Pulse+IT Magazine - November 2014

Australasia’s First and Only eHealth and Health IT Magazine

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ISSUE

17 NOVEMBER 2014

MOBILE HEALTH An Apple a day

Apple is targeting not just consumers but healthcare providers with its HealthKit platform, linking patient health data to doctors.

Practical apps

While health apps of questionable value proliferate, there are practical apps for appointments, apps for medicines and apps for patients.

Pathology, patients and portals Giving patients access to their pathology results through patient portals: where is the evidence?

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Inside

Publisher Pulse+IT Magazine Pty Ltd ABN: 34 045 658 171 www.pulseitmagazine.com.au Editor Simon James Australia: +61 2 8006 5185 New Zealand: +64 9 889 3185 simon.james@pulseitmagazine.com.au Advertising Enquiries Please visit our website for more information about advertising in Pulse+IT magazines, eNewsletters and website.

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Looking Ahead Pulse+IT welcomes feature articles and guest editorial submissions relating to the nominated edition themes, as well as articles relating to eHealth and Health IT more broadly.

In addition to our daily eNewsletter service, Pulse+IT is produced in print seven times per year with the first edition for 2015 to be distributed for release in February.

Edition themes for 2015 are available at the Pulse+IT website.

Submission guidelines and deadlines are available online: http://www.pulseitmagazine.com.au/editorial Pulse+IT acknowledges the support of the following organisations, each of whom supply copies of Pulse+IT to their members.

About Pulse+IT Pulse+IT is Australia’s first and only Health IT magazine. With an international distribution exceeding 35,000 copies, it is also one of the highest circulating health publications in Australasia. 32,000 copies of Pulse+IT are distributed to GPs, specialists, practice managers and the IT professionals that support them. In addition, over 5,000 copies of Pulse+IT are distributed to health information managers, health informaticians, and IT decision makers in hospitals, day surgeries and aged care facilities.

ISSN: 1835-1522 Contributors Dr Glenn Edwards, A/Prof Andrew Georgiou, Rob Khamas, Simon James, Richard Lawrance, Dr Michael Legg, Dr Elin Lehnbom, Dr George Margelis, Dr Mirela Prgomet, Kate McDonald, Dr Robyn Whittaker.

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

Copyright 2014 Pulse+IT Magazine Pty Ltd No part of this publication may be reproduced, stored electronically or transmitted in any form by any means without the prior written permission of the Publisher.

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FULLY DIGITAL, FULLY INTEGRATED

APP HELPS CARDIAC REHAB AT HOME

BLACKTOWN HOSPITAL IS PAPER-LITE

Editorials

Features

News

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APPLE HEALTHKIT

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APPOINTMENT APPS Apps for patients and apps for practices for online bookings.

Fully integrated v best of breed: St Stephen’s Hervey Bay

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PATIENT APPS

Telstra to launch patient-to-GP, 24hour telehealth service

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STARTUP Simon James announces an expansion of Pulse+IT’s digital services.

GEORGE MARGELIS Health apps and fitness devices continue to proliferate, but are they all bubble and hype?

LEHNBOM AND PRGOMET While tablet computer use at the bedside is not unusual, limitations mean it’s still not a necessity.

ROB KHAMAS Mobile devices are convenient, but there are dangers if the data they contain is not secured.

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The iPhone makes a strong but flawed start in the health space.

Medicare Locals to be sliced into 30 primary health networks HCN rebrands as MedicalDirector

Many health apps are of dubious worth; here are some that aren’t.

The market for apps that can send a script is heating up.

DVA claiming for allied health professionals online Datacom invests in Smartward to launch its new health solutions unit

BYOD IN AGED CARE BYOD is moving into aged care, for nurses and visiting GPs.

HIMAA

Alcidion partners with Fujifilm for cardiovascular care Easier path to approval for medical devices

eHealth and clinical classification emerged as key themes at the HIMAA NCCH conference in Darwin.

Resources

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EVENTS Up and coming eHealth, Health, and IT events.

Woz joins the faculty as UTS hosts social robots

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PULSE+IT DIRECTORY

ACHI

Smart app helps patients complete cardiac rehab in the home

Evidence is increasingly showing that mobile-based healthcare interventions work.

Evaluating the evidence for the efficacy of allowing patients to view pathology results through a portal.

Blacktown Hospital goes fully electronic with mobile Paper-Lite

The Pulse+IT Directory profiles Australasia’s most innovative and influential eHealth and Health IT organisations.

Mobile cardiology clinic takes to the road in rural Queensland

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Editorial

MAKING MOVES WITH MOBILE HEALTH As we head into the summer season, it’s timely to look back at what has been a tumultuous year in Australian eHealth. Anecdotal evidence would suggest that many in the sector are suffering from fatigue over the many changes that have occurred over the last three or four years, precipitated mainly by the launch of the PCEHR in 2012.

SIMON JAMES BIT, BComm Editor: Pulse+IT simon.james@pulseitmagazine.com.au

As the year draws to a close, the PCEHR is still struggling to make much headway and that hasn’t been helped by the uncertainty throughout 2014. It wasn’t until the May budget that we found out whether it would remain in existence, with the Royle review finally released shortly afterwards. Since then, the Department of Health has been holding a series of consultation meetings, the outcomes of which are also unclear.

While patient registrations for the system keep climbing – it is now at the two million mark – and some clinical documents are being uploaded regularly, it is in the area of the main clinical document that actual progress can be gauged. Prescription and dispense records are going up at a rate of knots, discharge summaries are flowing quite freely, and there has even been a start on event summaries, with 4000 now in the system.

About the author Simon James is the editor of Pulse+IT, one of Australia’s highest circulating health publications of any kind. Prior to founding the publication in 2006 he worked in an IT support capacity for various medical practices, and subsequently for both clinical software and secure messaging developers.

However, it is the lack of movement in shared health summaries where the real story is told. Uploads have ground to a halt, with just over 30,000 now in the system. This means that between June 2013 and September 2014, only 28,000 shared health summaries have been created. Few would give this a pass mark, and little evidence exists that documents of any type uploaded to the PCEHR are actually being reviewed by healthcare professionals.

It is to be hoped that a decision will be made on what happens next before the Christmas break, but in the meantime we are at a standstill when it comes to the PCEHR. Not so in other areas of eHealth and health IT, such as telehealth and mHealth. In the former, Telstra has made a few waves, announcing in late October that it was planning to set up a new service allowing patients to directly consult with a GP by phone or video conference. Telstra is also working with the Northern Territory government to establish a National Telehealth Connection Service, bringing to the disparate, pilot-driven telehealth sector one of the things it really needs – a workable scheduling system.

In the mobile health arena, probably the biggest news this year came from Apple, which has been dropping hints for some time about plans to make a move into the health sector. It is still early days, but in this issue of Pulse+IT, we take a look at what Apple’s Health app can do now and what it could potentially do in the future.

We also provide a round-up of a number of new apps released this year specifically for the Australian health sector.

Introducing Oz Medical Apps In preparation for the release of this edition, the Pulse+IT team has been busy preparing an online resource devoted to

mobile health. As the name suggests, the new website (www.ozmedicalapps.com.au) is dedicated to reporting on mobile apps of relevance to Australian clinicians and healthcare organisations.

Beyond timely news stories covering the latest developments in the field, apps presented on the site will be categorised in a number of different ways, such as by discipline, to make it easy to identify apps that may be of interest to your work in the healthcare sector. Feedback and discussion will be actively encouraged on the site to assist potential users of medical apps to gain a more complete picture about the characteristics and utility of the apps referenced.

Pulse+IT on Android and iOS In keeping with the spirit of our new venture, Pulse+IT is pleased to report that our publication is now available on both Android and iOS. While we have had an iOS app available in the Apple Newsstand for a few years now, Issuu, the technology that supports the online representation of our magazines, has developed native apps for both platforms and I encourage you to check them out via the following links: • iOS - http://bit.ly/issuuonios • Android - http://bit.ly/IssuuOnAndroid After downloading the app, simply search within it for ‘Pulse+IT’ (or pulse+it or

Outsourced Patient Management

pulseit) and our entire archive will be available for browsing on your mobile device. Magazines can also be viewed in most mobile device web browsers.

Looking ahead With this printed edition of Pulse+IT being the last one for 2014, I’d like to take the opportunity to thank all the subscribers, advertisers and membership organisations that have supported the publication throughout the year. Pulse+IT returns in print in February 2015, but our daily online reporting and our free eNewsletter updates will continue throughout the summer months to keep you abreast of the latest eHealth and health IT developments.

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Guest Editorial

BUBBLE AND HYPE:

THE REALITY OF HEALTH APPS The saying that “there’s an app for that” has quickly become a cliché, but that doesn’t mean there is not a lot of truth behind it. As health apps and fitness devices proliferate, it is timely to take a considered view of their relative worth and remember that in healthcare, it is the person, not the device, that is the lifesaver.

DR GEORGE MARGELIS MBBS M.Optom GCEBus Adjunct Associate Professor University of Western Sydney george@georgemargelis.com

I love my mobile phone and take it everywhere with me. I love it so much I have a spare one in case something happens to it so I can switch my SIM card and be back online in seconds. I don’t consider myself a Luddite, and judging by the number of gadgets in my home office my wife thinks I am trying to maintain the mobile electronics industry all by myself.

I have an iPad, an Android tablet and a Windows Surface tablet, just in case one of them wins the tablet wars, as well as a notebook and two desktop computers, one a Mac and one a PC. However, I have become pretty good at recognising hype, probably because I have been burned by it so many times before.

About the author Dr George Margelis is a medical doctor with experience in software development and an interest in improving quality and delivery of healthcare utilising information technology.

He is currently working with the TeleHealth Research & Innovation Laboratory to drive the adoption of telehealth as part of the healthcare available to all Australians.

Hype is not necessarily a bad thing. It usually correlates with passion, innovation, opportunities to make a profit and much more. However, I get a little upset about it in healthcare, because with the hype comes people who dream of their illness being cured, their suffering being lessened, their children being healthy.

Those are noble goals we all should aim for, and it is heart wrenching when you see them taken away from people by hype. mHealth is currently full of a lot of hype.

That’s not to say that there are not some good mHealth things out there. There are, and I use some of them every day.

But when people become so enmeshed in

the hype that they have to verbally attack anyone who questions its value, I smell the bad side of hype, and I get worried. I do believe that mHealth can play an important role in healthcare, but only when it learns to interact with the whole system. It needs to integrate not only with the technology used, but the workflow and the culture.

Technology as a tool Healthcare is a complex interconnected industry, and delivering good healthcare is a complex task requiring knowledge, communication and skill. To deliver it we need the best tools available, and many people have become rich from developing such tools. However, healthcare is still delivered to people by people with the aid of tools. When I start to see headlines telling me that my phone will replace my doctor, that keeping track of my pulse and weight and a few other things will diagnose my diseases, despite the fact that in many diseases none of these variables change, I get a bit concerned, and so should you.

It gets worse. When an IT company releases a “health platform” on its new phone that connects all your health data, but only on certain devices, and without telling me what health data it connects, I get even more concerned. The pictures are great, with charts which show me getting healthier by the day and smiling runners

who look down on their new smart watch and plan for the 2020 Olympics.

Problem is, last time I looked into a hospital ward it was full of old people with multiple diseases that interact with each other in a variety of ways that can’t be graphed on a simple chart. There are people with six or more different medications, some of which make them better, and some that make them sicker.

There are people who need a surgeon to remove a tumorous growth, or potent chemotherapy to try and cure their cancer.

We use tools to do this, and mHealth may be a great tool for keeping the patient informed, the doctor connected, and even help process the payment.

Hype bubbles

“In healthcare, we cannot afford to get overly excited by the technology du jour and the fervent hype that often surrounds it.”

Dr George Margelis

and the fervent hype that often surrounds it. We need to keep our eye on the target: the patient who is sick and needs our help.

We have to bring every tool we can to the battle, but we need to focus on how we use the tool to deliver better health outcomes, and not become enamoured by the tool.

To be a good tool it has to work with the other tools we are using. In eHealth, that would be the electronic medical record, the disease registry, the pharmacy dispensing system, and the data analytics platform for big data – although that too may be just another hype-filled bubble.

It is easy to say that device A or app B will help solve our healthcare crisis.

Unfortunately, it is that simplistic type of thinking which has gotten us deeper into the crisis. We hear governments complain about the cost of healthcare and we try to solve it by injecting more expensive proprietary solutions into the system.

In healthcare, we cannot afford to get overly excited by the technology du jour

I believe we need to step back and look at the healthcare interaction with fresh eyes,

and then work out how we inject relevant technology into it to help. That needs us all to take a deep breath, sigh once to get our frustrations out, and start collaborating on tools that work together, and deliver benefits.

If I sound like a Luddite who wants to return to the past, I apologise. However, in our grab for all things new and shiny we may have left some of the good things of the past behind us. I think it is time for us to slow down and look at where there are problems that need to be solved, and focus all our skills on those. If the solution comes on a mobile phone, great, but let’s not forget that sometimes the solution may be in the touch of a hand, or the smile of nurse.

www.hitcommunications.asia

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Guest Editorial

TABLET COMPUTERS IN HEALTHCARE SETTINGS NOVELTY OR NECESSITY?

Australian hospitals are increasingly encouraging the use of mobile devices such as tablet computers for clinical purposes beyond laptops and computers on wheels, and evidence suggests this is a popular move.

Recent research shows that while tablet computer use at the bedside is not unusual, access to the full range of clinical information systems and how that information is presented on a small device is still a stumbling block to getting the best value out of tablets.

DR ELIN LEHNBOM BScPharm, MPharmSc, MClinPharm, PhD, FACHI Postdoctoral Research Fellow, Centre for Health Systems and Safety Research elin.lehnbom@mq.edu.au DR MIRELA PRGOMET BAppSc(HIM)(Hons), PhD Postdoctoral Research Fellow, Centre for Health Systems and Safety Research mirela.prgomet@mq.edu.au

Clinical information in healthcare settings is becoming increasingly digitised. The majority of Australian GPs use clinical software packages for prescribing medications, checking interactions, and recording patient notes. Although the implementation of clinical information systems in hospitals has been slower than in general practice, there are now hospitals that are completely paperless.

With the introduction of clinical information systems, health professionals have had to adapt their work practices to integrate computing devices. GPs have an advantage in that most patient consultations occur in practice rooms within easy reach of a desktop computer or laptop. For doctors, nurses and other health professionals working in hospitals who are constantly moving between patients or wards, the integration of computers into their work is more challenging.

About the authors Dr Elin Lehnbom and Dr Mirela Prgomet are postdoctoral research fellows with the Centre for Health Systems and Safety Research at the Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University. They have published extensively on mobile computing devices and decision support in healthcare.

Desktop computers are typically located away from the patient bedside and carrying a laptop or carting around a computer on wheels (COW) is more cumbersome and time consuming than taking a paper record to the bedside. Tablet computers, such as iPads, are often promoted as having the potential to match the mobility of paper records. In theory, tablet computers could be used for quick and convenient entry or retrieval of patient information anywhere

and at any time. They could also be used to share information with patients at the bedside, such as showing patients their x-ray images.

In practice, however, the potential benefits of tablet computers can be limited by a hospital’s clinical information systems.

Many clinical information systems that are currently in place have been designed to be displayed on larger screens (i.e., laptops, COWs or desktop computers), and as a consequence, the system interface does not translate well onto the screens of smaller devices.

We found this to be the case in a study we conducted comparing doctors and nurses use of desktop computers, COWs and tablet computers.1 The smaller size of the tablet computers meant that less patient information could be displayed on the screen, requiring users to scroll more to view and obtain information compared to a desktop computer screen. In addition, the on-screen keyboard of the tablet computers obscured the “ok” button of decision support pop-up windows, making it difficult for users to close the window and return to the main user interface.

Issues of interoperability can also affect the functions that can be performed on tablet computers. If the hospital’s clinical information systems are Windows-based,

they may not adequately communicate with or be transferable to iOS devices.

In a recent study, we provided 10 senior doctors with iPads for use on ward rounds.2 However, the devices were limited to readonly functionality of the hospital’s Windowsbased clinical information systems and could not be used to access the picture archiving and communication system (PACS) to view radiology images.

During ward rounds, doctors were frequently observed looking up test results and medications, and to a lesser extent patient information, images and reports. Of the computing devices available (desktop computers, COWs, iPads and smartphones) the primary device of choice for accessing information on ward rounds was the iPad (56 per cent) followed by the COW (36 per cent). The regularity of iPad use on ward rounds was somewhat surprising given they were not fully integrated with the hospital’s clinical information systems (e.g., PACS could not be used) and they provided read-only access.

While doctors valued the mobility that the iPads afforded, in order to improve usefulness and efficiency, they emphasised

the need for tablet computers to allow full access to existing clinical information systems so that all relevant tasks could be performed on the devices.

high quality care that fosters confidence and improves patient satisfaction, they preferred to share information with patients verbally.

The ability for doctors to use tablet computers to access clinical information systems at the patient bedside lends itself to the possibility of showing patients relevant information during care interactions. We hypothesised that iPads could be used during ward rounds to show patients their test results and other clinical information leading to improved patient engagement in their care process.3

As it currently stands, tablet computers are more than a novelty but are not as yet a necessity. Tablets are useful for data retrieval during ward rounds but their use as a tool to engage patients in the care process remains limited.

Disappointingly, during 36 hours of observed interactions with 525 patients, we only observed one patient interaction where a doctor used the iPad to show the patient their test result. Nonetheless, 63 per cent of patients, whose doctor had used an iPad, reported feeling very or somewhat engaged in their care process. The patient who was shown their test result via the iPad reported that they thought the device had increased their engagement in the care process. Although doctors believed it is important to engage patients and share information with them to deliver

Individual health professionals or organisations contemplating the introduction of mHealth are advised to speak to their information technology (IT) department prior to purchasing tablet computers to understand their local clinical information systems requirements (e.g., operating system compatibility) and any limitations associated with translating the systems to smaller devices. Such considerations are critical if tablet computers are to deliver on their full potential.

References Full references are available online at www.pulseitmagazine.com.au

ozmedicalapps.com.au

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Guest Editorial

IS YOUR CLINIC PREPARED FOR BYOD? In a professional sector where security is essential, bring your own device (BYOD) is surprisingly common in healthcare, with staff members using their own portable devices to perform work-related tasks. Both healthcare organisations and staff must remember that while mobile devices are amazingly convenient, that convenience brings with it real dangers if the information they contain is not secured.

ROB KHAMAS B. Telecommunications Engineering Health solutions strategist REND Tech Associates rob.khamas@rendta.com

With hardly a week going by without a news story involving a high-profile data breach where customers’ personal and financial information are compromised, this can be an even more worrying scenario for healthcare professionals, given the importance and sensitivity of electronic health records and related billing information.

In general, BYOD adoption is driven by medical professionals seeking to improve efficiency and not by IT professionals who recognise the risks involved if BYOD is not introduced in a way that maintains data security. Medical professionals, quite rightly, focus on patient care and leave security concerns to their administrators and IT teams.

About the author Rob Khamas is an eHealth solutions strategist with REND Tech Associates. He has more than 10 years’ experience in IT implementations, technical support and project management, and now specialises in health IT and eHealth.

In large organisations, BYOD introduction is formally launched by an executive team that consists of legal, HR and other involved departments. A HR policy is drawn up that employees must agree to before being allowed to use their device on company networks. Under such arrangements the employee is effectively granting the company access to their personal device, to install partitioning software (which segregates personal data from business information) and other apps that allow remote wiping of data if the device is lost, stolen or if the owner leaves the organisation.

If remote wiping is necessary, personal data is sometimes lost, hence the necessity of a HR policy.

For healthcare facility owners, practical steps for safe BYOD implementation should include: • Creation of a BYOD policy that involves all department heads • Generating a list of approved devices and users • Create a back-up and disaster recovery process for each device and verify that it works • Installation of partitioning software on each device that allows separation of personal and business data • Installation of latest patches and security updates: IT should have remote access to the device, including the capability for remote wiping if the device is lost or stolen. Regular maintenance is also necessary • Installation of software that protects against viruses, malware and other security threats • Ensure that all devices are passwordprotected • Provide security training to staff members, highlighting the main avenues of attack used by hackers • Ensure that all devices are insured adequately • If devices are replaced, securely

remove data. It is important to remember that this only applies to business data as staff may have family photos and other data on the device.

BYOD costs can vary, with some companies supplying the devices to staff members and others happy to allow staff members to use their own. In addition, some offer a shared ownership-type facility where costs are shared.

Regardless of the payment method, most businesses will insist on approved manufacturers or platforms – some are more comfortable supporting Android devices while other prefer Apple devices.

Therefore, staff members need to: • Remember that only approved devices are suitable for business use • Carefully read the BYOD policy, as it will outline terms for the business and device owner. If the terms seem unsuitable (remote wiping, for example), do not use your device for business • Be aware that by using your own

device, you are giving administrator control to a third party • Report loss, theft or replacement of device so that IT can remove data from it • Refrain from deleting business data, just in case it is required in the future.

In a world where e-disclosure is increasingly common, this is the safest approach • Use secure connections when accessing data – avoid using free Wi-Fi hotspots to reduce data breaches.

In addition, there are legal concerns.

In the event of a court order requiring e-disclosure (known as e-discovery in the US), an employee is compelled to surrender their personal device for forensic examination and extraction of required company data.

While the area of e-disclosure is relatively new in Australia, it is worth noting that US employees who have destroyed company data have paid substantial damages as fines were levied against both the company and the employee involved, even though the device was personal property.

The same logical approach to BYOD introduction is advised for healthcare, in addition to compliance with local legislation. It is best if data does not reside on the device but instead located in the cloud or a secure local server, for example.

