Q&A: Orion Health’s Ian McCrae on precision medicine initiative

Precision medicine is defined by the US National Institutes of Health as an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment and lifestyle for each person. The concept is at the heart of a new collaboration announced this week by leading New Zealand health IT vendors Orion Health, Medtech Global and CSC.

Is this announcement a formal agreement with agreed outcomes or more of an informal collaboration?

Health is changing, so in addition to a normal clinical record with data from the lab or radiology or pharmacy, you are getting a lot of extra data being added to that: genomic data, microbiomic data, device data, environmental data. Medical records are becoming huge. There is a projection that the data will grow between 2012 and 2020 … by 50-fold. I think this is an underestimate, especially when you put genomic data in there. You have massive amounts of data and you have a number of different vendor systems that can access the data, but it’s getting to the stage where it doesn’t make sense that we all try to have our own separate data sources. New Zealand is uniquely placed in that we do have very comprehensive clinical records going back 15 years or more and we all basically know each other. We have all worked together in the past so we are pretty well placed to be one of the first countries in the world to truly do what they call precision medicine.

How would you define precision medicine as opposed to personalised medicine?

Precision medicine is pretty much personalised medicine with a bit of an extension. The word came about when [US president] Obama announced his precision medicine program at the start of this year. He’s putting a quarter of a billion dollars into it initially to sequence about a million patients in the US. At the moment we treat patients very crudely. For example, all diabetics are the same, which is clearly not the case. Your genome predicts all sorts of things. I’ve just had my variant file done. I have the Irish variant of [cystic fibrosis], which four and a half percent of the population have. There is now a drug that treats that particular variant of it and there are pharmaceutical companies now targeting patients with certain variants or single nucleotide polymorphisms (SNP). Coming back to New Zealand, we are pretty well placed to do something world leading in that area. It is recognised by Medtech, CSC and ourselves, and we would expect that pretty quickly we will have a number of organisations on board. They’ve already been showing some interest in joining up.

Is the idea to get into preventative medicine, to be able to predict what is going to happen and get in there early?

Yes, absolutely. From your genome you can predict all sorts of things. It can tell you how well you will metabolise warfarin but it will also tell you some things you don’t want to know, like Alzheimer’s. That is one of the dilemmas. These are difficult things to deal with but over the next three or four years just the amount of sequencing that is going to happen is going to be huge. The price of genomic sequencing is falling rapidly.

You mentioned in your announcement the national electronic health record that the government is planning to design. How do you see this collaboration working on that?

New Zealand is ready for an electronic health record, a national one. Precision medicine is the next-generation electronic health record. Electronic health records can deal with the traditional lab results etc whereas precision medicine includes that and all of these other data sources as well. The goal then is that if we can open up this data then you can get new people innovating, producing mobile apps, allowing patient access. There are a whole lot of possibilities. Of course you have to have the right credentialing, the right privacy and all of that but that should be provided by the platform. This should open up a whole lot of innovation in the country.

Do you foresee the collaboration building an actual product or is it an open platform that wouldn’t have any intellectual property attached?

We already have existing products and applications that are live, so we would probably just extend those products. But the key thing is to make the data really accessible, with the right privacy, readily accessible so new third-party applications can be written and there can be innovation in the sector. Patients can be connected up to their medical record, device data can be added and that’s really the future. I think this is awesome. A lot of us have competed pretty fiercely in the past but I think there is a realisation now that we have to work together because this whole precision medicine thing is going to take off. New Zealand could lead the world in precision medicine. It is a logical thing for us to do as a country and I think what we’ll find is that with the three of us collaborating a lot of other vendors will join in, and we will create a very open platform for everybody to collaborate and innovate.

International health IT week in review: December 6

Pulse+IT’s weekly weekend round-up of international health IT and eHealth news:

Summary Care Records: GPs add info
Digital Health News ~ Thomas Meek ~ 02/12/2015

Nearly all of England’s GPs are able to write additional information into a patient’s Summary Care Record from within their clinical system and more than 80% of SystmOne practices have added codes already.


Care plans shared with InterSystems
Digital Health News ~ Rebecca McBeth ~ 02/12/2015

London’s care plan sharing scheme Coordinate My Care has gone live with InterSystems’ HealthShare.


