Pulse+IT Magazine - September 2011

Australia’s First and Only Health IT Magazine

PULSE IT 

Issue

September

24 2011

Consumer eHealth Cooperation, standards and interoperability Derek Gower highlights the results of a successful collaboration between GP software developers.

Planning for a rainbow journey Bryn Evans intertwines observations from the HIC2011 event with insights into eHealth planning.

Beyond technical interoperability David Hancock outlines the areas crucial to facilitating an integrated collaborative healthcare system.

On the road to the PCEHR Simon James provides an update on the progress and ambitions of the six Vendor Panel members.

To tweet or not to tweet?

Alberto Tinazzi advises caution when it comes to the use of social media in the health sector.

Big results come from taking small steps Rachel de Sain provides a consumer’s perspective on the development of PCEHR.

www.pulseitmagazine.com.au

19 19 20 21 22 22 25

IHTSDO coming to Sydney in October Clintel Systems flags support for MacOS X Lion Sysmex to link Clinical Data Repositories in NZ Diagnostic Imaging Pathways released for iPad Advantech upgrades patient infotainment system NPS releases MedicineWise app for iPad Inala Primary Care deploys iPad for mobile use

Want to know more about eHealth?

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

Welcome to:

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

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

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

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

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

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

“ The speed at which medical service is provided will be

faster.

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

Devendra Maisnam Business Analyst, Information Modeller

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

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

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

Go to: www.nehta.gov.au

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

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

flexibility

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

Amy Richardson HR Business Partner

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

difference.”

Tony Warren System Administrator

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

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

PULSE IT +

Publisher Pulse Magazine PO Box 243 Gundagai NSW 2722 Australia ABN: 19 923 710 562 www.pulseitmagazine.com.au

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

Pages 32, 40, 42 Consumer eHealth

Subscription Enquiries subscribe@pulseitmagazine.com.au

Advertising Enquiries ads@pulseitmagazine.com.au

About Pulse+IT Pulse+IT is Australia’s first and only Health IT magazine.

With an international distribution exceeding 37,000 copies, it is also one of the 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.

Looking ahead The November 2011 edition of Pulse+IT will feature a selection of articles related to electronic prescribing, electronic transfer of prescriptions, and electronic medication management.

Pulse+IT welcomes feature articles and guest editorial submissions relating to this theme, as well as articles relating to eHealth more broadly.

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

ISSN: 1835-1522 Contributors Bryn Evans, Derek Gower, David Hancock, Simon James, Rachel de Sain, Dr Geoffrey Sayer, Cara Sayer-Bourne and Alberto Tinazzi.

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

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

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

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

Page 10 Strategic Planning

Page 28 Lessons Learnt

Page 40 Social Media

Editorials

Features

News

Page 6 STARTUP Editor Simon James introduces the 24th edition of Pulse+IT.

Page 32 FEATURE ARTICLE Simon James provides an update on the progress and ambitions of the six Vendor Panel members.

Page 19 IHTSDO meeting and showcase coming to Sydney in October

Page 8 GUEST EDITORIAL Derek Gower highlights the results of a successful collaboration between GP software developers.

Page 10 GUEST EDITORIAL Bryn Evans intertwines observations from the HIC2011 event with insights into eHealth planning.

Page 16 GUEST EDITORIAL David Hancock outlines the areas crucial to facilitating a integrated collaborative healthcare system.

Page 28 MSIA Dr Geoffrey Sayer shares some lessons about the lessons learnt process.

Page 30 NEHTA Andrew Howard provides an update on the PCEHR.

Page 40 FEATURE ARTICLE Alberto Tinazzi advises caution when it comes to the use of social media in the health sector.

Page 42 FEATURE ARTICLE Rachel de Sain provides a consumer’s perspective on the development of the PCEHR.

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

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

Page 19 Clintel Systems certifies The Specialist for MacOS X Lion, expands claiming options Page 20 Sysmex prepares to link Clinical Data Repositories in New Zealand Page 21 Diagnostic Imaging Pathways now available as an iPad app Page 22 Advantech upgrades patient infotainment system NPS Releases MedicineWise medication list app for iPhone Page 25 Inala Primary Care deploys iPad for community health assessments

EDITORIAL

Pulse+IT: 2011.4 Simon James

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

Welcome to the 24th edition of Pulse+IT, Australia’s

eHealth strategy and planning.

first and only Health IT magazine.

This edition presents a detailed look at the work

Andrew Howard provides some useful background

being undertaken by the Vendor Panel, a group of six

information and updates on the PCEHR, with Geoffrey

software companies tasked and funded by Government

Sayer from the Medical Software Industry Association

to incorporate specific pieces of functionality into their

encouraging the sharing of lessons to ensure the

clinical software. Much of this work is related to the

system becomes a reality.

forthcoming Personally Controlled Electronic Health

Record (PCEHR), with some parcels of development

details about the forthcoming International Health

already completed and finding their way into medical

Terminology Standards Development Organisation

centres around the country. Derek Gower provides a

meeting, to be held in Sydney in October.

complementary article about the work of a similarly

collaborative software development effort from New

edition featuring the MedicineWise utility from the

Zealand, which culminated in the recent unveiling of

NPS and an announcement about the launch of the

functionality that allows New Zealand general practices

clinician-centric Diagnostic Imaging Pathways app for

to electronically send entire patient records from one

iPad. A report from Inala Primary Care detailing their

practice to another, a technical achievement that has

innovative use of iPads by Practice Nurses operating in

not yet been matched in Australia.

the community is also included, with coverage about

the linking of Sysmex Clinical Data Repositories in New

Rachel de Sain provides a consumer’s perspective

on the ongoing development of the PCEHR, with Alberto Tinazzi advising health professionals and

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Pulse+IT

The National E-Health Transition Authority’s

This edition’s Bits and Bytes section includes

Apps for iPhones and iPads are also covered, this

Zealand rounding out this edition.

healthcare organisations to be cautious about their

Looking ahead

use of social media, particularly when engaging with

The next edition of Pulse+IT, and the final edition for

consumers.

the year, will focus on electronic prescribing, electronic

medication management, and electronic transfer of

David Hancock of Orion Health, a company recently

announced as an National Infrastructure Partner for the

prescriptions.

development of the PCEHR, outlines the areas crucial

to facilitating a integrated collaborative healthcare

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

system, while Bryn Evans intertwines his observations

simply like to discuss your experiences with eHealth,

from the recent HIC2011 event with insights into

don’t hesitate to get in touch.

As always, if you have any suggestions for future

www.pulseitmagazine.com.au

EDITORIAL

Some thoughts on cooperation, standards and interoperability Derek Gower

Managing Director Houston Medical derek@houstonmedical.net

In late August I attended a celebratory function

Houston Medical, Intrahealth6, MedTech Global7 and

in the Wellington Town Hall hosted by the New

MyPractice, and to make this wish come true. It was

Zealand National Health IT Board . Along with three

a cost recovery only budget with a total of around

other vendors, Houston Medical2 had completed a

$750,000 split between all of us.

ground‑breaking program in New Zealand called

GP2GP. Similar initiatives have been tried elsewhere

were so different, with completely different database

in the world but we believe, only if anecdotally, this

structures it would be necessary to build an interface

is the first one that could be regarded as a success for

engine to generate the Clinical Document Architecture

the interchanging of information between different

(CDA) message. This work, fortunately for us all,

practice management systems that are under different

was carried out by an independent contractor, Peter

ownership and management. As the project’s name

Jordan under the supervision of Dr David Hay from the

implies, at present it is only working between general

Auckland Health Alliance and Andre Bredenkamp from

practices. But given the will there are no technical

GPNZ. Over a 12 month period the vendors completed

reasons that the mechanism cannot be extended to

development, met for Connectathons, exchanged

other parts of the healthcare sector if the relevant

sample messages and found and squashed bugs. As

vendors are interested in developing the necessary

funding was provided through a fixed price contract,

protocols within their own software.

the project was delivered on budget. Although

The scope of the functionality of the system can

the same could not be said for the delivery date, a

also be extended. The next initiative is to use the same

six‑month project rapidly became 12! The vendors put

‘engine’ for ePrescribing, something that has already

aside their normal competitive behaviour, as we all

been demonstrated by Dr Ashwin Patel of MyPractice .

realised we had something to learn and something to

share and if it was not a success we were all the joint

1

3

Medical software is an area where New Zealand

It was quickly found that because the four systems

can play its small size to a big advantage. It is easy to

losers.

organise a meeting, nowhere is more than four hours

away and there are now just four practice software

practice to another can be instigated from either end,

vendors serving general practice. When Houston made

but in my first example, Jenny the patient has arrived

its first tentative offering in 1989 we were number 32!

from Christchurch with her two children at a new

The transfer of the patient record from one general

A poll from GPNZ identified the transfer of patient

practice and wishes to have their medical records

records from one doctor to another as the next most

transferred. Jenny enrols with the practice and then

important outstanding software need. The National

signs the record transfer request form, which is faxed

Health IT board took up the challenge and funded

or posted to her previous doctor. For obvious medico-

GPNZ, under Patients First , to project manage

legal reasons this request has to be approved and

4

5

Author Info

signed by the patient. On receipt of the request at the Derek Gower is Managing Director of Houston Medical, which has offices in Hamilton, New Zealand and Sydney, Australia. He started off in farming and was a Nuffield scholar to the United Kingdom in 1972, but a midlife crisis, share market crash and a change in lifestyle in 1987 saw him move into a small computer company in Hamilton. In the mid-90s he bought the company and grew it to be the one of the major suppliers of software to all medical professions in both countries.

sending doctor’s practice, Jenny’s records are brought up on the screen and quickly reviewed. Any notes marked confidential to the doctor or the practice may be withheld but in most cases the ‘Send’ button in the practice software is clicked. HealthLink8 picks up the encoded patient record and transmits it to the receiving doctor. If the file is over 5MB, which is the maximum

8

Pulse+IT

www.pulseitmagazine.com.au

file size that presently can be transmitted

request form there. As long as she had

have been HL7 compliant since the mid-

between practices, the sender is advised to

enrolled in the new practice, everything

90s. Over the years HL7 has evolved from

insert a CD and, unless a record is marked

would be waiting for her and her two

version 1 to version 2, and then through

confidential, everything is sent or copied

children when she arrived.

various iterations of version 2. New

to the CD. 128 bit encryption is used and

Obviously these are early days, there

Zealand has moved to version 2.4 which

the CD can only be read by the appropriate

will be enhancements and feedback to be

allows the inclusion of an embedded PDF

receiving software. It would therefore not

actioned and there is much more to it than

so images and letters can all be included.

be possible for the patient to take the CD

described above, but for $750,000, what a

Version 3 is under consideration and is

on holiday to India to use as a complete

bargain! NEHTA are you listening? This is

used in the GP2GP CDA message.

medical record! Confidentiality around

also a very important example of what you

encounter notes is maintained. Even when

can do with standards.

struggling to mandate even version

a medication is attached to a confidential

For the technically minded and industry

2.3.1. The Royal College of Pathologists

record the medication is sent and the

insiders, now comes a particular gripe and

Australasia mandated the use of HL7 three

associated note can be omitted.

a plea to my competitors and colleagues in

years ago, but unfortunately the Royal

Australia,

unfortunately

is

still

Jenny’s new practice will receive

Australia. Since Houston Medical started

Australian and New Zealand College of

the transfer notes as a message in their

supplying software in Australia in 1993, we

Radiologists still has to make a decision.

HealthLink

is

have had a constant battle with standards,

The transference of Referral, Status and

exchanged as a CDA HL7 V3 document.

in-tray.

The

message

in particular with PIT, the ‘birth’ of which I

Discharge messages between doctors and

Because there must be no dispute as to

am old enough to remember well.

hospitals cannot sensibly move ahead until

what has been sent, this document also

the HL7 international standard is accepted

contains the complete patient record in

pathology lab and I asked if they could

across all health disciplines.

human readable format. The receiving

send lab results to a dermatology client

doctor may decide that a record of a

in the HL7 format which we had been

to the software vendors of Australia that

runny nose when the 25-year-old patient

using in New Zealand for several years.

need to implement the transfer of medical

was three is not really necessary and

They looked at me aghast and I quote:

records from one practice or health

may decide not to import this particular

“Australian software would not be capable

service to another. If you really do want to

encounter note.

of receiving an HL7 message and we have

embrace an eHealth record like the PCEHR,

As an aside, this optionality is currently

Around 1996 I was with a Brisbane

Therefore I close with a personal plea

devised something easier to implement

then standards are essential and the first

a point of considerable controversy

called PIT”.

move you should make is to ensure that

between doctors. One school of thought

And now, in 2011 doctors are still

all RSD messages between doctors and

says

import

sending and receiving Referral, Status

all reports from radiology and pathology

everything because that runny nose might

and Discharge (RSD) messages and even

are sent using the internationally accepted

be important in another context, and

worse, having radiology results forced

HL7 standard.

another is equally emphatic that they only

upon them in the PIT format, even though

want what they want. This debate is still to

it is non‑standard and, in my opinion,

References

be resolved!

should have been put out of its misery and

1. http://www.ithealthboard.health.nz

that

the

doctor

must

buried years ago.

