Australasia’s First and Only eHealth and Health IT Magazine
26
Issue
20 FEbruary 2012
Wave 2 PCEHR UPDATE
Wave 2 PCEHR Lead Sites
Pulse+IT provides an overview of all nine Wave 2 sites, detailing their progress in the lead up to the launch of the PCEHR in July 2012.
eHealth grass roots and blue sky
Jenny O’Neill questions how eHealth providers will be engaged to align their activity with the national eHealth agenda.
Q&A with incoming HISA chair Pulse+IT chats with the Health Informatics Society of Australia’s recently appointed chair, Katerina Andronis.
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Inside
Publisher Pulse Magazine ABN: 19 923 710 562 www.pulseitmagazine.com.au Editor Simon James Australia: +61 2 8006 5185 New Zealand: +64 9 889 3185 simon.james@pulseitmagazine.com.au Subscription Enquiries subscribe@pulseitmagazine.com.au Advertising Enquiries ads@pulseitmagazine.com.au
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Looking Ahead
About Pulse+IT Pulse+IT is Australia’s first and only Health IT magazine. With an international distribution exceeding 37,000 copies, it is also one of the 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.
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.
ISSN: 1835-1522
Pulse+IT is produced in print seven times per year with the remaining six editions for the year to be distributed for release in:
Disclaimer The views contained herein are not necessarily the views of Pulse Magazine or its staff. The content of any advertising or promotional material contained herein is not endorsed by the publisher. While care has been taken in the preparation of this magazine, the publisher cannot be held responsible for the accuracy of the information herein, or any consequences arising from it. Pulse Magazine has no affiliation with any organisation, including, but not limited to Health Services Australia, Sony, Health Scope, UBM Medica, the New Zealand College of General Practitioners, or the Kimberley Aboriginal Medical Services Council, all who produce publications that include the word “Pulse” in their titles.
• • • • • •
April 2012 ~ Connected Care Mid-May 2012 ~ Preparing for the PCEHR Launch July 2012 ~ Telehealth / HIC2012 Preview Mid-August 2012 ~ PCEHR Analysis / HIMAA Conference Preview October 2012 ~ New Zealand eHealth / HINZ Conference Preview Mid-November 2012 ~ mHealth
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.
Contributors Bryn Evans, Simon James, Kate McDonald, Jenny O’Neill.
Copyright 2012 Pulse Magazine No part of this publication may be reproduced, stored electronically or transmitted in any form by any means without the prior written permission of the Publisher. Subscription Rates Please visit our website for more information about subscribing to Pulse+IT.
30 HISA CHAIR Katerina Andronis
36 MATER Health Services Shared EHR
Editorials
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STARTUP
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GUEST EDITORIAL
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Editor Simon James introduces the 26th edition of Pulse+IT.
Bryn Evans explains how better communication and rigorous rehearsals are necessary in the lead up to the launch of the PCEHR.
MSIA Jenny O’Neill argues that the doers and the dreamers must come together to deliver on the promise of eHealth.
HISA Katerina Andronis outlines her passion for health informatics and her hopes for the future as the first female chair of HISA.
Features
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MATER ONLINE
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DRUG REPOSITORY
Mater Health Services is creating a shared electronic health record for mothers and newborns.
MedView is a national repository for a consolidated view of prescribed and dispensed medications.
24 BEST PRACTICE SUMMIT
News
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MOBILE EHR
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THE 4 Cs
The Northern Territory is expanding its successful shared EHR to the Kimberley and South Australia.
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SELECTED BITS & BYTES Practice managers promote MedView, endorse ePrescribing Stat Health adds data reporting tool
The Cradle Coast Connected Care project is developing shared care plans for aged care residents.
Telehealth gets $20 million boost Registrations open for HISA Data Governance conference
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GP ACCORD
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GREATER WEST
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PERSONAL HEALTH Medibank is creating an online health record to allow individuals to maintain their health information.
Resources
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ACT NOW
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EVENTS
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PULSE+IT DIRECTORY
SYDNEY CONNECTS
Brisbane’s Accoras GP network is helping general practices sign up to the Healthcare Identifiers Service.
RACGP raises governance, liability concerns over PCEHR ePrescribing reduces clinical errors
Greater Western Sydney is sharing clinical documents across acute and primary care.
The ACT is working on eHealth for aged care, palliative care and chronic disease management.
Eastern Sydney has signed up GPs and consumers and has gone live with some PCEHR components.
HCN delivers Healthcare Identifiers in latest Medical Director update Best Practice gearing up for second annual summit
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
SQUARE PEGS AND ROUND HOLES
Lessons from THE SCHOOL YARD The first edition of Pulse+IT for 2012 hits the printing press at a time when interest in, and scrutiny of, the national eHealth agenda have reached record levels. The recent health ministry shake-up, a senate inquiry and the emergence of PCEHR technical specification problems have all contributed to an eventful start to the year, at least for those with an interest in eHealth. Simon James BIT, BComm Editor: Pulse+IT simon.james@pulseitmagazine.com.au
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.
This edition of Pulse+IT features an overview of nine eHealth pilot projects, which are collectively referred to as the Personally Controlled Electronic Health Record (PCEHR) Wave 2 lead implementation sites. Following a tender process in 2011, these projects were commissioned at a cost of up to $55 million to allow software vendors, healthcare providers and government eHealth stakeholders to build and trial technology with a view to informing the development of the national PCEHR system. This service is due to commence operations in July 2012, but it is a matter of current debate as to the exact functionality the PCEHR will provide in its early iterations. Unfortunately for a list of people too long to mention, a technical issue emerged in late January which threw almost all of the Wave 2 projects into a state of limbo. On the eve of putting this magazine into production the sufficient technical detail required to undertake a thorough analysis of the issues has yet to emerge. However, explained in terms even infants are taught to understand, one set of companies were commissioned to build a set of square pegs, and another set of companies were commissioned to build a set of round holes. Unfortunately the products these two groups of companies built were intended to interface with one another, an
outcome that — to continue the metaphor — is now likely to require some costly geometric reshaping to achieve. For those interested in a somewhat more technical description of the specification issue and an analysis of the impacts this problem will have on the very projects outlined in this magazine — and the PCEHR project more broadly — extensive coverage is available online at the recently relaunched Pulse+IT website.
A time to invest Notwithstanding the assorted challenges an editor and his journalists face when all certainty and media access to the projects they’ve devoted an edition to evaporate quite literally in the week before a print deadline, Pulse+IT has had a very positive and productive festive season ‘break’. In reflection of the increasing amount of eHealth-related activity occurring in both Australia and New Zealand, we have increased the frequency of our publication to seven times per year, up from five in previous years. This configuration means the publication will be released every six weeks from mid‑February through to mid‑November, leaving both the readership and the publishing team with a well-earned break from eHealth at the end of the year. The publication’s page
count has also increased, the magazine you are currently reading being the most substantial of the 26 editions we’ve produced in Pulse+IT’s now five and a half year history. To support the increased workload Pulse+IT has committed to undertake throughout 2012, I’m pleased to announce that Kate McDonald has joined the team in a senior journalist capacity. Having worked at various times as the editor of Australian Life Scientist magazine, Hospital & AgedCare magazine and Nursing Review, Kate brings a wealth of experience and passion to the role. As I hope will be instantly apparent to long‑time readers of the magazine, Pulse+IT has undergone a visual redesign since our last edition for 2011 was produced. Much like a new pair of shoes, magazine designs require a measure of ‘breaking in’ and I welcome any feedback readers may have to assist in refining the work our designers have done to date.
Digital services In addition to the investment we have made in our print publication, we have spent considerable time refining our digital services to allow us to provide the sector with objective, independent and timely reporting of eHealth developments. Free from the page space restrictions inherent in print publications, expanded versions
of many of the articles in this edition’s Bits&Bytes news section can be found at the Pulse+IT website. The website versions of the articles support user interaction and your comments and queries about anything presented in this magazine are both welcomed and encouraged. Naturally the website supports RSS feeds and interfaces with an ever-growing list of social media services, but for those that would prefer their eHealth news delivered to their email inbox, Pulse+IT has relaunched its free weekly eNewsletter service for 2012. In addition to our own original journalism, we are undertaking to link to quality third-party eHealth reporting, in addition to providing job listings, events and tender opportunities.
Kia ora New Zealand! At this juncture I’d like to extend a special welcome to new and returning readers from New Zealand. While Pulse+IT has had a substantial presence in New Zealand for several years through a distribution partnership with NZ Doctor magazine, additional partnerships with the NZ Healthcare IT Cluster and NZ Hospital and Healthcare magazine have recently been forged, which will extend the reach of the magazine to even more suppliers and end users of eHealth technology. As part of this expanded investment in our New Zealand operations, Pulse+IT will gradually increase the coverage of
New Zealand eHealth happenings in the pages of Pulse+IT magazine and online. Additionally we are undertaking to produce a New Zealand-themed edition later in the year to showcase some of the excellent eHealth developments that are occurring in New Zealand, most of which have direct applicability throughout the ‘West Island’.
Looking ahead While the Personally Controlled Electronic Health Record (PCEHR) system will dominate eHealth-related discussions throughout the year, it is important to stress at this early juncture that, like the National Broadband Network, the PCEHR system is likely not coming to a practice or healthcare facility near you any time soon. While Pulse+IT will naturally undertake to provide significant pre- and post-launch analysis of the PCEHR throughout the year, we intend to maintain the publication’s broad appeal by complementing such coverage with substantive journalism and feature writing devoted to other more readily available eHealth opportunities. As the Australian eHealth sector embarks on what will surely be one of the most pivotal in its short history, more so than ever, I look forward to 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.
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Guest Editorial
Will the PCEHR PRODUCTION Be
‘All right on the night?’ In March 2011, the National E-Health Transition Authority (NEHTA) convened a Personally Controlled Electronic Health Record (PCEHR) ‘Four-Cornered’ Roundtable meeting to consult with stakeholders and industry representatives across the healthcare sector. Having attended the second such meeting on 7th September 2011, Bryn Evans shares his observations about the session.
BRYN EVANS Director: JEMS Consulting bryn.evans@ozemail.com.au
Held on 7th September 2011, the second Personally Controlled Electronic Health Record (PCEHR) Roundtable meeting had the following objectives: • Detail the progress made since the first meeting in March. • Understand and learn from all participants in the healthcare arena, and better understand perspectives. • Provide participants with an opportunity to give feedback on components such as ‘benefits and evaluation’, and ‘change and adoption’. • Understand how you and your organisation would like to be engaged moving forward; leveraging existing communication and engagement channels to work together. There were over 200 attendees, drawn from across the health sector spectrum in the overall proportions shown in the table at the top of the following column.
What were the outcomes? About the author Bryn Evans is a management consultant, with many years experience as a CIO in healthcare, and as chief executive of a clinical software supplier. He writes extensively across a range of categories and genres, notably in the areas of management, information technology, sport, travel, history and fiction.
Putting to one side the question as to why it took NEHTA until 23rd December to release a summary report of the proceedings of the second Roundtable, what were the main outcomes which arose from the meeting? And what is their relevance to the PCEHR progress today?
Attendee ‘Corner’ (Category)
%
Healthcare provider
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Vendor
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Consumer
13%
Policy maker
11%
Other
20%
Total
100%
The key overall issues or needs raised by the attendees, are summarised in the report as follows: 1. More information on, and individual support for the PCEHR. 2. A clearer view of how the system will address specific stakeholder needs. 3. NEHTA to reach out and collaborate with the entire healthcare community. 4. NEHTA to listen, value input from stakeholders, and be transparent in response. In addition, by means of attendees using interactive individual handset technology, the report has been able to identify the top ten topics of the day, and their common themes, of which the top four are shown in the table at the top of the following page:
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Pulse IT Feb 2012
For more about the iSOFT HIE Suite, and how iSOFT is enabling the Health Identifer, visit: http://www.isofthealth.com/ANZ-HIE.aspx
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Top Four Topics
Common Theme(s)
1. Access and participation in the PCEHR system
• Accessibility to a PCEHR • Participation in the PCEHR program
2. Infrastructure
• Interoperability and compatibility of systems • Availability of infrastructures • Security associated with the use of systems
3. Opt-in/out
• Debate surrounding the pros/cons for opt‑in vs opt-out
4. Good news / benefits / factors for success
• Acknowledge the journey ahead of us • Consider all the population, including the indigenous, homeless etc • Use a targeted approach
From my recollections and notes made at the Roundtable, I would also make some additional comments: • One agenda item was to introduce the contracted national partners for (1) Change and Adoption, (2) Benefits and Evaluation, and (3) Infrastructure, and present a summary of their work to date at that time. Very little information was provided then, and it would appear this situation has remained, at least outside of NEHTA and the lead implementation site project circles. • Only superficial information was provided regarding the PCEHR lead sites. From memory no representative from a PCEHR lead site, gave a presentation on their site’s progress and project plans. • The Opt-in/out debate still seemed to generate major concerns. Consumer representatives spoke out forcibly in favour of the Opt‑out option, believing that the Opt-in option would be too complex, and significantly inhibit the voluntary take-up by consumers. • Concerns about the infrastructure were voiced, particularly in regard to interoperability, compatibility and integration, when the specifications for the software were still not finalised. At the conclusion of the day many key questions remained hanging. How will consumers be engaged and registered
for the Opt-in model? How useful and user-friendly will the PCEHR software be, and will clinicians and consumers accept and embrace it? Will clinicians be compensated, or incentivised in some way, for their time in implementing and operating the PCEHR? The objective of the Roundtable was commendable, but it required fast feedback on its outcomes, and an ongoing engagement with its attendees and a wider range of stakeholders. The core and underlying message of the Roundtable, confirmed by the report issued in December, was the attendees’ desire for more comprehensive and frequent communication on the PCEHR Project from NEHTA, the contracted national partners and the lead sites.
Achieving PCEHR implementation by 1st July 2012 – what must be done? For the PCEHR to achieve successful implementation, at least at some sites by 1st July 2012, there are four areas of activity, which are common and essential to all ICT implementations and change projects, which must be undertaken and managed at a best practice level. Assuming that the infrastructure and software is delivered on time, meets the specifications, and integrates successfully, the following areas would appear to
require performance at the best practice level, if implementation ‘Go Live’ is to be achieved: 1. Communication Communication on the project must move to a much more transparent, broader and frequent mode. From a personal involvement in the development of the business case for the NHI in 2004, the most important and costly item to achieve adoption by consumers and clinicians, was identified as communication through national mechanisms and channels. This is now critical for both health identifiers and the PCEHR. Communication should cover every aspect of the project, informing all project staff, management, clinicians and consumers, of implementation progress on a very frequent basis, through a regular bulletin at least monthly, and possibly every two weeks as the delivery deadline of 1st July 2012 draws closer. 2. User Acceptance Testing Rigorous user acceptance testing is critical, and in this case it has to cover both the clinical users in the lead sites, and the consumers who take up the Opt-in option. Too many ICT implementations run into difficulties, because testing has not been comprehensive and exhaustive. 3. Change in Processes and Work Practices Changes to processes and work practices related to the PCEHR, must be identified and agreed, and integrated with user testing, training and benefits evaluation. It is critical that the benefits to be gained from the PCEHR are measured, and communicated widely. Where the use of the PCEHR results in clinicians’ time in patient care being reduced, the issue of compensation must be addressed. The Roundtable report stated that: “Following the release of the final Change and Adoption Strategy, the National
Change and Adoption Partner and NEHTA will begin … an information drive …[which will] include events, training and the creation of an Internet portal, targeted separately at consumers and providers.” 4. Training The training of users is pivotal to the success of any implementation. Even if everything else in a project is perfect, if the users have not been trained effectively, it will be branded a failure Clinical users must be scheduled well in advance for training sessions close to Go Live with the option of web-based methods, so that where possible, they can be back-filled on their clinical duties. Some clinicians including GPs may need to be paid to undertake training.
Training of consumers, so that they can access the PCEHR over the web, may need to be through online access to a training module.
Conclusion As implementation activity gathers pace, improved communication is required on the PCEHR project’s latest plans and progress, by NEHTA, the national partners and the lead sites. It is the key to enthusiastic engagement nationally with clinicians, health services management, and consumers, which will make the implementation a success. Using the recent glitch concerning specifications for general and specialist clinical software as an example, difficulties
encountered and addressed, should be communicated in the context of overall progress, and the project milestones which are being achieved. Without a high quality, best practice approach to communication, no project involving major change, especially one of such a national exposure and importance, can be expected to succeed. Some people will say as they do in the theatre industry, “It will be all right on the night”, and the PCEHR can be delivered on 1st July 2012. But all successful productions rest upon rigorous rehearsals over many months (testing, process change and training), and lead up publicity (communications), before the first night (Go Live). Only then can the PCEHR be ‘All right on the night.’
HealthLink/Medinexus Half Page 180 x 120 Puse IT Mag
connecting healthcare
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News
Practice managers promote MedView, endorse ePrescribing The Australian Association of Practice Managers (AAPM) has joined the MedView Wave 2 PCEHR project and will promote it to members as a practical way to improve the efficiency and level of patient service offered by their practices.
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AAPM president Brett McPherson said MedView represented a big advance in medicines management and described ePrescribing as a vital link in the secure sharing of consented data. He said AAPM supports initiatives that will improve clinical efficiency, describing ePrescribing as an area that will assist.
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The MedView project is building a national medicines repository to present healthcare providers with a combined list of prescribed and dispensed medications collected from patients in the community, hospital and aged care settings.
The consented data will be securely shared with the national repository through eRx Script Exchange. A number of practice and pharmacy management software vendors are part of the project, including Fred IT Group, Best Practice Software, Zedmed, Simple Retail, BOSSnet, and Pharmhos, along with aged care software vendor iCare and the Geelong Division of General Practice, Barwon Health and numerous pharmacies in the Geelong area.