Access levels are determined by role, with senior-level staff having corresponding access permissions.

A casual approach to BYOD is a recipe for disaster and clinics should investigate their options, hiring outsourced solutions where necessary to recommend the best approach for their clinic. Compliance tools, security software, document management strategies and disaster recovery tools are identified in advance.

Perhaps the single most important aspect of BYOD is the creation of a comprehensive yet adaptable policy that meets the requirements of the business and also of staff members. Information that is unwittingly leaked by a staff member, for example, may see patients seek out and move to other healthcare organisations that value their health records and protect them diligently.

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News

Medicare Locals to be sliced into 30 primary health networks The Department of Health (DoH) has released the long-awaited boundaries for the new Primary Health Networks (PHNs) that are set to replace Medicare Locals, and has placed assisting general practice with eHealth back on agenda.

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Thirty PHNs have been established – more than the expected 20 or 24 – which DoH says will align with state-based Local Hospital Network (LHN) boundaries.

The alignment is apparent for the PHN boundaries in NSW, Queensland, South Australia and Western Australia, which mirror those states’ LHNs.

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Victoria has close to 90 LHNs centred on individual hospitals and health services rather than geographical areas, but it will have only six PHNs. As is currently the case with Medicare Locals, Tasmania, the NT and the ACT will be covered by one PHN.

Much of the reduction in ML numbers has occurred in the capital cities: the greater Sydney region will have five, Melbourne will have three, Brisbane two, Perth two and Adelaide one.

It is probable that regional sub-offices will need to be established for rural areas in WA, SA, Queensland and western NSW considering the vast distances the PHN will be responsible for. The whole of WA and SA outside of the capitals will have one PHN each, covering the same areas as Country Health SA and the WA Country Health Service.

In an overview of the proposed timeline for establishing PHNs, DoH says that an approach to market (ATM) process will take place late this year for organisations to bid to operate the PHNs. The successful applicants will be announced next year, with PHNs given about three months to begin

establishing themselves before the end of the financial year.

A strong emphasis on the role of PHNs in predominantly assisting general practice is apparent in the overview, with no mention of community pharmacy or aged care.

One of the roles for PHNs highlighted in the overview is to assist GPs in understanding and making meaningful use of eHealth systems.

PHNs will have five primary roles, including analysing and planning for the health needs of their local communities; helping general practices to assist patients in avoiding hospital admissions and supporting general practices in safety and quality measures.

They also include assisting GPs to use eHealth systems; and purchasing or commissioning clinical services for population health issues such as

chronic disease and mental illness.

Metro North Brisbane Medicare Local CEO Abbe Anderson welcomed the decision not to increase the size of her ML, which already has a population of near 900,000.

“The news that the boundaries for the Metro North Brisbane region will remain as they currently are will be a relief to many GPs and allied health professionals,” Ms Anderson said.

“A recent survey carried out by the Medicare Local revealed that many health professionals were concerned that the increased geographical size of PHNs would mean a loss of connection with local health professionals and providers.”

Northern Sydney Medicare Local CEO Ramon del Carmen said the move to align PHN boundaries with LHN boundaries was a logical one.

“Aligning to district boundaries is an effective way of reducing service duplication and concentrating funding and effort on keeping people healthy,” Mr del Carmen said.

As Medicare Locals operate as independent companies, they are all eligible to bid to run one of the new PHNs. Pulse+IT understands

that a number of the larger Medicare Locals that transferred directly from previous Divisions of General Practice are set to bid individually, while smaller, neighbouring MLs will put in a consolidated bid.

The chief executives of the Grampians, Great South Coast and Barwon Medicare Locals issued a joint statement welcoming the new boundaries. The three Victorian MLs fall within the new Grampians and Barwon South West PHN.

“Aligning to district boundaries is an effective way of reducing service duplication.”

“We are pleased that the government values the primary health coordination role – to provide better, more sustainable, more efficient access to local health services,” they said.

“The new boundaries make sense as they align with existing Local Hospital Network boundaries, contributing to wellconnected health systems in our community.”

Country North SA Medicare Local (CNSAML) CEO Kim Hosking said his organisation would be bidding to provide the new country SA network.

Mr Hosking said the decision to allocate two networks to SA was recognition of the fundamental differences in the provision of health services between the city and in the country.

HCN rebrands as MedicalDirector

“For example, country GPs are expected to provide services in local hospitals, as most country hospitals do not have salaried medical officers,” he said.

The market-leading general practice clinical software, Medical Director itself will now be known as MedicalDirector Clinical, while its general and specialist practice management products will be known as MedicalDirector PracSoft and MedicalDirector BlueChip.

“As an organisation that covers a vast and diverse area … we are strongly positioned to tender to join the new network, in partnership with other rural stakeholders, as we have a proven track record of working with regional health providers and communities.”

Mr Hosking said CNSAML had set up six local health clusters comprising local health providers, community leaders and health consumers that could become the basis for the community advisory committees and clinical councils that the Horvath review into Medicare Locals had recommended.

“We would seek to include existing groups and partners in other parts of the state that could fulfil these roles should we be successful in our bid to provide the new country SA network,” he said.

Maps for each PHN are on the department’s website.

The company formerly known as Health Communication Network (HCN) has changed its business name to MedicalDirector, reflecting its primary clinical software product.

“MedicalDirector is the name customers know us best by and provides a better overview of our business,” CEO Phil Offer said.

The company, a subsidiary of Primary Health Care, is gearing up for a new release of both Clinical and PracSoft at the end of the year, with the latter to include a new integrated online appointments booking module that the company has developed internally.

MedicalDirector Clinical will feature one-click medical certificate functionality, multiple user access to patient records and promised improvements in performance.

It also promises improved patient demographic fields, improved allergy and adverse drug reaction modules, and improved clinical examination data fields.

The company is currently conducting a roadshow over the next few months to introduce users to the new branding and to gather feedback to help it prioritise changes for future releases. It has also revamped its website.

The former HCN brought in revenues of $37 million in the 2013-2014 financial year, with earnings after tax of $20.2m. Both figures are the same as the previous year.

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Darling Downs Health-eRegions project expands

Health technology firms score high on BRW innovators’ list

The towns of Tara and Wandoan in the western Darling Downs have been added to the University of Queensland’s Healthe-Regions telehealth project, joining Dalby, Chinchilla and Miles in receiving improved access to specialist care.

Health IT firms, health insurers and iconic Australian firm Hills have all scored highly on BRW magazine’s list of 50 most innovative companies.

Half a million dollars in extra funding has been contributed by coal seam gas company QGC, the main sponsor of the project, to expand it to Tara and Wandoan, allowing patients and local clinicians to video conference with specialists from hospitals in Toowoomba and Brisbane.

While Kiwi cloud-based accounting software firm Xero took first place for its payroll module, there were a number of healthcare companies and healthcarerelated technologies in the top 50, including online appointment booking and directory service HealthEngine at number 22, and pharmacy IT specialist Fred IT at number 23.

Health-e-Regions has been running for over a year and in that time has seen a doubling of telehealth services provided.

Elderly patients in Dalby Hospital and residents of the Illoura aged care facility in Chinchilla are now receiving regular sessions with geriatricians from the Princess Alexandra Hospital (PAH) in Brisbane.

The project is also working with local GPs to help improve the referral process for specialist consultations by video.

As with the services being developed for the three original towns, the Healthe-Regions team, led by UQ’s Centre for Online Health (COH), will work closely with the new additions to develop services based on need, COH deputy director Anthony Smith said.

“We’ve had an overwhelmingly positive response from patients who have had a telehealth appointment as part of the Health-e-Regions project, and are looking forward to engaging with the Tara and Wandoan community to generate telehealth services specific to their needs,” Associate Professor Smith said.

QGC provided $1.3 million for the original project, which covers equipment installations and development costs.

HealthEngine was cited for the overhaul of the site and its functionality over the last 12 months, which has seen a mobile version of the platform launched and appointment numbers increasing by 57 per cent.

HealthEngine says its iPhone app is consistently in the top 20 medical app downloads in Australia and has seen more than 25 per cent of bookings now being made via a mobile device.

Fred IT is the market leader in dispensing systems in Australia and also owns the eRx electronic script exchange. It has also launched the eRx Express app, which is integrated with Fred and allows patients to order their prescription drugs and set a time to pick them up.

The company is now set to launch Fred NXT, the first full function, cloud-based software as a service (SaaS) offering for Australian pharmacies. Fred NXT is an integrated system for dispense, point of sale, professional services and retail management, hosted in the cloud with some locally installed proprietary and third-party software.

Fred CEO Paul Naismith said the company was born out of the vision of innovating as a means of making things easier for pharmacy.

“Investing in and nurturing innovation is the key to finding better ways for health professionals and their patients to connect.”

“Investing in and nurturing innovation is the key to finding better ways for health professionals and their patients to connect,” Mr Naismith said. “For pharmacy, this means freeing pharmacists up to spend more time with their patients, rather than trying to become IT experts.”

Health solution provider UHG was named at number

15 for its medEbridge information exchange, which is integrated into MedicalDirector and Best Practice and enables the extraction of patient data from the clinical software for secure transfer to insurance companies so they can assess claims faster and more efficiently.

Hills, which over the last few years has divested itself of its heavy manufacturing background and entered new markets in home security systems and healthcare delivery technology, was named at number 20. Hills is currently putting together a portfolio of solutions for the healthcare industry, including IP and wireless nurse call systems, patient infotainment systems and aged care home monitoring solutions.

Pharma company AbbVie Australia secured the 21st spot for the development of OnTrack, a patient adherence program for people with Crohn’s disease using one of its injectable biologics. OnTrack is run in two phases over a 12-month period. with patients provided with inhome and nursing support for four months and then a pharmacy liaison service for a further eight months. The pharmacy liaison service allows script pick-up data to be collected and reported via an online portal.

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Top-down and bottom-up eHealth interoperability A panel discussion on the steps needed to achieve optimal governance for eHealth interoperability is one of the highlights of the second eHealth Interoperability Conference, being held in Sydney at the end of October.

The panel discussion will look at how to balance top-down and bottom-up approaches to interoperability, as well as the need for an open dialogue and a shared vision on the use of data.

Chris Pearce, president of the Australasian College of Health Informatics (ACHI) and director of research at the Inner East Melbourne Medicare Local (IEMML), will provide the keynote speech on governing for efficiency, usability and safety, emphasising the importance of appropriate governance structures in large-scale eHealth programs.

Standards expert Grahame Grieve will discuss architectural approaches for exchanging information, while Michael Legg will use a case study of the Royal College of Pathologists of Australasia’s PITUS project to illustrate what is needed to achieve interoperability.

Some notable interoperable eHealth implementations will also be highlighted, including Jason Whakaari from Western Health on its acute to primary care messaging service, mobility device layer and its new intelligent Patient Journey System (iPJS), which has been rolled out in three hospitals.

Kate Richardson, a pharmacist from St Vincent’s Health Australia, will discuss the interoperable challenges of eMedicines and eAllergies. She will use a MasterChef analogy to illustrate medicines data from primary care to acute care and back again: “filleting components on admission, blending elements for administration, then trussing at discharge”.

Fully integrated v best of breed: St Stephen’s Hervey Bay There have been a couple of others in the running to be named Australia’s first fully integrated digital hospital, but it looks like the new St Stephen’s Private Hospital at Hervey Bay in Queensland claimed the honours when it opened in mid-October.

It will still need to scan in the paper medical records of patients previously admitted to St Stephen’s older facilities – a day hospital at Hervey Bay and a medical and surgical admissions facility at Maryborough – but when new patients begin to be admitted to the new hospital, they will all have a full electronic medical record from day one.

Operated by UnitingCare Health (UCH), the $96

million, 96-bed private hospital has been several years in the planning, with specific funding for its eHealth component coming thanks to a large grant from the Commonwealth Health and Hospital Fund.

That fund allocated $21 million to ICT and eHealth alone, and along with $15.5 million from UCH and the main software vendor, Cerner, represents a huge investment in what is hoped will prove a pilot for further digitisation of UnitingCare’s other hospital assets.

St Stephen’s is aiming to achieve HIMSS level 6 on opening due mainly to its fully electronic, closed loop medications management system, probably the only one of its kind in Australia.

For UnitingCare’s executive

director, Richard Royle, a closed-loop EMM system is one of the key elements of a full EMR. The St Stephen’s system involves electronic orders at the bedside, integration with the pharmacy system, and electronic drug cabinets in each ward that are also linked to Cerner. Mr Royle said UCH had worked with pharmaceutical companies to provide single-dose blister packs for each drug.

“The doctors will order their drugs, it goes electronically to the pharmacy, they pack them up in the individual blister packs and when the nurse comes to dispense the drug, the drug cabinet opens and there will be those individual blister packs in the tray,” he said.

“That means there is also barcoded medication administration which is linked with the pharmacy order that is in the EMR, and we have also installed a number of alerts in the electronic medication system.

“If the doctor has prescribed a drug that the patient is allergic to or prescribed the wrong dosage for the size of the patient or over the total maximum, it will trigger an alert in the system. I know it has been done before, but we are going one step further by making it closed loop.”

Another key element in the move to full integration is the choice of main software vendor. UCH has used variations on Cerner’s clinical information systems since 1999, when it was first implemented at the Wesley Hospital in Brisbane.

While it isn’t official, Cerner is likely to be rolled out in most of Queensland’s public hospitals, probably including Hervey Bay Public Hospital, which is located adjacent to St Stephen’s.

In addition to the ease with which St Stephen’s will be able to communicate with the public system through the same clinical system, Mr Royle said it was the ability of the other clinical systems to easily integrate with Cerner that was one of the main reasons for his decision.

He compares the relatively small number of interfaces to third-party software that will be used at St Stephen’s to the decision made at Fiona Stanley Hospital, where a best of breed platform was originally devised. It is this incredibly complex integration process with clinical systems, along with the enormous amount of work needed on nonclinical infrastructure, that caused the opening of FSH to be delayed by six months.

“St Stephen’s will be the first fully integrated, digital architecture hospital in the country.” “[St Stephen’s] will be the first fully integrated, digital architecture hospital in the country,” Mr Royle said.

“What I mean by that is that we have 29 Cerner applications being put up.

That includes all of the clinical side, and we have another 20 devices that link to it.”

The Cerner applications include inpatient pharmacy, surgery, anaesthetics, PowerOrders and PowerChart, critical care, clinical documentation with Dragon dictation and mPages ICU summary and mobile clinical review, as well as pathology specimen management and the CareAware suite for

medical device connectivity, alarm management and care team communication.

Some of the third-party equipment includes a patient entertainment and education system, while Cerner is also providing comprehensive barcode scanning and real-time location systems both for patients and equipment.

For nursing staff, UCH has contracted Ascom to provide its workstation on wheels (WoW) solution, providing a fully integrated, fully mobile nursing station.

Ascom will deliver 45 Advantech AMiS-50 WoWs together with integrated MedProx cabinets from Elliott Data as part of the solution.

“Our nurse call system is fully integrated with the EMR so every time a patient calls the nurse it is recorded on the EMR,” Mr Royle said. “The room link allows real-time location for patients and the equipment. Every one of our clinical systems links into the EMR. “This is integrated clinical architecture. If I look at some of the challenges ... at Fiona Stanley, one of the challenges is that ... there are 158 interfaces at Fiona Stanley. 158. They have a best of breed model, but history is showing that the more interfaces you have to build into a system the more challenges you will have.”

Madden, Fleming and Hambleton to headline RMA The Department of Health’s Paul Madden and NEHTA’s Peter Fleming and Steve Hambleton have been confirmed as participants on a special eHealth panel taking place at the Rural Medicine Australia (RMA 2014) conference in Sydney at the end of October.

Mr Madden will outline the main findings from the round of consultations held by DoH in August and September on the recommendations of the Royle review into the PCEHR. Mr Fleming will provide an update on moves to add pathology and diagnostic imaging reports to the PCEHR, and Dr Hambleton will discuss clinical involvement in the system.

The panel session is being held on Friday, October 31 at RMA 2014, the annual joint conference of the Australian College of Rural and Remote Medicine (ACRRM) and the Rural Doctors Association of Australia (RDAA).

ACRRM past president Jeff Ayton and RDAA’s Ewen McPhee will also take part in the session. It will be preceded by a demonstration from Dr McPhee on how he uses the PCEHR in rural general practice.

Following the panel session, representatives from state and territory health departments will outline eHealth and telehealth programs and achievements in each state to provide a “whole of health sector” view of eHealth and telehealth progress.

The topic of telehealth and its growing application will also be a major point of discussion at the conference. Dr Ayton and ACRRM president Richard Murray will lead a telehealth session that will include Shannon Nott, a registrar at Orange Health Service in NSW who was recently awarded a Churchill Fellowship to research the role of telehealth in delivering care to remote indigenous communities.

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UNSW deals in big data as AIHI moves across town The University of NSW is set to open a new health research centre concentrating on big data as three of its most wellrespected research groups prepare to depart for Macquarie University.

UNSW has lured epidemiologist Louisa Jorm from the University of Western Sydney to head its new Centre for Big Data in Health, which will investigate using large-scale and linked health data and translate it into better disease prevention and patient care, as well as more effective health care spending.

The Centre for Big Data in Health will concentrate on linking, scrutinising and mining the vast banks of data held by modern healthcare systems, including biological data, clinical records and information about environmental risks and lifestyle.

It will initially focus on Professor Jorm and her team’s current areas of expertise, including maternal and child health, chronic disease and multi-morbidity, Aboriginal health, substance use, drug safety, communicable disease and injury.

UNSW announced in July that three research centres within the Australian Institute of Health Innovation (AIHI) were moving to Macquarie, including the Centre for Clinical Governance Research, led by Jeffrey Braithwaite; the Centre for Health Informatics, led by Enrico Coiera; and the Centre for Health Systems and Safety Research, led by Johanna Westbrook.

The AIHI represents Australia’s largest health informatics research groups. About 100 staff and students will make the move to Macquarie, which hosts the Australian School of Advanced Medicine (ASAM).

The university also owns and operates the private Macquarie University Hospital, which opened in 2010 and is fully digitised.

Telstra to launch patient-to-GP, 24-hour telehealth service called ReadyCare Telstra Health has announced a joint venture with Swiss company Medgate to establish a new telehealth service called Telstra ReadyCare in which patients can consult directly with GPs over the phone or by video conference 24 hours a day.

Telstra also announced it was partnering with the Northern Territory government to build a National Telehealth Connection Service, including scheduling capabilities, that will initially provide telemedicine services to deliver health services to people in remote communities.

Telstra Health managing director Shane Solomon said that while there were a number of options for funding the service, including offering it through private companies for employee healthcare, partnering with health insurers and offering it eventually to GPs in private practice, the full details had not yet been worked out.

Telstra’s group executive for retail, Gordon Ballantyne, said ReadyCare would involve employing GPs to do the consultations. One major point of difference is that ReadyCare will be able to offer online diagnostic services, electronic

prescriptions and specialist referrals as well as advice.

Medgate has been providing telemedicine services in Switzerland for 13 years, with a central Medgate Telemedicine Service providing telephone and video consultations for minor ailments. It has developed an app that allows patients to take a photo of skin conditions, for example, and send them to a Medgate doctor, and it also allows patients to order medications.

“The service could be offered to GPs to use as their telehealth platform.”

It also has a partner network that allows patients to access highdefinition video consults with a Medgate doctor in their local pharmacy.

Services are paid for by health insurance.

While it is still early stages yet, Mr Solomon said he envisaged Telstra ReadyCare would become a national service that would complement the services GPs deliver. He also said the service could be offered to GPs to use as their telehealth platform in their own practice.

For the National Telehealth Connection Service, Telstra has been working with the Northern Territory Department of Health, which was chosen by the National Health CIO Forum to lead the development of the service.

It will involve coordinating clinical-grade video conferencing and scheduling services with metropolitan specialists initially for Aboriginal health and people living in remote communities. The plan is to eventually offer it for specialist consultations to rural areas nationwide.

Telstra Health also announced that the inhome monitoring platform it has been building with RDNS in Victoria has been chosen by Silver Chain, WA’s visiting nursing service, for its hospital in the home and specialist nursing care services.

Mr Ballantyne said it would involve hospital medical staff having access to a secure portal to keep track of the services provided by Silver Chain and remotely monitor changes in the patient’s condition.

Telstra revealed that it had invested $100 million in its health division over the last year, including investments in Fred IT, HealthConnex, HealthEngine, Verdi and Dr Foster.

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DVA claiming for allied health professionals online The Department of Veterans’ Affairs (DVA) has launched a new online claims system for allied health providers servicing the veteran community.

DVA Webclaim is now open to all allied, dental and optical health providers through the Department of Human Services’ (DHS) Health Professional Online Services (HPOS) portal.

It is a no-cost service aimed at allied health providers who only have a small number of DVA clients.

The system is currently only available through HPOS and is not integrated in practice management software. It is a ‘smart forms’-based system designed to reduce paper claims sent in by post, but still requires manual input of claiming data.

(Practitioners can also use plug-ins such as those offered by vendors such as Direct Control or Cutting Edge Software. Cutting Edge offers a free version of its product for low-volume DVA claims.)

Users will need a Medicare provider number and an individual public key infrastructure (PKI) certificate, available from DHS. The new system will allow providers to receive an instant response to submitted claims, receive payment within two working days, access past DVA statements and download claiming histories.

By using HPOS, which has a secure email facility, claimants can also ask DHS questions about claims. Claims are paperless and patient signatures are not required.

The department says medical claims will be able to be lodged through DVA Webclaim in the near future.