2. http://www.houstonmedical.net

‘Import All’ button, in which case allergies

The receiving doctor can click the

3. http://www.mypractice.co.nz

go to allergies, prescriptions go to

an international standard that was devised

4. http://gpnz.org.nz

prescriptions and medical notes go to

by Duke University in the United States in

5. http://www.ithealthboard.health.nz/

medical notes. Pathology and radiology

the late 80s for the secure transmission of

primary-healthcare-it-programme-

reports are also correctly filed.

health results from one facility to another.

group

If Jenny knew which practice she was

In New Zealand under the guidance of

6. http://www.intrahealth.com

going to before she left Christchurch then

HealthLink, all messages between doctors

7. http://www.medtechglobal.com

she could have signed the record transfer

and all pathology and all radiology results

8. http://www.healthlink.net

www.pulseitmagazine.com.au

For those not acquainted with HL7, it is

Pulse+IT

9

EDITORIAL

eHealth’s search for meaning – is it a rainbow journey?

Bryn Evans

Director JEMS Consulting bryn.evans@ozemail.com.

All health services face the challenge of the Commonwealth Government’s health reforms, its eHealth strategy and the pivotal Personally Controlled Electronic Health Record (PCEHR). Simultaneously, innovation and change in technology seems to be accelerating. How to move forward for the benefit of the consumer, from existing ICT systems is complex, and different for every health service provider.

Introduction

from hospital treatment to prevention and care in the

Everyone wants an electronic health record. Everyone

community. Healthcare must become more effective

wants their health to be looked after, and thinks that

in providing coordinated care in the home and

someone else should be responsible for it. Yet the gap

community settings, promoting healthier lifestyles,

between the dreams and plans for personalised and

and keeping people out of hospitals.

coordinated care still seem to be just that: dreams

and plans. Certainly the gap between the reality of

Commonwealth Government’s E-Health strategy,

existing healthcare systems, and what can be done

perhaps its flagship, is the PCEHR. Funding for

with innovation and new technology, appears to be

telehealth consultations is another aspect of the

widening.

strategy, and can exploit the NBN to reach consumers

Health Reform and the Consumer

Probably the highest profile initiative of the

in country and remote areas with a more timely and cost-effective service.

To help narrow that gap, the Commonwealth

Government’s eHealth strategy is designed as an

a patient’s health information needs to be shared

important driver to assist its hospital and health

across a wide spectrum of healthcare providers. These

reform objectives. Australia’s health reform is a

include GPs, outpatient and primary care clinics, public

political response to democratic pressures, to people’s

and private hospitals, medical specialists, community

desire to see health services more responsive to local

health, mental health, drug and alcohol clinics,

community needs. It has resulted in the creation of

aged care facilities, pharmacies, medical specialists,

local health networks, each with their own boards for

diagnostic services for pathology and imaging, and

greater local autonomy.

many other providers.

This structural change is closely aligned with the

To support coordinated care in the community,

It is hoped that the PCEHR can bring a measure of

established consensus in the healthcare industry, that

integration and interoperability of information across

there must be a shift of care, at least in emphasis,

all healthcare providers. At a summary level the PCEHR in time can enable the sharing of the consumer’s

Author Info

information at any point of care, wherever it may be.

Bryn Evans is a management consultant, with many years experience as a CIO in healthcare, and as chief executive of a clinical software supplier.

He writes extensively across a range of categories and genres, notably in the areas of management, information technology, sport, travel, history and fiction.

Within the national health reform agenda there

is another initiative, which is gathering momentum and has enormous implications for health services and their ICT. It is the intention to introduce by July 2012, activity based costing and funding of health services. For health services to be effective and obtain

10 Pulse+IT

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their appropriate funding needs, through the input

on using KPIs to measure clinical change, Steve

of activity data into clinical costing systems, they will

Shaha from Harvard University, pointed out that

require greater coverage and integration of clinical

only measured outcomes, which are proved to be

information systems.

beneficial to patient care, can justify the innovation’s

Innovation and technology trends – what do they mean for eHealth?

Dr Ilkka Kornhonen of Tampere University of

Technology in Finland, said that the consumer must

Besides the impetus of the Government’s health reform

make the most fundamental change. To confront

on eHealth initiatives, what are the other trends in

the explosion of chronic disease arising from both an

innovation and technology? Are the uncertainties and

ageing population and lifestyle disorders, Dr Kornhonen

gloom of the world economy providing motivation for

believes the 21st century must see behavioural change

an accelerating surge in technology innovation and

by the health consumer. Through health and wellness

change?

technologies, and by using the smart phone for self

At the recent HIC2011 conference in Brisbane,

monitoring, the consumer must become a co-producer

presenters and exhibitors displayed a bewildering

of personal health. Health resources and budgets

spectrum

innovative

cannot keep on increasing as a share of GDP. There

technology. The continuing challenge for healthcare

of

original

has to be a shift in focus from, not merely enhancing

providers — ‘Where do you place your bet?’ — just

healthcare diagnosis and treatment, but to improving

keeps getting harder. How do you pick a winner?

a person’s health and lifestyle.

And which innovation and technology, assuming a

successful implementation which is far from certain,

revolutionising communication. It is projected that

would best meet the needs of consumers served by a

500 million will be using mobile applications by 2015.

particular healthcare provider?

Mike Walsh, CEO of innovation research company

thinking

and

‘Tomorrow’ asked, ‘What happens when our smart

Here is a small selection from some of the HIC2011

Social

media

and

mobile

technology

are

speakers’ presentations:

phones become our healthcare monitors?’ An attendee

Whatever the new idea or technology may be,

from the floor was more specific, asking why her GP

implementation is critical to success. Yet a new idea,

would not accept an email from her mobile phone

stated Peter Kambouris from CSIRO speaking on

containing data on her health condition. There was no

Innovation in E-Health, is not innovation until it has

answer. Networks connecting everyone, and sharing

been delivered as a product and/or service, and been

healthcare information, are upon us now. In websites

successfully implemented. Yet in his presentation

like ‘Cure Together’, consumers are sharing everything

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

12 Pulse+IT

introduction.

- Abaki, Medinet - Access GP - Alcidion - Ambulance Services • Victoria • Tasmania • Queensland - Australian Pharmacy Solutions - Australian Sports Anti-Doping Authority - Best Practice Software - Cardio Vascular Systems - CDC Systems - charmhealth - Clintel Healthsolve, The Specialist - Cloud 9 Software

- Communicare Systems - CompuDoc Medical - Deltra Pty Ltd, Practice Pro - DoctorWare Australia, Smartrooms - DrsDesk Software - Episoft - Equipoise International, Totalcare - Genie Solutions - Global Health - Godbar Software P/L - GPComplete - Health Track Medical Systems - HealthCare Software - Healthpoint Technologies - Healthsoft Australia

- Healthways Inc - Houston Medical Australia - Incisive Medical Systems - InterSystems - International SOS (Australasia) - Intrahealth Systems, Profile - iSoft Group • Classic • ePharmacy • MedChart • Patient Safety International • Practix - Jam Software - Lane Cove General Practice - Manrex Pty Ltd, Webstercare - MediFlex

www.pulseitmagazine.com.au

about their health and conditions.

for widespread acceptance and implementation of

In the Q&A session hosted by the ABC’s Tony

standards. In another he wondered if we are now at a

Jones, one opinion was that innovation and new

point of such complexity, that we should not add more

technologies such as mobile applications, are stifled by

before identifying some which can be excised.

standard state-based systems. A clinician’s response

acknowledged that they may be the case, but on the

help to drive more healthcare out of large hospitals and

other hand recognised that standardised systems

nursing homes, and back into the home. Eric believes

to support connectivity and interoperability were

that large institutions of hospital centric facilities

vital. Another view was that industry’s ownership of

cannot keep growing, and are unsustainable. The aged

intellectual property was stifling innovation.

population will double by 2025, and then double again

by 2050. We should take on a challenge to move 50% of

In NSW a majority of public health services have

Eric Dishman from Intel asked how can technology

implemented a standardized eMR, which enables

healthcare from hospitals to the home by 2020.

clinicians to collaborate more easily, and share

information on a patient. It has introduced a new

conversational robotics for customer support and

paradigm of openness and transparency in patient

companionship solutions, Ms Liesl Capper-Beilby, CEO

care. However in an alternate view, Professor Jon

of ‘MyCyberTwin’ company, described their success

Patrick of Sydney University put forward the startling

with major customers such as NAB, HP, NASA and

idea of giving clinicians full control and responsibility

Westpac, and their work on prototypes for healthcare.

over design and support of information systems. He

Against the impact of an ageing population and an

advocates the embedding of language technology

increasing shortage of clinicians and other healthcare

within his own development of ‘generative clinical

professionals, Liesl posed the question, ‘Is a robot

information systems’. Of course questions hanging

companion better than no companion at all?’ Just like

in the air over this contrary stance are such as, ‘Who

Enrico Coiera, Liesl sees the future as a very different

would own the intellectual property?’, and ‘Which

country!

clinicians would get this power?’

In a presentation intriguingly titled ‘Seven

relevant in the future, Dr Simon Kos from Microsoft

Heresies’, Professor Enrico Coiera of NSW University,

stressed that change is essential, and embracing it

suggested that the future is a different country, and

now is necessary. The current models of care cannot be

that we will surely see changes which today we might

sustained. In a concluding session of the conference,

view as revolutionary or heresy. In one heresy Enrico

perhaps it all came together when the question was

envisioned that we not delay progress by waiting

asked, ‘Are we good enough at understanding all the

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- Promadis - Promedicus - Queensland Emergency Services - Queensland Eye Institute - Queensland Government - Shexie Medical System - SmartClinics - SmartHealth - Software for Specialists - South West Alliance of Rural Health - Stat Health - Sydney Adventist Hospital - Telethon Institute for Child Health Research - Zedmed

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In a presentation on the growing use of

For healthcare providers to improve and be

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

The team at MIMS

Pulse+IT 13

how to find the best way forward, with the

it for the benefit of the consumer?’ It

The search for an eHealth Strategy

appeared that no-one was prepared to

To make sense of the potential of

for their needs. The answer has to be,

answer in the affirmative.

innovation and technology trends, match

eHealth and ICT strategic planning. But

them with the Government’s eHealth

not for the sake of producing a voluminous

strategy, as well as reconcile them with

document which is out of date before it

existing ICT operations, current projects

is approved. Rather it is for the journey

innovation going on, and how to apply

The reality of health services’ ICT, and how to embrace eHealth

best mix of eHealth priorities and solutions

and future demands, every health service

of discovery, insights, and knowledge

So how can health services and the reality

faces a daunting challenge. Every health

of the business, which the ICT planning

of their current information systems,

service is different and has its own drivers

process reveals. Only then can an informed

embrace eHealth and all its manifestations

and priorities, with services and processes

decision be taken on which eHealth

of accelerating innovation? Apart from

which are continually changing and

technology should be adopted.

new start-up hospitals such as the

evolving. Resources, time deadlines and

Macquarie Private in Sydney, which has

budget constraints are different for every

a health service is an exercise in self

recently opened with some of the latest

provider, and ever present. For some

examination.

technology, most health services have

health services with their own EMR and

information, eHealth and ICT have become

valued information systems and ICT

own eHealth strategy, the PCEHR can

the life blood and sinews of health services.

infrastructure, built up from many years

seem to be a low priority. For others it

Every year at least, health services should

of staff effort and capital investment.

can look attractive, but not above more

re-evaluate all existing systems, review

To invest in new technology, requires

immediate needs. Somehow a balanced

ongoing and planned projects, assess new

significant planning, resources, funding

and informed judgement must be made on

and innovative clinical information systems

and the inevitable, painful disruption to

how to embrace eHealth.

and technologies such as: medication

daily

activity

during

implementation.

In essence eHealth planning for Recognise

it

or

not,

That judgement must be made in the

management, the PCEHR, anti-microbial

Above all the introduction of innovative

context of what innovation and technology

systems, mobile applications, robotics etc,

new systems, demands difficult process

will best improve patient care in each

for the feasibility of introduction. In parallel

and work practice changes, where not

health service. What will most benefit the

examine what is practicable in terms of

everyone can come out a winner.

consumer?

resources and funding. Above all, identify

what will most improve patient care, and

Despite the continual improvement

In some ways it is like a search for

in diagnostic and treatment procedures,

the end of the rainbow. And there at its

benefit the organisation’s consumers.

compared with many other industries

end is the legendary pot of gold, which

and their investment in ICT, healthcare

in healthcare is coordinated patient care

but the planning process is in effect a

has for many years been chronically

and the integrated health information to

productivity check of every aspect of a

under resourced and under funded in

support it, anywhere, any time.

health service’s operations, to identify its

ICT. Inevitably healthcare ICT has to

In Australia’s predominantly urbanised

changing priorities. The discovery process

cede priority for resources and funding

population, it is said that an average of

is in many ways as important as the

to clinical services. Remuneration rates

only around 2-3% of patients move from

planning’s conclusions. And is it a heresy

cannot attract the best quality of ICT

one health service to another. Eventually

to propose that every health service

professionals. There is also a tendency

the PCEHR may address that, but it is only

should survey its consumers, as part of the

for some clinicians and managers to view

one element, it is not a silver bullet. For

planning, to understand what technologies

ICT as a third or fourth order priority, not

many health services, just as important

and services consumers want?

dissimilar to maintaining the telephone

or more so, are their own EMRs, new

lines and switchboard. That is the reality of

clinical applications, secure messaging and

the rainbow, eHealth planning becomes a

health services ICT.

electronic referrals between all providers

fascinating journey. And the journey’s goal

Amidst the incessant daily demands

etc., in other words their own eHealth

gets ever closer, the tantalizing pot of gold

of delivering healthcare, often on a 24x7

priorities suitable for their own particular

— a consumer’s coordinated care.

basis, the glitter of potential innovation

requirements.

and technical wizardry is not enough to accelerate the take-up of eHealth

How to follow the rainbow

initiatives. Something else is required.