“What we want to do for practice managers is improve the uptake of the HI Service.” The AAPM will be encouraging members to take part and provide assistance in applying for Healthcare Provider
Identifier – Organisation (HPI-O) and Healthcare Provider Identifier – Individual (HPI-I) numbers, AAPM eHealth marketing officer, Hugh Miller, said. “What we want to do for practice managers is to improve the uptake of the Healthcare Identifiers Service,” Mr Miller said. “That’s been one of our main goals for a while, and we see this project and what MedView wants to achieve as a really good, practical reason for practices to sign up to the HI Service.” Mr McPherson said the association had already seen significant interest in ePrescribing. “However, for practice managers who have not yet embraced ePrescribing, this is the time to do so as one of the key steps towards eHealth.” MedView is an industry partnership funded as a Wave 2 implementation project for the PCEHR.
Cook Medical signs up to National Product Catalogue
Stat Health adds data reporting tool Practice and clinical management software vendor Stat Health will release a new data reporting tool next month that allows users to create their own data sets for clinical and administrative use. The data reporting feature is undergoing beta testing this month before being rolled out to current users of Stat software next month. Stat Health CEO Carla Doolan said the tool was aimed at “empowering users to run their own queries and extract a crosssection of data, including clinical, administrative and patient demographic information. “It allows users to interrogate clinical data more fully then they have been able to in the past,” Ms Doolan said. Users will have access to the entire administrative database, the MIMS drug database, the ICPC-2 PLUS coding system, vaccination register and coded pathology results, she said. This allows Stat to identify patient groups based on categories including demographics, conditions, medications, vaccinations, measurements such as height/weight and blood
pressure and other clinical information. Bulk notifications to patients regarding particular issues are available with the extracted data linked to the recall/ reminder system, the “To Do” action area and also letters for a mail-out.
“When designing this reporting tool, we ensured our clients had the ability to extract the information they need in an uncomplicated manner without the need for third party software.” Ms Doolan said that once a report or query is created, it can be saved, reused and modified with the end user able to view the particular filters in each report. “An example may be to search for all patients who have had no allergy recording performed in their clinical file. A “To Do” can then be placed on every identified file to remind clinicians to check this when the patient next attends.”
Another example is the ability to create a list of female patients in a certain age range who have not had a Pap smear in the last two years and to send them a reminder letter. Similarly, this feature would help identify patients who are due for care plans or health assessments. “When designing this reporting tool, we ensured our clients had the ability to extract the information they need in an uncomplicated manner without the need for third party software,” she said. “Experience tells us that practices are requiring more sophisticated queries all the time and the Stat reporting tool meets these requirements and allows practices to access statistics for benchmarking and risk management purposes.” The data reporting tool is one of several new features in the latest version Stat, which also includes the integration of eRx Script Exchange e-prescribing functions, the ability to add and edit graphic templates, a comprehensive “To Do” message/action facility which is practice/user definable as well as having a full audit trail to aid in risk management within the practice.
Medical device supplier Cook Medical has added its product range information to the National Product Catalogue (NPC). The NPC, hosted on the GS1net data synchronisation platform by GS1 Australia, is a single repository of product, pricing and healthcare data for all health industry product categories, including pharmaceuticals, medical devices, catering and food services and cleaning products. The platform enables the secure sharing of item master information such as product identifiers and descriptions, units of measure, package contents, product classification, pricing and related healthcare information. Cook Medical works with medical research facilities, teaching hospitals and specialists to produce angiographic and interventional devices such as endovascular stent graft technology at its facility in Brisbane. Moving Cook’s extensive product range into the NPC was an extensive and quite complex project, Bizcaps’ project manager, Paolina Biviano, said. “There were over 5000 products to be published with well over 30,000 associated pricing records for the various health authority contracts,” Ms Biviano said.“Data had to be pulled together from three different client systems before being uploaded to the NPC.” Bizcaps’ CEO Rob Clifton-Steele said the software has the capacity to integrate with all sorts of back-end systems, such as SAP, Oracle and any others. It can take a feed of information from these systems, both originally and then in regular updates, validates and then transfers it to a catalogue hosted by Bizcaps Software, and then publishes it to the NPC.
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Bits & Bytes
Population health statistics go online in NSW NSW Health has launched a new website allowing easy access to population health data for the state. Aimed at allowing local health districts and Divisions of General Practice to access population health data, the site, Health Statistics NSW, is thought to be the first of its kind in Australia. NSW chief health officer Dr Kerry Chant said it would allow users to access data and tailor reports about the health of the NSW population for their own use. Dr Chant said the application allows users to find data easily, visualise and interpret data and produce customised reports. Health Statistics NSW provides an overview of key population health indicators and topics, including information on the health status and demography of the NSW community, the burden of disease and current health challenges, and trends in health and comparisons between age groups and geographic locations. Data is available from a broad range of data sets collected by NSW Health statisticians, including hospital and deaths data, health survey risk factor data, infectious disease notifications, cancer data and population data. For example, a search of the letter C brings up statistics on cancer, cardiovascular disease, cervical cancer, children, chronic conditions, colorectal cancer, communicable diseases and coronary heart disease. Regular updates will occur to add new indicators and update existing data. Data is freely available and users can view and download data, maps, graphs and reports free of charge. The site allows users to create a graph of statistics of interest and download it for use in other documents, as well as creating a printable PDF and saving reports on the site.
Mater systems accredited for Healthcare Identifiers Service Queensland’s Mater Health Services has received accreditation from the National E-Health Transition Authority (NEHTA) for its interface to the national Healthcare Identifiers Service. It can also now communicate with other healthcare providers using the Secure Messaging Delivery (SMD) technical specification developed by NEHTA. Mater Health Services, which operates seven Mater hospitals in south-east Queensland, is part of the Mater Misericordiae Health Project, a Wave 2 PCEHR eHealth site. In July 2011, it received funding of $7.1 million over 12 months to implement a shared EHR for expectant mothers. Called the Mater Shared Electronic Health Record (MSEHR), the hospital group is collaborating with three GP Divisions — Brisbane South, South East Alliance and Southeast Primary Healthcare Division — along with private obstetric practices on the project. The MSEHR program will initially deliver an electronic alternative to the paperbased Pregnancy Health Record currently used in Mater Mothers’ Hospitals.
The shared EHR will store key information such as health history, previous pregnancy history, birth preferences, breastfeeding preferences, an obstetric management plan, pathology and radiology results, alcohol and drug screening information, medications, allergies and adverse reactions. The project is using InterSystems HealthShare healthcare informatics platform to develop the interface to the national Healthcare Identifiers Service, operated by Medicare Australia. HealthShare connects over 95 clinical and patient administration systems at Mater and also provides message translation for the HL7 healthcare interoperability standard and permanent storage of HL7 messages. The interface was one of the first to gain accreditation under NEHTA’s Compliance, Conformance and Accreditation (CCA) program. Mater’s chief information officer Mal Thatcher said the MSEHR will ultimately integrate with and support the national PCEHR. “The project will initially develop and implement
a repository for obstetric information with access for maternity patients, internal clinicians and affiliated external healthcare providers,” Mr Thatcher said. By connecting to the national Health Identifiers Service, Mater will incorporate Healthcare Identifiers to its MSEHR as part of the development. As well as storing the clinical information submitted by patients, participating external providers and Mater, the repository will use Healthcare Identifiers in Mater’s exchange of information with other healthcare repositories. Mater’s integration specialist Andy Richards said the team had started the development for the Health Identifiers Service towards the end of 2010. “One of the advantages HealthShare has given us is that we can create new interfaces quickly without having to rebuild interfaces to other systems,” Mr Richards said. HealthShare also allows Mater to communicate with other healthcare providers using the Secure Messaging Delivery (SMD) specifications.
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Bits & Bytes
Figures bode well for health investment in the US 2011 was a big year for investment in healthcare IT companies, with $US6 billion in mergers and acquisitions activity recorded, according to US consulting firm Mercom Capital Group.
Telehealth gets $20 million boost
In its annual report for the healthcare technology sector for 2011, Mercom found that almost half a billion dollars came into the sector through venture capital investment compared to $211 million in 2010 (all figures in US dollars). “Several factors, including strategic acquisitions, consolidation and increasing market share, played a role in the increased M&A activity in the sector,” Mercom managing partner Raj Prabhu said. The figures, which only include US deals barring one involving Japanese diagnostic imaging provider Toshiba Medical Systems, show that health information management companies received most of the disclosed VC funding in 2011, totalling $336 million in 30 deals, while personal health record companies raised $83.3 million in 12 deals. Mercom found that the top VC funding deal in 2011 was $75 million raised by online doctor appointment start-up company ZocDoc. Other top VC funding deals included a $27 million raising by Ability Network, a web-based healthcare network.
The federal government has announced $20 million in funding over two years for pilot projects to develop and deliver telehealth services in areas where the National Broadband Network (NBN) is being rolled out. The NBN Enabled Telehealth Pilots Program is aimed at NBN-enabled homes with a focus on aged, palliative or cancer care services, including advance planning services.
Merger and acquisition (M&A) activity was robust in 2011 with 104 recorded transactions totalling $6 billion, compared to $4 billion in 85 transactions in 2010, Mercom found.
Funded projects will be expected to be sustainable and scalable outside of the NBN early release sites and potentially to a national level as the NBN rollout continues.
The top M&A transaction in 2011 was the acquisition of Emdeon, a provider of revenue and payment management and clinical information exchange solutions, by Blackstone Capital Partners for $3 billion.
The program wants to develop and trial services which demonstrate how telehealth services can be delivered to the home in
new and innovative ways, enabled by high speed broadband. Participating consumers are expected to access high‐quality health services from the comfort and convenience of their homes through the remote monitoring of their vital health indicators, access from home to high‐definition video consultations, and healthy living support.
“What we want to do for practice managers is improve the uptake of the HI Service” The project is also aimed at showing how health services can become more
accessible in regional, rural, remote and outer metropolitan areas, and reduce unnecessary hospitalisation. Funding is available to cover the cost of equipment such as tablet devices, service provider computers, and staffing and administrative costs. The program will commence on 1st July and conclude on 30th June 2014, with the amount of funding for individual pilots generally set at around $1 million to $3 million. Applications will open in March and close in April. Draft program guidelines are available here and final guidelines will be released when applications open. Aged Care Minister Mark Butler said that older
Australians would stand to gain the most from the boost to telehealth services.
from a wider range of health professionals,” Mr Butler said.
“As we age, health issues tend to be more prevalent and we’re much more likely to require care and support
“Expanding telehealth services to older Australians still living in their own homes will help
health professionals identify potential health problems earlier, reduce the need for older Australians to travel to receive treatment and increase access to healthcare services and specialists.”
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Registrations open for HISA Data Governance conference The Health Informatics Society of Australia (HISA) is organising the second annual Data Governance Conference in Melbourne on March 29 and 30. The event is aimed at healthcare executives and managers both clinical and non-clinical, data and information professionals, health informaticians, health policy makers and academics. A HISA spokesperson said the conference will be dedicated to the issue of data governance in healthcare.
healthcare. The National Health Reforms add a cross‑organisational complexity — and opportunity — into the mix. Keynote speakers include Andy Bond, chief architect at the National E-Health Transition Authority (NEHTA); Paul Madden, deputy secretary and chief information and knowledge officer (CIKO) with the Department of Health and Ageing (DoHA); the CEO of the NSW Bureau of Health Information, Dr Diane Watson; and David Rowlands, principal of management consulting firm Direkt Consulting.
“Like clinical governance, data governance is about the organisational processes and structures that ensure data is used appropriately, reliably, and in time,” the spokesperson said.
Mr Rowlands will discuss data governance issues in Singapore’s national electronic health record (NEHR), which he has consulted on over a number of years.
“Data and information (and the integrity of both) are critical to organisational decision making and monitoring in
“The work towards a national EHR started in 2009 and I have provided some assistance in particular on standards and
enterprise architecture for the program,” he said. “I’ve done a series of projects, most recently at the end of last year when I went back to make some recommendations on information quality management for the NEHR to ensure that the data is clinically trustworthy and reliable. I will speak about that at the Data Governance conference.” “Information quality issues will affect Australia as well so it is very timely to have that discussion.”
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Users have their say on drug interaction alerts A survey of users of common prescribing and dispensing software has found they want information on drug interactions and its presentation to be improved. Software users indicated they want drug interaction alerts to be more relevant to practice and the format and presentation of alerts to be more easy to read. They also want the alerts to include information about the severity of the interaction and to be visually differentiated. The NPS survey of over 300 GPs and community pharmacists, published in the Medical Journal of Australia, found that there appears to be a gap between the current offerings of some software systems and what users are looking for. NPS’s Michelle Sweidan said the survey was devised following a 2009 paper that evaluated the quality of drug interaction alerts in six prescribing systems — Best Practice, Genie, Medical Director, MedTech, Plexus and Profile, along with three dispensing systems. She said based on the results of that paper, NPS thought it would be useful to talk to the end users as well. “The respondents wanted information about the severity of the drug interaction, the clinical effects of an interaction and they wanted management advice,” she said. She said the three most important points were increasing the relevance of the alerts to practice; improving the format and presentation of drug interaction alerts; and the differentiation of alerts by severity. “The software vendors need to work together with the publishers of the knowledge bases to look at how the information is structured and how it can be incorporated into the alerts,” she said.
MSIA voices concern over PCEHR legislation The Medical Software Industry Association (MSIA) has strongly criticised aspects of the legislation underpinning the creation of the Personally Controlled Electronic Health Record (PCEHR). It has also attacked the National E-Health Transition Authority’s (NEHTA) handling of the recent disruption to the roll out of work at Wave 1 and 2 PCEHR sites due to a specifications issue. “While a pause may be necessary, and a review of issues probably essential, no one in industry has been informed of what the issues are, when we may know the size of the problem or which of the many complex programs are incompatible with the build of the national infrastructure,” the MSIA said in its submission to the Senate committee inquiry into the PCEHR legislation. “It does not make for trusting relationships, or inspire confidence in a way that allows industry to make decisions to invest in, and engage with processes in which NEHTA is involved.” The MSIA said it made 18 recommendations to the improve the draft bill and was pleased to see that
some had been adopted, including compulsory breach notification provisions. However, it still has some concerns of a lack of an advisory role for the informatics community, the software industry and Standards Australia to provide and review technical advice to the system operator. It has called for much greater transparency about what is being built, saying “it is almost impossible for the legislation to accurately cover the issues of privacy, safety and data governance generally”. It has particular concerns with the power vested in the system operator as operator, funder and a board member of NEHTA, saying it would make the operator “impossibly conflicted”.
Another concern is that the onus not to upload data which could infringe copyright or moral rights was still placed on the healthcare provider. “Healthcare workers are not best qualified to judge these matters and the likely default instruction given to them by their organisations will be to not share data which could otherwise be usefully shared and used.” A particular concern is the low uptake of healthcare identifiers under the national Healthcare Identifiers Service. “A few programs are in place that access the unique patient identifiers (IHIs) but most IHI access has been through a NEHTA sponsored Wave 1 initiative to inject IHIs into GP desktop software,” it said. “This has been done largely without the consent or cooperation of the software vendors.”
The MSIA said this was “an inherently unsafe process” as outlined in a 2011 study by the MSIA’s Vince McCauley and Edith Cowan University researcher Trish Williams. “MSIA made NEHTA and [the Department of Health and Ageing, DoHA] aware of its concerns with this process at the Conformance Compliance and Accreditation Governance Group (CCAGG) over 10 months ago. However, the roll-out has continued unchecked and NEHTA has been unable to provide any information about subsequent evaluation of potential errors that may have been introduced into live patient records.” It also said less than one per cent of providers had opted in to the Medicare Provider Directory, which it says is currently the only way that verification of providers can be validated. “Whilst a change request is said to be in process to fix this problem, Medicare and NEHTA have not been able to provide either the details of the change or a time frame in which it might be deployed. “As at the time of writing, no one is able to access HPI-Is or HPI-Os via the HI service because the sector is still determining whether conformance test cases can be developed in a manner that satisfies patient safety
concerns because of the design flaws.
The peak industry body has made a number of recommendations, including:
• Increase advisory group to include representation from research, secondary data and aged care experts. • Make a provision that includes the taking of technical advice from the informatics community, Standards Australia and the software industry associations to ensure future changes and developments are appropriate, safe and timely. • Review the conflicts for the proposed system operator in the various roles held, as partial funder, system operator and as NEHTA board member. • Action as an immediate priority, change requests to the HI Service that are deemed to have a potential clinical safety impact. • Review urgently all the issues in the MSIA White paper on the Healthcare Identifiers Service and ensure changes are made to ensure the service can be used safely.
• Add a more detailed description of the roles of all participants to aid understanding and uptake. • Commit to a date to publish “Rules” to allow adequate time for those who may be of risk of breach to be fully aware and compliant.
The MSIA also repeated its call for a deferral of elements in the PCEHR which it says are not sufficiently mature or not sufficiently reviewed to ensure patient safety, such as the Australian Medicines Terminology (AMT) and SNOMED health terminology.
“These major unresolved issues with the Health Identifier service, with potential serious impact on patient safety and provider welfare, along with the immature state of the PCEHR specifications, was a major input to the decision made by MSIA to
“This has been done largely without the consent or cooperation of the software vendors.” call for a six-month delay in PCEHR implementation in a letter to DoHA in November 2011. “The department’s response was that such a delay was unwarranted.”