Datacom invests in Smartward to launch its new health solutions unit Technology solutions provider Datacom has taken a 20 per cent stake in Canberra-based health IT firm SmartWard as the first investment in its new healthcare solutions unit, which is being headed up by former Australian Centre for Health Innovation clinical director Keith Joe. New Zealand-owned Datacom is better known for its service, integration and bespoke software development capabilities, but has developed a longterm strategic plan to invest in new capabilities through solutions for market segments such as health, education and local government.

Dr Joe, who plans to keep working as an

emergency department doctor at Cabrini Hospital in Melbourne as well as his new role as chief medical information officer for Datacom Healthcare Solutions, said the new healthcare solutions division would focus on patient-centric technologies, of which the investment in SmartWard is the first step.

He said that while SmartWard was mainly focused on patient safety and clinical workflow in the hospital sector, there is also potential in residential care as well.

SmartWard inventor Matt Darling said the Datacom partnership was much more a collaboration than an investment.

“The collaboration with Datacom gives that bluechip, copper-bottomed backing to an emerging technology which is so important,” Mr Darling said.

“Hospitals, when they buy new technology, need a very high level of support, and Datacom is a very geographically distributed technical services company, so this gives the ability for us to support and train and deploy systems across the whole of Australasia.”

Mr Darling has designed SmartWard primarily as a patient safety technology that improves workflow. The system automates clinical records, and also provides decision-support, thereby increasing the time staff spend with patients.

It has undergone trials in wards at two different hospitals in Melbourne, with Deakin University research showing that it reduced the amount of time that nurses spent on documentation and freed them up to spend more time with patients.

The SmartWard system displays a schedule of patient care according to priority. Staff review and accept tasks, and are provided with treatment reminders and automated forms including best practice clinical guidelines.

Treatment is recorded at the bedside and stored in the application, and if staff are interrupted by a more urgent task, the application detects that the procedure has not been completed and reschedules it. Records are created automatically, reducing paperwork and handover time.

One of the keys to the system is a platform of Bluetooth authentication and location services. Mr Darling said Bluetooth was chosen over other technologies such as RFID and Wi-Fi for safety reasons.

“The issue with RFID is that the charge field is conical in shape so you get a lot of blackspots,” he said.

“This is safety technology in that we want to have high resolution at all times. The idea of having to deploy numerous expensive

sensors is not an option we would consider.

“There are also location services capabilities that are built around Wi-Fi, but the signal strength of that is very much higher than Bluetooth. Our ethos is really around patient safety so we wanted to make sure that anything we used was very low power so it could not constitute a risk to patients or staff.”

“This is safety technology in that we want to have high resolution at all times.”

Mr Darling and his team have spent four and a half years developing the technology in close consultation with healthcare professionals.

He said it allows staff to perform in a more effective manner.

“These guys are drawn to the profession because they want to help people and when they are dragged away and only able to interact with patients for less than 10 per cent of the shift, the interactions that are left over are fleeting, transactional and frustrating. They are not able to form relationships with the patient that they really want and that are of clinical benefit. A big part of our goal in this is

to increase job satisfaction and reduce stress on clinical staff.”

Mr Darling said staff had a very low opinion of systems they currently have to use, characterising them as “nested, siloed, and hierarchical.”

“What this means for people entering data is a huge amount of repetition and an enormous amount of complexity. From our point of view, what we wanted to do was to remove the complexity and that repetition.

“By knowing that the healthcare professional is with a particular patient at a particular time, we can display the exact information and support that they need at that time without them having to drill down into anything. It’s what we call context.

“This is a system that puts the information you need at your fingertips. It ensures continuity so that what needs to happen in the next minute, in the next hour, in the next 24 hours or in the next week is available to the user.

“Unlike paper, if you walk away from the data input and display device, the system is automatically locked so not just anyone can come and read the chart. It has many features that builds patient safety, privacy and improved productivity for the user.”

Queensland calls for MBS item for GP-to-patient telehealth A Queensland parliamentary committee that has conducted an extensive inquiry into telehealth services in the state has recommended that GPs be able to bill Medicare for direct telehealth consultations with patients, and that priority be given to implementing the NBN in remote communities.

Chaired by LNP MP Trevor Ruthenberg, the committee has been holding a series of public consultations and site visits since March, following the allocation by Queensland Health Minister Lawrence Springborg in last year’s budget of $30.9 million over four years to set up a rural telehealth service.

While the committee found that Queensland Health currently has good telehealth infrastructure, it was difficult for clinicians to access, particularly on mobile devices, and was not yet providing a great deal of benefit to patients.

In addition to its recommendations that the Minister for Health make representations to his federal counterpart to amend the MBS to enable GPs to bill for patient consultations, the inquiry has also recommended that the eligibility requirements in metropolitan areas be revised so that the elderly

and people with a disability or in palliative care can also receive Medicare-funded telehealth services.

It also recommended that the Queensland government propose to the Commonwealth that priority be given to implementing the NBN in remote communities to provide better access to health services for Aboriginal and Torres Strait Islander peoples and other remote residents.

“Technology and infrastructure are not barriers to greater use of telehealth in Queensland.”

It also wants the Department of Health to give greater priority to improving connectivity for clinicians wanting to use the existing infrastructure through personal devices, and to consider setting up a statewide telehealth scheduling system to coordinate telehealth in the state.

While the inquiry found that Queensland has one of the largest managed telehealth networks in Australia, it also found that much of the existing infrastructure was not being put to the best use.

Mr Ruthenberg said that although there has been significant investment in infrastructure in the past, the use of it for the benefit of patients remains low.

This echoes common criticisms that while most hospitals have video conferencing suites, they are often found in boardrooms and meeting rooms and are not accessible for clinical purposes.

While Queensland Health says bandwidth across its facilities is generally very good, with 70 per cent of Queensland Health facilities connected to the state’s fibre optic networks, the report found that in the areas where telehealth is most beneficial – western Queensland and remote areas – many facilities did not have reliable internet.

The report also echoes the common opinion that greater telehealth provision is not so much a technical challenge as one of coordination and workflow change management.

“With a few exceptions, technology and infrastructure are not barriers to greater use of telehealth in Queensland.

Clinician engagement emerged as an important factor in overcoming the barriers to the greater use of telehealth.”

Central PHO rolls out ManageMyHealth New Zealand’s Central PHO (primary health organisation) has funded the rollout of a shared care record using Medtech Global’s ManageMyHealth platform to general practices in the MidCentral district, with 18 practices currently participating in Horowhenua, Manawatu, Otaki and Tararua.

The shared care record includes details of health history, prescribed medicines, allergies, immunisations, reminders, test results and discharge summaries held in general practice systems.

It is accessible to clinicians at afterhours GP services, hospital emergency departments, hospital inpatient and outpatient services and aged care facilities in the region, including City Doctors and Radius Accident & Medical in Palmerston North and the Horowhenua after-hours clinic in Levin.

All patients enrolled with the Central PHO general practices are eligible for a shared care record but can opt-out completely or choose not to allow specific information from being shared.

Central PHO executive clinical director Chiquita Hansen said there was a high demand from patients for this sort of service and many were surprised it wasn’t already available.

“The transition of patient care through different times of the week, between health providers and across a range of medical centres has traditionally been a challenging area in health care but the shared care record is a positive step to smoothing the patient journey,” Ms Hansen said.

The Shared Care Record project is also being implemented in other areas of the MidCentral DHB as well as in the Wairarapa and Capital & Coast DHBs.

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APHS invests in Flamingo personal cloud platform Epic Pharmacy, the pharmacy services company formerly known as APHS, has invested $1.5 million in software firm Flamingo to create a healthcare technology platform aimed initially at health insurers and hospitals.

Epic Pharmacy is perhaps best known for its pharmaceutical packaging arm APHS Packaging, which supplies aged care facilities with medication sachets, manufactures dose administration aids (DAA) for pharmacies and distributes the Medido monitored compliance device.

Sydney-based Flamingo is a start-up firm headed by Catriona Wallace that is active in the customer relationship management (CRM) and vendor relationship management (VRM) fields. It has developed a ‘co-creation’, analytics and personal cloud solution that aims to allow businesses to co-create solutions with individual customers to personalise the way they communicate and interact.

Flamingo will use Epic Pharmacy’s funding to develop customer-directed healthcare solutions initially with healthcare insurers, and then with healthcare service providers like hospitals and aged care facilities.

“Customised healthcare is of growing interest and concern to the majority of Australians,” Dr Wallace said. “With this new funding, Australians for the first time will be able to co-create a personalised experience with a health service provider to meet their own individual requirements, beyond just the product.”

A ‘personal cloud’ is described as a customised offering that provides a way to store, manage and provide permissions to personal data as well as preferences for how the consumer interacts with an organisation. A personal cloud for healthcare data will be developed as part of the new venture, Dr Wallace said.

Alcidion partners with Fujifilm for cardiovascular care Adelaide-based health informatics and technology specialist Alcidion has rolled out the new intelligent Cardiovascular Information System (iCVIS) it has developed in association with Fujifilm Medical Systems in full operational mode at Melbourne’s Western Health. iCVIS, which was the overall winner in the health category at the iAwards in September, is based on Alcidion’s Miya health informatics platform, which forms the basis for a number of clinical and patient management applications used at Western Health as well as by the departments of health in the Northern Territory and Tasmania.

Miya is the brainchild of Malcolm Pradhan, an adjunct professor in health informatics at the University of South Australia, and Ray Blight, former CEO and chairman of the South Australian Health Commission.

The company’s technology is being used to build advance care planning capabilities for aged care providers in Tasmania as part of the PCEHR roll-out and provides the foundation for an intelligent patient journey system presently deployed at Western Health.

Called Miya Patient Flow,

it will also be rolled out at the Royal Darwin and Alice Springs hospitals this financial year. iCVIS, which Alcidion and Fujifilm have been developing over the last 18 months, has recently passed user acceptance testing (UAT) and is about to go into full operation at Western Health’s cardiology department, Mr Blight said.

Fujifilm came up with the concept of the new system, and after a search for technology partners, chose Miya as the underlying platform.

“The clinician still makes the decision, but once they have done so Miya can track the implementation.”

Mr Blight, who co-founded Alcidion with Professor Pradhan in 2000, said Miya has been designed as a health informatics platform that is able to extract information about a particular patient and highlight their clinical risk factors in order to provide real-time clinical decision support – what many in the health IT sector consider the nirvana of healthcare technology. “The Miya platform is about helping

the clinician understand a patient’s clinical risk so they can make the best possible decisions,” Mr Blight said. “We are able to gather expert knowledge about a particular condition and present that in the context of a specific patient, so the decision-maker can execute the treatment in the best manner.

“It has been designed to gather the relevant data to highlight clinical risks, not the extraneous data. We can then present the medical and clinical risk data and provide relevant guidance as to the best care options.

The clinician still makes the decision, but once they have done so Miya can track the implementation of the decision.”

One of Miya’s main differences is it can extract data from any clinical, administrative or logistics system in a hospital, including point-of-care devices, and marshal that data in a way that makes sense in terms of mitigating the patient’s clinical risk, he said.

“For example, if the patient has been admitted with chest pain, there’s no point presenting the data that you might have had from a previous episode which had nothing to do with cardiology. If the patient was in for a broken leg, then much of that information

may not be relevant for the patient’s current clinical risk. iCVIS has a cardiologyspecific electronic medical record that also includes logistic information as well as clinical risk factors for that particular patient, all in one system and available to the clinician instantly.

This includes information on when they are booked for an intervention such as catheterisation, but will display to the clinician that the patient hasn’t completed their fasting period, meaning not only are their risk factors apparent but also saving precious resources in having to cancel or delay interventions.

Alcidion has also built a series of clinician dashboards that highlight these critical issues in the cardiac lab and ward, Mr Blight said. “It’s essentially a bespoke application of the Miya platform to the clinical risk, workflow and logistic issues that are encountered in every cardiology lab.”

Alcidion has used a Victorian government innovation grant to develop the intelligent patient journey system (iIPJS) that is being used by Western Health at Footscray, Sunshine and Williamstown hospitals. The system is now being deployed in every ward in Western Health’s three acute hospitals, with three modes of clinician dashboard involved.

“We’ve got a desktop view, which is most commonly used at the nurse work station or ward work station, but we’ve also got a very large display panel view which is excellent for clinical handover where you might have half a dozen members of the care team standing around, reviewing patients one by one,” Mr Blight said.

“It can also be accessed directly from iPad Minis so that any clinician can go to the bedside, review the patient at the bedside, record their actions, record their decisions, and by early next year they will then be able to place orders for pathology and radiology over those mobile devices, direct from the bedside.”

Easier path to approval for medical devices The federal government plans to introduce new regulations to allow local manufacturers of medical devices to obtain market approval in Australia if they have been certified by a recognised European conformity body.

At present, medical devices must receive market approval from the Therapeutic Goods Administration (TGA) even if they have passed Europe’s CE Mark approval process.

Regulatory amendments to the Therapeutic Goods (Medical Devices) Regulations 2002 will be introduced later this year to cover applications for lower risk Class II and Class III medical devices and in vitro diagnostics (IVDs) such as hearing aids, joint implants and devices used for in vitro fertilisation procedures.

Assistant Health Minister Fiona Nash said the new rules will not apply to the very highest risk devices, such as those devices containing medicines or tissues of animal, biological or microbial origin, or Class 4 IVDs such as drug-eluting stents.

“These devices will still need TGA conformity assessment,” Senator Nash said. “With these changes, Australian manufacturers can choose to either have conformity assessment conducted by the TGA or an alternative conformity assessment body, such as a European notified body.”

She said the new arrangements would bring local manufacturers in line with the regulations for overseas manufacturers, and in some cases would enable devices to get to market more quickly.

“Australian medical device manufacturers will no longer have to duplicate conformity assessments if they want to supply their device in the European and Australian markets,” she said.

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Bits & Bytes

Hossack heads MSIA as it enters 20th year Extensia CEO Emma Hossack has been elected as the new president of the Medical Software Industry Association (MSIA) as it gets set to celebrate its 20th year in 2015.

Ms Hossack, who takes over from immediate past president Jenny O’Neill, said the MSIA had attracted a number of new members to the board who will complement the more experienced members.

“This reflects the growing stature of the MSIA as a trusted voice for the healthcare software industry,” she said.

At the MSIA’s AGM in Sydney in October, its part-time staff of Vince McCauley, Marg Prichard, John Green and CEO Bridget Kirkham were recognised by the membership for their dedication and hard work, she said.

Guest speakers at the forum included Navy Design, Opaque Media, CSIRO, NICTA and Simulation Australia.

The Andrew Magennis Award for outstanding service to the industry was presented to Richard Hutchinson from Emerging Systems.

The new board is: • Emma Hossack (Extensia) – president • Peter Young (Health Connex) – vice president • Dinah Graham (MIMS) – secretary • Nat Wong (Totalcare) – treasurer • Tom Bowden (HealthLink) • Paul Carr (Genie • Matthew Cherian (Global Health) • Russel Duncan (Emerging Systems) • Marg Gehrig (MG & Associates) • Andrew Griffin (POSworks) • Monica Schlesinger (Pen Computer Systems) • John (Yianni) Serpanos (coreplus)

Blacktown Hospital goes fully electronic with mobile Paper-Lite Western Sydney’s Blacktown Hospital has gone live in all clinical units with a fully electronic medical record system for new patients that can be accessed on a range of devices, including iPads, smartphones and computers on wheels (COWs), at the patient’s bedside.

Called Paper-Lite, the fully mobile system allows medical, nursing and allied health clinicians to access patient information from the existing Cerner EMR at the point of care, as well as document assessments and progress notes, create pathology, imaging and dietary electronic orders, and view discharge summaries and consultation notes.

The project also involves improvements and new functionality to Cerner.

Clinicians can access the system wirelessly on their own devices or through

laptops and COWs. All existing paper medical records and forms that cannot be made electronic are being scanned and incorporated into the system.

Blacktown Hospital’s information technology services (ITS) program manager Bill Rogan said that while Paper-Lite has been built for use with the Cerner application, many of the components have been built internally or by eHealth NSW. This includes the Between the Flags observation chart for nurses, which is integrated into Cerner, as well as an electronic dashboard for all active emergency theatre booking forms or green sheets.

A new patient summary is also included, called mPage, along with new forms for nursing and social work, allied health discharge summaries and

clinical documentation for physiotherapy.

The project kicked off 18 months ago with a view to getting all clinical units electronic before the opening of the hospital’s new Clinical Services Building in October next year.

The new building is part of the $322 million Blacktown Mount Druitt Hospital (BMDH) redevelopment and is being built with no storage space for traditional paper records.

It went live in the B42 Surgical unit on July 29, with all new patients documented electronically from that day. The other 15 clinical units and departments then followed throughout August, with all up and running by September 2.

It is set to be rolled out at Mount Druitt and Auburn hospitals.

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Woz joins the faculty as UTS hosts social robots A special session on social robots for therapeutic purposes will be held at the International Conference on Social Robotics (ICSR 2014), being hosted by the University of Technology, Sydney (UTS) in late October.

The University of Auckland’s Robotics Research Group, led by Bruce MacDonald, will present results from randomised cross-over trial it has conducted using robots in older people’s homes to improve medication adherence and quality of life.

UTS’s robotics faculty includes leading researchers in mechatronics and robotics for health applications, including Gamini Dissanayake, Hung Nguyen and MaryAnne Williams. Professor Dissanayake will present at ICSR 2014 on a novel, collaboratively designed robot to assist carers.

UTS has also announced that Apple cofounder Steve “Woz” Wozniak has joined the university as an adjunct professor.

Mr Wozniak is working with staff and students in the Magic Lab at UTS’s Centre for Quantum Computation and Intelligent Systems, led by Professor Williams.

“Woz loves the energy, the vibe and the robots in the Magic Lab,” Professor Williams said.

Calling him the “coolest person in the universe” she said he provides an exceptional inspiration for UTS students.

“He beams in on our telepresence device to chat with students, share his latest ideas and entertain with jokes and the occasional prank,” she said.

“Woz constantly highlights the new possibilities for technology to change the world and enjoys sharing his insights and experiences.”

Smart app helps patients complete cardiac rehab in the home Patients recovering from heart attacks are more likely to successfully complete rehabilitation when they do it at home using a new smartphone app compared to those who have to travel to outpatient clinics, new CSIRO research shows.

CSIRO has developed a smartphone-based home care delivery model known as the Care Assessment Platform (CAP) that has been trialled at the Prince Charles, Redcliffe and Caboolture hospitals in Queensland.

So successful has the trial been that it will soon be

offered at Ipswich Hospital and in the Metro North and West Moreton Hospital and Health Services.

The clinical trial, conducted through the Australian eHealth Research Centre, a joint venture between the CSIRO and Queensland Health, randomised patients in traditional, centre-based rehab programs and a program using the CAP platform.

It involved six weeks of cardiac rehab followed by six months of selfmaintenance.

The results, published in the journal Heart, showed that the CAP program had

significantly higher uptake (80 per cent vs 62 per cent), adherence (94 per cent vs 68 per cent) and completion (80 per cent vs 47 per cent) rates than the traditional program.

The CAP program is delivered in the participants’ homes through the app, which includes health and exercise monitoring tools and motivational and educational material delivery, as well as through weekly mentoring consultations.

There are a number of other programs around the country using technology to

help patients to complete rehab, including South Australia’s CATCH program, which offers a web-based system.

benefits, uptake is generally poor due to factors such as time constraints, accessibility, lack of referral and patient motivation.

Cardiac rehab programs have proven to have better outcomes for patients following myocardial infarction but many patients fail to complete the programs, particularly as they have to travel every week to the outpatients clinic or they live in rural or remote areas.

“The smartphone app offers another choice, overcoming one of the key barriers to patient participation and recovery,” Dr Karunanithi said.

Lead researcher Mohan Karunanithi said traditional programs usually take the form of group-based exercise and educational activities and are designed to help patients return to an active, satisfying life. However, despite the

“By integrating rehab with a patient’s daily life, they are more likely to complete the program and make their new healthy lifestyle permanent.”

The National Heart Foundation’s Rachelle Foreman said programs such as CAP can improve access for people living in rural areas as well as high-risk groups including

Aboriginal and Torres Strait Islander people.

Data management platform to power data network

The research team is now adapting the platform for rehabilitation for other chronic conditions such as diabetes.

Melbourne-based data management systems specialist Arcitecta and supercomputing giant SGI are working together to build customised research platforms to give the research community access to the massive amounts of data held in the national Research Data Storage Infrastructure (RDSI) project.

Dr Karunanithi is also a lead researcher for CSIRO’s Safer Smarter Homes platform, which involves a sensor-based in-home monitoring system to enable older people to live longer at home.

It combines hardware such as sensors and iPads with software such as apps and family and medical portals, and uses broadband connectivity to support sensor technology and connect residents with healthcare practitioners.

Ascom seeks to reduce alert fatigue Ascom Wireless Solutions is set to introduce a new mobile device specifically designed to improve nurse communications and clinical workflows to the Australian market early next year.

The device is linked to integration software called Ascom Unite that allows it to be connected with hospital or aged care facility information systems, patient monitors and nurse call systems.

Called Myco, the device combines the capabilities of a smartphone, such as a touch screen, 3G and WiFi, along with a barcode reader for patient and medicines identification. Ascom says it has a robust design that is capable of withstanding knocks and drops as well as hygienic requirements.

It allows nurses to drag and drop the names of their assigned patients onto their device, meaning they can receive automated messages, alerts and alarms just for those patients, helping to avoid alarm fatigue. The software also gives nurses access to patient records and results.

The device is able to filter and prioritise alerts, as well as forward and escalate them.

The nurse can see on the device what type of alert or alarm it is, the severity of the alarm, and which patient it is for, even when the device is in their pocket, as all necessary information is visible on the top display.