EHRs credited for increase in hospital patient safety
Health Data Management ~ Greg Slabodkin ~ 02/12/2015

Thanks in part to widespread adoption of electronic health records, an estimated 87,000 fewer hospital patients died and nearly $20 billion in costs were saved because of reduced hospital-acquired conditions from 2010 to 2014.


ONC: Two-factor authentication capabilities on the rise for hospitals
FierceHealthIT ~ Katie Dvorak ~ 02/12/2015

Two-factor authentication is on the rise at hospitals and health systems, according to the Office of the National Coordinator for Health IT.


EHR meaningful use often not worth the effort, radiologists say
Health Data Management ~ Fred Bazzoli ~ 02/12/2015

Radiologists have had varied success with becoming meaningful users of electronic health records.


Consumer engagement: ‘more rhetoric than reality’
HealthcareITNews ~ Jessica Davis ~ 01/12/2015

Health IT is moving toward a consumer engagement focus to fuelpopulation health. But despite a growing patient demand for electronic access to personal health records, technical and political barriers often limit the amount, value and accessibility of data.


GPs get read and write records access
Digital Health News ~ Rebecca McBeth ~ 01/12/2015

Clinical staff at Richmond’s new extended appointment hubs are able to read and write into patient records held in both Vision and Emis Web practice systems using Vision 360.


ICD-10 transition successful so far, but patient care takes hit
Health Data Management ~ Greg Slabodkin ~ 01/12/2015

Two new polls show mixed results since the Oct. 1 ICD-10 compliance date went into effect.


Medelinked partners with Samsung S Health
eHealthNews.eu ~ eHealthNews ~ 01/12/2015

Medelinked has been appointed a Samsung S Health partner and the Medelinked app is now available for Galaxy and other Android devices in Google Play via S Health.


Samsung introduces the next generation of S Health
eHealthNews.eu ~ eHealthNews ~ 01/12/2015

Samsung has launched the next generation of the S Health app, which provides users with more interactive and easy-to-use health functions. The updated app will also include compatibility with non-Samsung Android devices.


Hospital turns to digital video to bolster discharge efforts
FierceHealthIT ~ Dan Bowman ~ 01/12/2015

For many hospitals and health systems, technology increasingly is becoming a linchpin in efforts to improve care coordination efforts with patients following discharge.


MD Anderson Cancer Center kicks off Apple Watch pilot
MobiHealthNews ~ Jonah Comstock ~ 01/12/2015

The Apple Watch pilot that the MD Anderson Cancer Center at Cooperannounced last May finally launched today.


Judy Faulkner: Cambridge a success
Digital Health News ~ Jon Hoeksma ~ 30/11/2015

Cambridge University Hospitals NHS Foundation Trust will be recognised as the UK reference site for the benefits of hospital digitisation within a year, Epic Systems founder Judy Faulkner has said.


Hospital stops record scanning
Digital Health News ~ Thomas Meek ~ 30/11/2015

A Birmingham hospital trust has halted plans to scan its entire library of paper patient records.


Healthcare breaches surpass all others
HealthcareITNews ~ Bernie Monegain ~ 30/11/2015

The healthcare breach numbers are sobering, jolting even, as healthcare and government sectors move to the top of the list of sectors sustaining the most data breached.


Technology’s role in population health
Health Data Management ~ Elizabeth Gardner ~ 30/11/2015

As population health initiatives grow, technology is looming as an enabler of far-ranging efforts to achieve results.


Scripps, Aetna, J&J to study wearables, patches for atrial fibrillation screening
MobiHealthNews ~ Jonah Comstock ~ 30/11/2015

The Scripps Translational Science Institute is working with Aetna and Johnson & Johnson to launch a trial that will test iRhythm’s Zio Patch and the Amiigo activity tracker as possible new ways to screen at-risk populations for atrial fibrillation.


Health IT Now endorses VA telehealth expansion bill
Government Health IT ~ Jack McCarthy ~ 30/11/2015

A coalition of healthcare advocates has endorsed the Veterans E-Health & Telemedicine Support (VETS) Act of 2015, a bill that would expand veterans’ access to telehealth services.


