Holiday reading: New Zealand eHealth

Pulse+IT is taking a break from daily news reporting for the festive season but will return on Monday, January 5.

If you are after some holiday reading, you may like to review our 2014 New Zealand eHealth magazine online below. This and other editions of Pulse+IT are available via the ‘Magazines’ menu at the top of this site, and also via the Issuu app for iOS and Android devices.

State-by-state overview of eHealth and telehealth at RMA 2014

The states and territories are each sending a representative to the Rural Medicine Australia (RMA 2014) conference in Sydney next week to provide an overview of eHealth and telehealth programs in the jurisdictions.

The whole of health sector panel includes the acting chief technical officer for Queensland’s Health Information Services agency, Paul Carroll; the director of innovation, strategy and architecture with eHealth NSW, Michael Costello; and the NT’s chief clinical information officer, Leonie Katekar.

It will be chaired by the immediate past president of the Australian College of Rural and Remote Medicine (ACRRM), Jeff Ayton, who will also deliver a presentation on behalf of the Tasmanian government.

The federal Department of Health’s chief information and knowledge officer, Paul Madden, is expected to provide an update on the current status of the PCEHR following a series of consultation meetings the department has held over the last few months to gauge reaction to the Royle review into the system.

Mr Madden will be joined on another panel by the chairman and the CEO of the National E-Health Transition Authority (NEHTA), Steve Hambleton and Peter Fleming. The next release of the PCEHR is due in December.

All three have released videos inviting rural doctors to attend the conference. Mr Madden said he believes that rural doctors should be one of the the chief beneficiaries of any eHealth system.

“eHealth hasn’t stood still,” he said. “We’ve had the personally controlled electronic health system in operation now since July 2012. There has been a good deal of use of that system [but] not as much as we would expect.

“I’ll give you some insights on where we are headed from here, and probably get some feedback from you on how you believe we will be going forward with those plans.

“There is a lot of hype and a lot of silly messages out there about what the eHealth system is about. Things about usability – some of those are correct but we’ve actually done some good work to improve usability for clinicians and other healthcare providers. So we need to bring you up to speed with what that is.”

Dr Hambleton his decision to join NEHTA was “a great opportunity to be able to progress our eHealth agenda in Australia”.

“This is a unique position Australia finds itself in,” he said. “If you look internationally, there is no other country with a standard rail gauge that we’ve got on the table now.”

The eHealth stream will be held on Friday, October 31, kicking off with a telehealth session featuring Dr Ayton, ACRRM president Richard Murray and the CSIRO’s Yogi Kanagasingam.

Rural GP Ewen McPhee will also provide a demonstration of using the PCEHR in action in rural general practice.

Rural Medicine Australia 2014, organised by ACRRM and the Rural Doctors Association of Australia (RDAA), is being held at the Four Seasons Hotel in Sydney from October 30 to November 1.

Metadata problem with summary views of PCEHR documents

The Department of Health (DoH) has issued a warning through clinical software vendors that problems are occurring in summary views of certain clinical documents on the PCEHR.

Both Genie Solutions and MedicalDirector have issued statements to users that there is a potential risk in that some documents, while uploaded correctly, are not being displayed in certain views. Users are being warned not to rely on the Medicare Overview or Prescription and Dispense View for the time being, but to check the full Document List.

Clinicians are already warned not to rely on these views as a full medicines history. The Prescription and Dispense View, for example, carries a message that it “is not a complete record of the individual’s medicines information”.

A spokesperson for the department said the complete listing of consumer documents is available in the relevant Document List, such as the PBS list, and there is also a summary of information for each document that is presented in the Medicare Overview view or the Prescription and Dispense View.

However, the desktop clinical information systems (CIS) used by clinicians differ in the way they draw information from the PCEHR and display it, the spokesperson said.

“This will depend on how each CIS vendor has chosen to receive and display information. All CIS systems will request a list of documents available for each consumer record which is provided to them from the Document List.

“All documents that are requested by a CIS from the Document List are accurate and correctly presented. If a CIS has also chosen to ask for summary information for a ‘view’, that information will not be available for a small number of documents.

“This issue occurs when the metadata contained within documents sent to the PCEHR is not able to be stored in the system and used to display the summary information in the view. In all cases the complete document is stored in the system and available to users from the Document List.”

The spokesperson said the department is implementing a remedy to address the cause of the issue in the December release of the PCEHR.