It comes with a docking station for rapid battery swaps and has been optimised so it can be operated with one hand.

Arcitecta’s Mediaflux platform has been chosen as a key data management engine for the RDSI project, which is providing storage for some of the huge data sets generated through genomics, DNA sequencing, population health research and cancer tissue banks.

The data sets are held in eight distributed data centres or nodes, which currently contain over 11 petabytes of content and are expected to grow to over 55 petabytes as part of the project. The idea is to allow researchers to access, analyse and re-use the data held in the nodes in a coherently governed environment.

Researchers will be able to peruse data collections by name, type, owner, date and linked publications as Mediaflux is able to make disparate types of data available to users through its metadata search engine.

Data can also be quickly discovered and queried as it is ingested due to the metadata extraction capabilities.

Mediaflux is being used to build a webbased repository for the Cooperative Research Centre (CRC) for Mental Health, where researchers will be able to capture, access and query clinical observation data from longitudinal studies of biomarkers.

It is also being used to power Victoria’s Clinical Audit Research electronic Health Record (CAReHR), which has been set up to share data between clinics caring for refugees and to provide real-time surveillance for emerging health issues.

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HIMAA puts the focus on credentialing and workforce The Health Information Management Association of Australia (HIMAA) has relaunched its Professional Credentialing Scheme as part of its strategic focus on health information workforce needs.

The revised scheme involves introducing evidence-based criteria of educational effectiveness and quality improvement to its point allocation schedule, as well as mapping to HIMAA’s health information management competency standards.

The HIMAA professional credentialing scheme offers two classes of postnominal: certified health information manager (CHIM) or certified health information practitioner (CHIP).

HIMAA president Sallyanne Wissmann told the combined HIMAA National Centre for Classification in Health (NCCH) Conference in Darwin recently that because most HIMAA members already have a qualification, particularly those in the clinical coding (CC) and health information manager (HIM) occupations, the credentialing scheme was more focused on maintaining the currency of the member’s credential.

Victorian Department of Health productivity and health information workforce manager Julie Brophy told the conference that the profession needed to embrace certification as a means of better positioning the profession.

Ms Brophy is amongst the first group of graduates of the Certified Health Informatician Australia (CHIA) program offered through a partnership between HIMAA, the Heatlh Informatics Society of Australia (HISA) and the Australasian College of Health Informatics (ACHI).

HIMAA has discussed developing a joint workforce strategy with ACHI and HISA to present to government and industry.

Mobile cardiology clinic takes to the road in rural Queensland A mobile cardiology clinic equipped with diagnostic technology and telemedicine capabilities has taken to the road in south-western Queensland, aiming to provide specialist cardiology services to people in Dalby, Roma, Charleville, Goondiwindi and St George.

Called Heart of Australia, the clinic has been built on a retrofitted road train and contains two consultation rooms, a diagnostic suite with ultrasound and cardiac stress testing equipment, and a patient reception area.

It can share test results instantly with GPs and allow metropolitan hospitalbased specialists to attend consultations through video conferencing.

The brainchild of cardiologist Rolf Gomes,

who practices at the Medihearts clinic in Brisbane and Ipswich and is a visiting cardiologist at Ipswich Public Hospital, the clinic has been funded by coal seam gas firm Arrow Energy and the federal and state governments.

Dr Gomes said he had surveyed more than 180 regional GPs who were frustrated at the difficulties patients had in accessing specialist care and who “overwhelmingly supported” a Heart of Australia-type program.

It will do a circuit of the towns on a fortnightly basis with a rotating roster of specialist staff, and will also provide respiratory medicine. Patients must have a referral from their GP.

GPs can send a referral via secure messaging service Medical-Objects, download a referral form as a PDF from www.heartofaustralia. com or request a referral notepad via the website.

Dr Gomes said the mobile service would provide diagnosis, treatment and follow-up for a range of cardiovascular and respiratory conditions.

“Heart of Australia has everything that my city practice has, so people won’t have to drive for days to see a specialist,” he said.

Available tests include stress and transthoracic echocardiogram, exercise stress test, 24-hour and seven-day Holter monitoring, 24-hour BP monitoring, ECG and respiratory function.

Plans are afoot to extend the service to central and north-west Queensland in the future.

HealthEngine shakes up online booking with free AGPAL deal Online appointment booking and directory service HealthEngine has struck a deal with Australian General Practice Accreditation Limited (AGPAL) to offer its online booking system to AGPALaccredited practices for free. HealthEngine will also identify practices

that meet AGPAL quality accreditation in its online directory. AGPAL accredits about half of the estimated 7000 general practices in Australia.

HealthEngine CEO Marcus Tan said he did not expect the deal to be a big hit to the company’s revenue,

as the majority of revenue comes from other offerings such as its directory and the marketplace. The company is Google’s premium partner for healthcarespecific search engine marketing in Australia.

“We provide other services to practices that we can

HealthLink

Secure MessagingTransforming Healthcare HealthLink delivers on the promise of ehealth reform through standards compliance and nationwide secure messaging. generate revenue from, so we don’t feel that this will be a huge hit to our revenue from that perspective,” Dr Tan said.

Dr Tan said the deal would help drive patients to accredited practices and to understand what accreditation means. For practices, he said easier access to healthcare was part of providing a quality service and online appointments are part of this service.

“We’re willing to almost offer this up as a key piece of infrastructure, like a phone line or a fax line or an email,” he said. “This is something that quality practices should have, so we’ve negotiated a deal with AGPAL to provide that for patients as part of their accreditation.”

HealthEngine’s online booking system is integrated with PracSoft, Best Practice, Zedmed, Genie and Practice 2000, and it offers a plug-in for each practice’s website to make appointments available online.

The company says practices can save up to $20,000 a year through online bookings in terms of less time wasted on the phone for practice staff, extra bookings and fewer no-shows. Most of its rivals charge a monthly subscription, while HealthEngine charges per appointment.

The deal only involves the online booking system, with added extras still commanding a fee.

“It is part of a productivity suite that we offer, including marketing, to fill gaps within the practice,” Dr Tan said. “Whether it’s on Google or whether it’s on HealthEngine or whether it’s through a directory, we’re basically offering that suite of services to practices and that’s where we derive a significant amount of our income.”

“We’re willing to almost offer this up as a key piece of intrastructure, like a phone line or fax line or email.”

The move reflects an intensification of competition in the online booking market, which has traditionally been marked by a differentiation between practicefocused players such as Appointuit, OzDocsOnline and Clinic Connect and consumer-focused firms such as HealthEngine and 1stAvailable.

More recently, the market leader in GP clinical and practice management software, MedicalDirector, announced that it was set to launch its own online

booking system, integrated within PracSoft. However, MedicalDirector will also offer an application programming interface that will allow practices to continue using thirdparty appointment booking services if they wish.

Klaus Bartosch, managing director of 1stAvailable, said HealthEngine’s move was a strong signal that the Australian health industry is ready to embrace online appointment booking systems.

“However, the challenge for the market is to carefully consider which provider is aligned to doctors’ priorities of maintaining a continuous patient/doctor relationship and how this technology can enable their business and not disrupt it,” Mr Bartosch said.

Practice owner and cofounder of Appointuit, Gordon Cooper, said that while there are many online appointment models, Appointuit’s approach was firmly based on the RACGP standards, which concern understanding the healthcare journey, continuity of care and preventative healthcare.

“While there is a place for a search and find marketplace directory model, for one-off, lastminute appointments, patients and practices benefit far more from the continuity of care model,” Mr Cooper said.

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Events November

1

NOVEMBER

GENERAL PRACTICE EDUCATION DAY Adelaide, SA p: +61 1300 797 794 w: www.healthed.com.au

5-7

NOVEMBER

JOHN MURTAGH UPDATE COURSE Melbourne, VIC p: +61 3 9905 0059 w: www.med.monash.edu.au

10-11 NOVEMBER NATIONAL ACQUIRED BRAIN INJURY CONFERENCE Sydney, NSW p: +61 2 9080 4307 w: www.informa.com.au/conferences

11

NOVEMBER

HIC 2014 QUEENSLAND REPRISE Brisbane, QLD p: +61 3 9326 3311 w: www.hisa.org.au/events

11

NOVEMBER

BEST PRACTICE: CLINICAL MODULE FOR NEW AND EXISTING USERS Melbourne, VIC p: +61 7 4155 8888 w: www.bpsoftware.com.au

11

6

NOVEMBER

WORKING WITH TECHNOLOGY CHANGE AT THE FRONT DESK Online p: +61 3 9095 8712 w: www.aapm.org.au/events

7

NOVEMBER

NOVEMBER

13

12

13

NOVEMBER

BEST PRACTICE: MANAGEMENT MODULE FOR NEW AND EXISTING USERS Melbourne, VIC p: +61 7 4155 8888 w: www.bpsoftware.com.au

12

NOVEMBER

CLINICAL EMERGENCY MANAGEMENT PROGRAM - INTERMEDIATE Melbourne, VIC p: +61 1800 626 901 w: www.racgp.org.au/cemp

NORTHERN TERRITORY MEDICARE LOCAL EHEALTH UPDATE Darwin, NT p: +61 8 8982 1000 w: www.ntml.org.au/events/grantopportunity-ehealth-update

NOVEMBER

GENOMICS IN HEALTHCARE Sydney, NSW p: +61 2 9080 4307 w: www.informa.com.au/conferences

NOVEMBER

HIV TESTING: WHAT ARE YOUR RISKS? Newcastle, NSW p: +61 1800 626 901 w: www.racgp.org.au/education

NOVEMBER

HEALTH INFORMATION AND TECHNOLOGY WESTERN AUSTRALIA CONFERENCE 2014 Perth, WA p: +61 3 9326 3311 w: www.hisa.org.au/events

6TH AUSTRALIAN RURAL & REMOTE MENTAL HEALTH SYMPOSIUM Albury, NSW p: +61 7 5502 2068 w: anzmh.asn.au/rrmh

7-9

12

NOVEMBER

13

NOVEMBER

RURAL DOCTOR EDUCATION SEMINAR 2014 Broadbeach, QLD p: +61 2 8484 0896 w: www.ruraldoctorseminar.com.au

RCPA PATHOLOGY INFORMATICS SEMINAR Sydney, NSW p: +61 2 8356 5858 w: www.rcpa.edu.au/events

10-12 NOVEMBER

13

HINZ 2014 CONFERENCE AND EXHIBITION Auckland, NZ w: www.hinz.org.nz/page/conference/ conference-2014

BEST PRACTICE: MANAGEMENT MODULE FOR NEW AND EXISTING USERS Melbourne, VIC p: +61 7 4155 8888 w: www.bpsoftware.com.au

NOVEMBER 17

NOVEMBER

SUCCESSES AND FAILURES IN TELEHEALTH (SFT-14) Adelaide, SA p: +61 7 3876 4988 w: event.icebergevents.com.au/sft-2014/

December 17

NOVEMBER

CLINICAL EMERGENCY MANAGEMENT PROGRAM - ADVANCED Melbourne, VIC p: +61 1800 626 901 w: www.racgp.org.au/cemp

18

26

NOVEMBER

3RD ANNUAL ELECTIVE SURGERY REDESIGN CONFERENCE Melbourne, VIC p: +61 2 9080 4307 w: www.informa.com.au/conferences

NOVEMBER

27

NOVEMBER

HISA NSW - CHRISTMAS PARTY PLUS SPEAKERS Sydney, NSW p: +61 3 9326 3311 w: www.hisa.org.au/events

29

HISA VIC - AGED CARE Melbourne, VIC p: +61 3 9326 3311 w: www.hisa.org.au/events

4

DECEMBER

THE PHILOSOPHY OF BILLING Online p: +61 3 9095 8712 w: www.aapm.org.au/events

2ND ANNUAL INTEGRATING MENTAL HEALTH INTO THE NATIONAL DISABILITY INSURANCE SCHEME Sydney, NSW p: +61 2 9080 4307 w: www.informa.com.au/conferences

NOVEMBER

CLINICAL EMERGENCY MANAGEMENT PROGRAM - INTERMEDIATE Sydney, NSW p: +61 1800 626 901 w: www.racgp.org.au/cemp

NOVEMBER

DECEMBER

27-28 NOVEMBER

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26

DECEMBER

2ND ANNUAL HIP FRACTURE MANAGEMENT CONFERENCE Sydney, NSW p: +61 2 9080 4307 w: www.informa.com.au/conferences

NOVEMBER

3RD ANNUAL HEALTH TECHNOLOGY ASSESSMENT CONFERENCE Sydney, NSW p: +61 2 9080 4307 w: www.informa.com.au/conferences

THE 3RD AUSTRALIAN E-HEALTH INFORMATICS AND SECURITY CONFERENCE Perth, WA p: +61 8 6304 5176 w: conferences.ecu-sri.org

3-4

MEDICAL TOURISM SUMMIT Melbourne, VIC p: +61 2 9080 4307 w: www.informa.com.au/conferences

24-25 NOVEMBER

DECEMBER

CLINICAL TRAINING & WORKFORCE PLANNING SUMMIT Melbourne, VIC p: +61 2 9080 4307 w: www.informa.com.au/conferences

20-21 NOVEMBER

CLINICAL EMERGENCY MANAGEMENT PROGRAM - ADVANCED Brisbane, QLD p: +61 1800 626 901 w: www.racgp.org.au/cemp

1

2-3

HISA SA - RESEARCH Adelaide, SA p: +61 3 9326 3311 w: www.hisa.org.au/events

22

NOVEMBER

CLINICAL EMERGENCY MANAGEMENT PROGRAM - ADVANCED Sydney, NSW p: +61 1800 626 901 w: www.racgp.org.au/cemp

8-9

DECEMBER

SURGICAL ACCESS & REDESIGN CONFERENCE Melbourne, VIC p: +61 2 9080 4307 w: www.informa.com.au/conferences

10-11 DECEMBER HEALTHCARE ANALYTICS CONFERENCE Sydney, NSW p: +61 2 9080 4307 w: www.informa.com.au/conferences

Online Calendar: To view a comprehensive list of eHealth, Health, and IT events, visit: http://www.pulseitmagazine.com.au/events

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HIMAA

WORKFORCE, E-HEALTH AND CLASSIFICATION In addition to a number of workforce issues, eHealth and clinical classification emerged as key themes at the HIMAA NCCH National Conference in Darwin in October. Research was also high on the agenda, with a number of speakers urging the health information management and clinical coding professions to consider the value of research.

RICHARD LAWRANCE BEd, MEd (Hons), GAICD CEO, HIMAA ceo@himaa.org.au

In her keynote presentation, Joanne Callen, a senior research fellow at the Centre for Health Systems and Safety Research (CHSSR) at the University of New South Wales, took delegates through examples of research into ICT implementations undertaken by the centre that have demonstrated benefits of eHealth to those managing the change, and to patients.

In one example, a Sydney hospital’s rheumatology department reduced seven information systems – four manual and thee electronic – into the one electronic medication management (eMM) system.

Associate Professor Callen’s team was engaged to evaluate the impact of the eMM system on nurse work processes, and was able to demonstrate to management that nurses spent less time monitoring and more time on patient care.

About the author Richard Lawrance is the CEO of the Health Information Management Association of Australia (HIMAA). He has been an education and strategy consultant for several general practice organisations and spent nine years as the national rural manager for the RACGP.

Qualitative research with the nurses themselves revealed that, while they valued the improvement to their practice facilitated by eMM, what they particularly valued was its patient safety benefits – itself a positive outcome that decision makers might not otherwise have realised.

In another example, research with emergency department clinicians involved in the integration of electronic data systems into ward rounds across hospitals in two NSW local health districts found

that not only did they value the ability to electronically capture clinical information at the point of care for immediate input by remote physicians, but their own documentation skills improved – an unexpected benefit.

Dr Callen encouraged health information professionals attending the conference to embrace research in their own practice.

She and Dr Stella Rowlands, editors of HIMAA’s health information management journals, conducted a workshop on qualitative research called Research Without Numbers, which attempted to demystify pathways into research for delegates at the conference.

Dr Callen and Dr Rowlands are inaugural members of HIMAA’s new Research Working Group, which was launched at the conference by HIMAA president Sallyanne Wissmann. It aims to implement a dedicated research strategy in HIMAA’s 2014-16 Strategic Plan.

HIM in general practice Also at the conference, Dr Joan Henderson, the deputy director of the University of Sydney’s Family Medicine Research Centre (FMRC), encouraged the introduction of health information management in general practice to improve the value of primary care data to the health system.

Dr Henderson reminded delegates that although 85 per cent of the population visit a GP each year, at an average of five to six visits, there is no systematic data collection of clinical activity in the consultation for population health purposes.

“Medicare collects and analyses the item numbers, but there is no analysis of what takes place in the consultation,” Dr Henderson said.

The FMRC’s Bettering the Evaluation and Care of Health (BEACH) national program, which surveys 1000 GPs annually and is now in its 17th year, reveals that while 98 per cent of GPs access a computer, very few use it to full advantage. Many still use their computer simply as a word processor.

Dr Henderson pointed out that the 10 major providers of GP clinical software all use different system designs and terminology for decision support and medical records.

HL7 may be the standard underpinning the software, but its use is not mandatory and many communications, such as test results, cannot populate the appropriate section of the electronic health record (EHR).

Dr Henderson, a qualified health information manager, associate editor for HIMAA’s academic journals and a member of the HIMAA editorial board, said that a secure messaging standard to replace the prevalence of scanning in GP data entry and storage was essential if data collected in general practice EHRs was to be useful across the health system.

“Many GPs just write, scan and attach, preventing possible data extraction,” Dr Henderson said. “Data in GP EHRs doesn’t get a quality tick in any discernible area.”

She suggested that the money GPs already budget for staff to scan records could be better spent on clinical coders. Health

information managers would also help improve the quality of GP data.

“GP data systems need to speak the same language,” she said. “Ultimately the same standards are needed throughout the health system for data to be useful across the sectors.

“Health information managers understand standards. They’re ideal to help general practice make the link.”

Classification the code breaker The medical director of the FMRC, Graeme Miller, and research fellow Julie Gordon, demonstrated to the conference how primary care could be linked to the hospital sector through the use of SNOMED CT. SNOMED is designed for use by clinicians, but it is not useful for statistical purposes because it is not a classification system, Associate Professor Miller told the conference.

To be useful for health analysis purposes, SNOMED needs to be mapped to either ICPC – the international classification used in primary healthcare – or ICD, the international classification used in the hospital sector.

In the interests of continuity of data and therefore care, SNOMED needs to be mapped to both classifications, Dr Miller said.

A special interest group formed in 2009 through a collaborative agreement between the World Organisation of Family Doctors (WONCA), which owns ICPC, and the International Health Terminology Standards Development Organisation (IHTSDO), which owns SNOMED CT, has successfully mapped a reference set of over 4000 SNOMED CT concepts common in general practice to both ICPC-2 and ICD-10.

Dr Miller and his team believe that the work required to adapt these products for the Australian context through maps from general practice terminologies such as ICPC-2 Plus to SNOMED CT, and from SNOMED CT to ICD-10-AM – is readily achievable.

“The combined use of classifications and clinical terminologies such as SNOMED CT has the potential to improve the transmission and analysis of data collected throughout the healthcare system,” Dr Miller said.

Other key presentations, two of them workshops, reinforced the future role of clinical classification in integrating primary and hospital sectors through eHealth.

A keynote address by Bedirhan Ustun, classifications terminologies and standards coordinator with the WHO, showed how the next generation of the International Classification of Disease, ICD-11, would serve as a living consensus on clinical classification across the world as well as across out-patient and in-patient jurisdictional borders.

A NEHTA workshop on SNOMED CT AU, custom designed for health information management professionals, demonstrated the underpinning of ICD-11 by this international standardisation of clinical terminology.

HIMAA’s information technology and professional development manager, Ralph La Tella, conducted a closing workshop on database fundamentals that provided a suitable coda to the crucial role of relational databases in health information management through clinical classification in the electronic age of digital communication. For more information about the online database fundamentals course, contact Mr La Tella at information@himaa.org.au or call 02 8877 5378.

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NZ HIT Cluster

THE FUTURE OF HEALTH IS MOBILE Everyone these days seems to have a mobile phone, and most these days are smartphones, providing consumers with a portable computer wherever they go. This high penetration of smartphones means they can be harnessed for public health interventions, and evidence is increasingly showing that mobile-based healthcare works.

DR ROBYN WHITTAKER MBChB, MPH, PhD, FNZCPHM Program co-leader health informatics and technology, National Institute for Health Information, University of Auckland r.whittaker@auckland.ac.nz

Never has there been a technology with such rapid uptake globally as that seen with the spread of mobile phones. In New Zealand, we have had more mobile phone subscriptions than people since around 2008. While that may not mean every single person has a mobile phone, there is certainly very high penetration. And there is some evidence of a lack of a digital divide – that is, access to mobile phones is not affected by socio-economic status, unlike access to the internet.

The majority of New Zealanders with a mobile phone keep it close at hand 24 hours a day. The proportion of phones that are smartphones with a modern operating system is rapidly increasing, with up to 60 per cent of all mobile phones in 2013. This means that at any time of day, regardless of location, most people have a personal, portable, connected computer on them. This also means that they have unprecedented access to health information and close to 100,000 health and wellness apps.

About the author Dr Robyn Whittaker is a program leader in health informatics technology at the University of Auckland and a public health physician with the Waitemata District Health Board in NZ. Her research concentrates on the use of mobile health technology for population health interventions, as well as clinical trials and epidemiology.

What does all of this mean for health services? It could mean the rise of the well-informed and engaged patient.

