Pulse+IT Magazine - October 2012

Australasia’s First and Only eHealth and Health IT Magazine

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ISSUE

15 OCTOBER 2012

NZ E-HEALTH & HINZ 2012 PREVIEW NZ’s eHealth agenda

Pulse+IT takes an in-depth look at NZ’s National Health IT Plan with its architect, Graeme Osborne.

Life after the quake

How the Christchurch earthquake spurred the development of an electronic shared care record viewer.

Australian telehealth comes of age The MBS items and the NBN are expected to help telehealth expand even further in the next few years.

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Inside

Publisher Pulse+IT Magazine Pty Ltd ABN: 34 045 658 171 www.pulseitmagazine.com.au Editor Simon James Australia: +61 2 8006 5185 New Zealand: +64 9 889 3185 simon.james@pulseitmagazine.com.au Advertising Enquiries ads@pulseitmagazine.com.au

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

Pulse+IT is produced in print seven times per year with the final edition for 2012 to be distributed for release in mid-November. This edition will focus on mHealth.

Edition themes for 2013 will be announced in the next issue of Pulse+IT and online 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 which supply copies of Pulse+IT to their members.

About Pulse+IT Pulse+IT is Australasia’s first and only eHealth and Health IT magazine. With an international distribution exceeding 34,500 copies, it is also one of the highest circulating health publications in Australasia. 32,000 copies of Pulse+IT are distributed to GPs, specialists, practice managers and the IT professionals that support them. In addition, over 5,000 copies of Pulse+IT are distributed to health information managers, health informaticians, and IT decision makers in hospitals, day surgeries and aged care facilities.

ISSN: 1835-1522 Contributors Simon James, Kate McDonald, Lisa White and Laurie Wilson.

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

Copyright 2012 Pulse+IT Magazine Pty Ltd No part of this publication may be reproduced, stored electronically or transmitted in any form by any means without the prior written permission of the Publisher.

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PLIBERSEK ON PAY FOR PCEHR

HEALTH IT IN A DISASTER ZONE

ORION’S GLOBAL PLANS

Editorials

Features

News

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STARTUP Editor Simon James introduces the 31st edition of Pulse+IT.

HIMAA Lisa White outlines how Eastern Health implemented a scanned medical record system across all sites and programs, giving rise to a system callled ELIoT.

Resources

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EVENTS

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HINZ CONFERENCE PREVIEW

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We talk to the NZ Health IT Board’s Graeme Osborne about his goals for the National Health IT Plan.

GUEST EDITORIAL Laurie Wilson explains how the last few years have seen an explosion of activity and a fundamental change in the way telehealth is viewed within Australia’s health system.

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CHRISTCHURCH AFTER THE EARTHQUAKE Canterbury’s Nigel Millar explains how Christchurch’s health system responded to the 2011 earthquake.

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The annual Health Informatics New Zealand (HINZ) conference is being held in Rotorua in November.

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

GOING FOR GOLD IN MEDICATIONS MANAGEMENT NZ has an ambitious target for electronic medications management in acute care.

Up and coming eHealth, Health, and IT events.

PULSE+IT DIRECTORY

2014 AND BEYOND: NZ’S EHEALTH AGENDA

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SELECTED BITS & BYTES First clinical documents uploaded to PCEHR in Brisbane and Sydney Zedmed gets read to roll with PCEHR-compliant software ACT My eHealth portal targets chronic care patients NHSD to develop endpoint location, telehealth directories Houston Medical integrates with MedSpeech dictation Genie to release mobile app

THE CHALLENGE FOR HEALTH IT IN GENOMIC AND DEVICE DATA

cdmNet goes national with collaborative care plan

Pulse+IT talks to Orion Health CEO Ian McCrae about the patient-led revolution of the future.

Medical Director opens up to third-party developers

CROSS-CULTURAL COLLABORATIVE CARE

HL7 to offer interoperability standards for free

A network of specialist clinicians in Australia, New Zealand and Singapore for IBD.

Canterbury GPs get free text messaging system

PATIENT TRANSFER WITH GP2GP First launched in 2011, New Zealand’s electronic patient record transfer initiative is seeing exponential rates of adoption.

Emerging Systems completes interface to national PCEHR Medtech Global to launch patient portal and PCEHR functionality

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Editorial

NZ E-HEALTH & HINZ CONFERENCE As Australian healthcare organisations wait for their clinical software to be connected to the Personally Controlled Electronic Health Record (PCEHR) system, Pulse+IT has taken the opportunity to report on some of the eHealth and Health IT initiatives that are being undertaken in New Zealand.

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

Pulse+IT has been distributed throughout New Zealand for several years, however this issue marks the first opportunity we’ve had to devote an edition of the magazine to eHealth-related developments happening on the west side of the Tasman.

With Australia and New Zealand utilising eHealth technology developed by organisations operating in both countries, many of the articles presented will have – or may soon have – direct applicability to your practice or healthcare organisation, regardless of your locale.

The New Zealand government’s approach to eHealth is articulated in detail by Graeme Osborne, director of the National Health IT Board, with astute followers of Australian eHealth likely to be able to spot the divergent aproaches being undertaken by the respective governments. Attendees of the HINZ conference, to be held in Rotorua in November, will be able to get further details about the government’s revised Health IT implementation plan.

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

The edition also features an update on the GP2GP initiative, which allows practices to electronically send and receive entire patient records from one practice to another, regardless of which clinical software product they are using.

This article in particular will resonate with Australian general practices, if

only because this functionality is not yet available to them. While the PCEHR may go some way towards improving access to patient records throughout the health sector, ultimately the project is an attempt to solve a different problem and one that may have diverted attention and funding away from substantially cheaper and more easily achievable eHealth initiatives.

Looking ahead The forthcoming and final edition of Pulse+IT for the year will focus on the burgeoning field of mobile health (mHealth). The rapid rise of smart phones and tablet devices with consumer‑friendly price tags has dramatically reshaped the IT landscape, with the health sector as well placed as any to take advantage of the mobile computing revolution.

In the meantime, those interested in keeping abreast of the latest Australian and New Zealand eHealth developments are invited to sign up to our free eNewsletter service, or visit us online at: www.pulseitmagazine.com.au As always, I welcome the input of our readers. If you have any suggestions for future articles, would like to contribute to an edition, or would simply like to discuss your experiences with eHealth, don’t hesitate to get in touch.

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Guest Editorial

AUSTRALASIAN

TELEHEALTH CELEBRATES ITS COMING OF AGE The injection of funds into local telehealth provision through the MBS telehealth item numbers and the NBN-enabled telehealth pilots program means the more widespread adoption of telehealth in Australia is beginning to take shape. The potential of these initiatives, and the strategic directions for telehealth over the next few years, will be discussed at the Global Telehealth 2012 conference in Sydney in November.

LAURIE WILSON BSc PhD Honorary Secretary Australasian Telehealth Society Laurie.Wilson@csiro.au

Although telehealth has been part of Australian healthcare since the foundation of the Royal Flying Doctor Service, the last few years have seen an explosion of activity and a fundamental change in the way telehealth is viewed within the health system. The primary catalyst for change has been the Australian government’s introduction of telehealth items into the Medicare Benefits Schedule in mid-2011.

A number of other measures introduced since then have supported the use of telehealth; for example, in recent months several multi-million dollar projects have been announced under the Digital Regions Initiative of the Department of Broadband, Communications and the Digital Economy. The communications infrastructure supporting future telehealth initiatives is likely to receive a major boost over the next few years as the National Broadband Network is rolled out, and the NBN‑enabled telehealth pilots program is already funding a number of pilot projects.

About the author Laurie is a Post Retirement Fellow at the CSIRO ICT Centre, Adjunct Professor at the University of Technology Sydney and Honorary Secretary of the Australasian Telehealth Society. He has spent 35 years researching technology in healthcare, including medical imaging, advanced telehealth systems and human factors.

The promise of universal coverage should accelerate the implementation of services to the most remote communities, as well as facilitating the provision of health services directly to the home.

Internationally, the most rapid area of growth in telehealth is the provision of health services via mobile device, with predictions of huge growth in this sector.

Despite these advances, there are immense challenges for telehealth in Australia. Growth brings its own problems, and there is a growing perception that telehealth can fulfil its promise only with high-level goal-setting and a national perspective. Already, federal intervention is creating an environment for such a view, but there is a need for national policy and direction‑setting, with the Commonwealth acting as more than just a funding body.

The need for nationally agreed standards is one of many issues facing the rapidly growing telehealth community.

There are high expectations for telehealth.

For example, there are hopes that telehealth can assist providers and services in meeting the health needs of an ageing population. In-home care places a relatively small burden on health systems, and technological advances are making it easier to provide such services to the home. An ongoing challenge to Australia’s health systems is addressing the relatively poor health outcomes for our indigenous population; providers in several states and the Northern Territory are increasingly looking to telehealth to meet the needs of these communities.

Formation of ATHS A number of national bodies have provided forums for the telehealth community

to work through these issues. Medical colleges such as the Royal Australian College of General Practitioners have become active in telehealth, while the Health Informatics Society of Australia has mounted two national telehealth events. The Australian College of Rural and Remote Medicine is acting as a coordinating and educational body as well as providing a forum for those involved.

Since 2008, these relatively longestablished bodies were joined by the Australasian Telehealth Society (ATHS), the only organisation constituted to address the needs of the telehealth community in Australia and New Zealand.

Since that time, ATHS has ridden the wave of telehealth growth, and now has approximately 200 members.

One of the most significant activities of ATHS has been to organise Australia’s only fully peer-reviewed Australian telehealth conference (the highly successful and long-running Successes and Failures in Telehealth conference, organised by the Centre for Online Health, is now merged with the ATHS conference when it is held).

The first ATHS conference in 2010 was also the 15th International Conference of the International Society for Telemedicine and eHealth (ISfTeH), for which ATHS is the national member for Australia and New Zealand. That meeting adopted the title ‘Global Telehealth 2010’ (GT2010).

The second ATHS conference in 2011 was combined with the Successes and Failures in Telehealth conference, but in 2012 ATHS will present its second global telehealth conference, Global Telehealth 2012. This will be held in Sydney from November 26 to 28 at the Four Points by Sheraton Hotel.

Global telehealth forum Several themes will be explored at this meeting. The major sponsor of the conference is the federal Department of

“The primary catalyst for change has been the Australian government’s introduction of telehealth items into the MBS.” Laurie Wilson

Health and Ageing, and the conference is ideally placed in time to assess the success of DoHA’s many telehealth initiatives, as well as to look at strategic directions for telehealth over the next few years.

Two of the invited overseas speakers will highlight some of telehealth challenges likely over the next few years. Telehealth support in the home will be addressed

by Sabine Koch, professor of health informatics and director of the Health Informatics Centre Sweden (HIC).

Professor Koch has a background in medical informatics with a PhD from the University of Heidelberg. Her research interests comprise home telehealth, human-computer interaction in health and social care, and consumer informatics.

Her current research focus is on integration architectures for shared care environments as well as on visualisation and interaction techniques for contextbased presentation of clinical information.

Professor Koch is a well-known researcher in the international scientific medical informatics community and is an editorial board member of several international scientific journals in the field.

Telehealth to indigenous populations represents a challenge and opportunity, and GT2012 will be pleased to welcome A. Stewart Ferguson, CIO for the Alaska Native Tribal Health Organization in Anchorage, Alaska. Approximately 15 per cent of the Alaskan population is indigenous, and many of the issues of overcoming distance and communications deficiencies will be familiar to Australians.

Dr Ferguson’s eminence in his field is testified by the fact that he has been elected president for 2012-13 of the American Telemedicine Association.

Prior to becoming CIO, Dr Ferguson was director of the Alaska Federal Health Care Access Network (AFHCAN).

AFHCAN is Alaska’s largest telehealth project with deployments at 248 remote sites, and has been recognised with the President’s Award from the American Telemedicine Association, a TETHIC Award for Most Innovative New Technology Device for Diagnostics for 2004, the National Managed Health Care Congress AstraZeneca Award and the Grace Hopper Government Technology Leadership Award.

Invited Australian and New Zealand speakers include Sarah Dods (CSIRO), Leif Hanlen (NICTA), Len Gray (the University of Queensland’s Centre for Online Health) and Pat Kerr (NZ Telehealth Forum).

At the time of writing, a peer-reviewed program of proffered papers from Australia and a number of overseas countries is in the final stages of planning. Proceedings will be published in a special issue of the Journal of Telemedicine and Telecare and a volume of the IOS series Studies in Health Technology and Informatics. There will also be a comprehensive trade display and social functions, including a conference dinner. Satellite events supporting the conference themes are also being planned.

More information is available at the website www.gt2012.org. The website for the Australasian Telehealth Society is www.aths.org.au.

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News

First clinical documents uploaded to PCEHR in Brisbane and Sydney

Scan this QR code to read and comment on the latest eHealth news online.

General practitioners in Brisbane’s western suburbs and Sydney’s east were among the first to upload clinical documents to the national PCEHR.

Health Services (SV&MHS) Wave 2 project aimed at connecting hospitals, GPs and private specialists in the eastern Sydney area to the national PCEHR.

Suzanne Williams of Inala Primary Care uploaded a shared health summary to the PCEHR of Brett Silvester, CEO of Health Industry Exchange, using HIE’s Companion application, which created the document from information extracted from Dr Williams’ Best Practice clinical software.

Pen Computer Systems and HIE are currently the only two software companies that can access and share documents with the national system, although GP software that is PCEHRcompliant is shortly to be rolled out. Best Practice is aiming to have its software ready next month.

A couple of days later, well-known Sydney GP Raymond Seidler uploaded one of his patient’s shared health summaries to the PCEHR. Dr Seidler used Pen Computer Systems’ PrimaryCareSidebar tool to create and upload the document from his Best Practice system.

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Dr Seidler’s Kings Cross Clinic is part of the federally funded St Vincent’s & Mater

In a statement, Dr Seidler said GPs had previously received handwritten letters which are often indecipherable from overworked hospital doctors. “Some patients forget to bring their letter to the GP and so much pertinent information gets lost,” he said.

“Now we have a fail-safe method of information transfer. This makes the patient happy and produces

rejoicing amongst us GPs who were previously left out of the loop.”

The next step for the SV&MHS project is for St Vincent’s Hospital to become the first hospital in Australia to connect to the national system. St Vincent’s uses Emerging Systems’ EHS clinical software, known internally as deLacy.

Emerging Systems is thought to be the first hospital-based software to pass its Notice of Connection (NOC) and Certification, Compliance and Accreditation (CCA) testing for packaging and rendering electronic documents and interfacing with the PCEHR. In Brisbane, the shared health summary was created using HIE’s Companion tool, which extracted the data and then uploaded it using its Companion Gateway technology. Mr Silvester

was able to view his health summary through the PCEHR consumer portal.

Pulse+IT understands this is an interim measure being used in the Wave 1 and 2 sites to begin the process of populating individual PCEHRs. HIE has been funded to integrate the Companion into some of the clinical software packages.

Frank Pyefinch, CEO of Best Practice, said the version of his software capable of creating documents and uploading them to the PCEHR is on track to be released soon. “[HIE has] extracted the data from Best Practice and they’ve generated the health summary and put it up, but it wasn’t Best Practice that did the upload,” Dr Pyefinch said.

“But good on them – they’ve done the work and it’s good for us to be associated with.

In a statement, Dr Williams said the shared health summary was “surprisingly easy to create”.

“The HIE app is easy and fast to use and it is obvious that HIE have designed a health summary that supports the workflow in general practice and makes it an efficient and usable record,” she said.

The HIE Companion app was granted PCEHR production access by the Department of Health and Ageing in late August after successfully completing NEHTA’s Compliance, Conformance and Accreditation (CCA) program. The live upload was early September.

Inala Primary Care worked with the West MoretonOxley Medicare Local (WMOML), a partnership between the former Brisbane South and Ipswich

and West Moreton divisions of general practice, to roll out the technology. WMOML is one of the Wave 2 sites for the implementation of the PCEHR. Mr Silvester told Pulse+IT that HIE was providing the Companion technology to a number of the Medicare Locals it provides support for, who will then be responsible for rolling it out to practices.

HIE has been involved in a number of Wave 1 and 2 sites and was responsible for creating the eHealth Network website for four Wave sites. These networks have been involved in testing and deploying the national eHealth infrastructure and standards in real world healthcare settings, and have recruited several thousand patients to take part. These patients are yet to transition to the PCEHR.

Zedmed gets ready to roll with PCEHR-compliant software Clinical software company Zedmed has achieved its conformance certificate to interface with the PCEHR and is gearing up to roll the capability out to the practices of early adopters shortly.

Zedmed business analyst Jane Blakeley said the company believed it was the first GP desktop software vendor to have completed its full CCA testing. “Users can view, upload and download documents, so basically that gives you full access to the PCEHR directly through Zedmed and you don’t need any other third-party software.”

Ms Blakeley said Zedmed would have full capability for users to meet the new requirements for the eHealth Practice Incentive Program (ePIP), which will come into full effect next May. She said Zedmed had a large number of practices that have put up their hands to be early adopters for the system.

“We would anticipate that we will have practices up and running fairly soon.”

“We are really pleased for our clients as they will have confidence that they will be eligible for their ePIP requirements and have everything in place and it won’t all be happening at the last minute.”

Zedmed has had HI Service interface capability in its software since last year, and the search and validation service for HPI-Os and HPI-Is in its current version The software also currently supports the ETP requirement, with the ability to use either eRx or MediSecure.

It will also have full Secure Messaging Delivery (SMD) standard capability shortly.

Zedmed is working with both HealthLink and Argus to implement this functionality.

Zedmed uses the ICPC-2 PLUS coding system for problem diagnoses so will meet clinical coding requirement as well.

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Bits & Bytes

Specialist letters go electronic at Southern Health A pilot project to increase the use of electronic messaging to send specialist letters to GPs from Melbourne’s Southern Health outpatients clinics has seen electronic distribution grow from zero to around 30 per cent over the last year.

The project, which began in September 2011 and initially involved 15 general practices, has now become part of normal practice, according to Paul Macdonald, eHealth strategy and stakeholder engagement manager for the South Eastern Melbourne Medicare Local (SEMML). The project involves Southern Health, medical transcription service OzeScribe, secure messaging provider Global Health and SEMML’s founding member, Dandenong Casey General Practice Association (DCGPA).

“The project allows specialists’ letters, transcribed by OzeScribe medical transcription services, to be sent electronically through OzeScribe’s OzePost service,” Mr Macdonald said. “OzePost uses Global Health’s ReferralNet secure messaging system to send encrypted, HL7 messages that can be imported directly into patient records for GPs using any of the leading GP clinical information systems.”

The service has been expanded to all practices interested in receiving outpatients letters electronically.

“There is capacity for 100 per cent of computerised practices within SEMML to receive Southern Health Outpatients letters electronically via OzePost and ReferralNet,” Mr Macdonald said.

“The future implications of the announcement of the Secure Message eXchange (SMX) agreement between HealthLink, DCA’s Argus and Global Health is likely to see GPs increasing their use of secure messaging products to send information into other services in both the public and private sectors,” he said.

ACT’s My eHealth consumer portal to target chronic care patients The ACT government has launched a pilot consumer portal called My eHealth as part of a plan to provide consumers with improved interactions with the ACT Government Health Directorate. It aims to provide secure online access to appointment information, appointment notifications and referral renewal reminders as well as discharge summaries.

The My eHealth trial is a clinician-initiated consumer portal initially being offered to patients taking part in the directorate’s chronic care program. It is also anticipated that users will also be able to access their national PCEHR through it, should they choose to register for one.

Renee Schofield, project manager for the My eHealth portal with the eHealth and clinical records branch of the ACT Health Directorate, said the portal had been planned for some time and was something consumers had been asking for.

Ms Schofield said planning for the portal was aimed at improving consumer interaction with Canberra Hospital and Health Services and providing online access to information that’s not going to be held in the PCEHR. The Health Directorate worked closely with the

ACT’s main consumer health advocacy group, the Health Care Consumers’ Association (HCCA).

Currently, 14 HCCA representatives are piloting the program, in addition to patients from the chronic care program. At present, 22 patients are taking part, with plans for a total of 40 in the pilot stage.

Electronic discharge summaries are the first clinical documents viewable within the portal. Canberra Hospital has had electronic discharge summary capability for some years, using HealthLink as the secure messaging service to send discharge summaries to GPs. Until now, however, patients have only received a paper copy of the discharge summary. Ms Schofield said the discharge summaries can be viewed through My eHealth as PDFs. ACT Health signed a contract in January with Orion Health to build the consumer portal, having worked with the company to build its clinical portal, which is used by clinicians to view summary information.

Orion and HealthLink also worked with the Canberra Hospital back in 2009 to provide electronic discharge summaries and an eReferral service.

Participating in My eHealth is a clinicianinitiated process. “The clinician clicks on an invite button within the clinical portal, which initiates the registration process for patients wishing to participate. The clinician confirms the patient’s date of birth, name and patient demographic information; enters the consumer’s email address; and the system sends an email to the consumer to complete the process.

