Pulse+IT Magazine - May 2011

Australia’s First and Only Health IT Magazine

PULSE IT 

Issue

May

22 2011

Mobility Cloud connected mobile devices James Kavanagh examines the intersection between mobile devices and the Internet.

Using technology to prevent medication errors Dr Chaolin Chang advocates the use of technology to reduce medication errors in aged care settings.

Mobile key in the dialogue of care Rachel de Sain highlights some practical applications of mobile technology in the delivery of healthcare.

Cloud computing in the health sector Alberto Tinazzi provides an overview of cloud computing and its applicability to the health sector.

08 12 13 15 16 18 21 22 25

The PCEHR – Boon or Boondoggle? iSOFT MedChart gains traction in the NHS Speech Solutions revises voice recognition pricing Orion Health nominated for six NZ Hi-Tech Awards Best Practice holds inaugural Summit Data Governance conference preview Rural and Remote Telehealth conference preview Communicare and MMXe announce partnership Ascribe deploys Symphony in Eastern Health region

www.pulseitmagazine.com.au

Want to know more about eHealth?

Whether you are a consumer, healthcare manager, healthcare provider or vendor, you need a central location to quickly find and access eHealth information.

Welcome to:

www.ehealthinfo.gov.au Your gateway to the emerging world of modern healthcare.

Discover how information technology is delivering a more reliable and efficient health system.

Featuring: • The Healthcare Identifiers (HI) Service which commenced operations on 1 July 2010.

Access fact sheets for individuals, healthcare providers, healthcare organisations, and medical software vendors • How eHealth systems are being designed to maximize security and privacy • Why a national certification capability is an essential foundation for safe, secure and interoperable eHealth solutions in Australia • The latest Federal, State and Territory government eHealth initiatives • The delivery of a standard clinical language for use across Australia’s eHealth implementations and how it is a significant step towards improving the quality and safety of healthcare

www.ehealthinfo.gov.au is jointly brought to you by Australia’s Federal, State and Territory health authorities and the National EHealth Transition Authority (NEHTA) to help you explore the eHealth concept and stay in touch with the latest innovations as they unfold.

National E-Health Transition Authority www.nehta.gov.au

“ The speed at which medical service is provided will be

faster.

Better information means there is less chance of things going wrong.”

Devendra Maisnam Business Analyst, Information Modeller

Leading the progression of eHealth in Australia Join the NEHTA team The National E-Health Transition Authority (NEHTA) was established by the Australian Commonwealth, State and Territory governments on 5 July 2005 to develop better ways of electronically collecting and securely exchanging health information.

NEHTA is the lead organisation supporting the national vision for eHealth in Australia.

See how NEHTA’s work is helping to enable a better health system and support the Government’s goal of personally controlled electronic health records for all Australians.

Go to: www.nehta.gov.au

Use your health, informatics, analytical, project or architecture skills and join the NEHTA team who are making eHealth a reality in Australia

For up to date information on current opportunities see: www.nehta.gov.au ““The

flexibility

is brilliant – the opportunity and understanding of my situation after maternity leave is a huge help.”

Amy Richardson HR Business Partner

“The idea of being involved in something that could make a difference in Australia. You can actually see at the end of the line, your work has made a

difference.”

Tony Warren System Administrator

NEHTA is an Equal Opportunity Employer. Only people with the right to work in Australia may apply for these positions.

Enquiries and applications can be directed to: careers@nehta.gov.au

PULSE IT +

Publisher Pulse Magazine PO Box 7194 Yarralumla ACT 2600 Australia ABN: 19 923 710 562 www.pulseitmagazine.com.au

Editor Simon James Australia: +61 2 8006 5185 New Zealand: +64 9 889 3185 simon.james@pulseitmagazine.com.au

Subscription Enquiries subscribe@pulseitmagazine.com.au

Advertising Enquiries ads@pulseitmagazine.com.au

About Pulse+IT Pulse+IT is Australia’s first and only Health IT magazine. With an international distribution exceeding 37,000 copies, it is also one of the higest circulating health publications in Australasia.

32,000 copies of Pulse+IT are distributed to GPs, specialists, practice managers and the IT professionals that support them.

In addition, over 5,000 copies of Pulse+IT are distributed to health information managers, health informaticians, and IT decision makers in hospitals, day surgeries and aged care facilities.

Pages 32, 34, 36 and 38 MOBILITY

Looking ahead The next three editions of Pulse+IT will feature a selection of articles covering the following themes: • July 2011 - Medical Devices • September 2011 - Consumer eHealth • November 2011 - Electronic Prescribing Pulse+IT welcomes feature articles and guest editorial submissions relating to these themes, as well as articles relating to eHealth more broadly.

Submission guidelines and deadlines are available online: http://www.pulseitmagazine.com.au/editorial

ISSN: 1835-1522 Contributors Tom Bowden, Dr Chaolin Chang, Peter Fleming, Simon James, James Kavanagh, Rachel de Sain, Dr Geoffrey Sayer, Cara Sayer‑Bourne and Alberto Tinazzi.

Disclaimer The views contained herein are not necessarily the views of Pulse Magazine or its staff. The content of any advertising or promotional material contained herein is not endorsed by the publisher. While care has been taken in the preparation of this magazine, the publisher cannot be held responsible for the accuracy of the information herein, or any consequences arising from it. Pulse Magazine has no affiliation with any organisation, including, but not limited to Health Services Australia, Sony, Health Scope, UBM Medica, the New Zealand College of General Practitioners, or the Kimberley Aboriginal Medical Services Council, all who produce publications that include the word “Pulse” in their titles.

Copyright 2011 Pulse Magazine No part of this publication may be reproduced, stored electronically or transmitted in any form by any means without the prior written permission of the Publisher.

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

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

Page 8 PERSONAL HEALTH RECORDS

Page 36 MOBILE PHONES

Page 38 CLOUD COMPUTING

Editorials

Features

News

Page 6 STARTUP Editor Simon James introduces the 22nd edition of Pulse+IT.

Page 32 FEATURE ARTICLE James Kavanagh examines the intersection between mobile devices and the Internet.

Page 12 iSOFT MedChart gains traction in the National Health Service

Page 8 GUEST EDITORIAL Reflecting on the relative progress being made in the US and UK, Tom Bowden questions whether Australia’s approach to patient controlled health records is sound.

Page 28 NEHTA Peter Fleming, CEO of the National E-Health Transition Authority provides an update on the PCEHR rollout and an overview of the nine project sites recently selected for funding.

Page 30 MSIA Dr Geoffrey Sayer from the Medical Software Industry Association cautions that the human qualities of empathy, respect and regard should not be overlooked in the development of the PCEHR.

Page 34 FEATURE ARTICLE Dr Chaolin Chang advocates the use of technology to reduce medication errors.

Page 36 FEATURE ARTICLE Rachel de Sain highlights some practical applications of mobile technology in the delivery of healthcare.

Page 13 Speech Solutions revises voice recognition pricing Page 15 Orion Health nominated for six New Zealand Hi-Tech Awards Page 16 Best Practice holds inaugural Summit, debuts new version Page 18 HISA to host Data Governance conference in May

Page 38 FEATURE ARTICLE Alberto Tinazzi provides an overview of cloud computing and its applicability to the health sector.

Page 21 Rural and Remote Telehealth Conference coming to Cairns

Resources

Page 22 Communicare Systems and MMXe announce plans for partnership

Page 26 EVENTS CALENDAR Up and coming Health IT, Health, and IT events.

Page 44 MARKET PLACE The Pulse+IT Directory profiles Australasia’s most innovative and influential eHealth organisations.

Page 25 Ascribe completes deployment of Symphony emergency department solution in Eastern Health region

EDITORIAL

Pulse+IT: 2011.2 Simon James

BIT, BComm Editor, Pulse+IT Phone (AU): +61 2 8006 5185 Phone (NZ): +64 9 889 3185 simon.james@pulseitmagazine.com.au

Welcome to the 22nd edition of Pulse+IT, Australia’s

understanding of eHealth to review our events calendar

first and only Health IT magazine.

on page 26 of this edition and ‘save the date’ where

possible.

In this edition, James Kavanagh examines the

intersection between modern mobile devices and

the Internet, Dr Chaolin Chang advocates the use of

new conferences organised by the Health Informatics

mobile technology to reduce medication errors in aged

Society of Australia (HISA), namely the Data

care settings, Rachel de Sain highlights some practical

Governance Conference (May 19-20, Melbourne) and

examples of mobile technology used in the delivery of

the Rural and Remote Telehealth Conference (May

healthcare, and Alberto Tinazzi provides an overview

29-31, Cairns), both of which are previewed in this

of cloud computing and its applicability to the health

edition’s Bits and Bytes news section.

sector.

This edition also features a range of articles on

including the AGPN’s eHealth Conference (August

the Personally Controlled Electronic Health Record,

1-2, Brisbane), a consumer eHealth event dubbed

with National E-Health Transition Authority CEO

HealthBeyond (August 1-4, Brisbane), and Australia’s

Peter Fleming, Medical Software Industry Association

longest

President Dr Geoffrey Sayer, and Tom Bowden all

Informatics Conference (August 1-5, Brisbane).

contributing articles on the topic.

running

eHealth

event,

HISA’s

Health

September sees the HIMSS AsiaPac event come

This edition’s Bits and Bytes news section traverses

to Australia for the first time (September 20-23, Melbourne), with the event incorporating the Health

iSOFT’s recent medication management wins in

Information Management Association of Australia’s

the NHS, Ascribe’s deployment of its Symphony

National Conference.

emergency department solution in Victoria, a plan

by Communicare Systems and The University of

Association of Practice Managers National Conference

Western Australia’s Centre for Software Practice to

(October 18-21, Perth) is a must attend event for

collaborate on the future development of software

medical practices looking to evaluate their software

for Aboriginal health services and other primary care

options, the event known for attracting the who’s who

settings, and Orion Health’s bundle of nominations in

of GP and specialist software developers.

the New Zealand Hi-Tech Awards. Having attended the

inaugural Best Practice Summit in March, a report on

conference circuit — at least for this editor — is the

the event and the key product announcements made

Health Informatics New Zealand Conference and

during the conference is also included, as is an update

Exhibition (Auckland, November 23-25).

Save the date

Pulse+IT

August plays host to a suite of affiliated events,

a range of timely eHealth developments, covering

on a voice recognition system for Genie users.

6

Notable events on the horizon include a pair of

To be held later in the year, the Australian

Rounding out what will be a very busy eHealth

Looking ahead The next edition of Pulse+IT will focus on medical

As eHealth garners increasing interest from both

devices, with an emphasis on products that can

government and the private sector, the number of

integrate with popular Australasian clinical software

events devoted to the topic is rising rapidly.

solutions.

With some of these events scheduled to commence

As always, if you have any suggestions for future

in just a few short weeks, and with many more set

articles, would like to contribute to an edition, or would

to sneak up rapidly on the other side of tax time, I

simply like to discuss your experiences with eHealth,

encourage readers interested in gaining a deeper

don’t hesitate to get in touch.

www.pulseitmagazine.com.au

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EDITORIAL

The Personally Controlled Electronic Health Record – Boon or Boondoggle?

Tom Bowden

Dip BIA, MBA CEO, HealthLink tom.bowden@healthlink.net

In 1513 Niccolo Machiavelli wrote: “There is nothing

more difficult to plan, more doubtful of success, nor

needs to have a high degree of certainty that the

more dangerous to manage than the creation of a

information in the record is complete, accurate and

new order of things.” In many respects we need to

genuinely useful. This is much easier to achieve if all

salute the team at the National E-Health Transition

of the patient’s information is in one place (in the case

Authority (NEHTA) for being brave enough to try and

of Kaiser’s My Health Manager) and more difficult to

create significant and disruptive change to a health

do in the case of the NHS’ HealthSpace when source

system bound together with the arcane and confusing

information comes from multiple systems and there is

paper‑based communication paradigms that have

significant distrust in the quality of the information.1

remained unchanged for over a century.

electronic health record system either follows:

The Personally Controlled Electronic Health Record

To make a PCEHR system work, the patient

I put forward the viewpoint that the creation of an

(PCEHR) is a good idea at the sound-bite level, but

• A virtuous cycle, whereby all parties see value in

does it have the key ingredients that will be needed

the system working; where all parties trust the

to bring about structural change and galvanise a

integrity and completeness of the information

new (electronic) order of things? Will it follow in the

within the records system, and trust the motives

footsteps of Kaiser Permanente’s highly successful ‘My

and abilities of the other parties who collaborate in

Health Manager’ system? Or will it mimic the British

a shared electronic health record system’s creation.

Government’s ‘HealthSpace’ personal health records

• Or a vicious cycle, whereby no matter how much

service, which has been a spectacular failure?

money is put into it, none of the parties are able to

Between them, Britain’s HealthSpace and Kaiser

set aside their own self interest to create a record

Permanente’s My Health Manager system provide

system to a sufficient degree of quality that they

an excellent contrast in approaches. HealthSpace

can all use. As a consequence, the completeness

was designed to be a component of a much larger

and quality of whatever information is held within

government owned and run health records system.

the system is questioned at every level and the

Only 0.13% of patients tried it. The majority of those

system ‘fails to launch’ or staggers forward at

who tried it only used it once. On the other hand, usage

considerable cost.

of Kaiser Permanente’s My Health Manager personal

The success or failure of Australia’s PCEHR will

health records system has grown steadily due to the

substantially depend upon the country’s ability to

constant addition of features and a major emphasis on

create the right set of conditions for a virtuous cycle

user-friendliness. It now provides electronic access to

of PCEHR maintenance and creation. Without a

58% of Kaiser’s enrolled patients (more than 3 million

favourable set of conditions, the PCEHR will simply be

people use it).

a set of vapour trails and another case study in wishful thinking.

Author Info

To make the PCEHR successful, we need to ensure

that the information within it is complete and trusted Tom Bowden is CEO of HealthLink Ltd, a 70 person company providing Health-system Integration services to more than 9,000 individual healthcare organisations across New Zealand and Australia.

by all of the parties that need to rely upon it. Most importantly we need to acknowledge that the PCEHR itself will be a subset of information derived from a much larger record or set of patient records and all the information within the larger set of records needs

8

Pulse+IT

www.pulseitmagazine.com.au

to be complete and accurate (not just the

in addressing it when making the health

important to identify the key stakeholders

relatively small amount of information

system more efficient is regarded by all

whose information is needed to form

viewable by the patient).

as a matter of urgency? I can only assume

the building blocks of a shared health

that NEHTA has insufficient understanding

record system. We need to work with

PCEHR initiative enters a virtuous cycle?

of the issue and for that reason is totally

these source system owners to get the

dismissive of it. Any more Machiavellian

quality of their information output up to a

How do we ensure that Australia’s We need to address the fundamental

issue

patient

assumptions as to why this is so would

satisfactory level. In order to ‘encourage’

information into good shape. In particular

of

getting

our

basic

probably be inappropriate at this juncture.

these parties to change the way they store

that means focusing hard on the quality

To propel the Australian PCEHR

and distribute core record information, we

and usability of pathology and radiology

initiative forward into a virtuous cycle,

need to understand what they need to do

information, discharge summaries and

whereby patients can begin to see value

to change and why they appear to be so

specialist reports. These have to be robust

in gaining access to their health records,

reluctant to do so of their own accord, and

enough to become the basic building

we must ensure that all stakeholders

then we need to find the ways in which we

blocks of a health records architecture.

in the system can be confident that

can ‘persuade them to support the cause’.

At the moment, over 30 million sets

the information within those records is

After all is said and done, very few of us are

of pathology tests are created throughout

complete, accurate and capable of being

happy with the poor level of automation

Australia each year.2 Unfortunately their

aggregated and reused. Success depends

evident in the Australian health system.

format is not standardised, they have no

entirely upon removal of any risk. In

uniform coding and their basic structure

order to achieve the level of integrity

not interested in preserving the status

differs from laboratory to laboratory. Until

required, it is essential that we grasp the

quo; I want to overthrow it.” We need

this information can be reliably, seamlessly

nettle now and focus upon clinical record

to make the guardians of the status quo

aggregated, and is able to be re-used

standardisation at all levels.

throw down their weapons, and we need

and combined with other health record

The likelihood of whether or not

to do that quickly. Failure to do so will

information, the concept of a shared

the PCEHR will be a huge success or a

unquestionably mean an ignominious end

record (of any kind) remains a pipe dream.

multi‑million dollar flop is dependent upon

for the PCEHR.

Despite a number of commentators

whether we can take the Kaiser approach

remarking upon the primitive level of

(highly relevant, completely dependable

References

standardisation and coding within the

information, improved upon over time) or

1. https://www.ucl.ac.uk/news/

basic clinical messaging across Australia,

the NHS approach (based on information

very little has been done to address this

yielded from a system that no one trusts

fundamental issue. So, what is behind

nor particularly wants to support).

document/DOD%20paper%20+%20

this problem? Why is there no progress

append.pdf

To ‘create a new order of things’, it is

As Niccolo Machiavelli said: “I’m

scriefullreport.pdf 2. http://www.aapp.asn.au/images/

www.pulseitmagazine.com.au

www.pulseitmagazine.com.au

Pulse+IT

9

Kelvin’s eHealth Journey

1

3

Greeted by medical centre receptionist Lucy Black, the receptionist is logged into her computer and Kelvin is then added to the waiting list by Lucy.