Particularly in the context of the ‘quantified self’ movement and the rapid increase in mobile and wearable sensors, people are becoming more aware of their body’s responses to lifestyle changes and medications.

This could lead to several changes in the way care is provided, with patients coming to the consultation as the experts in themselves and the clinician bringing their expertise and experience to co‑develop a care plan. Potentially, far greater amounts of data will be available to inform care. Where data are currently available for particular time points, mobile and wearable sensors bring the ability to fill in the gaps with continuous monitoring data. This will entail a greater reliance on smarter health IT systems and algorithms capable of interpreting that data so that we know when to act on it.

Potential for the passive At this point in time, this may look like a system only for the engaged and motivated. However, systems are being developed that will passively collect data via the smartphone, with no motivation or action required. This leads to the concept of a health coach in the pocket, quietly collecting and analysing data in order to intervene with programs to support healthy behaviour change and self‑management of long-term conditions.

If this all sounds a step too far into an idealised future, let’s consider some of the current impacts of mobile on health services. Clinicians of all types are currently being asked to recommend apps to help support a myriad of conditions.

How do they know which ones are evidence-based or adhere to treatment guidelines? How would they assess whether they are at all useful for their patients? The idea of a New Zealand ‘App Formulary’ with evaluations of apps for various medical conditions that can be prescribed by clinicians for their patients is being discussed in many fora. The current lack of a decent evidence base in smartphone health apps should render this task quite do-able in the short term.

Health by text New Zealand has led the way internationally in evidence-based text messaging mHealth programs. We were the first to develop and publish a randomised controlled trial on a health

intervention delivered solely by text messages, and have gone on to confirm the effectiveness of text messaging for smoking cessation programes in Cochrane systematic reviews.

At the National Institute for Health Innovation, we have been working with Waitemata and Auckland District Health Boards (DHBs) on two new text message programs. These include TextMATCH, a text message health information program for pregnant women and their families, and for the families of young children.

This program supports a broader Healthy Babies, Healthy Futures initiative to prevent the onset of childhood obesity. It has been designed with different versions for Maori, Pacific, Asian and South Asian families and is currently being evaluated

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for its impact on attitudes and behaviours.

SMS4BG is a two-way text message program to support people with diabetes to self-manage between clinic visits. A pilot study across Waitemata DHB showed that it was appreciated by participants, supported them to manage their condition better, and improved diabetes control (measured by change in HbA1c level) in 81 per cent of participants with data available.

We have recently been awarded funding for a large trial of its effectiveness.

Many other good local mHealth examples exist including apps like FoodSwitch, Listen Please and Tapuaki. Health and wellness are happening around us, supported by mobile technologies, all the time. There can be little doubt that the future of health is mobile.

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ACHI

PATIENT ACCESS TO PATHOLOGY RESULTS The ability for patients to access their pathology results through a patient portal or potentially through Australia’s PCEHR has been a topic of intense discussion over the last year or so. However, the evidence for the efficacy of this approach has been mixed. In this article, ACHI’s Program Evaluation Subcommittee (PES) provides a targeted literature review of research and articles published between July 1 2013 and June 30 2014 as part of ACHI’s biannual evidence review (BER).

A/PROF ANDREW GEORGIOU BA MSc PhD FACHI FCHSM DR MICHAEL LEGG Bsc, PhD, FFSc (RCPA), FAICD, FAIM, FACHI DR GLENN EDWARDS MBBS, MAACB, MD, FRCPA, FACHI

There is a widespread interest, across Australia and internationally, in the development of person-centred care as a system that places people in the forefront of their health. Person-centred care can be defined as a means to help people make informed decisions about their own health as part of a partnership between providers and patients that caters for individual preferences, goals, lifestyles and abilities. eHealth developments have played a major role in shaping the person-centred care agenda, providing the technological infrastructure to drive the development of interactive information sources, online support groups, decision aids and selfmanagement applications. It is becoming increasingly possible for hospitals (and community pathology practices) to provide consumers access to information online using a secure electronic patient portal, which in addition to allowing access to appointment and personal clinical information, also facilitates communication with health professionals.

About the authors A/Prof Andrew Georgiou is a researcher at the Centre for Health Systems & Safety Research at UNSW’s Australian Institute for Health Innovation (AIHI). Dr Michael Legg is a consultant health informatician with Michael Legg & Associates. Dr Glenn Edwards is national medical director, pathology, at St John of God Pathology.

These changes have prompted considerations about patient access to information (including pathology test results), the physician-patient relationship and even the impact that patient access may have on the traditional physician role as the information gatekeeper.

This paper provides a targeted review of eight research articles related to patient access to pathology test results, published in the timeframe of 1 July 2013 to 30 June 2014 and identified by members of the Australasian College of Health Informatics (ACHI) (see Table 1).

The inclusion of three wide-ranging reviews (two systematic and one realist) highlights the current level of interest internationally in the topic of patient access to information. The reviews provide an expansive and complementary overview of existing evidence related to this issue.

They are supplemented by the inclusion of five studies that explored patient experiences and perceptions. Three of these studies were based on surveys and two studies employed qualitative methods using focus groups. Table 2 presents additional relevant resources, including grey literature, opinion pieces and news reports.

This targeted literature review is part of a biannual evidence review undertaken

by ACHI to help inform the profession and the community about key eHealth issues. The subject of the review is timely given that consultations are currently underway to incorporate pathology reports into the personally controlled electronic health record (PCEHR). This

follows the 2014 release of a review of the PCEHR commissioned by federal Health Minister Peter Dutton recommending the integration of diagnostic imaging and pathology into the PCEHR.

Enhancing the role of consumers According to the Australian Commission on Safety and Quality of Health Care,

the benefits of increased consumer engagement encompass better quality and safer health care practice. This is relevant to test result follow-up where the failure to inform patients has been described as legally indefensible factors in malpractice claims. Research evidence continues to show that patients are interested in being involved in medical decision making and in being notified of their test results, both abnormal and normal.

Table 1 Article

References

1

Christensen K, Sue VM. Viewing laboratory tests results online: patients’ actions and reactions. J Participat Med 2013,5:e38

2

Davis Giardina T, Menon S, Parrish DE, et al. Patient access to medical records and healthcare outcomes: a systematic review. J Am Med Inform Assoc 2014;21:737-41.

3

Kerns JW, Krist AH, Longo DR, et al. How patients want to engage with their personal health record: a qualitative study. BMJ Open 2013;3(7).

4

Lubick Goldzweig C, Orshansky G, Paige NM, et al. Electronic Patient Portals: Evidence on Health Outcomes, Satisfaction, Efficiency, and Attitudes: A Systematic Review. Ann Intern Med 141(3):196-204 2013;159(10):677-87.

5

Otte-Trojel T, de Bont A, Rundall TG, et al. How outcomes are achieved through patient portals: a realist review. J Am Med Inform Assoc 2014:amiajnl-2013-002501.

6

Turvey C, Klein D, Fix G, et al. Blue Button use by patients to access and share health record information using the Department of Veterans Affairs’ online patient portal. J Am Med Inform Assoc 2014:amiajnl-2014-002723.

7

Woods SS, Schwartz E, Tuepker A, et al. Patient experiences with full electronic access to health records and clinical notes through the My HealtheVet Personal Health Record Pilot: qualitative study. J Med Intern Res 2013;15(3).

8

Zikmund-Fisher BJ, Exe NL, Witteman HO. Numeracy and Literacy Independently Predict Patients’ Ability to Identify Out-of-Range Test Results. J Med Intern Res 2014;16(8).

Additionally, it is argued that sharing information and engaging patients can also contribute to improvements in the efficiency and effectiveness of the laboratory test process (e.g., decrease in test redundancy) and as a way of helping to reduce diagnostic errors.

The US Department of Health and Human Services has recently enacted legislation which allows patients to access test results directly from the laboratory by request.

There are similar moves underway in the NHS in England. Since 2001, Australian consumers have the right to view their pathology results (except in a small number of legal circumstances) under the Commonwealth Privacy Act – also an existing community pathology practice.

Since 2001, patient access to pathology results has also been a formal policy of the Royal College of Pathologists of Australasia and Pathology Australia.

Findings Despite the enthusiasm for direct patient access to laboratory and imaging results, the evidence from existing evaluations of electronic patient portals and their impact on the safety, effectiveness and quality of patient care is limited and inconclusive.

There are major questions about how patients use their record and respond to their results alongside concerns about the impact on authority and responsibilities within the current patient-doctor relationship.

A widely-publicised Annals of Internal Medicine systematic review in 2013 by Lubick Goldzweig et al., examined evidence of the effect of patient portals on clinical care since 1990. The review found 46 articles including randomised controlled trials, observational, quantitative and qualitative studies.

The authors reported that the evidence about the effect of patient portals on health

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“The majority of studies on the topic emanate from the US, which prompts the need for some caution about the generalisability and applicability of the findings.”

Although noting that patient portals are part of a concerted effort to encourage patient participation, they identified disparities in portal accessibility and usability, particularly amongst populations that are ill-prepared to take on personal health record systems. The authors concluded with a strong recommendation for policy efforts to overcome racial, ethnic and literacy barriers to portal use.

The Annals paper was followed by a Journal of the American Medical Informatics Association systematic review by Giardina et al., which proffered similar conclusions. The authors of this review found some examples of increased levels of patient satisfaction, but unclear evidence of any enhancements in the quality of care, or of any impact on safety, timeliness and equity.

They concluded that more rigorous research is needed to evaluate the impact of making medical records available to patients. The findings of both systematic reviews described above,

Positive surveys

draw similar conclusions to a 2012 review

by Ammenwerth et al., which despite noting improvements in patient treatment adherence and the rate of patient office visits, found no changes in health outcomes.

An email survey of US Kaiser Permanente members’ reactions to online viewing of laboratory results, published in 2013 by Christensen and Sue, reported overwhelmingly more positive than negative patient responses. Similarly, a survey undertaken by Turvey et al. on patients’ use of the US Department of Veterans Affairs online patient portal, drew attention to benefits including patients’ ability to understand and share personal information. However, the authors of this study made special note of the importance of educational efforts to address usability issues that hinder adoption.

A paper by Otte-Trojel et al. expressed concern that research findings on patient portals to date fail to help us appreciate how patient portals contribute to better patient care. The authors undertook a realist review of the evidence in order to investigate how the intervention works, for whom, and the circumstances in which it works. They concluded that it is necessary to identify and study the mechanisms by which patient access to results and their own information, namely: a) patient insight into information; b) the activation of information; c) the continuity of care; and d) patient convenience.

Patient comprehension of laboratory results was also considered by ZikmundFisher et al. who assessed whether adults can identify laboratory blood test values outside reference ranges in a patient portal format. The authors concluded that health literacy and numeracy skills were significant barriers to the basic use of laboratory test result data in patient portals. In their review of personal health records (PHRs), in Pulse+IT in July 2014, Day and Bain drew attention to similar challenges and raised important questions about whether a one-size-fits-all people approach is the best one for the future.

Recent research on the topic has begun to address some of Otte-Trojel et al.’s concerns. For instance, Kerns et al.’s qualitative study into how patients want to engage with their personal health records and Woods et al.’s study of patient experiences of full electronic access to health records and clinical notes, highlight some complementary themes, particularly the importance of integrating personal records into current care, promoting patient-clinician communication, improved

The majority of studies on the topic emanate from the US, which prompts the need for some caution about the generalisability and applicability of the findings, particularly given the nature of the Australian health system, Australian pathology services and the developing role of the PCEHR. For instance, in the US there is a distinction between “laboratory testing” and “pathology.”

The US version of “laboratory testing” is what Australia would refer to as clinical

Andrew Georgiou, Michael Legg, Glenn Edwards

outcomes is currently insufficient. The majority of positive examples they found related specifically to patients with chronic diseases, such as diabetes, hypertension and depression, where the portal was used as an accompaniment to case management.

patient knowledge, and building confidence in the security and accuracy and privacy of information.

pathology (biochemistry, haematology and microbiology), while US “pathology” is what Australians would call anatomical pathology. Laboratories are licensed in the US for certain tests only, while genetics and more sophisticated testing modes (e.g., genomics) are often undertaken in reference laboratories and reported separately.

Challenges for Australia Concluding themes emerging from the evidence about patient access to laboratory results and the challenges ahead are: • There is a need for a clearly articulated statement of purpose behind patient

access to pathology test results in the Australian environment.

• Electronic patient portals are a relatively new technology and the healthcare community has only just begun to engage with this innovation to optimise care delivery, outcomes and patient engagement.

• There are major obstacles which hinder the involvement of consumers.

These include a lack of access to clinical information and a lack of appropriate tools, educational aids and decision support aids that can help consumers to understand and engage in their own care.

• Clinicians’ unease about direct notification of pathology (including

Table 2: Additional resources Article

abnormal) results often relates to concern about patients’ understanding of, and ability to interpret results, which may lead to unnecessary anxiety and confusion on the part of patients.

• Clinicians’ apprehension may also be related to the impact that direct patient access to test results has on the traditional medical practitioner role as the information gatekeeper.

• There is much room for improvement in health informatics systems and their contribution to quality pathology practice. The significance of these opportunities was recently underscored by the US Emergency Care Research Institute (ECRI) 2014 report on patient safety which listed data integrity failures associated with health information systems, poor care coordination and test result reporting problems as the leading three items of their top 10 patient safety concerns.

References

Conclusion

1

The National Institute for Health Innovation. Patient Portals PMS Review 2 (Available at: http://www.patientsfirst.org.nz/wp-content/uploads/2014/09/ Patient-Portals-for-PMS-Requirements-Review-FINAL.pdf), 2014.

2

McDonald K. Fear and loathing in the early days of patient portals.

Available at: http://www.pulseitmagazine.com.au/index.php?option=com_ content&view=article&id=2083:fear-and-loathing-in-the-early-days-ofpatient-portals&catid=49:new-zealand-ehealth&Itemid=329. PULSE+IT 2014.

Clearly much of the work required to understand, and realise, any benefits of patient access to pathology reports is yet to be done. However, it appears inevitable that rising interest from consumers in their pathology will continue.

3

McDonald K. Patient portals: start simple, start small. Available at: http:// www.pulseitmagazine.com.au/index.php?option=com_content&view=ar ticle&id=2070:patient-portals-start-simple-start-small&catid=49:newzealand-ehealth&Itemid=329. PULSE+IT 2014.

4

Shapiro M, Johnston D, Wald J, et al. Patient-Generated Health Data (White Paper). USA: RTI International, 2012.

5

Bikman J. Patient Portals - Patient Engagement: The Holy Grail of Meaningful Use: peer60, 2014.

6

Ricciardi L, Mostashari F, Murphy J, et al. A national action plan to support consumer engagement via e-health. Health Affairs 2013;32(2):376-84.

In the Australian context much of the focus may be on the PCEHR, but other systems which may effectively compete with the PCEHR will likely appear in the market.

Private pathology operators and third‑party developers may offer such systems to attract customer loyalty and gain competitive advantage. The authors urge all key stakeholders, including consumers, to work together with some urgency to address the challenges set out above.

References Full references are available online at www.pulseitmagazine.com.au

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ONE HEALTH APP TO RULE THEM ALL? While the effectiveness of health and fitness apps and associated hardware devices varies widely, the sheer amount of activity in the space has not escaped Apple’s gaze. With new bathroom scales shipping with Wi-Fi capabilities, pedometers being worn as fashion accessories, and many people finding it impossible to run around the block unless they own a GPS enabled watch or have a telephone strapped to their biceps, the “quantified self” phenomenon is hard to ignore.

SIMON JAMES BIT, BComm Editor: Pulse+IT simon.james@pulseitmagazine.com.au

Despite popularising smartphones in the consumer market and developing the iOS ecosystem in which many health and fitness apps exist, Apple cannot claim to be an early entrant into the field of consumer health. In fact, the company lags long‑time rivals Google and Microsoft’s efforts to provide health services to consumers by many years. This is not to say that being a trailblazer in the health informatics space presents the fastest route to success, with the Google Health offering being shut down in 2011, just a few short years after being launched, and Microsoft’s HealthVault platform only being supported in a limited number of overseas locations despite launching seven years ago.

number of possible interactions between these various offerings, with many app developers only able to support interfaces with a handful of the most popular third‑party offerings.

Even when different solutions do provide supported interfaces to others, in a small sample size limited to my own fitness pursuits throughout the year, I can report uncovering many data quality issues that undermine the experience of using such services in the first place.

Launched as a flagship component of iOS 8, Apple’s Health app is the consumer‑facing component of its HealthKit developer environment, which the company describes as allowing “apps that provide health and fitness services to share their data with the new Health app and with each other. A user’s health information is stored in a centralised and secure location and the user decides which data should be shared with your app.”

For example, a Garmin GPS running watch is designed to upload the data it collects during exercise to the Garmin Connect online portal, allowing the runner’s speed, heart rate, elevation and indeed their entire mapped route to be reviewed in a web browser or on a smartphone app. Garmin supports an interface to the MyFitness Pal online food diary service, allowing, for example, the number of calories consumed in a day to be displayed against any activity recorded by the watch, without the data having to be entered manually into both services to view the basic ‘calories in, calories out’ equation.

While data sharing between the plethora of health and fitness-related services has existed for some time, the number of services that have sprung up over the past few years has led to an exponentially large

This interaction sounds quite simple in theory, but as the utilisation of additional apps increases, such as those capable of measuring resting heart rate or simply recording a weigh measurement, it

becomes quite difficult to prevent circular relationships between each of these connected services from being established.

In other words, a measurement or recording entered into one app can get automatically passed along to a second app and then a third, and then back to the original app, resulting in duplicated and invariably meaningless data begin displayed.

“... people finding it impossible to run around the block unless they own a GPS enabled watch or have a telephone strapped to their biceps...”

Simon James

With Apple controlling the development of both its phone hardware and operating system products, in releasing HealthKit the company has sought to use its clout within its own ecosystem to position itself squarely in the middle of the health and fitness app market. While the announcement of the Apple Watch and some of its health and fitness features might provide hints as to Apple’s future plans in this area, from a consumer perspective, at this stage the company’s initial foray into the space comprises the simple Health app.

measurement or observation on a per app basis.

• Medical ID: intended to be used by healthcare professionals in the event the owner of the iPhone is incapacitated, this screen allows medical conditions, allergies and medications to be pre-recorded for display on the iPhone’s lock screen, along with pertinent contact details of who to notify in the event of an emergency.

Comparing this app to many of the health and fitness apps that third-party developers have created for iOS and reflecting on the considerable resources Apple has at its disposal, the limited set of features the current version of the app contains may appear somewhat underwhelming.

As is readily apparent when using the Health app, the software does not deviate from Apple’s stated goal of providing a repository to better enable the storing and sharing of data, but additional features that would allow users to dispense with at least some third-party apps may well be around the corner.

The app has only four main screens:

Having upgraded to iOS 8, my initial impression of the Health app and underlying platform was that it felt very much like a work in progress. In fact, during the first week of the platform’s existence, Apple made a conscious decision to prevent third-party apps with HealthKit compatibility from being downloaded from the App Store owing to a critical bug in the system. While this issue was corrected, duplicated data of the kind described earlier also appeared in my Health app interface, a problem that appears to have since been corrected by either Apple or the offending third-party developer.

• Dashboard: allows the user to display graphs of various measurements plotted over different time scales.

• Health Data: contains categories including body measurements, fitness, nutrition, results, sleep and vitals. Each of these categories contains a range of measurements or observations that can be recorded and optionally plotted on the dashboard.

• Sources: displays the third-party apps the user has authorised to read and write data to the HealthKit service, with fine-grained controls for each

Potentially more serious issues have emerged however, with Apple confirming an issue that may cause confusion for some people using the Health app to record blood glucose levels as a result of the way the app deals differently with the milligrams per decilitre (mg/dL) and millimole per litre (mmol/L) conventions.

As this edition of Pulse+IT entered print production, Apple has signalled plans to remove part of its glucose recording functionality while a more permanent fix is developed.

Beyond the basic health and fitness features the Apple Health app will enable or play a supporting role in, it is Apple’s negotiations with the developers of clinical software that will ultimately be of interest to readers of Pulse+IT. While the data generated by and stored in clinical systems is far more complex than the simple weight and heart rate observations discussed in this article, it has been clear ever since HealthKit was first announced that Apple’s vision for its health data repository service extends far beyond the basics and into the realm of healthcare organisations.

Having partnered with US EMR vendor Epic Systems, the Mayo Clinic and Duke and Stanford university hospitals for the development of HealthKit, and with reports from the US starting to emerge about trials of the service, Apple has already made progress in this regard. How, or if, this will manifest itself in Australia remains very much to be seen.

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APPOINTMENTS IN THE PALM OF YOUR HAND The ability to book an appointment online – and preferably through a smartphone app – is usually in the top three when patients are asked to rate what they value most in electronic interactions with their healthcare providers.

There are now a number of online booking systems out there, many accompanied by a searchable or practicespecific app.

KATE MCDONALD Journalist: Pulse+IT kate.mcdonald@pulseitmagazine.com.au

Online appointment services have been around for a number of years and most can be integrated into practice management systems to streamline the appointments process and free up reception staff. Not all practices have taken advantage of these systems, but the ones that do often report productivity gains as well as providing an extra service to patients as the main benefits.

And with patients increasingly expecting to be able to search for or book appointments online or through an app, for practices open to new patients these services are becoming a must have. Even practices that don’t take new patients are being encouraged to offer an appointment app or at least an online booking capability to realise some of those productivity benefits.

About the author Kate McDonald is a senior staff journalist for Pulse+IT. Formerly the editor of Australian Life Scientist magazine, she has also edited industry titles Hospital & AgedCare and Nursing Review. Her interests cover health ICT, biotechnology and translational research.