“It’s similar to signing up for internet banking. The consumer confirms their name and date of birth and then chooses their user name and password and secret questions.”

The Health Directorate’s plan is to integrate with the PCEHR through the clinical portal, with discharge summaries sent straight up to the PCEHR from the clinical portal’s discharge summary module.

“Our intention is that from within My eHealth, consumers will be able to click on a button and link through to their national PCEHR in a seamless way.

It won’t be information sharing between the consumer portal and the PCEHR because that’s not the purpose, but they’ll be able to see their PCEHR through their local portal as well,” she said.

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Bits & Bytes

Houston Medical integrates with MedSpeech dictation

Plibersek gives way on pay for PCEHR

Houston Medical has integrated Speech Solutions’ MedSpeech voice recognition and dictation system into its VIP.net practice management software.

MedSpeech is a cloud-based platform that allows users to dictate patient notes or letters to be converted straight to text.

It has also been integrated into Genie Solutions’ software and HCN’s Blue Chip.

Houston Medical’s managing director, Derek Gower, said he was prompted to add the solution to VIP.net by a new client, who had used it in his previous software and wanted to retain access to the service.

Mr Gower said MedSpeech appeared superior to other voice-to-text products on the market such as Dragon Dictate, which he described as “very frustrating” at times.

Mr Gower said one noticeable difference between MedSpeech and other dictation systems was that the text didn’t appear immediately. In Dragon Dictate, for example, you can see the text as you speak, but MedSpeech instead records the dictation and then sends it into the cloud, where it transcribes the recording and returns it as text straight into a predesignated template.

Tanya Plibersek

MedSpeech uses highly sophisticated voice recognition software that is trained by comparing the voice file with an initial human transcription to build the individual clinician’s MedSpeech profile.

The federal government has acceded to the demands of doctors’ groups to be adequately remunerated for work on the PCEHR, announcing that doctors can count time spent on a patient’s PCEHR towards the total time of the consultation.

“Dictation is then done into a hand-held microphone in the usual way but the words do not appear on the screen as they would with Dragon,” Mr Gower said. “They are sent to a powerful server where speech patterns and diction are analysed. Because it is cloud-based very powerful servers and analytical software analyse and learn your speech patterns and transfer it into text within seconds.”

The government had previously stated that doctors could only claim longer MBS item numbers if the clinical complexity and duration of the consultation warranted it, without any consideration for the amount of time spent curating the PCEHR.

Doctors’ groups such as the AMA and the Australian Medicare Local Alliance had called on the government to create new MBS item numbers specifically for PCEHR work.

While the government has not done this, Health Minister Tanya Plibersek told the AMA’s annual parliamentary dinner in Canberra in August that doctors could use the time spent on a consultation that included the curation of a PCEHR as the sole determinant of whether a Level B or Level C item number would apply.

Explanatory notes now accompanying the MBS state: “The time spent by a medical practitioner on the following activities may be counted towards the total consultation time: Reviewing a patient’s clinical history, in the patient’s file and/or the PCEHR, and preparing or updating a Shared Health Summary where it involves the exercise of clinical judgement about what aspects of the clinical history are relevant to inform ongoing management of the patient’s care by other providers; or Preparing

an Event Summary for the episode of care.

“Preparing or updating a Shared Health Summary and preparing an Event Summary are clinically relevant activities. When either of these activities are undertaken with any form of patient history taking and/or the other clinically relevant activities that can form part of a consultation, the item that can be billed is the one with the time period that matches the total consultation time.

“MBS rebates are not available for creating or updating a Shared Health Summary as a stand alone service.”

Ms Plibersek also announced that changes to the eHealth Practice Incentive Program (ePIP), due to come into effect in February, will be pushed back until May. The new rules for the ePIP will require practices to participate in the PCEHR program or become ineligible for the incentive. The payments will also require practices to have secure messaging capability, electronic transfer of prescriptions (ETP) capability, the ability to match healthcare identifiers and to use clinical coding of diagnoses.

Industry sources have told Pulse+IT that the ePIP rules will be much more demanding than in the past,

with previous ePIP and IT/ IM benchmarks having only minimal effect on general practices. GP desktop software is being prepared to interface with the PCEHR and will start to be rolled out shortly.

It also appears that an agreement has been made between the Department of Health and Ageing (DoHA) and the AMA, the RACGP and doctors’ indemnity insurers over the participation of healthcare providers in the PCEHR.

“...additional time spent by a GP on a shared health summary or an event summary during a consultation will count towards the total consultation time...”

The doctors’ groups and insurers had strongly rejected the original terms and conditions of participation, saying they were too onerous and laid too much liability for privacy and security breaches on practices.

A range of participation agreements has now been posted on the ehealth.gov. au website, and Pulse+IT understands that doctors’ groups are in general

agreement with the terms, but have reserved the right to revisit this stance.

AMA president Steve Hambleton said the government had “provided important policy clarity and greater incentives for GPs to become fully engaged more quickly” with the PCEHR system.

“The government has clarified that additional time spent by a GP on a shared health summary or an event summary during a consultation will count towards the total consultation time, and that the relevant time-based GP item can be billed accordingly,” he said.

“The Minister has ... fully explained how doctors can now safely and confidently provide new PCEHR clinical services such as a shared health summary under current MBS items.”

Dr Hambleton said the changes would allow doctors more time to make the transition to the new eHealth environment in their practices. “The activity that is required to create and maintain a shared health summary is a new clinical service for doctors that will need to be factored into current clinical practice,” he said.

“The government has delivered a catalyst to accelerate the implementation of the PCEHR.”

Genie to release mobile app, gears up for PCEHR Clinical and practice management software vendor Genie Solutions is developing a mobile app for both smartphone and iPad/iPhone users to remotely access patient files.

The app will allow users to connect back to the practice server wherever they are, with the ability to both read and write information, Genie’s managing director, Paul Carr, said.

“You’ll be able to make appointments offsite, add new patients and that sort of thing,” Dr Carr said. “They won’t have complete functionality but they’ll have a lot of it and that will be improved over time. We have it working now but we plan to seed it to a few beta sites in the next month or two, so within a couple of months it should be available.”

Genie is also working on integrating eRx Script Exchange into the software, along with secure messaging delivery (SMD) capability through HealthLink.

The additional functions are part of a huge year of work for Genie, which has 2500 practices throughout the country, servicing around 40 per cent of Australian specialists. The company has recently made available version 8.3.1 of its software for general release, following a staggered rollout throughout the year.

New functionality in v8.3.1 includes most of the PCEHR capability, although much of it is still hidden, he said. “So far we’ve done the Healthcare Identifier Service integration, so you can download patient IHIs as well as doctors’ HPI-Is and HPI-Os. “We’ve completed our Compliance, Conformance and Accreditation (CCA) for CDA document rendering and display and we’re about to do the CCA for packaging the CDA documents. Users will have the ability to send CDA letters in October.”

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Interim NASH certificates available for PCEHR Healthcare providers who are registered with the Healthcare Identifier (HI) Service can now apply for an interim National Authentication Service for Health (NASH) token to begin viewing patients’ PCEHRs. Interim NASH tokens are being posted to healthcare providers and organisations who have registered for an HPI-I and an HPI-O respectively and have applied through the Department of Human Services for a certificate.

The interim NASH certificates will allow doctors to not only view a patient’s record through the provider portal, but to upload documents to the patient’s PCEHR as soon as conformant software is available.

The tokens are an interim measure designed by Medicare Australia to allow access to the PCEHR, following the failure of IBM to have the full NASH service available by its June deadline.

A spokeswoman for DHS said the interim NASH certificates are the required credentials for validating identity for access to the eHealth system and are different to, and do not replace, DHS’s PKI certificates used for HI Service access and other online Medicare services.

“At this stage the interim NASH certificates can only be used to connect to the national eHealth system,” she said.

“Once a patient has provided consent to the organisation, authorised doctors can search for a patient’s record through the eHealth provider portal. If a doctor has the demographic information of a patient and either the Medicare/DVA number or IHI, they can search for, and then verify and access the record.”

Authorised users can retrieve a patient’s IHI through HI Service-compliant software, or by phoning the HI Service operator.

NHSD to develop endpoint location, telehealth directories The recently launched National Health Services Directory (NHSD) will include of the ability to hold endpoint location service (ELS) information for secure messaging by the middle of next year.

The NHSD, developed and managed by the National Health Call Centre Network (NHCCN), is a shared infrastructure project that aims to provide one allencompassing directory for consumers and healthcare providers looking for a wide range of health services.

It went live in July and is currently being populated with information on general practices and hospital emergency departments.

It will eventually contain information about all healthcare services, including aged care,

pharmacy and allied health.

It is also planned to be used by telehealth providers as a national directory of users.

The directory is not yet being promoted to consumers as the information it contains is not complete, but NHCCN is working with Medicare Locals to include as much information about primary healthcare services as possible, NHCCN CIO Anton Donker said.

“All the Medicare Locals are doing the primary healthcare for their areas so we are working closely with them,” Professor Donker said. “It is only just being made available to the public as we’ve concentrated on getting the core service information to a good consistent standard throughout the country.”

At the moment the information includes basic details about healthcare services and providers, such as location and opening hours, but as it matures healthcare providers will be able to update their own information such as whether they are seeing new patients or if parking is available, he said.

While there is an important consumer information element, the national directory should prove invaluable to state health departments and to healthcare providers looking to refer to allied health practitioners.

“And it’s not just health services but human services, because GPs don’t really communicate extensively with other GPs,”

Professor Donker said.

“They want to know about specialists, hospitals and allied care because the people they refer to are the podiatrist, the dietitian, the specialists or Meals on Wheels, things like that.”

Information on healthcare services in Victoria are the most complete, as the national directory has been based on the successful Victorian Human Services Directory (HSD), created and maintained by DCA. Professor Donker said the NHCCN had used the Victorian HSD as a base as it did not want to reinvent the wheel. “It is a challenge to bring directory information from across the country together in consistent way. There are hundreds of them out there and none of them are modelled to scale.

“We decided to find the best one from around the country and use that. Not to say that there weren’t other good ones, but Victoria made its IP available.”

With the information from the Victorian HSD already available, the ACT and Northern Territory also used that as a base for their directories. Now, Medicare Locals throughout the country are coordinating the collation and inclusion of data from the other states.

The plan is that when the system is fully complete, healthcare providers will

be able to update their own information.

It will also enable links to other services such as the Healthcare Identifiers Service and the Australian Health Practitioner Regulation Agency.

“They want to know about specialists, hospitals and allied care, the podiatrist, the dietitian, the specialists or Meals on Wheels...”

“Using the Victorian model we try to ensure there are consent arrangements there, right down to the fact that at one level the public needs to know there is a GP surgery across the road and that it’s open, but it’s also useful to know they are not accepting new patients or there are no appointments available,” he said. “Our model is predicated on self-authorship, enabling any service provider [to maintain their details].”

The Victorian HSD also includes endpoint location service (ELS) capability, which is used for some electronic messaging services. Professor Donker said the ELS capability was already in use through the Victorian HSD in the

Melbourne Wave 1 site and the Northern Territory Wave 2 project on a daily basis, but warned that there was a large difference between making it work in a trial and making it work nationally.

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“It’s one thing to do it in [that] setting ... but it’s another thing entirely when it has to work every day, 24/7, with scalability, with resilience, with privacy and security and that’s what we have to make sure we put in place,” he said. “[ELS directories] are different from a service directory; there are very detailed provider levels, much more difficult maintenance and management regimes and there is a cost that isn’t signed off yet. But we are going to stand one up and make it available and we are on our way.”

He said the network was also working with the various telehealth groups to include telehealth end points and related service information, bringing together the different groups that have created their own directories, many of which overlap.

Creating a directory of telehealth service capability was not dissimilar to creating an ELS directory, he said. “You need to know that someone can do telehealth and you need to know how to contact them and what protocols they can deal with.”

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Shexie to roll out PCEHRcompatible software Clinical and practice management software provider Shexie is undertaking an overhaul of its product, adding PCEHR capability, IHI matching, SMD standards and a new server database.

Shexie, which is used mainly by surgeons and specialists, along with a few GP and day surgery sites, is swapping over to a SQL Server database and rebuilding the underlying architecture of the software to allow new functionality, including full compliance with NEHTA specifications for PCEHR compatibility and secure messaging delivery (SMD).

Shexie director Dean Jones said specialists had often been forgotten due to the concentration on getting GP software up to speed with PCEHR functionality, but his company has been working closely with NEHTA to add PCEHR and other eHealth capability to the software, with a focus on secure messaging standards.

He said his team was aiming to have the new version, called Shexie Platinum, up and running at the end of the year, but as it will contain a number of new functions, a full rollout might take until early next year.

Mr Jones said users will be able to access and upload documents to the PCEHR, which in the case of specialists will predominantly involve uploading event summaries and specialist letters. Health Identifier Service search and validation capability for individuals, providers and organisations will be included, as will secure messaging compliance.

“We are providing secure messaging compliant with the NEHTA SMD specifications with the assumption that everybody in the health industry is going down that track and will provide that facility in the future, then in theory everybody should be able to talk to each other,” he said.

cdmNet to go national with chronic disease collaborative care plan A pilot project to evaluate the effectiveness of collaborative care for chronic disease using Precedence Health Care’s cdmNet web-based technology has been declared a success and will now be offered nationally.

The Collaborative Care Cluster Australia (CCCA) project has been trialling cdmNet as a platform to improve chronic disease management in a number of healthcare provider organisations in Victoria, including Southern Health and the South Eastern Melbourne Medicare Local, as well as by over 1000 GPs and 3000 allied health professionals.

It has been independently evaluated by Monash University as being effective in managing diabetes patients in particular.

Leon Piterman, pro vicechancellor of Monash University, said the system was first trialled in Geelong with diabetes patients.

Jon Hilton, Precedence Health Care’s programs manager, said the aim was to see if it was possible to work with a number of organisations to improve the quality of care in collaborative chronic disease management using cdmNet as a platform.

“We are declaring this cluster a success and it is

now self-sustaining and it’s going national,” Mr Hilton said. “The organisations collectively have agreed to continue to work together on a national basis.

“The idea of the trial was to prove the concept that these groups could work together and that we’d all see benefits from cdmNet,” Mr Hilton said. Precedence Health Care is now working on an engagement framework and training materials for Medicare Locals who want to set up a similar service. cdmNet is a GP-led platform using web-based technologies that allows users to create general practice management plans (GPMPs) for chronic disease. The care plan and health records are shared across the care team and with the patient online.

It produces and distributes documentation, provides patient reminders, monitors progress against the care plan, automatically schedules follow up and review and manages Medicare compliance.

GPs, allied health professionals and patients can access the patient’s record via a secure, encrypted internet-based login. It also enables communication, referrals and reminders via email and text messages.

Mr Hilton said it was a “self-sustaining” system, in that it will be offered to GPs as a fee for service package. GPs receive payments to prepare and oversee chronic disease management plans for patients, funded by Medicare as part of the National Chronic Disease Strategy. Precedence Health Care receives payment for each care plan produced using the service.

Precedence claims that cdmNet can increase GP productivity by 250 per cent, with regular users able to increase their annual chronic disease management revenue by $35,000 per annum per GP. Cameron Profitt, a GP from Bannockburn Surgery in Geelong who was part of the original pilot group and has been using cdmNet for several years, said the fact that it simplifies the general practice management of chronic illness makes it worthwhile. “There is a cost involved, but even if you’re paying a portion of the consulting fee for the use of cdmNet it’s worth it because you save so much time,” Dr Profitt said.

“I’ve found cdmNet handy and useful for chronic disease management, and particularly the inclusion of allied care. It reduces the bureaucracy and time spent communicating.”

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HL7 to offer interoperability standards for free HL7 International has announced it will make much of its intellectual property, including its widely used V2.x, V3 and CDA interoperability standards, free under licence to the international healthcare community.

In what is being touted as one of the most important breakthroughs in interoperability in a decade, the global healthcare standards-making body said it will spend the next few months planning for the move with the policy expected to take effect early next year.

In a statement, HL7 International CEO Charles Jaffe said that by eliminating the price barrier, the organisation can come closer to realising its goal of using health IT to reduce costs and improve the quality of care.

“Coupled with increasing government demand for standards that do not require a licensing fee, our decision to move toward free standards is perfectly aligned,” Dr Jaffe said.

Richard Dixon-Hughes, chair of HL7 Australia and chair of the HL7 International advisory council which made the recommendation, said it was a step in the right direction that would be greatly welcomed by members and the wider eHealth community.

“It opens up opportunities for more open collaboration among health information standards developers,” Mr Dixon-Hughes said. “It helps HL7 to partner with many others in the standards development and software development communities who are committed to making their products available free of charge.”

HL7 standards are used in many eHealth developments in Australia, including CDA standards for the PCEHR and HL7v2 for electronic messaging.

Medical Director opens up to third-party developers Health Communication Network (HCN) has launched an integration framework that will allow third-party developers of medical apps and widgets to integrate directly with Medical Director, Australia’s market leading clinical software.

Widgets that are approved for use with Medical Director will be available to users in a Widget store, similar to Apple’s App Store, through which they can download the widgets they need and add them to a new MD Sidebar. The integration framework was launched to developers recently, while end users will receive the MD Sidebar in the next MD release, planned for November.

HCN director of operations Tania Taylor said many widgets would be suitable, particularly clinical tools and calculators, along with medication management and team care solutions.

HCN CEO John Frost said the sidebar framework will provide access to all of the data elements in Medical Director, and would also have a limited write-back capability to the patient file.

“The important thing in creating this environment and framework is to open it up to everybody that has a meaningful application,” Mr Frost said. “We’ve

seen literally hundreds of people over the years wanting to work with us, so this provides them the mechanism to enable them to do it.”

The MD Sidebar will host the widgets, allowing integration with Medical Director through HTML and JavaScript. HCN will provide developers with an API to integrate the widget into to the sidebar framework.

“We’ve seen literally hundreds of people over the years wanting to work with us, so this provides them the mechanism to enable them to do it.”

Widgets will be able to request and receive a number of events through the API, including progress notes, allergy requests, diagnosis information, pathology information and prescription information.

However, Mr Frost said there will be rules to ensure widgets are unable to make requests that will impede the function of MD in normal practice, such as a request for all progress notes for all patients.

“Part of this release is that there is a whole development environment for developers where they can get hold of the tools and submit the widget in an online process,” Mr Frost said. “Once they are approved they’re made available to end users.”

He said the integration framework was a major change for the company.

“In the past we have been overwhelmed by internal and external demand and at the same time on the perpetual treadmill of government-inspired change. As a result, HCN has turned away the vast majority of external development requests. This is about to change.

“The scope is almost unlimited, from clinical tools like cardiovascular risk calculators to pathology results presentation to patient-support prompts, decision-support tools, team care arrangements, doctor education.

“They can be customised precisely to your target audience, whether that is GPs, skin cancer clinics, orthopaedic surgeons, psychiatrists, or any others.”

He said another driver was feedback from some users who said MD has so much functionality that the desktop can become too

cluttered. One of the ideas behind the MD Sidebar is to simplify the desktop, allowing users to turn on or off those features and functions they use most.

prescription is added or when a result is reviewed.

And the sidebar or widgets that are operating in the sidebar can write back to the progress notes.”

There are are a number of major differences between the new MD Sidebar and other tools such as the RACGP Primary Care Sidebar, he said.

Developers will receive access to a software developers’ kit, a sandbox environment, a test widget and a developers’ portal to manage them through their development process, supported by HCN.

“The first and probably the most important is that it is directly supported by HCN, so every time we modify Medical Director or update it we make sure that the sidebar works with it. That makes it safe, reliable and dependable.

“The second big difference is the sidebar framework has access to various events within Medical Director, so the sidebar can be notified when a new

A pricing structure has been developed that is similar to that pioneered

by Apple. A small annual developers’ fee will be charged, with a revenue sharing arrangement agreed between HCN and the developer, Ms Taylor said. Potential business models include free apps, transactionbased payments, one-off purchases or subscriptions.

Mr Frost said HCN would help to promote the product to its customer base. “We think this is a real gamechanger in the industry.

“There are no clinical products in the industry like it to our knowledge and yet there is an enormous demand for integration and interoperability.”

Ms Taylor said HCN aimed to create a development community that delivers what users want. “Users can then pick and choose which widgets they have on their desktop,” she said.

“A lot of the feedback lately has been that there is too much out there and they don’t want access to everything, so this gives the users the opportunity to customise and download and use those tools that are relevant to them.”

Patient Connect expands home health monitoring Remote health monitoring provider Patient Connect is working with secure messaging companies to expand the use of HL7 messaging when coupled with remote vital sign management.

Patient Connect provides 24/7 monitored medical alarms and Bluetooth-enabled individual home health monitoring for people with chronic illnesses. It has formed a partnership with medical deputising provider Family Care Medical Services to combine its remote health monitoring services with Family Care’s after-hours doctor home visiting service in south-east Queensland and Sydney.