Kelvin is on holiday in far North Queensland Kelvin lives in Croydon, Victoria with his wife Betty. He is reasonably healthy, only suffering from hypertension that is well controlled with medication. He has an allergy to Penicillin. Over a period of three weeks he develops cramps and pain in his abdomen when he eats fatty food.

Kelvin’s IHI number is retrieved from the HI service electronically and seamlessly added to the local practice record. Kelvin takes a seat in the waiting room.

He is under the care of Dr Adam Jones at his local GP Practice.

2

GP consultation

4

Dr Grant opens Kelvin’s medical record on his PC which now also includes his Healthcare Identifier. Kelvin complains to Dr Grant of cramps in his stomach, especially after eating pizza and fish and chips which he has suffered from for about three weeks.

Kelvin presents to a medical centre While on holidays his condition gets worse and he presents to a medical centre in the town he is staying.

National E-Health Transition Authority

Dr Grant performs an examination and makes a provisional diagnosis of gallstones. He then orders an ultrasound which confirms the presence of gallstones.

After discussing with Kelvin, Dr Grant refers to a General Surgeon: Dr James Brecker at Bay Hill Hospital. The referral is sent electronically via secure messaging.

Kelvin’s eHealth Journey is brought to you by the National E-Health Transition Authority (NEHTA).

NEHTA is the lead organisation supporting the national vision for eHealth in Australia.

7 5

Specialist consultation

Pharmacy Kelvin takes his prescription from Dr Brecker to a Community Pharmacy. The pharmacist scans the prescription barcode. The prescription is retrieved from the PES (Prescription Exchange Service) and dispensed.

8

Dr James Brecker receives the e-referral. Frank is booked in for an appointment by his GP’s staff.

Dr Brecker reviews Kelvin’s ultrasound, performs an examination and determines that Kelvin needs surgery to remove the gallstones.

6

Pathology As per the recommendations on Kelvin’s discharge summary, he has a follow-up blood test for liver function done on the day he is to return home from holiday. The GP has requested that the pathology test results be copied to Kelvin’s usual GP.

Admission to hospital for surgery Kelvin is admitted to the General Surgery ward.

Kelvin then undergoes surgery by Dr Brecker, and he makes an uneventful recovery. Kelvin is discharged three days later, much improved and is referred back to his GP for follow up. An e-discharge summary is sent to Dr Adam Jones, his local GP.

For more information about NEHTA visit www.nehta.gov.au For more information about eHealth including the Healthcare Identifier (HI) Service visit www.ehealthinfo.gov.au

9 Returns from holiday Kelvin goes home without receiving his results but on his return home he goes to his usual GP who has received the blood test results and a copy of the discharge summary.

After consultation with Kelvin, Dr Jones confirms that the blood tests are normal.

What a wonderful outcome!

BITS & BYTES AGPN and RACGP to collaborate on eHealth Against the backdrop of lucrative funding for the rollout of eHealth pilot projects,

iSOFT MedChart gains traction in the National Health Service

the Royal Australian College of General

iSOFT has announced the rollout of its

being part of a much larger company with

Practitioners (RACGP) and the Australian

MedChart

management

a global presence and leadership postition

General Practice Network (AGPN) have

solution in the Pennine Acute Hospitals

in eHealth has allowed us to extend our

signalled plans to collaborate on eHealth.

NHS Trust and Stockport NHS Foundation

reach,” Dr Ainge said.

In a statement, RACGP President

medication

Trust, both of which are located in northern

Professor Claire Jackson highlighted the

England.

MedChart has been deployed in several

important role general practice will play in

hospitals throughout Australasia, including

advancing the national eHealth agenda.

medication charts with an electronic

in St Vincent’s and Dunedin Hospitals.

“General practice is the cornerstone of

system that allows clinicians to enter

the healthcare system, with 83 percent of

treatment orders, and track prescriptions

al in 2010 titled The effectiveness of an

the Australian population consulting a GP at

and medication records. MedChart also

electronic medication management system

least once a year. The ongoing relationship

has full medical decision support, alerting

to reduce prescribing errors in hospital,

between a patient and their GP is at the

the doctor to any patient allergies or bad

looked at the impact of a MedChart

heart of high quality healthcare. The first

drug combinations.

deployment in the inpatient mental

person a patient will consult regarding the

The system has been designed as a

health unit of St Vincent’s Hospital. The

PCEHR will be their GP,” Professor Jackson

“best of breed” solution, with localisations

study highlighted an over 50% decrease

said.

performed

achieve

in prescribing errors attributed to the

The Personally Controlled Electronic

MedChart is designed to replace paper

as

necessary

to

Prior to winning contracts in the NHS,

Research published by Westbrook et

integration with other clinical and patient

introduction of electronic medication

Health Record (PCEHR) is a system

administration systems.

management, a finding understood to be

proposed by Government that will allow

supported by as yet unpublished research

patients to view, maintain and apportion

by iSOFT as part of its 2009 acquisition

conducted in the Dunedin Hospital.

access to their own set of health records.

of Hatrix, a Canberra-based software

The MedChart solution was purchased

iSOFT Systems clinical director Dr

AGPN Chair Dr Emil Djakic stated that

development firm founded by Dr John

Dennis Armstrong said he would be

collaboration with the RACGP will ensure

Ainge and Dr Dennis Armstrong. Having

taking the learnings from the St Vincent’s

that patients and their primary healthcare

been pioneers in the Australian general

research to the UK, where he will be

providers will have access to relevant

practice clinical software market, the

leading the implementation and training

resources, education and tools to assist

two GPs identified a need for medication

local doctors for the next three months.

them to utilise eHealth technology.

management software in acute settings

“Working together on eHealth will

when hospitals started deploying the

enable us to engage more organisations

company’s GP solution, citing a lack

and associations to build the framework for

of products designed specifically for

the adoption of primary healthcare eHealth

hospitals.

in Australia.

improved

“The RACGP and AGPN are in a

Below – MedChart founders Dr Dennis Armstrong and Dr John Ainge, who sold their company Hatrix to iSoft in 2009.

Despite the recognised need for medication

management

position to strategically design the quality

in hospitals, Dr Ainge recalls that the

of work expected within the eHealth

organisational size of Hatrix prior to

agenda and by collaborating on the

its acquisition by iSOFT was a major

design, implementation and management

impediment,

of eHealth programs we can minimise

hospital customers unwilling to engage

duplication of resources and services.

a small business for the provision of such

solutions.

“The RACGP and AGPN are now inviting

“The Trusts are very excited and

with

many

potential

other organisations to engage with them on

how they can also be part of this strategic

didn’t have the leverage to attract business

collaboration,” Dr Djakic said.

from abroad despite our success, but now

“As a small, independent company we

12 Pulse+IT

www.pulseitmagazine.com.au

BITS & BYTES clinicians are lining up to be the first to try

prescribing, dispensing or administration

the new system,” Dr Armstrong said.

stage, which can result in the wrong

“As clinicians we understand the needs

medication, wrong or missed dose, with

of our peers and the processes required

potentially serious medical consequences

to help eliminate medication errors at the

for the patient.”

Speech Solutions revises voice recognition pricing Speech Solutions has announced a revised

Speech Solutions, “They don’t really care

pricing model for its MedSpeech voice

what happens after that as long as the

recognition system, which is currently

letter comes back efficiently.”

available to practices running Genie.

MedSpeech

The previous upfront cost for the

Speech Solutions is now offering to

Genie

users

for

solution — around $5500+GST per doctor

$199.95+GST per month with a 24 month

— proved an impediment to adoption

commitment. This arrangement allows for

for

notwithstanding

unlimited dictations to be made with no

the positive feedback the solution has

many

practices,

upfront costs. Typists and other practice

garnered from early adopters of the

support staff are able to install a version

system.

of the software that allows them to review

and edit dictations, but not dictate notes

As previously reported by Pulse+IT,

Genie released its interface to MedSpeech

themselves.

in late 2010. The MedSpeech dictation

window launched through Genie allows

pricing arrangements — introduced in

doctors to construct the body of a

March — have been successful in increasing

letter using their voice alone. Patient

the number of doctors using MedSpeech.

demographic details are already present

in the Genie letter template, negating the

are paying anything from $600 to $2000

need for this information to be dictated.

a month for transcription, so to be able

Corrections can be made by the doctor

to get their transcription done for $200 is

during the dictation process if required, or

almost surreal. They sign up for 24 months

left for a practice staff member to action.

but we have included a 45 day cooling off

The software is designed exclusively for

period to allow doctors to properly trial the

the medical industry and is built upon an

system.”

extensive medical vocabulary.

Unlike

other

voice

Mr Habib indicated that the new

“I’ve spoken to a few doctors and they

With Genie Solutions’ interface to

recognition

MedSpeech completed, Mr Habib is

solutions that require users to undertake a

now seeking to work with other clinical

prolonged period of training, MedSpeech

software

has the user dictate five minutes worth of

company’s potential user base. Mr Habib

prescribed text. The system is designed

indicated that HCN is working to integrate

to learn the nuances of the user’s voice

the MedSpeech solution with Blue Chip,

and vocabulary, with high accuracy levels

with other practice software solutions

achieved after 30-60 minutes of dictation.

slated for future consideration. Speech

“Realistically they [specialists] are

Solutions also plans to make MedSpeech

seeing 30-50 patients a day. They don’t

compatible with Macintosh workstations

want to fiddle, they just want to dictate,”

by the end of this year.

explains Rafic Habib, Managing Director of

www.pulseitmagazine.com.au

developers

to

expand

his

— Cara Sayer-Bourne

Pulse+IT 13

HealthBeyond The Interactive E-Health Experience

The Debut

1-4 August 2011, Brisbane at HIC 2011

The 2012 Roadshow

taking e-health to Australians in their cities and regional centres

HealthBeyond is an interactive experience which will take e-health to the Australian public. It will create a virtual e-health world and present Australia’s vision for e-health to a national audience; educate and inform consumers and health professionals as to the scope of e-health and showcase a healthcare future enabled by e-health. It will support and promote e-health literacy amongst healthcare consumers.

Do you have product(s) that you would like to showcase at HealthBeyond?

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Complete an expression of interest at www.healthbeyond.org.au

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Proudly supported by

BITS & BYTES

Orion Health nominated for six New Zealand Hi-Tech Awards

Global Health pursues allied health market

Orion Health has been named as a finalist

the contribution they have made as an

solution bundled with Monkey Software’s

in six categories in the New Zealand

industry leader.

flagship optometry solution, Optomate.

Hi-Tech Awards, including the Software

Product Award for their Electronic Health

been implemented in over 30 countries,

distributed with the next release of

Record (EHR) solution, Hi-Tech Company

including the US, Canada and the UK.

Optomate, and will ship to both new and

of the Year and Hi-Tech Company of the

“Whilst who becomes the winner is

existing users of the optometry software.

Decade.

always in the hands — and minds — of

Monkey Software has indicated that over

The New Zealand Hi-Tech Awards

the judges, we already consider the Orion

1000 optometrists will have access to the

recognise achievements in the New

Health EHR solution to be a winner. It is

ReferralNet software once the upgrade

Zealand technology industry. Companies

winning most major projects we bid for;

process has been completed.

enter themselves into the categories and

from Alaska to Singapore, Maine and

are then selected to be finalists by a panel

Louisiana, and we are not expecting this to

where

of international and local judges.

change as we pursue the myriad of deals

messaging solutions is almost universal

coming up in the short term.

— largely driven by electronic pathology

“Being nominated as a finalist is

Global Health and has announced a deal that will see its ReferralNet messaging

Orion Health’s other solutions have

The ReferralNet software will be

Unlike the general practice market the

penetration

of

secure

always another validation that we are on

be

and radiology reporting — the level of

the right track, but to be nominated in six

flexible and configurable, and able to

computerisation and the uptake of secure

categories is truly outstanding,” says Ian

meet a multitude of variations. Australia’s

messaging by allied health professionals is

McCrae, CEO of Orion Health, “What it

emphasis on ensuring consumers have

low by comparison.

does show is that the Orion Health team

the ability to access their medical records

is excellent across many disciplines, from

as well as control privacy settings of the

Strategic Business Development Manager

making sure we attract and retain the

records, is an example of the regional

Alby Creevey said: “Global Health is

best people, to creating great software

variations a good vendor must take into

committed to supporting the national

that puts our customers first and improves

account in developing an EHR solution.

eHealth

patient health.”

Our highly flexible solution ranges from

aligned with the Australian Government’s

“Great

technology

needs

to

In

a

statement,

agenda.

Global

Health’s

ReferralNet

is

well

This is the first year that the NZTE

high level national infrastructure through

standards and specifications for eHealth

Hi-Tech Company of the Decade award will

to ensuring the local GP is at the forefront

secure messaging. We are excited by the

be presented. Previous Supreme Award

of the care relationship.”

opportunity that allows us to provide secure

winners are invited to be finalists by the

messaging delivery services to over 1,000

panel of judges based on the company’s

place on May 6 in Wellington.

continued success and growth, as well as

The New Zealand Hi-Tech Awards take — Cara Sayer-Bourne

Australian optometrists.”

In a related development, Global Health

has also announced plans to deploy its Below – Orion Health CEO Ian McCrae, whose company has been nominated for six New Zealand Hi-Tech Awards.

ReferralNet messaging solution throughout selected HEARINGLife clinics in Victoria to better track incoming referals and facilitate the electronic transmission of Audiology reports to general practitioners.

HEARINGLife’s

National

Marketing

Manger, Duncan Armour, said “...we can also send all details of the appointment back to the GP so they are kept in the loop the whole time. From a patient experience point of view, ReferralNet makes the process easy and not at all confusing, which for our demographic is important.”

www.pulseitmagazine.com.au

Pulse+IT 15

BITS & BYTES

Best Practice holds inaugural Summit, debuts new version

D I SC OV E R SOMETHING NEW

iPhone app Available on the

App Store or call 1800 800 629

Speaking at the launch of the inaugural

concerns about the potential liability the

Best Practice Summit, company founder,

Medicare Australia developer contracts

Dr Frank Pyefinch, previewed a selection of

impose on software vendors.

new features included in the latest version

of Best Practice. Best Practice is a clinical

provider identifiers are also included

and practice management solution which

in the new build. Unlike patient IHIs,

counts over 1400 Australian general and

practices and providers are required to

specialist practices as customers.

apply for their identifier numbers through

The new version, dubbed “Build 532”

Medicare Australia and the Australian

includes many enhancements ranging

Health Practitioners Regulation Authority

from simple inclusions such as the addition

(AHPRA) respectively.

of fields for postal address details in the

patient demographic screen, through

announced by Dr Pyefinch, the revamped

to

more

comprehensive

Fields for practice identifiers and

Of the new features in Build 532

functionality

Document Scanning Module garnered the

including a new Document Scanning

most interest from Summit attendees.

Module.

The software now supports a workflow

The Skin Module in the new version

that allows practice staff to bulk scan

of Best Practice includes a wider range of

documents and subsequently allocate

drawing templates and the appointment

these documents to clinician ‘inboxes’.

book now permits small icons to be

Clinicians can then review and action these

displayed in each cell to more easily

documents

differentiate appointment types.

a process that historically required the

clinician to review documents in hard copy

Acknowledging ongoing government

electronically,

streamlining

eHealth initiatives, the software now

prior to them being scanned.

allows practices to insert patient Individual

Healthcare Identifiers (IHI) into the patient

version of Best Practice now allows

demographic screen. These numbers were

users to view PDFs within the program,

allocated to all Australians by Medicare

negating the need for an extra program

in 2010 to simplify the linking of data

— like Adobe Acrobat — to be launched.

between

systems,

Leveraging this interface improvement,

however they have not yet been used on

Build 532 allows for the display of

any meaningful scale pending requisite

pathology results containing graphical

development by software vendors.

content.

disparate

clinical

In a related improvement, the new

In

collaboration

with

both

After entering a patient’s 16 digit IHI,

Healthscope and HealthLink, Dr Pyefinch

the software performs a basic check to

has developed this feature to allow users

ensure the number is a valid IHI. Future

to switch between displaying traditional

versions of the software will allow practices

text based pathology results and a more

to

richly

automatically

retrieve

and

verify

formatted

PDF

representation

patient IHIs from the Medicare Australia

containing graphs, diagrams or photos.

Healthcare Identifier Service, negating the

The underlying ‘atomic’ data imported

need for practice staff to have to manually

from the HL7 clinical message is retained,

enter such numbers. Automatic retrieval

which allows the system to intelligently

of IHIs has been shunned by most medical

process such information in ways that PDF

software developers to date, many citing

does not support.