The online appointments market itself is hotting up, with MedicalDirector recently announcing that it has built its own internal system within PracSoft and HealthEngine announcing it is offering its booking service for free to AGPALaccredited practices, which account for approximately half of all general practices in Australia.

Many are now also accompanied by an app, with the majority of online booking services now making them available either as a consumer app in which patients can

search for the nearest practitioner or the best appointment time, or as practicespecific apps, which directly link to the practice’s online system. We take a look at what’s on the market.

Consumer-facing apps For both of the main consumer-facing online booking services an app is essential, allowing patients to search for the nearest medical or allied health practitioner and to search for the most convenient appointment time.

HealthEngine, the market leader, was established back in 2006 as an online directory for GPs looking for specialists for referral purposes and it is the company’s comprehensive directory that underpins its online search capabilities.

While it has had an app for consumers for a number of years, in June this year it also released a practice-specific app called Get Better that practices can provide to existing patients to let them book appointments on their smartphones.

“The HealthEngine app is the marketplace app that is basically for patients to find practices, but we also have a practicespecific app that they can promote to their individual private patients,” HealthEngine CEO Marcus Tan says.

“It’s powered by the HealthEngine system and is for practices to be able to promote to their patients as a home app that is specific to that practice. It’s a nice addition to the stable.”

Practices using Best Practice, PracSoft, Zedmed, Genie and Practice 2000 can choose to use the fully integrated HealthEngine platform or to use the pay-per-appointment service and offer appointments through the HealthEngine website. For AGPAL-accredited practices, the online booking system is free, while the customised app and other marketing services still attract a fee.

The company offers a plug-in that practices can add to their websites to allow for online bookings and can also build a simple webpage hosted on the HealthEngine site for practices that don’t have their own website.

It has a customisation service for the Get Better app but the basic model is free for subscribing practices to use. “It is basically end to end,” Dr Tan says. “Depending on what you’ve got already, when you want to update or whether you want to start from scratch, all interfaces are covered.”

HealthEngine’s main rival in the consumer-facing app space is 1stAvailable, which was launched in April 2012 by dentist Rick Luu. It’s point of difference is that it allows patients to search for the first available appointment in the most convenient location, regardless of the practice.

“We are trying to provide the patient with the most relevant search,” Dr Luu says.

“When you go to our website, we serve up actual appointments that fit the criteria. As a consumer, if I am looking for a dentist in the Sydney CBD today at two o’clock, I will

go in and say that I am looking for a dentist in the Sydney CBD today at two o’clock and I am willing to travel 5km.

“What our system does is look for appointments at around about two o’clock and serve back those appointments in chronological order. It will match the appointment to the user. The other sites, what they do when you say I am looking for a dentist in Sydney, they will provide all of the subscribers and show all of their appointments and you choose which one suits you. They don’t refine them for you.”

Now managed by Klaus Bartosch, who has worked with online sites including Wotif.com, Seek.com, Carsales.com. au, Realestate.com.au and Graysonline. com, 1stAvailable is also integrated into Best Practice, PracSoft, Genie, Zedmed, Practice 2000 and allied health specialists PPMP and dental4windows.

Selected iOS screenshots from 1st Available (L), Appointuit and DocAppointments (R).

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In addition to finding the first available appointment, patients can book an appointment with their preferred practitioner through the website and the app, which is available for iOS and Android devices. Practices sign up to the system and pay a subscription fee, while patients can also sign up and be notified of when new practitioners come online in their area.

The app allows patients to add details of family members, set preferred practitioners as the search default, find bulk-billing practitioners and share the app with friends.

Practice-centric apps Several of the online booking services also provide an app that practices can offer to their patients, either in generic or customised form. These companies,

including DocAppointments, Appointuit and HotDoc, specialise more in individual practices than the consumer market and have developed apps that can tightly integrate with the practice system.

Appointuit, for example, has developed an extremely well-designed app that it says is the single most popular medical appointment app in the Australian App Store and Google Play Store.

The app allows patients to easily register with their practice, book appointments with their regular doctor or another in the practice, and select what sort of appointment they might require, such as a new script, a pap smear or a standard appointment.

Other features include instant email confirmation of the appointment with a map, a link to the smartphone’s calendar

Selected iOS screenshots from Get Better (L), HealthEngine and HotDoc (R).

and an automatic notification two hours prior to the appointment.

Appointuit markets its service as a way for both practices and families to have continuity of care. It is fully integrated with Best Practice, Pracsoft, ZedMed and Genie and also has a customisable widget that sits on the practice website.

Appointuit also offers a dashboard and analytics service so practices can get detailed stats and reports on how patients are using Appointuit, as well as a service called Engage! that lets practices send out patient reminders, text message support for smoking cessation and do behavioural coaching.

It comes with a reporting function that lets practice managers see how effective campaigns have been and when patients received and opened an email or SMS.

Tasmanian-based DocAppointments has released a raft of apps in the last few years, all of which have been tried and tested at company founder Calin Pava’s practice in Devonport.

The basic DocAppointments app allows patients to search for available doctors who have signed up to DocAppointment’s online directory, but for practices who don’t want to compete with others, it also has a practice-specific app, available either in generic form or customisable with the practice’s logo.

The app also allows patients to find a nearby pharmacy, keep a history of doctors’ appointments, keep family members’ details in one place, and receive an email confirmation when making or cancelling an appointment.

In February, DocAppointments released a new feature that allows selected patients to send a request for a repeat prescription through the app, which they can then pick up from reception at their convenience. Dr Pava says repeat prescriptions is a free feature and practices can choose their own way of billing patients for the service.

In July, DocApppointments released a new check-in app for Android tablets that aims to streamline patient flow in general practices and free up receptionists’ time.

The app is a simple one that can be downloaded onto an Android device that is attached by a mount to the wall. When the patient arrives at the surgery, they can bypass reception and check in themselves, much like at an airport self-check-in booth.

It also has a patient demographics and survey app that integrates with Best Practice and PracSoft to create a new patient file. The app allows new patients to fill out their personal details on a tablet while waiting for their appointment and for existing patients to update theirs.

“A lot of them do use a couple of online appointment systems, and that is why we have built the API.” Phil Offer

It also allows practices to conduct surveys while the patients are waiting, including accreditation and patient satisfaction surveys, which might also help to reduce waiting time irritation.

Melbourne-based HotDoc is the most recent company to enter the online medical appointment booking market, offering a customised web booking application with a free mobile app and with plans to launch extra add-on features such as a practice management dashboard.

Established by Melbourne GP Ben Hurst in 2012, HotDoc has its sights set on improving patient flow and other efficiencies for general practices, and plans to differentiate itself by helping clinics make the best use of some of the existing analytical functions within practice management software.

Integrated with Best Practice, PracSoft and Zedmed, HotDoc offers full customisation to practices based on doctor preference, including retaining a manual system to allow practice staff to become used to an online system.

Non-app services While apps are useful for patients, booking online through a website is just as convenient. Established players include OzDocsOnline, which integrates with Best Practice, Medical Director, PracSoft and Zedmed and allows practices to customise their practice profile website, and Clinic

Connect, which is compatible with Best Practice, Houston Medical, Clinic Director, PracSoft, PPMP, MedTech, Zedmed, Genie Solutions, Network Logic and eClaims (ACSS). Both include automatic appointment confirmations and reminders sent by email or SMS. Practice management software market leader MedicalDirector, formerly known as HCN, caused a bit of a stir in August when it announced it would release an integrated online appointments booking module that is fully integrated into its PracSoft practice management system at the end of the year.

It will come with an application programming interface (API) that will allow practices to continue using thirdparty appointment booking services if they wish, which will allow practices to manage appointments from the one user interface.

Practices will be able to display the online appointments on their own websites, but if they don’t have one, MedicalDirector will host a web page on the practice’s behalf, which can then provide the link to patients.

“With our customers, a lot of them do use a couple of online appointment systems, and that is why we have built the API as well,” MedicalDirector CEO Phil Offer says.

“We expect them to continue to use other services to get to new patients. We see it as a platform in that they can use whatever service they want, but we are now providing them with some more choice.”

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PRACTICAL PATIENT APPS Do a search on iTunes or Google Play and you’ll be inundated with apps for health, fitness and wellbeing, most aimed at ‘the worried well’ and many of dubious worth to say the least. For patients with a chronic illness, there are some apps of practical use that clinicians can use in concert with their patients. Here’s a selection of some of the more impressive patient-focused apps released in the last year.

KATE MCDONALD Journalist: Pulse+IT kate.mcdonald@pulseitmagazine.com.au

Mobile asthma management Medical technology company iSonea released a smartphone app called AsthmaSense in September to help asthmatics manage their condition.

The app, available for iOS and Android devices, is aimed at helping asthmatics follow their asthma action plan, providing active reminders to take medications or lung function tests and allowing the user to keep a journal of symptoms and recordings of peak flow and wheeze rate.

It also allows users to receive alerts when their asthma is judged to be well controlled or poorly controlled – alerting them to a potential attack – to add emergency contact information and review up to two months of medication use. The app will also allow asthmatics to share their data with doctors or family members. iSonea plans to release future versions of AsthmaSense to incorporate its WheezoMeter device, which uses the company’s acoustic respiratory monitoring (ARM) technology to measure wheezing.

In future versions, the company plans to support other operating platforms and incorporate features such as a sensor that detects changes in environmental conditions such as air quality and weather.

iSonea is currently developing two new devices: SonoSentry, an over-the-counter acoustic respiratory monitoring device that acts as a “thermometer” for wheezing; and AirSonea, a device that integrates WheezoMeter technology with Bluetooth and mobile health apps to help better manage asthma.

Patient films online Melbourne-based radiology technology specialist Zed Technologies has gone live in its first practices with its new My Film Bag app, which allows patients to view their radiology images online.

In use by Melbourne’s Imaging @ Olympic Park and Port Macquarie X-ray in NSW, My Film Bag is available as both a web app and as a mobile app for iOS and Android devices. It has been developed by Zed Technologies’ Ross Wright and Ronald Li as a way to allow patients to view their own images and to share them with doctors without having to cart around films or CDs. Mr Wright said Imaging @ Olympic Park and Port Macquarie X-ray are paying for the app on behalf of their patients. “Their reasoning behind it is that it’s a valueadded service but there’s also a small saving on film,” he says. “It was something that they thought some of their patients

would appreciate, being mobile and reasonably tech savvy patients.”

In addition to allowing patients easy access to their scans while travelling and the ability to share them with multiple healthcare providers, another obvious market to explore is with new parents to allow them to store and view ultrasound images. However, the company plans to initially market the app to radiology providers before individual patients.

The app is the first consumer venture for the start-up company, which has also developed a DICOM viewer in use in hospitals as well as a mobile app that can be used with Medinexus.

Cardiac app graph results South Australian cardiologist Alistair Begg has developed an app that allows patients

“It’s a value-added service but there’s also a small saving on film.”

Ross Wright

with heart conditions to track, store and graph key data such as blood pressure, cholesterol, INR and medications and to send it through the app to their doctor.

Called What’s Wrong with My Heart, Dr Begg has based it on a DVD he helped develop with a cardiology rehab group from Ashford Private Hospital in Adelaide and available through the Heart Foundation.

It contains information about cardiac conditions, procedures and risk factors and provides links to videos clips from the DVD

and on Vimeo and Youtube, and also has handy graphing features so patients can keep track of their measurements.

In addition to graphing key data, the app allows patients to create a journal and to assess their response to medication. Data can then be emailed to the cardiologist.

The app is available for Android and iOS version for $4.99.

Dr Begg has also developed a free app called My Heart that explains technical

Selected iOS screenshots from AsthmaSense (L) and My Film Bag.

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“Some doctors are more keen on keeping in touch with their patients than others.”

Dr Alistair Begg

terms about a range of cardiac conditions, tests and treatments, and has just released a new app in association with a publishing company for a consumer magazine called Healthy and Heartwise.

Dr Begg says the app is comprehensive and covers all cardiac conditions, but there is also the potential to develop spin-off apps for particular conditions such as atrial fibrillation or hypertension. The idea is for doctors to encourage their patients to send them regular logs of their measurements.

There is also the potential to develop a similar app for conditions such as diabetes,

he says. “Some doctors are more keen on keeping in touch with their patients than others, and I know some diabetes doctors, for example, are always on the phone to their patients and always asking the patients to send them results.”

Pepster for PEP therapy While this app is still under development, the potential for the Pepster app and device looks very positive. Pepster is a breathing device that uses gaming techniques to help patients with cystic fibrosis complete positive expiratory pressure (PEP) therapy and lets parents and clinicians monitor progress over time.

Pepster includes a respiratory device linked to apps on a tablet or phone.

Pepster consists of a PEP therapy device that is linked to tablet or smartphone apps to monitor and motivate patients doing respiratory physiotherapy. The device is currently being trialled with 30 patients with CF at the Mater Hospital in Brisbane before being readied for the approval process with the Therapeutic Goods Administration (TGA).

Co-developer Elliot Smith and his team have designed a new PEP therapy device that can connect to standard face masks as well as to a tablet device. They have also designed two games – one involving spaceships and the other birds – that are controlled by the patient’s respiration.

“Essentially there are different elements in the games that are controlled through the device, so their breathing changes things in the game,” Mr Smith said.

“For example, in the space game, the spaceship moves up and down based on whether they are breathing in or out. The way to get the highest possible score in the

game is to do what is clinically recognised as ideal physiotherapy.”

For parents and clinicians, there is a huge amount of information that can be extracted from the data, including whether the child is actually doing their therapy in the first place, when they are doing it and for how long, as well as changes over time and whether exterior factors have an influence.

“Their progression in terms of their physio performance on different dates is something that we are definitely looking at, and due to the fact that we now have the time stamp of when they have done the physio, we can then gather things like the weather on that day and all sorts

of information like that to see if there are links that we would never have seen before.”

Simple selfie for anaemia This app is also under development, but considering the huge publicity it has received for winning the Microsoft Image Cup – and a prize of $50,000 – the Eyenaemia app looks likely to be popular.

Developed by Monash University medical students Jarrel Seah and Jennifer Tang, Eyenaemia is able to analyse the pallor of the conjunctiva of the eye and calculate the risk of anaemia. While the app – which measures conjunctival pallor by asking users to take a selfie of their eye

HealthLink now puts referrers in the picture

along with a colour standard, and then calculates haemoglobin levels – can be used by anyone, including pregnant women and children, it has been designed to be simple to use and could easily be used as a screening tool in the developing world to target conditions such as malarial anaemia.

Each user will have an account that is stored in the cloud so they can regularly monitor their haemoglobin levels, with the user’s target haemoglobin levels customised according to WHO guidelines for the diagnosis of anaemia. It has also been scientifically validated, the duo says, and can objectively evaluate the colour of the conjunctiva and return the same result every time.

Referrers can now see images from the patient record HealthLink already delivers tens of thousands of diagnostic reports every day. Now in conjunction with Medinexus, referrers can access reports and images directly from their clinical system or via a web portal - no matter where they are.

In association with

Tel: 1300 79 69 59 Email: help@ medinexus.com.au Suite 1102, 1 Newland Street, Bondi Junction NSW 2022

“We attract more referrers by delivering our reports and images via the HealthLink and Medinexus system” Radiologist, Liverpool NSW

“One of the great things with HealthLink and Medinexus is that when the radiologist calls me regarding an abnormal finding I already have the images and reports available on my screen ‘straight away’ so I can see exactly what he is referring to” Referrer, Pennant Hills NSW

“It’s so simple to use. There’s no longer any need for film or a hard copy report to be delivered to me. It’s also so convenient that I can access reports and images no matter where I am” Referrer, Sydney City

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INTEGRATED APPS FOR MEDICINES There are any number of apps available that consumers can use to keep track of their medications, but the real value in an app is the ability to order script repeats or set up a convenient time to pick up their medications. For that, the app needs to integrate easily with the pharmacy’s own systems, which is where specialist apps come into play.

KATE MCDONALD Journalist: Pulse+IT kate.mcdonald@pulseitmagazine.com.au

The National Prescribing Service (NPS) first released its MedicineList app back in 2011, at the time featuring some nifty capabilities such as allowing users to take a photo of their medicine’s packaging, dispensing label as well as the medication itself.

At the pharmacy end, Mr McCann developed a web-based dashboard app that received the SMS, managed the dispensing process and then sent a notification back to the consumer when the script was ready to be collected.

The app also allowed users to enter details of the brand, its active ingredients and the strength and dosage. Similar apps had flooded overseas markets and they began to appear here too, but whether any of them were used regularly or not is a matter for conjecture.

At the time, Mr McCann had it in the back of his mind to introduce new features such as the ability to scan a QR code or barcode on the paper script and SMS that instead. That capability was easily enough created, but the big issue was how to get the QR code or barcode on the script in the first place.

For consumers, what would prove much more valuable was a way to use their app to communicate directly with their pharmacy, particularly the ability to request that repeat scripts be dispensed, and to set a time to physically come into the pharmacy to pick them up. For that to happen safely, and to ensure it was the right patient and the right time for a repeat, the app had to be able to communicate with the pharmacy’s dispensing system.

This is something that electronic prescription exchange service eRx was able to achieve, as it was and still is the market leader in eScripts. eRx announced in June 2013 that it would launch its new app service, eRx Express, in October, which would allow consumers to pre-order their medicines from their regular pharmacy by scanning in a QR code on the paper script that replicated the eRx barcode.

That began to happen in earnest with the release of Send a Script in mid-2013, although the GP2U telehealth service had begun working on a similar system earlier that year. Send a Script, designed

by Wollongong pharmacist Fabian McCann, initially allowed consumers to take a photo of the script and SMS it to the pharmacist.

As eRx is owned by Fred IT, the leading dispensing system in community pharmacy, the back end was reasonably easily taken care of. Pharmacies are supplied with an Express Q software system loaded onto a Windows Surface tablet that interacts directly with Fred Dispense. And as eRx is integrated into the majority of general practice clinical systems, the company

was able to begin printing the QR codes automatically when the doctor printed out the script.

Paul Naismith, CEO of Fred IT Group, said the addition of QR codes gives doctors the ability to pass on a free service providing greater flexibility and convenience, and improving the experience for patients.

“This will make it significantly more convenient for people to manage their prescription medicines,” Mr Naismith says. “People are often trying to collect prescription medicines when they are unwell, dashing in at lunchtime, or with small children in tow.”

By June this year, eRx says the Express app had been downloaded 8500 times and is used by 10 per cent of pharmacies. It is available for iOS, Android and Windows devices.

The launch of eRx Express blindsided Mr McCann at Send a Script somewhat, as he lacked the industry muscle to compete. Send a Script is still available, but Mr McCann is now working on some new developments in medicines apps internationally, the details of which he says he will release soon.

“This will make it significantly more convenient for people to manage their prescription medicines.”

Paul Naismith

With funding from Apotex, NPS has been able to build an enhanced version that will interface with dispensary software to directly download details of prescription, over the counter and complementary medicines to the smartphone. There are also plans to add the ability to order a refill for repeat scripts.

Apotex’s marketing manager, Paul Chang, says the company has designed a piece of middleware that is already used in many pharmacies using the Pharmacy

Guild’s Guildlink service that will extract certain data from the dispensing system, including medication history and current medications, and send it to the app.

Apotex has also worked with the Pharmacy Guild’s Guildlink service to add QR codes to its packaging. It is now working with NPS on a second version that will allow patients to order a refill and set a time to pick it up, much in the same way that Send a Script and eRx Express do. In all cases, the patient can either leave their scripts

Selected iOS screenshots from Send a Script, which is currently being redeveloped.

Interface with dispensary Meanwhile, other players on the market have begun to move into the sector, including drug companies. NPS has partnered with generics pharma firm Apotex to add new functionality to the MedicineList smartphone app, including the ability to download data on medicines directly from pharmacy dispensing software.

NPS launched a new version called MedicineList+ earlier this year, adding extra functions such as the ability to scan barcodes to add data straight into the app, to email the medicines list to family or healthcare providers, and reminders.

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“MedAdvisor is notified of all dispense activity for patients that have activated and consented to MedAdvisor, via the GuildCare software suite installed in the pharmacy.”

Josh Swinnerton

with their pharmacist or bring in the paper script when they pick up their order.

Medicines compliance Late last year, Irish pharmaceutical company Actavis, formerly known as Watson Pharmaceuticals, launched a new

Selected iOS screenshots from eRX Express.

service called MedAdvisor, pitching it as a patient medications compliance program.

It quickly signed up the Chemmart, PharmaSave, Terry White, Amcal and Guardian chains of pharmacies, as well as partnering with the Guild. MedAdvisor is a digital platform including an iOS and Android app and a web app that

provides patients with a list of prescription medications and allows them to order refills from their regular pharmacy. They can receive reminders on when to take medications as well as when they need to refill repeats or to contact their GP to get a new script written.

For pharmacies, it creates the ability to better communicate with regular patients taking multiple medications and more easily keep track of patients with chronic illnesses who leave their scripts at the pharmacy, MedAdvisor managing director Josh Swinnerton says.

The system requires that pharmacies use the GuildCare software platform, which integrates with most dispensing software. MedAdvisor estimates that 1500 pharmacies have signed up.

MedAdvisor’s technology platform consists of a mobile app that can be used on an Apple or Android phone or device, or as a web app accessible from common browsers. Patients who don’t have an internet connection can receive alerts through GuildCare’s SMS script reminder service MemoCare.

Features include a medication list detailing medication name, brand name, repeats left, days’ supply left and colour indicators if action is required. Similar functionality is also available for non-prescription medications or vitamins.

It has a Fill-My-Scripts function that automatically reminds patients to fill repeats, and alerts them if they forget.