The remote health monitoring technology identifies early changes in a patient’s condition, facilitating medical intervention before the patient’s health deteriorates and thereby avoiding unnecessary hospitalisation, Patient Connect’s managing director, Archie Tait, said.

Patient Connect uses a custom-built encrypted software package called Rosetta which is able to talk to three separate parties – the primary GP, the nursing service and the after-hours home visiting doctor service.

“Rosetta is a cloud-based service that creates seamless communication between healthcare parties involved,” Mr Tait said.

“All of Family Care Medical Services’ after-hours doctors have mobile devices connected with Rosetta. When an afterhours doctor visits a patient in their home, data and images are entered and sent back to the Rosetta system for processing against that patient’s EHR. “Once the patient report is complete and verified, a medical report is then transmitted to the regular GP either by HL7 or fax, allowing GPs who have not started using HL7 yet to still participate in the system.”

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“Qualified” support for PCEHR: MDA National Medical defence organisation MDA National has given its “qualified support” to the PCEHR, saying the medico-legal concerns that were seen as a barrier to doctors’ participation in the system had been appropriately addressed.

In a recent article in the Medical Forum WA magazine, MDA National president Julian Rait said while the organisation and other doctors’ groups still had reservations about the system, the resolution of several aspects of the participation agreement that practices must sign meant the group could now give it qualified support.

Associate Professor Rait wrote that extensive discussions between doctors’ groups and DoHA had “resulted in more positive outcomes for doctors than initially proposed, with significant improvements to the Healthcare Provider Organisations (HPO) contract”.

“The recent removal of the ‘unilateral indemnity clause’ and modifications to the ‘intellectual property clause’ in the HPO contract means participating doctors will shoulder less legal liability and can feel more secure about being involved.”

However, he wrote that doctors’s groups were still concerned with several aspects of the PCEHR, including the ability of patients to conceal documents from specified healthcare practitioners through the system’ access control functionality.

MDA National and other doctors’ groups are also opposed to the government’s determination that general practices will become ineligible for the eHealth Practice Incentive Program (ePIP) if they choose not to participate in the PCEHR. A spokeswoman for the Department of Health and Ageing said that as at July 31, 1566 Healthcare Provider Identifiers – Organisation have been assigned to healthcare organisations.

Medibank reveals details of uptake for healthbook electronic health record Health insurer Medibank has reported a pleasing uptake of its new healthbook personally controlled health record, with eight per cent of its target group using the new service regularly since its launch at the end of May. The development of healthbook was one of the projects funded by the federal government as part of the Wave 2 sites for the implementation of the PCEHR. Initially targeting members with chronic illnesses who take part in one of Medibank’s Better Health programs, the plan is to connect it to the national PCEHR infrastructure and to broaden the offering to other Medibank customers, particularly the parents of young children.

“They are an interesting membership group because they tend to be more elderly and we were fascinated by their acceptance of an internet-based health book,” Mr Snyders said.

“We were interested in this group and wondered what the take up would be.

They are certainly a group that interacts well with our nurses through telephonic coaching who help them cope with their goals and what they want to achieve.

“It was a really good case study group from a number of angles – uptake, frequency of usage, and also allowing the nurses to interact with them and allowing nurses’s notes on healthbook.”

healthbook is also playing a part in the wider national eHealth records infrastructure as the nurses all have registered for a Health Provider Identifier – Individual (HPI-I), and the members using healthbook use the national IHI system.

“Initially when you register, you have to register for an IHI so we do that electronically for the customer,” Mr Snyders said. “They provide identity and we give them through Medicare the automatic IHI registration.

“That then gets them into their healthbook and they are then able to populate their healthbook with some personal details – emergency contacts,

Medibank’s CIO, Terry Snyders, said the company had specifically targeted a group of about 16,000 members who were on a Better Health program, which provides a range of services such as nurseled telephone counselling for people wth chronic illnesses.

To date, approximately eight per cent of that group were using the service and most of them were using it multiple times, which Mr Snyders said was a pleasing result.

Terry Snyders

health provider contacts, medications they are on, allergies, immunisations.

“They can also record their health goals and any health records or health history. And when they work with our nurses around their particular illness or situation, their nurse’s notes are included on the healthbook as well.” healthbook has three sections – the medical profile, which includes health details such as current conditions and medications; the nurses’ notes, which includes a

summary of conversations between the individual and their Medibank nurse; and health goals, which lists targets such as weight loss or blood pressure measurements set by a doctor or nurse.

Users can decided who has access to each section of the healthbook, and they can also print out the record when they are travelling or seeing a new doctor. healthbook is not yet connected to the national infrastructure as Medibank decided to take a “conservative route” and

use it internally for the time being, he said, but it has been designed to connect to the PCEHR. “The next step for us is to connect to the national grid and initially not be a supplier of information but to connect and take information from the national grid,” he said.

“There’s a wealth of information that could be available through Medicare – PBS and MBS information – and there could be other information out there that we could make available to our members.”

Blood glucose measurements sent via app Sanofi Australia has launched a blood glucose meter with a free app that allows people with diabetes to store and monitor their results on an iPhone or iPod Touch and email the results to healthcare providers or carers.

Called iBGStar, the blood glucose meter can act as a stand-alone device but also provides both testing and management functionality via the Diabetes Manager App, which is available free on the iTunes App Store.

The app provides an interactive logbook and results can be emailed directly from the iPhone to a healthcare provider or family member.

The meter itself has been designed for ease and simplicity, according to Sanofi. Users insert a test strip and then add a small blood sample. Sanofi claims the test time takes on average six seconds.

The data can be displayed on the meter’s screen or on the iPhone or iPad through the app. The meter can store up to 300 test results with the date and time, but the app will allow users to store several years’ worth of test results, depending on the memory capacity of the device.

The app includes a ‘share’ function to allow specific data to be emailed to healthcare professionals,

family members or carers.

It also includes graphs and statistics to record and track readings and colour-coded scorecards to show individual monitoring results for easy identification of high or low blood glucose levels.

Implementing the PCEHR from the bottom up Integrating the Healthcare Enterprise (IHE) Australia is planning a seminar for healthcare service providers and health IT vendors to discuss how to use IHE’s cross enterprise document sharing profile XDS. IHE-XDS integrates standard workflows and eHealth communication standards to support patient health record exchange and other health communication.

The seminar, to be held at the same time as the IHE Australia PCEHR 2012 Connectathon, aims to promote the use of IHE profiles in the context of the PCEHR. It will also look at international and local implementation experience.

IHE Australia events manager Bernie Crowe said the meeting will provide somewhat of a “bottom up” view of PCEHR implementations and will focus on local vendor experience.

Vince McCauley, director of McCauley Software and chair of IHE Australia, will discuss using XDS to “fuel the engine” behind the PCEHR. He will also lead a discussion on understanding NEHTA’s CCA program for the PCEHR and contrast it with the IHE Connectathon process.

Sanofi has also set up a team of diabetes support partners available to healthcare providers and has expanded its 24/7 toll-free line to include customer care for its blood glucose meters.

HL7 International co-chair and developer of the FHIR draft standard, Health Intersections’ Grahame Grieve, will explain how HL7 CDA is being used for discharge summaries and shared health summaries in the PCEHR. Oridashi principal and former Pen Computer Systems enterprise architect Brett Esler will explain how to extract information from GP clinical information systems into the PCEHR.

The device is available from pharmacies but the company plans to shortly launch a website to allow online purchases of meters, test strips and accessories.

Mr Crowe said a panel discussion would also be held on progress towards implementation of the PCEHR and how it can be implemented in various setting using IHE XDS-enabled software. See www.ihe.net.au for more information.

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New Zealand GPs to get free text messaging system General practices in New Zealand’s Canterbury region are being offered a free installation of Vensa Health’s TXT2Remind messaging system, funded by the Canterbury District Health Board (CDHB).

Approximately 40 per cent of practices in Canterbury already use the system, which allows GPs to deliver appointment, screening and immunisation reminders as well as key health messages direct to the patient via text message and interactive mobile content delivery.

The target of the two-year initiative, which will also provide a monthly allowance of text messages at no cost, is to have it installed in 95 per cent of practices.

It will be administered by Pegasus Health, the not-for-profit organisation that manages more than 100 practices in the Canterbury region, but is available to any practice providing primary healthcare.

Pegasus Health chief operating officer Mark Liddle said the perceived financial barriers to uptake of the TXT2Remind system will be removed through a free implementation.

“TXT2Remind is a tool that will support us as we become part of a more population health competent system,” Mr Liddle said.

“GPs benefit from an effective method of communication with patients and we gain a whole of system communication method for Canterbury.”

TXT2Remind is an SMS-based patient reminder system that interfaces with popular patient management systems in NZ such as Medtech32, VIP and MyPractice. It allows users to send automatic appointment reminders, comments on lab results after the doctor has reviewed them, and recalls for immunisations, screenings and diabetes annual checks.

HTR to hook up aged care providers to the PCEHR with Telhealth in the cloud Cloud-based electronic health record vendor HTR has officially launched its Telhealth clinical information solution and is working with a large aged care provider to connect it to the PCEHR. HTR, which provides a number of custom solutions for the healthcare industry, formally launched Telhealth at the Health Informatics Conference (HIC) in Sydney recently. It says it is the first company to have demonstrated connectivity to the PCEHR, presenting at a health consumers’ conference in WA with NEHTA in late June.

The solution has been available since 2011, when it passed its compliance certification for the secure messaging delivery (SMD) standard, and currently has four clients, including an aged care provider with licences for 13,000 beds.

The company was unable to reveal the name of the provider, but HTR’s project manager, Adrienn Volcz, said a contract had been signed with the provider to help it deliver PCEHR services in the aged care sector across Australia.

“It is not an aged carespecific product but it is most suitable for the 65+ age group,” Ms Volcz said.

“It is also applicable to younger people who have been diagnosed with a

chronic disease and need the help of many healthcare specialists. It is designed for people who need regular medical attention from multidisciplinary healthcare providers.”

Ms Volcz said Telhealth’s main point of difference was that it was web-based, meaning users don’t have to install software locally.

It provides an EHR function as well as admission, discharge and transfer functions for admitting residents or patients to an aged care facility or medical centre and to discharge or transfer patients.

It also has the capability to create and manage shared care plans, prescribe and manage medications and to send and receive secure messages from other healthcare professionals.

According to Ms Volcz, Telhealth is only one of two clinical information solutions that meet the Australian technical standards for SMD. “As far as we know there are only two software vendors who can do this,” she said. “Using Telhealth, doctors can send a message securely to any system as long as it is using the Australian Standard.

Implementation of the standard is beginning now but as it becomes more widespread, we’ll then develop a directory.”

Telhealth also has full PCEHR functionality, including the ability to create, upload and download shared health summaries, event summaries and discharge summaries.

The company has completed NOC testing and is currently going through CCA testing for the various PCEHR components.

HTR has also developed a number of mobile applications for Telhealth, including the ability for doctors to prescribe using a mobile phone.

“Because it is cloud-based, they can use an iPad, a desktop, an iPhone or any Windows-based or Android based device – it doesn’t matter as it’s agnostic.

Windows 8 is coming out but it really doesn’t matter to us – they can use any device they like.”

The company is also targeting general practitioners with the solution, particularly those who don’t want to bother with installing and maintaining software.

For the aged care client, Telhealth is working to connect its systems up to the PCEHR, Ms Volcz said.

“They have 13,000 beds and they think the PCEHR is a very good concept.”

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iCare to integrate aged and community care software

Emerging Systems completes interface to national PCEHR

Aged care clinical software vendor iCare has acquired UK-based community and home care specialist h.e.t. Software, with plans to integrate the two technologies to provide one solution for aged care providers active in both the residential and community care sectors. iCare is also rolling out version 2.10 of its clinical care and medication management software, which includes HI Service functionality, and is currently working on version 3, which will include full compatibility with the PCEHR. It expects this work to be completed in 10 months. iCare’s managing director Chris Gray said the two companies had an existing relationship, including joint customers in Australia, where iCare holds leading market share, covering 45,000 beds.

Mr Gray said the acquisition was driven by market needs, with residential aged care providers increasingly moving into community care, stimulated by more federally funded community care packages under the Community Aged Care Package (CACP) program.

“We are seeing significant growth in community care from residential aged care providers,” Mr Gray said. “What they are looking for is one record, so that when somebody is living in their home and there is nursing and care staff going to look after them, they want that record to be picked up and to be able to be seamlessly moved into the residential setting when they move into residential care.

“There will also be information coming from the PCEHR. We want to make sure that all of those records are present when you enter the aged care facility and no information is missed. What you want is your history of medical information and medications ... being able to be shared with the aged care provider.”

Russel Duncan (left), Richard Hutchinson and Liz English Clinical software vendor Emerging Systems has successfully achieved its Notice of Connection (NOC) with the PCEHR infrastructure, and has also completed testing for NEHTA’s Certification, Compliance and Accreditation (CCA) program for packaging and rendering electronic documents and interfacing with the national PCEHR infrastructure.

Emerging Systems is thought to be the first hospital software vendor to go through the full testing process for NOC and CCA for the PCEHR with its EHS clinical information system.

CEO Russel Duncan said the company had achieved NOC and CCA with Medicare for the HI Service over six months ago, and finished its CCA testing for the PCEHR in late August.

“We self-declared that we had achieved CCA as per the requirements but because it is all very new, we had third-party observers and NEHTA experts go through and re-evaluate all of our test cases and re-run all of test cases all over again, just to make absolutely certain.”

Mr Duncan said that depending on what capabilities software

providers want to support, there is a range of elements to achieving CCA. “There is the packaging specification, the rendering specification and the credentialing specification, and then the CCA for the clinical information system interface itself.

“Then you have to do CCA for the individual electronic documents, such as discharge summaries, event summaries and shared health summaries.

It’s an involved process.”

While the hospital sector won’t be involved in some of the document preparation

and uploading that general practice will, it still has to have the ability to read those documents.

Hospitals participating in the PCEHR are expected to concentrate mainly on uploading discharge summaries, referrals and event summaries, but users also need to be able to view other parts of the PCEHR such as shared health summaries and PBS information within the clinical software.

“The CCA accounts for two situations – you do the CCA for any documents that you are contributing, so you make sure you are signing them and the data is valid,” Mr Duncan said.

“As part of the clinical information system interface you have to do CCA so the system can actually read the documents as well.

“Theoretically, and within limits, you have to be able

to display any document the PCEHR sends you.”

iPad app next stop for ClinicalKey search engine

Emerging Systems has played a major part in the Eastern Sydney Connect Wave 2 trial, helping to test the transmission of admission and discharge notifications and discharge summaries from St Vincent’s Hospital in Darlinghurst to local GPs involved in the trial, as well as nurse-initiated discharge summaries from St Vincent’s Private.

Medical and scientific publishing company Elsevier is planning to release an iPadoptimised version of its recently launched ClinicalKey online search engine.

Professional Services Review seeks to streamline data extraction The Professional Services Review (PSR) agency has issued a statement of requirement looking for a vendor who can provide clinical data extraction software to speed up the lengthy process of extracting patient records for review.

The PSR, which has the power to review cases of practitioner claiming and prescribing under the MBS and the PBS, is required to receive and review samples of the practitioner’s patient medical records.

In most cases, this means the practitioner involved with a PSR investigation process has to look up each patient record, which typically numbers 120, print it out and send it to

the agency for audit. The agency then makes copies of the records as PDFs and distributes then to members of the PSR peer review committee.

They are used as case evidence and destroyed at the end of the process.

The PSR is now looking for a tool that can extract selected patient records and bundle them into a PDF format for review.

The solution must be able to accurately extract patient medical records from Medical Director, Best Practice and Genie, and preferably from as many clinical software systems as possible. Submitted quotes should itemise the cost of including practiX, Zedmed, Medtech32 and Profile.

The main requirements are the ability to provide a more efficient and cost-effective alternative to the manual collation, transport and scanning of physical paper records currently practiced.

It also needs to provide a secure system for extracting defined patient medical records that minimises disruption to the practitioner’s practice, the risk of privacy breaches and loss of records during transport.

It must also enable PSR staff to easily prepare the data extraction tool to run on the practitioner’s system, require minimal input or technical capability from the practitioner and include a user guide for the practitioner to consult.

The Australian version of ClinicalKey includes local content including Australian brand and generic drug names as well as additional terms from the SNOMED CT Australian release and the Australian Medicines Terminology (AMT), under licence from NEHTA. ClinicalKey is aimed at doctors and specialists as well as researchers and includes access to more than 600,000 articles from 500 medical journals, including local society journals. It can also search 900 medical and surgical reference books and five million images.

It includes 20 million abstracts from MEDLINE and and more than 800 First Consult point-of-care clinical monographs, along with the Australian Medicines Handbook drugs data.

There are also numerous medical and surgical videos, clinical practice guidelines and patient information documents.

ClinicalKey is powered by Elsevier’s Smart Content, tagged with Elsevier Merged Medical Taxonomy (EMMeT), which allows users to find the most relevant medical content. The tool allows physicians to filter search results by clinically meaningful subcategories such as content type, specialty and by relevant clinical categories such as treatment and diagnosis.

One of its niftiest tools is the ability to select images from its database and automatically insert them into a PowerPoint presentation. The images appear with an abstract, the correct reference including author and publication and copyright details.

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Bits & Bytes

TWEQ connects clients to healthcare system Victorian-based early childhood and parenting centres QEC and Tweddle have completed a roll out of a new client and clinical management system based on HSAGlobal’s CCMS platform.

The two organisations, which provide a range of residential and community-based nursing and support services to parents and families in Victoria, have replaced a number of different systems with a combined platform running across both groups but with different databases.

Health professionals from both organisations work across 14 sites to provide support to young children and parents, ranging from lactation education and advice on babies’ sleeping patterns to court-appointed observations of atrisk families. They have now moved to a completely paperless system they are calling TWEQ, replacing client data stored in Microsoft Word, Excel and Access and in handwritten file notes.

Staff are now using TWEQ for all of their clinical notes, assessments and observations, and those out in the field can open and amend client notes by remotely accessing the system through laptops and tablets. TWEQ includes an alert system that flags important information such as an allergy or a history of violence. It also includes shared calendars for greater visibility across teams.

HSAGlobal CEO Matt Hector-Taylor said the system allowed SMS messages to be sent to clients to remind them of appointment, and clients can send texts back to confirm or reschedule if required.

While it’s not being used just yet, functionality is available in CCMS to enable a web interface for clients or GPs to complete a scored assessment, which will then advise them of the options available for support.

Complex role for radiology as it prepares to participate in the PCEHR system The Australian Diagnostic Imaging Association (ADIA) is urging the federal government not to conflate radiology with pathology when formulating standards and specifications for their involvement in the PCEHR simply because they are both focused on diagnosis.

The challenging question of how to integrate diagnostic imaging with the PCEHR and with Australia’s broader eHealth agenda was discussed at the combined Asian Oceania Society of Radiology (AOCR) and Royal Australian and New Zealand College of Radiologists (RANZCR) annual scientific meeting in Sydney recently.

Well-known medical software expert Vince McCauley explained how the Integrating the Healthcare Enterprise (IHE) organisation, which has developed a number of radiology-related standards including the cross-enterprise document sharing for imaging or XDS-I profile, was working on assisting the sector.

RANZCR representative Nick Ferris said the meeting was about trying to align diagnostic imaging with the PCEHR agenda.

“The idea is to have pathology reports able to be uploaded to the PCEHR next year and diagnostic imaging will come after that,” Dr Ferris said.

A member of NEHTA’s diagnostic services reference group, Dr Ferris said the majority of its time had been spent on working out how to align the pathology sector with the PCEHR and that the initial idea was to develop a model for pathology and to adapt that to diagnostic imaging.

“Specimens and patients are very different beings and workflows that work for specimens don’t work for patients and vice versa...”

While there are some similarities between the two sectors in terms of developing standards for electronic referrals, radiology has a number of challenges that it will have to be faced differently, he said. This was echoed by ADIA representative Scott Ferrero, who said the view that pathology and radiology are similar and therefore what works for pathology will work for radiology is not true.

“Specimens and patients are very different beings and workflows that work for specimens don’t work for patients and vice versa,” Mr Ferrero said. “We’ve suggested pretty strongly

that they shouldn’t be using pathology templates for diagnostic imaging.”

At this stage attention is focused on uploading radiological reports to an individual’s PCEHR, while the future management of the accompanying images is unclear. Dr Ferris said he understood that pathology reports would be uploaded in a PDF format following the development of an HL7 CDA template.

For diagnostic imaging, however, it is rather more complex. “The PCEHR has been developed very much from the perspective of general practice and the people in the hospital sphere mainly have to deal with hospital IT systems and state health department arrangements, which vary across each state,” Dr Ferris said.

“I think the main role in the PCEHR for public hospital practices will be the provision of reports of outpatient studies, and some inpatient studies after discharge.