So the challenge for every health service, is

14 Pulse+IT

It may sound hard and complex,

Like gazing at the colourful strands of

‘E-Health and ICT planning’ sounds

boring and difficult. Perhaps we should rename it — ‘Planning for a rainbow journey!’

www.pulseitmagazine.com.au

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EDITORIAL

Enabling the Integrated Collaborative Healthcare System David Hancock

Head of Commercialisation Orion Health david.hancock@orionhealth.com

The promises of IT in healthcare, with a major part of

• Continued advancement in treatments, which has

this application known as eHealth, has had many false

led to greater medical specialisation and increased

dawns, but today we can see some real changes that

survival rates for many conditions that now have

mean Healthcare IT may at last be able to overcome

the characteristics of chronic disease — for example

the barriers that have prevented it from moving into

HIV and many cancers.

the 21st century.

In terms of IT maturity, Healthcare IT today is in

specialisation leads to a further increase in the

the same position that other industries were in 10 or 20

fragmentation in healthcare delivery, and an even

years ago. Proprietary/closed architectures still prevail;

greater co-ordination challenge.

many do not support open standards such as SQL

and the vast majority do not separate the application

to be supplied in completely different configurations

and data tiers. This makes sharing information with

with services delivered, not only in single healthcare

other applications extremely difficult, and lack of

facilities, but also now across multiple clinical

data transparency means there is no ‘plug and play’

organisations, outside of clinical settings and in the

interface for accessing or extracting data.

home, moving from episodic to chronic care.

However,

contemporaneously,

business

and

This has resulted in healthcare services needing

None of these issues are new. They have been the

clinical requirements of Healthcare IT have moved on

same for the last 15 - 20 years, but many of the barriers

substantially as a result of several impacting factors,

to change can be laid at the door of IT.

such as:

• Improved understanding of the scientific causes of

has continued to increase — despite acceptance that

diseases based on genomics and proteomics.

• A rapidly ageing population and a decreasing number of healthcare workers.

• Increasingly wealthy and empowered citizens in

Even as the proportion of GDP spent on healthcare

countries cannot afford to continue in this way — IT has not been applied at scale and with the participation and buy-in of patients, clinicians, policy makers and payers.

Governments see the cost of healthcare as a

developed/developing economies where lifestyles

tremendous drain on the economy contributing to very

have changed (become more unhealthy) and

large budget deficits and stifling economic growth in

expectations of their healthcare system are rising.

some countries. Facing such basic issues, Governments

• An epidemic in chronic conditions, particularly

now have the will, and often the political mandate,

Type II Diabetes, Chronic Obstructive Pulmonary

to make the necessary changes to at last join up the

Disorder (COPD), Congestive Heart Failure (CHF),

fragmented islands of healthcare information and

Coronary Artery Disease and mental illness,

to provide integrated patient records accessible by

with patients increasingly having more than one

healthcare providers, patients and individuals within

condition.

their circle of care across the complete Patient Journey.

Author Info

And the corollary is that greater medical

David Hancock is Orion Health’s Head of Commercialisation. Since July 2010 he has been responsible for Industry Strategy and Product Marketing. Prior to his appointment at Orion Health, David worked at Oracle Corporation for 13 years focusing on Healthcare and Life Sciences. Orion Health is a leading healthcare software solution provider with expertise in clinical workflow and integration technology for the healthcare sector.

Orion Health is seeing Governments increasingly

considering how to implement this kind of Strategic Healthcare Management at large scale to obtain the necessary economies of scale and to achieve a step change in reducing costs and improving patients’ quality of life and safety.

In particular this includes population management,

in terms of optimising access to scarce healthcare

16 Pulse+IT

www.pulseitmagazine.com.au

resources and supporting more self-care: large scale

maintaining the provenance and security of data

clinical workflow supporting end-to-end care processes across

primary

and

acute

care,

rehabilitation,

and complying with privacy programmes.

4. Improve adherence by healthcare providers to

community, remote and self-care while achieving economies of scale to do more with less.

evidence-based guidelines.

5. Remove the care-barriers between social, aged care

Disease management and citizen collaboration

and healthcare to better support those capable of

allows empowered patients and carers to make

independent living and reduce the heavy toll paid

informed choices about the healthcare services they

by the healthcare system of people not getting

use and to integrate them into the care team.

enough care for their needs consequently returning

Many countries have embarked on transformational

as frequent non-elective admissions.

Healthcare IT projects, including, for example,

6. Improve the productivity and outcomes of the

Australia, New Zealand, Canada, Denmark, England,

overall healthcare system through more effective

Netherlands, Singapore, Sweden and the US. While

utilisation of healthcare resources; such as

each country’s individual focus may be slightly different

transformative clinical workflows that support the

— each has a different starting point — they all have

pooling of resources to achieve economies of scale

similar objectives of improving cost-effectiveness of

in delivery, improving patient safety through the

healthcare services and improving patient care by

reduction in iatrogenic treatment and providing

better integrating the end to end care delivery process,

a platform for delivering more healthcare,

from the planning and commissioning of healthcare

for example through the use of telehealth or

services through to the shaping and delivery of care.

telemedicine.

Orion Health has identified seven key areas crucial

7. Improve the management of public health through

to developing an integrated collaborative healthcare

situational awareness with local and larger scale

system. In no order of priority, these are:

disease outbreaks.

1. Focus on the prevention and management of chronic disease.

At Orion Health, we see the move to integrated

collaborative

healthcare

happening

today.

This

2. Place the citizen at the centre of healthcare.

includes healthcare, social care and mental health

3. Secure sharing of clinical information within

to form a complete cross-care record supporting

facilities,

across

integrated collaborative care workflows. It is all about

regions, to alleviate issues resulting from the

between

strategic healthcare management, not just healthcare

fragmentation

interoperability and integration.

of

organizations healthcare

and

delivery,

yet

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Incrementally connecting healthcare.

Poor information flow hinders decision making and care coordination.

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The iSOFT HIE solution offers a pragmatic and flexible approach to connecting eHealth systems for the standards based electronic exchange of health-related information. Integration capability is provided by the Viaduct integration engine.

• Leverage existing eHealth systems • Achieve results with incremental implementations • Accelerate participation in the emerging connected national healthcare system • Connect iSOFT and third party solutions Visit http://www.isofthealth.com/ANZ-HIE.aspx to learn how the iSOFT HIE Suite can help you to achieve interoperability.

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The patient centred, connected eHealth ecosystem

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BITS & BYTES

IHTSDO meeting and showcase coming to Sydney in October

Clintel Systems certifies The Specialist for MacOS X Lion, expands claiming options

Clintel Systems, developer of ‘The

The International Health Terminology

and procedures. Ongoing priorities will be

Specialist’ practice software solution has

Standards

Organisation

defined through stakeholder consultation

announced product compatibility with

(IHTSDO) is holding its second major

and NEHTA’s assessment of benefits and

Apple’s recently released OS X 10.7 ‘Lion’

meeting for 2011 in Sydney in October.

capacity to support ongoing releases.

operating system.

Development

IHTSDO is an international not for

The five day event will comprise a three

Managing Director of Clintel Systems,

profit organisation that administers the

day meeting (10-12 October), followed

Nick Cuthbertson said that his company

rights to the Systematized Nomenclature

by a two day showcase (13-14 October),

was keen to maintain compatibility with

of Medicine-Clinical Terms (SNOMED

which is focusing on implementations

the evolving Mac platform, as well as other

CT), the clinical terminology selected

of SNOMED CT. The showcase will run

popular operating systems.

by the National

E-Health Transition

alongside a series of educational and

Authority (NEHTA) as the preferred clinical

poster sessions. This will be IHTSDO’s

committed to ensure that the Clintel suite

terminology for Australia.

first ever SNOMED CT Implementation

of software didn’t lag behind technology.

In IHTSDO’s own words: “SNOMED

Showcase, which will comprise an industry

Clintel’s other web based application,

CT is considered to be the most

exhibition with a range of local and

CareRight is compatible with most browsers

comprehensive,

international companies.

including

healthcare terminology in the world. Each

Firefox and Safari. It also runs on an Apple

year, avoidable deaths and injuries occur

of the showcase is to allow conference

iPad,” said Mr Cuthbertson.

because of poor communication between

delegates to interact with SNOMED CT

healthcare practitioners, or because busy

implementers from around the world

Systems has recently obtained a Medicare

practitioners forget or neglect to follow

and to share first-hand knowledge of the

Online ‘Notice of Integration’ for Bulk

their own criteria for best practices. The

challenges, benefits, and lessons learned

Bill Claims, Patient Claims and Eclipse

delivery of a standard clinical terminology

in SNOMED CT implementation.

in-hospital medical claims. Clintel’s first site

for

multilingual

clinical

According to the organisers, the aim

“As a long term Mac partner, Clintel is

Windows

Internet

Explorer,

In a separate development, Clintel

the

to implement the new functionality, a large

information systems can therefore make a

showcase is clinicians with an interest

independent billing service that provides

significant contribution towards improving

in structured clinical data for research,

billing services for a wide range of medical

the quality and safety of healthcare.”

quality improvement, clinical practice

specialists, went live at the beginning of

management

September.

use

across

the

world’s

health

SNOMED CT is now freely available for

The

target

audience

and

planning;

for

clinical

use in Australia, under NEHTA’s licensing

managers; clinical data managers; health

arrangements

International

information managers; health service

Services Manager indicated that the

Standards

managers interested in clinical and health

response from the site to the new claiming

Development Organisation. As SNOMED

business data futures; terminologists;

channels has been very positive, stating

CT does not provide total coverage of

clinical

project

that “the customer is looking forward to

all concepts and descriptions used in

managers; clinical information strategists;

the streamlined billing that is now available

the Australian healthcare environment,

clinical system developers, vendors and

to the clients that they serve”.

NEHTA is tasked with supplementing

commentators; and those with change and

SNOMED CT by developing specific

adoption interests.

Online function has been designed and

extensions and derivatives to cover local

The event will be hosted at the

developed within Clintel’s new Generation

clinical information requirements. The

Novotel, Brighton Le Sands, Sydney,

4 web-based platform, which is integrated

extensions and derivatives are anticipated

commencing

into the existing Specialist software.

to

Health

with

the

Terminology

information

on

system

Monday,

October

Julie Mulligan, Clintel System’s Business

Mr Cuthbertson said the Medicare

of

10 and running until Friday, October

terminology domains over time. However,

14. Further information, including a

adding further Generation 4 enhancements

initial priorities have been defined to

preliminary

to The Specialist, which will place our

cover areas such as medicines, allergies,

available from the IHTSDO website:

customers

adverse reactions, pathology, diagnosis

http://www.ihtsdo.org/index.php?id=818

technology in this space.”

cover

an

increasing

number

www.pulseitmagazine.com.au

conference

schedule,

is

Pulse+IT 19

“Over the coming months we will be

at

the

forefront

of Web

BITS & BYTES

Sysmex prepares to link Clinical Data Repositories in New Zealand Sysmex, developer of the Eclair Clinical

functionality, including the ability to

Data Repository (CDR) solution, has

check if a pathology report has not been

announced plans to enable geographically

reviewed by the appropriate clinician in

dispersed installations of Eclair to be

an appropriate time frame. In the event

connected.

of such an oversight occurring, an alert

will be raised by the system, prompting

Rolled out as the centralised electronic

health

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the

someone else to attend to the result.

TestSafe project in Auckland and the

While not deployed across all regions yet,

TestSafe South project in Canterbury, the

this functionality is currently being used

Eclair CDR is being used to collect and

by Auckland City Hospital, which also

store pathology and radiology results sent

leverages Eclair’s ability to store pharmacy

from various healthcare organisations

dispensing information.

operating across multiple District Health

Board (DHB) regions.

kept asking for this piece of added

record

community doctors can look up a patient’s

system has also been made available to

record”, says Dr Ross Boswell, Clinical

pharmacists and authorised healthcare

Director at Counties Manukau DHB.

professionals in the community. It allows

“Our doctors can immediately see all

them to cross reference medications and

investigations relating to that patient:

treatment, check related lab results and if

community and hospital laboratory tests,

needed, phone the prescriber.”

radiology reports and more, no matter

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where in the Auckland region those

solution running in New Zealand. These

procedures were carried out. TestSafe

installations service Auckland, Canterbury,

means patients don’t have to be tested

Whanganui, Taranaki, Bay of Plenty, with

twice for a diagnosis, and it also means

two CDRs deployed in the Manawatu

they’re treated more quickly, on the

region.

basis of reliable, full information,” said Dr

Boswell.

South deployment in Canterbury has been

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implementation

hospital

“Clinical teams at Auckland hospitals

information,” says Dr Boswell. “The

The

TestSafe,

for

and

“Through

infrastructure

According to Sysmex, the TestSafe

TestSafe

particularly well utilised, the company

has not displaced traditional electronic

stating: “It provided a lifeline during the

methods of pathology and radiology

February earthquake in Canterbury, which

reporting for GPs, who still receive HL7

placed enormous pressure on health

reports for investigations they have

and emergency services in Christchurch.

referred themselves. It does, however,

Many patients needing essential elective

give GPs and other referrers more ready

surgery and care were urgently transferred

access to reports ordered by GPs in other

out of the devastated city to different

practices, as well as access to reports

hospital sites across the main centres

generated as a result of pathology and

of New Zealand. Urgent relocation of

radiology investigations originating from

patients meant there was little time to

within hospital settings.

arrange the transfer of medical records

In addition to the storage of pathology

from Canterbury. As well as this, many

and radiology results, the Eclair system

GP clinics were closed due to earthquake

can be configured to provide other

damage meaning patient records were

20 Pulse+IT

of

Sysmex has six instances of its Eclair

www.pulseitmagazine.com.au

BITS & BYTES unavailable.”