The woes and goes of health information workforce supply

The Health Information Workforce Summit, presented by Health Information Management Association of Australia (HIMAA) in association with the Health Informatics Society of Australia (HISA) and the Australasian College of Health Informatics (ACHI) last week, heard from a variety of sources on the vicissitudes of workforce supply in the health information professions.

The shortage in health information workforce (HIW) was discussed by former HIMAA president Vicki Bennett, who was also the principal researcher on an Australian Institute of Health and Welfare (AIHW) study of the clinical coder and health information manager (HIM) workforce in 2009.

The AIHW data was complemented by more indicative membership research conducted by HIMAA in December 2014 which, according to HIMAA acting president Jenny Gilder, suggested that as many as one in three health facilities in Australia are facing clinical coder vacancies they cannot fill, while one in five facilities face the same challenge with HIM vacancies.

The HIMAA research indicated that capacity to supervise incoming clinical coders and/or HIM or coding student placements was between 41 per cent adequate and 37 per cent ‘poor-to-none’.

HIM supply

HIM course coordinators Merilyn Riley, from La Trobe University, and Maryann Wood, from Queensland University of Technology, outlined the university challenges from the workforce supply side.

Ms Riley said the relatively modest HIM degree and masters courses needed to serve four authorities – the Tertiary Education Standards and Quality Agency (TESQA), the Australian Qualifications Framework (AQF), university requirements in relation to graduate attributes and, unlike many other courses, professional accreditation by the health information management’s national association, HIMAA, to the profession’s entry level competency standards for practising HIMs.

HIMAA has been accrediting degree-level HIM courses since 1992.

Ms Riley said there was the further challenge of staffing HIM courses at the university level. Advanced academic qualifications are expected, preferably at PhD level, but HIM qualifications begin at Bachelor level, including graduate-entry masters (GEM), and these are often the best educational staff for the purpose. Industry also pays better at this level than the university.

Engagement in research is another university expectation that HIM course educators find hard to meet, given teaching load pressures and the need to locate and support suitable workplace placements for students.

Maryann Woods spoke of the threat to HIM courses of low student enrolments. Low interest can lead to acceptance of lower Year 12 scores, which in turn lowers the standing of the course in the context of higher ATAR high-enrolment courses in the health professions, she said.

On the other hand, HIM courses risk being amongst the low fruit for cancellation when there is pressure to increase revenue and university rankings.

Loss of a course in a jurisdiction leads to supply issues in that state. QUT has only just restored its HIM course after losing it in 2010.

NSW is regaining a HIM degree through Western Sydney University after the University of Sydney HIM degree disappeared in 2007. A distance learning bachelor level HIM course from Curtin University in WA has often filled the gap, but Curtin is phasing out GEM access to that course.

However, a new distance learning Master of HIM course from the University of Tasmania, for practising HIMs, brings the national HIM offering to five universities once more.

ACHI president Klaus Veil, an adjunct associate professor at Western Sydney University, spoke about similar woes for the health informatics courses available around the country. Western Sydney University and the University of Tasmania are two institutions in which HIM and health informatics courses sat side by side.

It was Karen Day, a health informatics academic from the University of Auckland and ACHI fellow, who pointed to a potential solution for workforce supply at the university level.

Dr Day said the update of New Zealand’s health strategy of 2000 and its alignment with the 1998 national health IT plan, which builds on the development of health informatics capability as a key to success, provides a structural pull factor into which the academic providers of workforce capacity-building can supply.

NZ’s national health IT plan is updated every three to five years, and a similar structural leadership from Australia focused on a health IT capability framework may provide similar certainty for Australian HIM course providers.

The need for a capability framework, and for continuity in the delivery of core HIM skills as a basis for supporting the specialisation and diversification already occurring in the health information management profession, were among the key topics of discussion in an open forum at the end of the summit’s morning session on workforce shortage.

Clinical coder supply

A number of recent solutions to clinical coder workforce shortages were also discussed.

HIMAA has a 25-year history of distance learning clinical coding education and training, initiated in direct response to our perception of workforce need in 1990. Despite being Australia’s largest provider of entry-level clinical coding graduates at the vocational education and training (VET) level, HIMAA has constantly grappled with an employer expectation of work readiness in graduates and reluctance to engage with the professional association on student workplace experience.