The problem is that for radiology, a lot of patients go in and out of the public and the private systems.

“A lot of radiology is done in private practices, so any comprehensive system would have to include both public and private practices.”

How do I do it?

Mr Ferrero said there were a number of challenges that had to be overcome before any involvement in the PCEHR. However, some of the foundation technologies that are being developed, such as the National Healthcare Provider Directory, would be “godsends”, he said.

He said ADIA firmly

believed that only medical practitioners should be contributing documents to the PCEHR. “And we are concerned, as other people are, that the patient is able to edit their record. They are able to say what goes into different parts of the PCEHR and we don’t support that.”

He also said the construction of large imaging repositories that private providers would be expected to populate was not the answer. A centralised index was a better choice. “There is technology called XDS-I which IHE has developed and we are big advocates of that,” he said.

Obstetric CDA specs in development Queensland’s Mater Health Services is completing a transitional contract with NEHTA that will help formalise a national CDA specification for obstetric information.

Mater’s Shared EHR is a repository for obstetric information that is accessible by patients, internal clinicians and external healthcare providers. It uses Mater’s existing clinicians’ portal along with a newly developed patient portal, which went live on July 1.

Mater’s CIO, Mal Thatcher, said the system uses InterSystems’ HealthShare informatics platform to extract data from three different CDA documents that are sent in from external clinicians, one generated by Genie Solutions and two different documents generated

by PEN Computer Systems software. The documents are all based

on a specialisation of the NEHTA-defined event summary, he said.

tool packages it up as a CDA document and sends it to the Mater repository.

Most of the consultant obstetricians engaged in the project use Genie software. “Obstetricians can submit a CDA antenatal record which the Mater can store and then extract relevant information to provide a composite view of a woman’s antenatal record, derived from internal Mater clinicians’ records and external providers,” Mr Thatcher said.

Once the information from external clinical systems is received in the repository, HealthShare is used to transform the incoming CDA files into a single document type and extracts relevant information to create an obstetric patient record. The original CDA file is attached to the record for future reference.

PEN Computer Systems’ PrimaryCareSidebar tool is used to extract information from Medical Director or Best Practice general practice software.

HealthShare then combines the obstetric patient record with information from a range of other Mater systems, such as patient registration, pharmacy and pathology, to create the Mater Shared EHR.

The Sidebar includes a widget that flags to the GP that a patient has enrolled in the Mater Shared EHR, so the GP can then choose to send a full antenatal record or a summary of a particular visit. The Sidebar

This is available to external clinicians and maternity patients via the provider or patient portal. Mr Thatcher said that since going live on July 1, over 1000 patients had registered for the patient portal.

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DCP and Wedgetail hit the high mark for online results A collaboration between Doctors Control Panel (DCP) software and the open source Wedgetail portal for the online distribution of routine test results to patients has chalked up the milestone of 100,000 results uploaded.

The free service, designed by Melbourne GP Anton Knieriemen as an added extra to his DCP software, allows patients to view their routine results online and is aimed at reducing telephone calls and unnecessary visits to surgeries.

Through DCP, doctors can upload results to the Wedgetail portal, established and maintained for free by the NSW Northern Rivers General Practice Network.

Dr Knieriemen first designed DCP in 2007 as a plug-in for Medical Director to reduce the amount of pop-up message boxes that appear when a patient’s file is pulled up.

New functions have been added since then and it also works for Best Practice users, as well as both systems’ billing packages.

It is aimed at streamlining preventive care tasks such as pre-consultation data collection, intra-consultation guideline assistance, billing management and managing results distribution. It was integrated with the Wedgetail online electronic health portal for distributing checked and annotated pathology and radiology results to patients online in 2010.

Dr Knieriemen said patients love the system as it is convenient and saves them time, but the main reason for developing it was eliminating telephone calls.

“Internet distribution of routine results has lot of benefits for the patients in terms of time but also for doctors and their staff when substituted for phone call result distribution. In effect it allows a ‘No telephone call policy’. I’ve reduced my time on the phone by up to two hours a week.”

Medtech Global to launch patient portal and PCEHR functionality in version 9 Medtech Global is in beta testing for a major upgrade of its Medtech32 clinical information system, which will feature the company’s ManageMyHealth patient portal along with new PCEHR capabilities.

The ManageMyHealth portal is one of the company’s flagship products, chief technology officer Rama Kumble said.

It allows patients to book appointments online and to receive email or SMS reminders from their doctor as well as request repeat prescriptions or enquire about pathology results.

Accompanying the patient portal is a new provider portal for GPs to access patient files offsite and to communicate by email.

Medtech will also launch a patient self-check-in system with Medtech32 version 9, either through a kiosk or tablet PCs at the practice. The idea is to encourage patients to check themselves in upon arrival, update their details, fill out registration or consent forms and to sign up to the patient portal.

“Practices want to be in touch with patients for the things that they need to do well, but they don’t want to be unnecessarily hassled by too many phone calls and too many emails and faxes that they have to respond to,” Mr Kumble said.

“Also, the doctors can share some clinical information with the patient in a very secure manner. It’s the

little bits of information that they’d like the patient to be aware of as well as recalls – if they forget about an appointment or a goal or measurement, that is automatically shown.”

Using secure portals that other health professionals can access would also improve team care for chronic disease management, he said.

“ManageMyHealth provides an infrastructure to do team care. Multiple people can look at it and each individual has different access to it and can participate in the care of that patient.”

Mr Kumble said there were two models the company was trialling for the

self-check-in function, a traditional kiosk model with a touch screen or tablet PCs. While trying to encourage patients to use the online product, self-check-in was important for walk-in patients, he said. The kiosk would be situated in a semiprivate area near the front desk so when new patients walk in the receptionist can ask them to check themselves in.

“We have a patient dashboard in our practice management system, so when the patient comes in it reminds the doctor of all things they need to look at. That information can also be used to remind the patient through the kiosk, such as ‘you haven’t had a cholesterol check for two years’. It’s a communication medium.”

Mr Kumble said the jury was still out on tablets, mainly for security reasons. Kiosks are popular as “no one can run away with them!”

“We are just starting with this and we’d like to cautiously learn from it.

We are learning from New Zealand where people are using ManageMyHealth more but here [in Australia] customers are asking more for self-check-in and new patient entry.”

Medtech will also release a number of add-on products in v9, including a clinical audit tool that brings up patient files from the query

results onto a patient palette for data clean-up, and NPS RADAR integration for independent and evidence-based information on new drugs, research and PBS listings.

“One of the focuses we have in this release is ... bring[ing] in a lot of companion products, because we live in an ecosystem.”

Users can also choose whether to use eRX Script Exchange or MediSecure for sending electronic prescriptions to pharmacies.

“One of the focuses we wanted to have in this release is, apart from having Medtech32 as the core product, I wanted to bring in a lot of companion products, because we live in an ecosystem,” he said.

Regarding PCEHR functionality, Mr Kumble said Medtech was “motoring along”.

The company achieved integration with the HI Service some time ago and the current version of Medtech32 is able to look up a patient’s IHI. Medtech has demonstrated it can download a CDA document and has achieved

its CCA certificate for shared health summaries.

The technology is available for uploading documents but Medtech still has to go through the CCA process, which should be some time soon in the next month.

“We have shown the actual workflow to a group in Brisbane,” Mr Kumble said. “They were pleased to see us showing how this all works in the practice situation, in the workflow.”

Medtech has added a colour-coded icon to the toolbar in Medtech32, which will alert the doctor to the patient’s PCEHR status.

“It will show whether they don’t have one, whether they have one which you have access to, whether they have one that you don’t have access to.

“When new documents are uploaded, let’s say the patient visits another doctor and new significant events have happened, you will be told. If you want to know you can optionally download it or just ignore it.”

Medtech also hopes to use the self-check-in kiosks as a way of encouraging patients to register for a PCEHR on the spot.

“NEHTA is pushing for assisted registration for the PCEHR. What better can there be than a simple kiosk? That’s our innovation on top of what NEHTA is trying to do.”

What GPs will need for the eHealth PIP payment The National E-Health Transition Authority (NEHTA) will establish an eHealth product register to allow practices to check whether their software adheres to the new requirements of the eHealth Practice Incentive Program (ePIP).

Health Minister Tanya Plibersek issued a statement after the May budget saying the new ePIP requirements for general practices would include secure messaging, healthcare identifiers, clinical coding of diagnoses, electronic transfer of prescriptions, and the capability to upload shared health summaries and event summaries to the PCEHR. According to a recent NEHTA webinar for medical software developers, the first four capabilities will be required to be in use in general practices by February 2013, and the ability to upload shared health and event summaries to the PCEHR by May. According to NEHTA, the ability to integrate IHIs into practice records will enable users to access the HI Service to find a patient’s IHI and to record the practice’s HPI-O and each practitioners’ HPI-I. Requirement two, secure messaging capability, will enable clinical messaging that is “standards-compliant” and able to “interoperate with other products which conform to the same specification”.

Requirement three is for data records and clinical coding, although details on what exactly this will include are unknown.

As specifications for the electronic transfer of prescriptions are not yet finalised, it is expected that practices will simply need to use the services of either eRx Script Exchange or MediSecure, or both.

Initial PCEHR capabilities are believed to be nearing completion for many popular GP software programs and are due to be rolled out in the next few months.

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Bits & Bytes

Orion Health signs up as reseller for Caradigm Orion Health has signed a letter of intent to become a reseller and services provider for Caradigm, the joint venture between GE Healthcare and Microsoft formed last year.

Orion Health will be able to resell Caradigm’s Amalga enterprise health intelligence platform, which aggregates electronic data from multiple sources into one repository, as well as Caradigm’s identity and access management (IAM) products for healthcare, which include expreSSO, an enterprise single sign-on solution, and Vergeance, an integrated single sign-on solution.

Orion Health CEO Ian McCrae said access to the Caradigm IAM products will complement Orion’s existing range of clinical workflow and data integration applications.

These include the Orion Health Hospital Information System (HIS) – which was previously known as Microsoft Amalga HIS and was acquired by Orion Health in October last year – as well as radiology imaging and picture archiving and communications (RIS/PACS) products.

Orion Health HIS is a fully integrated hospital information system, including patient management, full electronic medical record, CPOE, end to end medication management, laboratory information system, pharmacy, RIS/PACS and back office functions.

Subject to finalisation of a definitive agreement, Orion Health will resell software licences and deliver implementation and support services to hospitals and health systems in the Australian and Thai markets.

Mr McCrae said the agreement would allow Orion Health to offer a comprehensive eHealth solution when allied to its existing EHR solutions.

DocAppointments to release mobile app for Android Online doctor appointments provider DocAppointments. com.au has launched a new app for Android devices, an addition to the free iPhone and iPad app released six months ago.

The apps enable patients to book an appointment with their doctor through their mobile phone or iPad, with an additional function of automatically placing appointment reminders in the user’s calendar.

Patients receive reminders one day and one hour before their appointment through the calendar function, meaning practices do not have to pay for SMSs

while also reducing the amount of patients missing appointments.

Designed by Tasmanian GP Calin Pava, from the Devonport GP Superclinic, DocAppointments.com.au is a computer-based system that is integrated into PracSoft and Best Practice.

It allows practices to make appointments available through their own website and is aimed at reducing the time receptionists spend fielding phone calls, particularly first thing in the morning.

Dr Pava said the reason he had designed the system

was due to dissatisfaction with the other online appointment booking products on the market.

“There were two systems we looked at for our practice but one was too expensive, charging a fee per month per doctor and then a charge per appointment,” Dr Pava said.

“For practices with more than six doctors, for instance, that can get too expensive. And I couldn’t see the logic in paying for appointments. I want more appointments to be made online but the more I make available the more I pay. It seemed counterproductive.”

He said other products he looked at allowed the patient to choose the earliest appointment available at different practices, with surgeries advertising on the same page as competitors.

“That’s convenient for the patient but a bit counterproductive for the practice,” he said. “You lose not only revenue but also the continuity of care that is so important in caring for our patients.”

DocAppointments lets patients book an appointment with their regular doctor or with other doctors in the practice if the regular doctor is not available. If the patient needs to cancel, they simply go back into the system and delete the appointment, freeing it up for others.

The patients can see all the appointments available in the surgery on one particular day or sort by doctor and by week, so nonurgent appointments can be booked weeks in advance.

For patients who need urgent care, such as mothers of sick children, they can book in for the first available appointment without having to go to a hospital or wait until morning to try to get an appointment. It also reduces the time spent time on the phone.

Doctors and receptionists merely need to designate

a free appointment as “Internet” in their clinical or practice software to bring up the system, which will then automatically make the appointments available online for patients.

The practice manager can choose which doctors have online appointments and have full access to the

“That’s convenient for the patient but a bit counter productive for the practice. You lose not only revenue but also the continuity of care that is so important in caring for our patients.” contact details of registered patients in the admin area.

Each patient can add family members and can make only one appointment at a time for each registered family member.

Having access to each registered patient allows the practice to block a patient from making online appointments, avoiding any possible abuse of the system.

Dr Pava said that in his practice over one-third of the appointments are now

booked online. He has also been able to move two of his reception staff away from the phone and into chronic disease management work.

The service is available for an initial installation fee and a monthly licence fee per practice, with no additional charges per doctor or per appointment.

While at the moment around 65 per cent of the appointments are made through the desktop, the mobile applications actually make the whole process faster and simpler.

“It’s easier with the app than on the computer because the app will remember your password and user name. It also remembers who your doctor is,” he said.

“And once you have made an appointment it will email you, and integrate into your calendar so you are reminded 24 hours and then one hour before your appointment.”

The apps also let new patients open a Google map to show them where the practice is located.

While the service is currently only available with PracSoft and Best Practice, Dr Pava has contacted Stat Health to integrate it with Stat, and he is in discussions with other commonly used practice management software companies.

Drug-herb interactions engine added to eMIMS MIMS is offering a trial of a new complementary versus mainstream drug interactions module to subscribers of its eMIMS service.

The information has been sourced from fully referenced, evidence-based data collected by professors Basil Roufogalis and Andrew McLachlan of the Herbal Medicines Research and Education Centre, part of the University of Sydney’s Faculty of Pharmacy.

The database delivers over 500 interaction modules to the integrative medicines website IMgateway, run by UnityHealth.

According to MIMS, surveys by NPS have found that safety and interactions between herbal medicines and prescription drugs are amongst the information most required by health professionals.

The module can be accessed through the essential resources tab in eMIMS, and then by selecting MIMS Drug Interactions.

It allows users to select complementary and mainstream medications from a list to analyse their interactions.

Any adverse drug interactions come with references to published studies, along with advice for the patient and general commentary.

For example, a search for interactions between the antidepressant amitriptyline and the popular herbal remedy St John’s wort (Hypericum perforatum) will reference a 2002 study that found co-administration of St John’s wort can reduce the effectiveness of the prescription drug. It advises doctors to tell patients to avoid this combination.

MIMS business development manager Margaret Gehrig said that as eMIMS is so widely used, it has been chosen as the first MIMS product to carry the module.

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Events

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HIMAA

THE BIRTH OF ELIOT EASTERN LOAD INTERFACE TOOL

Many health organisations refrain from developing in-house applications and purchase established applications off the shelf. The Eastern Load Interface Tool (ELIoT) is an excellent example of a small application developed at Eastern Health that has positively changed the workflow of many staff.

LISA WHITE Manager, Clinical Patient Folder Eastern Health lisa.white@easternhealth.org.au

Background Eastern Health, with over 29 service locations, is the largest geographical metropolitan health service in Victoria, covering a geographical area of 2816 square kilometres.

Eastern Health recently implemented a scanned medical record system called Infomedix Clinical Patient Folder across all sites and programs. The project team continually looks for potential system integrations and during the project, integration with Symphony (ED) and and Birthing Outcomes Suite (BOS – Maternity) was put into place.

One area identified for potential efficiency improvement was typed letters and reports that are created electronically, printed and sent for scanning. The main objective was to have these documents electronically fed directly into the Clinical Patient Folder.

Objective About the author Lisa has been a Health Information Manager at Eastern Health in Melbourne, Victoria, Australia. Lisa has been involved in health IT for over 25 years in Canada and Australia and has interests in health informatics, eHealth and project management.

The project manager and health information manager developed the specifications for a new application that would allow staff to load documents directly into the Clinical Patient Folder system, thus reducing the number of paper documents to scan.

Eastern Health ICT (Applications) was approached to develop an in-house solution that would: • • • • • • • •

Be web-based Be easy to use for administrative staff PDF all files (.doc, .docx, .rtf, .dat) Have the capability to load pictures (.jpg, .gif) Include adequate audit trails Help to eliminate any delays with the scanning of outpatient letters Reduce the amount of paper to scan (and thus reduce stationery costs) Reduce the amount of resources required for associated scanning processes (scanning, quality assurance, archiving and storage)

Process After a number of meetings and development time, the Eastern Load Interface Tool (commonly referred to as ELIoT) was developed. ELIoT’s web interface was developed using Microsoft’s ASP.NET and C#. ELIoT is tightly linked to Eastern Health’s Active Directory to ensure that the users are valid Eastern Health staff and a full audit trail exists. The audit trail is important as we rename the files during the conversion to a PDF file format.

The PDF format was chosen as it meets the legal requirements for a health record.

The second application, which is not visible to the users, is a Windows service which picks up the uploaded files and converts them into PDF (.doc, .docx and .rtf). Images and PDFs remain in their original file format and will automatically move to the Infomedix Document Load Interface (DLI) module pick-up folder. This application was designed to be extremely flexible and easily modify the location of any working folder without having to alter the code.

Currently, there are a few constraints put in place by Eastern Health. They include: • Documents to be uploaded are filed in non-episodic sections of the scanned medical record (e.g. correspondence and diagnostics) • Documents being uploaded must be smaller than 7MB in size • Documents being uploaded must be of the file types specified • Medical record forms being uploaded must meet AS 2828 Standards

The outcome Eastern Health Health Information Services and ICT Applications have produced a user-friendly interface that allows administrative staff to load any documents (with the file types specified above) in five easy steps.

A number of areas have changed their processes and started using ELIoT, thus enhancing the communication process around a patient’s care. These include: • HIS Typing Service: uploading all typed letters, which greatly reduces the amount of time compared to their previous practice (i.e. the documents are loaded at the end of each working day instead of after the doctor signs off the letter – a process that could sometimes take weeks).

• Neurosciences Department: uploading the NCS/EEG reports for all new patients. Any historical reports which

are kept on a shared drive are uploaded immediately on request (eliminating the need to fax copies to the clinic).

• Fibroscan Clinic: uploading the Fibroscan reports, thus increasing the availability of all reports.

• Multidisciplinary Cancer Care Meeting document(s): timely access to the MDM documentation has improved communication between health professionals involved in patient care.

Eastern Health staff using ELIoT have been very receptive and have provided very positive feedback: “ELIoT is very user friendly. Good to get reports to CPF immediately. Will save time running urgent reports to outpatient clinics.”

Sleep Disorders Unit - Box Hill Hospital “Since ELIoT was introduced, it has certainly decreased the time to upload our reports.

Very quick and efficient.” Neuro Diagnostic Unit – Box Hill Hospital.

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Feature

NEW ZEALAND’S EHEALTH AGENDA 2014 AND BEYOND

New Zealand is at the half-way stage of implementing its National Health IT Plan, an overarching implementation plan to improve patient care and information sharing throughout the country. At the Health Informatics New Zealand (HINZ) conference in Rotorua in November, National Health IT Board director Graeme Osborne will explain progress to date and provide details of the revised 2012 plan.

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

In 2009, New Zealand’s new National Health IT Board was tasked by the government with developing a national plan to improve patient care and information sharing through health IT. In 2010, the board released its plan, which took as its main goal the enabling of person-centred integrated care.

From an Australian perspective, one of the most crucial elements of New Zealand’s plan was its pragmatism. It is not a wishy‑washy collection of vision and mission statements, but a detailed plan aimed at setting actual implementation goals and deadlines for real change and investment. And at the heart of the plan was the realisation that while setting national targets was important, a regional approach would be faster and would build on already proven successes.

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.

Having led the establishment of the National Health IT Board and then the development and introduction of the plan, Graeme Osborne is now charged with its implementation. At the HINZ conference in November, he will outline the progress so far, but will also detail a revision of the plan that will see it refocus on priority programs towards 2014 and beyond.

The spark for the plan came from the change of government in 2008, when the new Health Minister, Tony Ryall, expressed

his frustration that not enough was being done to improve healthcare through the use of information technology. For a small population with limited resources, it made sense to harness eHealth initiatives to improve the quality of care.

“What the minister did was set up the National Health IT Board as a sector group and charged us with creating a national plan for the first time,” Mr Osborne says.

“The real difference was that it would be an implementation plan, not a strategy plan. From there, working with the board we came up with a goal, and the goal was we wanted to enable person-centred integrated care. We thought that if we enabled person-centred integrated care wherever the health sector moved, that would be a common theme.”