CDRs and the existing jurisdictional health

boundaries make the federated approach

To enable authorised clinicians to

access information about patients from

a more viable proposition at this time.

other regions, Sysmex is developing a

‘federation’ capability into the Eclair CDR

reach of the system, Eclair’s security

which will allow secure access between

model is designed to ensure patient

Eclair CDRs. According to the company,

privacy is highly regarded at all times.

the federated CDR system will allow

Healthcare professionals that have been

one Eclair CDR to query another CDR for

authenticated to their local Eclair CDR

patient records. For example, when a

can view information about their patient,

clinician accesses a patient record in the

regardless of which regional Eclair CDR

Eclair CDR system in Canterbury, they

is hosting the data. All access to both

would be notified if there were records for

local and remote CDRs is logged for audit

that patient in the Eclair CDR in Auckland.

purposes, with patients having the choice

The clinician can then view the results and

to opt out of TestSafe if they do not wish

reports held in the Auckland Eclair CDR,

their health records to be shared.

from within the local patient record hosted

in Canterbury.

have been viewed and who viewed them,”

While modern IT infrastructure could

says Mr James Webster, CEO at Sysmex.

facilitate a completely centralised service,

“This adds confidence in the integrity of

the historical establishment of separate

system use.”

Despite the increasing geographic

“It is possible to monitor what records

Diagnostic Imaging Pathways now available as an iPad app The University of Western Australia’s

Pathways initiative, Professor Richard

Centre

(CSP)

Mendelson, said the app will help doctors

has released a new iPad application

more appropriately refer patients to

designed to help clinicians to choose the

imaging services.

most

for

Software

appropriate

Practice

diagnostic

imaging

“Thirty per cent of imaging requests

examinations in a wide range of clinical

are incorrect or inappropriate — the iPad

scenarios.

application ‘DipHD’ will help make sure

The

diagnostic

decision

support

that patients have the best chance of

tool and education resource has been

getting the most accurate diagnosis,” said

developed by CSP in collaboration with

Professor Mendelson.

the Department of Imaging Services at the

Royal Perth Hospital.

Glance said having the pathways available

on the iPad ensures that doctors will have

Originally released as a web-based

CSP Director Associate Professor David

resource, Diagnostic Imaging Pathways

ready access to this and future guidelines.

includes

more

than

130

pathways

“Imaging is the first step in future

covering all the major organ systems and

pathways that will also involve pathology

common clinical scenarios. The pathways

and clinical referral guidelines,” Associate

development was based on broad clinical

Professor Glance said.

consensus and best-available evidence,

with the pathways under continuous

DipHD app is available at the Diagnostic

review and development. The principle

Imaging Pathways website: http://www.

clinical lead behind the Diagnostic Imaging

imagingpathways.health.wa.gov.au

www.pulseitmagazine.com.au

Further information and a link to the

Pulse+IT 21

BITS & BYTES Advantech upgrades patient infotainment system An upgraded and more cost-effective patient infotainment system has been

NPS releases MedicineWise medication list app for iPhone

released by Advantech.

The National Prescribing Service (NPS)

‘change log’ that automatically updates

Powered by Intel’s first dual core Atom

has released ‘MedicineWise’, an app that

itself as the user adds and removes

processor, the terminal supports full high

allows users to maintain a medications list

medications from their current medications

definition video, radio, games, VoIP, email,

on their iPhone or other iOS device.

list. As with the medications list, this

Internet services, nurse call capabilities and

The application, developed with the

change log can be emailed for review on a

emergency alarm functions.

assistance of Creative Licence Digital,

desktop computer by either the user, their

models,

allows users to track the brand, active

carer, or a health professional.

Advantech has reduced the size and weight

ingredients, strength and dosage of their

of the system, which the company says

medicines, including prescription, over the

app will be of benefit to a range of patients,

will permit lower-cost articulating arms to

counter and complementary medicines.

not just the technologically saavy.

be used to hold the terminal next to the

As well as capturing textual information,

bedside.

the app allows the user to take photos of

who take many medicines and need

In addition to the patient centric

each medication’s packaging, dispensing

to keep that information to tell their

applications, the terminals are designed

label, and the medication itself, with these

healthcare providers, so they don’t have

to be used by clinicians to access medical

photos categorised in separate fields

to remember all of those long, hard to

records at the patient’s bedside.

within each medication’s record.

pronounce names, or those who don’t take

MedicineWise prompts the user to

medicines regularly and don’t remember

clinicians is built around paper-based

enter their key demographics into the

to take them,” says NPS Clinical Adviser,

systems, or a mix of various portable IT

interface, which also contains fields for

Dr Danielle Stowasser.

systems. These platforms have a place

allergies,

for some applications, but as a general

and their usual GP and pharmacist. A

to use. It’s suitable for people who are

medical record, users are finding they are

list of predefined questions ‘to ask your

younger, or older, or if you’re a carer for

difficult to carry around. We’re finding that

health professional’ is included alongside

someone. So it’s suitable regardless of

many clinicians are leaving them back in

these demographics, featuring common

whether you are a new iPhone user or an

the nurses station and they’re not being

queries such as “Why do I need to take

old pro.”

used to their potential,” says Brad Waters,

this medicine?”; When should I take my

Advantech’s

Improving

“The

upon

current

previous

workflow

Medical

of

many

Product Support

emergency

contact

details

The NPS believes the MedicineWise

“The major benefit will be for those

“It’s designed to be intuitive and easy

NPS indicated it has plans to extend

medication and for how long?”; and “What

the MedicineWise app to include an

Manager.

do I do if I miss a dose?”. A free-text field

alarm designed as a medication reminder

“Going to a patient infotainment

also allows the patient to make a note of

system. Users will have the choice to tailor

terminal by the bedside enables the

any other questions they may wish to ask

both weekday and weekend alarms to

clinician to access medical records so they

their healthcare professional.

their needs. Further into the future, the

can update the charts of patients or view

Once the medications list has been

organisation intends to link the application

information from the system. It saves

compiled within the app, the user can

with the Australian Medicines Terminology

having paper, and it improves the efficiency

email it as PDF to themselves for printing,

(AMT) as well as other information

in managing the medical records and

or directly to a practice or pharmacy,

resources.

medical data.

if indeed the healthcare organisation

welcomes this type of correspondence.

program specifically with all of the

“We are seeing a huge push towards

having

infotainment

systems

by

“Next year we’re doing an antibiotics

the

The PDF medications list includes the

commonly used antibiotics pre-loaded.

bedside, and realistically the potential

patient’s name, emergency contact, the

The patient or consumer will get to

savings for a hospital are huge in

creation date of the list, allergies, and the

select their medicine, and it will tell them

that medical records will be available

questions the patient made a note of to

other important information about their

instantaneously, with accuracy far greater

ask their healthcare professional.

medicines, and link to websites with that

than possible when relying on paper.”

information,” said Dr Stowasser.

— Cara Sayer-Bourne

In addition to keeping a list of current

medications, MedicineWise maintains a

22 Pulse+IT

— Cara Sayer-Bourne

www.pulseitmagazine.com.au

At we’d rather catch you than catch you out

At GPA they’re called Quality Accreditation Managers (QAM) QAM Job description:

Not letting you fall. Ever.

Work in the interest of our clients from first contact to reaching accreditation.

Support and guide our clients through every step of the process.

GPA AccrEditAtion plus does things differently.

Accreditation doesn’t have to be the daunting process. As so many of GPA ACCREDITATION plus clients are happy to repeat “GPA’s process has changed what we thought was going to be a hardship into a rewarding experience.” From the beginning your own personal QAM steers you through the entire accreditation process at your own pace. The flexible GPA ACCREDITATION plus modular programs (online or paper-based) are designed to be user friendly, ensuring practices confidently prepare to meet the RACGP standards. We report back to you step by step, giving you the opportunity to make improvements along the way. “I was very happy with the modules – it allowed me to work slowly and consistently through the requirements and I felt supported at the same time.”

When your Practice is ready, GPA ACCREDITATION plus will liaise with you to organise a survey visit conducted by experienced surveyors. “GPA ACCREDITATION plus surveyors were very helpful, which made everything run smoothly on the final stage of accreditation – there were no surprises!!” If that sounds different to the way you’ve been used to, call GPA ACCREDITATION plus and let’s get started. call us now on: 1800 188 088 or log on to: www.gpa.net.au

BITS & BYTES

Inala Primary Care deploys iPad for community health assessments Inala Primary Care (IPC) is using Apple

protective cover that incorporated a

iPads to mobilise its practice nurse

Bluetooth

workforce, enabling patients eligible for

however after trialling the

Medicare claimable Health Assessments

accessory, the nurses have reverted to

to undergo preliminary review in their own

using the iPad’s ‘on screen’ keyboard and a

home.

stylus for data entry.

Cathy Brown, CEO of the not-for‑profit

keyboard

into

its

“We’ve found that because of the way

innovative arrangements came about

a lot of the data entry is just ticking, so

in May of this year as a result of a lack of

instead of using the Bluetooth keyboard,

available consulting rooms on certain days

we use the on screen keyboard as required

of the week.

and a stylus, and it’s really fast.“

iPhone app

Practice nurses from IPC are typically

South Complex Diabetes Service and the

able to perform six or seven patient

place is just buzzing. Although we have

reviews in the community per day, which

11 consulting rooms, on Tuesday morning

Ms Brown says is providing greater insight

we have 12 bodies wanting to use those

into the patients living arrangements than

rooms. The solution? One of our practice

would be possible in a typical consultation

nurses goes on the road and completes

conducted in the practice.

the nurse component of the 75 year and

over Health Assessments in the homes of

and does these health assessments in

our patients using an iPad. She remotely

the home, which gives us a much clearer

connects into the practice and is able

picture of the patients’ conditions and

to complete all nursing aspects of the

surroundings as well.”

health assessment along with a follow up

appointment with the GP.”

picture of their patients’ healthcare

“Every Tuesday the nurse goes out

In addition to gaining a more complete

While there are numerous remote

requirements, Ms Brown believes the

access solutions that allow iPad users

convenience offered to patients is seen as

to connect to and control a desktop

a major benefit.

computer, IPC settled on PocketCloud

Pro, which is available for under $10 from

do not have to spend extended time in

the Apple App Store. Once logged in

the practice seeing the nurse and then

using the iPad, nurses from IPC are able

their GP after. For the elderly people we

to interact with the clinic’s installation of

have coming into the practice, for them to

Best Practice, despite the fact this clinical

come in and sit for 45 minutes with a nurse

software runs natively on Microsoft

and then to have to go back to the waiting

Windows platforms.

room and sit for another 15 minutes to half

“Patients just love this service as they

“I don’t know of any other practices

an hour, only to have to sit for 20 minutes

doing this. The GPs that I know that work

with a doctor, it’s just too long a day for

in other practices around us are amazed

them, especially as most have to catch

that we are using an iPad to link back to

buses to and from the practice just to be

software that isn’t running on an Apple

here. Under the new arrangements, the

platform,” says Ms Brown.

patients just pop in and see the doctor and

off they go again.”

www.pulseitmagazine.com.au

NEW

third-party

Best Practice has setup their templates,

IPC purchased their iPad with a

SOMETHING

design,

practice in Brisbane’s South West said the

“On Tuesdays, we run the Brisbane

DISCOVER

Pulse+IT 25

Available on the

App Store or call 1800 800 629

EVENTS SEPTEMBER

OCTOBER

NOVEMBER

2nd Annual Clinical Audit Improvement Conference 8 September - 9 September Melbourne, VIC P: +61 2 9080 4300 W: www.iir.com.au

HISA NSW Educational Event 6 October Sydney, NSW P: +61 3 9326 3311 W: www.hisa.org.au/nsw

GPCE Melbourne 11 November - 13 November Melbourne, VIC P: +61 2 9422 2700 W: www.gpce.com.au

GP11 Conference 6 October - 8 October Hobart, TAS P: +61 3 8699 0533 W: www.gp11.com.au

Australian General Practice Network National Forum 2011 16 November - 19 November Melbourne, VIC P: +61 2 6228 0835 W: www.gpnetworkforum.com.au

3rd Annual National Cancer Centres Symposium 8 September - 9 September Sydney, NSW P: +61 2 9080 4300 W: www.informa.com.au 2nd Annual National Disability Summit 15 September - 16 September Melbourne, VIC P: +61 2 9080 4300 W: www.iir.com.au HIMAA National Conference 2011 20 September - 23 September Melbourne, VIC P: +61 2 9887 5001 W: www.himaa.org.au HIMSS AsiaPac 2011 20 September - 23 September Melbourne, VIC P: +65 9848 5259 W: www.himssasiapac.org WAGPN State Forum 20 September - 21 September Perth, WA P: +61 2 9472 2922 W: www.wagpnetwork.com.au Best Practice Group Training 20 September - 22 September Sydney, NSW P: +61 7 4155 8800 W: www.bpsoftware.com.au

IHTSDO Conference 10 October - 14 October Sydney, NSW P: +61 2 8298 2600 W: www.ihtsdo.org AAPM National Conference 18 October - 21 October Perth, WA P: +61 3 9095 8712 W: www.aapm.org.au