Genie is warning its users not to rely on the Medicare Overview or Prescription and Dispense View within the Genie PCEHR-viewer to provide a complete list of information from a patient’s eHealth record. Likewise, MedicalDirector says users should not rely on the Prescription and Dispense View within the MedicalDirector Clinical PCEHR screen, but use the PCEHR View to check all documents.

Best Practice chief commercial officer Craig Hodges said that according to the information supplied to the company, it believes there is no issue within Best Practice Software.

The problem is not affecting the consumer view of their record.

Healthcare practices and outsourced appointment services

This story first appeared in the August 2014 issue of Pulse+IT Magazine.

Despite being early adopters of computers and information technology in general, medical centres remain staff-intensive businesses. The personalised, one-to-one services provided in practices of all types typically extends beyond the consultation room and into the reception and administration functions. However, many of these non-clinical duties can be outsourced without the patients even knowing it.

Businesses of all shapes and sizes are starting to explore the possibilities that internet-enabled workforces can deliver by tapping into global marketplaces such as Elance, oDesk and Freelancer. However, the sensitive nature of the work undertaken in medical centres and the privacy requirements associated with the data contained in practice IT systems precludes many jobs from being performed overseas.

Despite this, there are some duties that may lend themselves to being outsourced from your practice, with third-party telephone and appointment-related services available to businesses in the healthcare sector for a number of years.

One such service, VConsult, launched in 2011 as an offshoot of established medical locum service Medic Oncall.

Melissa Bennett, managing director of VConsult, says the idea for the business came from a desire to offer the junior doctors the company had worked with as locums some assistance as they started their own practices.

“What we’re trying to achieve is to allow doctors to not have to worry about staffing headaches and running the practice, especially when they start up and they can’t afford to have a full time secretary,” Ms Bennett says. “Answering calls five days a week when patients might be only making two, three, four, five appointments in the whole week is not cost effective.”

While traditional third-party answering services are used by many small businesses and may be applicable for some medical practices, VConsult offers a broader range of services than simply taking and forwarding messages.

To read the full story, click here for the August 2014 issue of Pulse+IT Magazine.

Virtual reality app for people living with dementia

Well-known Melbourne-based performer and journalist Mandy Salomon has designed an app for people living with mid-to-later stage dementia, drawing inspiration from the world of virtual reality.

Ms Salomon, a senior researcher at the Smart Services Co-operative Research Centre (CRC) who is doing her PhD at Swinburne University of Technology, has for some years been working on a project called Applying Virtual Environments for Dementia Care (AVED), which uses virtual reality to help dementia patients living in aged care facilities.

AVED is a pilot prototype of an interactive, tablet-based, 3D environment that includes familiar places such as a sitting room, kitchen and garden. “They can decorate their virtual rooms using colours, fabric swatches and paintings or drag their favourite photos into wall frames,” she said.

The prototype has been built by a team of former and current Swinburne students led by PhD students James Bonner and Norman Wang, who were also involved in the design of the gaming technology used for the Virtual Dementia Experience at Alzheimer’s Australia Victoria’s Perc Walkley Dementia Learning Centre in Parkville, which won the educational category award at the national iAwards last month.

The Perc Walkley Centre aims to use serious game technology to transform dementia care education.

For AVED, Ms Salomon looked at a number of factors including how the residents ‘experienced’ the activity, the interactions they undertook and if using the app provoked reflection about themselves and the world.

Mr Bonner said the team closely observed aged care residents using the app. “[We] found that when we revisit, they remember us and the application, which, given their condition, is quite profound,” he said. “It makes us feel fantastic.”

Ms Salomon is travelling to Scotland next month to present her findings from AVED at the Alzheimer’s Europe Conference and the IdeasLab 2014, hosted by the University of Stirling.

ITAC: Hills focuses on interactive tech in acute and aged care

Last month, Hills Health Solutions added an exclusive distribution partnership for the Lincor range of interactive patient care technologies to its existing portfolio of IP and WiFi nurse call systems as part of its strategy to provide integrated solutions that underpin the delivery of care in hospitals and aged care.

It might sound strange to those who have grown up with Hills and its iconic Hoist, but Hills has long been active in the technology and communications sector, particularly in electronic and video security solutions, audio visual technology and communications and mobility.

Following an agreement to sell its steel manufacturing business to Bluescope last year, Hills has set out on a new path to diversify its markets, including a new venture into healthcare with Hills Health Solutions.