In 2010, the board introduced a four-year plan that set out a number of priority programs to begin implementation in 2011/2012, aiming to achieve real goals by 2014. It would build on eHealth initiatives already established, such as the Safe Medication Management program and the eReferral solution implemented in 2008 at Hutt Valley DHB, but would also set some foundational goals to bring the whole country up to a similar level.

“We didn’t just try to make the argument for why [innovation] was important – we

which was a big step forward, he says. The second was to get some key capabilities working across the regions and nationally.

And the third was to target those areas where a national and controlled system was more likely to work.

For 2011/2012, four priority programs were identified, under each of which lay a number of initiatives. The four priority programs are regional information platforms, integrated care initiatives, national solutions, and eMedicines.

Regional information platforms The regional information platforms program encompasses a number of different aspects, the most interesting from an Australian perspective being the creation of regionally based clinical data repositories underlying a common clinical workstation for hospital clinicians. It also involves bringing the acute care sector up to scratch in terms of patient administration systems, radiology information and picture archiving communication systems, and clinical support for laboratories and pharmacies, as well as improvements in the continuum of care out to the primary sector, involving eReferrals and eDischarges.

Graeme Osborne were in fact really looking for where successes had already been proven,” Mr Osborne says. “The plan was based on the idea of lifting everybody up to the current good practice as a base standard, while not wanting to slow down innovation as well.

While the plan stated that these platforms would be implemented through DHBs, it made sense to group the DHBs into four different regions – Northern, Midland, Central and Southern – all of which are developing regional implementation plans. The plans call for all DHBs to have a single PAS for each region, common systems for laboratory information systems, up-to-date pharmacy systems and improved RIS/PACS.

“In many cases the plan was based around quite careful consideration of what was achievable, by looking at what had already been achieved, pretty much in isolated parts. Throughout New Zealand there were some strengths but a lot of weaknesses as well so we were trying to lift everyone up to the strengths.

It also calls for one common system, implemented regionally, for the clinical workstation throughout the country, with four underlying sets of clinical data repositories. While many aspects of the plan allow DHBs or the four regions to choose their own vendor, the National Health IT Board has insisted on one vendor for the clinical workstation based on a patient safety and productivity argument. That vendor is Orion Health with its Concerto platform, which is being implemented as part of the PCEHR project in Australia.

“We did adopt a few things (that were already happening) although not many. The medications and eReferrals were probably the two that we picked up. We talk a lot about what we call the beneficial owner – we like to leave the accountability for building and delivering and operating an IT solution with the beneficial owner.

It was pretty clear therefore that we had to work with those people who were taking the lead, rather than try to compete.”

“We call it a clinical workstation but the underlying technology is web-based,” Mr Osborne says. “That means it is able to more easily integrate, collect data and represent data. Hospitals have multiple systems – most hospitals have around 70 to 100 systems – and we’ve had some very smart hospitals that are using the Orion web-based clinical workstation and have really progressed very quickly on being able to present integrated information.

There are three main issues the plan seeks to solve. The first was to get the DHBs to make investments in health IT for their regions,

“It was on the back of that best practice that we actually went out to the four regions and said we believe it would be very smart if

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our clinicians had a common clinical workstation throughout the country, and they’ve come to that conclusion as well. So each of the regions is moving towards the single regional instance of the latest version of Orion’s Concerto and that means that the ones that haven’t used it in the past will come on board. They’ll turn off their local version to enable a regional version.”

The Central region has chosen to use Orion Health to build its clinical data repository (CDR) as well as the workstation, while the Northern and Southern regions have chosen Sysmex’s Eclair “Testsafe” product for the CDR. The Midland region has yet to choose a preferred vendor.

The plan also calls for common PAS, RIS/PACS, ePharmacy, eReferrals and eDischarge summaries, Mr Osborne says. Each region will be allowed to choose which one it uses, but all will be tied together with the common view provided by Concerto.

“We believe that the combination of the three things – the clinical workstation, the CDR and the PAS – are the fundamental systems that we want to have consistently throughout the regions. And we want to have a national view across that as patients move from one region to another. Allied to that is we want to have common RIS/PACS, common ePharmacy, common eReferrals and discharge summaries.

“Once you put all of that into place, you take a lot of the 70 systems out and you can rationalise how many other systems you need in your hospital. That is our philosophy. We don’t talk about hospital systems, we call them regional information platforms, so ultimately this is our strategy about how to rationalise the investment in IT strategy within hospitals.”

While each region can choose its preferred vendor, the National Health IT Board uses a “guided market model”, in which the board sets minimum standards. “We haven’t gone through what I would call a formal certification process yet, although we are building towards that,” he says.

Using the hospital ePrescribing program being pioneered by Dunedin Hospital in the Southern region as an example, Mr Osborne says the board has endorsed a single solution – CSC’s Medchart system – as the national standard (see page 44).

“Does that mean that product is going to be rolled out across New Zealand? The answer is that unless there is another product that is endorsed, then yes. The DHBs like that because they just want to know what has been endorsed. What we are trying to do is reduce the amount of solutions that are in any one segment of the sector, but we are also needing to show that we are following good procurement practices. There is a balance there.

“We don’t want to have many [different solutions] and in things like medications we would be very happy if there was only one solution. We have to endorse it and it has to be researched – Johanna Westbrook showed that Medchart was as good as Cerner and clearly better than nothing at all. There are a couple of other vendors with products but they don’t have the independent research behind them. That has been what has made us confident around Medchart.”

National solutions While the regional information platforms are what they say on the tin, it was decided that there should also be some national solutions that must be implemented. These include systems for different specialities, such as oncology and cardiac and renal health, along with a national assessment system for aged care.

Underlying this is a national system of healthcare identifiers.

New Zealand has had a National Health Index (NHI) for its population for 17 years, and this has not changed under the plan.

What has changed is new technology to support the NHI along with the Health Practitioner Index and an index of what facilities those practitioners are working from.

“We need to know who is providing care to whom and what facility are they working at, and the Health Identity Programme picks up that – it’s the national index number for the patient and a national number for the provider and the facility they working out of,” Mr Osborne says. “The first one, the National Health Index, we’ve had running for 17 years. Now we are replacing all three into one really smart system. We believe that to have an integrated system we have to have commonalities.”

For the specialty areas, Mr Osborne says the board is setting standards for software solutions specific to those areas. “We prioritise areas where there is commonality and agreement and also where there is value. When you look at oncology or cardiology in New Zealand, we are only talking about 20 or 30,000 patients that are diagnosed each year, so that is very readily manageable on a national system.

“We would expect that when we complete this work, that there will be common systems used throughout the country, although it is interesting that as we go into these areas in more detail, to say there will be a single system is probably a bit simplistic.

A system that might be used in say, cardiology, around risk assessment in the community is likely to be one version, and then the system that manages patient flow, that follows people through the tertiary sector may be another system, but at the end of the day we have a national approach working to a common outcomes data collection.”

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“...it is about the clinicians learning to work differently supported by the software tool, and it’s about them having confidence to engage the consumer in that new approach.”

Graeme Osborne

A national approach to aged care has also been decided, based on the work of the interRAI standard, a collaborative network of researchers devised in Canada and now in use in over 30 countries. interRAI has developed a structured interview protocol to provide a consistent view of individual needs, whether they are as simple as helping older people shower to more complex medication and clinical needs. interRAI is now known as the Comprehensive Clinical Assessment (CCA) tool in New Zealand. This tool is being used to assess the needs of anyone over 65 who needs access to publicly funded services, with the assessment information stored in a national repository. The wider benefits of a national system were brought into stark relief during the Christchurch earthquake last year, when it was able to be used to assist more than 600 elderly people living in their homes (see page 48).

“We have accepted in New Zealand that we see value in having that common assessment process for aged people whether they are getting that care in the home or in an aged care facility,” Mr Osborne says. “What we did was create a national solution that DHBs and the aged care facilities will utilise but it will be one national system and process.”

Integrated care initiatives Another benefit of the CCA system for aged care is its integration into other parts of the national health IT system, including the plans for a national shared care record. Much different in its structure and outlook than Australia’s PCEHR, it is the most innovative part of the national plan, Mr Osborne says.

“We are very clear that a group of New Zealanders, people who have co-morbidities or are recovering from a major accident and

they need lots of care, will benefit from having a way of logging into a system that has all of their care team members and they can see the action plan to get them well again.

“We are trialling that at the moment. We have a long-term conditions project in Auckland and we have the work going on in Canterbury. It is looking positive but when you are in an innovative area of health IT, it is about the clinicians learning to work differently supported by the software tool, and it’s about them having confidence to engage the consumer in that new approach.”

The integrated care initiatives program includes the development of a shared maternity record of care, a shared care plan for long-term conditions, which is being piloted in Auckland, and a shared care record view, which is developing technology to enable emergency access to patient records and was developed and implemented in Christchurch after the earthquake.

Other projects in this program include the Patients First initiative, which is overseeing the implementation of the primary care sections of the national plan. It includes the GP2GP project (see page 56), which is developing technology to enable the transfer of patient’s files electronically from one general practice system to another, along with the practice management systems certification program. This is defining and prioritising the clinical, functional and non-functional requirements of GP practice management systems, together with the interoperability needs of a PMS within the broader eco-system.

While it more generally falls under the regional information platforms program, the eReferrals system that is up and running in Auckland is also providing foundation technology to better enable person-centric integrated care at the community level. NZ secure messaging company HealthLink has been a driving force behind this project, which is being used in three metropolitan DHBs in Auckland, covering a million people.

The four regions are being allowed to choose their own vendor for eReferrals, with the Northern and Central regions choosing HealthLink while the Midland and Southern regions are understood to have chosen a different vendor. Mr Osborne says this will create competition to drive further innovation over time.

eMedicines The eMedicines program has five parts to it: the introduction of electronic prescribing and administration in hospitals; electronic systems for medicine reconciliation to allow clinicians to view the most accurate list of patient medications, allergies and adverse drug reactions; the New Zealand Electronic Prescription Service (NZePS), to allow GPs to send prescriptions to community

pharmacies electronically; the NZ Universal List of Medicines, a master list of all medicines used in the country under a common terminology; and the NZ Medicines Formulary, a point of care reference addressing the day-to-day needs of those prescribing, dispensing and administering medicines in NZ. The eMedicines program has already achieved a number of goals, with the Universal List of Medicines up and running for 12 months and the formulary going live in July. A deadline of 2014 was initially set for all hospitals to use a common ePrescribing system, but that has been adjusted slightly, with a more pronounced focus on the medicines reconciliation and GP-pharmacy prescription service to be rolled out nationally.

“With medications we’ve decided to get the GP to community pharmacy right and getting the medicines reconciliation in and out of hospitals right. The hospital ePrescribing program is an important program to address but we expect it to take a year or two longer to get it fully rolled out around the country.”

“This will be in our revised 2012 IT plan – we launched it in 2010 and we are going to have a revised version in 2012. I’ll be sharing feedback from our consumers, because they are saying it all sounds really good but what does it mean for us? Who is going to hold it, what is it going to look like? There are still quite a lot of New Zealanders who ask us is there one big database that is going to be sitting in Wellington.”

Asked if New Zealand had considered going down the path of a PCEHR, Mr Osborne says it did, but the idea was quickly discounted. “I go back to that concept of the beneficial owner,” he says. “As soon as you create a national electronic health record, you get into two problems. One is that the people who are the beneficial owners of the information, being the consumer and the clinician at the point of care, feel disconnected from it.

HINZ

“And the second one is how do you maintain the quality of information that ends up in the national system without having a moderation function to ensure the information is coherent? We think the best moderators are the consumer and the clinician together, not individually.

The Health IT plan will not come to a halt in 2014 – the idea is to build on its momentum past that date. At the HINZ conference, Mr Osborne will provide the audience with an update on achievements to date, but will also be releasing both a revised 2012 plan and some consumer feedback. “We are going to provide a tree diagram that we’ll share publicly to answer the question of ‘2014 and beyond, how does all of my information fit together?’

“There is one other reason – we think electronic health records are pretty boring. We think the shared care plans are more interesting in terms of setting out what the person needs to address in their language and how the health workforce is going to work together to address their objectives. We believe it’s a hybrid activity centred around the person and we’ve got to enable the whole sector to work well together.”

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Feature

NEW ZEALAND GOES FOR GOLD IN MEDICATIONS MANAGEMENT

New Zealand has taken on the ambitious target of rolling out an electronic medications management (eMM) system in every hospital in the country by 2014. With only a couple of hospitals using it at the moment this might seem a tall order, but under the national eMM program, all work is being shared and guidelines prepared so all hospitals are working off the same sheet.

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

Dunedin Hospital in NZ’s South Island has been trialling an electronic medications management system since 2010. Using MedChart, from the vendor formerly known as iSOFT and now part of CSC, the system has now been installed beyond the two wards it was trialled in and an extension throughout the remainder of the district is underway

least of which was a complete rewrite of the main piece of legislation covering medicines, the Medicines Act 1981.

And it is no longer being called a trial, according to Andrew Bowers, an internal medicine specialist who is also the medical director of information technology at Southern District Health Board (DHB) and who has been leading the project from the outset.

The 1981 Act required a hand-written signature on all prescriptions – a huge step forward in patient safety in those days but one that has had the unintended effect of stymieing the progress of electronic systems.

The trial is now a staged roll out, Dr Bowers says, and is an integral part of NZ’s ambitious target to have an eMM system in place in every hospital in the country by 2014, part of the Ministry of Health’s Go for Gold strategy.

This strategy has meant huge changes to the way things are done in New Zealand, which has for many years been split into 22, now 20, disparate district health boards, many using different systems and different ways of doing things.

Several barriers have had to be overcome to enable widespread adoption, not the

The new legislation, which passed the lower house of Parliament in February but has not progressed much since then, will change the wording of the 1981 Act to enable electronic signatures.

As the new legislation is not yet law, the team running the eMM system in Dunedin has been working under a special dispensation allowing electronic signatures to be used.

According to Dr Bowers, the dispensation application process was supposed to have been streamlined, but says it remains a significant barrier to a timely rollout.

It was also a barrier that affected the last time NZ tried to introduce an eMM, back in 2004 when MedChart was brand new.

“We actually implemented MedChart in 2004 but it didn’t go well, for several

reasons,” Dr Bowers says. “The biggest reason was that legislation didn’t support electronic signatures and it still doesn’t.”

“Back in 2004, we had to have a hybrid solution in place with paper and electronic charts, and that was inherently dangerous.

Also, nobody had electronic prescribing in place anywhere in the southern hemisphere and we didn’t really know how to roll it out very well.

“But we’ve learned from our mistakes, from the other places that have put it in since that time, and we have now developed a national process to achieve it. We understand how to engage better and on this occasion, we did a much better job of it.”

The Ministry of Health’s plan to have the system in place in every hospital in country is ambitious, but unapologetically so, Dr Bowers says. “The Ministry has said they do appreciate that we may not achieve 100 per cent of that, but if we ask for a longer timeline we won’t achieve that either. So this is really pushing it and stimulating development.”

Broad vision for eHealth Another barrier to overcome is the way district health boards function and are funded. New Zealand has now decided to split the country into four alliances for the purpose of streamlining the several elements of the National Health IT Board’s broader vision for eHealth in NZ. This includes the Connected Health program, a standards-based, commercial model for the delivery of universal connectivity across the New Zealand health sector. There is also a Health Identity program, which aims to deliver a single integrated system that will lay the foundation for a secure and transferable electronic shared care record.

The National e-Medication Programme (NeMP) is also part of the vision, and it has been given priority status. A huge part of it is the eMedicines program that Dr Bowers is helping to lead in his district. He is now taking part in the South Island Information Systems (SI IS) Alliance, one of the four new alliances created to allow the programs to be streamlined.

“I chair the SI IS Alliance, but I am also the medical director of IT for the South Island Alliance, covering every South Island public hospital,” Dr Bowers says. “This role is collectively funded by every SI DHB, which indicates the strength of resolve for the Alliance, I believe. This role has gone full time when combined with my MD of IT role for the Southern DHB. I expect that I have more that 10 years of work ahead of me.

“The patients that are there are the most complex and the most unstable, using the most medications and with the highest turnover. If we could do it well there, we felt that the rest of the hospital would be relatively simple.”

Dr Andrew Bowers

“What it means is that in NZ we have broken our health service down into four health regions. The South Island is its own health region – we’ve got roughly equivalent numbers of people in each of the regions. The aim of that of that is not to fragment but actually to align our processes alongside a vision that has come out of the National Health IT Board and various other advisory groups.

“One is called the National Information Clinical Leadership Group (NICLG). The South Island Alliance has a very large number of work streams but one of those is medicines management, and we are implementing the Ministry’s “Go for Gold” program.”

MedChart has been live in two acute internal medicine wards at Dunedin Hospital since October 2010, and the reason they were chosen is they were the “hardest nut to crack”, he says.

“The patients that are there are the most complex and the most unstable, using the most medications and with the highest turnover. If we could do it well there, we felt that the rest of the hospital would be relatively simple.”

The system is now being rolled out throughout the 388-bed hospital, and the plan next is to roll it out to the other hospitals in Southern DHB, and in parallel with the rest of the South Island.

“We are now aiming to have the whole of the South Island on electronic prescribing and administration by the end of 2014, and we are likely on track to achieve most of this,” he says.

“We have achieved board support and funding for the whole Southern DHB. We have also achieved SI IS Alliance support for this, making it a major regional workstream. Canterbury DHB has advanced plans, hopefully going live early next year, and we are in the process of forming governance groups across the whole South Island to ensure regional alignment of process.”

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Single clinical desktop Work is also in hand to redesign all patient management systems in every South Island public hospital to ensure there is a single system across all hospitals, enabling improved patient journeys between hospitals, fully aligned business processes, reduced cost and the ability to develop shared business intelligence and planning across the whole region.

“Expressions of interest for a partnership in this are soon going to be published,” Dr Bowers says. “We have been supported in this by the National Institute of Health Innovation (NIHI), which is based in Auckland, and by the National Health IT Board. Other health regions are also taking interest in the outcome of this process and of course we aim to share our activities with them.”

The team has also started rolling out a single clinical desktop across every hospital in the South Island. Based on Orion Health’s clinical portal package, formerly known as Concerto, this has been rebranded as Health Connect South. “We are in partnership with Orion Health to develop this and other innovative additions to clinical support via this interface. Doing so will enable identical access to shared complete patient records in every DHB, via a standardised desktop with a single login, and reduces the risk we know exists when clinicians move between hospitals in shared services who have to learn new systems or lose track of patients.”

Beyond that, the plan is to have electronic medications management installed in every hospital in the country. It is a requirement that everything this team does is shared, right down to the business case, he says. “We will be developing people as train the trainers and through the National e-Medication Programme that is part of the National Health IT Board, and the Health Quality and Safety Commission, we’ll be developing guidelines that can be mirrored in every hospital.”

It will also be spread out into the community. Dr Bowers is very keen to see eMM systems used more in the community, particularly in nursing homes but also for community mental health provision. “We want to develop it further regionally so that we have what we call a My List of Medicines, which is a single list that rules them all, which is reconciled so that all of our electronic systems both in the general practices and in the hospitals read and write from the same source of truth and it is reconciled.

“We do have great interest in moving MedChart into the community, not only to rest homes but into the general practices themselves and we do want to keep that enthusiasm boiling. Our primary aim at this stage though is to keep focus on the activities within the hospital and to stay within our limited resources. Once

we have this consolidated in every public hospital we will extend the scope to close the loop with all community prescribers, and with hopefully additional funding by then.”

New Zealand has very much got the jump on Australia with the development of its Universal List of Medicines (NZULM), which is already up and running. “We know there are different ways of prescribing medication that vary according to which hospital and which company you are purchasing from, so part of this is to have a single list of descriptions of medicines and a single type of barcode that describes a medication right across the country.”

Mandate for support Another thing Australia could learn from our cousins is the formation of the four alliances and a mandate from the Ministry of Health that they all support each other, he says. All information must be open as well, so Australia is free to pinch any ideas if we see fit, he said.

While Dr Bowers can’t speak for the other IS regions, there is an expectation that they will progress along this path also, he says. “Taranaki Hospital went live with MedChart in a Care of the Elderly area [recently], and also has plans to keep the momentum up for rollout. Counties Manukau DHB is in the final stages of preparation and intends to go live early next year with a rapid rollout beyond that.

“We all struggle with issues of funding. Not every DHB has the advantage of a clinician-directed IS service, but hopefully, based on our success in the South Island, this will become standard practice. I believe that we are on the cusp of great change in IS in terms of refocussing activity towards improving patient outcomes through clinical partnerships with IS. “We are far too small to have 20 district health boards in a country of only 4.5 million. It’s silly. Each hospital was working on parallel processes with different ways. It also wasn’t good for the software vendors because they have very small markets, each of which is going in a different direction so they had to configure things differently for each hospital – it was inefficient.