HINZ Conference and Exhibition 2011 23 November - 25 November Auckland, NZ W: www.hinz.org.nz

The 2nd Annual National Pathology Forum 24 October - 25 October Melbourne, VIC P: +61 2 9080 4300 W: www.informa.com.au

2nd Annual Healthcare Complaints Management Conference 28 November - 29 November Melbourne, VIC P: +61 2 9080 4300 W: www.iir.com.au

4th Annual Hospital & Healthcare Security & Safety Conference 24 October - 25 October Melbourne, VIC P: +61 2 9080 4300 W: www.iir.com.au

DECEMBER

2nd Annual Hospital Nutrition & Hydration Summit 26 October - 27 October Melbourne, VIC P: +61 2 9080 4300 W: www.iir.com.au

14th Healthcare Facilities Planning and Design Summit 27 September - 28 September Sydney, NSW P: +61 2 9080 4300 W: www.informa.com.au

PCI DSS Compliance Conference 27 October Sydney, NSW P: +61 2 9080 4300 W: www.iir.com.au/interestareas/ict

The 7th Annual Ageing Population Summit 28 September - 30 September Melbourne, VIC W: www.informa.com.au

Rural Medicine Australia 28 October - 30 october Alice Springs, NT P: +61 7 3105 8200 W: www.acrrm.org.au

26 Pulse+IT

ACEM 20 November - 24 November Sydney, NSW P: +61 2 9213 4000 W: www.acem2011.com

Successes and Failures in Telehealth 1 December - 2 December Brisbane, QLD P: +61 7 3876 4988 W: www.icebergevents.com/sft11 Dental Healthcare Policy Forum 1 December - 2 December Melbourne, VIC P: +61 2 9080 4300 W: www.informa.com.au 3rd Annual Reducing Medication Errors Conference 7 December - 8 December Melbourne, VIC P: +61 2 9080 4300 W: www.iir.com.au

Online Calendar

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

www.pulseitmagazine.com.au

AAPM SS C

PRACTICE MANAGEMENT CONFERENCE

NATIONAL CONFERENCE

PERFORMANCE

perfection Registration includes:

• • • •

Attendance at plenary and concurrent sessions Welcome Reception Happy Hour Gala Conference Dinner

For details of speakers and the program visit www.cdesign.com.au/aapm2011

Terry Hawkins Michael Licenblat Carmen Lawrence David Joske Wendy Wardell

Panel Discussion

The Future of Healthcare – PCRHR – What has it got to do with me?

Sponsored by NEHTA, AAPM Platinum Sponsor Moderator: Gerry Gannon

Panellists: Marina Fulcher – AAPM, Marianna Kelly – AVANT, Vince McCauley – MSIA, Prof. Bernard PearnRowe – GP, Peter Szucs – NEHTA, Trish Williams – Edith Cowan University, Sue Kruse – Medicare

Optional Functions

• First Time Attendees Dinner • UNE Partnerships Graduation and Awards Ceremony

Keynote speakers:

• • • • •

✓

CONFERENCE CHECKLIST LIST

• • • • •

Michelle Ray Sue Kruse Justin Langer Peter Fleming Glenn Singleman and Heather Swan

• Dinner at Matilda Bay Sponsors and Exhibitors AAPM is grateful to all the sponsors and exhibitors. Visit the website to check out who will be exhibiting this year.

Pre-conference workshops – optional

• Benchmarking for General Practice • The Emotionally Intelligent Communicator • Fundamentals of Project Management two-day workshop (UNE Partnerships)

Workshops during the conference:

• • • • • • •

Pressure Proofing Excel Workshop Australian Medical Benchmarks Myers Briggs Leadership Lasseter’s Reef World Class Service Excellence Customer Service

Conference Secretariat Conference Design Pty Ltd 228 Liverpool Street Hobart Tasmania 7000 P: 03 6231 2999 F: 03 6231 1522 E: info@cdesign.com.au W: www.cdesign.com.au

Burswood Entertainment Complex Perth Western Australia 18 – 21 October 2011 Including workshops on Monday 17 and Tuesday 18 October, 2011

MSIA

Sharing the lessons learnt: A vehicle for engagement and fast tracking eHealth adoption

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

There is a lot of stock in the listening to the lessons of

failure. However, there is greater engagement and fast

along an effective eHealth agenda. Leadership

tracking of uptake of lessons when they are integrated

is different from management in that it inspires.

with the stories of success.

Leadership finds ways that no one else has thought of.

The software industry is full of optimistic people.

Leadership focuses on outcomes and strategies, how

They are excited about an evolving and changing

to get there with effective planning and consideration.

world. They often are working on developments that

Leadership is effective problem solving that uses

they can see benefit clinicians in the way they deliver

problem solving as part of the engagement process.

care, and for patients in how their care and health can

be improved. They are glass half full people. Some are

is Alexander the Great’s Art of Strategy by Partha Bose.

happy when even the glass is only a quarter full. They

Alexander’s leadership skills are unquestionable.

are still excited about opportunity when there is more

This book is a great read as it provides many lessons

air in the glass than actual refreshment.

in how to look at problem solving and strategy that

gives one the best chance of success. It speaks of

The Deloitte National E-Health Strategy in 2008

Leadership is the key lesson to moving Australia

One of my favourite business management books

gave the industry great hope with its talk of:

stories of success under great adversity and clear and

• “Market driven” projects and solutions

articulate leadership. It speaks of how, in conquering

• National infrastructure, legislation and standards

an empire larger than the Roman Empire was to

• A 10 year implementation roadmap: communicate,

become, Alexander the Great was actually great at

collaborate, consolidate

engaging, listening and respecting all opinions and

• An incremental and distributed approach to

ideas. This allowed his armies to be effective in quite

development and implementation of Individual

difficult situations where his forces were considerably

Electronic Health Records

outnumbered, and to achieve the unexpected. The

The National E-Health Strategy received further

focus was about a successful outcome, what would

endorsement in 2009 with the release of The National

prevent that, and how approaches could be used to

Hospital and Health Reform Commission Final

deliver the desired outcome. This made it clear to

Report. Significantly, Recommendation #123 from

his forces what they needed to d0, even when things

the report states: “There is critical need to strengthen

became tough.

the leadership, governance and level or resources

committed by governments to enable a National

Alexander’s exploits and at the end of each campaign

E-Health Plan.”

point it discusses how the strategy and approach

The author provides a good historical account of

provides us with valuable lessons in problem solving

Author Info

and achieving success. By engaging the reader into a As well as being President of MSIA, Geoffrey is Head of Operations, HealthLink. He has spent the past 20 years working as an epidemiologist. For the past 10 years Geoffrey has occupied senior management positions in medical software companies.

historical account — and quite a good story — it gives us lessons and inspires us to achieve greater things in our working lives.

The underlying premise of Bose’s narrative is to

challenge any proposed strategy and look at how that strategy could fail rather than listening to the people

28 Pulse+IT

www.pulseitmagazine.com.au

who are only interested in why it will work.

shopping and exchanging ideas, arms

people to catch up when compared with

This is not a negative stance. Rather it is a

the participants to ‘go and do’. When

having them going along for the ride from

dose of reality, looking at how to mitigate

the lessons learnt process is to increase

the outset. Many documents speak of the

against the unexpected and often turning

participation amongst vendors to get to a

lessons learnt from the Health Connect

those into positives. It also allows one to

tipping point, lessons should show vendors

days. I always found it hard to get a simple

get a sense of success as you realise you

what is possible. It should excite the

list of those lessons and it was not until in

are now armed with greater tools and

market place which, to be honest, doesn’t

the last 12 months that something that

techniques than you previously were. It

need much to get excited. The lessons

sort of looked like a list surfaced. That is

builds a team through all the ranks. This

should show how easy successes can be

many years after the event. If we want

is particularly evident in Bose’s lesson of

achieved, while dealing with problems that

people to be engaged and firing by 1 July

listening to the local goat herders and the

can be resolved from working the problem

2012, we need to know the lessons as they

front line foot soldiers. This lesson tells us

over with like minded people.

are being learnt.

that listening to the Generals while sipping

tea in the tents well away from enemy

of the early lessons from the Health

right information at the right time. Many

lines does not give us the real valuable

Identifier developments in the field. While

electronic

insights into local conditions. Wasting

it is important to understand, for example,

designers talk about information ‘just in

resources at the frontline is uninspiring,

the value of a middle name field in clinical

time’ or real time. Yet when it comes to

and not many others will want to join the

software to improve patient identity

information about the PCEHR program it

frontline. Listening to those who know

matching, it is not that exciting, even to

seems that it is the wrong information at

the conditions gives a better outcome.

those who are glass quarter full people.

the wrong time.

Progress and success brings greater

To be successful in eHealth we want the

participation than failure.

market place to see the wave starting to

the more sharing of experiences, the

form. Let us not give them reasons to not

more likelihood that the strategy will

that were uninspiring, negative, complex

want to get involved.

be challenged and alternate favourable

and irrelevant to what we were interested

Lessons have to be timely when there

solutions and successes will be found and

in. These lessons do not inspire us to

is a heightened sensitivity and interest.

implemented. Remember, if you are part

change or participate. Being lectured

Leaving the lessons to some time down

of the solution you are much more likely to

at is uninspiring. White boarding, work

the track will make it harder to engage

implement the solution.

I am sure we all remember lessons

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Pulse+IT 29

24/08/2011 12:02:48 PM

NEHTA

Q&A with NEHTA Head of PCEHR, Andrew Howard Andrew Howard Head of PCEHR NEHTA

From 1 July next year, all Australians will have the opportunity to register for their own Personally Controlled Electronic Health Record (PCEHR).

Andrew Howard is leading NEHTA’s PCEHR programme and it is all systems go.

What difference will a PCEHR make to Australians?

program is the provision of two waves of funding for

A big difference. For the first time, all Australians who

and functional parts of the Australian health sector.

choose to participate will be able to see their important

The lead eHealth sites collectively will aim to enroll

health information, when and where they need it. They

up to 500,000 individuals. The lessons learned from

will be able to share this information with trusted

these sites will be incorporated into the national

healthcare providers.

infrastructure so that when we scale to a national level,

we are scaling the right processes.

A personally controlled electronic health record

twelve lead eHealth sites spanning different geographic

system will enable better access to important

information held in dispersed records around the

the core PCEHR system infrastructure. The Department

The team that I am leading is focused on delivering

country. It will mean that patients will no longer need

of Health and Ageing acts as the programme manager

to unnecessarily repeat their medical history every

and has engaged a number of partners, including

time they see a doctor or other health professional.

NEHTA. NEHTA is responsible for managing the requirements and high-level architecture of the PCEHR

How is the personally controlled electronic health record system being implemented?

system, managing agent for the delivery partners,

The PCEHR system is being built on the foundations

process.

and as well, supporting the standards development

developed by NEHTA such as the Healthcare Identifiers (HI) Service.

What is NEHTA’s role with these partners?

We act as a ‘managing agent’ of the PCEHR programme

The implementation of the PCEHR system will

be based upon a combination of ‘top down’ national

partners which include:

initiatives and ‘bottom up’ lead eHealth sites. This

• A Benefits Evaluation Partner responsible for

allows for tangible eHealth project outcomes on the

developing a benefits realisation and evaluation

ground, while at the same time ensuring a focus on

framework and assessing the ongoing progress

the central actions required to deliver a nationally

of the PCEHR system. The outcomes of the

interoperable system.

evaluation process will be used to help inform the

ongoing implementation programme and future

A key part of the bottom-up implementation

Author Info

investments.

Andrew Howard is the Head of PCEHR at NEHTA. Previous to this he was the Head of Strategy and E-Health Architecture and the interim Chief Executive Officer with NEHTA, and the Chief Information Officer of the Department of Human Services in Victoria. Andrew has an extensive background in eHealth and 15 years international consulting experience as an Associate Partner with Accenture where he ran the Australia Post Commercial Systems Portfolio.

• A Change and Adoption Partner responsible for the strategic plan for driving adoption including the strategies for communications, engagement, training and adoption levers and providing change management support to adopters of the PCEHR system. As well, the change and adoption partner is responsible for ensuring the lessons learned by

30 Pulse+IT

www.pulseitmagazine.com.au

our lead sites are incorporated into the national

the Commonwealth, states and territories. This has

programme

required ongoing collaboration with numerous peak

• A National Infrastructure Partner responsible for

bodies and industry associations as well as the analysis

delivering the infrastructure components of the

and adoption of substantial public comment through

PCEHR system.

the PCEHR submissions.

We are excited to have started working with the

We are navigating through a complex range of

partners to build a system that is tailored for our

viewpoints and advice to arrive at the most practical

national needs while taking on board lessons learned

outcome for the nation. We do this knowing that some

from international experience.

groups will continue to disagree with aspects of these decisions as we move towards a launch date for PCEHR

What does the 1 July 2012 deadline mean?

registration of 1 July 2012.

While all Australians will have the option of registering

for a PCEHR in July 2012, adoption of the PCEHR

Roxon, released the final concept of operations on

system capabilities by healthcare providers and their

September 14. The concept of operations documents

eHealth system suppliers will take time. Beyond July

how the PCEHR will work. The document is based on

2012, the government will work with consumers,

an initial draft concept of operations developed with

healthcare providers and the ICT industry to build upon

stakeholders in early 2011, followed by an extensive

the capabilities provided by the PCEHR system and

public consultation process and final review of policy

look to incrementally expand the breadth and depth of

positions by the minister.

The Minister for Health and Ageing, Nicola

adoption over time.