16 Pulse+IT

www.pulseitmagazine.com.au

BITS & BYTES

Build 532 includes an expanded range

Concluding

the

event, his

Frank

Pyefinch

with other PDF resources, can now be

development priorities for the remainder

displayed within Best Practice. A library

of 2011. Amongst these is the building of

of 3D video animations are also included

interfaces to various EFTPOS terminals

in the new version. Published by Push Pull

developed by Tyro, the National Australia

Medical, these visual patient resources

Bank and the Commonwealth Bank. Such

have been packaged under Best Practice’s

interfaces would negate the need for

existing subscription pricing structure.

practice staff to have to manually re-key

Finally, the new version of Best

payment amounts into their EFTPOS

Practice includes integrated spell checking

terminals, a process which is susceptible

functionality in the Word Processing

to both transcription error and fraud. Dr

Module, which is typically used by doctors

Pyefinch has also flagged an intention to

to write referral and other letters.

integrate Best Practice with a range of

ECG and Spirometer devices.

All delegates were presented with a

outlined

Dr

of patient education sheets, which along

company’s

disk containing Best Practice Build 532 at

the conclusion of the three day event. The

present in Build 532, Dr Pyefinch flagged

official widespread rollout of the software

an intention to engage with the National

followed in the coming days, with the

E-Health Transition Authority (NEHTA) to

update distributed via the Best Practice

incorporate many of its key specifications.

online software update service, and via

Amongst these is an interface to the

DVD on request.

Medicare Australia Healthcare Identifier

During his presentation, Dr Pyefinch

Service, SNOMED CT functionality, and

indicated that Best Practice is currently

development related to the Government’s

able to convert data from MD2, MD3,

Personally Controlled Electronic Health

MedTech32

Record (PCEHR) system.

and

Promed

Clinical.

A

As highlighted by some enhancements

conversion routine for practices looking

to convert data from Practix is also under

Practice Summit are available at the

A selection of photos from the Best

development and is due for release in the

Pulse+IT

coming weeks.

facebook.com/pulseitmagazine.

Facebook

Page:

http://www.

Below – Dr Frank Pyefinch presenting a session at the innaugural Best Practice Summit, which was held in Bargara (near Bundaberg) in mid-March.

www.pulseitmagazine.com.au

Pulse+IT 17

BITS & BYTES Pavilion Health releases PICQ version 7 Pavilion Health has announced the release of Performance Indicators for Coding

HISA to host inaugural Data Governance Conference in May

Quality (PICQ 7.0) Enterprise and Local

The

of

feature plenary sessions presented by Jeff

Health Network versions.

Australia and its Healthcare Management

Schmitt (Harvard Pilgrim Health Care,

Health

Informatics

Society

PICQ is a set of indicators which

Informatics and Computing (health-mic)

USA); John Zelcer (National E-Health

identifies records in admitted patient

special interest group will hold its inaugural

Transition Authority); Prof Louisa Jorm

morbidity data-sets that may be incorrectly

Data Governance Conference in May.

(University of Western Sydney); Michael

coded

The first Australian event of its kind, the

Steine (NCS); David Kalisch (Australian

Standards. The software looks at the

conference will focus on ‘Data Governance:

Institute of Health and Welfare); Grant

disease and procedures codes used in a

Concepts, Current Concerns and Emerging

Robinson (International Association for

hospital data-set record, and identifies

Issues’, ‘Data Governance in Practice’, and

Information and Data Quality) and Stan

inconsistencies.

‘Data Access and Availability’.

Capp (InterSystems).

based

on

Australian

PICQ

was

Coding

originally

developed by the University of Sydney and

was sold to Pavilion Health last year.

health‑mic special interest group founder,

the conference will feature a multitude of

The release of PICQ 7.0 provides

Dr Chris Bain, believes the increasing

concurrent sessions grouped under the

managers with increased benchmark and

prominence of these themes necessitates

themes ‘Data Governance Framework’,

performance reporting that offer greater

the event. “I think the recent discussions

‘Data Quality’, ‘Stakeholder Perspectives’,

support, with graphics across nine filters

about

‘Managing Access’, and ‘Problems in

that

specific

perspective, and the ongoing slow burning

Health Systems’.

reporting requirements. This includes an

of eHealth have come to a point where

enhanced identification and correction

those of us who are working in data can

Robert Hillard, Janette Bennett, Janaka

system of potential coding errors, the

really see a need to focus in and specialise

Dissanayake, Felicity Flack, Ronald Hicks,

measurement of data accuracy throughout

in this area. Although a lot of these

Mark Matthews, David Millichap, Ross

time, benchmarking across coders, and the

activities have been happening in different

Nable, Judy Evans, Pat Grantham, Jennifer

identification of training requirements for

ways, it’s more about forming a common

Heath, David Stokes, Emma Hossack,

coders and clinicians. The software uses

understanding of the breadth of activity

Simon

more than 1200 queries that can set off 300

under a data governance banner,” said Dr

Patricia Williams, Laurie Hawkins, Steve

indicators, supporting the seventh edition

Bain.

Toal, Paul Macdonald, Susan Smith, Sue

of ICD-10-AM.

Data

Evans, Neville Board, Paddy Dewan,

“The quality of disease and hospital

Governance as, “the leveraging of people,

Alexandra Gorelik, Chris Van Leuvan,

procedure is growing in importance,”

process and technology in a systematic

Jannette Collier, Neville Board, Jon Patrick,

explains

and

way so that organisations can use data

Chris Farmer, Aditya Ghose, Mary Lam,

Programs Manager of Pavilion Health.

as a corporate asset,” believes that Data

Timothy Moon and Naomi Rafael.

”Hospitals increasingly want to use their

Governance is becoming increasingly

data to improve decision making and

relevant as the debate over the sharing of

three concurrent workshops focusing

resource management in the provision of

health records comes to the forefront.

on ‘Data Governance at the Coalface’

health care services.”

“It is already important in many

(Susan Smith), ‘Data Governance for

accommodate

Joe

customer

Berry,

Operations

Director

Dr

new

Bain,

of

the

models

who

conference

from

a

and

federal

describes

In addition to the plenary sessions,

Presenting

these

McBribe,

sessions

Tatiana

are

Stebakova,

The conference will conclude with

Features to be implemented into PICQ

ways from a corporate reporting point.

Managers’ (Dr Campbell Miller), and ‘Data

throughout the year were identified by

Elements of it have already been in finance

Governance:

workshops, under the guidance of the

departments and parts of audits programs.

information

PICQ Advisory Board. The Advisory Board

It’s just trying to — from an organisational

Watson).

is composed of government organisation

point of view — give it a home and give it a

representatives, health industry ‘thought

lightning rod for action,” said Dr Bain.

Conference takes place on May 19-20 in

leaders’, clinicians, researchers and end

Melbourne, with delegate registration now

users.

by Dr Bain and Fran Thorn (Secretary, — Cara Sayer-Bourne

The conference, which will be opened

Department of Health, Victoria), will

18 Pulse+IT

The

safely for

providing

quality

health-mic

care’

quality (Fiona

Data Governance

open.

— Cara Sayer-Bourne

www.pulseitmagazine.com.au

Clinical decision making unleashed Allowing clinicians to make timely and informed decisions, the iSOFT Mobility Suite provides instant access to clinical patient information from underlying systems, at the point of care or remotely. For example: • Immediate access to diagnostic results and PACS images

• Availability of up-to-date patient history and current medications • The ability to view dynamic patient lists

Ava il

able for immed iat iSO users FT’s of ely web PAS

• Remote approval of patient treatment Evidence both locally and overseas indicates that the implementation of clinical systems needs to be both incremental and pragmatic to succeed. Importantly, ease of use and time saving benefits to clinicians are paramount for user uptake.

The iSOFT Mobility Suite utilises Apple’s mobile device technology to provide clinicians with access to patient information through the intuitive and increasingly familiar interface, which provides for more natural data entry and viewing capabilities.

To see the iSOFT Mobility Suite in action view the video at:

www.isofthealth.com/MobilitySuite.aspx Or to read the iSOFT Mobility Suite brochure visit:

www.isofthealth.com/MobilitySuiteBrochure.aspx

E ANZMarketandSolutions@isofthealth.com P 02 8251 6700

iSOFT Mobility Suite is an independent solution and has not been authorised, sponsored, or otherwise approved by Apple Inc. iPad and iPhone are a trademark of Apple Inc.

Cabrini Health now rolling out iSOFT Mobility Suite for doctors to access clinical results and patient information via iPads.

BITS & BYTES

Rural and Remote Telehealth Conference coming to Cairns

Vensa Health appoints new executives Vensa Health has appointed two new executives, with Cornelius Dirven taking

The Health Informatics Society of Australia

of

Networking

over the position of National Sales Director

(HISA) will hold their inaugural Rural and

Foundation of India, will address the

and Anossis Oliveira commencing as

Remote Telehealth Conference in May.

Apollo

Telemedicine

conference on telehealth issues. Dr Edward

General Manager ICT.

a

Brown has won a number of awards for his

scientific society for those interested in

work in telehealth, being chosen as one

Mobile Health (mHealth) provider. Their

health informatics. The event, organised

of 25 ‘Tranformational Canadians’ by the

‘Txt2Remind’ practice-patient messaging

by leaders in the telehealth industry,

Globe and Mail, CTV and Cyberpresse in

system assists primary and secondary

brings together a range of national and

2010. Professor Ganapanthy is a pioneer

health providers to send mobile text

international guest speakers to discuss the

of telemedicine in India, assisting in the

message

various themes of the conference, which

deployment of 10,000 telehealth end

health promotion messages. The system is

include: ‘The Clinical User Experience’,

points.

used by 500 GP surgeries and throughout a

‘Clinical Workflow Integration and EHR’,

number of District Health Boards.

‘National Broadband Network Design

entitled ‘Practical Aspect of Telehealth’.

and Opportunities’, and ‘The Practice of

The 90 minute session will cover outreach

Vensa Health, is pleased with his company’s

Telehealth’.

services and explain how to establish

recent appointments, explaining: “Our

Established

in

1992,

HISA

is

The conference features a session

Vensa Health is an Auckland-based

appointment

reminders

and

Ahmad Jubbawey, the Chief Executive of

Michael Gill, the chair and driving

video services in clinics, featuring a

vision is to be a leading player in the global

force behind the conference, believes that

sophisticated, real-time demonstration of

mHealth market. Having the right team on

telehealth in a rising agenda item in health

the use of telehealth video services.

board will help us achieve our goal. With the

circles, stating, “the treatment of image

new appointments we hope to improve our

for clinical, diagnostic and consultative

Geoffrey

purposes is rapidly increasing. There’s a

with the Department of Health and

business problems in the sector.”

whole range of telehealth services out

Ageing, the Department of Broadband

there and we thought it was time to pull

Communications and Digital Economy,

the health sector, working in both Holland

together the interest groups and started to

and National E-Health Transition Authority

and New Zealand. Mr Oliveira founded a

explore a more strategic approach to what

(NEHTA). The hypothetical will deal

software development company in Brazil,

is going on.”

with healthcare and the government’s

selling the company in 2003 and migrating

Event organisers will also facilitate a Robertson-style

hypothetical

market-share, as well as solve fundamental Mr Dirven has spent his entire career in

positioning in the sector, as well as the

to New Zealand.

necessitates the conference — the first

NBN.

of its kind in Australia — with “30 leading

working in their new roles and helping to

lights in the telehealth sphere; people from

item numbers for video‑based telehealth

address the needs of the healthcare sector.

just about every state and every health

will be announced during the conference.

jurisdiction.”

He explains, “The previous issue was that

about healthcare and increasing efficiencies

James Fergerson from the National

specialists had access to item numbers and

in the sector using smart IT solutions. I’m

Health Service of Britain, and Professor

could therefore have their services paid

excited to join the team at Vensa Health

John Wilson from Monash University

for, but a GP couldn’t be remunerated on

and look forward to making a positive

will be key note speakers at the event.

the same telehealth consult. That was then

contribution not only to the company but

Professor Wilson recently appeared on

modified and changed by the government

to the sector also.”

ABC Television’s ‘Four Corners’ program,

to allow both endpoints to charge an item

discussing

number.”

rewarding area,” says Mr Anossis, “ICT

Network (NBN).

The Rural and Remote Telehealth

can help make some real healthcare

Other speakers such as Dr Edward

Conference will be held on May 29-31

improvements and Vensa Health is a

Brown, CEO and founder of the Ontario

at the Cairns Convention Centre, with

company that is very focused on improving

Telemedicine

delegate registration now open.

well-being.”

It is such reasons that Mr Gill believes

the

National

Network

Broadband

(OTN),

and

Professor K. Ganapanthy, the President

www.pulseitmagazine.com.au

Mr Gill is hopeful that the new Medicare

— Cara Sayer-Bourne

Pulse+IT 21

Both executives are looking forward to

Mr Dirven explains, “I am passionate

“mHealth is a very exciting and

— Cara Sayer-Bourne

BITS & BYTES eJHI releases 9th issue The Electronic Journal of Health Informatics (eJHI) has released its latest issue, Volume 6, Number 1 (2011).

Communicare Systems and MMEx announce plans for partnership

Guest-edited by Vitali Sintchenko and

Communicare Systems and The University

company’s products.

Peter Croll, the edition is a special issue on

of Western Australia’s Centre for Software

the 2009 Health Informatics Conference

Practice (CSP) have announced plans to

it is a much greater standardisation across

(HIC). It includes an editorial on the special

collaborate on what they are describing as

the whole Aboriginal health sector in terms

proceedings of the conferences with papers

a next generation health platform. The two

of the process and the protocols. The

on a wide range of health informatics topics:

organisations have signed a memorandum

collaboration will involve close consultation

“Building SNOMED CT References Sets for

of understanding to formalise a negotiation

with user groups and will provide greater

Use as Interface Terminologies” (P. Hansen,

process that may ultimately lead to the

scope and opportunity for health service

M.Giermanski, M. Dujmovic, J. Passenger

release of a unified software offering.

and affiliate body representation,” said Mr

& M. Lawley), “A Preliminary Investigation

Dunstan.

of an Integration Tool to Improve Access to

the University of Western Australia said a

Information Resources in Clinical Software”

memorandum of understanding between

proposed arrangements, customers would

(J. Calabretto), “Patients and Health Care

the CSP and Communicare Systems

not be beholden to the operations of a

Providers’ Concerns about the Privacy of

would bring together new technologies

single company as software products

Electronic Health Records: A Review of

to improve patient care, particularly in

would be owned by the not-for-profit

the Literature” (N. Shaw, A. Kulkarni & R.

remote areas and in the field of Aboriginal

entity, which would be free to contract out

Mador), “A Preliminary Investigation of

health.

ongoing development and maintenance.

Complex Adaptive Systems as a Model for

Explaining Organisational Change Caused

a web-based eHealth platform used for

self‑determination and control over the

by the Introduction of Health Information

secure information sharing and clinical

way the IT system is developed. They

Systems” (K. Diment, P. Yu & K. Garrety),

patient management.

have the certainty that we’re not going

“Intensive Care Unit Nurse Workflow During

The Communicare patient healthcare

to be taken over by a company that takes

Shift Change Prior to the Introduction

system was designed for the use of primary

the product off in a direction that doesn’t

of a Critical Care Clinical Information

healthcare workers and nurses, with the

interest our customers,” said Mr Dunstan.

System” (N. Shaw, M. Ballermann, R.

software used extensively in Aboriginal

Hagtvedt, S. Ho, D. Mayes & N. Gibney),

community controlled health services

combination of resources from both

“Benefits Measurement from the Use of an

across Australia, as well as in other primary

the CSP and Communicare would allow

Automated Anaesthetic Record Keeping

care organisations.

the new entity to deliver customers an

System (AARK)” (Sue McLellan, M. Galvin &

updated technology platform.

D. McMaugh), “Developing Measurements

the University of Western Australia and

of the Quality of Electronic versus Paper-

Communicare will both be contributing

the functions of MMEx that are missing

based Nursing Documentation in Aged

their intellectual property to the new

in Communicare. Things like electronic

Care Homes” (N. Wang, P. Yu, D. Hailey & D.

venture, with the ultimate goal of creating

medication management and the ability to

Oxlade), “Efficacy of Electronic Discharge

a national, not-for-profit organisation

synchronise and share patient information

Summaries: A Case Study Demonstrating

owned

through a central record. MMEx also has

Early Results at Two Hospitals” (J. Forsythe,

organisations. Communicare Systems and

capabilities for telehealth.

A. MacDonald, M. Strachan & D. Evans),

UWA are currently working with several

“A SpatioTemporal Model for Seasonal

peak bodies that represent Aboriginal

to provide MMEx and Communicare’s

Influenza” (S. Edlund, M. Bromberg, G.

health services in an effort to establish the

service excellence and build on the

Chodick & J. Douglas) and “Dynamic

new entity.

reputation

Programming Algorithms for Discovery

Communicare’s Managing Director,

consumers while bringing innovation and

of Antibiotic

Brian Dunstan, overviewed the benefits of

strong research ties through the Centre,”

the proposed collaborative arrangements

says Professor Glance.

Resistance

in

Microbial

Genomes” (M.E. Helal & V. Sintchenko).