“The other change that has happened is that we now have a mobile workforce – people are moving constantly between district health boards and hospitals within the region and having to learn completely different ways of doing things. So we now are going to align all of our clinical processes, all of our software systems, so that doctors and nurses and patients can move very easily between different parts of New Zealand and have a complete health record that they can rely upon being safe.”

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Speakers will include: Bruce Sullivan Keynote Speaker, Author & Business Leader

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Claire Jackson National President of the Royal Australian College of General Practitioners, Professor in General Practice & Primary Health Care

Marion McKay Dip Counselling and Group Work, FAAPM

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NATIONAL CONFERENCE Brisbane Convention & Exhibition Centre

Tuesday 16 – Friday 19 October 2012

www.aapm.org.au

Australian Association of Practice Managers Visit www.aapm.org.au to register online

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Feature

CHRISTCHURCH AFTER THE EARTHQUAKE One of the most popular presentations at the recent Health Informatics Conference (HIC) in Sydney was by Nigel Millar, chief medical officer of the Canterbury District Health Board. He explained how Canterbury’s health system responded to the February 2011 earthquake that devastated Christchurch, and how the disaster has actually spurred further IT investment in better, more coordinated care.

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

Nigel Millar doesn’t go so far as to recommend experiencing an earthquake in order to test the foundations of a healthcare system, but he does recommend pretending to have one.

The earthquake that destroyed much of Christchurch in February 2011 has taught the Canterbury District Health Board (CDHB) an awful lot about how IT systems coped in the emergency, but it also had an unexpected effect of boosting the use of innovative healthcare models and systems to provide better care to the community.

Dr Millar, the chief medical officer of the CDHB and a specialist in geriatric and general medicine, took a leadership role in the response to the disaster. Both before and after the earthquake, part of his role had been to try to transform the health system into a fully integrated and efficient one that is sustainable for the future.

For Dr Millar, one of the most beneficial systems already in place was interRAI, the clinical needs assessment program developed by an international network of aged care specialists that has been rolled out throughout New Zealand for home care and which is now being introduced to residential aged care.

Under the NZ Health IT plan, it is being rebadged as the Comprehensive Clinical

Assessment program and will be used throughout the country to assess the needs of all people over 65 who require it, whether they are living in their own homes, a rest home or residential aged care.

Dr Millar, who has been involved in interRAI since 2002 and a fellow since 2008, told the conference that vulnerable people such as the elderly living at home were some of the top priorities in the immediate aftermath of the quake.

Having quick, secure access to their information through the interRAI protocol meant that those who had been assessed could be checked on by primary healthcare providers in a hurry.

“About 600 people were evacuated from rest homes and about 300 from residential care, but we had people at home,” Dr Millar told the conference. “We had old people at home.

“I’m part of the interRAI collaborative, which is an aged care assessment protocol for the country. It is standardised, organised and every aged care assessment in the country is done using that protocol.

“And I was able to send an email to a colleague in Canada, asking for help. He sent an email to someone in Wellington,

they worked overnight developing an algorithm, they interrogated the data and they gave us back a list of all of the people we had living at home who had been assessed, in order of risk.

“We had that in under 24 hours after the earthquake, including some people who had been assessed on the morning of the earthquake. That is live and that’s real. So we sent it out to the healthcare providers and said if you’ve got people on this list here are the high risk ones. It was great information in an emergency.”

Community and collaborative care The damage done to many of the residential aged care facilities meant residents could not move back in quickly, and with Christchurch Hospital stretched to the maximum, the earthquake also spurred on the introduction of another community-based program for older people.

Called the Community Rehabilitation Enablement and Support Team (CREST), this had been in the planning stages before the earthquake, and was aimed at helping older people to get out of hospital earlier and reduce admissions in the first place by providing coordinated at-home care or through the city’s rehab hospital, the Princess Margaret.

After the earthquake, the introduction of CREST was fast-tracked in order to care for older people in their homes and provide support through the city’s recovery, Dr Millar said.

“Life was complex after the earthquake but in a few hours we had things organised, we got the system back on its feet, but now we had a fragile system where things are broken. However, it

was the best opportunity. I don’t recommend earthquakes, but I recommend you pretending you have had one.

“We came up with a program called CREST, a simple program, hospital in the home, rehab, get you out of hospital, provide comprehensive care in the community… We started from zero and we had it going in three weeks, because people wanted to do it.”

CREST is the first phase in a wider roll-out of services and technologies under Canterbury’s Collaborative Care workstream.

Linking many aspects of this workstream is Project Chain, the introduction of HSAGlobal’s Collaborative Care Management Solution (CCMS), which is also being used in Auckland’s Shared Care Plan project.

CCMS will be used as the underlying technology to create shared care plans for patients with multiple chronic conditions and will bring together GPs, pharmacists, hospital specialists, hospital services and other community health providers.

Matt Hector-Taylor, managing director of HSAGlobal, describes the CCMS as a purpose-built shared care management product that is web-based, highly configurable, designed to integrate and built using industry standards. It has been developed using standard Microsoft interfaces to provide rich functionality and a familiar look and feel for users.

“Because of the earthquake the Canterbury region lost a number of acute care beds and residential aged care beds so they have a real shortage of capacity,” Mr Hector-Taylor says. “Project Chain is a group of targeted initiatives, all enabled by CCMS to help maintain the health of high-needs patients in the community.”

In addition to CREST, Mr Hector-Taylor says the project involves a medications management service for high-needs patients with complex medications requirements, and a variety of other “frequent flier” type initiatives. “Most importantly, Project Chain is looking to introduce long-term funding models to support integrated care, as well the technology enabler (CCMS) and new service delivery models,” he says.

Shared care view The earthquake has also spurred the introduction of an electronic shared care record viewer, or eSCRV. Based on Orion Health’s Concerto portal, the eSCRV is aimed at allowing healthcare providers access to patient records held in a number of different facilities.

In the immediate aftermath of the earthquake, the DHB faced a big struggle to get general practice back on track, Dr Millar said.

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“We ran into problems because GPs had really great systems but people were leaving Christchurch to get healthcare and there was no information on them.”

Dr Nigel Millar “But we ran into problems because GPs had really great systems but one of the problems was people were leaving Christchurch and Canterbury itself to get healthcare, but there was no information on them. So we came up with a concept about a month after the earthquake called the eSCRV – it is a response to the earthquake but it is more about getting the right healthcare to the right people at the right time.

“It is a shared care record view. It is a set of essential information, at the point of care. For hospital clinicians, GPs, pharmacists and nurses in the first instance. After-hours GPs, community nurses, emergency departments – it is accessible at these points of care with some access controls.”

The eSCRV is an opt-out program – patients who do not want to participate can opt-out quite easily – but while some patients might not want to participate, Dr Millar said the main hurdle to overcome was breaking down the barriers between different healthcare providers.

“We had to develop a control system that we call the matrix. This is where the fun started. We had a GP say, hang on, I’m not having a pharmacist look at a liver function test because they might give them liver tonic. “ “We said, say you are prescribing a medication that can affect the kidneys but the pharmacist can’t look at their renal function?

What about the hospital pharmacist, they have full access. It went through a process and in the end it turned out to be a bit of a row.

Everyone said it was about privacy, but what it was really about was changing things that made people feel uncomfortable.” eSCRV was up and running in July, with a modest set of data available. However, based on early feedback and expressions of interest, more than 90 per cent of Canterbury clinicians are expected to take part.

Flight control In addition to these initiatives, Christchurch Hospital itself had earlier introduced a patient flow and capacity planning program called CapPlan, developed by local company Emendo and which is also used at Royal Adelaide Hospital in South Australia.

Dr Millar likened the system to an airport flight control centre.

“We worked with a company called Emendo in Christchurch to develop a snapshot of the hospital, that tells you what is going on everywhere.

It updates every five minutes, it goes down to the ward level and the patient level. It sits in an operations room on the wall and we are running the hospital like we are running flight control for Air New Zealand.”

Together with the CapPlan system, an audit system specifically targeting hospital patients admitted for more than 10 days, and the initiatives introduced after the earthquake, Dr Millar said the DHB had achieved quite remarkable results.

“We’ve probably avoided about 10 to 18,000 admissions by having an acute demand program in the community, because we are working as one system,” he said. “We’ve taken out 1.5 million days of patient waiting, simply by reorganising our system. We took 70 to 100 bed days out a year by doing our project. We saved $1.1 million for about 10 hours staff time a week, and we’ve got more productivity.”

Dr Millar said the earthquake had taught the health system and those who work in it an awful lot, some of it tragic, some of it unintentionally amusing. People who insist on sticking to paper records rather than electronic due to perceived safety – electronic records aren’t accessible with no electricity, for example – learned a hard lesson. As did some clinicians who hadn’t allowed software updates for some time.

“When you have an earthquake everything moves and the medical records are at risk. Some of the people who don’t like electronic records and still have paper records … well, their building got a big red sticker on it and they can’t go back in. The records have to go to the dump with the rest of the building.

“In the hospital, we have some Microsoft products in the ED and they sit on PCs that run 24/7. So when the earthquake hit we lost power about seven times because the generators failed. When the PCs came back on, they said ‘please wait while we update’.

Some of them had a year’s worth of updates to do that would take hundreds of hours. It wasn’t funny at the time.”

Feature

GENOMICS AND THE PATIENT-LED REVOLUTION New Zealand’s Orion Health has grown from its early beginnings as a health integration vendor into a full-service eHealth provider almost two decades later. For founder and CEO Ian McCrae, the next decade will bring more growth for eHealth companies as a patient-led revolution, harnessed to the power of genomic information and device data, promises to radically change the delivery of healthcare globally.

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

Late last year, Orion Health purchased the Microsoft Amalga Hospital Information System (HIS), now known as the Orion Health HIS. Combined with Orion Health’s existing hospital solutions, the company is now able to provide a full hospital information system, including patient management, full electronic medical record, CPOE, end-to-end medication management, laboratory, pharmacy, radiology and back office functions.

When aligned to its existing electronic health record (EHR) solution, its clinical portal technology and its Rhapsody integration engine, Orion Health is now able to offer a comprehensive eHealth suite of solutions that rivals the offerings of some of the world’s largest players, including Epic, Cerner and CSC. For Ian McCrae, the founder and CEO of Orion Health, it means Orion Health’s solutions can be considered part of a “best of breed” option or as a fully integrated option – customers can choose one of the company’s products or the whole shebang.

And considering the company’s success in the US, where both Rhapsody and Orion’s EHR, or Health Industry Exchange (HIE) as it is known there, are widely used, he should be rather pleased that a New Zealand company has come so far.

There’s a long way to go, however, and for Mr McCrae, the challenge for the next decade lies in harnessing the power of what he, amongst others, believes will be a patient-led healthcare revolution, in addition to the remarkable power that will result from unravelling the secrets of the human genome. For a healthcare software company, the opportunities are endless.

“What we are starting to see and will become the norm over the next 10 years is a patient-led health revolution,” Mr McCrae says. “We have fluffed around with reorganising providers into different groups and there have been some gains there, but I think over the next decade, the patient has to become the centre of the health system, which they are not today.”

The great potential he sees for health IT companies in the next decade is two-fold: opening up personal health records to individual consumers and allowing them to take control of their own healthcare, along with assisting clinicians in their decisionmaking and care provision by managing, analysing and distributing data gleaned from structured clinical data, genomics and medical devices.

“The way we see it, is device data and genomics are going to have a big part to play in the future,” he says.

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Osborne, confirmed that the Orion Health clinical portal has been chosen as the single solution that will be used to provide a comprehensive clinical view of patient data in the country’s acute sector under its clinical workstation program. The clinical portal has also been chosen by the government of Northern Ireland to provide secure, web-based access from a single browser to patient information under its electronic care record plan, which Orion Health is also providing.

In Australia, the technology has been used to build the consumer and the provider portals for the PCEHR, as well as a recently announced trial by ACT Health to offer chronic care patients a portal to their care plans and healthcare information from Canberra Hospital. It is also being used to provide clinicians with a single view of the three clinical data repositories that NSW Health is building, one of which, a centralised imaging repository, is already available.

Ian McCrae

“The data created from devices and genomics doesn’t have a home. You are not going to put it into a GP system. With genomics, a short-run genome is four gigabytes, so there is a lot of data, and GP systems don’t have the ability to store that much information.

“And then once you have stored it you have to understand it, to see that a person has the [genetic] potential to develop this condition, and the device data is telling you that too. What does this all mean? The poor old GP, they are getting swamped as it is. Most of the systems out there, you type data and you get it back out again, you type more data in and you get more back. The big push for us – and the area that I find most interesting because I have a couple of engineering maths degrees – is actually analysing that data and providing suggestions.”

By suggestions, Mr McCrae says you are still reliant on doctors to use their training and clinical judgement, but data analysis will allow IT systems to provide recommendations and determine key trends among populations. “The patient is gaining weight quite quickly, which would suggest they are taking on fluid and there might be signs of another heart attack, so here are some interventions that you might suggest,” he says. “You are assisting the clinician to provide better healthcare outcomes.”

It is in the US and Canada, however, where Orion Health has long had its largest market. Its EHR technology was recently chosen

by Catholic Health Initiatives (CHI), the US’s second-largest Catholic healthcare system, to provide the cornerstone of the organisation’s $1.5 billion OneCare program to create a shared, universal health record for patients.

It was also recently named as one of six leaders in IDC’s MarketScape vendor assessment report, citing its relationship with more than 30 HIE customers worldwide and its relationship with 49 of the 50 US state departments of public health for biosurveillance and public health reporting. According to Chilmark Research, it is the leader in the HIE market overall in the US. Allied to the Amalga purchase and the success of its Rhapsody integration engine, Orion Health is sitting pretty. Mr McCrae says while in the past he was happy to be considered part of a “best of breed” option, where a hospital uses a range of different IT systems from different vendors, underpinned by an integration engine like Rhapsody, the addition of a full hospital option rounded off the company’s offering.

“We have three product offerings these days,” he says. “One is our integration engine, Rhapsody. We are a full vendor now for hospitals, so for example we do PAS, departmental software including radiology, laboratory, pharmacy, ERP, everything.

And the third area is the primary sector with electronic health records.”

Orion today

Orion in the future

While Mr McCrae was unable to comment when Pulse+IT spoke to him, the director of New Zealand’s Health IT Board, Graeme

While Orion Health will continue to promote its integration and full-line hospital solutions, the area that Mr McCrae sees his

company leading the world in is electronic health records. They will not, however, be the electronic health records we have come to know and love.

Australia’s PCEHR aside, most countries around the world are developing EHRs that clinicians can access but that patients often don’t get to see.

“Once you have an electronic health record that doctors and others can log on to, the next thing you create is a personal health record. You allow patients to log on to their medical record, which is a novel concept – allowing patients to get involved in their care!

The medical profession is taking a while to get used to it but it is happening.”

Mr McCrae admits it’s a hobby horse of his, but he does not agree with the idea that it is the doctor, rather than the patient, who controls the health record. He also doesn’t agree with building electronic health systems that better suit the providers rather than the patients.

“Ultimately you are going to serve specialised views to health providers, community health workers, eventually GPs, of a patient’s medical record rather than having little snippets all over the place that you can’t merge back together again. Even if you transfer a summary medical record around the place, the problem is that different doctors will say if the patient has diabetes they will use different codes and so then you have the problem of who is right.

“If you are building a clinical system to make people healthier, then you would not build a system with snippets all over the place.”

Ian McCrae

“Is it the family doctor, is it the doctor who saw them last, is it the emergency department who saw them yesterday, is it the specialist or the community health worker? They might all enter in slightly different codes, so then you need a human operator to look at them all and say the family doctor is right. Then you have to reconcile all of the drugs. It is just a nightmare.

“Basically if you are building a clinical system to make people healthier, which is what we are doing, I believe, then you would not build a system with snippets all over the place. That model was built for the providers, not for the patient.

“And the patients are going to win. They will vote with their feet. If a doctor says you can’t have your lab results then the patient will go down the road where they are a little more progressive.”

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Feature

CROSS-TASMAN COLLABORATION FOR CLINICAL COMMUNITIES

Australian company EpiSoft has developed a software platform that is being used by a network of specialist clinicians in Australia, New Zealand and Singapore to improve the management of patients with inflammatory bowel diseases. Called IBD.Net, the network is one of several clinical communities using EpiSoft to not only manage patients with chronic disease, but to facilitate multi-party clinical trials.

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

EpiSoft is a secure web-based electronic health record and clinical research software platform designed specifically for use by clinical communities of interest.

One of its first and certainly its most international clinical communities is a group of gastroenterologists and clinical nurse specialists that is working together to not only provide chronic disease management of patients with inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis, but also to enable a low-cost, high-value way of conducting clinical trials.

While it was initially targeted at research collaborators, IBD.Net now involves a number of specialists providing clinical care. The technology for IBD.Net is being used at 31 sites across Australia and New Zealand, with a new site recently launching in Singapore, bringing the total to 32.

For Jenny O’Neill, EpiSoft’s executive director and business development director, who wrote the specifications for the system and designed its interface, IBD. Net is exactly what the core product was designed for.

“We have developed a generic health record system that supports clinical research as well as clinical care, mainly

targeting particular diseases of interest rather than a broad health record,” Ms O’Neill says.

“It does have a broad health record capability but it’s really designed for the purpose of specialised care. It also supports prospective research and is a low-cost way for investigators to publish their clinical trial protocols and get other sites engaged in participating in their clinical trials.”

In New Zealand, IBD.Net involves clinicians from a number of organisations, including Christchurch District Health Board (DHB), Taranaki DHB, the Shakespeare Specialist Group in Milford, and the Hutt, Wellington, Auckland, Dunedin, Waikato and Middlemore hospitals. It is used by clinicians in six states in Australia as well as the new one in Singapore.

“Basically, EpiSoft supports chronic disease management of the patient in a secure partition of the system and it also supports clinical trials,” Ms O’Neill says.

“It also has a registry capability of deidentified data and benchmarking. So the clinicians have secure partitions where they can manage their own patients and they can benchmark data with each other in a range of different ways – they could

“This lets them manage their own patients while at the same time contributing to a de-identified data pool to benchmark outcomes against a much larger group of patients.”

Jenny O’Neill

do it across the whole group, within set groups that are defined by them, and within a clinical trial group.

eligibility forms. “The system pre-populates a PDF version of the forms with all necessary data,” she says.

“This lets them manage their own patients while at the same time contributing to a de-identified data pool to benchmark outcomes against a much larger group of patients.”

Benefits

How it works For the patients, the system’s visit cycle and treatment cycle planner automatically generates a cycle of future appointment dates and test requests. It reminds patients of appointments and requests for online completion of data by SMS. The treatment cycle planner also incorporates the recording of drug doses in accordance with the standard treatment regimen and a visible audit trail of messages sent to patients is available.

“It establishes protocols of treatment and sets up reminder schedules against a standardised treatment protocol,” Ms O’Neill says. “It can also incorporate requests for secure data capture from the patient as part of the clinician’s clinical workflow, so at a certain point in time, based on the protocol of the patient management, it can say this patient is due to send us a symptom diary, can you please get online and enter it.

“So we have patient secure data capture capabilities as well, which are really effective. They come into a temporary area that is then imported to the record after verification by the clinician.”

Online decision support algorithms have been developed to take complex clinical criteria and create a simple checklist to determine a recommended treatment pathway for a patient or to assess whether a patient is eligible for a particular treatment.

Ms O’Neill says this function is of particular benefit for clinicians with patients taking medication through Australia’s PBS or NZ’s PHARMAC system, as it automates the onerous task of filling out

The main benefit of using the system for the gastroenterologists is to provide a low-cost platform for clinical trial data management, Ms O’Neill says. “It combines the interest in research with their clinical care processes. That’s a key benefit and why we are targeting the specialist sector and the academic specialists, but not exclusively.”

For nurses, there are significant time-saving benefits, as the software has been designed to ensure that clinical workflows assist in saving time in clinical care of the patients.

For the patients, the main benefit is in an improved understanding of new treatments, but also the ability to move to a different specialist and take their records with them if they relocate.

“There have been a number of complete record transfers across states in Australia,” she says. “For example, there has been a patient looked after in WA under a professor of gastroenterology over there who transferred the care of their patient when they moved to Melbourne to somebody else.

“They were in a very significantly beneficial clinical trial for that patient, and that patient would have been lost to follow up but we were able to transfer all of their historical records plus their clinical trial information, so they just picked up where the other clinician had left off.”

EpiSoft is also being used by a Division of General Practice in Australia for data capture and reporting for its mental health services provision, along with indigenous chronic disease and a multidisciplinary network of gynaecologists, colorectal surgeons and urologists to undertake quality assurance on patients undergoing surgery for vaginal prolapse and stress incontinence.

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Feature

GP2GP INITIATIVE ACHIEVES EXPONENTIAL ADOPTION With over 375,000 patient files being transferred between general practices in New Zealand using traditional paper-based workflows, a group of software developers has collaborated with the support of Patients First to deliver an electronic alternative called GP2GP. First released in the middle of 2011, adoption rates are rapidly improving with practices at both ends of the transfer starting to benefit.