This is despite the fact that internships and work placements are readily accepted practice in other, more therapeutically frontline health professions.

A recent solution to this challenge for HIMAA was presented by Maria Stephanou, project manager on a NSW Health collaboration with HIMAA to deliver HIMAA coursework from its introductory, intermediate and advanced clinical coding courses to NSW Health coding employees.

At the introductory level, NSW Health offered 30 traineeships with successful employee placement outcomes in 29 cases. At the intermediate and advanced levels, practising clinical coders were offered on-the-job supervision and mentoring in addition to the HIMAA coursework.

The results for the practising coders showed tangible improvements in workplace performance in the context of career advancement. A total of 59 clinical coders completed the intermediate course, compared to HIMAA’s equivalent national average intake of 65.5, and 30 completed the advanced course, compared to HIMAA’s equivalent national intake of 34.5 – an indication of what strategic government-led support can achieve in terms of career development with productivity enhancement.

The chair of HIMAA’s workforce working group, Julie Brophy, spoke in her professional capacity as manager of productivity and the health information workforce with the Victorian Department of Health and Human Services.

Ms Brophy discussed Victoria’s six-year strategy to address clinical coder workforce shortages, including an alumni strategy, transition to work project, capability framework and, most recently, the accreditation of a Certificate IV course in clinical classification with the Victorian Registration and Qualifications Authority in 2014.

A number of registered training organisations (RTOs) are being supported to deliver the Certificate IV course in conjunction with local public health providers in Victoria, and HIMAA is developing its coursework for the certificate, incorporating material from its existing benchmark comprehensive medical terminology, introductory clinical coding and intermediate clinical coding courses.

Advantages of the Cert IV Clinical Classification are that it is a recognised VET-level course with a certificate-level qualification, which will enhance the career prospects of graduates, and it places RTO providers in a position to negotiate traineeship options with participating jurisdictions and providers.

HIMAA hopes to apply to the Australian Skills Quality Authority to secure the Certificate IV Clinical Classification on its scope of registration early in 2016 and, if successful, plans to deliver the new qualification nationally from July 2016.

Richard Lawrance is CEO of the Health Information Management Association of Australia (HIMAA).

Health information workforce faces drastic shortfall in supply: summit

The health information workforce is facing a drastic shortfall in supply in the face of inconsistent data on demand, a forum on workforce shortages has heard.

The forum, staged during a workforce summit held in Sydney last week, also heard that as many as one in three health facilities in Australia are facing vacancies for clinical coders that they cannot fill, and one in five are facing the same challenge with health information managers (HIM).

New Zealand was also represented at the summit by ACHI fellow Karen Day, from the University of Auckland.

The forum heard that actual data on which to base forward planning, as recommended by Health Workforce Australia in a health information workforce report in 2013, has been disputed.

The summit, organised by the Health Information Management Association of Australia (HIMAA) in conjunction with the Australasian College of Health Informatics (ACHI) and the Health Informatics Society of Australia (HISA), heard there was a need for ongoing research on health information workforce supply and demand in consultation with industry.

HIMAA acting president Jenny Gilder said the data on the health information management profession’s two occupations, which formed part of the HWA report’s recommendations, was at odds with data from substantive workforce research conducted by the Australian Institute of Health and Welfare (AIHW) in 2009.

“Census data between 2001 and 2011 indicates a growth of 70 per cent in HIMs in the period, from 865 to 1473, yet the AIHW’s 2010 report places [a full-time equivalent] figure of 630 HIMs right in the middle of the period between a 2006 census figure of 1255 and the 2011 result,” Ms Gilder said.

“This casts doubt on the HWA HIW report’s recommendation two, that a combination of existing data gathering institutions, including the ABS and AIHW, should be approached to improve workforce data collection.”

Ms Gilder said indicative membership research conducted by HIMAA in December 2014 showed that there were unfilled clinical coder vacancies in a third of Australian health facilities, and HIM vacancies in one in five.

Coder demand is rising for 62 per cent of respondents to the HIMAA survey, but supply is poor in 53 per cent, the research found. HIM supply is rising for 45 per cent of respondents where supply is poor for 51 per cent.