— Cara Sayer-Bourne

Associate Professor David Glance of

The CSP’s flagship product, MMEx, is

Under the proposed arrangements,

by

Aboriginal

health

sector

for both existing and potential users of his

22 Pulse+IT

“One thing that I hope will come out of

He went on to stress that under the

“It gives them more security and

Professor Glance indicated that the

“The aim would be to bring across

“The combined operation will continue

of

working

closely

with

— Cara Sayer-Bourne

www.pulseitmagazine.com.au

australia’s premier & largest e-health conference

hic

1 - 5 august

brisbane

2011

the transformative power of innovation www.hisa.org.au/hic2011

BITS & BYTES

Ascribe completes deployment of Symphony emergency department solution in Eastern Health region

Ambulance Service upgrades Case Management System The Ambulance Service of NSW is extending its use of Resolve’s Case Management System with the inclusion of a new solution to address the processes of the Death and

Ascribe has announced the ‘go live’ of

and the doctors, whereas nurses tend to

Disability Unit (D&D). This follows the

its Symphony Emergency Department

prefer using a stationary PC, except when

use of the system within the Professional

solution in the Maroondah Hospital. The

they are doing shift handover,” said Ms

Standards and Conduct Unit (PSCU) of the

hospital is the third in the Eastern Health

Laracuente.

Ambulance Service.

region of Victoria to install the solution,

following deployments at Box Hill Hospital

smartphone to interact with Symphony

and owned global provider of workflow

in March 2010 and Angliss Hospital a

stated: “The application is user-friendly so

management

month later.

Dr

Archer,

who

uses

his

HTC

Resolve is an Australian operated solutions.

becoming proficient at using it in real-time

Management

workflow was quite painless and simple,

interested parties’ information to be

patient triage and tracking, clinical orders,

and also faster than we thought it would

attached to a case, and can also handle

bed management, progress notes and

be. Ascribe’s Emergency Department

the storage and retrieval of emails and

clinical documentation, and electronic

solution is now a valuable tool in our

documents relating to the case. The system

discharge summaries, a feature set that

clinical patient management, the system

has the ability to create documents with the

has been well received by both clinicians

also provides us with the data we need to

information gathered and exporting these

and nurses at Maroondah Hospital.

manage the department and patient care

to Microsoft Word. Documents generated

more efficiently.”

are automatically stored in the Resolve

The

Symphony

solution

“The Ascribe Emergency Department

Manager

department at Maroondah and at the

Department was also pleased with the

other two Eastern Health sites of Box

workflow changes brought about by the

according to the matters being dealt

Hill

Symphony rollout.

with, allowing the information to be

“The nurses are now recording all

filtered and presented as required by the

Department Director at Maroondah. “The

of their triage, patient assessment, care

user. All parties are notified of any new

implementation and go-live went very

planning and nursing notes electronically

changes or actions. In addition, Resolve’s

smoothly and staff are impressed with

within the Ascribe solution. The use of the

Case Management System features an

the system. The support given from the

iPad mobile device for handover is great

in-built permissions system, which defines

Ascribe implementation team and Eastern

and a very useful timesaver. The transition

and restricts users’ activity by role and

Health IT staff was great.”

to Ascribe was well planned with a high

responsibility, to shield selected users from

Symphony has been deployed in the

level of end-user input to the configuration

sensitive or inappropriate data.

hospital using Citrix, which allows the

and workflow design. This made the

software to be accessed using a range

go-live quite seamless and even for those

Management System will replace the

of mobile devices, as well as with more

who are not very tech savvy,” stated Ms

existing spreadsheet used to manage

traditional computing platforms. Toni

Vermeulen.

and

Laracuente, Head of Ascribe’s Point of Care

Division indicated that hospital staff are

health

Ascribe’s

D&D Unit’s data capture and management

making good use of the various platforms

Symphony solution, with the Maroondah

requirements. It will also provider additional

Symphony is being made available on.

installation

benefits that will ensure the timely

and

Peter

Angliss Archer,

Hospital,” Emergency

at

Nurse

Maroondah

Unit

platform, along with any correspondence

the way we want to work, both in our

Dr

Vermeulen,

all

Hospital

Lisa

for

application has been configured to suit

said

Ms

allows

Case

includes

System

Their

Emergency

Eastern Health is the fourth Victorian service

to

following

deploy

deployments

in

related to the case.

The

The

system

move

track

categorises

towards

requests,

a

the

case

Case

implementing

a

configuration of Resolve that meets the

department,

the Barwon Health (Geelong Hospital),

completion of each step in the process.

mobile devices are supplementing, rather

Southern Health (Monash Medical Centre,

than replacing larger computers. They

Dandenong Hospital and Casey Hospital)

for the Health and Wellness Unit, and Risk

are really good for staff that are mobile

and Melbourne Health (Royal Melbourne

Management Unit in the future.

between patients, such as bed managers

Hospital) regions.

“In

the

emergency

www.pulseitmagazine.com.au

Further rollouts of Resolve are planned

— Cara Sayer-Bourne

Pulse+IT 25

EVENTS MAY

JUNE

OCTOBER

The 3rd Annual GP Super Clinics Summit 5 May - 6 May Brisbane, QLD P: +61 2 9080 4300 W: www.informa.com.au

HISA NSW Branch Meeting - Clinical Excellence Commission and AGM 23 June Sydney, NSW P: +61 3 9388 0555 W: www.hisa.org.au/nsw

Royal Australian College of General Practitioners GP 11 Conference 6 October - 8 October Hobart, TAS P: +61 3 8699 0414 W: www.gp11.com.au

AUGUST

2011 Royal Australasian College of Medical Administrators Annual Conference 12 October - 14 October Melbourne, VIC P: +61 3 9824 4699 W: www.racma.edu.au

12th International HL7 Interoperability Conference 13 May - 14 May Orlando, USA P: +1 734 677 7777 W: www.ihic2011.org HL7 International 16 May - 20 May Orlando, USA W: www.hl7.org Data Governance Conference 19 May - 20 May Melbourne, VIC P: +61 3 9388 0555 W: www.hisa.org.au/data-governance General Practitioner Conference and Exhibition 20 May - 22 May Sydney, NSW P: +61 2 9211 7454 W: www.gpce.com.au RACP Congress 2011 22 May - 25 May Darwin, NT P: +61 3 9645 6311 W: www.racpcongress2011.com.au 2nd Annual Managing Ward Finances & Budgets Conference 23 May - 24 May Brisbane, QLD P: +61 2 9080 4300 W: www.iir.com.au Rural and Remote Telehealth Conference 29 May - 31 May Cairns, QLD P: +61 3 9388 0555 W: www.hisa.org.au/telehealth eHealth@CeBIT 31 May - 2 June Sydney, NSW P: +61 2 9280 3400 W: www.ehealthexpo.com.au

26 Pulse+IT

AGPN eHealth Conference 1 August - 2 August Brisbane, QLD P: +61 2 6228 0800 W: www.agpn.com.au HealthBeyond 1 August - 4 August Brisbane, QLD P: +61 3 9388 0555 W: www.healthbeyond.org.au HISA Health Informatics Conference (HIC2011) 1 August - 5 August Brisbane, QLD P: +61 3 9388 0555 W: www.hisa.org.au/hic2011 HISA NSW Branch Meeting - Health Informatics Research 18 August Sydney, NSW P: +61 3 9388 0555 W: www.hisa.org.au/nsw

SEPTEMBER HIMAA National Conference 2011 20 September - 23 September Melbourne, VIC P: +61 2 9887 5001 W: www.himaa.org.au HIMSS AsiaPac 2011 20 September - 23 September Melbourne, VIC P: +65 9848 5259 W: www.himssasiapac.org HISA NSW Branch Meeting - Electronic Medical Record 6 October Sydney, NSW P: +61 3 9388 0555 W: www.hisa.org.au/nsw

Australian Association of Practice Managers National Conference 18 October - 21 October Perth, WA P: +61 3 6231 2999 W: www.aapm.org.au 9th National Allied Health Conference 23 October - 25 October Melbourne, VIC P: +61 2 9265 0700 W:www.alliedhealthconference.com.au

NOVEMBER General Practitioner Conference and Exhibition 11 November- 13 November Melbourne, VIC P: +61 2 9211 7454 W: www.gpce.com.au Australian General Practice Network National Forum 2011 16 November - 19 November Melbourne, VIC P: +61 2 6228 0835 W: www.gpnetworkforum.com.au 10th Annual Health Informatics New Zealand Conference and Exhibition 23 November - 25 November Auckland, New Zealand W: www.hinz.org.nz

Online Calendar

To view a comprehensive list of Australian, New Zealand and International Health IT, Health, and IT events, visit the Pulse+IT website: http://bit.ly/gFr0Vk

www.pulseitmagazine.com.au

Incorporating HIMAA 2011 National Conference

The place to connect with global leaders who are advancing healthcare through IT.

The HIMSS AsiaPac 2011 Conference & Leadership Summit, incorporating the HIMAA 2011 National Conference, will provide for unlimited networking with the best minds in health care and technology.

For both attendees and exhibitors, this provides tremendous opportunities to exchange ideas and stay on top of the latest developments in technology, policy and industry practice. Save the date!

20-23 September 2011 melbourne Convention and exhibition Centre www.himssasiapac.org/11 For inquiries Mr. Gabriel Sim, HIMSS Asia Pacific | +65 9299 0802 | gsim@himss.org For HIMAA Corporate members Ms. Rose Wong, HIMAA | +61 2 9887 5001 | himaa@himaa.org.au

Diamond Sponsor

Gold Sponsor

Supported by

NEHTA

eHealth takes shape across Australian communities In March 2011 the Commonwealth Government announced another nine eHealth sites across Australia (in addition to the three sites announced in late 2010)

Peter Fleming Chief Executive NEHTA

for the national Personally Controlled Electronic Health Records (PCEHR) project. This is a significant step forward on the road to a nationally integrated eHealth system.

It is an exciting time for the development of

eHealth in Australia, with eHealth taking shape across Australian communities.

The nine sites were selected following a competitive

process by the Department of Health and Ageing and the National E-Health Transition Authority (NEHTA).

All organisations managing these projects are now in the process of developing their implementation plans to ensure their work programs clearly meet national

coverage across the Australian healthcare sector,

objectives. It is worth taking a look at what these lead

deliver early benefits and demonstrate new and

sites are expected to achieve.

innovative concepts.

The approach to building a national PCEHR

Together, the nine sites offer:

system is twofold. Based on a combination of ‘top

• Targeting of a broad number of key groups such

down’ national initiatives and ‘bottom up’ lead

as mothers and newborns, aged care, people with

implementation projects the approach allows for the

chronic conditions, palliative care and Indigenous

delivery of tangible eHealth project outcomes on the

populations.

ground across Australia — critical for building clinical, consumer and political support for the national PCEHR

• Coverage of all Australian states and territories and rural and regional communities.

agenda — whilst at the same time ensuring a focus on

• Inclusion of a number of healthcare sectors —

the national frameworks and actions required to deliver

public and private, primary care, aged care and

a national electronically interoperable healthcare

private specialists.

system.

• Broad coverage of the vendor community, with

The key objectives of the eHealth sites are to

vendors comprising the majority of the market in

achieve national demographic coverage, widespread

acute and primary care involved in one or more of

Author Info

the sites.

Peter Fleming is the Chief Executive of the National E-Health Transition Authority Limited, which was established by the Australian Commonwealth, State and Territory governments on 5 July 2005 to develop better ways of electronically collecting and securely exchanging health information. NEHTA is the lead organisation supporting the national vision for eHealth in Australia and is jointly funded by the Australian Government and all State and Territory Governments.

• Projects which test and support broad consumer engagement and registration.

• The broad set of functions that the PCEHR will need to provide so that lessons and foundations can be derived to support the development of national infrastructure. In addition to Health Summaries, Discharge Summaries

28 Pulse+IT

and

Medications,

the

www.pulseitmagazine.com.au

Brisbane South General Practice Division

Northern Territory Department of Health and Families

Will develop a substantial major capital city PCEHR system and

Will provide the residents of the Northern Territory with

will bring two Divisions of General Practice onboard (Brisbane

access to a PCEHR-aligned shared electronic health record.

South and Ipswich & West Moreton) and public and private

In particular the project will focus on indigenous communities

hospitals, allied health and GPs. The project will target people

and also extend into six East Kimberley hospitals in Western

with disabilities and their carers, war veterans and war widows

Australia and to remote Aboriginal Community Controlled

and children commencing school.

Health Services in South Australia.

Greater Western Sydney eHealth Consortium (NSW Health)

St Vincent’s and Mater Health Sydney

Will focus on high priority consumer groups in the Greater

hospitals and other health professionals through the delivery

Western Sydney region, including mothers and babies, aged

of key PCEHR components including GP health summaries, GP

and chronic and complex diseases, Aboriginal medical services

referrals and interoperability between two major Australian

and the culturally and linguistically diverse population. The

shared electronic health record solutions, Smart Health

project will include secure messaging and eReferral programs

Solutions and Precedence Healthcare.

Will improve clinical communication across the participating

and a medical imaging repository.

Cradle Coast Electronic Health Information Exchange Medibank Private

Targets aged and palliative care patients and their families,

Will implement a PCEHR and Personal Health Diary called

palliative care medical specialists and clinical nurse consultants

‘Health Book’. The solution will initially target all customers and

in north-west Tasmania.

their providers enrolled in Medibank’s Health Management and

Mater Misericordiae Health Services Brisbane

Chronic Disease Management programs.

Will implement a PCEHR for maternity patients and newborn

FRED IT MedView Project

babies for the Brisbane area.

This is the first time a project will provide a solution that will allow Australian clinicians to see a combined list of prescribed

Calvary Health Care ACT

and dispensed medications regardless of how many different

Strong focus on aged and palliative care and will test existing

doctors and pharmacies the patient has attended.

eHealth solutions under the new national PCEHR foundations.

Figure 1 – The nine new locations selected to lead the roll-out of eHealth records

portfolio

overview of the nine sites.

the PCEHR across consumers and key

Health Diary and Consumer Portal

also

includes

Personal

One of the most important aspects

healthcare sectors so they are in essence

implementations.

about the approach is that these sites

serving as a catalyst for kicking off eHealth

• Delivery of early benefits in a range of

will help lead the way in developing and

around the country.

areas, including improved coordination

informing future planning of eHealth,

of care, enhanced continuity of care,

improving technology and identifying what

Further Information

improved medication management and

works well and what could work better.

Further details on the PCEHR and lead

the delivery of sustainable components

implementation sites is available from

which will enable later integration with

sites on their implementation planning.

http://www.yourhealth.gov.au

the national infrastructure.

The sites will deliver a solid foundation

NEHTA website: http://www.nehta.gov.au/

Figure 1 shows a more detailed

for the future national deployment of

ehealth-implementation/pcehr-lead-sites

www.pulseitmagazine.com.au

NEHTA is working closely with these

and

the

Pulse+IT 29

MSIA

Who Cares? Empathy, Respect, Regard and the PCEHR

Dr Geoffrey Sayer BSc(Psychol), MCH, PhD President, MSIA president@msia.com.au

If we consider the Personally Controlled Electronic

does seem that there is little regard for what the PCEHR

Health Record (PCEHR) it appears that many have

was set out to achieve — empowerment of people with

forgotten the impact that empathy, regard and respect

empathy, respect and regard. If we don’t consider these

have on people’s health and healthcare delivery. We

qualities from the outset, the participation levels will be

often forget that for many people who are having

low and will not deliver cost effective benefits, leading

health related issues that it is the feeling that someone

to the scuttling of further eHealth funding. While no

cares that brings so much value to the healthcare

one wants to throw good money after bad, if we don’t

experience. Healthcare is dominated by technology

seize the opportunity and use the funding effectively we

with medicines; surgical procedures; scanning devices;

will not deliver the most tangible benefits from eHealth

pathology tests; computers; software; and implantable

ever in this country. But let’s not forget the basic human

devices — many of which have the backing of millions,

qualities we are after in healthcare.

tens of millions and almost scarily in many cases,

hundreds of millions of dollars. However, it is the

applications have already considered the impact

human qualities of empathy, regard and respect that

their solutions have on the caring process in terms of

have arguably the most significant impact on health

empathy, respect and regard, but we seem reluctant

outcomes and how people feel about their health

to consider them when one considers the PCEHR

and the healthcare they have received. We have $467

Concept of Operations. The PCEHR is essentially a

million allocated to delivering of the PCEHR in its first

communication enabler — not just a storage container

budgetary consideration. The disturbing thing when I

of data that gives some vague sense of control of

last checked: empathy, regard and respect are free but

what goes into the pot. Isn’t communication leading

at times it seems it is unobtainable with the PCEHR. It is

to engagement a two way conversation of issues

something money can’t buy.

and options? We don’t seem to consider the impact

It

seems

for

many

stakeholders

that

It is fair to say that existing health software

the

that communication mediums are already having on

conversations concerned with empathy, regard and

peoples’ lives when it comes to health. Rather, we are

respect are only just beginning now. Just 15 months to

concerned with stifling the conversations; controlling

go, but are we actually listening, do we actually care?

what is accessible; preventing patients (if clinicians in

The political side seems to be more concerned with

some quarters have their way) from documenting their

media releases; the debate between clinicians is who will

health and healthcare delivery in their PCEHR.

really be in control of the information; and the designers

are making the process so prescriptive we are limiting

around the world. I can be provided an update by

choice. Choice — a basic tenant of empowerment. As

the ones I love; be assured that things are well or be

an observer and participant — maybe an ineffectual

provided with an insight into how a person is feeling.

participant it seems — of the many things to do with

I can provide advice; assurance; regard; express

the road map of foundation pieces and the PCEHR it

respect for the decision making and follow-up earlier

Instant messaging, SMS and texting are flipping

decisions. I can send an image with text commentary

Author Info

from the highlands of New Zealand to Australia using As well as being President of MSIA, Geoffrey is General Manager Australia of HealthLink. He has spent the past 20 years working as an epidemiologist. For the past 10 years Geoffrey has occupied senior management positions in medical software companies.

my iPhone and get a reaction in minutes. This medium allows a light touch approach that can be escalated to a more involved process. Using instant messaging, SMS and texting it is possible to be empathetic; bring joy; connect with people; remove a sense of isolation and give confidence that things are going well. Now I

30 Pulse+IT

www.pulseitmagazine.com.au

know many will frown upon my simplistic

really is no difference between an IHI and

supporting empathy, regard and respect.

view of instant messaging, SMS and

a Medical Record Number (MRN). It allows

These seemed to have been forgotten

texting as a means of healthcare delivery.

machines to work better to make sure only

in the push for a PCEHR. I am aware

There will be medico‑legal arguments

your data from one system is matched with

that it will be argued that Wave 2 will be

about patient safety and quality of care.

your data in another system. However,

showcasing existing capabilities and will

There will be arguments about privacy

IHIs used as part of an indexing service

be delivering foundation pieces. However,

concerns. However it is a medium that is

for the PCEHR can pull greater amounts

in the push for apparent benefits there

so widespread; has such ease of use; and

of sensitive data together. Given this

will be a push for deliverables, possibly

a medium that individuals who use it have

capability there has been concern that IHIs

at the expense of the emotional qualities

‘opted in’ to. It is an existing capability. It

and PCEHR will expose an unnecessary

that will make a difference. Many will

is an empowering medium and creates

privacy risk. The challenge is that data

argue that Information Technology (IT)

a

information.

can be stored at disparate locations and is

and Information Management (IM) are

Effectively with instant messaging, SMS

only relevant when linked with identifiable

emotionally neutral. That IT and IM are just

and texting individuals are consenting

information. If we store data anonymously,

tools — technology that frees up clinicians’

and controlling their own privacy policies.

then the following is possible:

time and not utilised for the direct benefit

Individuals have already consented to the

IHI number: 8003768974932891

of the people that clinicians are serving.

process.