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

An initiative coordinated by Patients First, the Electronic Patient File Transfer project (GP2GP) was conceived to reduce the administrative burden and potential loss of clinical information that results when patients change general practices.

Patients First reports that over 375,000 patient files are transferred between general practices as patients move around New Zealand.

While the country is a recognised leader when it comes to the secure electronic transfer of clinical messages between healthcare organisations, until last year the goal of easily sending entire patient records between general practices using electronic methods remained elusive.

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, as a result of work undertaken by clinical software developers Houston Medical, Intrahealth, Medtech Global and MyPractice, each of which incorporated a common data exchange toolkit produced

by Health Alliance, it is anticipated that the vast majority of general practices will be able to use the GP2GP system, if indeed they don’t already have this capacity installed in their practice today.

HealthLink’s secure messaging service, which is widely deployed throughout New Zealand, is being used to encrypt and transfer the patient records

between practices as Clinical Document Architecture (CDA) messages. The CDA format allows the data contained within the message to be intelligently processed and imported by the ‘recipient’ clinical software, with information filed into the correct parts of the patient’s electronic record at their new practice.

Practices using GP2GP can eliminate the need to print off and compile entire patient records, and post them or pass them along to the patient to transfer to their new general practice. Under such workflows, the recipient general practice would either have to scan the record or file it along with their existing paper archives, in addition to entering all relevant patient demographics into their clinical system, an extra step that record transfers conducted using GP2GP can obviate.

While a simple idea conceptually and an obvious area for workflow improvement, variations in the four general practice clinical software products used throughout NZ and a previous lack of defined standards in this area meant that a significant amount of work needed to be undertaken before the vendors could deliver the GP2GP functionality.

In a guest editorial for Pulse+IT written at the conclusion of his company’s

development work for GP2GP [Issue 24, pp8], Derek Gower of Houston Medical summarised the undertaking as follows: “Over a 12-month period the vendors completed development, met for Connectathons, exchanged sample messages and found and squashed bugs.

As funding was provided through a fixed price contract, the project was delivered on budget. Although the same could not be said for the delivery date, a six‑month project rapidly became 12! The vendors put aside their normal competitive behaviour, as we all realised we had something to learn and something to share and if it was not a success we were all the joint losers.”

Adoption, uptake and looking to the future The GP2GP system has been live since the start of this year following some controlled testing in the latter half of 2011. However, according to Andrew Terris, Patients First program director, the majority of electronic patient record transfers have occurred

since Medtech Global made its GP2GP functionality available to practices.

“Medtech have only just come out with Release 20, which happened about three months ago,” Mr Terris says. “Given that Medtech have about 80 per cent market share, we’ve only really seen the numbers go up fairly rapidly in the last three months. Month-on-month transfers have pretty much doubled and we’re now seeing an exponential growth of usage.”

Patients First also reported the following statistics for the GP2GP initiative for the period January 1, 2012 to August 31, 2012: • 8710 patient files have been sent using GP2GP, with 4277 of these sent in August alone.

• 585 practices have used GP2GP, with 324 having sent patient records.

• 542 practices have received patient records via GP2GP. • 289 practices have sent more than one patient record and 181 have sent more than 10 patient records.

GP2GP: patient records transferred per month in 2012 Sent

Acknowledged

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“We’re pretty pleased with these figures and the feedback has largely been positive; the uptake speaks to that as well,” Mr Terris says. “It’s still version 1, so there’s still a few teething problems that we need to work through but we think it’s being adopted pretty rapidly and the GPs we’ve spoken to that are using it report that it is saving them a lot of time.”

He went on to explain the variations in the numbers of reports sent and the number of computer generated acknowledgements returned to the originating practice, as shown in the diagram below.

“Some files are being sent to practices that have not yet upgraded to the relevant version of their PMS that is GP2GP‑enabled. Where this is the case, the item appears at the receiving practice’s PMS inbox with a human readable version in the message; they just cannot import the structured data. As you see from the stats, the ‘tail’ is being picked up quite quickly.”

As part of the GP2GP project, a toolkit was developed that enables any structured information to be transported securely in CDA format between any of the general practice clinical systems. This toolkit (codenamed the Babel Fish) has already been leveraged for electronic transfer of prescriptions and eDischarge initiatives, and also for modelling summary records for use throughout the health sector.

“A useful bi-product of GP2GP is the rich dataset that’s been created, which is being taken into some of the HISO standards and is starting to evolve with the summary record work. For example, one of the things that emerged from the Christchurch earthquake was a realisation that they didn’t have a useful combined summary note that was able to be used across primary, secondary and pharmacy.

So they’ve taken a dataset that has used quite a lot of GP2GP for its clinical content, and are now presenting that in a unified view.”

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Feature

CLINICIANS SET THE CHALLENGE AT HINZ The head of New Zealand’s National Health IT Board, Graeme Osborne, and Bill Pascal of the Canadian Medical Association are two of the headline speakers at the 11th annual HINZ Conference and Exhibition, being held in Rotorua in November. New Zealand’s premier event for health IT will see clinicians throw down a challenge to vendors to move ideas into clinical practice.

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

Health Informatics into Clinical Practice is the theme of this year’s HINZ conference and it is an apt one considering the real effect health IT is now having on healthcare delivery globally. Health IT is not only becoming embedded in clinicians’ every day workflow, but its effects on consumers and patients is also becoming more noticeable.

Consumer feedback on the NZ National Health IT Board’s National Health IT Plan is therefore a timely part of the presentation that board director Graeme Osborne will deliver at HINZ 2012. In addition to details on the 2012 version of thep lan, Mr Osborne will release the findings of the board’s research into what consumers think of the plan. “[Consumers] are saying it all sounds really good but what does it mean for us?”

Mr Osborne says. “Who is going to hold it, what is it going to look like? There are still quite a lot of New Zealanders who ask us is there one big database that is going to be sitting in Wellington?”

Mr Osborne will present a tree diagram the board has constructed to help consumers and the healthcare industry in NZ as a whole understand how their health information hangs together. He will illustrate the diagram with several

examples, including how the country’s electronic medications reconciliation (eMR) program, which aims to allow clinicians to view an accurate list of patient medications, allergies and adverse drug reactions and compare this with prescribed medicines and documented allergies, is working. The eMR project is currently underway at Counties Manukau, Waitemata and Taranaki DHBs and is expected to go live in Auckland and one other DHB this year.

Also at speaking at the conference is Bill Pascal, chief technology officer for the Canadian Medical Association. He has spent the last 20 years assessing how innovation can help transform healthcare delivery and was one of the authors of the first national health IT strategy for Canada.

In particular, he will share his views on how technology is opening up a new era that will completely change healthcare.

Other keynote speakers at HINZ 2012 include Australia’s Emma Hossack, who will discuss privacy and health IT; Claudia Pagliari of the Centre for Population Health Sciences at the University of Edinburgh Medical School, who will discuss the value of telehealth; Marie Shroff, New Zealand’s Privacy Commissioner; and NZ’s Associate Minister of Health, Jo Goodhew.

Clinicians’ challenge One of the highlights of HINZ 2012 is the Clinicians’ Challenge, an annual competition to find potential technology solutions to solve an important and recurring problem that health professionals face in their daily practice.

HINZ asked clinicians to put forward day-to-day work-related challenges that they would like health IT vendors to help answer. A judging panel has chosen three of the challenges to present at the conference, covering the topics of improving the effective delivery of healthcare in a rural environment, supporting integrated care and self care, and testing the best ways to utilise new e-pad technology to improve productivity within hospitals.

The first challenge is from a rural GP who would like to streamline the process for issuing the standing orders for nurses and physicians’ assistants that allow them to prescribe certain medications for routine and simple conditions. The submitting clinician describes the process as cumbersome, and would like vendors to meet the challenge of creating a database of drugs that could be supplied and administered under standing orders, as well as a software program that could be embedded within a practice management system or on a stand-alone secure website linked to the PMS. The idea would be to enable a standing order to be generated and edited on an online template by selecting each element from drop-down menu.

The second challenge asks vendors to develop an IT system to streamline nephrology referrals from primary and secondary care. The idea is to help to identify and refer patients with chronic kidney disease (CKD) who are at high risk of developing end stage renal disease (ESRD). The clinician envisages that the system will use an established risk prediction model for progression to ESRD in patients with moderate to severe CKD. The third challenge is a fascinating one. It asks the vendor community to come up with a way of improving ward round note-taking via mobile devices in real time. According to the submission, taking notes that automatically link to the hospital’s electronic medical record can be time-consuming and interrupt team efficiency, as one person has to type the note into the device using a portable keyboard or touch screen.

According to the submission, the clinician is advocating “the development of a system based on ‘operational transformation’ technology as seen in commercial products like Google Wave and Etherpad”. These products “allow several simultaneous users to edit a ward round or admission note in real time, for instance one recording the history while another records examination findings

and a third corrects errors. The system should also allow for easy template-based content creation, freeform graphic insertion, and be based on open web HTML5 technologies to be compatible with a broad range of tablets, phones and traditional computers.”

The Clinicians’ Challenge, which is supported by HINZ, the New Zealand Health IT Cluster and the National IT Health Board, will involve three selected vendors and the three clinicians who put forward the challenge to give a five-minute presentation to the judges at HINZ. The winners are expected to finish their proposal

by September 1, 2013, and to present their findings at next year’s HINZ conference. Winners will be judged on innovation, feasibility, potential health benefits and the effective use of health workers.

Scientific papers NZ’s National Shared Care Plan program initially involved eight general practices in greater Auckland and several disease specialties, along with pharmacists and community care services.

The technology underpinning the program is HSAGlobal’s Collaborative Care Management Solution (CCMS), a web-based electronic health record and clinical case management solution that is integrated with My Practice, Medtech32 and secondary care systems to support care planning and co-ordination.

Not surprisingly, this project has raised a great deal of interest in New Zealand and beyond. At HINZ 2012, PhD student Helen Gu of the University of Auckland will deliver a paper reporting on the experiences and lessons learned to date from the staged implementation of IT-enabled shared care planning. The paper will outline some observations of the trial and highlight the need for further development in technology and in governance frameworks, including medico-legal, clinical workflows and funding models.

Primary care information architect at Patients First and eHealth standards specialist Peter Jordan will discuss the challenges of implementing the HL7 CDA standard in practical applications. He will examine the development and use of common data models and the NZ CDA Toolkit to generate and consume CDA documents from practice management systems.

Sheree East, director of nursing with Canterbury’s Nurse Maude community nursing service, will discuss the results of a 12-month trial of using Microsoft Dynamics CRM as a fully electronic clinical documentation system in the community setting.

The HINZ Conference and Exhibition will be held at the Energy Events Centre in Rotorua from November 7 to 9. Register online at www.hinz.org.nz

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Advantech

3M Health Information Systems P: +61 2 9498 9499 F: +61 2 9498 9377 E: gharris@mmm.com W: www.3m.com.au/his 3M Health Information Systems is a leading provider of software solutions to help healthcare organisations capture, classify, and utilise data — accurately and efficiently.

With more than 28 years of experience in health information management, 3M offers integrated solutions for: • Coding, Grouping and Reimbursement • Document Management and Scanned Medical Records, providing: ◊ Access anytime to complete patient history ◊ Intuitive, customisable document viewing ◊ Automated worklists ◊ Electronic signature • Dictation and Transcription, providing: ◊ Reduced dictation time ◊ Increased accuracy ◊ Lower transcription turn‑around‑time ◊ Seamless integration with PAS and EHR systems

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

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

Secretariat contact: Joan Edgecumbe j.edgecumbe@ehe.edu.au

P: 1300 308 531 F: +61 3 9797 0199 E: info@advantech.net.au W: www.advantech.net.au Advantech’s medical computing platforms are designed to enhance the quality and efficiency of healthcare for patients and users alike. All of Advantech’s medical PCs match the performance of commercial PCs but are medically rated to UL/EN 60601-1 third revision, IPX1 drip‑proof enclosures and are designed to suit ward and theatre based applications.

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

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

• Mini-PC and Medical Imaging Displays.

• Mobile Medical Tablets.

• Computerised Medical Carts.

• Patient Infotainment Terminals.

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

Australasian College of Health Informatics P: +61 448 355 338 F: +61 3 9288 4174 E: Secretary@ACHI.org.au W: www.ACHI.org.au The Australasian College of Health Informatics is Australasia’s Health Informatics professional body, representing the interests of a broad range of clinical and non-clinical e-health professionals. ACHI is the community of Health Informatics thought-leaders in Australasia.

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

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

Argus ACSS

AAPM P: 1800 196 000 / +61 3 9095 8712 F: +61 3 9329 2524 E: headoffice@aapm.org.au W: www.aapm.org.au The Australian Association of Practice Managers (AAPM) is a not for profit, national peak association founded in 1979, dedicated to supporting effective practice management in the healthcare sector.

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

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

• Provides specialised services to support quality practice management including advocacy, education, resources, networking, advice and assistance.

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

P: +61 3 5335 2220 F: +61 3 5335 2211 E: argus@argusconnect.com.au W: www.argusdca.com.au Argus provides and supports Argus secure messaging software; a popular electronic solution that enables healthcare practitioners to exchange pathology, radiology and specialist reports, hospital discharge summaries, referrals and clinical data securely and reliably.

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

Argus is the messaging solution chosen by 65 Divisions of General Practice through the ARGUS AFFINITY program. With over 12,800 users Argus continues to grow in popularity by delivering a highly secure message, reliable product, backed by outstanding customer service all at the lowest cost possible.

Best Practice P: +61 7 4155 8800 F: +61 7 4153 2093 E: sales@bpsoftware.com.au W: www.bpsoftware.com.au Best Practice sets the standard for GP clinical software in Australia offering a flexible suite of products designed for the busy GP practice, including: • Best Practice Clinical (“drop-in” replacement for MD) • Integrated Best Practice (Clinical/ Management) • Best Practice Automatic SMS reminders Visit us at the following conferences throughout the year: • AAPM National Conference Brisbane, 23 - 26 October • ACRRM Fremantle, 25 - 28 October • AGPN Adelaide, 10 - 14 November • GPCE Melbourne, 16 - 18 November

cdmNet P: +61 3 9023 0800 F: +61 3 9614 2650 E: info@precedencehealthcare.com W: www.precedencehealthcare.com Chronic Disease Management just got a whole lot easier cdmNet simplifies team-based care for the estimated 30% of patients in general practice who qualify for MBS Chronic Disease Management Items. cdmNet minimises the bureaucracy, eliminates the paperwork and helps ensure compliance with Medicare requirements If you wish to use cdmNet to provide high quality care* for your chronic disease patients while increasing your revenues, contact us now. * See cdm.net.au/evidence

Cerner Corporation Pty Limited

Clintel Systems P: +61 8 8203 0555 E: info@clintel.com.au W: www.clintel.com.au The Specialist: A complete solution for your Appointments, Billing including Online Claiming and Clinical requirements in an intuitive scalable solution.

Clintel provides systems to Specialist and Day Surgeries nationally. Powerful, highly configurable and easy to use, our systems mirror the needs and workflow of your practice and individual specialty.

Our industry standard SQL database enables a true “paperless” practice.

Our leading edge architecture is future proof, it is designed to meet changing requirements and offers first class reporting and analysis of clinical and business data. Standalone or networked multi-site installation which runs on both Mac OSX and Windows operating systems.

Our support is first class, our philosophy is “whatever it takes”.

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.

P: +61 2 9900 4800 F: +61 2 9900 4990 E: AsiaPacific@cerner.com W: www.cerner.com.au Cerner is one of the leading global suppliers of health care information technology solutions. Cerner’s mission is to contribute to the systematic improvement of health care delivery and the health of communities.

Our vision of proactive health care management drives innovation in the development of effective solutions for today’s health care challenges, while creating a foundation for tomorrow’s health populations. Working with more than 4000 clients worldwide, Cerner is solving health care’s many challenges making sure the right people have the right information at the right time.

Our innovative leadership is allowing us to push boundaries by: • Leveraging clinical and pharmaceutical data in Condition Management and Personalised Medicine • Connecting the community with personal and community health records

CSC’s HealthCare Group P: +61 2 8035 6700 F: +61 2 8035 6801 E: healthsolutions@csc.com W: www.csc.com/healthsolutionsAPAC Healthcare is key part of CSC’s global business. It has a strong track record of delivering successful government health programs across Europe and in both the public and private healthcare sectors in the US. Focused on eHealth, CSC’s Healthcare Group provides an end-to-end service combining technology innovation, world-class consulting and system integration services with proven healthcare software.

In the Asia Pacific region, CSC provides localized solutions to improve: patient flow, access to clinical information, medication safety and pathology diagnostics. CSC participates in regional government health information exchange initiatives to connect care across care environments and to enable clients to leverage existing e-health investments. For more information, visit the Healthcare Group’s Asia Pacific website at www. csc.com/healthsolutionsAPAC

Direct Control P: 1300 557 550 F: +61 7 5478 5520 E: support@directcontrol.com.au W: www.directcontrol.com.au Direct CONTROL is an affordable, intuitive and educational Medical Billing and Scheduling application for Practitioners of all Disciplines.

Seamless integration with Outlook, MYOB or Quickbooks. Direct CONTROL’s Clinical Module manages Episodes of Care and includes State, Federal and Health Fund Statistical Reporting for Day Surgeries/Hospitals.

Direct CONTROL facilitates Medical Billing Australia-wide and overseas.

Included is all Medicare, DVA, Work Cover, Private Health Insurance fee schedules with built in rules relevant to each medical discipline (allied health, general practice, surgeons, physicians, anaesthetists, pathologists, radiologists, day surgeries/hospitals).

Ideal for the single practitioner or the multidisciplinary Practice.

Digital Medical Systems P: 1300 865 977 F: +61 3 9753 3049 E: inform@dgs.com.au W: www.dgs.com.au Easier ICT is a technology partnership with DMS — we make I.T. work for you.

DIGITAL MEDICAL SYSTEMS has provided ICT solutions and services to medical practice clients across Australia since 1990. We have specialist expertise and experience in the installation and support of leading medical software applications.

DMS is a Business Partner for IBM, Lenovo, HP and Microsoft. Other leading ICT brands include Trend Micro, Symantec, CA, Cisco, Toshiba, Canon, Epson, Kyocera, Fujitsu and Brother.

Accreditation is easier with the customised DMS IT Systems Documentation. Ensure your practice has the best quality IT policy, security and maintenance program that meets and exceeds the standards guidelines from the RACGP and AGPAL and GPA. World leading DTech provides 24x7 near Real-Time Monitoring and Management that alerts and enables our engineers to quickly troubleshoot and solve problems of security, network, Internet, Server and software remotely on almost any client computer system or device. Medical IT systems are automatically maintained by DTech to the most highly available status to minimize downtime by preventing problems from occurring or reducing their impact.

Proactive, Flexible, Consistent, Reliable, Audited, and Affordable — for even the smallest practice.

Call DMS for: • Systems Analysis & Consulting • Solutions Design • Procurement & supply of hardware, software, network and peripheral products • Installation & Configuration • Support Services inc Help Desk • DTech Monitoring, Maintenance & Management • Disaster Recovery solutions • Fully managed & automated Online Backup customised for clinical data Easier IT — we make I.T. work for you.

Direct CONTROL supports ALL your Business needs letting you and your staff get on with earning a living doing what you enjoy most … Patient Care.

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Emerging Systems P: +61 2 8853 4700 F: +61 2 9659 9366 E: sales@emerging.com.au W: www.emerging.com.au/ehealth

Doctors Control Panel E: www.pracsoftutilities.com W: PSU_admin@pracsoftutilities.com • Download and trial DCP software for GPs and health teams.

• DCP is your digital PA and guidelines advisor.

• DCP facilitates TCA, GPMP and MHCP creation and tracking.

• Contains guidelines licenced from RACGP. • Low annual subscription.

• The best preventive care add-on software in Australia.

• Compatible with MD3 and BP. • Achieve new heights in preventive care performance.

• Significant benefit for patients.

• Increase your revenues.

• Streamline your workflow.

• 3000 current users.

• Several research projects based on DCP. • Try it today.

eHealth Security Services P: 1300 399 116 / +61 2 9016 5378 F: +61 2 9016 5379 E: info@ehealthsecurity.com.au W: www.ehealthsecurity.com.au eHealth Security Services (eHSS) specialises in the provision of security as a service and offers an extensive range of Managed IT Services including IT Support for small to medium businesses in the health sector. eHSS’ MediAccess® service provides comprehensive and cost-effective managed security and remote access solutions. eHSS has thorough knowledge and understanding of IT matters in the health industry and its regulatory aspects. eHSS has extensive experience reviewing and assisting with organisational policies and procedures and technical implementations against applicable standards.