Healthy growth in eScripts but large gap remains The companies behind Australia’s two electronic prescription platforms say transactions are up by several magnitudes from the same time last year, although many GPs and pharmacists are not yet using the technology. eRx Script Exchange saw overall dispense transactions grow by 40 per cent in 2011, while MediSecure Script Vault had an increase of 287 per cent in original scripts to the end of November 2011. eRx expected to pass previous records and handle more than 4.2 million dispensing transactions in a single week in the week leading up to Christmas. Those transactions include originals and repeats dispensed manually as well as those scanned using the eRx barcode, David Freemantle, general manager for Health at the Fred IT Group, said. He said eRx does approximately 3.2 million scripts for an average week, which is equivalent to approximately 160 million dispense transactions per year. “This includes PBS, under co-payment and private scripts,” he said. “The best estimate we have is that there are approximately 260 million items dispensed per year across those three categories of scripts, so we are achieving a fraction over 60 per cent of those dispense records in eRx.” MediSecure CEO Phillip Shepherd said his most recent figures show that in October 2011, MediSecure handled about 12 per cent of all original prescriptions written by doctors. Both agreed that the uptake of electronic prescriptions in pharmacies has been higher than in general practice and that engaging more doctors to use eScripts is the key.
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March the target for NEHTA specification fix The National E-Health Transition Authority (NEHTA) is hoping to finalise changes to its specifications for GP desktop software by mid to late March. Problems were discovered in the Clinical Document Architecture (CDA) specifications assigned to a group of GP software developers last year, which were incompatible with the specifications given to the national infrastructure partner, the consortium tasked with building the centralised infrastructure for the Personally Controlled Electronic Health Record (PCEHR). NEHTA has put a hold on further implementation of the software, affecting most of the Wave 1 and 2 sites for implementation of the PCEHR. “The changes required to be made to specifications will be completed over coming weeks and are expected to be finalised mid to late March,” NEHTA CEO Peter Fleming said in a statement. “Our specifications are subject to rigorous assessment processes and this has highlighted some technical incompatibilities across versions. We have identified problems with the specifications and have made the decision in order to avoid any risks.” Mr Fleming said that as the scope of changes is being determined, “NEHTA is working closely with the sites to verify all activities and target completion dates”. He said the pilot sites were established to test and deploy software and eHealth capability in real world healthcare settings prior to the introduction of the PCEHR. “While the pilot site and national infrastructure projects have operated in parallel, neither is a critical dependency for the other project.”
RACGP raises governance, liability concerns over PCEHR Problems with governance, the administrative burden on general practice, and professional and financial risk need to be resolved in order for general practitioners to have full confidence in the proposed PCEHR, the Royal Australian College of General Practitioners (RACGP) says. In its submission to the Senate Committee on the Personally Controlled Electronic Health Records Bill, the college said issues needed to be addressed including the provision of a clear governance structure to oversee the system operator of the PCEHR, the proposed repository system, and potential secondary use of PCEHR data. It also raised questions as to the administrative burden of the system and professional and financial risks associated with an unintended breach. “The PCEHR system is managed by the System Operator and the specific entity of the Service Operator is not clearly defined,” the submission states. “Further, there are references to operational matters that again are not defined and without which the provisions in
the legislation cannot be judged.” In terms of the national repository system and its associated portals, which will be operated by a mix of private and public sector organisations, the RACGP has queried who exactly is the true custodian of the data held within these repositories, and how the various federal and state privacy laws will apply. “The RACGP is concerned about the preservation and availability of data when a repository operator unregisters or ceases to exist as an entity,” the submission states.
“The RACGP is concerned about the preservation and availability of data when a repository operator unregisters or ceases to exist as an entity.” It also wants clarification on the secondary use of PCEHR data. The RACGP, which provides the secretariat for the General Practice Data Governance Council, supports an appropriate
information sharing environment for secondary use of general practice data in order to improve patient and population health outcomes, and to support research. However, the RACGP said it was concerned that the revised Concept of Operations suggest that the de-identified PCEHR data may be used for secondary purposes without appropriate regulation. Dr John Bennett, chair of the RACGP national standing committee on eHealth, said GPs will need to be confident that the PCEHR system and the legislation that supports it will be robust, secure and function as designed. “The RACGP is committed to the uptake of eHealth initiatives within the health sector and we continue to strongly support the PCEHR and the foundations of electronic communications,” he said. “However, the PCEHR must meet the needs of clinicians and patients. GPs must have confidence in the PCEHR system for it to be successful. Currently, there are still a number of issues that we would like to see addressed in regards to the legislation including the consequential amendments.”
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Rowlands expands Direktly into Asia eHealth consultant David Rowlands has stepped down as chair of the Health Informatics Society of Australia (HISA) and director of HL7 Australia to concentrate on the new offices his firm Direkt Consulting has opened in Hong Kong and Singapore. Direkt Consulting opened a Hong Kong office in the first week of January and is in the process of establishing an office in Singapore. That office will be up and running in February, along with a new website. His place as chair of HISA is now being filled by former vice-chair Katerina Andronis, a consultant in life sciences and healthcare at Deloitte in Melbourne, becoming the first woman to take on the role. Mr Rowlands said Direkt Consulting had been doing work in Singapore for several years on the design and development of its national electronic health record (EHR). Singapore and Hong Kong are trying to connect up their health systems using IT, just like other jurisdictions. “The focus of Direkt Consulting is making sure that the pieces of the eHealth jigsaw come together coherently. Stronger linkages and deeper understanding of experiences across the wider Asia region will help provide our clients with that coherence and assist them to get maximum value out of eHealth.” Mr Rowlands will be back in Australia in March to give a keynote address at HISA’s Data Governance conference, where he will discuss the implementation of the national EHR in Singapore. “They want to make sure that information is of the highest quality and I have made some recommendations about systems they can put in place to ensure information quality, which I will be speaking about that at the Data Governance conference,” he said.
ePrescribing reduces clinical errors Commercial ePrescribing systems are able to reduce prescribing errors by up to 66 per cent, a University of New South Wales study has found. Researchers studied prescribing errors both before and after the introduction of iSoft’s MedChart and Cerner’s Millennium PowerOrders ePrescribing systems in two Australian teaching hospitals. The study involved a medication chart audit of 3291 admissions, before and after the systems were installed, and compared error rates. They found that procedural prescribing error rates such as unclear and incomplete prescribing orders fell by more than 90 per cent, while the most serious prescribing errors declined by 44 per cent. In Hospital A, the Cerner Millennium ePrescribing system was implemented on a geriatric ward, with three other wards — one geriatric, one renal/vascular and one respiratory — acting as controls. In Hospital B, the iSoft MedChart system was implemented on two wards – one psychiatric and the
other cardiology – with the researchers comparing before and after error rates. “The use of the system resulted in a decline in errors at Hospital A from 6.25 per admission to 2.12 and at Hospital B from 3.62 to 1.46,” the researchers, led by Professor Johanna Westbrook of UNSW’s Australian Institute of Health Innovation, reported. “This decrease was driven by a large reduction in unclear, illegal, and incomplete orders.”
“This decrease was driven by a large reduction in unclear, illegal and incomplete orders” Data was collected from daily reviews of all inpatient medication charts by three pharmacists independent from the hospitals for at least two months pre- and post-intervention. The study found that of the pre-intervention admissions, there were an average 5.8 prescribing errors per admission, the majority of which were procedural (unclear, incomplete, or illegible orders) and the rest
comprising clinical errors, such as the wrong strength, dose, frequency or wrong drug, as well as drug-drug interactions or allergies. Total error rates fell significantly in each intervention ward following ePrescribing system implementation, driven by a marked reduction in procedural errors. There were some problems with the systems, particularly in terms of decision support, the researchers found. One problem was that even if decision support was available, it was observed during ward rounds that senior clinicians were seen to instruct junior clinicians to enter the orders, and thus alerts were not seen by the decision-makers. However, the study provides persuasive evidence of the value of commercial ePrescribing systems to significantly and substantially reduce a range of prescribing errors, Professor Westbrook said. “Most of this technology was developed in the US with the big medical centres designing their own customised systems,” she said. “Hospitals in Australia can’t afford to do that, so
they’re taking commercial off‑the‑shelf systems. We set out to see whether these systems are as effective as the home‑grown ones.” She said more research was required to ensure the new technologies were both effective and safe. Despite the significant improvements, the study found that the new technology — which
demands changes in doctor, nurse and pharmacists’ work practices — also introduced new errors. “ePrescribing systems can be very effective, but we need to monitor them closely,” she said. “They can unwittingly introduce system‑related errors such as a clinician accidentally selecting the wrong drug name from a drop down menu.
“Systems are most useful when they provide user support to guide clinicians in their decision making. The systems we examined had very limited decision support and thus we would anticipate that, with support added over time, even greater reductions in medication errors can be achieved.” The research findings are published in PLoS Medicine.
HCN delivers Healthcare Identifiers in latest Medical Director update Health Communication Network (HCN) has added national health identifiers functionality to its Medical Director and PracSoft software packages, in a development that constitutes a boost to the federal government’s eHealth initiatives. Medical Director is the market leading clinical software for general practitioners, while PracSoft is HCN’s practice management software. CEO John Frost said HCN had been working on developing the functionality and achieving Compliance, Conformance and Accreditation (CCA) through the National E-Health Transition Authority (NEHTA) for a number of months and the products had been in beta testing for
several weeks. The updates were made available to practices in January. “HCN is committed to the government’s eHealth strategy and will ensure that those aspects of eHealth that are important to our customers and their patients are delivered,” Mr Frost said. “Over coming years the increased use of IHIs will, we expect, have a profoundly positive effect on reducing the incidence of misidentification which today is a major cause of medical misadventure.” He said once a practice obtains its Healthcare Provider Identifier – Organisation (HPI-O) and practitioners obtain their Healthcare Provider Identifier – Individual (HPI-I)
numbers, Medical Director and PracSoft would be able to automatically interface with the Healthcare Identifiers Service operated by Medicare. HCN has also added Clinical Document Architecture (CDA) handling for discharge summaries and specialist letters to the Medical Director update. CDA is NEHTA’s preferred format for the exchange of clinical documents, however other formats are still prevalent in Australia. “I’m proud that HCN, through our market leading products, can assist clinicians in more reliably matching discharge summaries and specialist letters with the correct patient file through the automatic use of IHIs,” Mr Frost said.
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ePrescriptions could save billions: US study A US study has found ePrescribing could save the healthcare system billions by reducing the rate of non-adherence. US ePrescription network Surescripts conducted a study from de-identified data that links ePrescribing to a significant increase in first-fill medication adherence. The World Health Organisation estimates that as many as 50 per cent of patients do not adhere fully to their medication treatment, leading to premature deaths and billions in preventable costs. The Surescripts analysis suggests that the increase in first-fill medication adherence (new prescriptions that were picked up by the patient) combined with other ePrescribing benefits could, over the next 10 years, lead to between $US140 billion and $240 billion in healthcare savings and improved health outcomes. Surescripts collaborated with pharmacies and pharmacy benefit managers on the study to quantify the benefits of ePrescribing. Reviewers analysed de‑identified data sets representing over 40 million prescription records — comparing electronic prescriptions with paper, phoned- and faxed-prescriptions — to measure the impact on first-fill medication adherence. The data showed a consistent 10 per cent increase in patient first-fill medication adherence among doctors who adopted ePrescribing technology when compared with those who did not. Doctors who adopted ePrescribing used the technology to route up to 40 per cent of their prescriptions electronically during the time of the study, and Surescripts estimates that first-fill medication adherence rates will continue to improve as ePrescribing adoption and usage increase.
Dr Frank Pyefinch
Best Practice gearing up for second annual summit Medical device integration, SMS appointment setting and the launch of a new touchscreen patient assistant tool to help manage chronic diseases are some of the highlights of the upcoming Best Practice Summit, being held in Bundaberg from March 8 to 10. The focus of the summit, first held in March 2011, is eHealth and the RACGP standards for clinical software.
It will feature workshops on remote access to Best Practice when using a iPads, iPhones or laptops, as well as a new function in Best Practice to allow SMS messages to be sent from the Best Practice appointment book. Best Practice Software’s support and training officer, William Dunford, said the new SMS function will be released shortly and will be fine-tuned in time for the summit in March.
He also said Best Practice was adding the NPS Radar, which provides regular updates on new drugs and those newly list on the PBS, to the software, and has finalised the coding required to integrate more medical devices such as ECGs and spirometers. “We are now waiting for companies like Edan, QRS and Welch Allyn to start putting it into their software,” he said. “We’ve given them our bit of code
that makes their software talk to ours so most probably in March those vendors will have software that will support device integration.” Other topics include: • Are You eHealth Ready? • The Paperless Practice • The New eHealth features In Best Practice • Pathology Workflow for Your Practice • The Action/Reminder System • Getting Control of Your Accounts • Closing the Gap • Regular IT Maintenance for the Practice Local GP Pat Byrnes will describe his new Patient Assistant Tool (PAT) for chronic disease management, which he has developed with the
assistance of Best Practice software engineers. Dr Byrnes, who won the Royal Australian College of General Practitioners (RACGP) General Practitioner of the Year Award in 2010, has designed the application for tablet PC use and to integrate with popular practice management software such as Best Practice, Medical Director and practiX. The application allows the patient to use a tablet in the waiting room to answer questions normally asked by the nurse. The questions trigger appropriate educational information, with the waiting room becoming in effect a virtual consulting room. The process continues in the consulting room where
the doctor uses PAT on his or her desktop with a click option instead of touch. At the end PAT automatically generates a general practice management plan (GPMP) specifically determined by the patient and the doctor answers. The software is currently the subject of a University of Queensland trial to ensure clinical outcomes are improved. Mr Durnford said he was expecting about 250 delegates to the March summit, which will be held at the Bundaberg campus of Central Queensland University. “We had to turn away quite a few people last time, especially some local people, so we have moved the event from Bargara to a bigger venue.”
BT promotes Fiona Stanley bid leader Lisa Altman has been promoted to head of healthcare for BT Australasia, following the company’s successful tender to provide IT and communications services for the Fiona Stanley Hospital in Perth. Ms Altman led the bid for the new hospital, due for completion in 2014, which includes deploying a
secure local area network and providing systems integration services, unified communications, mobility and conferencing technologies. BT plans to build a highly resilient network infrastructure that will use cabled multi-protocol label switching (MPLS) technology on the campus for fast access, augmented
by a Wi-Fi mesh network. The hospital also intends to build an RFID service to track equipment such as scanners, ultrasound equipment and defibrillators. Ms Altman was previously head of deal structuring for south-east Asia with BT and has worked as a senior deal architect and in commercial and development roles.
Global Health and GP2U partner for secure telehealth Secure messaging provider Global Health is partnering with video conferencing specialist GP21U Telehealth to provide a new interoperable telehealth solution aimed at GPs and specialists. Global Health runs the ReferralNet messaging service, a fully encrypted secure message delivery (SMD) system designed to meet the National E-Health Transition Authority (NEHTA) standards for secure messaging. GP2U is a new service in which accredited specialists can make telehealth appointments available. Users can book their own patients into the appointments and also make appointments publicly available. Patients with valid referrals can also book these public appointments. Using the system, patients wait in a virtual waiting room, and when the specialist is ready to start the consultation they simply click one button to connect the video conference. The new service will allow documentation, images and pathology reports to be exchanged between the patient and consulting specialist securely before, during or after the tele-consultation using the ReferralNet system. “The combined GP2U and ReferralNet service provides the simplest possible solution while ensuring that security and privacy are never compromised,” GP2U founder James Freeman said. “This extends the reach of specialists while maintaining the safest possible environment for consultations.” Global Health CEO Mathew Cherian said the partnership would be a significant step forward in providing a full range of secure communications between patients and their health professionals.
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MSIA
From eHEALTH blue sky to eHEALTH grass roots Will the twain ever meet?
Beyond the Wave sites, the usual measured approach to investment in clinical software seems to be occurring by healthcare providers and software companies without a lot of regard for the national agenda. Which begs the question — how can the grass roots of eHealth become more readily engaged in the blue sky vision to help deliver on the government’s health reform agenda?
Jenny O’Neill Secretary: MSIA secretary@msia.com.au
About the author Jenny O’Neill has been a member of the management committee of the MSIA since 2008 and has been on the national executive as Hon Secretary since 2009. During this time she has represented the MSIA on numerous working groups in addition to undertaking her duties as Director of eHealth company EpiSoft.
Since the Federal Government’s announcement that all Australians will be able to sign up for a Personally Controlled Electronic Health Record (PCEHR) by 1st July 2012, you would think there would be frenetic activity going on at every level of the sector towards that common goal. But with blue-sky-thinking outpacing grass-roots-doing at a ratio of around four hundred and sixty seven million to one, the world of eHealth is in danger of spinning off its axis into the blue beyond.
passion and the debate and the acronym creation, we all collectively seem to be more bemused than ever. A melding of grass roots doing and blue sky thinking is urgently called for. Let me illustrate the extent of the disconnect with an example.
If you think it is only doctors and other health professionals who are feeling bemused by all of this, think again. I have had eSomething in my job title literally or metaphorically for nearly fifteen years and I am more bemused today than ever by the passion the term can engender, the bureaucracies it can support, the debates it can foster, the conferences it can spawn, the acronym‑wielding academics it can breed and the consultants’ nests it can feather.
The manager of a busy day surgery had a presentation from a software vendor on the benefits of eClaims. An annual figure was mentioned which sounded pretty reasonable to me, but then, I was looking at this from a software industry perspective, with some knowledge of what kind of effort probably went into the product R&D, what salaries solution architects and healthcare integration specialists are commanding, let alone the hoops this company had to jump through to get the various Notices of Integration with Medicare to offer this particular product as an add-on to their main system. ‘Cheap’ was the word that sprang to my mind.