For the past 18 months, the company has been scoping the Australian and New Zealand acute and aged care markets and has made some strategic purchases and distribution agreements that now position it as a major player in patient care delivery technologies.

This includes the purchase last year of IP nurse call system specialist Merlon and related company Hospital Television Rentals (HTR), and more recently the purchase of Questek, also a big player in WiFi and analogue nurse call systems, particularly in the aged care market.

Hills has also secured an exclusive distribution agreement with MyLive!y, a range of home monitoring sensors that tracks a person’s activity and send alerts if a person does not take their medicine, leaves the house or opens the fridge door.

Hills Health Solutions has now also added Lincor’s range to its portfolio, targeting both hospitals and aged care providers with its patient engagement technology, an integrated software and hardware solution that allows for both patient infotainment and the ability to access clinical systems at the bedside.

Head of Hills Health Solutions Peta Jurd said the plan was to become a major player in technologies that enable the delivery of care to hospitals, residential aged care and into the community and home.

“We are not an infrastructure player and we don’t at this stage plan to move into the delivery of clinical services,” Ms Jurd said. “We’ve been very strategic in the targets that we’ve identified. Merlon and HTR were already partnered in the marketplace and with Questek we’ve added wireless, so we’ve now got a very good range of technologies in that space. Our CEO Ted Pretty describes it as putting an electronic blanket over those systems in the hospital.”

Ms Jurd, who has a background in the private hospital sector, said Hills saw an opportunity in the fragmented healthcare market to provide integrated solutions. “If you add to that the great fortune to have a brand like Hills, which people, particularly of an older demographic who are our key customers in healthcare, they have a very great fondness for Hills and it translates into quality and reliability.

“We saw that the timing was right, because of the analogue to digital change. Particularly with Merlon, which has been very successful in having a strong IP solution, we are ahead of some of the others.”

A recent big win for the company was a contract with SA Health to design and build an IP-based nurse call system for the new Royal Adelaide Hospital, which is scheduled to complete construction in 2016. The hospital is expected to see more than 80,000 admissions per year.

The RAH contract will see more than 8500 nurse call devices go into the 800-bed hospital. “This new system is designed for patient comfort and assurance and to empower nurses to provide prompt and effective responses to patients’ calls,” Ms Jurd said. “It will provide critical end user patient safety and staff functions via instantaneous visual and audible alert and messaging.”

Hills is also concentrating on the aged care sector. Like the private hospital sector, residential aged care is going through a period of rationalisation that Hills plans to target with its product range. “What you are getting is rationalisation in those markets and getting larger customers with large portfolios who want to deal with more than a family business,” Ms Jurd said.

“We saw after doing quite extensive due diligence that there were some good quality businesses that were under-capitalised and could benefit from a corporate coming along.

“Questek has been buying a solution from Hills in the security space so what we are doing is leveraging the capability of the technology distribution business of Hills into healthcare. Hills was already selling in excess of $20 million into healthcare through its distribution businesses, but because it has been looked at on a technology basis rather than on a vertical basis that wasn’t obvious.

“With the three acquisitions, we have the customer relationships and we have the opportunity to pull through the other solutions that Hills has.”

The two recent distribution agreements with MyLive!y and Lincor were on display at Hills Health Solutions’ stand at ITAC this week, signalling the company’s emergence as a major player in the aged care market, which is also a target for the Lincor suite.

Ms Jurd said Lincor has been installed in hospitals around the world covering an estimated 30,000 beds, and the Australian and New Zealand markets are prime targets as public hospitals begin to invest in patient infotainment. Hills’ home state of South Australia, for example, has rolled out bedside patient infotainment in all of its public hospitals.

What Lincor offers over competitors, Ms Jurd said, is a complete, flexible range of offerings. “You can have the Lincor solutions on a flat screen on the wall, on an arm or on a pole, although that’s not the most common way they use it. You can have it ceiling-mounted and you can run it on an iPad.

“The other solution that’s very clever is that they have a clinical workstation that has been very popular in the US. As well as having the arm-based solution, which is the most common delivery model, they have a clinical workstation in the corner of the patient’s room. That draws the nurses into the patient’s room and gets them out of the nurses’ station, so you get better one-on-one face time with the nurses.

