a leading provider of health management solutions to the healthcare industry enabling the comprehensive management of patient information throughout all aspects of the healthcare environment. Medtech’s Medtech32 and Evolution solutions improve practice management and ensure best practice for electronic health records management and reporting. Clinical Audit Tool integrates with Medtech32 and Evolution providing fast, efficient and secure analysis of patient data enabling practices to identify and deliver services, which address health care priorities across their population. Medtech’s ManageMyHealth patient and clinical portal enables individuals to access their health information online and engage with their healthcare provider to support healthy lifestyle changes.
Mouse Soft Australia Pty Ltd
MITS:Health P: 1300 700 300 E: info@mitshealth.com.au W: www.mitshealth.com.au Managed IT Services for the Health Industry MITS:Health provides a full range of IT services specifically tailored for medical centres, GPs and specialists across Melbourne. • • • • • •
Equipment supply and installation Remote monitoring and support Data backups Networking Internet Website Development
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. Throughout its 19 year history, Medical Wizard has led the way with innovative solutions. We are constantly evolving Medical Wizard to meet the challenges of the medical profession for today and tomorrow. A software of choice for discerning Specialist practices, notably Gastroenterologists, Cosmetic Surgeons, Ophthalmologists, General Surgeons, IVF Centres and Day Hospitals amongst others. All aspects of practice management from appointments, billing, clinical, theatre management and compliance reporting are covered and backed by a dedicated local support team. Feature Rich. Dynamic. Innovative.
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NEHTA
Orion Health
P: +61 2 8298 2600 F: +61 2 8298 2666 E: admin@nehta.gov.au W: www.nehta.gov.au
P: +61 2 8096 0000 / +64 9 638 0600 E: enquiries@orionhealth.com W: www.orionhealth.com
The National E-Health Transition Authority was established by the Australian, State and Territory governments to develop better ways of electronically collecting and securely exchanging health information. NEHTA is the lead organisation supporting the national vision for eHealth in Australia.
Nuance Communications P: +61 2 9434 2300 F: +61 2 9929 0815 E: Vicki.Rigg@nuance.com W: australia.nuance.com W: newzealand.nuance.com Nuance (NASDAQ: NUAN) is a leading provider of speech and imaging solutions for businesses and consumers around the world. Its technologies, applications and services make the user experience more compelling by transforming the way people interact with information and how they create, share and use documents. Every day, millions of users and thousands of businesses utilise Nuance’s proven range of productivity applications which include Dragon NaturallySpeaking (speech recognition), OmniPage (OCR), PaperPort (document management) and PDF Converter Professional (PDF creation and conversion).
Orion Health is a world leader in the e-health industry. We specialise in electronic health record (EHR) solutions, disease management, clinical decision support, and hospital administration tools. More than 300,000 clinicians in 30 countries use Orion Health products. Our EHR solutions have been widely adopted across Canada, Europe and the USA to enable secure crossorganisational and regional sharing of patient information, resulting in improved patient care. Our Rhapsody Integration Engine, a healthcare dedicated and standards based Integration hub, is used by customers to easily create interoperability between existing healthcare information systems. 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 intuitive solutions to meet your current and future needs.
Precision IT Pen Computer Systems P: +61 2 9635 8955 F: +61 2 9635 8966 E: enquiries@pencs.com.au W: www.pencs.com.au Established in 1993, Pen Computer Systems (PCS) specialises in developing information solutions for National and State eHealth initiatives in Primary Health that deliver better Chronic Disease outcomes. 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.
OzeScribe P: 1300 727 423 F: 1300 300 174 E: sales@ozescribe.com.au W: www.ozescribe.com.au OzeScribe is the dictation and transcription solution for most Australian university teaching hospitals and major private clinics. It really does make sound business sense to let OzeScribe worry about managing dictation, transcription and technology. We provide free electronic document delivery – OzePost – to your EMR and your associates’ EMR, saving you thousands of dollars in time, packing and postage. OzeScribe is the provider of the most advanced solutions available. • Run by doctors – for doctors. • Australian trained typists. • Manage dictation and transcription via computers, iPhone, iPad, android or smartphones. • Integrated M*Modal speech recognition technology on demand.
P: 1300 964 404 F: +61 2 8078 0257 E: info@precisionit.com.au W: www.precisionit.com.au • Cloud Computing Specialists. • Onsite Medical IT Support. • VoIP Telephone Systems and Internet Connectivity. • IT Equipment Procurement. • Experience with all clinical & practice management software packages. • Sydney, Brisbane, Gold Coast and Melbourne. Precision IT is a highly competent and impeccably professional IT support firm with a primary focus on working with GPs and Specialists. Working with our clients, we develop reliable, robust and feature rich IT systems to meet the demands of the modern medical practice today and into the future. Our Precision Cloud service is fast becoming the choice for new and established practices and covers all of the standard guidelines from the RACGP and AGPAL and GPA. Talk with us today about the future of your practice!