What is an individual’s personally controlled electronic health record and how is it being developed?

Essentially it is an electronic record of an individual’s important health information, stored and shared in a secure network of connected systems.

PCEHR Snapshot Australians will have the opportunity to register online from 1 July 2012 to establish a PCEHR. Participation is voluntary and individuals will have a range of controls over the record.

People will have easy-to-access information

about a summary of their medical history — including medications, test results and allergies. In addition to

The system will be underpinned by rigorous governance and oversight to maintain its clinical integrity, utility, privacy and national standards and core national infrastructure.

the summary information, consumers and clinicians will have access to specific information related to health care events on their health journey. These may include

The system complements (but does not replace) existing records and clinical communications

event summaries, discharge summaries, specialist letters, test results and reports.

Consumers will be able to present for treatment

anywhere in the country, and give permission for health professionals to access their relevant history.

What consultation has been undertaken to get to this point?

NEHTA has been involved in lengthy consultations

The record will bring key health information from a number of different systems together and present it in a single view.

Information will be able to be accessed by the individual and their authorised healthcare providers. With this information available to them, healthcare providers will be able to make better decisions about health and treatment advice.

The record will not hold all the information held in a doctor’s records but will complement it by highlighting key information.

with consumers, healthcare providers, the ICT software industry, and policy makers and these conversations continue. These discussions have built upon years of work and significant investment by

www.pulseitmagazine.com.au

In the future, as the PCEHR becomes more widely available, individuals will be able to access their own health information anytime from anywhere in Australia.

Pulse+IT 31

FEATURE

Towards the PCEHR: An update from the Vendor Panel Simon James

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

Introduction

patients remains a point of contention.

In November 2010, the National E-Health Transition

Authority (NEHTA) called for proposals from clinical

consortia tasked with building the core PCEHR

software developers to support a series of eHealth pilot

technology — only recently named and awarded

projects being undertaken by three then-Divisions,

funding, any attempt to detail what the PCEHR

namely GP Partners in Queensland, Hunter Urban

will look like in practical terms and how healthcare

Division of General Practice, and the Melbourne East

providers and patients will interact with it after

General Practice Network. Collectively know as Wave 1,

its launch on 1st July 2012 would be somewhat

these localities were selected to serve as regions where

speculative, notwithstanding the availability of the

eHealth specifications could be tested in live settings

Draft Concept of Operations: Relating to the introduction

by practices and other healthcare organisations, with

of a personally controlled electronic health record system

a view to this process informing the development of

and the PCEHR System: Legislation Issues Paper. Over

the Personally Controlled Electronic Health Record

160 submissions were received in response to the first

(PCEHR) and ongoing eHealth specifications and

document, which is scheduled to be finalised and made

standards development. Nine additional pilot projects

public in September.

have since been enacted under the Wave 2 initiative,

however it is important to note that the work of

Partner consortia includes Accenture, Oracle, Orion

the software developers detailed in this article has

Health and Telstra, who have been awarded a total of

relevance and applicability that transcends both the

$77m to undertake their program of work.

Wave 1 and Wave 2 pilots, and indeed the PCEHR.

The Personally Controlled Electronic Health Record

With the National Infrastructure Partner — the

Announced in August, the National Infrastructure

In announcing the winners of the tender process,

Minister for Health and Ageing, Nicola Roxon, cited the group’s collective experience in Singapore as a major factor in their selection, referring to the fact that

While the terms used to describe the architecture vary

members of this consortia had built and ‘gone live’ with

depending on whether it’s being discussed by politicians

the first phase of the Singapore National Electronic

or software developers, the PCEHR will ultimately

Health Record in June this year.

manifest itself as a collection of repositories intended

to allow information from various clinical systems to

the Singapore project is likely to emerge as the basis

be aggregated together for the purpose of making this

of Australia’s core PCEHR infrastructure, Brad Cable,

information readily accessible to healthcare providers

Accenture’s Australian Health and Public Service

across the sector. Patients will also have the ability to

lead, acknowledged the differences between the

view and add information to ‘their’ PCEHR, however

Singaporean and Australian health sectors and the

the extent to which this opportunity will be pursued by

countries’ ambitions for their respective health record

While much of the underlying technology used in

projects.

Author Info

Simon James is the editor of Pulse+IT, one of Australia’s highest circulating health publication of any kind. Prior to founding the publication in 2006 he worked in the statistics division of a clinical research organisation, in an IT support capacity for various medical practices, for a clinical software developer, and subsequently for a secure clinical messaging developer.

“The health industry in Singapore is certainly a lot

different to the one in Australia. What we are doing in Australia is utilising our experience from Singapore, plus some other electronic health records projects we have been involved in globally. We’ll be using similar products in Australia, but again, using them in the context of what Australia wants to deliver, being a

32 Pulse+IT

www.pulseitmagazine.com.au

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Personally Controlled Electronic Health Record.

intended to allow clinical software to more reliably

match electronic correspondence, minimising the risk

“Oracle and Orion Health will provide fundamental

products for this project, and these are what we

of clinical information being misfiled and overlooked.

use globally as well. Accenture also has significant

software assets ourselves, which bring all these pieces

associated with the project, namely:

of technology together. Whilst principally we use the

• Individual Healthcare Identifiers (IHI)

same basis, the health sectors are all slightly different

• Healthcare Provider Identifiers for Individuals

in the way they approach it, the way they implement it, with different clinical software packages feeding

There are three types of healthcare identifiers

(HPI-I) • Healthcare Provider Identifiers for Organisations

the health records to consider as well. Conceptually

(HPI-O)

the same, but they are all unique and have their

differences,” said Mr Cable.

that may ensue in the event of a mismatched clinical

The Vendor Panel

Given the serious patient safety consequences

document, software developers are required to submit to two levels of third-party testing before they can

As the National Infrastructure Partner works on the

interact with the Medicare Australia‑run Healthcare

mammoth task it has been assigned, what will be

Identifier Service.

more immediately relevant to clinicians and the people

working with them in private practice settings is the

is designed to test basic communication between

project being undertaken by the Vendor Panel. This

a clinical software package and the Healthcare

group is made up of six software companies tasked and

Identifier Service. Dr Frank Pyefinch of Best Practice

funded by Government to incorporate specific pieces

Software described this process as “quite simple”,

of functionality into their clinical software, with some

notwithstanding the few days that were required to

parcels of development already completed.

work through the various testing scenarios.

The initial Vendor Panel comprised of Best

The first, dubbed the ‘Notice of Connectivity’

A more rigorous and costly testing process

Practice, iSoft, Medtech Global and Zedmed. Two

overseen by the National Association of Testing

additional vendors, Genie Solutions and Communicare

Authorities (NATA) is also required to be undertaken

Systems were added to the Vendor Panel after its

by software developers looking to interface their

initial formation, purportedly in reflection of the fact

solutions with the Healthcare Identifier Service. This

that customers of these companies were expected to

process, performed by a NATA accredited testing

be important to the viability of several Wave 2 pilot

laboratory, requires the software developer to hand

projects.

over their software to be functionally tested, a process

Scope of Work

that takes around five to seven days according to most of the vendors on the panel. During this process, the

The work being undertaken by members of the

testing laboratories were required to perform over 100

Vendor Panel has been divided into three project

practical tests to ensure the clinical software safely and

milestones, imaginatively named Release 1, 2 and

appropriately handles any interaction the software has

3. The priority order of the pieces of development

with the Healthcare Identifier Service or healthcare

within these Releases has allowed some of the early

identifiers stored within the software.

software enhancements to be piloted by practices located within the Wave 1 geographic catchments,

Clinical Document Architecture

however only minimal details about the rollout of these

The second parcel of work within Release 1 requires

enhancements have started to emerge.

members of the Vendor Panel to enable their software to display electronic Discharge Summaries and

Release 1

Specialist Letters. While most modern Australian

Healthcare Identifiers

clinical software can already display incoming

The first component of Release 1 requires that

electronic correspondence, much of this existing

healthcare identifier functionality be incorporated

functionality is built upon the HL7 v2 standard and not

into the vendors’ clinical software. In broad terms,

the Clinical Document Architecture (CDA) specifications

the widespread adoption of healthcare identifiers is

being advocated by NEHTA.

www.pulseitmagazine.com.au

Pulse+IT 35

In a logical combining of the aforementioned

Release 3

healthcare identifier functionality and the required CDA

Intended for completion in early 2012, Release 3

capabilities, the vendors’ software needs to be able to

requires that Vendor Panel members deploy a range

match incoming CDA documents to the appropriate

of functionality, namely the Australian Medicines

patient and clinician using the Healthcare Identifiers

Terminology (AMT), SNOMED CT, Event Summaries,

embedded in the CDA message.

and Electronic Transfer of Prescription features. With

The deadlines for the delivery of the Release

Vendor Panel members mostly consumed with the

1 work has now passed, with all six Vendor Panel

requirements of Release 2 at this time, few had turned

members having successfully completed the requisite

their attention to the specifics of Release 3, limiting

development.

the amount of available information about the specific requirements of this final project stage.

Release 2 To be delivered by the end of October, Vendor Panel

Funding

members are required to enhance their software to

To defray some of the development and deployment

allow it to generate Electronic Referrals and Health

costs associated with the work being undertaken

Summaries in CDA format, and then transfer these

by the Vendor Panel, members are to receive fixed

using a Secure Message Delivery (SMD) carrier. For

price payments varying from around $15,000 to

a comprehensive overview of SMD, see [Pulse+IT

$30,000 for each of the various pieces of functionality

Magazine, July 2010, pp20], however in essence, the

described above. In addition, per site payments for

technology is designed to allow secure messages

each healthcare organisation that deploys software

to be sent from one clinical software package to

containing the updated functionality will also be

another, regardless of which messaging capability the

made to the corresponding member of the Vendor

sender and receiver have selected. Secure messaging

Panel, however it is unclear whether such payments

solutions are plentiful in Australia, however few if any

will apply only to healthcare organisations within the

are compatible with offerings from competing vendors,

Wave 1 geographic catchments, or additionally include

effectively requiring that both the sender and receiver

healthcare organisations operating in the Wave 2

of secure electronic correspondence are using the

localities.

same system.

While the intent of the SMD initiative is laudable,

members of the Vendor Panel, presumably to subsidise

there are several pieces of infrastructure that have

the costs associated with the collaborative process

not yet emerged, the ongoing absence of which

members of the panel are contractually required to

would stifle any large scale attempt for messages to

undertake.

be sent between competing messaging carriers using

A ‘sign-on bonus’ has also been afforded to

SMD. However notwithstanding the need for the

Updates from the Members

ongoing development of shared SMD infrastructure

With the Release 1 deadline now passed and with all

components, the funding of CDA development for

software developers on the panel working on Release

Electronic Referrals should remove many of the

2, interviews with the companies involved have yielded

electronic clinical document compatibility issues that

the following progress updates. Note that due to space

have hampered adoption, particularly by general

restrictions and the similarities between the work being

practice, the vast majority of whom do not generate

undertaken by each vendor, only a small selection of

Electronic Referrals.

each vendor’s progress has been highlighted in this

article.

The Health Summaries produced by the software

are ultimately intended to be passed along to the

36 Pulse+IT

PCEHR, however such documents could just as easily

Best Practice

be sent to other healthcare providers directly. These

As a result of the Release 1 development work, Best

summaries would typically contain information about

Practice users will soon be able to download and verify

allergies, medications, demographics, adverse drug

patient IHI’s from the Healthcare Identifier Service from

reactions, immunisations, pathology results, and a past

the demographics screen in the software. As will be the

history list.

case with other clinical software, this feature requires

www.pulseitmagazine.com.au

that a first name, last name, date of birth, and either

Medicare numbers so that it will be an easy transition

a Medicare or DVA number be accurately recorded for

for users. In the same way as we have developed our

the patient.

existing Medicare Online functionality, we display

While it is technically possible for a patient’s

colour coding over the healthcare identifier number to

address to be used in the matching process, the wide

indicate whether it has been validated or not,” said Ms

variety of ways to record an address has meant some

Tudehope.

vendors, including Best Practice under advice from

NEHTA, have steered away from this approach to

the Vendor Panel project will not be unfamiliar to

matching at this time.

Communicare Systems, the company having already

participated in a range of shared electronic health

Best Practice has allowed users of its software to

The work associated with later Releases of

easily check if patients displayed on the appointment

records initiatives.

screen have valid healthcare identifiers stored in the

Best Practice database. If they do, a green flag will be

not in the same format exactly, we already do a similar

shown adjacent to the patient’s name, and if not, a red

thing with the Northern Territory Shared Electronic

flag will be displayed. In the event of a patient having

Health Record and another shared record product

a red flag next to their name, the receptionist would

called RecordPoint, developed by Extensia,” said Ms

endeavour to check the key demographics for the

Tudehope.

“While the deliverables for the Vendor Panel are

patient and subsequently download the patient’s valid healthcare identifier into the Best Practice database.

Genie Solutions

In support of the Wave 1 initiative — a part of which

Genie Solutions received notice that the healthcare

involves the large‑scale importation of healthcare

identifier components of its software had been

identifiers into clinical software — Best Practice

successfully tested in mid-August. As the company

worked with Health Industry Exchange to allow its ‘HIE

produces software for both Apple Macintosh and

Sync’ software to perform batch lookups of healthcare

Microsoft Windows operating systems, independent

identifiers in Wave 1 sites using Best Practice.

testing was necessary for both versions of the software.