“They have a very nice clinical dashboard where you can see a range of personal information about the patient and some biometric information, as well as some extracts from the clinical record. All of that is available on the touchscreen. They have a quality product and we are looking to install that with one of the leading hospital and aged care providers at the moment.”

Ms Jurd said Hills was still on the lookout for complementary solutions such as those that streamline clinical workflows as well as RTLS and RFID. “They’d be most likely to be ones that interface in some way to the core solutions that we’ve bought already,” she said. “These are the enabling solutions that support the delivery of care.”

Hills’ first focus was on institutional care with public and private hospitals, aged care and independent living units, but as Ms Jurd says, once you get into ILUs it’s only a very small step to community care and care in the home, which is where MyLive!y comes in. “We saw a good product and we thought it fit the market here, and it’s an opportunity to get Hills’ name in the home other than as a clothesline and alarm provider.”

Hills is also investing in innovation, opening two innovation centres in Adelaide in partnership with the South Australian government and the three SA universities. One of the first products to come out of this will be a new nurse call handset for aged care residents with arthritis or limited dexterity that Hills is developing with the University of SA.

“When you think about it many people who end up in hospital have limited dexterity and we want to make it a little bit easier,” Ms Jurd said. “Our aged care customers are very keen to be involved in trials and have input into the design of that solution so we can improve the experience for the patient.”

While the technology portfolio is aimed at enabling care delivery, there are patient wellness benefits. Lincor’s research, for example, shows that interactive patient education can reduce length-of-stay, lower readmission rates and has been shown to improve patient satisfaction.

“There is a lot of research showing that the more educated the patient is, both about what is going to happen to them in surgery but importantly what they need to do once they go home, it translates into better outcomes and lower readmission rates,” Ms Jurd said.

“Being able to have the capability to watch videos about the kinds of exercises that an orthopaedic patient should do once they go home, to have them watching that while they are in the bed recuperating has definitely been shown to improve patient outcomes.”

Medtech gets the go-ahead for CHF home monitoring

A proposal by technology vendor Medtech Global and Peninsula Health in association with the CSIRO to trial remote monitoring of patients with chronic heart failure in their homes has been selected to receive full funding as part of the Victorian government’s Health Market Validation Program (Health MVP).

The project was one of 12 feasibility studies conducted last year and put forward for the $15 million Health MPV, which aims to partner Victorian health agencies with innovative small to medium enterprises to improve health service delivery by developing new, market-ready technology.

The chronic heart failure model of care project was one of four selected to go into a full trial. It will involve 300 patients, half of whom will receive standard care and the other half using Medtech’s VitelMed software on their mobile phones or devices to automatically track their weight and activity levels.

Weight measurements are collected from a Bluetooth-enabled scale and sent to Medtech’s cloud-based ManageMyHealth portal, to which clinicians have access. The trial is also using Medtech’s MD Analyze software to analyse the clinical data and improve treatment pathways.

The software includes prompts for the patients if they do not weigh themselves, and the ability for healthcare staff to contact them through VitelMed if they need to speak to the patient.

The project will use Peninsula Health’s existing MEPACS personal alarm emergency response service if the patients are not weighing themselves to enhance compliance and improve adoption of the technology. The MEPACS service is offered to elderly and vulnerable people living at home in Victoria.

Peninsula Health CEO David Anderson said the trial would involve the existing chronic heart failure clinic, which is serviced by a team of cardiologists and cardiac nurses.

“The idea is that we will do a trial between the existing group and the existing services with the proposed service, which includes the scales, the daily measurements, the feedback back to the patient that says you’ve forgotten your measurements, as well as the clinical protocol,” Mr Anderson said.

“It is a clinical trial of around 18 months to hopefully identify hopefully both better outcomes and reduce costs using the technology.”

Mr Anderson said the project team had consulted with cardiologists on what measurements to track using the technology, and weight was the prime indicator. “A key part of the feasibility stage was for the cardiologists to say whether they wanted to collect a large number of data and it was concluded that the change in weight and activity were really the two key signs.”

The technology also has the ability to measure other indicators, including physical activity, and Medtech is working on the capability to add data from wearable devices such as Fitbits.

The rich audio video capability of mobile devices can also be used to better provide educational resources to patients in the months between scheduled visits to the cardiac clinic.

“Where the patient stays interested and engaged there is a better response, and we think daily weighing will enable a better response,” Mr Anderson said. “We can feed back some information and we can remind them if they haven’t measured themselves, as well as getting earlier warnings about whether their weight has gone up or not.