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Emerging Systems EHS web-based Clinical Information System records the clinical care delivered to a patient from pre-admission through to discharge. EHS interfaces with the hospital’s PAS system, capturing and providing all of the information Clinicians require during a patient stay to support the delivery of effective, appropriate, quality care outcomes in a secure and auditable environment.

Information is displayed in a user friendly single pageview for easy access by to information by clinicians.

Importantly, EHS links Clinical Care with Workforce Rostering and Staff Allocation allowing for predictive Resource Allocation based on the care required, enabling valuable productivity improvements.

EHS is a proven and highly useable electronic medical record (EMR) developed within Australia and operating successfully in St Vincents & Mater Health, Sydney and Government of South Australia, Department of Health Hospitals.

EHS provides:• Pre-Admission • Patient History • Orders & Results • Clinical Care Guides • Assessments • Progress Notes • Referrals • Labour & Birth • Medications Reconciliation • Clinical and Non Clinical Messaging • Discharge Summaries • Appointments • Rostering & Allocation • GP Connect • Workforce Resource Calculation • Document Management System • Clinical Dashboard and more EHS supports interactions with the health identifier service and PCEHR. The extensive list of modules work seamlessly with other systems via our integrated interface engine which accepts HL7 and other accepted Health IT standard protocols complying with the Australian Technical Specification: ATS 5822:2010 eHealth Secure Message Delivery.

Accessibility: EHS is accessible on a range of devices according to user preference including our latest iPad application.

Extensia P: +61 7 3292 0222 F: +61 7 3292 0221 E: enquiries@extensia.com.au W: www.extensia.com.au Extensia links healthcare providers, consumers and their communities for better and more efficient health care.

The products used to do this can be custom branded for all Organisations and include: • RecordPoint – a proven Shared Electronic Health Record that links all clinical systems, hospital settings, care plan tools and any other sources of information available. It provides a secure means of sharing critical patient data in a privacy compliant and logical structure.

• EPRX – an Electronic Patient Referral Exchange and Directory. It streamlines the process of selecting a provider and completing a referral.

Patient information is transferred seamlessly from clinical software. The most relevant providers, services and products are presented instantly and referral documents are generated and sent electronically.

Genie Solutions P: +61 7 3870 4085 F: +61 7 3870 4462 E: info@geniesolutions.com.au W: www.geniesolutions.com.au Genie is a fully integrated appointments, billing and clinical management package for Specialists and GPs. Genie runs on both Windows and Mac OS X, or a combination of both. With over 2500 sites, it is now the number one choice of Australian specialists.

GPA P: 1800 188 088 F: 1800 644 807 E: info@gpa.net.au W: www.gpa.net.au GPA ACCREDITATION plus (GPA) is the only independent accreditation program for general practice in Australia.

Established in 1998 and run by a team of committed general practitioners, business leaders and experienced administrators, GPA has developed a program that continuously evolves in order to set new standards in general practice accreditation, while offering full support to practices to make accreditation both achievable and rewarding.

GPA is committed to providing an accreditation program, which is flexible and understands the needs of busy GPs and practice support staff. Whilst accreditation gives practices access to the Practice Incentive Program (PIP), GPA believes it should offer benefits that go well beyond the PIP. Our program provides practices with a pathway to enhanced patient care, continuous professional satisfaction, improved practice efficiency and superior risk management. GPA ACCREDITATION plus certificates and signage remind patients that their practice has achieved a level of care and service above and beyond essential general practice standards.

GPA provides a system designed to accommodate busy general practices.

Among our services, we offer practices the opportunity to use technologicallyadvanced, environmentally-friendly online programs, allowing staff to upload documentation at their own pace; individually assigned client managers, supporting practices through accreditation from start to success and beyond; highly-trained and sensitive surveyors, with extensive experience in all facets of general practice; and interactive training seminars, bringing practices the latest information in standards and innovation.

At GPA, we believe that accreditation should be an accomplishment, not a test, and we uphold that belief in our approach and service. For an accreditation program that will offer you assistance, support, information and satisfaction…the choice is yours.

Houston Medical Healthbank Consult P: 1300 856 722 F: 08 8301 4001 E: support@healthbankconsult.com.au W: www.healthbankconsult.com.au Healthbank Consult is a telehealth system developed in Australia for Australian healthcare providers.

Secure, fully encrypted and HD capable, Healthbank Consult is designed to be compatible with your clinical desktop for easy integration with your practice’s workflow and retains an audit trail for Medicare.

Compliant with RACGP telehealth guidelines, Healthbank Consult will qualify Rural GPs, Specialists, Aged Care Facilities and Aboriginal Medical Services for a $4,800 Medicare telehealth rebate plus ongoing fees.

Health Informatics New Zealand

Health Communication Network (HCN) is the leading provider of clinical and practice management software for Australian GPs and Specialists and supplies Australia’s major hospitals with online Knowledge resources.

HCN focuses on improving patient outcomes by providing evidence based software tools to health care professionals at the point of care.

Market snapshot: • 17,000 medical professionals use Medical Director • 3,600 GP Practices use PracSoft • 800 Specialist Practices use Blue Chip and • 2,100 Specialists use Medical Director • Leading suppliers of Knowledge Resources to Australia’s major hospitals

“We provide time to health professionals through efficient practice management software”

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

The Executive Committee works to maintain the purpose and service for the members, through dynamic goals of improved healthcare outcomes through the dissemination and utilisation of information, knowledge and technology.

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

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

Health Communication Network P: +61 2 9906 6633 F: +61 2 9906 8910 E: hcn@hcn.com.au W: www.hcn.com.au

P: 1800 420 066 (AU) P: 0800 401 111 (NZ) E: info@houstonmedical.net W: www.houstonmedical.net

Health Information Management Association Australia P: +61 2 9887 5001 F: +61 2 9887 5895 E: himaa@himaa.org.au W: www.himaa.org.au The Health Information Management Association of Australia (HIMAA) is the peak professional body of Health Information Managers in Australia.

HIMAA aims to support and promote the profession of health information management.

HIMAA is also a Registered Training Organisation conducting, by distance education, “industry standard” training courses in Medical Terminology and ICD-10-AM, ACHI and ACS clinical coding.

HISA is Australia’s health informatics organisation. We have been supporting and representing Australia’s health informatics and eHealth community for almost 20 years. HISA aims to improve healthcare through the use of technology and information. We: • Provide a national focus for eHealth, health informatics, its practitioners, industry and a broad range of stakeholders • Support, promote and advocate • Provide opportunities for networking, learning and professional development • Are effective champions for the value of health informatics HISA members are part of a national network of people and organisations building a healthcare future enabled by eHealth. Join the growing community who are committed to, and passionate about, health reform enabled by eHealth.

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

InterSystems

Health Informatics Society of Australia P: +61 3 9326 3311 F: +61 3 8610 0006 E: hisa@hisa.org.au W: www.hisa.org.au

Our multidiscipline software provides interfaces to every major manufacturer, enabling many clinics to save space by becoming completely paperless!

HealthLink P: 1800 125 036 (AU) P: 0800 288 887 (NZ) E: enquiries@healthlink.net W: www.healthlink.net Australia’s and New Zealand’s largest effective secure communication network.

• Referrals, Reports, Forms, Discharge Summaries, Diagnostic Order and Reporting • Provider of Secure Messaging Delivery (SMD) services • Fully integrated with leading GP and Specialist clinical systems • Robust; Reliable and Fully Supported Join the network that more than 70 percent of GPs use for diagnostic, specialist and hospital communications.

P: +61 2 9380 7111 F: +61 2 9380 7121 E: anz.query@InterSystems.com W: www.InterSystems.com InterSystems Corporation is a global leader in software for connected care, with headquarters in Cambridge, Massachusetts and offices in 25 countries. InterSystems TrakCare™ is an Internet‑based unified healthcare information system that rapidly delivers the benefits of an Electronic Patient Record. InterSystems HealthShare™ is a strategic healthcare informatics platform for information exchange and analytics within a hospital network, and across a community, region or nation.

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.

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Medtech Global Ltd ISN Solutions P: +61 2 9280 2660 F: +61 2 9280 2665 E: info@isnsolutions.com.au W: www.isnsolutions.com.au ISN Solutions is a Medical IT company that specialises in the design, setup and maintenance of computer networks for medical practices and private hospitals.

We manage IT services, we are dedicated to the medical industry.

We know that if you are consulting then you need a quick response.

Our support model is designed to minimise the interruptions to the doctor specially. We are familiar with most medical software applications in Australia. We have strong industry references.

Some of our solutions include, but are not limited to: • Cloud based computing tailored to medical industry • Medical voice recognition • Capped cost medical support and maintenance plan • Ability to consult remotely • Medical application support

Mouse Soft Australia Pty Ltd

For over 28 years, Medtech Global has been a leading provider of health management solutions to the healthcare industry enabling the comprehensive management of patient information throughout all aspects of the healthcare environment.

MITS:Health

P: +61 3 9888 2555 F: +61 3 9888 1752 E: sales@medicalwizard.com.au W: www.medicalwizard.com.au

Medtech’s Medtech32 and Evolution solutions improve practice management and ensure best practice for electronic health records management and reporting.

P: 1300 700 300 E: info@mitshealth.com.au W: www.mitshealth.com.au

Medical Wizard saves time and money through greater efficiency and comprehensive integration.

Managed IT Services for the Health Industry

Throughout its 19 year history, Medical Wizard has led the way with innovative solutions. We are constantly evolving Medical Wizard to meet the challenges of the medical profession for today and tomorrow.

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.

MIMS Australia

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

P: +61 2 9902 7700 F: +61 2 9902 7701 E: info@mims.com.au W: www.mims.com.au

A Worldwide Leader in Health Care Information Systems

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.

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MITS:Health provides a full range of IT services specifically tailored for medical centres, GPs and specialists across Melbourne.

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

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

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

Feature Rich. Dynamic. Innovative.

MEDITECH Australia

MEDITECH today stands at the forefront of the health care information systems industry. Our products serve well over 2,300 health care organisations around the world. Large health care enterprises, multi‑hospital alliances, teaching hospitals, community hospitals, rehabilitation and psychiatric chains, long-term care organisations, physicians’ offices, and home care and hospice agencies all use our Health Care Information System to bring integrated care to the populations they serve. Our experience, along with our financial and product stability, assures our customers of a long-term information systems partner to help them achieve their goals.

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P: 1800 148 165 E: salesau@medtechglobal.com W: www.medtechglobal.com

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

Medical Software Industry Association P: +61 427 844 645 E: ceo@msia.com.au E: president@msia.com.au W: www.msia.com.au With the increase in government e-health initiatives, the MSIA has become increasingly active in representing the interests of all healthcare software providers.

The MSIA is represented on a range of forums, working groups and committees on behalf of its members, and has negotiated a range of important changes with government and other stakeholders to benefit industry and their customers. It has built a considerable profile with Government and is now acknowledged as the official ‘voice’ for the industry.

Join over 100 other companies across all areas of medical IT/IM so your voice can be heard.

NEHTA P: +61 2 8298 2600 F: +61 2 8298 2666 E: admin@nehta.gov.au W: www.nehta.gov.au The National E-Health Transition Authority was established by the Australian, State and Territory governments to develop better ways of electronically collecting and securely exchanging health information. NEHTA is the lead organisation supporting the national vision for eHealth in Australia.

New Zealand Health IT Cluster P: +64 4 815 8177 E: admin@healthit.org.nz W: www.healthit.org.nz The New Zealand Health IT Cluster is a vibrant alliance of organisations interested in health IT, comprising software and solution developers, consultants, health policy makers, health funders, infrastructure companies, healthcare providers, and academic institutions – who have agreed to work collaboratively.

• New Zealand industry is consistently well regarded in providing quality, relevant solutions domestically and in offshore markets.

• New Zealand has an internationally regarded model of partnership that fosters development of innovative solutions to healthcare challenges.

• In key and emerging markets the New Zealand health IT brand is strongly recognised. By 2015 sales growth is doubled from the 2010 baseline.

OzeScribe

Shexie Medical System

P: 1300 727 423 F: 1300 300 174 E: sales@ozescribe.com.au W: www.ozescribe.com.au

P: 1300 743 943 F: 1300 792 943 E: info@shexie.com.au W: www.shexie.com.au

OzeScribe is the dictation and transcription solution for most Australian university teaching hospitals and major private clinics. It really does make sound business sense to let OzeScribe worry about managing dictation, transcription and technology.

We provide free electronic document delivery – OzePost – to your EMR and your associates’ EMR, saving you thousands of dollars in time, packing and postage.

OzeScribe is the provider of the most advanced solutions available.

• Run by doctors – for doctors.

• Australian trained typists.

• Manage dictation and transcription via computers, iPhone, iPad, android or smartphones.

• Integrated M*Modal speech recognition technology on demand.

Medilink from Practice Services P: +61 3 9819 0700 F: +61 3 9819 0705 E: Sales@practiceservices.com.au W: www.practiceservices.com.au Medilink Practice Management Software • 21 years young, large user base • Medilink = Intuitive ease of use • Solo Drs up to Hospitals in size • Claiming via integrated EFTPOS ◊ and/or integrated HICAPS ◊ and/or Medicare Online ◊ and/or ECLIPSE • Many standard features • Many optional modules • Links to many third party packages and services • Cut debtors and boost cash flow • 17 years as an Authorised Medilink Dealer, selling, installing & training • Fixed Cost Support, Onsite or Remote

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.

Pen Computer Systems 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.

P: +61 2 9635 8955 F: +61 2 9635 8966 E: enquiries@pencs.com.au W: www.pencs.com.au Established in 1993, Pen Computer Systems (PCS) specialises in developing information solutions for National and State eHealth initiatives in Primary Health that deliver better Chronic Disease outcomes.

PCS expertise extends to: • Chronic Disease Prevention and Management • Population Health Status, Reporting and Enhanced Outcomes • Decision-Support tools delivered LIVE into the clinical consult • Web-based Electronic Health Records (EHRs) • SNOMED-CT and HL7 Standards Frameworks Our Clinical Audit Tool (CAT) for example delivers an intuitive population reporting and patient identification extension to the leading GP systems in Australia. CAT delivers enhanced data quality and patient outcomes in general practice.

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.

Stat Health Systems (Aust) P: +61 7 3121 6550 F: +61 7 3219 7510 E: carla.doolan@stathealth.com.au W: www.stathealth.com.au Stat Health Systems (Aust) has built a progressive and resilient system that introduces a new level of stability and flexibility to the medical software market.

Stat is an integrated clinical and practice management application which has embraced the latest Microsoft technology to build a new generation solution. Fully scalable and the only medical software application to incorporate a multi-functional intuitive interface, Stat is at the forefront of computing technology.

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

Facebook: facebook.com/StatHealth Twitter: @NotifyStat

Talk with us today about the future of your practice!

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Sysmex New Zealand P: +64 9 630 3554 F: +64 9 630 8135 E: info@sysmex.co.nz W: www.sysmex.co.nz Sysmex New Zealand is a market leader in the development and implementation of health IT products and services for clinical laboratories, hospitals and healthcare organisations.

We offer the following health IT solutions: • Delphic LIS – a market-leading laboratory information system for hospital and community laboratories with a strength in providing multi-lab solutions.

Specialised modules manage workflows in the anatomical pathology, haematology and microbiology work areas.

• Eclair – an advanced clinical data repository (CDR) which stores patient data from a range of systems including laboratory, radiology, pharmacy and clinical document sources to create a secure patient-centric record.

Eclair provides complete electronic ordering functionality.

Totalcare P: +61 7 3252 2425 F: +61 7 3252 2410 E: sales@totalcare.net.au W: www.totalcare.net.au Totalcare is a fully integrated Clinical, Office and Management software suite designed to suit the particular needs and processes of healthcare providers. Used since 1995 by health care facilities across Australia including General and Specialist practice, Radiology, Day Surgery and Hospitals, Totalcare is stable, scalable, customisable and easy to learn and use. From a small practice to a multisite, multi-disciplinary corporate entity or hospital, Totalcare can provide solutions for your needs.

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Admissions / Appointments Billing Statutory Reporting Integrated SMS Prescriptions Orders & Reports Clinical Notes Letter/Report Writing, Document and Image Management • Scanning and Barcode recognition • Video and Image Capture • HL7 Interfaces

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TrendCare

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Therapeutic Guidelines Ltd

Trend Care Systems

P: 1800 061 260 E: sales@tg.org.au W: www.tg.org.au

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

Therapeutic Guidelines Limited is an independent not-for-profit organisation dedicated to deriving guidelines for therapy from the latest world literature, interpreted and distilled

by Australia’s most eminent and respected experts.

These experts, with many years of clinical experience, work with skilled medical editors to sift and sort through research data, systematic reviews, local protocols and other sources of information, to ensure that the clear and practical recommendations developed are based on the best available evidence. eTG complete Incorporates all topics from the Therapeutic Guidelines series in a searchable electronic product, and is the ultimate resource for the essence of current available evidence.

It provides access to over 3000 clinical topics, relevant PBS, pregnancy and breastfeeding information, key references, and other independent information such as Australian Prescriber (including Medicines Safety Update), NPS Radar, NPS News and Cochrane Reviews. eTG complete is available in a range of convenient formats – online access, online download, CD, and intranet access for hospitals. Multi-user licences, ideal for a practice or clinic, are also available.

It is widely used by practitioners and pharmacists in community and hospital settings in all Australian states and territories.

Updated three times per year, eTG complete meets the criteria for ‘key electronic clinical resources’ in the Practice Incentives Program (PIP) eHealth Incentive.

The November release of eTG complete will include revisions of the Cardiovascular and Analgesic topics, with Management Guidelines: Developmental Disability 3 available to subscribers as an ebook. miniTG The mobile version of eTG complete is miniTG, offering the convenience of having vital information at the point of care and designed for health professionals who practise and consult on the move. It is supported on a wide range of mobile devices, including Apple®, Pocket PC®, and selected Blackberry® devices.

Vensa Health P: +64 9 522 9522 F: +64 9 522 9523 E: website@vensahealth.com W: www.vensahealth.com

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

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

• Projecting patient throughput and workforce requirements.

• Rostering and work allocation.

• Efficiency, productivity and HRM reporting.

• Discharge analysis, bed management and clinical handovers.

• Allied health registers with extensive reporting.

• Clinical pathways with variance reporting.

• Patient assessments and risk analysis.

• Diet ordering and reporting.

• Staff health tracking and reporting.

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VConsult P: 1300 82 66 78 F: 1300 66 10 66 E: admin@vconsult.com.au W: www.vconsult.com.au VConsult offers outsourced practice management solutions for medical and allied health practitioners allowing the focus to be on your professional practice and patient care. VConsult provides a seamless “behind the scenes” service by professionally managing your telephone calls, reception, invoicing and medical transcription requirements.

VConsult is perfect for your practice if you are: • Setting up, already established or winding down in Private Practice • Working in a public appointment and want to portray a professional image • Looking to minimise your overhead costs • Requiring your patient calls to be answered by a professional and experienced medical receptionist.

Vensa Health is the leading mHealth solutions provider focusing on delivering mobile health innovations worldwide. If you have received an SMSfrom your doctor, hospital or physio it is almost certain Vensa Health was responsible for its delivery.

At Vensa we are focused on offering solutions and innovations, which add value to our clients, this is the fundamental philosophy underpinning all of our services and technology offerings.

With nearly 80% adoption of mobile health in New Zealand and a solid customer base, Vensa Health is focusing on Australasia and Middle East regions in its expansion with a BHAG of closing the gap for 10% of earth’s population health.

Zedmed P: 1300 933 000 F: +61 3 9284 3399 E: sales@zedmed.com.au W: www.zedmed.com.au Owned by Doctors who understand the challenges facing the medical profession every day and backed by 34 years of experience in medical software, Zedmed office and clinical is designed to be simple, intuitive and seamlessly integrated.

Zedmed would also like to introduce to you Medical Record Exchange – a free, simple solution allowing Doctors to send patient’s medical information to insurance companies electronically.

Using the latest in data extraction technology and fully encrypted, this is a secure, time-saving solution to one of the most dreaded requests Doctors receive on an almost daily basis.

For more information about Medical Record Exchange, please contact us: Phone: 1300 933 833 www.medicalrecordexchange.com.au

Today a number of organisations are selling electronic messaging solutions into the health sector. Unfortunately, in their haste, several are taking shortcuts resulting in significant risks for practices and patient care.

Typical shortcuts being taken include; • Not using the correct message acknowledgement process as set out in the Australian messaging standards (and thus being unable to ensure that a message is actually received by the intended recipient).

• Turning all forms of referrals and specialist letters into observation (lab report) messages and filing them away in the results section, effectively losing them in wrong section of the patient record.

• Neglecting to put in place end-to-end support arrangements with the medical software at either end of the messaging system.

There is a safe and sensible solution that deals with these issues correctly.

HealthLink is the electronic messaging system synonymous with quality and careful risk management. Don’t take risks with patient information; there is absolutely no need to!

Tel 1800 125 036 enquiries@healthlink.net Integration

Standards

www.healthlink.net Scalability