Diagnosis: HIV Positive

I beg to differ. IT and IM are enablers;

Should we just be a meaningless

empowering tools; they can be emotional

the access control processes with the

number? In an electronic world you can be.

charging; and even a comforting medium

PCEHR unmanageable for all except

Does that mean you are losing empathy?

that people are using throughout the

the intellectually elite. Why doesn’t the

This approach certainly considers respect

community everyday already. Yet we are

PCEHR Concept of Operations take into

and regard for privacy associated with

not using it, as well as we could, in the area

consideration ease of use? Does the

confidential information. While this is a

where we already know what the impact of

proposed PCEHR consider the impact

simplistic view, when it comes to privacy

caring has on people with emotional angst;

that it will have on empathy, regard and

there is a trade-off between usability,

worry; relief; and joy that is part and parcel

respect? Does it empower patients in a way

cost, risk of a breach and the access/

of health and healthcare delivery.

that allows them choice — allows them to

authentication method decided upon.

have a “Personally Controlled” Electronic

As the complexity of the privacy model

commitment from government, clinicians

Health Record primarily for their use? Does

increases the ability for people to effectively

and industry to ensure the PCEHR is

it have the right balance of privacy and the

manage their privacy decreases. There are

sensitive to the actual concerns of the users

ability for sharing of valued confidential

many people who will want varying levels

of the PCEHR. We need to listen to those

information?

of control. If you want greater control you

people wanting to have greater control over

Concerns around the PCEHR largely

are able to opt in when a provider of such

their health and the healthcare they receive.

focus on issues around privacy and the

a system delivers something that meets

Let’s respect the roles and responsibilities

ability

platform

for

sharing

In contrast we are looking to make

to

aggregate

disparate

There

has

to

be

longer

term

data

the control level you are after. If we are to

of all stakeholders and remind ourselves

through an indexing service. While we

get choice for patients we need to look at

of our roles, and not assume we are able to

want to ensure that privacy is regarded

methods that will allow innovation in the

represent the views of other stakeholders.

and respected, there are a number of

sector. Not stifle innovation and ignore

Let clinicians be clinicians; consumers

misconceptions about the PCEHR, the role

current approaches, but rather build on

be consumers; industry be industry; and

of an indexing service and Individual Health

existing capabilities — capabilities that are

government be government. Let’s examine

Identifiers (IHIs). The IHI is simply a number

already effective in dealing with respect

the existing technologies inside and outside

that tells you nothing at all about the

and regard for the handling of confidential

of health to serve as a basis for progressing

associated individual. There is no specific

health information.

eHealth. Let’s not be so prescriptive that

privacy link between IHIs and the PCEHR

It is not just a PCEHR that will deliver

we lose fundamental elements of empathy,

— it will just be another data element that

better health and healthcare delivery,

respect and regard, which is so important

can be used to reference (index) a health

but a number of existing applications

for peoples’ health and the healthcare they

record. From a privacy perspective, there

that are already in play — already

receive.

www.pulseitmagazine.com.au

Pulse+IT 31

FEATURE

Cloud connected mobile devices James Kavanagh

Healthcare Technology Lead Microsoft Australia jamesk@microsoft.com

How cloud computing provides the foundation for mobile devices in healthcare

predictions of the total number of Internet-connected

Mobile smartphone devices are proliferating at a

public and private cloud computing infrastructure

staggering rate, driven by consumer appeal and the

is predicted to more than double from $3.1bn to

ability to pick and choose from tens of thousands of

$6.4bn. With pervasive connectivity between devices

available ‘apps’. Each app is a self-contained program

and to a range of cloud computing services, each

that serves a specific need. In healthcare, we are

device becomes a gateway to continuous monitoring,

already seeing many apps purpose-built for condition

visualisation and interaction with medical or other

management, exercise and wellness self-support,

data.

medical alerts and even radiology image sharing. With

devices by the same time — numbering some 22 billion devices globally. In the same period, investment in

intuitive, accessible mobile experiences integrated with

Drivers of cloud computing adoption

data, and connectivity services increasingly supported

So why is it that cloud services are becoming the

by cloud computing, technology is being used in

essential foundation for these mobile experiences?

scenarios that were previously unimaginable.

Firstly, it’s simply a question of economics. When

Microsoft has a focus on stimulating and

upfront capital costs for infrastructure are borne by

supporting these scenarios. For example, finalists in

a cloud computing provider, the application operator

Microsoft’s global competition for student innovation,

only pays for computing resources that are actually

Imagine Cup, built a solution that combined an

used. With capacity provisioned on demand, a cloud

inexpensive ultrasound device with a mobile tablet and

enabled scenario can be rapidly deployed and scaled

Microsoft Azure cloud storage. The intent is to provide

to meet unpredictable demand. In response to the

ultrasound imaging that can be performed in regions of

H1N1 pandemic in the US and the Queensland flood

Africa with remote image interpretation and archiving.

emergency locally, Microsoft leveraged its Azure

In the United States, organisations like MedApps with

platform to rapidly deploy and scale applications to

their CloudCare platform are providing multi‑function

gather information and provide assistance.

personal monitoring devices that stream data

continuously to cloud based personal health records.

part of the story. Cloud computing also provides a fabric

But even these scenarios are bounded in quite

of services for identity and access control, storage,

conventional models of data gathering and user

processing, interoperability and integration, data

interaction. Globally more than 450 million smart

analysis and management of content. Identity services

phone devices will be sold in 2011, 50% more than

in the cloud based on OpenID enable consumers to

last year and this is expected to grow to more than 1

create a single identity for use across many different

billion devices by 2015. But even this is dwarfed by

applications and devices, while cloud based secure

1

But these utility and scale characteristics are only

token services can provide an interoperable mechanism

Author Info

for access control and authorisation. These services can James leads the technology strategy of Microsoft Australia for the healthcare industry across the hospital, community, primary and aged care. For the past thirteen years he has guided software architecture and innovation in government and healthcare.

eliminate the cumbersome and inadequate controls that are commonly found on websites that employ only user names and passwords.

Other cloud services such as Microsoft Azure

AppFabric provide a mechanism for secure messaging, directory lookup and interoperability. These services

32 Pulse+IT

www.pulseitmagazine.com.au

can

enable

resilient

communication

between

security measures in our hospitals and clinics.

clinical applications using open standards or secure

However, although security is an essential component

connectivity between medical devices and other

of strong privacy safeguards in all online computing

data endpoints. They build on and extend the core

environments,

cloud computing services for access to on demand

Consumers, clinicians and organisations are willing to

computing and storage. Taken together these services

use cloud computing only if they trust that their data

compose a complete backend platform on which

will remain private and secure. The ability of cloud

any healthcare application can be deployed, with the

computing providers to live up to these expectations is

frontend platform being desktop, web browser, tablet

critical not only for the future of cloud computing but

or mobile devices. It is the complementary nature of

also for protecting our fundamental right to privacy.

these two platforms that is driving the mutual advance

of mobile device and cloud computing technology in

and public policy issues remain to be solved in order

healthcare scenarios.

for both mobile and cloud computing to fully thrive.

Software developers who are building these

But these issues are not holding back adoption of cloud

cloud‑connected device experiences need a set

connected mobile experiences. Indeed, the Federal

of platform assets including tools, programming

Government recently made strong recommendations

languages, runtimes, and skills to accelerate their path

for agencies to take the first step of adopting

to development, deployment, and commercialisation.

public cloud services for public facing “unclassified”

The question of privacy

security

alone

is

not

sufficient.

In Australia, a number of regulatory, jurisdictional,

government services.2 Over the next few years we will see a vibrant movement towards greater use of these

It’s not a black and white choice between physical

cloud connected mobile technologies, a movement

infrastructure deployed on premise versus vast, shared

that will help reshape how clinicians access the

infrastructure held within global mega datacentres.

information they need and patients participate in their

In reality, there are many intermediate options such

own care.

as private cloud and hosted services. In healthcare, the most appropriate choice often boils down to

References

preferences around regulatory requirements and

1. Worldwide Smartphone 2011–2015 Forecast and

control.

Analysis, IDC Study #227367, Mar 2011

Security countermeasures and controls in public

2. Cloud Computing Strategic Direction Paper, April

cloud infrastructure far surpass typical healthcare

2011, The Department of Finance and Deregulation

Figure 1: The architecture of a cloud-connected mobile platform.

www.pulseitmagazine.com.au

Pulse+IT 33

FEATURE

How a mobile solution can prevent medication administration errors in aged care Dr Chaolin Chang

PhD, MMgmt, GradDipBusSys, BSc Manager, Product Strategy and Development, iCare changc@icare.com.au

There is a plethora of mobile devices on the market

1. Medications are often administered at the point of

today for aged care providers to choose from. They range from devices targeted predominantly at

care; 2. Administering medications are repetitive tasks;

consumers, such as Apple’s iPad and Samsung’s Galaxy

and

Tablet, to industry grade devices, such as Panasonic’s

3. The mobile device can be used as reminders to

Toughbook series. In between, there is a wide range

nursing staff for allergies, additional medication, or

of Microsoft Windows based tablets, which have been

medication due.

around for some years.

Mobile devices are particularly suited for point of

drive the medication policy at the operational level.

care solutions but they should be the means to an end

For instance, the solution could ensure a valid reason is

rather than the starting point. This article will look at

always entered by the nursing staff for any medication

how to choose a mobile solution by using a common

that is missed.

issue faced by many aged care providers today —

medication administration errors.

used to drive the solution because the gap between

A study of medication administration errors in long

what the mobile solution provides and your existing

term elderly inpatients in Japan revealed that the top

medication policy will determine the effort required to

three errors are crushing tablets without authorisation,

re-train staff.

omission without valid reasons and not signing for

an administered medication. These three types of

to a possible mobile solution for PRN administration.

errors are also commonly observed in many aged care

facilities in Australia.

between the current workflow and the possible mobile

These errors often occur when nursing staff

solution. The steps carried out by the mobile solution

are distracted during the medication round or the

are shown in italic. When the mobile solution mirrors

registered nurse is simply too busy. The problem is

current workflow, staff are not required to be re-trained

exacerbated by the use of paper medication charts

extensively to adopt the new solution.

and signing sheets. The use of Dose Administration

Aid (DAA) helps to improve omission in packed

such as checking of past administration history and

medications but it is still up to the nursing staff to

recording PRN administration in resident’s progress

identify all additional medications from doctors’ hand

notes are handled by the mobile solution. By moving

writen orders.

these chores from the existing workflow to the mobile

solution, nursing staff will have more time to deal with

1

A mobile solution is particularly suited to

medication administration because:

A well executed mobile solution will allow you to

It is imperative that existing medication policy is

The Figure 1 compares steps of a current workflow As you can see, there is no difference in steps

Steps that are crucial to prevent medication errors

other tasks at hand. Registered nurses can focus on medication management rather than handing out pills.

Author Info

Dr Chaolin (Charles) Chang received his PhD in Computing from Monash University in 1995. He also has a Master degree of Management and Graduate Diploma in Business System. Since 1995 he is being developing IT products for start-up firms in retail, customer service, and health care.

Dr Chang specialises in integrated web and mobility solutions.

Any

mobile

solution

used

for

medication

management needs to provide the following key features: 1. Flexible workflow so it can be catered for different scenarios without incurring costly re-programming work; 2. Display of drug administration history at the point

34 Pulse+IT

www.pulseitmagazine.com.au

of care; and 3. Prompt the user essential medication information of the resident in concern.

Finally, for a mobile solution to deliver the

should also meet your infection control policy and can be used to enforce medication management policy at the operational level.

expected return, medication policy must drive the

References

mobile solution. The selection of the mobile device

1. H. Ito and S. Yamazum, Common types of

should be considered in the context of ease of cleaning,

medications errors on long-term psychiatric care

durability, battery life, and of course cost of each unit

units, International Journal for Quality in Health

and its accessories. The device selected for the job

Care 2003: Vol. 15, No. 3, pp. 207-212

Figure 1 – PRN administration workflow comparison.

Current workflow

Possible mobile solution workflow

1. Nurse has identified the need for PRN administration

1. Nurse has identified the need for PRN administration

2. Nurse checks dosage and direction of the PRN on medication chart

2. Nurse enters the mobile solution and is authenticated

3. Nurse checks past administration of PRN on signing sheet and resident’s progress note

3. The mobile solution prompts the dosage, direction and past administration of the PRN to the nurse

4. Nurse administers PRN

4. Nurse administers PRN

5. Nurse signs on signing sheet

5. Nurse acknowledges the administration on the mobile device

6. Nurse records on resident’s progress note

6. The mobile solution makes an entry in the resident’s progress notes

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• Track and Scale—view progress towards reducing return of service obligations as part of the Rural Health Workforce initiative • Healthcare Identifiers (HI) Service—view your provider and organisation HI details and access a directory of HI providers.

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Health Professional Online Services (HPOS) gives health professionals and delegated practice staff access to Medicare Australia’s online services through a single entry point.

Pulse+IT 35

FEATURE

Mobile key in the dialogue of care Rachel de Sain

Director, Flaxworks rdesain@flaxworks.com.au

Mobile: the word means different things to different

within hospitals with smart phones? Would developing

people. In fact when I was working as Director of

mobile centric enterprise applications enable smoother

Mobile at MTV Networks in London a few years ago,

communication between care teams?

I was asked if that meant I looked after the mobile

homes on location shoots. Yes, really!

shared equipment, mobiles can also act as a remote

Being able to locate people, and importantly,

Understanding and integration of mobile has come

log in or authorisation tool for access to other ICT

a long way since then, with mobile strategy now a key

equipment. The amount of time, and in turn money,

component for business in many industries. Advances

wasted looking for people, equipment, waiting to log

in device design and capability, processing power,

onto machines could be greatly improved if smart

operating system enhancements, faster connectivity

applications were developed that were carried with you

and download speeds — fuelled by a commercially

on your mobile device.

driven application environment — have led to explosive

growth in the uptake, acceptance and usage of mobile

their care plans should also be investigated and can

phones for far more than just talk and text.

provide a variety of operational improvements, from

Integrating patients’ own mobile phones into

To take advantage of new mobile technology,

simple appointment reminder texts — which have been

infrastructure investment is required and this has been

shown to reduce no shows — to specific applications to

sadly lacking within the public health service. Apart

monitor or track certain symptoms such as mood and

from pagers and standard ‘call centric’ devices, most

exercise.

healthcare professionals are not equipped with smart

mobile devices, unless they bought it themselves.

about the more complex smart phone features and

I experienced this firsthand late last year following

possible applications, however a range of benefits

major abdominal surgery. After ten days recovering in

can be achieved through the use of simple voice and

hospital I was sent home, but my scar was not looking

messaging services.

too good. Given the pain, time and difficulty in getting

back to the hospital, I was grateful that my nurse was

clinic while I was in Cape Town in March this year, and

a 26 year old with an iPhone and a healthy dose of

spoke with the wonderful women working there about

common sense. She gave me her personal mobile

how mobile phones are improving health outcomes for

number and said, “MMS me some photos of the scar

patients. In townships like Langa, where the average

and I’ll discuss it with the surgeon and see whether you

weekly wage would cover about two Melbourne

need to come in”. The surgeon promptly determined

coffees, people struggle to get to a clinic and worry

the wound was healing OK, and said I was to monitor it

about the costs involved. Yet 90% of people own a

and send him more pictures direct to his personal email

mobile phone.

address if anything changed.