HIMAA CEO Richard Lawrance said it appeared that supply is not meeting demand, with HIMAA-trained entry-level clinical coding graduates between 2011 and 2015 totalling 726 – less half of the minimum requirement forecast by the AIHW for the 2010-15 period.

“And HIMAA is the largest supplier of VET level clinical coding graduates in the country,” Mr Lawrance said.

“This, coupled with a reluctance of employers to accept that clinical coding graduates require on-the-job induction, even though internship is accepted for almost every frontline therapeutic position, has further limited clinical coder supply.”

The forum agreed that definitional clarity was required before an appropriate data set could be developed for ongoing workforce research.

The forum also discussed how core health information management skills were the foundation from which specialisation and diversification could then occur.

HISA treasurer Phil Robinson and ACHI president Klaus Veil provided examples of people with HIM and clinical coding skills who then reached senior and executive levels in the health system, often involving a health informatics pathway.

HISA CEO Louise Schaper also presented on the Certified Health Informatician Australia (CHIA) program, which a number of health information management professionals have completed.

The peak bodies also agreed that a united voice was necessary to lobby for change, which was supported by Mr Veil and Dr Schaper.

“There is no doubt that we collectively feel that there is a problem; but we need to take an evidence-based approach that is supported by a common voice of the health information community,” Mr Veil said.

“We believe there is a real risk that the benefits sought from the recently re-booted My Health Record cannot be realised due to workforce limitations.”

Dr Schaper said the health informatics workforce was vital in the digital age. “We welcome and encourage [the Australian Health Ministers’ Advisory Council’s] prioritisation of addressing the information needs of the current and future health workforce.”

NZ’s Dr Day said there was a potential solution for workforce supply at the university level. The alignment of NZ’s national health strategy and its national health IT plan, which targets the development of health informatics capability as a key to success, provides a structural pull factor into which the academic providers of workforce capacity-building can supply.

From manual Excel mashing to practical analytics at Big Data 2015

How to extract real, practical value from big healthcare data is the theme of the Big Data conference being held in Sydney later this month, organised by the Health Informatics Society of Australia (HISA).

With an opening address by Zoran Bolevich, the acting CEO/CIO of eHealth NSW, Big Data will feature representatives from a number of jurisdictions and academic institutions as well as overseas speakers, including Isaac Kohane of the Centre for Biomedical Informatics at Harvard Medical School.

The first day of the conference will feature a debate on whether every healthcare CEO needs a measurement for how they manage and get value out of their information assets. Debaters will include Teresa Anderson, CEO of the Sydney Local Health District, Michael Costello, director of innovation, strategy and architecture at eHealth NSW, George Margelis, health and life sciences lead at Intel Australia, and Trish Williams of the School of Computer and Security Science at Edith Cowan University.

There will also be four masterclasses on practical big data analytics, including presentations by:

Day two features sessions on population health, convergence medicine, health services and practice-based evidence, and patient analytics and clinical decision making.

Keynote speeches include a presentation by University of SA research professor Libby Roughead on improved health outcomes as a result of identifying medication-related problems through analytics, and another by Centre for Health Informatics director Enrico Coiera on using data for building quality and safety at the health system level.

Big Data 2015 is being held at the Swissotel Sydney on October 20 and 21. See the conference website for more information.

Orion Health gets a bite of $4.3bn Dim-sum project through Rhapsody

Orion Health has announced that its Rhapsody integration engine will act as the link between the US Department of Defense’s new electronic health record and those used by civilian healthcare facilities as part of the $US4.3 billion Defense Healthcare Management System Modernization (DHMSM) project, colloquially known as Dim-sum.

The US Department of Defense (DoD) announced in July that it was awarding the contract for a commercial off-the-shelf EHR for serving military personnel to a conglomerate led by technology solutions giant Leidos in association with EHR vendor Cerner and Accenture.

The initial price for the contract is $US4.3bn over 10 years to deliver an EHR, integration activities and deployment across the military health system, although the actual price tag is likely to be double that figure over its expected 18-year lifecycle. DoD officials said in July that $US9bn was a more realistic figure than the original estimate of $11bn.