Communicare Systems

Customers of Communicare Systems will first have

complete, users of the software will have the option

access to functionality developed as part of the Vendor

to download or verify healthcare identifiers from

Panel process with the impending release of v11.3.

within the patient demographics screen. A date field

This build of the software is intended as a general

and colour coding system has been incorporated to

release for all Communicare customers and will feature

indicate the amount of time that has elapsed since the

additional enhancements not directly related to

last verification has taken place.

healthcare identifiers and CDA.

Heidi Tudehope of Communicare Systems indicated

company’s software will be rolled out to users of Genie

that the company’s work with the Healthcare Identifier

v8 within the Wave 1 catchment, but this will expand

Service will be familiar to users, many of whom are

over time as part of the existing rollout the company is

using the somewhat similar Medicare Online Patient

undertaking with the latest version of its software.

Verification features of the product.

messages, the functionality having been added to the

“In a lot of ways we’ve mimicked the user

functionality that we already had for referencing

With the healthcare identifier functionality now

Dr Paul Carr of Genie Solutions indicated that his

Genie has long had the ability to display CDA

software in response to previous NEHTA initiatives.

www.pulseitmagazine.com.au www.pulseitmagazine.com.au

Pulse+IT 37

iSoft

to v16. This version was made available to all practices

Due to the large number of products developed by

running Zedmed in late August, with Dr Andrew Pascoe,

iSoft that will need to interact with the healthcare

Zedmed’s Clinical Lead, highlighting the important role

identifier service, Byron Phillips indicated that his

healthcare identifiers will play in connecting healthcare

company’s approach to the Vendor Panel has been

organisations electronically.

mindful of the need to ensure any code produced can

be utilised throughout a range of iSoft products.

toward achieving a comprehensive approach to

“The introduction of HI’s is one of the first steps

“One of the things we’re reasonably proud of is

eHealth. GPs need software capable of delivering

that we were first to be certified through the third

this seamless communication of reliable healthcare

party independent labs. We were first to market with

information between individuals, healthcare providers

the enablement of our GP product, which is nice. The

and other provider organisations. We have a solution

reason, partially, for that is we’ve always maintained

that is ready and available in the market right now,”

that we would do this development as external to the

said Dr Pascoe.

applications as we can, so that we can reuse it, not

just across our GP platforms, but our patient systems,

subsequent release of the software (v17) will follow

our ED systems, our clinical systems, our pharmacy

in October, which is expected to incorporate the

systems and so on. However it was the first test where

additional features being developed by the company

we had to put something on the ground and get it

as part of Release 2.

independently tested,” said Mr Phillips.

iSoft has indicated that they are applying this

According to Simonne Norton of Zedmed, a

Conclusion

approach to their work with SMD.

With the support of NEHTA, members on the Vendor

“Again, that’s a component that we’re building

Panel are charged with delivering a large parcel of

agnostic of the application, which is really important

software development in a very aggressive time

to us. We have a large set of applications in the acute

frame. In fact many members on the Vendor Panel

market that we obviously need to have enabled

have indicated that other, more customer-centric

through a similar approach.”

development priorities have had to be put on hold to meet the agreed contractual deadlines of the process.

Medtech Global

Having completed the development work associated

undertaken, it is evident that there is acceptance of

with Release 1, Medtech Global has been testing its

the process by members of the panel, and a belief

healthcare identifier functionality in a selection of the

in the benefits the project will yield as specifications

clinics using its software in the Wave 1 geographic

and standards are rolled out in mainstream Australian

regions. Notably, one such healthcare facility in the

clinical software. Summarising this sentiment are the

Hunter Region of NSW has a database with over

words of a Vendor Panel member: “This whole project

250,000 patients.

is about putting NEHTA’s work into some actual real

Reflecting on his company’s range of clinical

life applications. Until Government decided to pay to

products, Rama Kumble of Medtech Global noted that

have it done there was no real incentive for any of the

a conscious decision was made to develop the requisite

vendors to actually do it. It was a lot of work and users

healthcare identifier functionality as an independent

weren’t crying out for it, and to be honest, everyone

module.

had pretty much come up with ways to get it done

However despite the additional workload being

“We’ve produced a reusable component. We’ve

anyway. Pathology, radiology and discharge summaries

made only minimal changes to MedTech32 and nearly

have been flowing between hospital and doctors and

everything is in a component which we can pick up

labs for years, so there was no huge imperative to get

and use in other MedTech products, such as MedTech

some of these NEHTA specifications in place because

Evolution and Rx,” said Mr Kumble.

they weren’t really going to add anything to the functionality that users had already. But, at the end of

38 Pulse+IT

Zedmed

the day, they make it all a hell of a lot easier and a lot

Zedmed users will be able to interact with the

more standardised, which, from our point of view, will

Healthcare Identifier Service once they have upgraded

be good in the long term.”

www.pulseitmagazine.com.au

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FEATURE

Social networking in healthcare – security and privacy implications Alberto Tinazzi

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

The Internet is in constant evolution and while most

cause of embarrassment to their employer.

users find this exciting, it also introduces a series of

new threats and a range of new opportunities for cyber

accidentally post sensitive information on public

criminals. New technologies such as social networking

websites, forums and blogs. Even the publishing

tools are rapidly growing in popularity, including

non‑sensitive information may have a considerable

amongst healthcare professionals.

impact on security. In fact any personal information

A growing number of organisations have jumped on

posted may be used by cyber-criminals to develop a

the social networking bandwagon as a means to extend

detailed profile of the employee and help them to build

the reach of their business. Tools like Facebook, Twitter,

a trusting relationship with their victims for malicious

LinkedIn and MySpace and many other blogging sites

purposes.

are an excellent way to promote products and services

and keep in touch with customers, or patients in the

information

case of the health sector. However, social networking

information published on a blog for example. This

tools could also pose some serious security threats to

phenomenon is known as ‘inference’. Similarly, two

businesses if not wisely used.

or more pieces of non-sensitive information may

Employees need to be extremely careful not to

An individual may be able to discover sensitive deduction

from

non-sensitive

According to a study conducted by Medical

increase their sensitivity when they are put together.

Observer in 2010, 79% of Australian doctors use

This phenomenon is know an ‘aggregation’ and is very

Facebook. Most of them use social networking tools

common on blogs and online forums, where multiple

for social purposes but there is a growing number of

individuals discuss a common topic.

doctors that use social networks to provide healthy

lifestyle advice and education to patients.

aggregation as individuals can access a great volume

Some doctors may find themselves in an awkward

of information from multiple sources over a long

situation when their patients add them as ‘friends’

period of time and then correlate all the gathered data.

on Facebook and wish to discuss their medical

Healthcare workers should be trained and aware of the

issues. Health professionals need to be aware of the

risks posed by aggregation and inference.

professional and legal issues introduced by using social

media to interact with their patients.

University of Pennsylvania revealed that 56.8% of blog

Another problem related to the use of social

authors provided sufficient information to reveal their

networking tools, from a security point of view, is the

own identity and in 42.1% of these blogs individual

leakage of confidential information. Staff discussing

patients were described. 16.6% of the blogs contained

work related issues on social networking sites may

enough information for patients to identify their

inadvertently disclose confidential information about

doctors or themselves.2

the business, a competitor, a customer or patient, or

may make inappropriate comments which may be a

making

1

It is very difficult to prevent inference and

A review of 271 medical blogs carried out by the

There have been cases in Australia of doctors inappropriate

confidential

Author Info

by

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

statements

information

on

or

social

discussing networking

media. Doctors need to be very careful when posting comments or other information on the Internet as it can more than likely become very public very quickly, potentially having serious consequences on their reputation and career.3

The Australian Medical Association in collaboration

with three other peak medical bodies has developed

40 Pulse+IT

www.pulseitmagazine.com.au

Social Media and the Medical Profession, a guide to

use of social networking tools. However the employer

online professionalism for medical practitioners and

can obviously exert no technical controls over what

medical students. This document provides advice

employees do outside business hours, or during

to health professionals and medical students about

business hours using their own Internet connected

preserving their personal integrity and reputation when

devices. Confidential or embarrassing information

using social networking media. One of the first pieces

involving the organisation may still be leaked. It is

of advice provided by this guide is an invitation to

therefore advisable that organisations have a policy

doctors to search for their full name on popular search

covering the use of social networking tools and provide

engines such as Google and consider whether they are

them with adequate information and training on the

comfortable with the results.

topic.

4

It is also important to understand that on the

The social networking phenomenon continues to

Internet, where users go, cyber-criminals follow. They

grow and has started playing quite an influential role on

have in fact developed many techniques that leverage

the political landscape in many countries. We only need

social networking tools to steal users identity, to

to look at recent events in Egypt, Libya and Algeria,

gather personal information and confidential data

where social media has assisted in driving political

and to infect their victims’ computers with malware.

changes. In January 2010 Facebook had 350 million

These techniques include, for example, hijacking users

active users however, just a year later the total of users

accounts, spreading fake applications, setting up fake

had exceeded 640 million, half of which connect to the

accounts, contacting users as Facebook itself and

service daily.5

more.

Most

malware

can

propagate

via

Social networking is impacting on all industries

popular

and the healthcare sector will not be immune.

social networking tools. New malware that has

Providers and the organisations they work for may be

been specifically engineered to take advantage of

required to adopt such technologies in order to remain

vulnerabilities of social networking media has started

competitive. The risks are surely always going to be

to appear. For instance the Koobface worm, which

there but these can be mitigated through the use of

after infecting a computer, spreads itself by sending

the technologies in an informed manner.

messages to friends of Facebook users. Koobface also works with Twitter, MySpace and other popular

References

social networking tools. Consequently the information

1. Brill D. Social networking: facing the facts. http://

gathered from users’ accounts such as names, age and

www.medicalobserver.com.au/news/social-

job titles, for example, can be used to impersonate the

networking-facing-the-facts (accessed Aug 2011).

individual and to send emails containing malware on

2. Tara Lagu, MD, MPH, Elinore J. Kaufman, David

their behalf.

A. Asch, MD, and Katrina Armstrong, MD,

MSCE. Content of Weblogs Written by Health

Organisations should have a social networking

policy that regulates the use of social networking tools

Professionals. http://www.ncbi.nlm.nih.gov/pmc/

in accordance to the organisation’s objectives. An

articles/PMC2533366/ (accessed Aug 2011).

organisation may decide to provide unrestricted access

3. Rose D. Warning to doctors on Facebook. http://

to social networking sites in which case it is advisable

www.dailytelegraph.com.au/news/breaking-

that users are trained about the risks posed by the use

news/warning-to-doctors-on-facebook/story-

of social networking tools. Or an organisation may

e6freuyi-1225963359472 (accessed Aug 2011).

decide to allow for restricted use of social networking

4. Australian Medical Association et al. Social Media

tools by limiting access to specific employees or to specific hours of the day. This arrangement can be implemented through a web content filtering

and the Medical Profession. http://www.ama.com. au/socialmedia (accessed Aug 2011).

5. Browser Media. 2011 social media statistics

application or the administration interface of many

show huge growth. http://www.browsermedia.

modern routers.

co.uk/2011/03/30/2011-social-media-statistics-

show-huge-growth (accessed Aug 2011).

Other organisations may decide to totally ban the

www.pulseitmagazine.com.au

Pulse+IT 41

FEATURE

Big results come from taking small steps Rachel de Sain

Director Flaxworks rdesain@flaxworks.com.au

At the time I was working in Finland in the late 90s,

Nokia was in the process of releasing a new type of

rollout of eHealth tools such as the Personally

mobile phone that could connect to the Internet. The

Controlled Electronic Health Record (PCEHR) here in

Internet was already a must have tool for connecting

Australia. I do believe the PCEHR is a very important

you to the people, places and information you needed

first step on the journey to a more sustainable patient

through your computer, and the thought of having

centred model of care, but one of many. Perhaps given

the possibility to connect whenever from wherever

the very short time frames to its launch on 1 July 2012

you were using the device in your pocket was pretty

and the massive development work needed to just

exciting.

simply get the clinical system in building A to talk to

the clinical system in building B, maybe we should just

A short time later I returned to London and told

I worry that a similar path is unfolding for the

my friends about this amazing new thing called WAP,

start small?

which I believed was going to revolutionise the way

we lived. However most of them really didn’t care, it

to avoid pain, costly time off work, and further

didn’t mean much in their lives at that point in time,

procedures. I have, over the years, learnt to understand

the phones were out of their price range and they

my body but also seek out more information from both

didn’t see the value. They were more interested in

the medical and patient world to help me help myself.

the slide functionality of the prototype Nokia 7110 I

had brought back with me — which made a cool noise

for me, the patient, to help me manage my health

as it flipped back and forth — than the possibilities

through an online portal of applications and services

an Internet connected mobile phone could bring.

designed to support me in making decisions about my

Although a decade later they are all now happy iPhone

health needs. It would be a way to migrate us from a

and Android owners who wouldn’t leave home without

provider centric model of care to the patient centric

their precious smart phones.

system where consumers are empowered to take more

responsibility for their own health and play a more

Soon after I returned to the United Kingdom I

As a patient with a chronic disease, I am motivated

Initially I thought the PCEHR would be a tool

started seeing major print, outdoor and TV advertising

active role in their healthcare dialogue.

run by BT Cellnet — the major carrier in the UK at the

time — asking you to come and surf the BT Cellnet.

document which talks about the need to reform

The advertising campaign featured a slick silver

healthcare delivery to ensure a sustainable future

avatar surfing down through a multicoloured tube of

for all. Using Microeconomic reform to deliver patient

light, giving you the impression you could get all this

centred care highlights the need to migrate more of the

information at your fingertips at lightening speed. The

care away from the ‘mainframe’ model where people

reality at 9kb/s was more like teletext than television.

come in to a healthcare facility to seek help, towards a

The Business Council of Australia has a brilliant

system where tools and support for people is provided

Author Info

closer to, if not in, their own homes. Cost effective Rachel consultants on digital strategy, is part of the clinical leads & consumer reference forum at NEHTA, she is a board member for HISA (Health Informatics Society of Australia) and previously held positions on the board at AIMIA Victoria and Vic ICT for Women.

systems are needed to support a more prevention-led environment for managing health rather than today’s reactive model focused on the delivery of medical care.