What would a cost benefit analysis show us if we

go door to door informing people of free testing. The

were to look at equipping healthcare professionals

issue then arises that people have to return to a clinic to

A lot of press and excitement has been generated

I was fortunate enough to be invited to visit at TB

Tents are set up in the townships and TB nurses will

get their results. By simply taking the mobile numbers

Author Info

of people when they are tested they are provided with a Rachel consultants on digital strategy, is part of the clinical leads & consumer reference forum at NEHTA, she is a board member for VIC ICT for Women, and previously held positions on the board at AIMIA Victoria and HISA.

lifeline, a connection, a way to continue the healthcare conversation and ensure that if required, these people get treated. Given the cramped living environments and highly infectious nature of these sorts of diseases, that care is provided to the family and community as well. They have seen great results and infection rates

36 Pulse+IT

www.pulseitmagazine.com.au

are coming down.

has shown baseline improvements in

role in enabling continued conversation

In India, a country with a tele-density

adherence. Studies are ongoing to look at

between

(as of July 2010) of 58% with a 2.5%

the reduction in care requirements after

patient, and are an essential tool in the

monthly growth rate — although arguably

implementing these services, but a major

fight to reduce the cost of healthcare and

a larger actual usage base given shared

winning factor to me is that the users

improve outcomes for patients.

and pay phones — there have been a

were happy, stating unanimously that the

number of research initiatives looking at

system was effective at reaching out to

you of your appointment; a recorded

the improvements mobile connectivity

them without any side effects.

message asking you to ‘press 1’ to confirm

can play in reducing the healthcare needs

Although Australia has a lower number

you have taken the day’s medicine; or an

of minority communities. One such project

of marginalised communities and less

iPhone app that utilises GPS to enable you

looked at providing a mobile service for

extreme poverty than India and South

to record your exercise and present your

urban sex workers in Bangalore. This

Africa, there are lessons to be learnt. A very

progress in a creative graphical format,

group, generally having a dual identity, is

smart medical student at the University of

there are many ways mobile phones can

often marginalised by society and is at risk

Cape Town summed it up by saying, “We

help migrate us from a ‘find and fix’ service

of HIV and other STIs.

continue to have a major proportion of

provider centric model of care to a patient

healthcare

practitioner

and

Whether it’s a simple SMS reminding

Using voice content, phones are

our population struggling with 3rd world

centric preventative one.

unconstrained by literacy concerns and

disease, compounded with the western

mimic existing formats of everyday

first world increases of cardiovascular,

of care rather than a one off event and

conversation.

diabetes and other chronic disease. We’ve

therefore it makes sense to use the most

reminders of appointments, medication

got the worst of both worlds.”

effective communication tool out there —

as well as microfinance repayments and

the mobile phone.

The

service

provides

Yet mobile phones are playing a key

Multiple Video Source Billing Scheduling

Letters HL7

Secure Workflow

Evolving

Devices

Robust Clinical coding

Adaptive

Instant Messaging

Endoscopy Claim management

Video

Multilingual

General Practice

Hospital

Radiology

“Liszt” - Live Video

Presence Tasks Lists

Intuitive

Healthcare is a dialogue; a continuum

SOA

Banking

Themed

Specialist

Totalcare

Appointments

Multi disciplinary

SQL

Day Surgery

SMS

Complete

Endoscopy Machines Integrated DRG Grouper

Access Control

medical management software

Paperless Electronic Records

Waitroom Reliability

Efficiency

Integrated

Reporting

Personalised

Dashboards and Workbench

Still Images

totalcare www.pulseitmagazine.com.au

Elegant

Modularity

Surgical Audit

Auditable

Admissions

Touch Screen Technology

web www.totalcare.net.au email info@totalcare.net.au

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

Pulse+IT 37

FEATURE

Cloud computing in the health sector – ready for the prime time?

Alberto Tinazzi

IT Security Consultant eHealth Security Services atinazzi@ehealthsecurity.com.au

What is cloud computing?

the customers have to install and configure on their

Cloud computing is a new term that is being

computers and servers, the software is centrally hosted

increasingly used thanks to the large interest the media

and made available to customers via the Internet.

are showing on the topic. But what is cloud computing

What makes this service attractive is that software

exactly?

maintenance is handled by the vendor.

Should

health

professionals

consider

cloud computing? What implications will a health

professional be facing if considering the adoption of

development environments that customers use to

this technology?

build their own applications.

Typically services, data and applications are located

With Platform as a Service, the provider offers

the business premises. Under a cloud computing

‘Going cloud’ is a business decision, not an IT one

arrangement, data, applications and services are

The advantages of ‘going cloud’ for an organisation

situated in specialised data centres and made available

include:

to the end user via the Internet.

• Reduced upfront costs of computer equipment;

• Flexible on-demand processing capacity;

on the end user’s machine or on servers located on

The US National Institute of Standards and

Technology defines cloud computing as: “...a model for

• Collaborative capabilities;

enabling ubiquitous, convenient, on-demand network

• Reduced operational ongoing costs;

access to a shared pool of configurable computing

• A reduced carbon footprint; and

resources (e.g. networks, servers, storage, applications

• Improved business continuity.

and services) that can be rapidly provisioned and

released with minimal management effort or service

obsolete servers with new ones, greatly reducing the

provider interaction...”1

up-front costs and downtime. The organisation only

needs to pay an ongoing fee to their cloud service

There are three delivery models for cloud

An organisation no longer needs to replace

computing services:

provider, which in exchange supplies processing power,

• Infrastructure as a Service (IaaS)

memory, storage space and network access.

• Software as a Service (SaaS)

• Platform as a Service (PaaS)

environments is the flexible on-demand processing

In Infrastructure as a Service the cloud provider

capacity, which makes the provisioning for new servers

offers a range of virtualised infrastructure components

a simple task. If the business grows and more resources

such as virtual network devices, virtual storage devices

are required, the customer will simply have to acquire

and virtual servers to meet customer specifications.

more resources from the provider. Most of the time, a

new server can be provisioned within minutes.

Software as a Service represents a new way of

delivering software. Rather than selling software that

Another great advantage of cloud computing

The collaborative capabilities introduced by

Author Info

cloud computing allows businesses to explore new Alberto Tinazzi is a Certified Information Systems Security Professional (CISSP). He works as an independent information security consultant specialised in the healthcare sector. He has 16 years experience as an IT professional, specialised in information management and security. He has spent the last 10 years working within the health sector covering a number of different roles within the Division of General Practice Network.

opportunities for interacting with their customers and business partners.

The ongoing costs of managing IT infrastructure

may also be reduced as customers do not have to worry about air conditioning, power, physical security, scheduled maintenance, breakages and other related costs.

38 Pulse+IT

www.pulseitmagazine.com.au

Facilitated by the more efficient use

may be running a test environment that

not protect their passwords adequately.

of computer hardware and the reduced

requires minimal protection while another

Two‑factor-authentication (e.g. user name

requirements of air conditioning and

tenant may be running a critical application

and password, plus a one-time password

electrical power, cloud computing also

handling sensitive data. There may be

or digital certificate) will provide greater

plays a very important role in reducing an

consequences impacting on all other

protection in a SaaS scenario.

organisation’s carbon footprint.

tenants if the first system misbehaves or is

taken over by malicious intruders.

for

Cloud computing has great potential

providers

should

account

isolating

for such issues to provide a secure

responsible for securing the applications

solution to ensure business continuity in

multi‑tenant environment, in reality, due

that they develop.

case of major disasters, such as floods, fire

to the complexity of the cloud environment

or earthquakes. However, it also introduces

these events are not always easy to detect

protecting operating systems and data,

a number of new issues, particularly related

or prevent.

while providers should ensure adequate

to the sensitiveness of clinical records and

Often, cloud providers may be able

network segmentation and proper data

their protection, which should be properly

to offer very sophisticated approaches

partitioning between customers’ systems.

considered and addressed.

to security beyond the capability of

IaaS customers are still responsible for

many businesses. However, a customer

backing up data, implementing access

should not take this for granted. Typically,

control mechanisms, establishing services

Most large enterprises have their own

customers and cloud providers share

that should be available over the Internet,

private cloud infrastructure, but small and

the responsibility of security and privacy

installing and maintaining software and so

medium businesses looking to embrace

and each cloud model implies different

on.

cloud computing will have to rely on public

responsibilities for each party.

or community clouds. These type of cloud

responsible for backing up customers’ data

models operate in multi-tenancy mode,

for

and

(mostly SaaS or managed PaaS and IaaS) it

meaning that a single physical server or

applications, while customers will have

is important to check with the vendor how

a storage device is partitioned among

to be careful to protect their access

long it would take to recover data in the

various customers.

credentials. Under SaaS, password based

case of a problem. This should be clearly

securing

customers’

data

while

computing

better mobility as well as provides a

SaaS providers should be responsible

environments,

customers’

for healthcare operators as it enables

Cloud and security

While

PaaS providers should be responsible customers

are

IaaS customers are responsible for

In circumstances where the provider is

In a multi-tenant environment each

authentication may not be a suitable

stated in the Service Level Agreement

customer may have different security

option to protect the data. Individual

(SLA).

requirements. For example, a tenant

users may select weak passwords or may

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Pulse+IT 39

measures should be considered to prevent

protection and security best practice,

meaning that they can have as many

providers from abusing customer data.

customers should rely on the provider’s

interruptions of 29 minutes as they wish

Information stored on the cloud and

current certifications, which may include

without legally breaking the agreement.

travelling over the Internet should be

ISO27001, DSD Gateway Certification,

encrypted and only the customer should

ASCI-33, the Protective Security Manual

for direct losses and exclude liability

know the key or password to decrypt the

and PCI-DSS.

for indirect losses. They may not offer

data.

A very important aspect which should

adequate compensation for the damages

Most SLAs provide limited liability

The SLA or contract may specifically

be carefully assessed when selecting a

caused by unscheduled downtime, data

exclude provider liability regarding data

cloud service provider is their Service Level

loss or privacy violations.

protection, security and backups thus

Agreement. This document describes the

leaving customers solely responsible for

service and states priorities, responsibilities

happen in the event of a security breach

the protection of their data.

and warranties. It will state things such as

and it should also stipulate the obligation

the performance of the service in terms

of the provider to inform the customer of

of connection speed, service uptime,

such breach.

Things to consider when choosing a cloud

A SLA should clearly state what would

allocated resources and more.

While the customer may be able to take

or no infrastructure and resell services

care of some aspects of security and data

service provided and establishes penalties

provided

integrity, such as maintaining independent

if the service provided falls below an

providers will pass onto their customers

back-ups and using data encryption, other

agreed level. For instance, the agreement

conditions reflected by the SLA they have

aspects of data security in a cloud based

may establish a credit on the monthly

in place with their suppliers. As such, their

environment are outside of the customer’s

fees paid by the customer if a service

customers are unable to negotiate on

control and knowledge. This includes the

availability falls below the agreed 99.0%.

these conditions.

physical security of the data centre, virus

Note that 99% availability may sound

protection, protection against external

good in the first instance, but it equates to

cloud reseller is that they may change

attacks and maintaining data security as it

three and a half days of downtime over a

supplier without letting their customers

is transferred between data centres.

year. Also, the SLA may exclude from the

know about it. This could have serious

This underlines the importance of

calculation some types of outages such as

consequences as data may be transferred

choosing a reputable service provider

scheduled maintenance, failure caused by

overseas without the customer even

with strong data protection policies and

third parties and so on.

knowing it. This particularly applies to

procedures. As it would be impractical, if

Some providers may offer 100%

SaaS providers as they may be delivering

not impossible, for a customer to assess

availability not counting outages that are

their services through an infrastructure

the provider’s compliance with data

below a certain threshold (e.g. 30 minutes),

(IaaS) managed by another provider.

Typically a SLA states the quality of the

vendors.

These

Another issue with working with a

- Healthpoint Technologies

- Alcidion

- DoctorWare Australia, Smartrooms

- Healthways Inc

- Ambulance Australia

- Ambulance Victoria, VACIS

- Deltra Pty Ltd, Practice Pro

- DrsDesk Software

- Australian Sports Anti-Doping Authority

- Episoft

- Cancer Council of Victoria

- Global Health

- Best Practice Software - CDC Systems - charmhealth

- Cardio Vascular Systems

- Cloud9 Software

- Communicare Systems

e

other

- CompuDoc Medical

- Clintel Healthsolve, The Specialist

40 Pulse+IT

by

- Abaki

- Access GP

Clinical software providers who integrate MIMS medicines information and decision support into their applications to ensure that clinicians have the most trusted information available at all times.

Some cloud providers own limited

- Equipoise International, Totalcare - Genie Solutions

- Healthsoft Australia

- Houston Medical Australia - Incisive Medical Systems - InterSystems

- International SOS (Australasia) - Intrahealth Systems, Profile - iSoft Group

• Locum

• Patient Safety International

• MHAGIC

• Practix

• MasterCare

- Godbar Software P/L - GPComplete

- Health Track Medical Systems - HealthCare Software

• MedChart • Classic

• ePharmacy

- Jam Software

- Lane Cove General Practice

www.pulseitmagazine.com.au

When choosing a cloud provider it

in developing countries offering cheaper

responsible may be a very expensive

is also very important to verify that the

labour, rent and services.

exercise. For this reason it is important

connection speed between cloud and site

that the agreement with the service

is adequate. Aspects such as availability,

legislation

and

provider includes a ‘choice of law’ clause

traffic throughput, latency and packet

copyright. Most of the largest cloud

which ensures that disputes are handled

loss should be seriously evaluated. A tool

providers reside in the US, however US

in Australia rather than overseas. Also, the

to measure connectivity performance

legislation about privacy and data handling

agreement should state that Australian

between a customer’s site and some of

is significantly different from Australian

law will apply even if the provider resides

the most popular providers (including a

regulations. For instance the US Patriot

in another country. Typically, however,

few Australians) can be found at http://

Act gives the FBI the right of accessing

agreements are developed by service

cloudharmony.com/speedtest.

any data stored within the US, even if it

providers and therefore contain clauses

belongs to foreign companies.

which play in their favour. Large corporate

Other risks introduced by cloud

Some countries may have inadequate

in

fact

privacy

2

of

or government customers may be able

case of a local disaster. A provider should

“transborder data flows” as established

to negotiate these terms but for small

replicate customers’ data across multiple

by NPP 9 of the Privacy Amendment

to medium businesses, the chance of

data centres geographically distant to one

(Private Sector) Act 2000,3 which states

negotiating a customised agreement is

another.

that organisations thinking of transferring

likely to be slim.

The customer should be very careful

data offshore should seek individuals’

when selecting a provider by gathering

consent and that they need to disclose

Jumping off the clouds

customer feedback, selecting providers

that information stored overseas may

While everybody seems to be talking about

with proven technical competence and

not be protected by Australian law. NPP9

joining the cloud not many discuss how to

economic stability.

also stipulates that the organisation must

leave the cloud. As cloud computing is a

take reasonable steps to ensure that

very new field, it still lacks the adoption

data exported overseas will be handled

of commonly agreed on standards. Each

A very important aspect to consider

in accordance to the Australian National

cloud provider has its own proprietary

when selecting a cloud provider is the

Privacy Principles.

system making it very difficult for a

location your data will be stored. Storing

customer to transfer services to a different

data overseas introduces the very serious

provides that a company keeping financial

provider, or even back on-site.

problem of data sovereignty.

records overseas, must inform ASIC about

The cloud computing model is driven

is

to

computing are related to resiliency in the

Where does a cloud live?

There

relating

the

issue

The Australian Corporations Act 20014

Proprietary

standards

are

often

where the records are kept.

intentionally used by some vendors to ‘lock

by economies of scale. For this reason,

in’ a customer. A customer should ensure

data may be stored in data centres located

happens

- Manrex Pty Ltd; Webstercare

- Practicare

- MediFlex

- Promedicus

- Mater Public Hospital - Medical - Objects

- Mednetwork Systems - Medtech Global

- Merck Sharp and Dohme - MMex

- Mountain Top Systems - Mouse Soft

- Mx Solutions - NPS

- NIB Health Funds

overseas,

prosecuting

the

that the provider has a well documented

- Promadis

- Queensland Emergency Services - Queensland Eye Institute - Queensland Government - Shexie Medical System - SmartHealth

- Software for Specialists - Stat Health

- Sydney Adventist Hospital - SurgiWare

- Pen Computer Systems

- Telethon Institute for Child Health Research

- Pharmacy Computer Solutions

- Zedmed

- Pharmacy4U

If a data leakage or a privacy breach

A special thank you to all those who partner with us to deliver our trusted medicines information and decision support to the point of care.