“The other benefit will be that the care will be better streamed. If they only need to reduce their weight, they don’t need to come in to a particular clinic, it will show if they need to get into a clinic sooner rather than later.”

Medtech’s chief technology officer Rama Kumble said the trial aimed to use simple technology that is easy for the patients to use.

“It is a piece of software that runs on tablets and mobile phones and it connects with the weight scale through Bluetooth,” Mr Kumble said. “The information is gathered automatically so the patient doesn’t have to intervene; they just have to stand on the scale. It automatically gets transmitted and then securely stored in ManageMyHealth.

“The whole clinical group is then able to participate in analytical care of the patient. The ManageMyHealth data is analysed by our MDAnalyse, which is also being used in the Royal Children’s Hospital, Macquarie University Hospital and many other research hospitals around the world to improve the treatment pathways based on good clean clinical data. The data will be used by the clinicians at Peninsula Health to do long-term research as well.”

Through ManageMyHealth, the clinical team and the staff at MEPACS will be able to monitor each patient individually. If the data indicates something unusual is happening with the patient, MEPACS staff can call them or video conference them through VitelMed.

The other major benefit of the system is to include active participation of patients’ GPs in the care plan. The integration with PCEHR will enable GPs to use their own desktop software or they can directly log on to ManageMyHealth portal.

Medtech has developed a dashboard for an easy view of the data that can be set for each individual patient, and an algorithm developed by CSIRO can inform them if the patient is in danger of moving from green to amber to red.

It will also allow regular questionnaires about how the patient is feeling, whether they have shortness of breath or airway constriction problems when they are sleeping.

Mr Anderson said it was clear that this sort of home monitoring could be used for other chronic illnesses such as diabetes and pulmonary diseases, but it was essential that services such as these are sustainable and cost effective. To that end, it is using relatively simple technology joined to existing services such as MEPACS.

The primary objective of the trial is to improve the compliance rate of daily weight monitoring, with secondary objectives such as mortality, hospital readmission, risk factor management, symptoms management, medication, and quality of life.

The three other successful projects in the Health MVP include the development of a bidirectional cannula that will allow full circulatory support to avoid the risk of complications to limbs during surgery, involving MTMM and Alfred Health; the development of a new preservation technique for donor organs using perfusion instead of ice storage (Perfusion Solutions and Alfred Health); and a plaque removal device for children and others who have difficulty using a toothbrush (APS Innovations and Dental Health Services).

How to set up telehealth in rural general practice

The Australian College of Rural and Remote Medicine is holding a webinar on Wednesday explaining how to incorporate telehealth into general practice.

Featuring well-known GP and telehealth advocate Ewen McPhee, his wife and practice manager Wendy McPhee and Department of Health medical advisor Megan Kearney, the webinar is aimed at GPs, specialists, nurses, midwives and practice managers who are interested in establishing or refining telehealth services for people in rural and remote communities.

It will also cover the benefits and difficulties with the uptake of telehealth and how they can be managed.

Dr and Mrs McPhee will present their experience in establishing an effective telehealth service for their patients in Emerald in central Queensland. They will discuss issues of duty of care, clinical management and organisational considerations, including engagement with specialists.

Dr Kearney, acting assistant secretary and medical adviser with the department’s medical specialist services branch, will speak about the changes to the telehealth incentives and MBS billing arrangements commencing in July.

The webinar is accredited for professional development points with ACRRM.

Attendance is limited to the first 100 who register. It will be held on Wednesday at 12.30PM AEST.

Secure clinical message delivery: lost in the mail?

This story first appeared in the April 2014 issue of Pulse+IT Magazine.

The PCEHR has consumed much of the government’s eHealth focus, and indeed its budget, in recent years. Despite claims it would deliver “the right information about the right patient at the right time”, in its current state the PCEHR has done little to improve the ability of healthcare providers to communicate between themselves electronically.

Better means of secure electronic communication between healthcare providers has long been a priority, particularly in general practice where the benefits of electronic delivery of diagnostic results have for many years been appreciated by those who remember the paper-based alternatives.

In fact, Pulse+IT’s own research conducted as far back as November 2006 highlighted just how important practices deemed improvements directly related to the reduction of both inbound and outbound paper correspondence.