Stat Health Systems (Aust)
Medilink from Practice Services P: +61 3 9819 0700 F: +61 3 9819 0705 E: Sales@practiceservices.com.au W: www.practiceservices.com.au Medilink Practice Management Software • 21 years young, large user base • Medilink = Intuitive ease of use • Solo Drs up to Hospitals in size • Claiming via integrated EFTPOS ◊ and/or integrated HICAPS ◊ and/or Medicare Online ◊ and/or ECLIPSE • Many standard features • Many optional modules • Links to many third party packages and services • Cut debtors and boost cash flow • 17 years as an Authorised Medilink Dealer, selling, installing & training • Fixed Cost Support, Onsite or Remote
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. Facebook: facebook.com/StatHealth Twitter: @NotifyStat
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Sysmex New Zealand P: +64 9 630 3554 F: +64 9 630 8135 E: info@sysmex.co.nz W: www.sysmex.co.nz Sysmex New Zealand is a market leader in the development and implementation of health IT products and services for clinical laboratories, hospitals and healthcare organisations. We offer the following health IT solutions: • Delphic LIS – a market-leading laboratory information system for hospital and community laboratories with a strength in providing multi-lab solutions. Specialised modules manage workflows in the anatomical pathology, haematology and microbiology work areas. • Eclair – an advanced clinical data repository (CDR) which stores patient data from a range of systems including laboratory, radiology, pharmacy and clinical document sources to create a secure patient-centric record. Eclair provides complete electronic ordering functionality.
Totalcare P: +61 7 3252 2425 F: +61 7 3252 2410 E: sales@totalcare.net.au W: www.totalcare.net.au Totalcare is a fully integrated Clinical, Office and Management software suite designed to suit the particular needs and processes of healthcare providers. Used since 1995 by health care facilities across Australia including General and Specialist practice, Radiology, Day Surgery and Hospitals, Totalcare is stable, scalable, customisable and easy to learn and use. From a small practice to a multisite, multi-disciplinary corporate entity or hospital, Totalcare can provide solutions for your needs. • • • • • • • •
Admissions / Appointments Billing Statutory Reporting Integrated SMS Prescriptions Orders & Reports Clinical Notes Letter/Report Writing, Document and Image Management • Scanning and Barcode recognition • Video and Image Capture • HL7 Interfaces
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TrendCare
R O
Therapeutic Guidelines Ltd
Trend Care Systems
P: 1800 061 260 E: sales@tg.org.au W: www.tg.org.au
P: +61 7 3390 5399 F: +61 7 3390 7599 E: support@trendcare.com.au W: www.trendcare.com.au
Therapeutic Guidelines Limited is an independent not-for-profit organisation dedicated to deriving guidelines for therapy from the latest world literature, interpreted and distilled by Australia’s most eminent and respected experts. These experts, with many years of clinical experience, work with skilled medical editors to sift and sort through research data, systematic reviews, local protocols and other sources of information, to ensure that the clear and practical recommendations developed are based on the best available evidence. eTG complete Incorporates all topics from the Therapeutic Guidelines series in a searchable electronic product, and is the ultimate resource for the essence of current available evidence. It provides access to over 3000 clinical topics, relevant PBS, pregnancy and breastfeeding information, key references, and other independent information such as Australian Prescriber (including Medicines Safety Update), NPS Radar, NPS News and Cochrane Reviews. eTG complete is available in a range of convenient formats – online access, online download, CD, and intranet access for hospitals. Multi-user licences, ideal for a practice or clinic, are also available. It is widely used by practitioners and pharmacists in community and hospital settings in all Australian states and territories. Updated three times per year, eTG complete meets the criteria for ‘key electronic clinical resources’ in the Practice Incentives Program (PIP) eHealth Incentive. The July 2012 release of eTG complete includes a complete revision of the Toxicology and Wilderness topics. miniTG The mobile version of eTG complete is miniTG, offering the convenience of having vital information at the point of care and designed for health professionals who practise and consult on the move. It is supported on a wide range of mobile devices, including Apple®, Pocket PC®, and selected Blackberry® devices.
Vensa Health P: +64 9 522 9522 F: +64 9 522 9523 E: website@vensahealth.com W: www.vensahealth.com
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.
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VIRTUAL CONSULTING ROOMS
VConsult P: 1300 82 66 78 F: 1300 66 10 66 E: admin@vconsult.com.au W: www.vconsult.com.au VConsult offers outsourced practice management solutions for medical and allied health practitioners allowing the focus to be on your professional practice and patient care. VConsult provides a seamless “behind the scenes” service by professionally managing your telephone calls, reception, invoicing and medical transcription requirements. VConsult is perfect for your practice if you are: • Setting up, already established or winding down in Private Practice • Working in a public appointment and want to portray a professional image • Looking to minimise your overhead costs • Requiring your patient calls to be answered by a professional and experienced medical receptionist.
Vensa Health is the leading mHealth solutions provider focusing on delivering mobile health innovations worldwide. If you have received an SMSfrom your doctor, hospital or physio it is almost certain Vensa Health was responsible for its delivery. At Vensa we are focused on offering solutions and innovations, which add value to our clients, this is the fundamental philosophy underpinning all of our services and technology offerings. With nearly 80% adoption of mobile health in New Zealand and a solid customer base, Vensa Health is focusing on Australasia and Middle East regions in its expansion with a BHAG of closing the gap for 10% of earth’s population health.
Zedmed P: 1300 933 000 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 Medical Record Exchange – a free, 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. For more information about Medical Record Exchange, please contact us: Phone: 1300 933 833 www.medicalrecordexchange.com.au
SMD Putting all the pieces together Better Communication, Better Care
Secure Message Delivery is a key foundation of the National eHealth reform and HealthLink has delivered.
HealthLink has the largest SMD compliant network across Australia making your practice or organisation eHealth ready. SMD enables the exchange of patient information between health care providers in a seamless, timely, accountable and standards based way. Having your patient information in the right place at the right time will transform your practice and your patients’ care.
Talk to us today on 1800 125 036 to realise the benefits of HealthLink Secure Messaging ehealth@healthlink.net www.healthlink.net
Better Communication, Better Care