We are not the only ones to be focusing on this

migration. The Health 2.0 summit taking place in San Francisco in late September will bring together

42 Pulse+IT

www.pulseitmagazine.com.au

key stakeholders from health, industry

don’t need to try and remember the exact

care for me. The patient apps and services

and patient advocacy groups to discuss

details of a surgery performed over 10

are important and we need to ensure the

the opportunities modern technologies

years ago. I can’t imagine what it must be

PCEHR is designed for their integration,

present. I believe this event will provide

like for someone twice my age or suffering

but they can come later.

significant insights into the barriers to

from cognitive issues.

change and ideas about how to drive the

The PCEHR is not the patient portal

is needed most: primary care. GPs will be

adoption of eHealth in Australia.

I thought it was initially — it is even more

on the frontline of rolling this out and this

For my own healthcare needs I have

important. It is the secure space where my

is where the health conversations already

created a medical folder with sections for

care team — regardless of where they are

happen, so let us work on making it right

all my test results and medical information,

or what system they use — can access the

for them to begin with, while still ensuring

as well as notes and questions from articles

right information when they need it, and in

that we meet the patient privacy and

or conversations conducted online with

turn provide me with the best care.

security concerns.

other patients. I take this with me to all of

my various appointments so that I know

in the cloud. The clinicians I choose to care

the foundations in first, the PCEHR is

my care team are all on the same page

for me will be able to access this service

no different. I am really pleased NEHTA

with current medications, tests, allergies,

to retrieve the most important health

has and continues to bring together all

previous history and I don’t waste our time

information about me.

4 corners — Consumers, Clinicians, ICT

repeating all this information. Another key

I want the PCEHR to be a digital version

and Policy to talk about the design and

advantage is as a memory aid, my blue

of my little blue folder. I want to feel safe

roadmap, but for 1 July 2012 — let us keep

folder ensures in those moments when I

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it simple and ensure we don’t over promise

Puse IT Mag and under deliver.

connecting healthcare

www.pulseitmagazine.com.au

Pulse+IT 43

Cerner Corporation Pty Limited

Advantech Australia AAPM

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

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

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

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

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

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

• Mini-PC and Medical Imaging Displays.

• Mobile Medical Tablets.

• Patient Infotainment Terminals.

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

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

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

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

cdmNet

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

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

Best Practice

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

Argus

Australasian College of Health Informatics

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

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

Argus provides and supports Argus secure messaging software; 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.

T: +61 3 9023 0800 F: +61 3 9614 2650 E: info@precedencehealthcare.com W: www.precedencehealthcare.com cdmNet is an online service specially designed to manage the entire life cycle of a patient’s chronic disease. cdmNet delivers best practice chronic disease management, including creation of GPMPs, TCAs and Reviews.

In addition, collaboration with your care team is quick, easy and ongoing. cdmNet minimises the bureaucracy, eliminates the paperwork, and ensures compliance with Medicare requirements for chronic disease management. cdmNet optimises patient care, simplifies care team collaboration and minimises administration & paper work.

Find out more about how cdmNet can assist you and your practice by typing cdm.net.au/info into your browser address bar. cdmNet: Chronic Disease Management just got a whole lot easier.

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”.

www.pulseitmagazine.com.au

Direct Control

CH2 (Clifford Hallam Healthcare) P: 1300 720 274 F: 1300 364 008 E: marketing@ch2.net.au W: www.ch2.net.au

Clifford Hallam Healthcare (CH2) is today Australia’s largest pharmaceutical and medical healthcare service provider with a catalogue of over 30,000 products servicing metro, regional and rural customers across Australia.

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

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

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

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

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

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

Communicare Systems

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

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

dbMotion

P: +61 2 8011 4885 E: info-aus@dbmotion.com W: www.dbmotion.com dbMotion’s connected healthcare solutions for shared electronic health records (Shared EHRs) and health information exchange (HIE) transform healthcare, empowering physicians and revolutionizing patient care for healthcare organisations. The service oriented architecture (SOA) based dbMotion™ Solution gives caregivers and information systems secure access to an integrated patient record composed from the patient’s medical data maintained at facilities that are otherwise unconnected or have no common technology through which to share data, without replacement of existing information systems.

Healthcare organisations using dbMotion have realised benefits in a wide variety of areas, ranging from patient safety, quality, efficacy, and IT agility.

Digital Medical Systems P: 1300 865 977 F: +61 3 9753 3049 E: inform@dgs.com.au W: www.dgs.com.au

Easier ICT is a technology partnership with DMS — we make I.T. work for you.

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

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

Accreditation is easier with the customised DMS IT Systems Documentation. Ensure your practice has the best quality IT policy, security and maintenance program that meets and exceeds the standards guidelines from the RACGP and AGPAL and GPA. World leading DTech provides 24x7 near Real-Time Monitoring and Management that alerts and enables our engineers to quickly troubleshoot and solve problems of security, network, Internet, Server and software remotely on almost any client computer system or device.

Medical IT systems are automatically maintained by DTech to the most highly available status to minimize downtime by preventing problems from occurring or reducing their impact.

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

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

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

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

Direct CONTROL facilitates Medical Billing Australia-wide and overseas.

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

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

eHealth Security Services

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

CH2 recently won the “SAP Best Business Intelligence with Channel Partner” award at the SAP Customer Awards of Excellence 2011. CH2 are also sponsoring the 2011 Victorian SCLAA awards.

www.pulseitmagazine.com.au

Pulse+IT 45

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

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

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

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

• EPRX – an Electronic Patient Referral Exchange and Directory.

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

Equipoise (International) Pty Ltd Totalcare

Totalcare is a fully integrated Clinical, Office and Management software suite. Totalcare is stable, scalable, customisable and easy to learn and use. From a small practice to a distributed, multi site, multi disciplinary corporate entity or hospital, Totalcare can provide a solution for your needs.

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P: +61 2 9906 6633 F: +61 2 9906 8910 E: hcn@hcn.com.au W: www.hcn.com.au

Global Health

P: 1300 723 938 F: +61 3 9675 0699 E: sales@global-health.com W: www.global-health.com Global Health is a leading provider of e-health solutions that connect clinicians and consumers across the healthcare industry. Global Health’s portfolio consists of: • ReferralNet - a cloud-based secure message delivery system for the exchange of information between healthcare providers.

• MasterCare® - a suite of health information systems that provides tools to collect, manage and access clinical and patient information at the point of care.

• LifeCard® - a personal health management system for keeping all your important medical information in ONE secure location.

With LifeCard® you can maintain a personal health record, access emergency health information and be rewarded for looking after your health.

P: +61 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 2200 sites, it is now the number one choice of Australian specialists.

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

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

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

Genie Solutions

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.

Health Informatics Society of Australia

GPA

P: +61 7 3252 2425 F: +61 7 3252 2410 S: skype.totalcare.net.au E: sales@totalcare.net.au W: www.totalcare.net.au

Equipoise International Pty Ltd (EQI) is the developer and supplier of the ‘Totalcare’ clinical and office management system. Used since 1995 by health care facilities across Australia including General and Specialist practice, Radiology, Day Surgery and Hospitals.

Health Communication Network

GPA ACCREDITATION plus has given general practices a reliable alternative in accreditation. GPA is committed to offering a flexible accreditation program that understands the needs of busy GPs and practice staff. GPA assigns all practices an individual quality accreditation manager to support practices with their accreditation.

Choose GPA for more support, improved service and greater choice.

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

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InterSystems

P: +61 2 9380 7111 F: +61 2 9380 7121 E: anz.query@InterSystems.com W: www.InterSystems.com

Health Information Management Association Australia 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.

InterSystems Corporation is the worldwide leader in breakthrough solutions for connected care, with headquarters in Cambridge, Massachusetts, and offices in 23 countries. InterSystems TrakCare™ is a Web-based healthcare information system that rapidly delivers the benefits of an Electronic Patient Record. InterSystems Ensemble® is a seamless platform for integration and the development of connectable applications. InterSystems HealthShare™ is a strategic platform for healthcare informatics, providing capabilities for sharing of clinical information, comprehensive advanced analytics, building clinician and patient Web-based communities, and quickly filling informational and functional cross-system “gaps.”

InterSystems DeepSee™ is software that makes it possible to embed real‑time business intelligence capabilities in transactional applications. InterSystems CACHÉ® is a high performance object database that makes applications faster and more scalable.

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

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

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

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:

MEDITECH Australia

P: +61 2 9901 6400 F: +61 2 9439 6331 E: sales@meditech.com.au W: www.meditech.com.au A Worldwide Leader in Health Care Information Systems MEDITECH today stands at the forefront of the health care information systems industry. Our products serve well over 2,300 health care organisations around the world. Large health care enterprises, multi‑hospital alliances, teaching hospitals, community hospitals, rehabilitation and psychiatric chains, long-term care organisations, physicians’ offices, and home care and hospice agencies all use our Health Care Information System to bring integrated care to the populations they serve. Our experience, along with our financial and product stability, assures our customers of a long-term information systems partner to help them achieve their goals.

Medtech Global Ltd

P: 1800 148 165 E: sales@medtechglobal.com W: www.medtechglobal.com

P: +61 427 844 645 E: ceo@msia.com.au E: president@msia.com.au W: www.msia.com.au

For over 27 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.

With the increase in government e-health initiatives, the MSIA has become increasingly active in representing the interests of all healthcare software providers.

Medtech’s Medtech32 and Evolution solutions improve practice management and ensure best practice for electronic health records management and reporting.

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.

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.

Medical Software Industry Association

HealthLink

P: 1800 125 036 (AU) P: 0800 288 887 (NZ) E: enquiries@healthlink.net W: www.healthlink.net

iSOFT

Join over 100 other companies across all areas of medical IT/IM so your voice can be heard.

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.

• Cloud based computing tailored to medical industry • Medical voice recognition • Capped cost medical support and maintenance plan • Ability to consult remotely • Medical application support

www.pulseitmagazine.com.au

Pulse+IT 47

MIMS Australia

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

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

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

Pen Computer Systems

Mouse Soft Australia Pty Ltd

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

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

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

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

P: +61 2 9635 8955 F: +61 2 9635 8966 E: enquiries@pencs.com.au W: www.pencs.com.au

Nuance Communications

P: 1300 550 716 F: +61 2 9434 2301 E: Vicki.Rigg@nuance.com W: australia.nuance.com W: newzealand.nuance.com Nuance (NASDAQ: NUAN) is a leading provider of speech and imaging solutions for businesses and consumers around the world.

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

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

Feature Rich. Dynamic. Innovative.

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.

Orion Health NEHTA

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

MITS:Health

P: 1300 700 300 E: info@mitshealth.com.au W: www.mitshealth.com.au Managed IT Services for the Health Industry MITS:Health provides a full range of IT services specifically tailored for medical centres, GPs and specialists across Melbourne.

• • • • • •

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

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.

P: +61 2 8096 0000 / +64 9 638 0600 F: +61 2 8096 0001 / +64 9 638 0699 E: enquiries@orionhealth.com W: www.orionhealth.com Orion Health is a world leader in the e-health industry. We specialise in electronic health record (EHR) solutions, disease management, clinical decision support, and hospital administration tools. More than 300,000 clinicians in 30 countries use Orion Health products.

Our EHR solutions have been widely adopted across Canada, Europe and the USA to enable secure crossorganisational and regional sharing of patient information, resulting in improved patient care.

Our Rhapsody Integration Engine, a healthcare dedicated and standards based Integration hub, is used by customers to easily create interoperability between existing healthcare information systems.

Our solutions are designed to support emerging health IT trends and standards, we work closely with our customers, clinicians, government bodies and other industry leaders to deliver intuitive solutions to meet your current and future needs.

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Medilink

from Practice Services P/L

P: +61 3 9819 0700 F: +61 3 9819 0705 E: Sales@practiceservices.com.au W: www.practiceservices.com.au 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 àà and/or integrated HICAPS àà and/or Medicare Online àà 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

www.pulseitmagazine.com.au

Spellex

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

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

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

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

Sysmex New Zealand

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.

P: 1800 061 260 E: sales@tg.org.au W: www.tg.org.au

Sysmex New Zealand is a market leader in the development and implementation of health IT products and services for clinical laboratories, hospitals and healthcare organisations.

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.

Real Outcomes Real Productivity Minimising Waste

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

Therapeutic Guidelines Ltd

P: +64 9 630 3554 F: +64 9 630 8135 E: info@sysmex.co.nz W: www.sysmex.co.nz

Trend Care Systems

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

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Therapeutic Guidelines was awarded ‘Best eBook Publisher’ for eTG complete in 2009 by The Association of Learned and Professional Society Publishers. 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.

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Pulse+IT 49

Kelvin’s eHealth Journey

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

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

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

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

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GP consultation

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

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

National E-Health Transition Authority

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

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

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

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

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Specialist consultation

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

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

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

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

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

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

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

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

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

What a wonderful outcome!