It also automatically detects if scripts are filled as it is linked to the pharmacy system. A See-My-Doctor function reminds patients to visit their GP for a new prescription after the final repeat is filled, with reminders sent several weeks prior to running out.

There is a Take-My-Meds timing alert on the mobile app, and a Tap-To-Refill

function that sends a message to the pharmacy to dispense the drugs in advance. Patients need to leave their scripts at the pharmacy to allow this.

Participating pharmacies provide an activation code to the patient to set up an account, which is then linked to their prescription record in the pharmacy system.

“The activation code is used when the patient first creates their account on their mobile device or internet browser,” Mr Swinnerton says. “It links the patient’s new account to their prescription records in pharmacies and also sets the patient’s ‘favourite pharmacy’ to be the pharmacy that created the activation code.”

A medication-specific electronic medical record is also held on MedAdvisor’s servers, which are integrated with the pharmacist’s dispensing software.

“MedAdvisor is notified of all dispense activity for patients that have activated and consented to MedAdvisor, via the GuildCare software suite installed in the pharmacy,” he says.

Selected iOS screenshots from MedicineList+ (above) and MedAdvisor.

In its most recent update, the MedAdvisor app now includes new functions such as the ability to link medication to particular alerts, scheduling options and a summary view of alerts.

It has a settings tab that allows for reminders to be set up to take the specified dose and drug at breakfast, lunch, dinner and bedtime. This can be customised in the new version of the app for more complicated dosage regimes.

The scheduling options allow for alert scheduling for specified days of the week, as well as a tab that provides a list of all alerts scheduled for the day ahead. A ‘create new message’ button has also been added so patients can send a message to the pharmacy for review and response.

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Feature

WESLEY GOES MOBILE WITH CLINICAL SYSTEMS IN THE CLOUD

When it comes to bring your own device (BYOD) in healthcare, we usually think of how mobility can assist doctors and nurses in accessing and collecting information at the point of care in hospitals. In aged care, however, it is similarly as revolutionary, allowing nurses, care assistants and visiting GPs to use a mobile device to access different systems at the bedside and provide holistic care to residents.

KATE MCDONALD Journalist: Pulse+IT kate.mcdonald@pulseitmagazine.com.au

Earlier this year, Wesley Mission Brisbane (WMB) has embarked on a mobility strategy for its 12 residential aged care communities, equipping care staff with mobile devices to provide real-time access to the organisation’s roll-out of Leecare’s cloud-based Platinum 5.0 clinical information system.

WMB is currently rolling out Platinum 5.0 to all of its aged care communities, with its three largest sites now complete and a fourth in the process. It has installed WiFi in all sites to support the mobile devices, which are a mixture of the Samsung Galaxy Tab 3 and the Note 10.1.

Selina Beauchamp, WMB’s business systems group manager, says all staff members on every shift have access to a device.

“Clinical staff such as registered and enrolled nurses and allied health professionals are given the device, and care staff are using kiosk devices, which are stored in a lockable cabinet and signed in and out at each shift,” Ms Beauchamp says.

WMB is hosting Platinum 5.0 locally and provides access based on roles for clinical and care staff, of which there are well over 1000 in aged care, and full access to the system for visiting GPs. The organisation

also plans to roll out Leecare’s medications management module once the core clinical system is fully implemented.

Ms Beauchamp says from both a clinical and operational perspective, the real benefit of the mobile devices was in the real-time data capture capability and the reduction in risk.

“When we embarked on this, we looked at a number of opportunities to improve care practices and reduce risk,” she says.

“We looked at re-engineering processes and changes to work practices, and that included the roll-out of mobile devices.

“The purpose for the whole implementation was to implement a system that will assist us to deliver efficient, quality and userfriendly electronic clinical systems that will improve holistic care to the residents.”

Real-time data access Ms Beauchamp says using mobile devices for real-time data access will also enable the organisation to use the Platinum system to its full potential. “[For example, a] speech pathologist can make changes to a resident’s dietary profile and that information is immediately available to hospitality staff, allowing them

to make the necessary alterations, and therefore reduce any risk of residents not receiving the correct nutrition,” she says.

“Previously if changes were made to a diet, the transfer of information may take a couple of days. Now we’ve got the residents’ current real-time data in there and as soon as changes are made, they’ll know about it.”

Wesley has also taken advantage of the capabilities of the software to create pictorial care plans to provide care staff with information on the care and personal needs of residents. Many care staff have English as a second language, so the pictorial care plan provides essential information at a glance.

“Care staff are able to run a care plan, which is real time, ensuring that they know exactly what the resident needs and it has lots of pictures so that they don’t have to read a lot of information,” she says. “Our carers are just loving it. There is still some writing on there and they can run a more detailed care plan if they’re not sure or want to check something.

“We believe that it’s a very progressive step within Wesley and the provision of aged care in general. The information is there so if they’re not sure they can always drill down, but at a glance they know that Mrs Smith likes that chair and she has this hoist, and all that sort of thing.”

Wesley has also modified the tea trolleys that deliver drinks to the residents so that the mobile tablets sit on the trolley, doing away with the need for paper lists.

Ms Beauchamp says there are some aged care providers that claim that they are paperless, but Wesley’s investigations have shown that this is not entirely the case.

“Wesley has now reduced the reliance on paper to the bare minimum where we are now at the point of operating essentially paperless.”

“Now we’ve got the residents’ current real-time data in there and as soon as changes are made, they’ll know about it.”

Selina Beauchamp

GP access Platinum 5.0 has differing levels of security to allow access based on role, and being a web-based solution it provides clinicians with the ability to log in remotely, including visiting GPs. Ms Beauchamp estimates that about 20 to 30 GPs are accessing the system both on-site and remotely, and are happy to directly enter their progress notes into Wesley’s system. This further enables real-time care to be provided to residents.

“For all of the GPs that indicate their interest in using the system, we give them access to our system and training to use it.

They are also able to speak to an RN from their clinic if they need to and access the information immediately.

“Often GPs will write something down that can be difficult to read, so legibility is a bit of a problem, but as they are actually documenting it in our system that reduces the risk of their notes being misunderstood as well.

“Not all GPs have come on board but we’ve got quite a few, and they are really impressed with the benefits.”

Ms Beauchamp believes GPs will also welcome the introduction of electronic medications management, as will Wesley clinical staff.

“When the independent reviews of medication are done, the details are on Leecare so they are actually going into the

system and looking at the risks as they have real-time information.,” she says.

As expected, some staff were initially nervous about the implementation, but it has proved very popular with both staff and residents. “I think some staff initially were a little bit nervous because it is change and it is new for them.

“There are staff who’ve never used a computer in their lives, so not only has it changed their lives at work but also at home. For example we have a staff member who didn’t even have an ATM card, so by introducing them to new technology, it has given them the confidence to say ‘I can do this’.”

WMB has a dedicated information services department that did most of the WiFi implementation and which supports the mobile devices. The organisation also has the PCEHR on its organisational roadmap, with Wesley having registered for the program. It also uses EOS technologies’ ComCare software for its community care services, and both Platinum 5.0 and ComCare are PCEHR-compliant.

“We have a fairly extensive roadmap for the next two to five years for what we want to do and where we want to go, and this is really just the start of it,” Ms Beauchamp says. “We have some big projects in the pipeline for Wesley. [The PCEHR] is definitely on our roadmap but ... it’s essential that people understand what it is and how it could [affect] them.”

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Argus ACSS AAPM P: +61 1800 196 000 / +61 3 9329 8787 F: +61 3 9329 2524 E: headoffice@aapm.org.au W: www.aapm.org.au The Australian Association of Practice Managers (AAPM) was established in 1979 as the national peak association supporting effective practice management in the healthcare sector.

The Australian Association of Practice Managers: • Provides education, resources, networking, advice and assistance to promote excellence in healthcare practice management.

• 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.

ACIVA

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P: 1300 788 005 / +61 2 9632 0026 F: +61 2 9632 0096 E: sales@acsshealth.com W: www.acsshealth.com ACSS provides innovative and customisable patient management software streamlining day-to-day operations for GPs, Allied Health, Specialists, Radiologists, Pathologists, Private and Public Hospitals. eClaims® — Comprehensive and robust appointment and billing system with digital/voice recognition capabilities, electronic reporting transmissions and HL7 PACS system integration. eClaims® Hybrid — A solution tailored to Hospitals and other health service providers including billing agents who lack online capabilities. eClaims® Hybrid is the interface solution for connecting you to Medicare and health funds through ECLIPSE. SimDay® — Proven PAS (Patient Administration System) specifically designed for day surgeries and private hospitals – Now with ECLIPSE integration.

Argus provides and supports Argus secure messaging software; a popular electronic solution that enables healthcare practitioners to exchange many forms of patient related information securely and reliably and to Australian standards.

Best Practice

Argus interfaces with most clinical software applications sending directly from within your letter writing facility or word processor and runs virtually invisibly in the background. Documents sent using Argus can be automatically added to electronic patient records; thus avoiding the need to scan or manually file them.

Best Practice sets the standard for GP clinical software in Australia offering a flexible suite of products designed for the busy GP practice, including:

Argus is the messaging solution chosen by many Medicare Locals through the ARGUS AFFINITY program delivering eHealth strategies across Australia. With over 17,000 users Argus continues to grow in popularity by delivering highly secure messages, a reliable product, backed by outstanding customer service all at the lowest cost possible.

Advantech

E: secretary@aciva.org.au W: www.aciva.org.au

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

The Aged Care IT Vendors Association (ACIVA) was formed in early 2010, a not-for-profit organisation, incorporated in NSW. ACIVA represents the residential aged and community care sectors and vendors at various national forums regarding strategic developments and eHealth. ACIVA members are residential aged and community care software vendors, industry benchmarking software, financial software, call-bell, hardware, networking, infrastructure and industry partners.

Advantech’s medical computing platforms are designed to enhance the quality and efficiency of healthcare for patients and users alike. All of Advantech’s medical PCs match the performance of commercial PCs but are medically rated to UL/EN 60601-1 third revision, IPX1 drip‑proof enclosures and are designed to suit ward and theatre based applications.

Advantech offers long term availability and support plus a proven track record of reliability.

Members are committed to furthering the interests of residential aged and community care in national forums to ensure eHealth and access to the personally controlled health record (PCEHR) becomes a reality for the aged care industry in the very near future.

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

• Mini-PC and Medical Imaging Displays.

• Mobile Medical Tablets.

• Computerised Medical Carts.

• Patient Infotainment Terminals.

Contact: Emma Pate emma.pate@eostech.com.au

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

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P: +61 3 9037 1000 F: +61 3 5335 2211 E: argus@argusconnect.com.au W: www.argusdca.com.au

P: +61 7 4155 8888 F: +61 7 4153 2093 E: support@bpsoftware.com.au W: www.bpsoftware.com.au

• Best Practice Clinical (“drop-in” replacement for MD) • Integrated Best Practice (Clinical/ Management) • Best Practice Automatic SMS reminders Visit us at the following conferences throughout the year: • • • • •

BP Summit, 14-16 March GPCE Sydney, 23-25 May RDAQ Brisbane, 6-8 June GPCE Brisbane, 12-14 September RACGP Adelaide, 9-11 October

Cerner Corporation Pty Limited

Australasian College of Health Informatics 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

P: +61 2 9900 4800 F: +61 2 9900 4990 E: AsiaPacific@cerner.com W: www.cerner.com.au Cerner is a leading global supplier of health care information technology solutions engaging across Australia for 24 years. We partner with health services ranging from tertiary referral academic hospitals to rural health facilities.

Our vision of proactive health care management drives innovation to address today’s health care challenges, while creating a foundation for tomorrow. The best way to solve a challenge is through innovation as evidenced by our Forbes ranking as 13th most innovative company worldwide.

Our focus for Australia is driven by realising improvement in clinical outcomes. Facilitating clinical transformation, while delivering capability to manage the overall health status of the population, contributes to better health and care.

CONNECT DIRECT Pty Ltd

cdmNet P: +61 3 9023 0800 F: +61 3 9614 2650 E: info@precedencehealthcare.com W: www.cdmnet.com.au cdmNet is the Number One collaborative care management product in Australia. cdmNet is the only care management product endorsed by the RACGP as supporting quality improvement in general practice. cdmNet helps practices take a systematic approach to chronic disease management and preventive care. It simplifies collaboration with the care team and ensures regular follow up and review.

University trials show cdmNet results in improved quality of care and better patient outcomes (Med J Aus, 201; 199: 261-265). cdmNet eliminates paperwork and makes compliance with Medicare requirements easy. It increases the productivity of the entire practice. Regular users of cdmNet show substantial increases in revenues from MBS-rebated services.

If you wish to use cdmNet to provide high quality care for your patients while increasing your revenues, contact us now.

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

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

Cloud9 Software P: 1300 875 297 F: +61 2 9715 6573 E: globalsales@c9s.com W: www.c9s.com At Cloud9 we understand the complexity of healthcare. We understand the importance of having the right information available when and where it’s needed.

So Cloud9 created an eco-system to connect healthcare providers that supports the availability of key information to improve outcomes for the patient, clinician and organisation alike.

An information infrastructure with real-time access across primary, community and acute setting benefits Clinicians trying to provide the best care for individuals as well as Researchers looking to improve safety and effectiveness of treatments.

Our e-Health infrastructure has been designed to fit in with your current systems, whilst Cloud9’s next generation administrative and clinical applications allow you to upgrade existing systems as your business grows.

Cloud9 Solutions: • Cloud9 Spine, Health Information Exchange • Synchronicity, Application Integration Suite.

• Clarity for GP’s and Specialists.

• Clarity Hospital Information System.

Digital Medical Systems P: 1300 865 977 F: +61 3 9753 3049 E: inform@dgs.com.au W: www.dgs.com.au EASIER MEDICAL IT is a technology partnership with DMS – we make IT 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 all Australian leading medical software applications.

DMS is a Business Partner for IBM, LENOVO, HP, CISCO and Microsoft. Other leading ICT brands include Webroot Secure Anywhere, StorageCraft, CA, Toshiba, Canon, Epson, Kyocera, Fujitsu and Brother.

Accreditation is easier with the customised DMS IT Systems Policy and Procedures Documentation. This ensures your practice has the best IT policy, security and maintenance program that meets and exceeds the standards guidelines from the RACGP.

P: 1300 557 550 / +61 7 5478 5510 F: +61 7 5478 5520 E: support@directcontrol.com.au W: www.directcontrol.com.au Direct CONTROL is the innovative answer to administrative excellence integrating with Microsoft Office, accounting applications, the OOP, clinical applications and Medicare Online.

Included are all fee schedules (Medicare, DVA, Work Cover, TAC, CTP, Private Health Insurance) with built in rules relevant to each medical discipline (Allied Health, General Practice, Surgeons, Physicians including Oncology, Anaesthetists, Pathologists, Radiologists, Day Surgeries/Hospitals).

Manage Episodes of Care including State, Federal and Health Fund Statistical Reporting for Day Surgeries/ Hospitals.

Restructuring work flow with Direct CONTROL guarantees to provide remarkable results, enabling you to grow your business and increase cash flow.

World leading DTech provides 24x7 near Real-Time Monitoring and Management technologies sends alerts and enables our engineers to quickly troubleshoot and remotely solve problems fast of security, network, Internet, server and software on almost any client computer system or device – most are fixed in minutes…

Proactive, Flexible, Consistent, Reliable, Audited, and Affordable - for the smallest to the largest practice.

Call DMS for: • Systems Analysis, Solutions Design & Consulting • IT Systems Documentation for Accreditation & Compliance • Procurement & supply of leading brand hardware, software, network and peripheral products • Full Installation & Configuration services • On-Site and Remote Technical IT Support • 24x7 IT support Help Desk with extensive medical software expertise • 24x7 DTech Monitoring, Maintenance & Management • Disaster Recovery solutions • Fully managed Online Backup customised for clinical data • Fully managed Internet and Web Security

Doctors Control Panel E: www.pracsoftutilities.com W: PSU_admin@pracsoftutilities.com • Download and trial DCP software for GP’s and health teams.

• DCP is your digital PA and guidelines advisor.

• DCP facilitates TCA, GPMP and MHCP creation and tracking.

• Contains guidelines licenced from RACGP. • Low annual subscription.

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EASIER MEDICAL IT – Call 1300 865 977

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Emerging Systems P: +61 2 8853 4700 E: sales@emerging.com.au W: www.emerging.com.au/ehealth Emerging Systems is a market leader of healthcare information and integration technology solutions.

Our eHealth products and services have supported clinicians in leading Australian public and private hospitals for over a decade to deliver safe, quality healthcare.

The award-winning EHS Clinical Information System is a modular, patient-centric system providing a wide range of clinical functionality to track, record and monitor patient care from pre-admission to discharge creating a multi-disciplinary EMR - improving clinical communication and patient flow while reducing patient risk. PCEHR Compliant. EHS Clinical Mobility Solution further enhances multi-disciplinary clinical communication. Emerging Systems provide clients with a full range of tailored IT services including Consultation and Managed IT Services.

Extensia

GE HCIT Solutions

P: +61 7 3292 0222 F: +61 7 3292 0221 E: enquiries@extensia.com.au W: www.extensia.com.au

P: +61 2 9846 4000 F: +61 2 9846 4001 E: GEHCinfo@ge.com W: www3.gehealthcare.com.au

Extensia links healthcare providers, consumers and their communities for better and more efficient health care.

The products used to do this can be custom branded for all Organisations and include:

Connecting productivity with care

• 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.

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Patient information is transferred seamlessly from clinical software. The most relevant providers, services and products are presented instantly and referral documents are generated and sent electronically.

P: +61 2 8985 6688 / 1300 799 904 E: enquiries@episoft.com.au W: www.episoft.com.au Accessible anytime, anywhere and on any device, Episoft deliver comprehensive clinical, practice and research management software in one seamless system that facilitates multicentre investigator initiated trials.

Affordable and scalable, EpiSoft is used by: • Private Hospitals • Medicare Locals • Public Hospital outpatient departments • Specialist clinics Create multidisciplinary teams, collaborate effortlessly and streamline workflows with our intuitive cloud based software.

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• Clinical solutions to drive improved patient outcomes • Robust clinical data at the point of care • Imaging solutions to drive productivity • Analytics to improve efficiencies and reduce cost • Interoperability with other systems.

Centricity Perinatal integrates documentation and foetal monitoring.

The Connect module integrates perinatal information in context with other clinical data, continuously and on one screen – enabling clinicians to see perinatal and enterprise EMR data at the same time. Remote access allows clinicians to view foetal strips while away from the hospital, providing continuous access to clinical expertise.

Centricity Perioperative integrates and simplifies surgery management and anaesthesia workflows throughout the pre-op, intra-op and post-op care areas, helping to manage anaesthesia and nursing documentation, scheduling, operating theatre inventory and more.

EpiSoft

EpiSoft has developed platforms for chronic disease management for: • Cancer including surveillance and infusion medication management • Hepatitis treatment including GP shared care programs • Mental Health • Indigenous Health • Respiratory disease • Specialised surgery • Pre-admissions patient portal

GE Healthcare IT provides robust clinical and imaging solutions that help you do more with less.

Genie Solutions P: +61 7 3870 4085 F: +61 7 3870 4462 E: sales@geniesolutions.com.au W: www.geniesolutions.com.au Genie is a fully integrated appointments, billing and clinical management package for Specialists and GPs. Genie runs on both Windows and Mac OS X, or a combination of both. With over 3000 sites, it is now the number one choice of Australian specialists.

Centricity Imaging Solutions will help you simplify your workflows, access data, and collaborate efficiently. They provide radiologists and physicians with tools to collaboratively inform the patient treatment plan and enhance decision-making. Our portfolio includes: Picture Archiving System (PACS), Radiology Information System (RIS), Universal Viewer, Vendor Neutral Archive, and Image Exchange for departments, enterprises, and communities.

GE Services can increase usability, enhance performance, and optimise a solution’s ROI. Our offering includes consulting, implementation, customisation, education, support, and enablement services.

GPA P: 1800 188 088 F: 1800 644 807 E: info@gpa.net.au W: www.gpa.net.au Specialising in general practice accreditation, and with a well-deserved reputation for meeting practices’ needs, GPA ACCREDITATION plus continues to deliver innovation, attention and proven customer satisfaction to practices nationwide.

Founded in 1998 by a team of general practitioners, GPA was established to give practices a choice of accreditation provider, making a commitment to promote the benefits of accreditation, and encourage ongoing quality improvement in the process. Whilst accreditation gives practices access to Practice Incentive Program payments, we believe it should offer benefits that go beyond financial incentives.

The GPA program offers a unique preliminary document review, using a secure online portal that doubles as a library of your practice documents.

Your dedicated Quality Accreditation Manager will guide you through the accreditation process, providing you with feedback and advice. Our carefully selected surveyors will ensure your survey visit is an opportunity to show off your practice and engage with your peers. Finally, a GPA certificate on your wall acknowledges your achievement, and assures your patients that your practice meets exacting standards in efficiency, risk management and patient care.

GPA is committed to providing support and resources that enhance and promote general practice accreditation.

Our series of free webinar sessions delivers training on the Standards for general practices, as well as pertinent accreditation topics. Our app for iPad encourages practices, and those that support them, to participate in self-assessment for accreditation preparation as well as continuous improvement between accreditation rounds. Our video series brings selfled training and resources directly to practices in a weekly email format, and our fortnightly eNews keeps you up-to-date with current accreditation information.

GPA continues to lead the way in delivering comprehensive, quality accreditation to general practices across Australia. Contact us now to make the switch, and discover an accreditation provider that gives you more.