And let’s not forget the Committees it can spawn. Listing them all would chew up the word length of this article quick smart. The MSIA — because we are told we are the ones who have to make all of this eHealth stuff automagically happen — is participating at just about all of them. Though industry is at the forefront of the
It’s a bit like catching a taxi. On first blush, $75 seems an outrageous amount to pay to cross a few suburbs. But when you consider fuel and car running costs and the cost of taxi licensing and the 45 minutes it took to get there and the likelihood that the driver will have to head back into town empty to pick up their next fare, you start to
worry that the modest tip you gave him was woefully inadequate. The day surgery manager’s perspective was very different — ‘expensive’ was the word that sprang to her mind. And that was in no way an unreasonable point of view. Like most taxi passengers, she was looking at the price at its face value relative to all her other costs. When it came to it, we didn’t even get beyond adding up the postage before the vendor’s solution had paid for itself; and that was before any of the potential savings in staff time were included. If grass roots providers have that amount of difficulty placing a value on software when the value is readily quantifiable, placing a value upon clinical computing, upon maintenance of clinical data quality and data transfer is even more challenging. In the case of clinical information exchange, there is a quantifiable cost of what can go wrong when a referral slips through the cracks, when critical results get faxed to the wrong doctor, when current conditions are not known because of inadequate handover and a contraindicated medication is prescribed, when clinical content is transcribed incorrectly, when clarity is needed and a plethora of phone-calls ensue. So why is it not patently clear to most healthcare businesses that they are paying a high price for inefficiency in their clinical processes? Because it’s buried in day to day activity, because it’s made up of many small ticket items, because the staff have to be there anyway, that’s why. People become so adept at managing entrenched inefficiency as efficiently as possible, the issues become invisible. Much more important than inefficiency, though less quantifiable, is the human cost. When the process of handover goes disastrously wrong, the ultimate price can be paid by the patient. Which is why the common view of “why fix a system
“I have had eSomething in my job title literally or metaphorically for nearly fifteen years and am more bemused today than ever by the passion the term can engender...” Jenny O’Neill that works most of the time?” does not come close to a ‘best practice’ approach — it’s not even in the ‘best endeavours’ neighbourhood. The purchase of an IT system by a healthcare business with their eye on the bottom line (which is all of them in my experience) starts with a business case, a real one that means something to the business. A real one that stands up to the scrutiny of a business manager or a Board weighing up investment in eAnything against all the other investment priorities for their business. Instead of some useful proformas for calculating a return on investment for eHealth solutions at the grass roots, we get the expected returns for the whole nation: impressive enough for a headline but not remotely meaningful to someone at the front line of care. And when some of the most quoted figures are also known to be downright rubbery, there is a widespread upgrade from bemusement to scepticism among the folk at the grass roots. Assuming that healthcare businesses, large and small, will continue to invest in eHealth at their usual pace — which is to say no more quickly than you’d expect to see anyway in a gradually maturing market — getting them to align their eHealth priorities with the national agenda is the next challenging objective. Without this alignment, it is quite probable that Australian taxpayers will be signing up to a Personally Controlled Largely Empty Shell (PC-LES) in 2012. That is fine, so long as taxpayers know what to expect. It will
certainly simplify the current debates about privacy and confidentiality and medicolegal risk. Still, we are all confident the content will follow at some stage … aren’t we? At the current rate of pace of investment by grass roots care providers, when exactly do we imagine that the content will come? Not soon enough for some eHealth mafia. I recently heard that some GPs were demanding specialists adopt a certain secure messaging agent or they would cease to refer to them. Can this sort of market lever really be considered a force for good? Some blue sky people would just count up all the new electronic referrals and think that healthcare had improved but don’t consumers have a right to expect that the professional they are relying upon to act in their interests will give more weight to the specialist’s reputation as a specialist and less weight to what widget they have on their computer? The next goal in alignment of grass roots and blue sky is tackling the renegade software industry. One way to get as many of us as possible on the same page is to make sure the page says what it ought — no more, no less. A spot poll at our recent MSIA forum tells us that more than half of the senior people in the medical software industry have been working in Health IT for more than ten years. These seasoned practitioners of Health IT are often the first port of call for reviewing any eHealth specifications that a company is considering implementing. These are the people with the domain knowledge of clinical practice and/or healthcare business practice who won’t hand something to their developer
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colleagues until they’ve got some handle on what is required themselves. Many of these people are still practising clinicians or former practising clinicians; many are hands on software developers themselves. So the majority audience for eHealth implementation guides are time‑poor who have to manage a very finite set of resources carefully and who only want to be told what they don’t know already, not what they’ve known most of their working lives and certainly not reams of stuff they don’t need to know at all. Like our customers, we are looking for practical and succinct guidance that is tailored to the needs of experienced practitioners who have no interest in the theorising. Another interesting result from our spot poll was that over half of the industry is made up of businesses of less than ten people. Some blue sky folks think that the grass roots Health IT industry is too fragmented, that as many of these small businesses as possible should get steamrollered when we move to the next notch of marketplace maturity. There is nothing more irritating to a small businessperson than to hear a tenured well superannuated person think that. You can only hope they can’t hear what you are thinking. This isn’t the fast moving consumer goods industry. Healthcare providers are not necessarily guaranteed lower price, higher quality IT product and greater choice from increased marketplace consolidation. There is one lesson we should have learned from the global financial crisis — business maturity has nothing to do with organisational size. So this fragmented industry is being asked to adopt an increasing number of specifications rolling off the NEHTA presses. Interoperability with other systems is a cost of doing business for most of us, not the main event. This means you want to get through the process as efficiently and painlessly as possible and get back to your own product R&D. Furthermore,
it is complex, time‑consuming and costly relative to most other development because at least two parties need to be co-ordinated and often more than two, so once an interface is operational, you don’t want to mess with it unless there is a genuine need. Exchanging one message format for another is not a genuine need. A genuine need is a new requirement not met by the current method or a general groundswell of adoption across the sector such that staying on the current path will result in having a less interoperable system. Even when there is a need, you also want to be sure that there is no loss of functionality in moving from something older and proven to something newer and less proven, that there has been governance over the safety and reusability of the specification, that the version in question will stay the flavour of the month for a lot longer than a month and that there is a map to migrate from whatever is operational at the moment. A health informatics practitioner only has to read a couple of specifications tailored to beginners or worse, to academic informaticians, to cause them to disengage from the national eHealth agenda completely and let the PCHER ‘Wave sites’ sort it out. Unfortunately for the ‘Wave sites’, they are being engulfed by a veritable tsunami of not quite complete specifications. One wave site colleague told me recently that his team needed to read no less than 93 documents to implement what they needed for their project, most of them published in the fourth quarter of 2011. Another Wave site colleague told me that if he hadn’t had the hand-holding to navigate the specifications he had to implement by the people who wrote them, he couldn’t have implemented them — and this coming from one of the most experienced health informaticians in the country. Which begs the question: how is the rest of industry supposed to do this without hand-holding? There is no shortage of experience among MSIA members in developing sustainable businesses around eHealth, but there is a
shortage in understanding how currently sustainable solutions and businesses will fit in with the national agenda. And there is an absolute dearth of members who can justify adding a further 200% to a project budget to trawl through such an enormous number of specifications and pages to find out how closely their own domain knowledge and customer requirements aligns with the national approach. The grass roots people in clinical care and clinical software provision are in dire need of practical assistance and clarity: clarity on exactly why they should invest in eHealth at all, much less the national eHealth agenda. And assuming the why is solved, how they can invest in the most efficient way, given finite resources, competing pressures and the need to run their own grass roots continuous improvement agendas. You cannot allocate $467M to eHealth over a two year period, move nearly all of it between government agencies or to large consulting firms and start up companies and expect to answer the question in the minds of most healthcare businesses and eHealth businesses at the grass roots: why fix a system that works most of the time? The answer to that question is the key to building a sustainable ecosystem of interconnected independently sustainable solutions long after the political ribbon is cut in mid 2012 on the PC-LES. I don’t suppose the majority of consumers will be too troubled by the slow start. When you don’t have time to go to the doctor, let’s face it — you’re not going to be generating too many clinical event summaries. The trouble is that the line between wellness and illness is as thin as the edge of a coin. It is when you cross that line or you have a loved one cross that line that you start to appreciate what the eHealth lost opportunity feels like. It feels like attempting a jigsaw puzzle containing large amounts of blue sky, but not enough colour and variety to gain the clear perspectives required to solve it.
Save the Date
NATIONAL CONFERENCE Brisbane Convention & Exhibition Centre
Tuesday 16 – Saturday 20 October 2012
www.cdesign.com.au/aapm2012
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HISA
Health Informatics: “seriously COOL” Katerina Andronis, Director at Deloitte, has recently become the first female chair of the Health Informatics Society of Australia. She spoke to Pulse+IT and shared her passion for health informatics.
Health Informatics Society of Australia ceo@hisa.org.au
How do you describe health informatics to those outside the field? I describe health informatics as an understanding of how health information is used by health professionals; how they engage with technology and use technology in the best way possible to help them make informed clinical decisions.
we have is communicating what health informatics is. Most clinicians practice health informatics on a daily basis in their job, but most of them and many of their employers don’t recognise or understand what health informatics is. I have always seen it as part of my job to teach people what informatics is and why it is important.
How did you come to work in the field? My health informatics journey started over 30 years ago when I worked as a junior programmer in Clinical Biochemistry at the Queen Elizabeth II Medical Centre in Perth. I have spent all of the past 30+ years in healthcare, mostly in the hospital sector. I have been a CIO in both the private and the public sector and have worked in all eight jurisdictions.
With your election as Chair, you become HISA’s first female to occupy the role in the organisation’s 20 year history. What are HISA’s plans for 2012 and beyond? HISA has a long history that I am proud to be part of. We have a bright future ahead of ourselves and the organisation is in a growth phase. We are Australia’s largest and oldest organisation representing and supporting Australia’s eHealth and health informatics community and we will continue to grow and evolve.
All those years spent with clinicians has given me a strong understanding of “what’s in it for me” from the clinician point of view. I believe as an informatician, my job is to help clinical staff use technology in the best possible way and to see technology as an invaluable tool to complement their clinical skills and help them do their job. Why health informatics? I really care about healthcare and the vital role health informatics must play in our healthcare future. As a relatively new discipline, the ongoing challenge that
We represent a very broad church and our membership is growing. The growth in membership and diversifying the services we provide to members is evident, as more people across the healthcare sector recognise the importance of aligning themselves with HISA and the value they derive from being a part of, leading and contributing to the community. The HISA Board, our State and special interest group leaders, our CEO Dr Louise Schaper and the team at HISA HQ have
some really exciting things in the pipeline for 2012. Some of these include the launch of a new website and membership portal; the launch of the South Australian branch on 22nd February; the upcoming release of a series of thought leadership white papers; delivering four conferences — Data Governance in Melbourne, HIC in Sydney, the Australian Telehealth Conference in Melbourne and HITWA in Perth; an international study tour encompassing three continents; and the list of local State‑based events continues to grow. Of special mention is that 2012 sees Nursing Informatics Australia celebrate their 21st anniversary, and we are planning a range of activities to celebrate this milestone and the achievements of the past 21 years. Our strategy encompasses a range of new activities and services as we continue to focus on workforce issues and raising awareness of the importance of informatics across the health sector. HISA members have access to amazing networks, information about national and international developments in the field, and opportunities to take up leadership positions. Being a part of HISA provides multiple platforms and opportunities for you to connect with innovative, creative and seriously cool people who are doing amazing things. I am so blessed and grateful to be in the position of HISA Chair and to contribute further to HISA’s central role in advocating for and supporting Australia’s health informatics community. Recently in the United States, Farzad Mostashari, MD, National Coordinator for Health IT in the United States predicted that 2012 will be the year that Health IT “truly comes of age”. That same day Australia was hit with headlines of a halt to the PCEHR implementation Wave sites due to specification problems. Is 2012 going to be the year that Health IT comes of age in Australia?
Katerina Andronis
“Health and biomedical informatics is the key element that will help us produce really good care for patients. After all, that is the reason we are in this industry, it is all about the patient.” Katerina Andronis
Those of us who have been in this industry a long time understand the challenges of complex initiatives of this sort. Health IT around the world is coming of age and while there has been, and will continue to be set-backs along the way, collectively we are making significant progress. We must remember that technology is not the problem — we are already building digital hospitals, and there are many, many healthcare practices throughout Australia that are applying health informatics principles, integrating technology and managing information and patient care better as a result. People in our community are doing a lot of great work in this space.
While the PCEHR has suffered a set‑back, Australia is building the important foundations for eHealth, the benefits of which will be significant for years to come. Health informatics is about information, systems and people. Understanding this, applying thorough change management principles and stakeholder engagement is the key to successfully bringing people on board and getting successful outcomes from Health IT implementations. Health and biomedical informatics is the key element that will help us produce really good care for patients. After all, that is the reason we are in this industry, it is all about the patient.
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Events February 20-21 February
28
3RD ANNUAL CLINICAL DOCUMENTATION, CODING & ANALYSIS CONFERENCE Melbourne, VIC p: +61 2 9080 4090 w: www.iir.com.au
IT RISK MANAGEMENT SIG Brisbane, QLD p: +61 2 9299 3666 w: www.acs.org.au
20-24 February
February
28 February
HIMSS 2012 Las Vegas, USA p: +1 301 694 524 w: www.himssconference.org
THE 3RD ANNUAL NATIONAL RECORDS AND INFORMATION OFFICERS CONFERENCE Melbourne, VIC p: +61 2 9299 3666 w: www.acs.org.au
22
27-28 February
February
TELEHEALTH – A CALL TO ARMS Auckland, NZ p: +64 4 389 8981 w: www.hinz.org.nz
22-24 February AUSTRALIAN HEALTHCARE WEEK Melbourne, VIC p: 61 2 9229 1000 w: www.austhealthweek.com
3RD ANNUAL TECHNOLOGY IN HEALTHCARE SUMMIT Sydney, NSW p: +61 2 8908 8555 w: www.acevents.com.au
29
February
A leap into eHealth Melbourne, VIC p: +61 3 9326 3311 w: www.hisa.org.au
March
5
March
MEDICARE LOCAL FORUM Canberra, ACT P: +61 2 6228 0846 w: www.agpn.com.au
8-10 March 23-24 February 5TH ANNUAL HOSPITAL BED MANAGEMENT & PATIENT FLOW Melbourne, VIC p: +61 2 9080 4090 w: www.iir.com.au
24-26 February PHARMACY CONVENTION Sydney, NSW p: +61 2 9467 7127 w: www.guild.org.au
27-28 February CENTRAL GOVERNMENT ICT PROCUREMENT WORKSHOP Wellington and Auckland, NZ p: +64 4 815 8177 w: www.healthit.org.nz
BEST PRACTICE SUMMIT Bundaberg, QLD p: +61 7 4155 8800 w: www.bpsummit.com.au
19 March PREPARING FOR PCEHR CONFERENCE Melbourne, VIC p: +61 2 9080 4090 w: www.iir.com.au
20-22 March GLOBAL GS1 HEALTHCARE CONFERENCE Sydney, NSW p: +61 3 9558 9559 w: www.gs1au.org
21-23 March AUSTRALASIAN COLLEGE OF HEALTH SERVICE MANAGEMENT CONFERENCE Hunter Valley, NSW p: 61+ 2 9878 5088 w: www.achse.org.au
22 March CLINICAL GOVERNANCE WORKSHOP Sydney, NSW p: +61 2 6228 0846 w: www.agpn.com.au
22-23 March 4TH ANNUAL NATIONAL TELEMEDICINE SUMMIT Sydney, NSW p: +61 2 9080 4090 w: www.iir.com.au
27-28 March IHT2 HEALTH IT SUMMIT San Francisco, USA p: +1 561 748 6281 w: www.ihealthtran.com
29-30 March DATA GOVERNANCE CONFERENCE 2012 Melbourne, VIC p: +61 3 9326 3311 w: www.hisa.org.au
April 19-20 April INFORMATION TECHNOLOGY IN AGED CARE Melbourne, VIC p: +61 3 9670 5900 w: www.agedcare.org.au
24-25 April IHT2 HEALTH IT SUMMIT Atlanta, USA p: +1 561 748 6281 w: www.ihealthtran.com
May
Save the dates
20-21 May
30 July – 2 August
7-10 November
HIMSS MIDDLE EAST Abu Dhabi, UAE p: +65 6664 1189 w: www.himssme.org
HIC2012 Sydney, NSW P: +61 3 9326 3311 w: www.hisa.org.au
AGPN NATIONAL FORUM Adelaide, SA p: +61 2 6228 0846 w: www.agpn.com.au
24-25 May
14-16 September
SOCIAL MEDIA IN HEALTHCARE Sydney, NSW p: +61 2 9080 4090 w: www.informa.com.au
THE GENERAL PRACTITIONER CONFERENCE & EXHIBITION - Brisbane Brisbane, QLD p: +61 2 9422 2007 w: www.gpce.com.au
17-19 September HIMSS ASIAPACIFIC 2012 Singapore p: +65 9299 0802 w: www.himssasiapac.org
16-20 October AAPM NATIONAL CONFERENCE Brisbane, QLD p: +61 3 6231 2999 w: www.cdesign.com.au/aapm2012
25-27 May
29-31 October
AMA NATIONAL CONFERENCE Melbourne, VIC p: +61 2 6270 5400 w: www.ama.com.au
HIMAA 2012 NATIONAL CONFERENCE Surfers Paradise, QLD p: +61 2 9887 5001 w: www.himaa.org.au/2012
7-9 November HINZ 2012 Rotorua, NZ p: +64 4 389 8981 w: www.hinz.org.nz
16-18 November THE GENERAL PRACTITIONER CONFERENCE & EXHIBITION - Melbourne Melbourne, VIC p: +61 2 9422 2007 w: www.gpce.com.au
Online Calendar: To view a comprehensive list of eHealth, Health, and IT events, visit: http://www.pulseitmagazine.com.au/events
Register Now!