When asked “What IT/IM innovations are going to make the greatest difference to general practice”, the top four selections as ranked by survey respondents were:

  1. Specialist reports received electronically
  2. Electronic discharge summaries
  3. Ability to send referrals electronically from within the clinical software
  4. Sending electronic prescriptions to a hub to be pulled down by a pharmacist used by the patient.

The seventh- and eighth-ranked responses also related to the electronic transfer of information between healthcare providers.

Notably, given what has and hasn’t transpired in the years since the research was conducted, a PCEHR-like concept described in the survey as a “centralised patient medical record” ranked just tenth on the general practice IT/IM innovation priority list.

To read the full story, click here for the April 2014 issue of Pulse+IT Magazine.

Hits and misses with eHealth foundations: PCEHR review

The PCEHR review panel has recommended that the government implement a standardised secure messaging platform for the health sector and expand the secure messaging strategy to include consumers as well.

Secure message delivery (SMD) and the Healthcare Identifiers Service (HI Service) are highlighted in the panel’s report as essential foundations for the eHealth system that are immediately valuable platforms.

The report says many submissions to the review were highly critical of the implementation of some of the eHealth foundations – including the National Authentication Service for Health (NASH), which has been plagued by problems, as well as the myGov services website, clinical information systems in general and the PCEHR itself – SMD and the HI Service were singled out for their immense potential value.

The panel is critical, however, of missed opportunities to provide benefit through poor usability, inability to agree on standards or an inability to adopt standards in a timely manner.

On the HI Service, the panel says it is an “excellent foundational system” that is widely recognised for its value in linking information between disparate systems. However, further focus is needed for a widespread roll-out to all healthcare systems.

The HI Service is used in all clinical software that is PCEHR-compliant, especially general practice and aged care software, but is not widely used in hospitals as yet. The mapping of Individual Healthcare Identifiers (IHIs) to hospital medical record numbers (MRNs) and other patient and provider identifiers is still ongoing.

On secure messaging, the report highlights the common opinion in the healthcare industry that it is an important enabler of interoperability between clinicians. While there is an SMD standard, the review found that software providers “have not adopted this strategy in a manner that enables true interoperability”.

The report says this has resulted in multiple proprietary networks and an inefficient outcome for users who must use multiple different products depending on who they need to interact with.

“A new approach is needed to ensure compliance with the standard, either through defined compliance programs that ensure providers meet the intent of the strategy and enable true interoperability linked with ensuring only compliant providers must be used to receive the ePractice Incentive Payment (ePIP), or via centralisation of messaging to operate through a standards compliant messaging gateway,” the report states.

“This work would require evaluation, however immediate action is needed to ensure meaningful progress is made.”

While the report does not go into detail, several submissions to the review made the point that in addition to frequent use between pathology providers and general practitioners, SMD is now being increasingly used between general practice and hospitals for discharge summaries.

The use of secure messaging between GPs and medical specialists or allied health practitioners is very low, however.

In its report, the review panel harks back to the eHealth strategies of last decade, which broached the issue of secure messaging between clinicians and patients, something that has been off the agenda for some years.

The review panel wants this revisited, saying secure messaging is a “closed network that operates between clinicians and it has not been designed to include communication to patients and consumers.

“Action must be taken to expand the scope of secure messaging to a next generation service that ensures interaction between the medical profession and consumers for information that must be passed in a reliably secure manner to facilitate improved workflow and secure communication of private information.

“The intent is to enable a next generation of secure messaging capability that can enable instant and secure communication between the medical industry and consumers for the purpose of enabling workflow and communication of information that is appropriate to exchange electronically and without an in-person discussion. This capability is in line with the government’s policy.”

It also recommends that work be done on using the ECLIPSE billing system used in hospitals to see if this could be harnessed as a method of integration and alignment.

In addition to recommendations 23 and 24, which call for the implementation of a standardised SMD platform and expanding secure communication to consumers, the panel recommends that consumers be notified by SMS when their PCEHR is opened or used.

This would require everyone’s mobile number to be recorded on their profile, and the panel does not investigated the cost of such a proposal in the report.

The panel also recommends that the government commission a scoping project to identify the options available to encourage further take up of electronic transmission of data by specialist medical and allied health professional practices and private hospitals.

On the other eHealth foundations, NASH and myGov come in for some criticism due to their complexity and lack of ease of use, and the known problems with the PCEHR itself are highlighted, with recommendations for potential remedies.