The team at MIMS

- Western Australia Police

www.pulseitmagazine.com.au

Pulse+IT 41

business when opting for the cloud.

vendor-neutral format before committing

Is ‘going cloud’ the right option for my practice?

to it. This is particularly important in SaaS

Contrary to what many believe, cloud does

while a cloud based solution may be more

as data may have to be imported into a

not completely eliminate the need for an

expensive in the long run, the cost of a

new software product.

IT support person and actually brings along

physical server has typically to be faced

process to export customer data in a

Some agreements may state that

Something else to keep in mind is that

new responsibilities which may not have

up-front. In the example shown in Figure

the provider is entitled to delete data on

been previously considered.

1, it would be a total of $3,909.60 plus

cancellation of the service. The customer

ongoing costs.

may be solely responsible for data retrieval

wagon, consider very carefully all the

which has to be organised before the

aspects and variables involved. Costs are

Defence established a set of guidelines

termination of the service. Some providers,

very relevant but they shouldn’t be the

for government agencies considering

however, reserve the right to terminate the

only deciding factor when ‘going cloud’.

cloud computing.6 Despite the intended

agreement immediately without notice in

As a guide, Figure 1 shows a comparison

audience, these guidelines are also relevant

some circumstances.

between an entry level physical server and

for private healthcare operators due to the

So before jumping on this cloud band

The

Australian

Department

of

Another issue that customers should

a cloud based server with similar technical

extremely sensitive information handled

consider when migrating away from a

specifications offered by some of the

in this sector. These guidelines make the

cloud provider concerns data sanitisation.

leading Australian based providers. These

following important observations:

How do we know that our data have been

cost estimates do not consider the cost of

• Cloud computing should not be used

completely and properly erased from the

server and software configuration.

to store highly confidential/sensitive

provider’s system? Unless the storage

The scope of this cost comparison

information. The Privacy Amendment

space allocated to us has been properly

is not to establish which model is more

(Private Sector) Act 2000 as well

overwritten, data stored on it may be

convenient, since the variables considered

as the Guidelines on Privacy in the

recovered by the next customer who

fluctuate constantly, but it highlights

Private Health Sector for health service

moves into ‘our’ storage space.

5

HealthLink/Medinexus HalfbePage 180 xby120 IT Magstipulate that health records which variables should considered a Puseproviders

connecting healthcare

42 Pulse+IT

www.pulseitmagazine.com.au

should be considered as such.

bankruptcy?

data classification schemes should be

• A copy of data stored on the cloud

• Data sovereignty. Where is your data

should be kept locally or with a second

physically stored? Data stored overseas

fully independent provider.

may be subject to the legislation of the

standard

host country.

management — Implementation guide for

• Data sanitisation, or in other words,

customised to the specific organisation.

Section 4.4 of the HB 174—2003 Information

security

what happens to your data when you

Practices considering cloud computing

the health sector7 establishes a scheme

leave the provider, as well as what

should establish a classification system

based on four classification levels as

procedures the provider has in place to

based on the sensitivity of the data they

summarised in Figure 2.

dispose of obsolete or non-functional

handle and then perform a risk analysis to

storage media.

determine which data may be suitable for

to decide what data are suitable to be

storage in the cloud.

stored in the cloud.

• Data ownership. Do you retain legal ownership of your data, or does

it belong to the vendor and may

many

Health

professionals

operate

in

depending

on

cloud computing should ultimately seek

be considered an asset for sale by

their specialisation, size of the business

guidance from their representative bodies,

liquidators if the vendor declares

and other relevant factors. Therefore,

particularly with regards to compliance

different

ways

Data classification is useful particularly

Health

professionals

considering

with legal obligations and accreditation Monthly cost

Physical Server (over 3 years)

Cloud Server

Server and operative system

$55.60

$190.00

UPS

$20.00

$0.00

Backup

$33.00

$30.00

Power

$73.00

$0.00

$0.00

$30.00

$181.60

$250.00

Internet traffic Total

standards.

References References are available online at the Pulse+IT website: http://bit.ly/kFDg7b Figure 1 – Left – An indicative cost comparison between a traditional and cloud computing server hosting arrangement.

Figure 2 – Below – A data sensitivity classification model.

Level

Description

Protection

Public

Information that if made public will not have detrimental impact to the business or to the customer. For example, information brochures, website, etc.

This information requires to be carefully assessed for accuracy and protected against unauthorised modification, as it may have a negative impact on the reputation of the organisation.

Internal Only

Information that if disclosed may cause minor damage or embarrassment to the health provider or to a patient.

Examples: internal telephone and address books, internal project details, general email correspondence, etc.

No external access. Internal access provided on a selective basis. Electronic information should be password protected. Paper information should not be left around or on desks. This information may be emailed.

Confidential - Health Information

Information that if disclosed, destroyed or altered or misused may cause severe damage to the organisation or to the patient. Examples: patient data, medical records, identified research data, radiology and pathology results, etc.

Access should be granted on a need-to-know basis.

Electronic information should be password protected and possibly encrypted. Paper information when not in use should be kept in locked cabinets, drawers, rooms, safes, etc. Electronic transfer should occur only in an encrypted format.

Confidential - Non Health Information

Information that if disclosed, destroyed or altered or misused may cause severe damage to the organisation or to a third party. Examples: staff and salary information, accounts data, patient bank accounts, digital certificates, lists of passwords, business plans and other business sensitive documentation, etc.

Access should be granted on a need-to-know basis.

Electronic information should be password protected and possibly encrypted. Paper information when not in use should be kept in locked cabinets, drawers, rooms, safes, etc. Electronic transfer should occur only in an encrypted format.

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Pulse+IT 43

Advantech Australia AAPM

P: 1800 196 000 or +61 3 9095 8712 F: +61 3 9329 2524 E: headoffice@aapm.org.au W: www.aapm.org.au The Australian Association of Practice Managers (AAPM) represents Practice Managers and the profession of Practice Management. Founded in 1979, AAPM is a non-profit, national association recognised as the professional body dedicated to supporting effective Practice Management in the healthcare profession.

The Australian Association of Practice Managers: • Represents Practice Managers and the profession of Practice Management throughout the healthcare industry.

• Promotes professional development and the code of ethics through leadership and education.

• Provides specialised services and networks to support quality Practice Management.

Advantech’s medical computing platforms are designed to enhance the quality and efficiency of healthcare for patients and users alike. All products match the performance of commercial PCs and tough medical safety ratings like UL60601-1 and EN60601-1; adding to this they are all IPX1 certified dust resistant and come with water dripproof enclosures. Advantech offers long term support and a proven track record of reliability.

The medical range extends through: • Point-of-Care Terminals.

• Mini-PC and Medical Imaging Displays.

• Mobile Medical Tablets.

• Patient Infotainment Terminals.

Advantech is also an official distributor of Microsoft Windows Embedded software across Australia & New Zealand.

P: +61 3 5335 2220 F: +61 3 5335 2211 E: argus@argusconnect.com.au W: www.argusdca.com.au

P: +61 412 746 457 F: +61 3 9569 9449 E: Secretary@ACHI.org.au W: www.ACHI.org.au

The Australasian College of Health Informatics is Australasia’s Health Informatics professional body, representing the interests of a broad range of clinical and non-clinical e-health professionals. ACHI is the community of Health Informatics thought-leaders in Australasia.

ACHI is committed to quality, standards and ethical practice in the Health Informatics profession.

More information is available at: www.ACHI.org.au Join the ACHI Info email list at: www.ACHI.org.au/List

44 Pulse+IT

P: 1300 720 274 F: 1300 364 008 E: marketing@ch2.net.au W: www.ch2.net.au

Clifford Hallam Healthcare (CH2) is today Australia’s largest pharmaceutical and medical healthcare service provider with a catalogue of over 15,000 products servicing metro, regional and rural customers across Australia.

Best Practice

P: +61 7 4155 8800 F: +61 7 4153 2093 E: sales@bpsoftware.com.au W: www.bpsoftware.com.au Best Practice sets the standard for GP clinical software in Australia offering a flexible suite of products designed for the busy GP practice, including: • Best Practice Clinical (“drop-in” replacement for MD) • Integrated Best Practice (clinical/ management) • Top Pocket (PDA companion software for Pocket PC)

Cerner Corporation Pty Limited P: +61 2 9900 4800 F: +61 2 9900 4990 E: AsiaPacific@cerner.com W: www.cerner.com.au

Argus

Australasian College of Health Informatics

CH2 (Clifford Hallam Healthcare)

P: 1300 308 531 F: +61 3 9797 0199 E: info@advantech.net.au W: www.advantech.net.au

Argus provides and supports Argus secure messaging software that enables doctors and healthcare organisations to exchange clinical documents securely and reliably.

Argus can be used to send specialist reports to referring doctors but it can also exchange pathology and radiology reports, hospital discharge summaries and notification between healthcare providers. Healthcare practitioners can use any of the popular clinical software packages to send reports and other clinical correspondence via Argus.

Argus is the messaging solution chosen by 65 Divisions of General Practice across Australia through the ARGUS AFFINITY program.

Cerner is a leading supplier of healthcare information systems and our Millennium suite of solutions has been successfully installed in over 1200 sites across the globe. Cerner’s technology has been designed so that it can be adapted to meet the needs of the very different healthcare delivery systems that exist, with a universal framework that allows clinician workflow to seamlessly span role and venue.

Our innovative leadership is allowing us to push boundaries by: • Leveraging clinical and pharmaceutical data for new discoveries in Condition Management and Personalised Medicine • Connecting the community with personal and community health records • Seamlessly connecting the patient record across the continuum of care

Supported by a National Network, CH2 utilises local knowledge and local people to provide pharmaceuticals, medical consumables and equipment products to the healthcare market.

CH2 is represented by a National Sales Force as well as a local Customer Service team in each state.

CH2 understands the value of quality data and are committed to implementing the GS1 system throughout our business and with our partners. The use of EANCOM standard messages, Global Trade Item Numbers (GTIN) for product identification, Global Location Numbers (GLN) for location information and Serial Shipping Container Code (SSCC) labels are paramount to our industry moving forward. CH2 are passionate supporters of these philosophies and believe the uplift in quality systems will result in improved patient safety.

CH2 are currently working with partners to implement the National E-Health Transition Authority (NEHTA) National Product Catalogue. “Our aim is to be a great company to do business with. The right product, at the right price, at the right time.”

WardBox® is CH2’s direct to ward distribution system. It is a just in time replenishment system where orders are created in a theatre or ward area and then transmitted electronically to one of CH2’s warehouses using SOS or an EDI interface. The service incorporates barcode scanning technology, direct delivery to individual wards or departments, monthly invoicing and comprehensive reporting. WardBox® is designed to assist our customers in reducing purchasing and supply operating costs. This valuable service increases supply chain efficiencies, improves service delivery models and assists in achieving economies of scale.

WardBox® distribution is used for pharmaceuticals, medical, surgical and general supplies at numerous healthcare facilities.

In 2009 CH2 won the ASCLA Information Management Award and are gold sponsors for the ASCLA Awards 2010.

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DoctorBill

Cutting Edge Software Communicare Systems

P: +61 8 6212 6900 F: +61 8 6212 6980 E: sales@communicaresystems.com.au W: www.communicaresystems.com.au Established in 1994, Communicare Systems have built an enviable reputation for delivering results, supported by excellent service based on mutual respect, mutual trust and mutual benefit.

Communicare is the electronic medical records and practice management system of choice for Aboriginal Health Services employing multidisciplinary holistic healthcare, featuring: • Ease of use for all providers • Shared electronic health records • Standards based electronic messaging • Comprehensive easy to use automated reporting • Scalable from small service to multi organisational enterprise • Multi axial security and access logging

Computer Initiatives

P: 1300 85 39 39 (Melbourne) P: 1300 85 39 85 (Brisbane / GC) E: tim@cinet.com.au W: www.cinet.com.au Computer Initiatives has been supporting the medical profession for over 15 years. Providing IT consultancy services, quality hardware, professional support with qualified engineers.

Recommended and preferred by a number of Divisions of General Practice and specialist software providers we: • Supply and install of hardware/ software and peripherals • Implement disaster recovery and replication plans • Remote monitoring and diagnosis • Advanced networking deployment and support • Prompt and competitive support • Internet configurations and content filtering services • Security audits, configurations and monitoring • Regular maintenance services • Microsoft Gold Partner and a Microsoft Small Business Specialist

P: 1300 237 638 F: +61 3 9787 8210 E: enquiries@cesoft.com.au W: www.cesoft.com.au Cutting Edge produces affordable, intuitive billing solutions for Mac, Windows, Linux and iPad. Cutting Edge is ideal for practitioners who prefer to maintain control of their own billing from a number of sites.

Cutting Edge Software is approved by Medicare Australia to manage your electronic: • Verification of Medicare and Fund membership • Bulk Bill and Medicare claims • DVA paperless claims • Inpatient claims to Health Funds We have solutions tailor-made for • Anaesthetists • Surgeons/Surgical Assistants • Physicians • GPs • Allied Health The software comes with up-to-date schedules for MBS/Rebate, Gap Cover (all registered health funds), Workers’ Compensation, Transport Accident authorities and DVA.

Direct Control

P: 1300 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.

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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 237 638 F: +61 3 9787 8210 E: sales@doctorbill.com.au W: www.doctorbill.com.au DoctorBill is a simple and secure way for doctors to accept online payments through a single portal without the need to setup a website. You can accept direct deposits, credit card via PayPal® or your existing Merchant Facility if you have one. All of the available payment methods are secure and can be used with confidence.

We provide you with a customised website address to put on your stationery which directs your patients to your practice’s DoctorBill page.

For an example of what patients will see when using the service, visit: www.DoctorBill.com.au/DrExample If you already have a website, you can easily place a link to direct patients to the page. Patients receive a receipt and your practice is advised by email when payments are made.

Setting up DoctorBill for your practice is easy and affordable, and transactions cost just 90 cents each (excluding bank fees).

eHealth Education Pty Ltd

P: +61 3 9653 9433 F: +61 3 9653 9307 E: info@ehealtheducation.net W: www.ehealtheducation.net • The Registered Training Organisation specialising in quality Health Informatics education provided by senior, education qualified HI professionals.

Educational programs are designed to up-skill clinicians, technical staff, consumers and administrators in healthcare.

• Delivery options include focused workshops, single subject courses or fully integrated programs delivered face to face or online through our extensive and quality assured online education delivery infrastructure.

• Servicing professional and education organisations, we also aim to support professional and healthcare education providers.

You can deliver your material using EHE infrastructure, or we can help you develop and/or deliver quality educational material.

Pulse+IT 45

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.

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.

GE Healthcare Australia Pty Ltd P: +61 2 9846 4000 F: +61 2 9846 4001 E: GEHCinfo@ge.com W: www.gehealthcare.com

Global Health

GE Healthcare is a $17 billion business of General Electric Co. and provides a broad portfolio of healthcare technologies and services. GE Healthcare’s ‘Healthymagination’ initiative is a $6 billion commitment to improve healthcare through innovation - reducing costs, improving quality and expanding access for millions of people. A leader in solutions for the entire healthcare enterprise.

GE Healthcare has extensive global experience in successful ehealth implementations and offers a broad ehealth solution portfolio including Personal Health Manager, Provider Portal, Master Patient Index and Health Information Exchange Solutions. GE Healthcare also provides the Centricity® suite of integrated information technology for enterprise hospital information systems and specialist clinical information solutions, for theatre, anaesthesia, intensive care, cardiovascular, radiology and maternity.

P: +61 3 9675 0600 F: +61 3 9675 0699 E: sales@global-health.com W: www.global-health.com Global Health is a premier provider of technology software solutions that connect clinicians and consumers across the healthcare industry. The portfolio consists of 3 core brands: ReferralNet promotes a secure technology platform which connects all facets of all the healthcare industry with encrypted and online messaging and claiming functionality.

MasterCare is a suite of health information management systems that provides healthcare practitioners with tools to collect, manage and access clinical and patient information at the point of care. is a secure and confidential online health record that lets you keep all health information current, organised and in one place.

Extensia Emerging Health Solutions P: 02 8853 4700 F: 02 9659 9366 E: mail@emerging.com.au W: www.emerging.com.au

Emerging Health Solutions (EHS) is a web-based Clinical Information System for hospitals that is patientcentric capturing and providing appropriate, timely, clinical information in a secure and auditable environment. to assist clinicians deliver effective, quality care. Our prestigious clients include St Vincents & Mater Health Sydney and the Government of South Australia Department of Health.

EHS has integrated Sabacare’s Clinical Care Classifiaction (CCC) System, a diagnosis framework integrated in SNOMED CT. EHS’ extensive list of modules work seamlessly with other systems via our integrated interface engine which accepts HL7 and other accepted Health IT standard protocols complying with the Australian Technical Specification: ATS 5822:2010 eHealth Secure Message Delivery.