GPsupport P: +61 3 9999 1212 F: +61 3 8678 0607 E: admin@gpsupport.com.au W: www.gpsupport.com.au Information Systems for the health care industry.

When associated with GPsupport all your technology needs are completely managed, freeing you to focus on patient care and clinical operations.

Your I.T is for us to worry about.

Since 2008, GPsupport has been dedicated to delivering I.T solutions to General Practice, Allied Health and Aged Care providers.

• • • • • •

Healthcare Centric IT Support Private Cloud Services Equipment Supply and Installation Multi-site networks Disaster Recovery Planning Accreditation Compliance

Our private cloud service is fast becoming the preferred choice for healthcare providers to relieve the pain of maintaining in-house systems while adhering to accreditation standards and your future needs.

InterSystems

Health Informatics New Zealand E: admin@hinz.org.nz W: www.hinz.org.nz Health Informatics New Zealand (HINZ) is a national, not-forprofit organisation with a focus on collaboration, education and advocacy for the use of IT in the health sector. HINZ enables professional collaboration through conferences, seminars and an interactive online portal, bringing together clinicians, administrators, allied health professionals and many others with an interest in health IT and the advances it can enable. HINZ provides a platform to share information about the Health Informatics industry - leveraging best practice from New Zealand and overseas, as well as facilitating networking activities to bring industry experts and interested parties together to collaborate. Membership is for anyone with an interest in Health Informatics.

Health Information Management Association of Australia P: +61 2 9887 5001 F: +61 2 9887 5895 E: himaa@himaa.org.au W: www.himaa2.org.au The Health Information Management Association of Australia Ltd (HIMAA) is the peak professional body for health information management professionals in Australia serving the profession since 1949. Recognised occupations include health information managers and clinical coders. HIMAA provides quality standards for the delivery of education and training, including the accreditation of degreelevel HIM courses and online delivery of VET-level courses in Medical Terminology and ICD-10-AM, ACHI and ACS Clinical Coding. We strive to promote and support our members as the universally recognised specialists in information management at all levels of the healthcare system.

P: +61 2 9380 7111 F: +61 2 9380 7121 E: anz.query@InterSystems.com W: www.InterSystems.com.au InterSystems is a global leader in software for connected care, with headquarters in Cambridge, Massachusetts, and offices in 25 countries. InterSystems TrakCare® is an Internet-based unified healthcare information system that rapidly delivers the benefits of an electronic patient record.

InterSystems HealthShare® is a strategic platform for healthcare informatics, enabling information exchange and active analytics across a hospital network, community, region or nation. InterSystems CACHÉ® is the world’s most widely used database system in clinical applications. InterSystems Ensemble® is a platform for rapid integration and the development of connectable applications. InterSystems’ products are used by thousands of hospitals and laboratories worldwide, including all of the top 15 hospitals on the Honor Roll of America’s Best Hospitals as rated by U.S. News and World Report. For more information, visit InterSystems.com.au.

Health Informatics Society of Australia HealthLink P: 1800 125 036 (AU) P: 0800 288 887 (NZ) E: enquiries@healthlink.net W: www.healthlink.net Transforming healthcare by connecting healthcare providers. Australia and New Zealand’s most effective secure communications service.

• NEHTA compliant Secure Messaging Delivery (SMD) services • Fully integrated with leading GP and Specialist clinical systems • Referrals, Reports, Forms, Discharge Summaries, Specialists, Diagnostic Orders and Reporting • Affords all healthcare providers efficiencies in reducing paper based handling • Expert partnerships with Healthcare organisations, State and National Health Services • HL Connect for Allied Health, Telehealth and Aged Care Providers • Working with Medicare Locals Australia-wide for eHealth delivery Join HealthLink and connect with more than 85 % of Australian GPs and 99% of NZ GPs who are already part of the HealthLink community.

P: +61 3 9326 3311 F: +61 3 8610 0006 E: hisa@hisa.org.au W: www.hisa.org.au HISA is Australia’s health informatics organisation. We have been supporting and representing Australia’s health informatics and e-health community for almost 20 years. HISA aims to improve healthcare through the use of technology and information. We: • Provide a national focus for e-health, health informatics, its practitioners, industry and a broad range of stakeholders • Support, promote and advocate • Provide opportunities for networking, learning and professional development • Are effective champions for the value of health informatics HISA members are part of a national network of people and organisations building a healthcare future enabled by e-health. Join the growing community who are committed to, and passionate about, health reform enabled by e-health.

Houston Medical P: 1800 420 066 (AU) P: 0800 401 111 (NZ) E: info@houstonmedical.net W: www.houstonmedical.net

Intrahealth

“We provide time to health professionals through efficient practice management software”

P: +61 2 9956 3827 (AU) P: +64 9 480 7442 (NZ) E: enquiries@intrahealth.com W: www.Intrahealth.com

Our multidiscipline software provides interfaces to every major manufacturer, enabling many clinics to save space by becoming completely paperless!

We are a progressive medical software company and take pride in working with our health care clients to deliver tailored EMR and PMS packages based on each unique situation and practice requirements. We’re focused on helping to make their businesses more efficient and productive as well as delivering measurable improvements in customer satisfaction and market share.

You can arrange a free demonstration of our software by visiting: www.HoustonMedical.net

Intrahealth is a global software and associated services company supplying solutions to the outpatient environment.

Intrahealth provides a highly configurable integrated EMR (including case management), web access applications for real time patient, provider and external provider connectivity and a native application for the iPad and iPhone. Intrahealth solutions function across multiple community based practice types (Primary Care, Specialist Physician, Community Care, Home Care, Residential Care, etc).

Intrahealth’s suite of products are used in: Individual community based clinics, Chains of clinics, Corporate medical environments & Large scale Government implementations.

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MEDrefer

Leecare Solutions P: +61 3 9339 6888 F: +61 3 9339 6899 E: enquiries@leecare.com.au W: www.leecare.com.au Leecare Solutions, with their products Platinum 5 & P5 Exec, are the aged care industry’s leading web browser based clinical and management software system. Since 2000, Leecare has provided relevant, contemporary software solutions for Australian and New Zealand aged care organisations.

Leecare’s mission and products provide outstanding clinical decision making support, and management support tools that use any device, can be installed on multiple platform types and in any location. Used in over 30,000 aged care places, it is the solution used by quality providers, proven through thousands of accreditation, validation and other regulatory visits, as it is based on professional clinical and lifestyle provision concepts.

Medical Software Industry Association E: ceo@msia.com.au E: president@msia.com.au W: www.msia.com.au With the increase in government e-health initiatives, the MSIA has become increasingly active in representing the interests of all healthcare software providers.

The MSIA is represented on a range of forums, working groups and committees on behalf of its members, and has negotiated a range of important changes with government and other stakeholders to benefit industry and their customers. It has built a considerable profile with Government and is now acknowledged as the official ‘voice’ for the industry.

Join over 100 other companies across all areas of medical IT/IM so your voice can be heard.

P: 1800 556 022 E: mail@medrefer.com.au W: www.medrefer.com.au MEDrefer is a secure online referral tool used by GPs, Specialists and Allied Health Professionals to manage the referral process for the benefit of patients.

MEDrefer is a free service for GPs with an extensive search directory and profile of Specialists and Allied Health Professionals, a search reveals their listing in order of relevance and availability.

MEDrefer provides an automatic tracking system for the GP to know if the patient attends their appointment, assisting duty of care.

Now integrated with Best Practice and Genie software, as well as other systems, through the MEDrefer Manager.

Join MEDrefer today to close the loop on your referral process.

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.

Medtech Global Ltd MEDITECH Australia

MedicalDirector P: +61 2 9906 6633 F: +61 2 9906 8910 E: medicaldirector@medicaldirector.com W: www.medicaldirector.com MedicalDirector has been supporting healthcare professionals and improving health outcomes for more than 20 years. We pride ourselves on developing solutions that help you achieve more in your day.

Formally known as Health Communication Network (HCN), we employ dedicated software development and customer care teams, committed to the delivery and support of new and enhanced products for healthcare professionals. Our flexible systems are easy-to-use and created for the busy world of modern healthcare. With the latest evidencebased medicine at your fingertips, this software is designed to make your job easier.

For more information about MedicalDirector visit www.medicaldirector.com

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P: +61 2 9901 6400 F: +61 2 9439 6331 E: sales@meditech.com.au W: www.meditech.com.au A Worldwide Leader in Health Care Information Systems MEDITECH today stands at the forefront of the health care information systems industry. Our products serve well over 2,300 health care organisations around the world. Large health care enterprises, multi‑hospital alliances, teaching hospitals, community hospitals, rehabilitation and psychiatric chains, long-term care organisations, physicians’ offices, and home care and hospice agencies all use our Health Care Information System to bring integrated care to the populations they serve. Our experience, along with our financial and product stability, assures our customers of a long-term information systems partner to help them achieve their goals.

P: 1800 148 165 E: salesau@medtechglobal.com W: www.medtechglobal.com For over 30 years, Medtech Global has been a leading provider of health management solutions to the healthcare industry enabling the comprehensive management of patient information throughout all aspects of the healthcare environment.

Medtech’s Medtech32 and Evolution solutions improve practice management and ensure best practice for electronic health records management and reporting.

Clinical Audit Tool integrates with Medtech32 and Evolution providing fast, efficient and secure analysis of patient data enabling practices to identify and deliver services, which address health care priorities across their population.

Medtech’s ManageMyHealth patient and clinical portal enables individuals to access their health information online and engage with their healthcare provider to support healthy lifestyle changes.

Orion Health P: +61 2 8096 0000 / +64 9 638 0600 E: enquiries@orionhealth.com W: www.orionhealth.com Orion Health is New Zealand’s largest privately owned software exporter and a global leader in eHealth technology.

Founded in 1993, by CEO Ian McCrae, Orion Health has grown from a specialist health integration vendor into a company that sells a comprehensive suite of eHealth solutions. Orion Health has extensive experience in the design and installation of complex systems within demanding healthcare environments.

Orion Health designers and engineers work right alongside in-house clinicians in order to develop elegant and intuitive products that encourage swift adoption with minimal disruption, allowing your clinicians to focus on patients.

Today, our products and solutions are currently implemented in more than 30 countries, used by hundreds of thousands of clinicians, and help facilitate the care for tens of millions of patients.

OzeScribe

PicSafe Medi

P: 1300 727 423 F: 1300 300 174 E: sales@ozescribe.com.au W: www.ozescribe.com.au

P: +61 419 572 222 E: kerri-anne@picsafe.com W: www.picsafe.com

OzeScribe is the dictation and transcription solution chosen by most Australian university teaching hospitals and major private clinics.

Our system is entirely flexible and can be tailored to your specific requirements, whether it be co-source or total outsource, for one doctor or a public hospital!

We provide free electronic document delivery - via OzePost - to your EMR, your associate’s EMR, saving you thousands of dollars in time, packing and postage.

OzeScribe is the provider of the most advanced solutions available, interfacing with most market leading PAS/Practice management solutions.

OzeScribe is:

The Secure Mobile Clinical Imaging System Are you using mobile devices to take clinical photographs of your patients?

Current Australian Privacy Principles, effective 12 March, 2014, surrounding capture, use, and storage of medical photographs, state that illicit usage of mobile cameras can lead to fines for individuals ($340,000) and institutions ($1,700,000). iOS and Android compatible, PicSafe Medi suffices patient privacy and related government regulatory requirements in Australia, UK, USA, and Europe. Designed by Australian and US Dermatologists and Plastic Surgeons, it is used like the camera function on your mobile smart device - now with the new “pinch-zoom” feature.

• Run by doctors - for doctors.

• Free NEHTA compliant electronic delivery to referring GPs etc via OzePost - powered by Argus.

• Australian based and trained typists.

• Superior accuracy via Quality Assurance (QA) transcription guaranteed.

• Windows and Mac compatible web‑based dictation, transcription and document management portal.

• Free app for iOS and Android devices.

• Integrated M*Modal speech recognition technology on demand.

Photos are completely secure, and legally compliant in their patient consent (written or recorded), transmission, and storage. Photos are watermarked to assure authenticity and never stored on the mobile device.

We store photos and data in a highly secure, auditable, private server, for up to 25 years, accessible to the user at any time.

With demonstrated time and cost saving benefits, it really does make sound business sense to let OzeScribe take care of managing your dictation, transcription and associated technology.

• Improve your patients’ clinical outcomes • Avoid costly patient privacy breaches • Assure quick, efficient pictorial documentation of your patient’s status • Facilitate a streamlined medical referral process • Fully document patient encounters for billing, auditing, and medicallegal purposes

To speak with a consultant call us now on 1300 727 423!

Healthcare professionals can quickly connect to document a patient’s status pictorially, ultimately improving patient outcomes and satisfaction.

PicSafe Medi - available on the Apple App store and on Google Play for Android @ $4.99 per month.

Try a FREE one month trial at: www.picsafe.com

Precision IT P: 1300 964 404 F: +61 2 8078 0257 E: info@precisionit.com.au W: www.precisionit.com.au • Cloud Computing Specialists.

• Onsite Medical IT Support.

• VoIP Telephone Systems and Internet Connectivity.

• IT Equipment Procurement.

• Experience with all clinical & practice management software packages.

• Sydney, Brisbane, Gold Coast and Melbourne.

Precision IT is a highly competent and impeccably professional IT support firm with a primary focus on working with GPs and Specialists. Working with our clients, we develop reliable, robust and feature rich IT systems to meet the demands of the modern medical practice today and into the future.

Our Precision Cloud service is fast becoming the choice for new and established practices and covers all of the standard guidelines from the RACGP and AGPAL and GPA. Talk with us today about the future of your practice!

Prospection P: +61 2 9209 4035 E: info@prospection.com.au W: www.prospection.com.au Prospection is a specialist healthcare information and analytics consultancy.

• Clinical Intelligence Solutions – medication specialists • Commercial Effectiveness and Consulting • Clinical, technical and commercial expertise • Geo-mapping visualisation and reporting solutions Prospection specialises in the design, development and hosting of clinical and costing intelligence systems and consulting solutions. Our PharmDash platform allows us to analyse and report on complex healthcare datasets, and deliver web‑based reporting.

We have particular expertise in understanding medication utilisation working with large, complex pharmaceutical databases. Our clients include over 30 large Australian healthcare companies in both specialist and chronic therapy areas.

We can assist public and private healthcare organisations to improve commercial and clinical outcomes.

Shexie Medical System Professional Transcription Solutions P: 1300 768 476 E: marketing@etranscriptions.com.au W: www.etranscriptions.com.au Australia’s Most Trusted Teaching Hospital and Private Practice Transcription Provider • Web-based - Dictate and receive reports anywhere • Double-edited with over 99.5% accuracy • Fast turn-around within 24 - 48 hours, as required • All medical and surgical specialities covered in Australia’s largest teaching hospitals • Rapid documentation of recorded HR interviews, Research and Expert Reports • Guaranteed cost savings • Data held securely at a State Government owned data centre • Call our friendly staff anytime for your overflow, backlog or all of your typing or data entry requirements • Call us now for a no obligation free trial

P: 1300 743 943 F: 1300 792 943 E: info@shexie.com.au W: www.shexie.com.au Shexie is an Australian owned business which has been developing software for medical practices for over 15 years.

Our industry and technical knowledge allows us to provide the ultimate ‘easy to use’, ‘fully functioned’ and ‘robust’ product on the market.

Shexie Medical System clinical and practice management software is ideal for surgical or specialist practices of any size. Many fully integrated features including Paperless Office, SMS, full Paperless Electronic Claiming including Eclipse, MIMS Integrated, statistical analysis, security, synchronize appointments with Outlook/PDAs, transcription interface, diagnostic equipment interface, automated MBS/Fund rates updates.

Soon to be released Shexie Platinum version also contains eHealth - Health Identifiers, PCEHR and Secure Messaging.

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Stat Health Systems (Aust) P: +61 7 3121 6550 F: +61 7 3398 5064 E: carla.doolan@stathealth.com.au W: www.stathealth.com.au

P: 1800 061 260 E: sales@tg.org.au W: www.tg.org.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.

Therapeutic Guidelines Limited is an independent not-for-profit organisation dedicated to deriving guidelines for therapy from the latest world literature, interpreted and distilled

by Australia’s most eminent and respected experts.

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 incorporates all eHealth requirements as per the NEHTA specification.

These experts, with many years of clinical experience, work with skilled medical editors to sift and sort through research data, systematic reviews, local protocols and other sources of information, to ensure that the clear and practical recommendations developed are based on the best available evidence.

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

Facebook: facebook.com/StatHealth Twitter: @NotifyStat

Sysmex P: +61 3 9013 4445 E: info@sysmex.com.au W: www.sysmex.com.au Sysmex is dedicated solely to helping your healthcare organisation achieve more in less time, with fewer errors and better patient outcomes.

Sysmex leads the way in eDiagnostics: • Providing an essential building block for the electronic medical record with the Eclair Clinical Information System • Enabling sharing of key patient information across regions through the Eclair Clinical Data Repository • Completing the electronic loop with laboratory and radiology order request management (CPOE) • Streamlining all areas of the anatomical pathology laboratory workflow from request to report with Delphic AP • Improving reporting times and reducing costs through an enterprise Delphic LIS, shared across multiple laboratories

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Therapeutic Guidelines Ltd

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eTG complete Incorporates all topics from the Therapeutic Guidelines series in a searchable electronic product, and is the ultimate resource for the essence of current available evidence.

It provides access to over 3000 topics, relevant PBS, pregnancy and breastfeeding information, key references, text articles and relevant Cochrane Library Reviews. eTG complete is available in a range of convenient formats – online access, online download, CD, and intranet access for hospitals. Multi-user licences, ideal for a practice or clinic, are also available.

It is widely used by practitioners and pharmacists in community and hospital settings in all Australian states and territories.

The November release of eTG complete contains Antibiotic 15. Therapeutic Guidelines: Antibiotic is Australia’s leading source of independent advice on the treatment of infectious diseases. All topics in this version have been extensively reviewed and updated to ensure the most appropriate treatment for individual patients, while minimising the potential for antibiotic resistance. miniTG The mobile version of eTG complete is miniTG, (in offline format), offering the convenience of vital information at the point of care for health professionals who practise and consult on the move. It is supported on a wide range of mobile devices, including Apple®, Pocket PC®, and selected Blackberry® devices.

Webstercare

Totalcare

P: 1800 244 358 F: 1800 626 739 E: info@webstercare.com.au W: www.webstercare.com.au

P: +61 7 3252 2425 F: +61 7 3252 2410 E: sales@totalcare.net.au W: www.totalcare.net.au Totalcare is a fully integrated Clinical, Office and Management software suite designed to suit the particular needs and processes of healthcare providers. Used since 1995 by health care facilities across Australia including General and Specialist practice, Radiology, Day Surgery and Hospitals, Totalcare is stable, scalable, customisable and easy to learn and use. From a small practice to a multisite, multi-disciplinary corporate entity or hospital, Totalcare can provide solutions for your needs.

• • • • • • • •

Admissions / Appointments Billing Statutory Reporting Integrated SMS Prescriptions Orders & Reports Clinical Notes Letter/Report Writing, Document and Image Management • Scanning and Barcode recognition • Video and Image Capture • HL7 Interfaces

Webstercare is a world-leading medication management innovator and was recognised in 2013 by BRW as Australia’s sixth most innovative company. About 30 years ago, Webstercare developed Webster‑pak®, the world’s first medication dose administration aid, and today the majority of Australia’s community pharmacies use the Webster-pak system to help consumers maximise their medication use.

Webstercare has since developed another 300 products and services– all developed to solve existing problems.

These include MedsPro®, a system for maximising the efficiency of dispensing Webster-paks; MedsCom® Connect which connects pharmacies with aged care facilities and GPs; and MedSig® to streamline clinical medication administration processes.

Zedmed ™

VIRTUAL CONSULTING ROOMS

VConsult P: 1300 82 66 78 F: 1300 66 10 66 E: admin@vconsult.com.au W: www.vconsult.com.au VConsult offers outsourced practice management solutions for medical and allied health practitioners allowing the focus to be on your professional practice and patient care. VConsult provides a seamless “behind the scenes” service by professionally managing your telephone calls, reception, invoicing and medical transcription requirements.

VConsult is perfect for your practice if you are: • Setting up, already established or winding down in Private Practice • Working in a public appointment and want to portray a professional image • Looking to minimise your overhead costs • Requiring your patient calls to be answered by a professional and experienced medical receptionist.

P: 1300 933 000 F: +61 3 9284 3399 E: sales@zedmed.com.au W: www.zedmed.com.au At Zedmed, we provide general practice, specialist and allied health clinics with turnkey software solutions for their most common practice needs.

We’re committed to producing best in class products and services and are consistently striving to provide additional value-added products and services to help practices work more profitably and efficiently, so our customers can focus on delivering patient care.

Zedmed - Focused Innovation.

The GPA Webinar Series‌ Delivering free online training for accreditation and beyond

Live events designed to fit in with the busy schedules of practices Join from your location (including mobile devices) The comprehensive Standards Educationals series looks at every criterion in detail Certificates of participation available for attendance at the live webinars AAPM CPD points available for attendance at Standards Educationals webinars Subscribe to the GPA YouTube channel and catch up on any webinars you missed

Find the full schedule, and links to register, at www.gpa.net.au/webinars

HealthLink

Adding a whole new dimension to healthcare

At HealthLink we understand our products work best when they free up medical practitioners to concentrate on what they do best - personalised patient care - while giving them the accurate, timely and complete information to further enhance that care.

Today’s complex, hurried healthcare environment demands patient information systems that are absolutely dependable.

At HealthLink we work through every challenge to ensure our clients have nimble, fit -for- purpose systems that deliver peace of mind performance.

www.healthlink.net