Data Governance 2012 Melbourne
Health reform & data governance - in a climate of transformational changes to Australia’s healthcare system, leveraging your data as an enterprise asset has never been more crucial.
29 - 30 March 2012
Event details & registration at
www.hisa.org.au/DG2012
for further information phone (03) 9326 3311
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PCEHR: Wave 2
Mater puts expectant mothers online The Wave 2 Personally Controlled Electronic Health Record (PCEHR) project being piloted by Queensland’s Mater Health Services has tied in nicely with its ambitious Smart Hospital strategy. It has already set up a portal for external doctors and is now building one for patients too.
Kate McDonald Journalist: Pulse+IT kate.mcdonald@pulseitmagazine.com.au
Mater Health Services has for a number of years pioneered the use of eHealth to improve patient care in its seven hospitals in south-east Queensland. Its Smart Hospital strategy, launched in 2005 with industry backing from IBM, Cisco, Intel, Microsoft and software provider InterSystems, has seen the health service become one of the leading lights in eHealth integration in Australia’s acute care sector. Eighteen months ago, Mater launched an external doctor portal to allow general practitioners and private specialist clinicians to access Mater’s electronic health record, and more recently attention has turned to creating a patient portal to do the same for patients. So it was opportune that the Federal Government announced the second wave of PCEHR implementation sites in March last year, with Mater Health Services chosen to create a shared electronic health record for one of the priority patient groups: mothers and newborns.
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.
The Mater Shared Electronic Health Record (MSEHR) will initially deliver an electronic alternative to the paper-based Pregnancy Health Record currently used in Mater’s maternity hospitals for publicly funded expectant mothers, and will store key information such as health
history, previous pregnancy history, birth preferences, pathology and radiology results, alcohol and drug screening information, medications, allergies and adverse reactions. Mater is working with Medicare Locals, general practitioners and a number of private obstetric practices on the project, which again ties in nicely with the organisation’s overall strategy, according to Mater’s CIO, Mal Thatcher. “There are five strategic themes within our Smart Hospital strategy: one is about the patient experience and another is around our clinical partners,” Mr Thatcher says. “We made a conscious decision to embark down the path of developing portals for both of those cohorts. In around August 2010 we established our external doctor portal … and part of the strategy around the patient experience was to build a patient portal, so what the Commonwealth program has allowed us to do is accelerate our aspirations in that area.” Mater judiciously chose a particular cohort of patients to work with on this project who are known to engage with online resources and initiatives. “Mothers are a very engaged group and are interested in anything that has to do
with the care of their children, so it is the ideal target group,” Mr Thatcher says. “We already have in place well‑established protocols for the sharing of care for maternity patients between the obstetricians and primary care, so the proposition here was a great opportunity to leverage those existing patients and to leverage our existing infrastructure along with the work we had already done on our doctor portal, and to bring together that cohort online. “What it will allow those mothers to do is go online and access healthcare information and all of the information on their electronic health record associated with their pregnancy. At the moment they
carry a hand-held record when they visit the GP, the GP puts their observations and notes into it and they carry it physically with them when they visit our antenatal clinic or their private obstetrician. “The obstetricians do the same thing with their observations and notes, and that record goes with the mother. Soon they will be doing it online.”
Integration into the PCEHR Mater already has its own EHR based on the Verdi system from IP Health, which allows Mater clinicians to access health summaries from close to 100 different clinical information systems. Mr Thatcher hopes that this EHR, and the new Mater
Shared EHR, will be integrated into the eventual PCEHR. “We have a service-oriented architecture (SOA) model, so we are able to reuse web services and therefore don’t have to rebuild them for each application,” he says. “We are able to separate out the presentation layer or interface from the data services, so even though the Mater external doctor portal uses a different interface and different applications, it is accessing exactly the same data services as our internal system. For the patient portal, when we choose to expose that same data to the patient, it will use the same data services.”
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Mater has also worked with integration partner InterSystems since about 2005, using its Ensemble platform. This was chosen to ensure that instead of point-to-point messaging, a hub and spoke model was used. “This means we publish a message once to the central hub, and then one or more subscribers can access that message,” Mr Thatcher says. “Ensemble does that really well, and because of that capability we are able to do some great things, like when we get pathology information, we can manipulate that into a form that allows us to expose it to an electronic health record. “With our patient administration system, which does admissions, discharges and transfers, we built a patient master index, so we had a lot of these foundation elements under way when the PCEHR opportunity came up. I think that is one of the reasons why Mater was chosen as one of the lead sites.” Mater is also using the project to test some of the most important parts of the PCEHR, especially how its systems will interact with the national infrastructure and standards being devised by NEHTA. Mater has worked with InterSystems, using its HealthShare technology, to build an interface with the Medicare Healthcare Identifiers Service to match patients with their Individual Healthcare Identifier (IHI) numbers. In November last year, Mater received its Compliance, Conformance and Accreditation (CCA) certificate for the Mater HI Service, which went live on 6th December. By connecting to the HI Service, Mater has incorporated IHIs to the Mater Shared EHR. As well as storing the clinical information submitted by patients, participating external providers and Mater, the repository will use healthcare identifiers in Mater’s exchange of information with other healthcare repositories.
Mal Thatcher to send information through secure messaging and have the IHI embedded in it. Nationally we are not ready for it, but by 30th June we will be close.”
“We are currently building our databases with those IHIs, but we are not relying on those for the sharing of information with the GP practice management systems at this stage.
Mater as an organisation has received its HPI-O number and has established the governance protocols around that internally. The Mater Shared EHR team will liaise with internal Mater clinicians to obtain their HPI-Is, guiding them through the steps of obtaining this number from the Australian Health Practitioners Regulation Agency (AHPRA). In addition, internal recruitment processes will ensure that any new clinicians have their HPI-I recorded upon commencement with Mater.
“We are currently matching about 500 patients a day and we probably have around 25,000 matches in our patient master index, but that is only a small number in terms of total patients. It’s going well — we are getting around an 85 per cent match rate in terms of requests to Medicare — and we hope that through the vendor panel that NEHTA has set up we will be able
Like most of the other projects at this stage, Mater is using the existing Medicare PKI certificate, which external clinicians use to access the external doctor portal. In the near future, when the National Authentication Service for Health (NASH) being built by IBM is available, Mater and the other projects will transition to that service to allow practitioners access to its systems.
“At the moment we are doing searches and matches with the Medicare service for IHIs,” Mr Thatcher says.
Secure messaging Mater is also working on secure messaging as part of the next stage in the project. InterSystems and Mater have worked together to enhance messaging capability to be compliant with the national Secure Messaging Delivery (SMD) standards. Although Mater has signed an agreement with Pen Computer Systems to provide a messaging interface, Mater has already completed work with InterSystems to communicate with other healthcare providers regardless of their secure messaging systems. InterSystems and Mater worked together to add the national Secure Messaging Delivery (SMD) standards to Mater’s interface.
“We are currently matching about 500 patients a day and we probably have around 25,000 matches in our patient master index...” Mal Thatcher
30th June is also the target for enrolment of over 400 expectant mothers that the project is recruiting. Active recruitment of consumers is due to begin at the end of April, but it has already begun its recruitment of general practices and private specialists, working with the Greater Metro South Brisbane Medicare Local and Accoras (formerly part of Brisbane South Division). About 80 GPs in 50 different practices are involved, and Mater is targeting nine consultant obstetricians in South Brisbane with whom it already has strong relationships.
“We are waiting to see what the government is going to do about messaging services,” Mr Thatcher says. “The standards will be a little bit like HL7, but while that is an international standard it is not particularly well-adhered to and is interpreted differently, so there will probably be a national secure messaging service that could be administered by NEHTA or Medicare whereby we don’t have to worry about vendor compliance around secure messaging. “Our target is 30th June but at the moment that is all in development. What we are hoping to achieve is for the GP practice to be able send antenatal event summaries to us and for our antenatal clinics to send back reports to the GP through that secure messaging service.”
“It is a slightly different model for them (private specialists), and what we are really interested in with the consultant obstetricians is that quite often we don’t have a lot of exposure to those private patients. What we’d really like to do is get an antenatal summary from the private obstetricians’ system so that when the midwife is first dealing with the expectant mother, we already have their antenatal history.”
29 - 31 October 2012
HIMAA 2012 National Conference
Surfing the Wave of Health Reform
Surfers Paradise Marriott Resort & Spa | Gold Coast | Queensland
BENEFITS FOR DELEGATES...
Hear from leading figures in the reform agenda Plenary presentations Workshop sessions Trade exhibition Exceptional networking opportunity Picture-perfect location
BENEFITS FOR SPONSORS...
HIMAA Members are decision makers Reach HIMAA Members directly Attendees are forward looking and early adoptors Sponsorship is very cost effective with realistic ROI
To find out more visit www.himaa.org.au/2012/
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Feature
Medview takes a
consolidated view of medications history The MedView medications repository project is fast approaching deployment and already has some runs on the board. It is developing a national repository that will allow clinicians, pharmacists, aged care facilities and hospitals to see a combined list of prescribed and dispensed medications.
Kate McDonald Journalist: Pulse+IT kate.mcdonald@pulseitmagazine.com.au
If there is one area that eHealth can assist in more than most, it is the ability to help doctors and pharmacists make informed decisions concerning an individual’s medication history. That is one of the driving forces behind the MedView Wave 2 project, which is aimed at providing a consolidated view of medications so that pharmacies and GPs have the ability to call up a profile and make more informed decisions about prescribing and dispensing. MedView is one of the more scalable Wave 2 projects and is intended to be a national repository that will allow clinicians, pharmacists, aged care facilities and hospitals to see a combined list of prescribed and dispensed medications regardless of how many different doctors or pharmacies the patient has attended. Bringing together software vendors from each of those areas — primary care, aged care and acute care — the project is utilising the existing eRx Script Exchange electronic prescription platform as well as partnering with number of different software vendors. These include GP software providers Best Practice and Zedmed, pharmacy software vendors Fred, Simple Aquarius and Pharmhos, aged care software specialist iCare, and acute care prescribing and dispensing systems BOSSnet and Merlin.
The initial MedView trial will focus on the geographic area of Geelong, and is aiming to involve every pharmacy in that city and a significant proportion of GPs, along with Geelong Hospital and targeted aged care facilities. Working in close partnership with the Barwon Medicare Local, MedView’s momentum is rapidly building towards deployment commencing in February. And more recently, the Australian Association of Practice Managers (AAPM) has joined the project and will promote it to its membership as a practical means of providing additional benefit to their patient cohorts.
Software integrated with HI Service Progress to date has been rapid, according to David Freemantle, general manager for eHealth at Fred IT Group and the lead spokesperson for the MedView project. Part of the work has involved ensuring that aged care and acute care software is integrating the Health Identifiers Service (HI Service), as is being done by GP desktop and pharmacy dispensing software providers. And the core medications information is being enabled by electronic transfer of prescriptions (ETP) using the services of eRx Script Exchange.
“It is such a basic concept, really,” Mr Freemantle says. “Pharmacies have been using computerised dispensing systems for 20 years but they’ve never been able to look at a consolidated history of medications for a patient. It has really been enabled by ETP.” The project is leveraging NEHTA-defined specifications and services, including secure messaging, HL7 CDA (clinical document architecture), Australian Medicines Terminology (AMT) and various others. However, one of the prime roles of the project is the integration of the HI Service. To date, all of the vendors involved in the project have passed their Compliance, Conformance and Accreditation (CCA) testing, Mr Freemantle says. GP software vendors have been working on this for some time through the GP Software Vendors Panel, and through this project, individual healthcare identifier (IHI) functionality is being driven in the pharmacy, acute and aged care software sectors as well. IHIs are also included in the eRx messages transmitted between clinical systems, he says.
Consent matters Patient consent is an area many involved in eHealth are working on, and it will be a big factor in the national PCEHR initiative. For this project, patient consent is again captured within the pharmacy and GP desktop systems, Mr Freemantle says. “The doctors and pharmacists will ask for the patient’s consent to send the information to MedView. The patients likely to benefit most are the elderly, infirm or chronically ill, most of whom have a long-term relationship with their healthcare providers and a consistent care team, who will capture consent. “We’re in the transitional planning process with NEHTA to investigate the transition into the national PCEHR. MedView is a relatively localised trial which will demonstrate the capabilities of the system and the technologies, with the next step being integration to the national PCEHR.”
“The HI Service is integrated at the GP and pharmacy desktop ends — after authenticating the user, the clinical system authenticates the patient’s IHI and adds it to their patient record. The only real change in eRx from the ETP side is that it will now be able to transfer that IHI and a consent flag for MedView participation.
Health Informatics Society of Australia
“eRx will see the consent flag and a copy of the prescription and dispense records will be sent to MedView through the standard ETP process. When a GP or a pharmacist is wanting to view the record in MedView, using their clinical system they initiate a query of MedView with the click of a button. Based on the patient’s IHI, the medications data is then displayed in the MedView viewer, which provides the ability to filter, sort and save the view.”
The project is currently completing vendor integration testing. “We are in testing at the moment,” Mr Freemantle says. “We have a
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test system up and running that can demonstrate full integration through the ETP process, the HI Service at Medicare for the patient IHI, capture patient consent and then view a medications history in MedView for that patient. This is the pointy end of the project, and it is great to see the hard work starting to pay off!” The process of recruitment will shortly speed up, along with deployment throughout Geelong. The goal is to have the pharmacies in Geelong along with all of the general practices using Best Practice and Zedmed recruited to the project. Also involved is Geelong Hospital, which uses the BOSSnet prescribing system and the Merlin dispensing system, and an aged care facility, which is being assisted by iCare.
Aged care signs on Dr Chaolin Chang, product strategy and development manager with iCare, says the MedView project is extremely important for the aged care sector for a number reasons. “This is a health initiative that is designed to improve resident health outcomes,” Dr Chang says. “It will create a national conformant medicines repository that provides the ability to view a combined record of community prescribed and dispensed medications for residents.”
David Freemantle
For aged care facilities, it will allow medications to be managed to ensure safe and effective outcomes, reduce errors and medication risk and reduce adverse drug events, including medication dispensing errors, he says.
“This will bring benefits to the resident including reducing unnecessary repetition of information and filling out forms, repeating their history and avoiding unnecessary risks in their medications as well as transfers and discharge.”
“There will be access to medication information at the point of care which will give healthcare providers a real-time view of medication information,” he says. “This provides a more complete basis for decision-making, improved communication between clinicians and ensures appropriate follow-up after discharge from hospital.”
David Freemantle says this is an interesting project to work on because there are a number of dependencies that are out of the control of the trial partners which could make or break it.
iCare has completed the work necessary to add Individual Healthcare Identifiers (IHI) functionality to its software, and is currently working with a residential aged care facility (RACF) in the pilot phase. RACFs will have to apply for a HPI-O and potentially a HPI-I, but all care staff will be trained on the use of healthcare identifiers, Dr Chang says. He says that when a resident is first admitted to a facility who has previously consented to having their medicines information submitted to the MedView medicines repository, the GP will be able to look up all previous medications prescribed by other authorised doctors.
“The technology works and we have now demonstrated that, but it is the dependencies on external services and specifications — such as Healthcare Provider Identifiers (HPI-I and HPI-O) — that we have limited control over which creates a challenge,” he says. “We are actively involved in assisting practices and pharmacies to apply for their HPI-O and HPI-I at a later stage, but it can be a slow process. As practitioners and patients build their understanding of the benefits of such systems, I’m sure these issues will gradually iron themselves out.” It is also pointing the way to the future, when the infrastructure requirements of eHealth are going to become enormous, he says. “The infrastructure requirements are going to grow rapidly as data increases exponentially across the whole PCEHR system.”
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PCEHR: Wave 2
SharinG Records in THE north, west and South The Northern Territory is working on expanding its widely successful shared electronic health record to communities in the Kimberley and South Australia, as well as planning its transition to the PCEHR. With 47,000 users to date, the NT is a prime example of how eHealth can work.
Kate McDonald Journalist: Pulse+IT kate.mcdonald@pulseitmagazine.com.au
If there is one jurisdiction in Australia where the benefits of a shared electronic health record are most obvious, it is the Northern Territory. The NT has been a pioneer in the adoption of eHealth and — with good reason — was chosen last year as one of the Wave 2 sites for the implementation of the PCEHR. The NT Department of Health introduced a shared electronic health record (SEHR) in 2005, predominantly for indigenous people in rural and remote areas. In the ensuing seven years, the SEHR has gradually added both users and functionality, but only reached critical mass in the last two years, according to NT Health’s CIO, Stephen Moo. Now, the SEHR — recently rebadged to My eHealth Record (MeHR) — has around 47,000 people registered, a remarkable achievement in a challenging environment. Predominantly clients of clinics administered by the NT Department of Health and the Aboriginal Medical Services Alliance of the Northern Territory (AMSANT), these clients represent almost 90 per cent of the entire remote indigenous population. Some non-indigenous people working in remote areas — on cattle stations, for instance, who attend the same clinics as Aboriginal people — are also registered for the service.