The Cerner-Leidos-Accenture partnership was chosen over the favourite team of Epic and IBM and another involving Allscripts, CSC and HP. An earlier team of PricewaterhouseCoopers, General Dynamics Information Technology and Google was cut from the short list despite promising to be able to interface directly with the Department of Veterans Affairs’ open source VistA platform, which is also being modernised.

Officially known as the Leidos Partnership for Defense Health, the team also includes Orion Health. The Auckland firm’s US division president Paul Viskovich said the Leidos Partnership for Defense Health was selected as the best value solution for the DHMSM contract.

“Together, our qualified and experienced team is working with the Department of Defense to deliver a world class interoperable electronic health records solution for our nation’s armed forces, their families and beneficiaries,” Mr Viskovich said in a statement.

“We look forward to the work ahead and are committed to improving access to comprehensive healthcare data in order to facilitate improved clinical outcomes for our deserving men and women in uniform.”

The DoD has selected Orion Health’s Rhapsody integration engine, which is designed for rapid interoperability between healthcare IT systems, regardless of technology or standards.

Rhapsody will provide the required link between the DoD’s Cerner EHR system and the civilian facilities that provide care to over 50 per cent of military personnel.

Orion Health says Rhapsody provides a comprehensive set of tools to simplify complex healthcare interoperability, and is the first integration engine to implement the HL7 FHIR standard.

Rhapsody is used by thousands of organisations around the world, including hospitals, software companies, public health agencies, health information exchanges (HIE), health plans and financial clearinghouses.

Orion says the integration engine provides comprehensive support for an extensive range of communication protocols and message formats, and helps analysts and hospital IT administrators reduce their workload while meeting the complex technical challenges associated with making healthcare data accessible to all stakeholders.

International health IT week in review: September 6

Pulse+IT’s weekly weekend round-up of international health IT and eHealth news:

Digital stethoscope that links with EHR gets FDA clearance
Health Data Management ~ Greg Slabodkin ~ 03/09/2015

The Food and Drug Administration has approved use of a digital stethoscope that can integrate heart sounds into a patient’s electronic health record.


Bryant puts paperless future on CCGs
Digital Health News ~ Rebecca McBeth ~ 03/09/2015

Clinical commissioning groups have overall responsibility for delivering a paperless NHS by 2020 and will manage any funding made available to support this ambition, NHS England has said.


NIH grants support incorporation of DNA info into EHRs
FierceEMR ~ Marla Durben Hirsch ~ 02/09/2015

The National Institutes of Health (NIH) has awarded 12 grants to support research that incorporates DNA sequence information into electronic health records.


What will DoD-Cerner mean for EHR ROI?
HealthcareITNews ~ Mike Miliard ~ 02/09/2015

The landmark Department of Defense contract awarded to Cerner and Leidos will have a big effect on how private-sector health systems gauge the worth of electronic health record systems, a new report from IDC Health Insights suggests.


CHEO leads with paperless outpatient clinics
Canadian Healthcare Technology ~ Staff writer ~ 02/09/2015

The Children’s Hospital of Eastern Ontario (CHEO) has become the first hospital in Canada to receive a Stage 6 electronic health records designation for its outpatient clinics from the Healthcare Information and Management Systems Society (HIMSS).


Salesforce jumps into healthcare with a tailored cloud platform
Computerworld ~ Katherine Noyes ~ 02/09/2015

Sales and marketing have long been Salesforce’s proverbial bread and butter, but on Wednesday the CRM giant branched out in a new direction with a cloud platform tailored specifically for healthcare providers and patient data.


ONC decertifies two SkyCare EHR products
FierceEMR ~ Marla Durben Hirsch ~ 02/09/2015

Two electronic health record systems have had their certifications terminated by the Office of the National Coordinator for Health IT for failure to continue to meet the EHR certification program requirements.


London to roll out eRedbook
Digital Health News ~ Lyn Whitfield ~ 01/09/2015

A handful of London trusts are about to start trialling the eRedbook child health record, ahead of a capital-wide roll-out over the next couple of years.


ICD-10 readiness: shaky optimism
HealthcareITNews ~ Tom Sullivan ~ 01/09/2015

ICD-10 is officially a month away and all indications suggest this Oct. 1 will be the day that finally matters for the code set conversion.