46 Pulse+IT

P: +61 7 3292 0222 F: +61 7 3292 0221 E: enquiries@extensia.com.au W: www.extensia.com.au Extensia links healthcare providers, consumers and their communities to deliver better and more efficient health care outcomes. The products used to do this can be custom branded for all Organisations and include: • RecordPoint – a proven Shared Electronic Health Record that links all clinical systems, hospital settings, care plan tools and any other sources of information available. It provides a secure means of sharing critical patient data in a privacy compliant and logical structure.

• EPRX – an Electronic Patient Referral Exchange and Directory.

It streamlines the process of selecting a provider and completing a referral. Patient information is transferred seamlessly from clinical software, then the most relevant providers, services and products are presented instantly and referral documents are created automatically and sent electronically.

GPA

P: 1800 188 088 F: 1800 644 807 E: info@gpa.net.au W: www.gpa.net.au 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.

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.

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 2000 sites, it is now the number one choice of Australian specialists.

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HealthSolve

P: +61 8 8203 0500 E: info@healthsolve.com.au W: www.healthsolve.com.au

Health Communication Network 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

HealthSolve provides Care Management systems for aged, acute, and community care that can be shared across all health care sectors.

Health Informatics New Zealand E: admin@hinz.org.nz W: www.hinz.org.nz

Health Informatics New Zealand (HINZ) is a national, not-for-profit organisation whose focus is to facilitate improvements in business processes and patient care in the health sector through the application of appropriate information technologies.

HINZ acts as a single portal for the collection and dissemination of information about the New Zealand Health Informatics Industry.

Membership is for anyone who has an interest in health and informatics.

Health Informatics Society of Australia

Health Information Management Association Australia P: +61 2 9887 5001 F: +61 2 9887 5895 E: himaa@himaa.org.au W: www.himaa.org.au

The Health Information Management Association of Australia (HIMAA) is the peak professional body of Health Information Managers in Australia.

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.

P: +61 3 9388 0555 F: +61 3 9388 2086 E: hisa@hisa.org.au W: www.hisa.org.au

HealthEasy

P: +61 7 5665 7995 F: +61 7 5502 6543 E: info@healtheasy.com.au W: www.healtheasy.com.au HealthEasy is a 100 percent web‑based “Cloud Computing” solution as used by leading Web 2.0 apps like BaseCamp and SalesForce.

• • • • • •

No hardware upgrades No local Server needed No manual software upgrades No local backups required No contracts (pay monthly) Runs on Windows, Mac & Linux

eHealth Initiatives Support: • Electronic Prescribing (eRX) • Personal Health Record (IEHR) • Unique Health ID (UHI) Built using Open Source tools with source code available.

We invite expressions of interest from all sectors of the industry.

The Health Informatics Society of Australia is a membership based not-for-profit organisation which has been supporting and representing Australia’s health informatics and e-health community for almost 20 years. HISA aims to improve healthcare through the use of technology and information. We: • Provide a national focus for e-health, health informatics, its practitioners, industry and a broad range of stakeholders • Support, promote and advocate • Provide opportunities for networking, learning and professional development • Are effective champions for the value of health informatics HISA members are part of a national network of people and organisations building a healthcare future enabled by e-health. Join the growing community of organisations and individuals who are committed to, and passionate about, health reform enabled by e-health.

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.

• 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.

Features: • Web-based.

• Flexible, dynamic, and highly configurable.

• Mirror your specific work flow and document style.

• Resident/client centric with a focus on the whole “journey.”

• Brings together administration, staff, providers, and facilities.

Houston Medical

P: 1800 420 066 or +61 2 9669 1844 P: 0800 401 111 or +64 7 834 9354 F: +61 2 9669 1791 E: houston@houstonmedical.net W: www.houstonmedical.net INTEGRATION ACROSS THE PRACTICE Houston Medical delivers one streamlined system integrating medical equipment with financial, claiming and administrative areas that works reliably and securely for small practices through to large multi‑disciplinary practices.

GREATER ROI VIP.net for medical specialists and VIP Allied for General practice/Allied Health delivers great ROI through smoother workflow, improved data quality, boosted productivity and reduced costs.

FLEXIBLE Individually configurable, Houston’s systems support you in the way you work and deliver better results.

TRUSTED Houston delivers software that you can trust - built on 20 years experience and used by many hundreds of leading practices across Australasia and beyond. Our first customer is still a customer.

Demonstrations available under NDA due to late 2010 release.

www.pulseitmagazine.com.au

Pulse+IT 47

InterSystems

P: +61 2 9380 7111 F: +61 2 9380 7121 E: anz.query@InterSystems.com W: www.InterSystems.com InterSystems Corporation is the worldwide leader in software for connected healthcare. With headquarters in Cambridge, Massachusetts, and offices in 24 countries, InterSystems provides advanced software technologies for breakthrough applications.

InterSystems TrakCare™ is a Web‑based healthcare information system that rapidly delivers the benefits of an Electronic Patient Record. InterSystems CACHÉ® is a high performance object database that makes applications faster and more scalable. InterSystems Ensemble® is a seamless platform for integration and the development of connectable applications. InterSystems HealthShare™ is a platform that enables the fastest creation of an Electronic Health Record for regional or national health information exchange. InterSystems DeepSee™ is software that makes it possible to embed real-time business intelligence in transactional applications.

iSOFT

P: +61 2 8251 6700 F: +61 2 8251 6801 E: company_enquiry@isofthealth.com W: www.isofthealth.com iSOFT is one of the world’s largest providers of healthcare IT solutions.

We work with healthcare professionals to design, develop and implement healthcare solutions that deliver administrative, clinical and diagnostic services to ensure continuity of care across all care settings. iSOFT provides flexible and interoperable solutions to the whole spectrum of providers, from single physician practices through to integrated national solutions supporting thousands of concurrent users.

Our capacity to embrace change and keep abreast of emerging new directions in healthcare has allowed our clients to explore the exciting potential of new technologies while securing their existing investments.

JOSE & Associates

P: +61 3 9850 1350 F: 1300 889 012 E: news@jose.com.au W: www.jose.com.au JOSE and Associates – IT Management and Support for Medical Practices • Complete IT support for medical practices: • Support for most clinical and practice management software àà Support for all network topology àà Dedicated help desk àà 24/7 support - response in most cases is immediate • New practice installation • Server maintenance on a monthly basis which includes full monthly reporting • Satisfying IT accreditation standards • Data conversions • Disaster recovery and business continuity plans – monthly data restores • Australia Wide coverage • References available on request

Jam Software ISN Solutions

P: 1300 300 471 F: +61 2 9280 2665 E: info@isnsolutions.com.au W: www.isnsolutions.com.au ISN Solutions is a medical IT company that specialises in the design, setup and maintenance of computer networks for medical practices.

Our consultants and engineers are dedicated to the medical industry, understand your business needs and know what is required to run a practice. We strive to take away the pain from you, on managing the day to day IT issues regardless of which medical application you use. Our claim is supported by strong industry references.

Some of our solutions include but are not limited to: • A paperless practice • Speech Recognition • Capped cost medical support & maintenance plan • Ability to consult remotely • Linking your imaging equipment to your network • Medical application Support

48 Pulse+IT

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

P: +61 2 9799 1888 F: +61 2 9799 4042 E: enquiries@jamsoft.com.au W: www.jamsoft.com.au

P: +61 2 9901 6400 F: +61 2 9439 6331 E: sales@meditech.com.au W: www.meditech.com.au

MED™4i (Medical Electronic Desktop™) streamlines Health Care with easy-to-use customisable interfaces. Modular Versatility & Connectivity backed by friendly expert engineers.

Medical-Objects

Comprehensive Patient database with multiple-format billing including electronic Online Patient Verifications & Claiming to Medicare, DVA & Health funds (paperless), Letters, Prescriptions (including MIMS), Orders, e-Results, MS Office integration & CustomDB including surgical & other audits. Now with HL7 Secure Messaging.

Medical-Objects has provided secure messaging to over 10,500 health professionals with referrals, reports, letters and discharge summaries.

Delivering directly into leading practice software, removing the need for scanning and faxing.

Your specific needs can be accommodated easily, onsite & remote installation, training, ongoing support including upgrades to meet the ever‑changing health requirements.

Medical Software Industry Association

A Worldwide Leader in Health Care Information Systems

P: +61 7 5456 6000 F: +61 7 3221 0220 E: info@medical-objects.com.au W: www.medical-objects.com.au

Referrals are digitally signed and encrypted, moreover, compatible with Medicare’s requirements and in line with NEHTA’s eHealth PIP direction.

Using Medicare supported PKI, you can trust that referrals are digitally signed with PKI and we are working with NEHTA as an eHealth PIP eligible secure messaging vendor.

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.

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MIMS Australia

P: +61 2 9902 7700 F: +61 2 9902 7701 E: info@mims.com.au W: www.mims.com.au MIMS Australia is built on a heritage of local expertise, credibility and adaptation to changing healthcare provider needs. Our information gathering, analysis and coding systems are proven and robust.

MIMS information is backed by MIMS trusted, rigorous editorial process and constantly updated from a variety of sources including primary research literature. Our database and decision support modules are locally relevant, clinically reviewed and updated monthly and compatible with a host of clinical software packages. Indeed, the majority of Australian prescribing packages and many dispensing applications are supported by the MIMS medicines data base.

MIMS is delivered all the ways you need – print to electronic, on the move, to your patient’s bedside or your consulting room desk. Whatever the format, MIMS has the latest information you need.

Orion Health Mouse Soft Australia Pty Ltd

P: +61 3 9888 2555 F: +61 3 9888 1752 E: sales@medicalwizard.com.au W: www.medicalwizard.com.au Medical Wizard saves time and money through greater efficiency and comprehensive integration.

Throughout its 17 year history, Medical Wizard has led the way with innovative solutions. We are constantly evolving Medical Wizard to meet the challenges of the medical profession for today and tomorrow.

A software of choice for discerning Specialist practices, notably Gastroenterologists, Cosmetic Surgeons, Ophthalmologists, General Surgeons, IVF Centres and Day Hospitals amongst others.

All aspects of practice management from appointments, billing, clinical, theatre management and compliance reporting are covered and backed by a dedicated local support team.

P: +61 2 8298 2600 F: +61 2 8298 2666 E: admin@nehta.gov.au W: www.nehta.gov.au

P: 1300 700 300 E: info@mitshealth.com.au W: www.mitshealth.com.au Managed IT Services for the Health Industry

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.

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P: 1300 550 716 F: +61 2 9434 2301 E: Vicki.Rigg@nuance.com W: www.nuance.com/au

Nuance (NASDAQ: NUAN) is a leading provider of speech and imaging solutions for businesses and consumers around the world.

Its technologies, applications and services make the user experience more compelling by transforming the way people interact with information and how they create, share and use documents.

Every day, millions of users and thousands of businesses utilise Nuance’s proven range of productivity applications which include Dragon NaturallySpeaking (speech recognition), OmniPage (OCR), PaperPort (document management) and PDF Converter Professional (PDF creation and conversion).

Feature Rich. Dynamic. Innovative.

NEHTA

MITS:Health

Nuance Communications

Equipment supply and installation Remote monitoring and support Data backups Networking Internet Website Development

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 cross‑organisational and regional sharing of patient information, resulting in improved patient care.

Orion Health Patient Portal enables patients to access their personal medical record, request appointments, and communicate with their care providers.

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.

Software of Excellence

P: +61 3 8872 5500 F: +61 3 8872 5524 E: sales@oasis-software.com.au W: www.oasis-software.com.au Developed in Australia by the leading practice management provider in the Dental Market, OASiS Software has now released OASiS Health.

Already used by Medical Specialists, Physiotherapists, Chiropractors, Podiatrists, Physiologists and a variety of other Allied Health Professionals.

With full appointment book and clinical functionality, many customers have used OASiS Health to create the paperless practice by taking advantage of OASiS Health powerful document and image handling features.

Described as the most flexible practice management system available, OASiS Health specialises in Multi-Branch, Multi-Practitioner and Multi-Discipline practices.

OASiS Health is designed to create a Healthy, Profitable business.

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P: +61 2 8096 0000 / +64 9 638 0600 F: +61 2 8096 0001 / +64 9 638 0699 E: enquiries@orionhealth.com W: www.orionhealth.com

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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The Specialist

P: +61 8 8203 0500 E: info@clintelsystems.com W: www.clintelsystems.com

Medilink

from Practice Services P/L

P: +61 3 9819 0700 F: +61 3 9819 0705 E: Sales@practiceservices.com.au W: www.practiceservices.com.au

“The Specialist” is an intuitive and comprehensive tool that allows management of patients within specialist medical practices and day surgeries.

The Specialist includes 5 modules: • Accounting • Correspondence • Time Manager • Medical Records • Mobile Data Facility

Medilink Practice Management Software Key features: • 21 years young, large user base • Runs on both Macintosh™ and • Medilink = Intuitive ease of use Windows™ platforms.

• Solo Drs up to Hospitals in size • Scales easily from stand-alone • Claiming via integrated EFTPOS users, to multi-site networks. àà and/or integrated HICAPS • Industry standard, and readily àà and/or Medicare Online interoperable with other systems. àà and/or ECLIPSE • Comprehensive data migration • Many standard features tools for most systems.

• Many optional modules • Unlimited training and support.

• Links to many third party packages • Designed with the future in mind. and services • Cut debtors and boost cash flow • 17 years as an Authorised Medilink Dealer, selling, installing & training • Fixed Cost Support, Onsite or 20/02/09 14:50:20 Remote SR Logo_65x42mm.pdf

Stat Health Systems (Aust)

P: +61 7 3121 6550 F: +61 7 3219 7510 E: carla.doolan@stathealth.com.au W: www.stathealth.com.au Stat Health Systems (Aust) has built a progressive and resilient system that introduces a new level of stability and flexibility to the medical software market. Stat is an integrated clinical and practice management application which has embraced the latest Microsoft technology to build a new generation solution.

Fully scalable and the only medical software application to incorporate a multi-functional intuitive interface, Stat is at the forefront of computing technology.

Stat Health provide a premium support service, clinical data conversion from existing software and tailor made installation and training plans for your practice.

Real Outcomes Real Productivity Minimising Waste

Spellex

P: +61 2 8014 4573 E: info@spellex.com.au W: www.spellex.com.au Spellex has been the leading provider of comprehensive medical dictionary enhancement software to thousands of the world’s most prominent healthcare companies for 21 years.

Our easy-to-use Australian medical spell checking software integrates fully with all Microsoft programmes, Web-based applications, and popular platforms.

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SmartRooms by Doctorware P: +61 3 9499 4622 F: +61 3 9499 1397 E: sales@doctorware.com.au W: www.doctorware.com.au

SmartRooms provides a comprehensive software solution for specialist practices for both Mac and Windows.

Comprising both practice management and clinical software, our all-in-one patient record and superior after-sales support provides the basis for a stable and time effective software solution for specialist practices of all sizes.

SmartRooms is available in an appointments and billing-only version for practices with uncomplicated software needs.

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Spellex Medical is available for end-users to ensure the medical accuracy of documents and to enhance their productivity. Spellex software development kits can also be integrated with developer’s custom programmes and Web sites. Whether you’re an individual transcriptionist or you need to provide greater medical documentation accuracy across an entire hospital or campus, Spellex has a solution that’s right for you.

For a free trial of Spellex software, go to spellex.com.au and click the Free Trial tab.

Vensa Health

P: +64 9 522 9522 F: +64 9 522 9523 E: website@vensahealth.com W: www.vensahealth.com The next time you receive a text message mobile reminder or an alert from your doctor, hospital or physio you now know its done by Vensa.

Vensa Health is a mobile health (mHealth) provider in the health care sector offering eHealth integrated mobile solutions, enabling text-messaging for patient communications for applications such as appointment reminders, medication reminders, test results alerts, recalls for screenings such as mamograms, immunisations and more.

Vensa has invested substantially into developing products and services that offer communication solutions to better content providers with patients, including mobile text-messaging, voice, mobile sites and Telehealth services delivery.

Trend Care Systems

P: +61 7 3390 5399 F: +61 7 3390 7599 E: support@trendcare.com.au W: www.trendcare.com.au

Zedmed

A national and international award winning solution recognised for its ability to provide real benefits in the acute and sub-acute health care settings.

TrendCare is an international leader for e-health solutions excelling in all of the following: • Patient dependency and nursing intensity measures.

• Projecting patient throughput and workforce requirements.

• Rostering and work allocation.

• Efficiency, productivity and HRM reporting.

• Discharge analysis, bed management and clinical handovers.

• Allied health registers with extensive reporting.

• Clinical pathways with variance reporting.

• Patient assessments and risk analysis.

• Diet ordering and reporting.

• Staff health tracking and reporting.

P: +61 3 9284 3300 F: +61 3 9284 3399 E: sales@zedmed.com.au W: www.zedmed.com.au Owned by Doctors who understand the challenges facing the medical profession everyday and backed by nearly 30 years of experience in medical software programming, Zedmed provides innovative, full featured and sophisticated practice management and clinical records software solutions.

Zedmed would also like to introduce to you 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

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