So with this sort of experience in designing and operating an electronic health record, it is no wonder that NT Health was chosen as one of the nine Wave 2 sites for the implementation of the PCEHR. The NT consortium’s five partners — NT Department of Health, AMSANT, General Practice Network NT (GPNNT), Western Australian Country Health Service (WACHS) and Aboriginal Health Council of South Australia (AHCSA) — plan to expand registrations into the Kimberley region of WA and down into SA. AHCSA is already working with the NT in the northern part of South Australia and Central Australia, including the Anangu Pitjantjatjara (APY) Lands. Along with 47,000 consumers, the MeHR system is used by 105 clinics and five public hospitals in the NT. As part of the Wave 2 project, consortium partner GPNNT is looking to offer MeHR to urban populations as well, predominantly through general practices and specialists in the major towns of Darwin, Alice Springs, Katherine, Tennant Creek and Nhulunbuy. “With AHCSA, which is based in Adelaide, the target is their member organisations, of which there are about 11 across SA, in regional areas and in Adelaide,” Mr Moo says.
In Western Australia, the target is in the Kimberley, with a plan to connect up the hospitals initially and then expand it into primary care. The consortium is initially targeting six hospitals in the Kimberley region to provide the MeHR service. “What we are looking to do is have a large footprint across northern Australia and into SA and WA with a service that is already proven and is providing benefits,” Mr Moo says. “About 4000 healthcare providers are already registered and we are getting significant usage rates. We have around 100,000 new records a month going into a repository, and we are now up around 30,000 views a month, which is an exceedingly high viewing rate and clearly demonstrates the clinical benefits of the service.” One of the main reasons for the success of the system, according to AMSANT’s Simon Stafford, is that it has become an essential part of remote clinical practice, overcoming the fear of many that EHRs interfere with clinical workflows. “It is working well because it has become part of clinical practice now,” Mr Stafford says. “For the clinicians and the services out there, they don’t even think about it any more. It is integrated into normal clinical practice.” In addition to expanding the service into urban areas in the NT and to the Kimberley and South Australia, the consortium plans to upgrade the repository for its EHR to incorporate items that will make up the PCEHR, Mr Moo says. “We are moving towards what we call a fully atomised repository that will accept the new clinical documents that are being developed as part of the PCEHR,” he says. “As part of our expansion project we are looking to work with the vendors to be able to produce discharge summaries and health summaries and event summaries using the new CDA specification.” The other major implementation the team is undertaking is the adoption of national healthcare identifiers. Until now, the MeHR has used an internally-built identification system, called the Health Connect ID, which is what Mr Moo calls a jurisdictional‑based healthcare identifier. This has been mapped to the NT Health’s Territory-wide client master index and to the Medicare numbers used by the Aboriginal Medical Services. “We have had our own identifiers for our registered clients and we will be progressively adopting the individual healthcare identifiers (IHIs) and the healthcare provider identifiers,” Mr Moo says. “All of our registered 47,000 consumers have them and those we register between now and June will be registered with a Health
Simon Stafford
Connect ID, but we will start to allocate the IHIs in parallel — hence the importance of having that in the clinical information systems. And as we start to get the software enabled, we will start to capture the IHIs. In some point in the future the IHI will become our primary identifier but that will be done down the track.”
Critical mass for data As Mr Moo and Mr Stafford emphasise, the MeHR has been a longterm labour of love for the NT, starting off with very small steps with a view to future benefits. Those benefits are appearing now, as clinics and hospitals throughout the Territory have access to a wide range of health data. “We have a large number of data sources coming in,” Mr Moo says. “We have a current health profile, which is a health summary; we have individual primary care event summaries so that when you go in for a consultation, whether it is a GP or a primary care clinic, you get an individual event summary for that consultation; we have pathology results coming in from community pathology providers, if the pathology is ordered from the primary care consultation. Separately, the pathology results are stored in the repository. “From hospitals, we have accident and emergency summaries, we have inpatient discharge summaries, we have specialist letters, and recently we have added radiology reports from hospitals.
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“We have very clinically rich data sources now available, and most of the clinical documents that you would require are now accessible.”
well‑accepted service. We need to make sure that whenever we go into the transition, we can’t afford to lose any service quality. “We expect the transition to take up to two years because it is not an overnight thing. There are extensive software development, engagement, change and adoption processes to be done.” The team is also now ready to kick off a major consumer registration campaign in WA and SA, as well as urban areas in the NT, to register more clients.
Stephen Moo
“We also have two external databases we are able to access: the Rheumatic Heart Disease Registry and the Northern Territory Child Immunisation Register. We are able to go through a portal to access records in those registers. “And soon we will be bringing in hospital pathology and advanced share care plans. They will start to be available later this year. We have very clinically rich data sources now available, and most of the clinical documents that you would require are now accessible.” The majority of AMSANT and AHCSA members use the Communicare system, while the Health Department uses a primary care information system (PCIS). GPs in the area predominantly use Medical Director, Best Practice and Genie, and all of these vendors are working with Pen Computer Systems for system integration. “There are a lot of activities going on at the moment but the key activities are with our vendors in terms of doing a lot of work to create the new CDA documents and also to incorporate the identifiers,” Mr Moo says.
Transition to the PCEHR Progress to date has predominantly been around implementation planning and developing the engagement strategies. The consortium has also done some extensive work on consent forms and privacy impact assessments, and between now and June the focus will be on getting as many consumers and providers registered as possible. “The other big activity we have been involved with is the transition planning to the PCEHR,” Mr Moo says. “We’ve had some intensive workshops with all of our consortium partners and NEHTA and we spent four days workshopping how we would transition what we have to the national PCEHR service. It is quite a complex process to work through because we have such a mature and
Mr Stafford says while the details of the campaign are still being finalised, work has begun through GPNNT to ensure the system is integrated with GPs’ business processes. GPNNT is working with 28 general practices to target urban consumers for registration as they come into the practice. “When the SEHR started there were a whole lot of mass community activities out bush,” Mr Stafford says. “It started with a basic ‘this is what it is’. That is the kind of stuff that AHCSA will be doing — they have communities that haven’t really been exposed to what that story is yet.” WA Country Health will be similarly involved, hoping to run forums in remote communities as well as country towns, he says. “The idea is to tie it in with the fabric of those communities — the sports carnivals or the local show. “For example at AHCSA, they have already started the engagement with the clinicians, and then the next step is engaging with the boards of health services, the CEOs, with administrative staff in clinics, and then once they start doing the community thing, everybody is ready and understands what this is all about. “In the Territory, what we have done is to re-engage with our membership around the shared record, which is now a seamless thing that is just done, and now it is time to work on things like data quality. Sharing information is only worthwhile when the information is of good quality. “This was a process that we learned when the shared record first started. You have to make sure the data is of high quality. What is happening now with advanced things like shared care planning, that data quality has to have another step up. “We will be working with the health boards — the community people, the leaders — talking about ‘that health story thing that’s in the computer’, making sure that people remember that all the kids are registered and to make sure that it almost becomes part of life. And we’d like to see ourselves up around the 98 per cent mark for registrations.”
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CRADLE COAST MODEL
EMPHASISES DIGNITY OF END OF LIFE CARE The Cradle Coast Connected Care (4C) project is building a PCEHR-conformant repository to house shared health summaries and advance care plans for aged care residents, which will inform national policy for future PCEHR-based end-of-life care components.
Kate McDonald Journalist: Pulse+IT kate.mcdonald@pulseitmagazine.com.au
The Cradle Coast area of Tasmania has been working on an electronic health information exchange (eHIE) project since the end of 2009. Set up by a consortium of local groups — including General Practice North-West (now known as Tasmania Medicare Local North West Branch), the University of Tasmania Rural Clinical School, the North West Area Health Service and the Cradle Coast Authority, an umbrella group of nine local councils in the region — the aim of the eHIE is to develop a virtual network for the secure, electronic sharing of patient health information between healthcare providers in the region. The electronic sharing of information is important in this area of Australia, covering as it does one-third of the island of Tasmania and reaching into remote as well as rural areas. According to project manager Colleen Cheek, the project had in its initial stages a very broad brief, but the main requirements from local general practitioners were the ability to send referrals more easily to the Area Health Service and an improvement in the sharing of information. “They were really keen to use, not a bespoke version, but something that would be sustainable and would transition to some sort of national system,” Ms Cheek
says. “When people have to travel to receive health services, they want to go where their family support is, which might be in a different state. People move about in Australia, and that was at the forefront of the practitioners’ minds. They also wanted it to have a place in accreditation and for the project to improve the quality of information, not just be able to send from one place to another.” Work had begun on sending electronic referrals to the specialist health services, but with the advent of the PCEHR, including NEHTA’s eReferral plans, the Cradle Coast eHIE has changed its focus from the sending of eReferrals to the receiving end. The Cradle Coast eHIE is currently working with Alcidion on an eGateway project so that when eReferrals are available in GP software, the eGateway will be set up to receive those referrals at the area health service level. To do that, the eHIE is using NEHTA’s Health Provider Identifier – Individual (HPI-I) and Health Provider Identifier – Organisation (HPI-O) structure. “We have worked with the Area Health Service in identifying the referral end points and assigning an HPI-O structure to those points,” Ms Cheek says. “(Alcidion) has developed the gateway, and they
have an inbound referral management system that flags that the referral has been received and then routed to the particular end point for the management of that referral, through the HPI-Is.”
“Five residential aged care
The eHIE is currently waiting for the release of the eReferral system within GP software, and will then complete its conformance and compliance requirements. Following that, the group will pilot-test the system and then roll it out to general practices and the North West Area Health Service.
Colleen Cheek
Advanced care planning With that under way, the eHIE has now embarked on the Cradle Coast Connected Care or 4C program under the Wave 2 round. The 4C program aims to build a local shared electronic health record specifically to be able to share advance care planning for residents of aged care facilities. The role of this project is to test cross-boundary access of authorised users to the consumer’s care planning and health record, with an emphasis on advance care plans for end-of-life care. Alcidion is developing an electronic repository for this project which is planned to be integrated directly with the hospital-based electronic medical record (eMR) which will be developed by Tasmania’s Department of Health and Human Services over time. “We are building it on state-wide infrastructure so if it is proven locally, it could be adopted state-wide,” Ms Cheek says. “What has worked well for us is that the VP of research at Alcidion, Professor Malcolm Pradhan, is a NEHTA clinical lead, so we have been able to get cracking on a lot of the development with the vendor already having knowledge of how it is all supposed to work.” As well as having the capacity to receive shared health summaries and event summaries, the system will include the components of traditional advance care plans, such as nominating a person responsible, listing if an Enduring Guardian is available or registered and also recording things that are important to people and their dignity, their preferences for care and for decision making. These are hugely important documents for aged people, outlining their wishes in terms of health care. Many do not wish to end their days in a hospital bed or to be resuscitated if their heart fails, but without clear plans which are aligned with their wishes, medical and nursing staff often find it difficult to determine exactly what a person might have wanted at the time the care is required. The clinical care plans developed with the person, and their nominated person responsible, outlines their wishes and the steps that have been agreed with their primary health team, available to all providers involved in their care.
facilities have signed up so far.”
“It will also list goals of care in relation to their function, their expected length of life, their comfort requirements and planning ahead for expected deterioration,” Ms Cheek says. “The idea is that when a person goes into care or is a resident of an aged care facility, they complete this in conjunction with their primary healthcare team, listing what is important to them and what their goals of care are.”
Shared health repository Shared health records will hopefully improve coordination and communication of end-of-life care, as it allows aged care facilities to contact after-hours GP services and have that service know exactly the wishes of the patient. “If the care they need exceeds the capacity of the aged care facility and they need to be transported to hospital, then the idea is that this would be integrated with the eMR so when they arrive at the ED it will be flagged that there is one of these plans available and the ED staff will then be able to view those plans,” Ms Cheek says. The repository will accept shared health summaries from GPs and event summaries from hospitals. It will be accessible only to those holding HPI-Is and the patient or resident will be identified by their IHI. Ms Cheek says the repository will be accessible through a web interface so GPs and aged care staff can log on from anywhere. Allied health professionals such as pharmacists are also a large aspect of the project. Five residential aged care facilities have so far signed up and will be working with the project team to ensure it is implemented by the end of June. Patients, however, will not be enrolled until late in the project to ensure their dignity is preserved. “We can’t sign anybody up until we have our privacy review and consent model completed. I haven’t been in a rush to do that, as we do not want to consent anyone until the system is near to being available. We hope to have our consent model approved and be ready to recruit people around April or May.” If the project is successful, the aim is to roll it out throughout Tasmania and use it to inform national policy for future PCEHR‑based end-of-life care components.
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PCEHR: WAVE 2
Accoras seeks accord with health identifiers The eHealth team at Accoras (formerly Brisbane South Division Limited), is working closely with general practices to sign them up to the new Health Identifiers Service. It has so far signed up 70 practices and is looking to begin recruitment of 25,000 patients, particularly war veterans, people with disabilities and school-aged children.
Kate McDonald Journalist: Pulse+IT kate.mcdonald@pulseitmagazine.com.au
The Health Identifiers Service (HI Service) is one of the core components of the PCEHR system. Operated by Medicare Australia, it is responsible for allocating Healthcare Provider Identifiers for individuals and organisations (HPI-Is and HPI-Os), and Individual Health Identifiers (IHIs) for every person currently listed on its existing databases. It is also creating a Healthcare Provider Directory (HPD), which will allow GPs to locate other clinicians and specialists in a timely manner and improve communication when referring patients or making decisions about patient care needs. Accoras is concentrating on the primary care aspects of the PCEHR system in its project, and is leveraging the work already done by the Wave 1 sites: Metro North Brisbane Medicare Local (formerly GP Partners) in Brisbane, Hunter Urban Medicare Local (formerly GP Access) in the Hunter, and Inner East Melbourne Medicare Local (formerly Melbourne East GP Network). For Accoras, the focus is on networking with general practices in its catchment area to assist them to sign up to use the HI Service. The eHealth project manager with Accoras, Nigel Fairhurst, says that subsequent to that phase, the team will
be working with practices to take on board the concept of a shared electronic health record that can be used by themselves and other practitioners. “It’s a grounding project for the government’s national roll out,” Mr Fairhurst says. “In our case, we have some specific target cohorts that we are working with as part of the project, and those are people with disabilities, war widows and war veterans, and school-aged children, specifically in the starting school, four to six-year-old bracket.” Mr Fairhurst says the main reason these cohorts were targeted was the prior relationships Accoras had with some of the organisations representing these groups, including the Department of Veterans Affairs (DVA) and several child care centres in the area. It has also recently signed a memorandum of understanding with the Queensland Centre for Intellectual and Developmental Disabilities (QCIDD). “The government wants the various sites to tackle different target cohorts so they will have a wider view of how best they can approach the national roll out,” he says. “Some of the other projects are running with different cohorts so the government gets that feedback and the understanding that what works in this space might not necessarily work in another.”
The main focus to date has been on assisting practices to apply for and receive their HPI-Os and HPI-Is. Mr Fairhurst says his team has developed its own procedure to streamline the application process with Medicare. “We go into the practice and provide them with the necessary knowledge and explanation of what it is all about and what they need to do,” he says. “But at the same time, we’ve been able to get the practices to sign us up as the contact point for Medicare, so if there are any problems then Medicare deals directly with us, not the practice, which makes it a bit easier. Often times we can solve 80 per cent of what Medicare might want to find out, as we already know.” As part of the process, an officer responsible is chosen at each practice to maintain the data in each organisation. The team is also working with practices to ensure they put their details on the Healthcare Provider Directory, which at the moment is not an automatic process, and is training practice staff in the effective use of the HI Service using Public Key Infrastructure (PKI) certificates. “We can also make enquiries on behalf of the practice as to how things are progressing,” Mr Fairhurst says. “It also gives us the opportunity that once we know a practice has been registered, we can go back to the practice and say now that you’ve got your HPI-O or a new PKI certificate is coming through, we can come out and double check the next day.”
Health Record (MSEHR), an electronic alternative to its paper‑based pregnancy health record. Accoras is working with Mater in about 14 practices in its catchment, Mr Fairhurst says. “We also recently signed an agreement with the Queensland Centre for Intellectual and Developmental Disabilities (QCIDD), a not-for-profit group based at the Mater, which is run by the University of Queensland’s Professor Nick Lennox,” he says. “They are going to identify from their clients about 10 or 12 families with disabilities, and then go through the consent process and subsequent presentation at practices and interview them to provide us with some specific reports and case studies. “For them, it is a terrific opportunity to get more information about how well society allows people with disabilities to interact in things like this. For government, it gives them lessons learned on whether this will or won’t work with people with disabilities or only certain types of disabilities. “It will also address concerns about legal issues, carers, guardians and consent issues and privacy issues. That’s an example of how we are working with specific organisations to look at getting details about target cohorts. It is a real win-win.”
Patient and practice recruitment Accoras currently has over 70 practices involved, and has worked closely with these to ensure the appropriate support has been provided. The next step will be the roll out of health identifier functionality in GP software. Patient recruitment is the next phase of the project, with Accoras looking to enrol 25,000 patients. The team is reviewing a number of ways to recruit patients, including manual enrolment, where the practice will be provided with a printed consent form and brochures, Mr Fairhurst says. “We are also looking at doing a bulk mail-out process where we will provide a pre-printed consent form. We will be looking to see what sort of data we get from that because this is all adding to the government’s learning about the best approach, remembering that this is an opt-in system.” Accoras has also signed a memorandum of understanding with Mater Health, another of the Wave 2 sites, to refer expectant mothers to the Mater to sign up for the Mater Shared Electronic
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GREATER WESTERN SYDNEY
closing the primaRy acute care loop Good communication about a patient’s clinical management is a major component to providing continuity of care across acute and primary healthcare settings. The Lead Site for PCEHR in Greater Western Sydney aims to share clinical documents between these settings, and is developing an electronic Blue Book for mothers and newborns.
Kate McDonald Journalist: Pulse+IT kate.mcdonald@pulseitmagazine.com.au
The Greater Western Sydney region is both culturally and geographically diverse with a mix of urban, regional and rural areas. It includes almost two million people and is still growing rapidly, and will soon accommodate 60 per cent of Sydney’s growth and 25 per cent of all national population growth. Therefore, a key objective of this Wave 2 site is to introduce a range of clinical solutions where eHealth benefits can be proven on a significant scale. The Greater Western Sydney program is being delivered via a collaborative consortium consisting of NSW Health, Nepean Blue Mountains Local Health District, Western Sydney Local Health District, the Sydney Children’s Hospitals Network, the WentWest and Nepean Blue Mountains Divisions of General Practice, and a range of industry partners. According to Greg Wells, the NSW Health Chief Information Officer and program sponsor, the ultimate goal of the program is to close the loop between primary, community and acute care. “Our patients assume the sharing of key clinical documents is already occurring, and our clinicians have made it clear this will improve care, so the program intends to deliver this for the region, to progressively extend these solutions
across the state and ultimately integrate with the PCEHR,” Mr Wells says. The program has an initial focus on high priority consumer groups such as aged Australians, those with complex and chronic disease, mothers and their children under the age of 16, as well as indigenous and culturally and linguistically diverse (CALD) populations. The program is targeting 140 general practices, 10 hospitals and 95 community health centres in the region, providing the capability to share clinical documents.
eDischarge starts rolling Statistics show that 78 per cent of Australian GPs are not directly informed that their patient has been admitted to hospital, and 73 per cent do not directly receive discharge summaries. As part of the first round of the GWS project, 12 GPs in Katoomba in the Blue Mountains are currently receiving electronic discharge summaries direct to their desktops. “The trial at Blue Mountains District Anzac Memorial Hospital will evaluate the end‑to-end delivery of discharge summaries before the solution is extended to a significant number of clinical specialties across western Sydney hospitals,” Mr Wells says.
“We have now achieved a reasonable level of electronic medical record (EMR) maturity within our hospitals, with electronic orders, results, theatre and emergency department documentation rolled out to more than 80 per cent of beds across the state. The opportunity through the lead site program is to make this information available to all providers associated with a patient’s care.” In order to link discharge summaries within GP software, discharge summaries will include the consumer’s Individual Healthcare Identifier (IHI), which will be maintained in the new NSW State Patient Registry Service. Mr Wells says NSW Health is now an accredited participant in the national Health Identifiers Service following a successful completion of NEHTA’s Compliance, Conformance and Accreditation (CCA) process in December 2011. The NSW Patient Registry Service incorporates patient information including patient IHIs from across the Greater Western Sydney region for up to two million patient records. The patient registry is part of a broader service-based approach that allows health ICT infrastructure to be better utilised in the management and sharing of clinical information with target audiences, including those that participate in NEHTA programs such as the national PCEHR.
‘Conformant’ repositories According to Mr Wells, the move to a national PCEHR solution is a significant journey. “Over time, some local or regional solutions may be supported within the national solution; however at this stage, lead sites are critical,” he says. “Clinical engagement, building relationships with general practice, and consumer enrolment best occurs on the ground in targeted patient cohorts where all providers can participate. In healthcare, starting from specific geographies and expanding out has a greater chance of success than a broad ‘big bang’ approach.” At the core of enabling this in Greater Western Sydney is a range of clinical repositories for GP-generated shared health summaries, medical images and public health event and discharge summaries. “In time, these repositories will allow information to be viewed directly in a doctor’s main clinical system to minimise workflow impacts,” he says. “For example, an ED clinician will be able to view a shared health summary in the EMR; however all information will also be available to view through a clinical portal to be established as part of the program.”
Mobile access to child health records An electronic version of the My First Health Record (or electronic Blue Book) is also being trialled, providing parents with an electronic version of the paper Blue Book currently given to every newborn child in NSW. Babies born in a maternity ward in one of the area’s public hospitals — such as the Blue Mountains, Blacktown, Mt Druitt, Westmead or Auburn hospitals or the Children’s Hospital at Westmead — may be registered for the trial, with the parent or guardian’s consent, which will involve the creation of an electronic version of the My First Health Record for storing and updating information. Parents will be able to access their baby’s Blue Book through a parents’ portal, where they will be able to put in their own notes, key milestones or specific events. A portal will also be established for healthcare providers to input healthcare information, such as growth and weight details and immunisation records, and the program is currently developing a mobile application for consumer access. “The mobile application, in particular, is an exciting component of the program,” Mr Wells says. “Consumers want a simple, highly mobile way of accessing their child’s health information — we think the electronic Blue Book is the right way to deliver this and would like to make it a national solution.”
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PCEHR: WAVE 2
MEDIBANK builds portal for consumer health Health insurer Medibank is creating an online health record for its customers in which users can store their personal health information. It is aimed at allowing consumers to take control of their health information and will eventually link up with the PCEHR.
Kate McDonald Journalist: Pulse+IT kate.mcdonald@pulseitmagazine.com.au
The Medibank healthbook is a personally controlled electronic record of an individual’s health information and history. healthbook will be overseen by 100 Medibank Health Solutions nurses who are already registered with their Healthcare Provider Identifier - Individual (HPI-I). According to Isabel Frederick, general manager for eHealth at Medibank, the portal will enable customers to record their medical information, so it will act as a supplement to the larger PCEHR. “healthbook will be an important tool for maintaining and collecting health information that will enable a person and those authorised by them to access useful health information, online, anytime and anywhere,” Ms Frederick says. “Over time, users will also be able to have access to chronic disease management information and support, take part in health risk assessments, and connect to many other offerings available to members and customers of Medibank.” It will be different from other consumer health portals like Microsoft’s HealthVault and the now-defunct Google Health, she says, in that the initial users of the product will already have established relationships with Medibank, so healthbook will be an extension of that customer relationship.
Medibank is building the solution but is partnering with IBM Australia, which has been engaged to provide system integration and project support capabilities. “Underpinning the capabilities of healthbook is an important security, privacy and audit layer,” Ms Frederick says. “This will ensure that only authorised customers, Medibank health providers and, in the longer term, external health service providers will have access to view and create health content on customers’ records. “Importantly, the user will control their own health information and control who can view that information.”
‘Defence-level’ security In the initial stages, the consumer will post health information to the website manually but will eventually be able to import images. When healthbook links up to the national PCEHR infrastructure, GPs will then be able to access data from the repository, with the consumer’s consent. “The security system has been designed by architects with a defence background,” Ms Frederick says. “Furthermore, the level of security will exceed current Medibank levels, which are approved and audited.”
“The project is running on track and is scheduled for a soft launch in May 2012, with the intention to go live in June...In due course it will be expanded to Medibank’s 3.7 million private health insurance customers and hopefully the broader public.” Isabel Frederick
It will in due course connect with the PCEHR, via suitably secure communication channels, including the secure shell (SSH) network protocol for secure data communication, hypertext transfer protocol secure (HTTPS) and SSH file transfer protocol (SFTP). She says different encryption will be used at different levels, including “encryption at rest”, which she
described as being similar to that used in the banking and finance sectors. “In short, the security will meet or exceed the national PCEHR requirements. “The project is running on track and is scheduled for a soft launch in May 2012, with the intention to go live in June.”
Initially, it will be available to a small subset of Medibank customers, who are enrolled in chronic disease management and coaching programs. “It will in due course be expanded to Medibank’s 3.7 million private health insurance customers and hopefully the broader public.”
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PCEHR: Wave 2
CALVARY BUILDING A SHARED CARE REPOSITORY As one of the nine Wave 2 sites, Calvary Health Care ACT and St Vincent’s & Mater Health Sydney are collaborating on some of the core components of the PCEHR, including discharge summaries, eReferrals and specialist letters. Calvary eHealth is targeting aged care, palliative care and patients living with chronic disease.
Kate McDonald Journalist: Pulse+IT kate.mcdonald@pulseitmagazine.com.au
Together with the Eastern Sydney Connect team at St Vincent’s & Mater Health, Calvary eHealth is working closely with acute and primary healthcare groups as well as GP and hospital software vendors to produce an electronic system for secure communication between providers.
to have each other on board because, together, they can provide both a hospital clinical system and a care plan from the GP side. But while Calvary eHealth and St Vincent’s are trialling the same components, the two are focusing on different patient cohorts.
Work has been under way for some time on delivering electronic discharge summaries, specialist letters and eReferrals to and from general practice and acute care providers. In Calvary eHealth’s case, aged and community care providers are also taking part.
“We are focusing on aged care, palliative care and chronic disease, because they are the specialisations of our parent company, The Little Company of Mary Health Care, in Australia,” Mr Morgan says. “We have done that for a long time and we do it well. Although we have strong links to those groups, any person of any age may enrol, as we provide health services across all demographics.”
Both projects are using the same technology partners, including Smart Health Solutions and Precedence Health Care, to build components of a shared health record and repository, while HealthLink is providing the secure messaging service. Smart Health provides an online information management system for sharing patient summaries using secure web technologies and public key infrastructure, while Precedence Health Care has developed the cdmNET system, an online service for developing care plans and documentation for chronic disease management. According to the project manager for Calvary eHealth, Declan Morgan, both Smart Health and Precedence were keen
Calvary eHealth has signed a range of healthcare providers as project partners including Calvary’s public and private hospitals in Canberra, and its palliative care facility Clare Holland House. It is also working with aged care facility Calvary Retirement Community; Calvary Riverina, a private hospital in Wagga Wagga; and ACT Health. NSW Health is also participating through the Southern NSW and Murrumbidgee Local Health Districts. GP partners include ACT Medicare Local, Murrumbidgee Medicare Local and the Southern General Practice Network, a division of general practice based in
Moruya and covering the south-east corner of NSW. “GPs are core to Calvary eHealth and we are looking at eDischarge summaries going to the GPs as point-to-point communication,” Mr Morgan says. “The ACT Health Directorate is already doing this electronically but we still send them by fax and some other places still rely on the post. Our hospital specialists receive referrals either by fax or mail. “We want to be able to give GPs an acknowledgement that we have received those referrals and, eventually, confirmation of their patient’s appointment date and time. Following the patient’s treatment with us we want to be able to respond to the GP with an electronic specialist letter, confirming what occurred, the outcome and include any further instructions.” Mr Morgan says GPs have long wanted to receive electronic discharge summaries direct to the desktop to avoid the quite common situation of a patient presenting to them post-discharge but the GP not having any prior knowledge of hospitalisation. “Often a patient will be admitted to hospital and on discharge be instructed to see their GP,” he says. “But when a discharge summary takes three to four days to arrive, in many instances after the patient has already been to the GP, it becomes a major point of frustration. “So with the patient sitting with them in consultation the GP then has to ring the hospital, track down and talk to the specialist and ask what to do with the patient. They wait on the phone forever and of course are dragging specialists away from their own consultations. “A secure electronic solution will streamline patient care and quite simply mean healthcare professionals can spend
“A secure electronic
solution will streamline patient care and quite simply mean healthcare professionals can spend more time with their patients, and less time stuck in a whirlpool of paperwork.”
In late January, more than 70 healthcare professionals from across the ACT and southern NSW met at Calvary Hospital in Canberra for a dinner event, within the Model eHealth Community exhibition run by NEHTA. Well-known Sydney GP and eHealth ‘early adopter’ Dr Raymond Seidler gave the keynote address, outlining the positive changes eHealth had already made to his practice and his patients. Already, 43 GPs have signed and nine practices enrolled in Calvary eHealth as a direct result of the dinner.
Aged and palliative care Declan Morgan more time with their patients, and less time stuck in a whirlpool of paperwork.”
Staged roll out Mr Morgan says his team divided its strategy for the project into two parts. With NEHTA working on specifications for clinical document architecture (CDA), Calvary eHealth decided that while that functionality would be the end goal, before that happened it would like to deliver something using standard HL7 messaging and systems that are already in place. “That is our stage one solution and we are ready to have our electronic discharge summaries go out to GPs and into the repository,” Mr Morgan says. “We already have patients signed up and consenting to share that information.” The long-term goal is to enrol 150,000 patients from across the ACT and southern NSW. “We’ve got a marketing plan with an advertising campaign, and that will roll out in the next two months. It’s integrated with the strong brand work we have put in place and will reflect our printed collateral that is targeted to our cohort group.”
With the close connections to the Calvary Retirement Community at Bruce in the ACT, Calvary eHealth has recruited a number of elderly residents, and is including marketing material in preadmission packs for the hospitals. “We also have two consumer liaison officers who are talking to patients on the wards,” Mr Morgan says. For palliative care patients, Calvary eHealth has installed a clinical system at Clare Holland House that will lead into the shared repository. It is also working with patients that are cared for in the home. “The electronic health record will help them because they often are seen late at night by community nurses through the ACT Health Directorate’s Link program,” Mr Morgan says. “At the moment, a full record of that patient has to be left in the home so the Link nurses can see the record and add to it. Then when staff from Clare Holland House visit they have access to this information. “Obviously, with the electronic health record, that will be a lot more secure than a paper file which anyone can pick up and read. It will make the work of nurses a lot easier too, because they will be able to read the information remotely before the home visit.”
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PCEHR: WAVE 2
SYDNEY CONNECTS WITH SHARED HEALTH RECORD The Eastern Sydney Connect Wave 2 site has already signed up 338 GPs and 1300 consumers to the project, which will test some of the core components of the PCEHR, including discharge summaries, electronic referrals and specialist letters. It is a huge undertaking involving a number of software vendors.
Kate McDonald Journalist: Pulse+IT kate.mcdonald@pulseitmagazine.com.au
The Eastern Sydney Connect (ESC) project is one of the larger sites in the Wave 2 round, covering a large and disparate demographic and geographic area. The project encompasses St Vincent’s Public Hospital, St Vincent’s Private Hospital and St Vincent’s Clinic private specialists in partnership with three divisions of general practice — East Sydney, South East Sydney and the Murrumbidgee Medicare Local. The project is demonstrating all of the core components of the PCEHR with the exception of the consumer portal, and is differentiated from the other eHealth sites by its focus on medication management, engagement of private specialists and the technical integration of conformant repositories. The Eastern Sydney Connect eHealth site has two phases — Phase 1 is about e-enabling the community as a precursor to Phase 2, which will deliver the PCEHR, project manager Steve Saunders says. “It’s a huge project that’s not only about the PCEHR; it’s also about e-enabling the community,” Mr Saunders says. “There are many benefits for participating providers even before we implement the PCEHR. As an eHealth site, a requirement of participation is that whatever we do has to be sustainable beyond 30th June 2012. Everything we are putting in place here
— the discharge summaries, specialist letters, referrals — will continue.” Phase 1 components include electronic referrals, electronic admission and discharge notifications, electronic discharge summaries, nurse-initiated electronic discharge referrals and public and private specialist letters. It is a massive job but progress to date has been swift. Phase 2 will focus on health providers of consenting patients accessing the PCEHR, which will contain event summaries, referrals, clinic letters, discharge summaries, shared health summaries and event summaries — all accessible with patient consent. The project is working with a number of industry partners, Mr Saunders says, who are all working together to get the system up and running, with some components already happening. Electronic referrals, shared health summaries and event summaries will be sent to the St Vincent’s campus from general practice using Best Practice, Zedmed, Genie, practiX and Medtech32 clinical desktop software, while the admission and discharge notifications, the discharge summary from the public hospital and the nurse-initiated discharge from St Vincent’s Private are being sent
“Some of the solutions used by providers that are not on NEHTA’s clinical desktop panel won’t be CDA compliant so these messages will continue to use HL7 and be included as a PDF attachment to a CDA document.” Steve Saunders
from Emerging Health Systems’ (EHS) clinical information system, known in‑house as deLacy, which has been used on the St Vincent’s campus for many years.
Healthcare is providing care planning support for chronic disease management. The shared electronic health record repository is provided by Smart Health.
The creation of specialist letters is being handled by practice management systems used by some of the private specialists within St Vincent’s Clinic, while public specialists are being equipped with either an internal or an outsourced specialist letter service. Secure messaging is being delivered by HealthLink and Argus, while iSOFT is enhancing MedChart for the medications component of the project. Pen Computer Systems is providing its Clinical Audit Tool to improve clinical data quality and Precedence
The HL7 standard is being used in Phase I for exchanging information, but Phase II will require conformance with NEHTA’s prescribed CDA specifications. “The referral will be CDA and all of the discharge summaries and letters back will be CDA,” Mr Saunders says. “Some of the solutions used by providers that are not on NEHTA’s clinical desktop panel won’t be CDA compliant so these messages will continue to use HL7 and be included as a PDF attachment to a CDA document.”
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Multiple messages coming and going If it sounds like a major undertaking, it is. “It is a requirement of GP participation that they will electronically refer to this campus — St Vincent’s Public Hospital, St Vincent’s Private Hospital and St Vincent’s Clinic — where the private specialists are based. It’s important to get critical mass in the community so GPs don’t have to think about whether the recipient can receive electronic referrals or not. For this campus, all inbound referrals are electronic — even if we have to hand‑deliver some of them!” Although not in the original scope, Prince of Wales Hospital has also agreed to accept electronic referrals into its ambulatory clinics to improve the value proposition to local GPs, he says. “In return for the electronic referral, we’ll be doing several things. For all admissions and discharges from the public and the private hospitals, we’ll send an admission and discharge notification. Often GPs don’t know that their patients have been in hospital, and they really appreciate receiving the notifications, which they have never had before. “With discharge summaries, St Vincent’s Hospital is now live across all inpatient wards and 100 per cent of all public hospital discharge summaries will be sent to the GPs electronically, where a nominated GP has been provided. “The next thing will be the specialist letters. St Vincent’s Hospital has replaced the old dictation system with a hosted service by Ozescribe offering a 24‑hour turn-around time to the hospital. The specialist letters are then sent electronically to GPs.” The private specialists who are participating at St Vincent’s Clinic who use
Genie will be sending specialist letters through that software, but if they don’t use a conformant system, the project team has devised an internal system so the specialist letters can still be sent electronically, Mr Saunders says. “GPs will be getting admissions and discharge notifications from the public and private hospitals, specialist letters from public hospital and private specialists, and discharge summaries. Where there is no discharge summary from the private hospital they’ll get a specialist letter back. For nurse-initiated ongoing care, say in an aged care facility, nurse-initiated discharge summaries to those facilities will be going electronically point to point to GPs.” Then it is on to Phase 2, which is aligned with the work the NEHTA GP desktop panel is currently completing. “The timing hasn’t been finalised yet but all of the GPs and healthcare providers will start accessing the PCEHR and submitting shared health summaries and event summaries,” he says. “That’s when things start to get really interesting.”
Patient recruitment gearing up The initial target for GP recruitment was 260 GPs, which the team achieved back in December. The project has now reached a total of 330 GPs, led particularly by the work of the divisions of general practice. The well-known Sydney GP Ray Seidler, medical director of the Eastern Sydney Division of General Practice, is a firm supporter of the project and recently appeared on a Channel 10 news story spruiking its value. Now, recruitment is being geared up to target community pharmacies, allied health providers, community-based specialists and consumers themselves,
with the massive task of enrolling 46,800 people. Priority consumer targets will be people with chronic diseases, people with addictions, homeless people, older Australians and indigenous Australians in particular. Mothers and newborns will also be part of the recruiting phase but will not be targeted specifically. Patient recruitment involves sending “dear patient” letters from GPs in participating practices asking patients to participate and to consent to the sharing of their EHR. Recruitment is supported by community advertising as well as direct practice —initiated recruitment of priority patients. “We have now ramped up recruitment at the St Vincent’s campus,” Mr Saunders says. “All of the patients attending priority outpatient clinics will get a letter with a registration booklet. We are also targeting pre-admission clinics, and patients discharged from St Vincent’s Hospital. “The letter to patients explains what it is we are doing and how it will benefit them, such as that there will be less of an onus on remembering the specifics of past healthcare interactions. We’ll also explain the opportunity to improve care coordination and continuity of care by better communication between their GP, other providers and the hospital system.” The team is now merging with the Calvary eHealth site in the implementation in the Murrumbidgee, due to the overlap of referrals between that region and St Vincent’s and Calvary providers,” he says. “We are changing our consent and registration processes and our GP and provider recruitment to the Murrumbidgee in a coordinated joint effort. Although not in our original scope, Griffith and Wagga base hospitals will also participate as the main service providers to the local GPs.”
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) represents Practice Managers and the profession of Practice Management. Founded in 1979, AAPM is a non-profit, national peak association recognised as the professional body dedicated to supporting effective Practice Management in the healthcare profession. The Australian Association of Practice Managers: • Represents Practice Managers and the profession of Practice Management throughout the healthcare industry. • Promotes professional development and the code of ethics through leadership and education. • Provides specialised services and networks to support quality Practice Management.
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.
Argus
cdmNet
P: +61 3 5335 2220 F: +61 3 5335 2211 E: argus@argusconnect.com.au W: www.argusdca.com.au
P: +61 3 9023 0800 F: +61 3 9614 2650 E: info@precedencehealthcare.com W: www.precedencehealthcare.com
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.
cdmNet is an online service specially designed to manage the entire life cycle of a patient’s chronic disease.
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.
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
Advantech’s medical computing platforms are designed to enhance the quality and efficiency of healthcare for patients and users alike. All products match the performance of commercial PCs and tough medical safety ratings like UL60601-1 and EN60601-1; adding to this they are all IPX1 certified dust resistant and come with water drip‑proof enclosures. Advantech offers long term support and a proven track record of reliability. The medical range extends through: • Point-of-Care Terminals. • Mini-PC and Medical Imaging Displays. • Mobile Medical Tablets. • Patient Infotainment Terminals. Advantech is also an official distributor of Microsoft Windows Embedded software across Australia & New Zealand.
cdmNet minimises the bureaucracy, eliminates the paperwork, and ensures compliance with Medicare requirements for chronic disease management. cdmNet optimises patient care, simplifies care team collaboration and minimises administration & paper work. Find out more about how cdmNet can assist you and your practice by typing cdm.net.au/info into your browser address bar. cdmNet: Chronic Disease Management just got a whole lot easier.
Cerner Corporation Pty Limited
Advantech P: 1300 308 531 F: +61 3 9797 0199 E: info@advantech.net.au W: www.advantech.net.au
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.
P: +61 2 9900 4800 F: +61 2 9900 4990 E: AsiaPacific@cerner.com W: www.cerner.com.au
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) ANNOUNCING:The 2012 Best Practice Summit Following the success of last year’s event, The Best Practice Summit will be held at CQ University in Bundaberg from March 8-10. www.bpsummit.com.au
Cerner is a leading supplier of healthcare information systems and our Millennium suite of solutions has been successfully installed in over 1200 sites across the globe. Cerner’s technology has been designed so that it can be adapted to meet the needs of the very different healthcare delivery systems that exist, with a universal framework that allows clinician workflow to seamlessly span role and venue. Our innovative leadership is allowing us to push boundaries by: • Leveraging clinical and pharmaceutical data for new discoveries in Condition Management and Personalised Medicine • Connecting the community with personal and community health records • Seamlessly connecting the patient record across the continuum of care
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Direct Control
CH2 (Clifford Hallam Healthcare) P: 1300 720 274 F: 1300 364 008 E: marketing@ch2.net.au W: www.ch2.net.au Clifford Hallam Healthcare (CH2) is today Australia’s largest pharmaceutical and medical healthcare service provider with a catalogue of over 30,000 products servicing metro, regional and rural customers across Australia. Supported by a National Network, CH2 utilises local knowledge and local people to provide pharmaceuticals, medical consumables and equipment products to the healthcare market. CH2 is represented by a National Sales Force as well as a local Customer Service team in each state. CH2 understands the value of quality data and are committed to implementing the GS1 system throughout our business and with our partners. The use of EANCOM standard messages, Global Trade Item Numbers (GTIN) for product identification, Global Location Numbers (GLN) for location information and Serial Shipping Container Code (SSCC) labels are paramount to our industry moving forward. CH2 are passionate supporters of these philosophies and believe the uplift in quality systems will result in improved patient safety. CH2 are currently working with partners to implement the National E-Health Transition Authority (NEHTA) National Product Catalogue. “Our aim is to be a great company to do business with. The right product, at the right price, at the right time.” WardBox® is CH2’s direct to ward distribution system. It is a just in time replenishment system where orders are created in a theatre or ward area and then transmitted electronically to one of CH2’s warehouses using SOS or an EDI interface. The service incorporates barcode scanning technology, direct delivery to individual wards or departments, monthly invoicing and comprehensive reporting. WardBox® is designed to assist our customers in reducing purchasing and supply operating costs. This valuable service increases supply chain efficiencies, improves service delivery models and assists in achieving economies of scale. WardBox® distribution is used for pharmaceuticals, medical, surgical and general supplies at numerous healthcare facilities. CH2 has recently released version 1.4 of CH2 Direct, their simple, intuitive and fast, online ordering system. There is no installation required so simply contact their national customer service to obtain a login. 062
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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. Our industry standard SQL database enables a true “paperless” practice. Our leading edge architecture is future proof, it is designed to meet changing requirements and offers first class reporting and analysis of clinical and business data. Standalone or networked multi-site installation which runs on both Mac OSX and Windows operating systems. Our support is first class, our philosophy is “whatever it takes”.
dbMotion P: +61 2 8011 4885 E: info-aus@dbmotion.com W: www.dbmotion.com dbMotion’s connected healthcare solutions for shared electronic health records (Shared EHRs) and health information exchange (HIE) transform healthcare, empowering physicians and revolutionizing patient care for healthcare organisations. The service oriented architecture (SOA) based dbMotion™ Solution gives caregivers and information systems secure access to an integrated patient record composed from the patient’s medical data maintained at facilities that are otherwise unconnected or have no common technology through which to share data, without replacement of existing information systems. Healthcare organisations using dbMotion have realised benefits in a wide variety of areas, ranging from patient safety, quality, efficacy, and IT agility.
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.
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. 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.
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.
Emerging Systems P: +61 2 8853 4700 F: +61 2 9659 9366 E: sales@emerging.com.au W: www.emerging.com.au/ehealth 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 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. 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 developed within Australia and operating successfully in St Vincent’s & Mater Health, Sydney and Government of South Australia, Department of Health Hospitals.
Equipoise (International) Pty Ltd Totalcare P: +61 7 3252 2425 F: +61 7 3252 2410 S: skype.totalcare.net.au E: sales@totalcare.net.au W: www.totalcare.net.au Equipoise International Pty Ltd (EQI) is the developer and supplier of the ‘Totalcare’ clinical and office management system. Used since 1995 by health care facilities across Australia including General and Specialist practice, Radiology, Day Surgery and Hospitals. Totalcare is a fully integrated Clinical, Office and Management software suite. Totalcare is stable, scalable, customisable and easy to learn and use. From a small practice to a distributed, multi site, multi disciplinary corporate entity or hospital, Totalcare can provide a solution for your needs.
GPA P: 1800 188 088 F: 1800 644 807 E: info@gpa.net.au W: www.gpa.net.au
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.
GPA ACCREDITATION plus has given general practices a reliable alternative in accreditation. GPA is committed to offering a flexible accreditation program that understands the needs of busy GPs and practice staff. GPA assigns all practices an individual quality accreditation manager to support practices with their accreditation. Choose GPA for more support, improved service and greater choice.
Genie runs on both Windows and Mac OS X, or a combination of both. With over 2200 sites, it is now the number one choice of Australian specialists.
Health Communication Network
EHS provides: • • • • • • • • • • • • • • • • •
Pre-Admission Patient History Orders & Results Clinical Care Guides Assessments Progress Notes Referrals Labour & Birth Medications Reconciliation Clinical and Non‑Clinical Messaging Diets Discharge Planning Appointments Rostering Allocations Resource Calculation Clinical Dashboard and more
EHS has integrated Sabacare’s Clinical Care Classification (CCC) System, a diagnosis framework integrated in SNOMED CT. EHS’ extensive list of modules work seamlessly with other systems via our integrated interface engine which accepts HL7 and other accepted Health IT standard protocols complying with the Australian Technical Specification: ATS 5822:2010 eHealth Secure Message Delivery.
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.
Global Health P: 1300 723 938 F: +61 3 9675 0699 E: marketing@global-health.com W: www.global-health.com 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.
P: +61 2 9906 6633 F: +61 2 9906 8910 E: hcn@hcn.com.au W: www.hcn.com.au Health Communication Network (HCN) is the leading provider of clinical and practice management software for Australian GPs and Specialists and supplies 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
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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 e-health community for almost 20 years. HISA aims to improve healthcare through the use of technology and information. We: • Provide a national focus for e-health, health informatics, its practitioners, industry and a broad range of stakeholders • Support, promote and advocate • Provide opportunities for networking, learning and professional development • Are effective champions for the value of health informatics HISA members are part of a national network of people and organisations building a healthcare future enabled by e-health. Join the growing community who are committed to, and passionate about, health reform enabled by e-health.
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.
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. 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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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:
InterSystems P: +61 2 9380 7111 F: +61 2 9380 7121 E: anz.query@InterSystems.com W: www.InterSystems.com
Health Information Management Association Australia
ISN Solutions
InterSystems Corporation is the worldwide leader in breakthrough solutions for connected care, with headquarters in Cambridge, Massachusetts, and offices in 23 countries. InterSystems TrakCare™ is a Web-based healthcare information system that rapidly delivers the benefits of an Electronic Patient Record. InterSystems Ensemble® is a seamless platform for integration and the development of connectable applications. InterSystems HealthShare™ is a strategic platform for healthcare informatics, providing capabilities for sharing of clinical information, comprehensive advanced analytics, building clinician and patient Web-based communities, and quickly filling informational and functional cross-system “gaps.” InterSystems DeepSee™ is software that makes it possible to embed real‑time business intelligence capabilities in transactional applications. InterSystems CACHÉ® is a high performance object database that makes applications faster and more scalable.
• Cloud based computing tailored to medical industry • Medical voice recognition • Capped cost medical support and maintenance plan • Ability to consult remotely • Medical application support
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.
MEDITECH Australia iSOFT P: +61 2 8251 6700 F: +61 2 8251 6801 E: company_enquiry@isofthealth.com W: www.isofthealth.com iSOFT, a CSC company, is one of the world’s largest providers of healthcare IT solutions. We work with healthcare professionals to design, develop and implement healthcare solutions that deliver administrative, clinical and diagnostic services to ensure continuity of care across all care settings. iSOFT provides flexible and interoperable solutions to the whole spectrum of providers, from single physician practices through to integrated national solutions supporting thousands of concurrent users. Our capacity to embrace change and keep abreast of emerging new directions in healthcare has allowed our clients to explore the exciting potential of new technologies while securing their existing investments.
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 P: 1800 148 165 E: sales@medtechglobal.com W: www.medtechglobal.com 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.
MITS:Health
Medtech’s Medtech32 and Evolution solutions improve practice management and ensure best practice for electronic health records management and reporting.
Managed IT Services for the Health Industry
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.
P: 1300 700 300 E: info@mitshealth.com.au W: www.mitshealth.com.au
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.
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.
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
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
Mouse Soft Australia Pty Ltd MIMS Australia
NEHTA
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.
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.
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.
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Sysmex New Zealand
Medilink
from Practice Services P: +61 3 9819 0700
P: +64 9 630 3554 F: +64 9 630 8135 E: info@sysmex.co.nz W: www.sysmex.co.nz
P: 1800 061 260 E: sales@tg.org.au W: www.tg.org.au
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.
F: +61 3 9819 0705 E: Sales@practiceservices.com.au W: www.practiceservices.com.au
We offer the following health IT solutions:
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
• 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.
Real Outcomes Real Productivity Minimising Waste
Stat Health Systems
Trend Care Systems
P: +61 7 3121 6550 F: +61 7 3219 7510 E: carla.doolan@stathealth.com.au W: www.stathealth.com.au
P: +61 7 3390 5399 F: +61 7 3390 7599 E: support@trendcare.com.au W: www.trendcare.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.
A national and international award winning solution recognised for its ability to provide real benefits in the acute and sub-acute health care settings.
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.
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Therapeutic Guidelines Ltd
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.
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 November 2011 release of eTG complete includes new topics on Diagnostic approach to fatigue in primary care and Ulcer and wound management. 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 The next time you receive a text message mobile reminder or an alert from your doctor, hospital or physio you now know its done by Vensa. Vensa Health is a mobile health (mHealth) provider in the health care sector offering eHealth integrated mobile solutions, enabling textmessaging for patient communications for applications such as appointment reminders, medication reminders, test results alerts, recalls for screenings such as mamograms, immunisations and more. Vensa has invested substantially into developing products and services that offer communication solutions to better content providers with patients, including mobile text-messaging, voice, mobile sites and Telehealth services delivery.
Zedmed P: +61 3 9284 3300 F: +61 3 9284 3399 E: sales@zedmed.com.au W: www.zedmed.com.au Owned by Doctors who understand the challenges facing the medical profession everyday and backed by nearly 30 years of experience in medical software programming, Zedmed provides innovative, full featured and sophisticated practice management and clinical records software solutions. Zedmed would also like to introduce to you 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 please visit: www.medicalrecordexchange.com.au
At we’d rather catch you than catch you out
At GPA they’re called Quality Accreditation Managers (QAM) QAM Job description:
Not letting you fall. Ever. Work in the interest of our clients from first contact to reaching accreditation. Support and guide our clients through every step of the process. GPA AccrEditAtion plus does things differently.
Accreditation doesn’t have to be the daunting process. As so many of GPA ACCREDITATION plus clients are happy to repeat “GPA’s process has changed what we thought was going to be a hardship into a rewarding experience.” From the beginning your own personal QAM steers you through the entire accreditation process at your own pace. The flexible GPA ACCREDITATION plus modular programs (online or paper-based) are designed to be user friendly, ensuring practices confidently prepare to meet the RACGP standards. We report back to you step by step, giving you the opportunity to make improvements along the way. “I was very happy with the modules – it allowed me to work slowly and consistently through the requirements and I felt supported at the same time.” When your Practice is ready, GPA ACCREDITATION plus will liaise with you to organise a survey visit conducted by experienced surveyors. “GPA ACCREDITATION plus surveyors were very helpful, which made everything run smoothly on the final stage of accreditation – there were no surprises!!” If that sounds different to the way you’ve been used to, call GPA ACCREDITATION plus and let’s get started. call us now on: 1800 188 088 or log on to: www.gpa.net.au
Better Communication, Better Care
Just what the Doctor ordered “Our Electronic Referrals initiative has been very well received by our GPs. At our recent strategic planning meeting, electronic referrals was raised as one of the best initiatives that we have undertaken in recent years.
This project is already making a difference for GPs and patient care and will open up huge opportunities for better communication and collaboration between our Primary Care and hospital clinicians.”
Better Communication, Better Care
The HealthLink eReferral system is currently being implemented across more than 60% of New Zealand’s hospitals and general practices. It is now ready for implementation in any Australian or New Zealand region. Call us today
Dr Adrian Gilliland, Clinical Advisor Primary Care, Capital and Coast District Health Board HealthLink serves 9,000 practices (75% of Australia’s general practices, 100% of New Zealand’s) and exchanges more than 65 million clinical transactions annually. HealthLink has seven offices across Australasia focusing on web services and online communications.
AUS: 1800 125 036 NZ: 0800 288 887 Email: info@healthlink.net www.healthlink.net
Better Communication, Better Care