AHRQ funds target research, IT tools to improve patient safety
Health Data Management ~ Joseph Goedert ~ 01/09/2015

The Agency for Healthcare Research and Quality is making millions of dollars available for ambulatory care and long-term care facilities to research strategies to improve patient safety through information technology and other evidence-based tools.


Black Book: Greenway tops EHR vendors for primary care doc satisfaction
FierceEMR ~ Marla Durben Hirsch ~ 01/09/2015

Greenway Health is now the top-ranked electronic health record vendor for customer satisfaction among primary care physicians, edging out Practice Fusion, according to a new report from Black Book Rankings.


NME trust plans i.PM wrap and replace
Digital Health News ~ Thomas Meek ~ 01/09/2015

Sandwell and West Birmingham Hospitals NHS Trust has issued a tender for an electronic patient record that can integrate with its existing systems.


Argonaut interoperability project focuses on testing
Health Data Management ~ Greg Slabodkin ~ 31/08/2015

The Argonaut Project has entered Phase Two of its efforts to accelerate development and adoption of Health Level Seven International’s Fast Healthcare Interoperability Resources (FHIR), an interoperability framework leveraging the latest web standards.


Can telemedicine appeal to both consumers and providers?
mHealth News ~ Eric Wicklund ~ 31/08/2015

History is filled with businesses trying to stand out in the crowd and differentiate themselves from their competitors. It’s no different in telemedicine, where companies like American Well, Teledoc and Doctor on Demand seem to be taking up all the space.


Are digital health technologies really good for our health?
Fortune ~ Christina Hernandez Sherwood ~ 31/08/2015

Countless entrepreneurs around the world have launched digital health companies in the last decade and more than 100,000 mobile apps are currently on the market—all with the goal of making us healthier. But how many of these companies have concrete evidence to support their health claims?


eRx of controlled substances now legal in 50 states
HealthcareITNews ~ Mike Miliard ~ 28/08/2015

With e-prescribing of controlled substances now legal nationwide, providers and pharmacies are empowered with a new technological tool in the fight against prescription painkillers.


The San partners with EpiSoft for integrated cancer centre

The Sydney Adventist Hospital (The San) has chosen EpiSoft’s Cancer CareZone cloud-based clinical information system for the new Integrated Cancer Centre it is building as part of its $200 million redevelopment.

Sydney-based EpiSoft launched Cancer CareZone last year for the management of patients undergoing chemotherapy. EpiSoft and the San have worked together before on the development of an eAdmissions module that has been up and running for several years.

The Cancer CareZone clinical system has integrated practice management features including inpatient and outpatient billing, protocol-based appointment scheduling and day-of-visit patient flow, as well as over 400 evidence-based chemotherapy regimens pre-loaded.

It has an advanced protocol authoring module known as EpiSteme that allows clinicians to tailor cycles of care in line with their own treatment preferences for cancer and other cycle-based chronic illness.

It also has the option of a nurse administration chart and a pharmacy orders module for complete clinical management of patients in day infusion centres.

EpiSoft’s marketing manager Aoife O’Sullivan said the company developed Cancer CareZone as an all-in-one solution to support day procedure centres providing care to patients with cancer.

“But certain practice management functions can be switched off to enable larger hospitals to use the product as a clinical departmental system integrated to the hospital’s [patient administration system] and other [electronic medical record] systems,” Ms O’Sullivan said.

Cancer CareZone has been in use at an infusion centre in Sydney for almost a year with several more sites, including The San, set to go live this year.

CareZone is a cloud-based product that is being used for a number of highly specialised areas of clinical management of patients with severe chronic illnesses. It is designed for use on any browser and any device.

The company also markets a Primary CareZone product for patients with mental health disorders and an alcohol and drug disorders clinical system designed to cover the information requirements defined by the Victorian Department of Human Services as part of its sector reform during 2014.

The alcohol and other drugs system includes a central intake function that manages client appointments, stratifies clients based on initial assessment of risk and refers them to an appropriate agency and treatment pathway for ongoing management. Drug and alcohol counsellors use the system to record episodes of care and measure outcomes of treatment.

The company also provides the technology for a colorectal cancer surveillance program, has been working with one of the specialist colleges on a new clinical audit system and has long worked with inflammatory bowel disease (IBD) research groups to manage patients with chronic disease and facilitate multi-party clinical trials.

EpiSoft co-founder Jenny O’Neill said customers of the CareZone product include private hospitals, private day procedure centres, specialised diagnostic clinics, Medicare Locals, community health centres, public hospital outpatient departments, and research institutions.

“We have had to rapidly mature the product to meet the many and varied requirements of such a broad customer base,” Ms O’Neill said. “Our vision when forming the company was to use the power of the cloud to develop and deploy functionally rich clinical applications at undreamed of economies of scale.

“We delivered on that vision but found that maintaining the ‘s’ in ‘applications’ was rapidly maturing the staff – and not in a good way.

“So we improved on the economies of scale model further this year by developing and deploying a single application that looks like many different ones, depending on your credentials, centralising maintenance of some of the shared system functions while continuing support for highly customised health record components.”

EpiSoft received assistance from Commercialisation Australia in the development of Cancer CareZone.

Hills Health signs with Sonitor for real-time location services

Hills Health Solutions has signed an official agreement with Norwegian firm Sonitor to bring its real-time location services (RTLS) solutions to Australia.

Widely used in the US, where it is partnered with global giants like IBM, Cisco, Cerner, Aruba and Meru Networks, Sonitor’s technology combines ultrasound, low frequency radio and Wi-Fi to provide asset management, patient flow, workflow, mobile duress calls, staff safety and infection control solutions.

Hills Health Solutions first showed off the Sonitor range at its Hills Tech Expo in March.

Hills’ national manager of products and technology, Damien Cox, said partnering with Sonitor for RTLS provides Hills with the opportunity to deliver the future of operational intelligence for local customers.

“Sonitor allows healthcare operators to gather data and use it to improve the healthcare workflows as well as manage patient and staff safety,” Mr Cox said.

“Combined with Hills Health’s integrated platform, Sonitor products provide customers with a significant range of options for locating and managing patients, staff and assets in healthcare facilities as a unified solution.”

The Sonitor range has remarkable battery life with the ability to operate for one to three years without needing charging. The ultrasonic location system also provides location accuracy to within 30 centimetres and does not rely on Wi-Fi infrastructure for critical operation.

It is suitable for hospitals, residential aged care facilities and private homes.

eScripts continue to grow as eRx racks up a billion

One billion prescriptions have been dispensed electronically through eRx Script Exchange since its debut in 2009, the company says, and the system is now averaging over 750,000 dispensed eScripts a day.

Electronic prescribing works as both an efficiency and a safety mechanism by ensuring that prescription information, including patient and medication data, can be shared safely and securely between GPs and pharmacists.

eRx is integrated with 24 medical and pharmacy software packages with a further 11 in the process.

eRx says that since 2009, 89 per cent (4714) of pharmacies and 76 per cent (19,930) of GPs have connected to and are using the exchange.

Paul Naismith, CEO of eRx parent company Fred IT Group,, said electronic prescribing and dispensing are two of the most fundamental ways of adding efficiencies in the medication supply process while also improving safeguards against potential dispensing issues.

“The achievement of creating an Australia-wide electronic script network is a direct result of the significant support behind the scenes,” Mr Naismith said. “This has included cooperation across pharmacy and medical professions, industry groups, IT companies and government.

“The majority of pharmacies have also told us that funding support, such as the recent continuation of electronic script funding under the 6th Community Pharmacy Agreement, is critical for the ongoing success of electronic prescribing.”

eRx’s 2015 survey of pharmacists found that 74 per cent said government funding was very important to their ongoing use of electronic scripts and the same amount said they found eRx extremely valuable. Almost half said dispensing efficiency was the major motivation for using eRx.

Mr Naismith said eRx was focused on building on the achievements already in place. “This means connecting more doctors and pharmacies, and continuing to identify ways to further improve eHealth connectivity so that doctors and pharmacists are able to experience the benefits of real-time medications histories, better medicines management and real-time communication with other professionals in their day to day work.”

According to company figures, by July 2015, pharmacies using eRx were electronically dispensing: