eHealth NSW projects running behind schedule but benefits revised up

Several major eHealth NSW IT projects are running behind schedule, including the statewide roll-out of the MetaVision ICU system, Cerner’s Community Health and Outpatient Care (CHOC) EMR extension and the new incident management and rostering systems, but in many cases the estimated benefits have been revised upwards.

Acting auditor-general Tony Whitfield tabled a financial audit of NSW Health today that shows that of the nine major IT projects worth more than $20m that eHealth NSW is currently managing, six are running behind the original timeframes but all seem to be within budget.

The main laggard is the roll-out of the MetaVision system from iMDsoft to all adult, paediatric and neonatal ICUs in the state. The auditor-general reported that this $43.1 million project was supposed to have been completed in 2016 but will only get started in earnest next year, with a completion date of 2020 most likely.

However, the estimated quantitative benefits of the project, which eHealth NSW says is the world’s largest system-wide ICU clinical information system implementation, have been revised up to $481 million, more than double the original estimate of $211m.

As the auditor-general writes, over the next four years eHealth NSW plans to spend more than $240 million completing the nine projects with the expectation that the NSW health sector will achieve $2.7 billion in quantitative benefits from its overall investment of $671 million, or $3.98 for every dollar spent.

iMDsoft won the tender for what eHealth NSW is now calling the electronic Record for Intensive Care (eRIC) solution in 2013. It is also widely used in Queensland.

eHealth NSW said the first go-live of eRIC was planned to take place at Blacktown Hospital’s ICU in mid-2016. The design and build phase of the eRIC program began over a year ago with six build cycles completed and a remediation period to improve the user experience and user interface.

Of the other projects, the massive $170m electronic medications management (EMM) statewide roll-out appears to be on track for a completion date in 2018. As part of the project, Cerner’s EMM module will be implemented in 28 hospitals. It has already gone live at Concord Hospital and is about to at the Children’s Hospital at Westmead and Prince of Wales.

eHealth NSW has revised up its estimate of quantitative benefits of the overall EMM program from $369.6m to $479.2m. There is still no word as yet on when the Local Health Districts that use Orion Health’s EMR will choose an EMM system, but that is part of the overall budget.

Cerner is also building the Community Health and Outpatient Care (CHOC) system as an extension of its EMR. It has already been rolled out to a number of community health services over the last two years and was originally planned to be completed by next year, but that has been pushed out by a year to 2017. Its benefits have also been revised down from $401m to $265m.

Phase two of the roll-out of Cerner’s EMR is on track to be completed in 2017 and it seems to be on budget. It has the largest quantitative benefits associated with any project at an estimated $590.7m.

There will also be a two-year delay in the full roll-out of the $22m incident management system to 2018, and the timeline for the new statewide rostering system HealthRoster has blown out by five years.

The auditor-general has recommended that eHealth NSW perform a detailed review of the way it manages information technology projects. The review should analyse the reasons for project delays and identify strategies to mitigate the risk on future projects, he said.

Non-clinical and construction

HealthRoster was expected to be rolled out last year but now has a completion date of 2019, and it is in danger of breaking its budget. It was originally budgeted for $94.8m, which has since been revised down to $89.6m but $85m has already been spent.

The rostering system is seen as essential to bringing down the rate of NSW Health employees, particularly medical officers, who are not taking their holidays or are being paid lots of overtime because they keep getting called back to work.

Mr Whitfield reports that one medical officer earned more in overtime and call backs than in base salary in one year, and another earned more than $503,000 in overtime and call backs over the past three years.

NSW Health wants the new rostering system to provide better visibility of employees between rosters and to help minimise back-to-back shifts inside required rest periods, but admits there have been delays in the roll-out.

These delays have been caused by different maturity levels in rostering practices throughout the state, problems with software performance, and ongoing scalability issues which the auditor-general says are currently being resolved with vendors.

In terms of infrastructure projects, the auditor-general also reports that all four of the major hospital construction projects that had an estimated cost above $50 million or more were completed ahead of time and within the approved budget, including the Campbelltown Hospital redevelopment, the Hornsby Hospital redevelopment, the Missenden Mental Health Unit upgrade and the Royal North Shore Hospital clinical services building (pictured).

The Royal North Shore project was $62.1 million higher than the original budget due to scope changes and delivery of 60 additional beds.

In all, NSW Health is currently managing 20 major projects costing more than $50 million, at a total cost of $4.3 billion. The auditor reports that most projects are running on or ahead of time. At June 30, NSW Health’s infrastructure division had spent $1.6 billion on these projects, or 36.3 per cent of the original budgeted cost.

The auditor-general also found that four local health districts or specialty networks were not meeting performance expectations – three of which were rural LHDs that have special circumstances – and only South Eastern Sydney was assessed as a serious underperformance risk.

Mr Whitfield says the district has a formal recovery plan, but fell short of both expenditure and revenue strategies in 2014-15.

NSW ambulance response times remain above the national average and the time to transfer patients from ambulances to hospitals remains below target, but emergency department response times were, on average, met across all triage categories.

NSW has a longer average length of stay in hospital than the rest of the country at 3.1 days, and it also has more available public hospital beds per 1000 of population than the national average.

National elective surgery targets (NEST) were improving and near the state’s goals, although unplanned readmissions were at seven per cent compared to the Ministry of Health’s target of five per cent.

NSW Health reports that as elective surgery wait times do not include the time it takes for patients to see a specialist and get onto the waiting list because data on surgical access time is not recorded, the ministry is now working with the Australian Institute of Health and Welfare to devise a national measure on surgical access time, being the time taken from seeing the general practitioner to surgical care.

UQ licenses CeGA Online assessment system for geriatricians

Finnish aged care software firm Raisoft has signed a non-exclusive licence with the University of Queensland for its CeGA Online web-based geriatric assessment and clinical decision support system.

Designed by researchers from UQ’s Centre for Research in Geriatric Medicine (CRGM) in association with the Centre for Online Health (COH), CeGA Online supports comprehensive assessments of frail older patients in the acute care setting, including acute geriatric wards and geriatric consultations in general wards.

The two centres have also developed a residential aged care version that is used by the Res-e-Care telehealth service, also developed by CRGM and COH and lead researcher Len Gray.

The software incorporates the interRAI international assessment system, which Raisoft also uses. Founded in 2000, the Finnish company provides a care planning solution for aged care, rehabilitation and mental health. RAIsoft is also licensed by the interRAI corporation.

UQ’s software is designed to give older patients improved continuity of care by recording and monitoring their progress before, during and after a hospital stay.

Professor Gray said his team was excited to see its software being used more widely around the world to improve health care for older people.

“Raisoft is already a leader in aged care software but they were keen to incorporate aspects of the CeGA Online system into a new product offering because it was developed for aged care clinicians, by aged care clinicians,” Professor Gray said in a statement.

“The software has already been shown to work in a test population and is now widely used by Queensland Health.”

Patient profiles are kept concise and searching through patient charts is minimised. Assessments can be viewed online by external providers and the software can be used to facilitate telehealth consultations to bring geriatric expertise to rural and remote areas.

Raisoft CEO Robert Astrom said the health needs of ageing populations were becoming more complex and CeGA Online had been shown to simplify patient planning and help health professionals work together for improved patient care.

“Some older people have care provided by many different specialists from geriatricians through to physiotherapists and other allied health professionals,” Mr Astrom said.

“CeGA Online will help by collecting all patient information in one place including nurse assessments, diagnoses, living arrangements and support, and recommended areas for intervention.

“Raisoft recognises that effective aged care planning relies on having a single report on a patient and a single place to identify their associated health issues and care arrangements.”

The licence was negotiated through UniQuest, UQ’s commercialisation company.

Lessons from a model of effective eHealth implementation

Earlier this year, I took a three-month sabbatical at the Universidad Catolica (UC) and its extended healthcare institutions in Santiago, Chile, where I was able to make some observations on the implementation of an electronic medical record (EMR) and other eHealth developments that could provide some lessons for similar implementations in Australia.

The Chilean healthcare system is funded under a national health insurance scheme which is sourced by a seven per cent tax on incomes. The system has separated into two main streams of care delivery with public and private components. Care within the private system usually requires supplementary funding from the patient or insurance, and like in Australia, patients may have care in both systems.

Each component of the Chilean health system has significant differences in care delivery, with the public system in Chile experiencing similar care delivery issues as the public system in Australia. That is not to say that the private component of healthcare delivery is perfect, and it is definitely more expensive with significant overuse, underuse and inappropriate use of healthcare resources.

My working association during my sabbatical was predominantly within the UC private system, which covers both primary care clinics and hospital-based care, and I also taught some workshops in the department of biomedical informatics at the regional Duoc-UC San Joaquin, Valparaiso and Concepcion campuses, which provide TAFE-level education.

The Universidad Catolica group has a complex patient management system, with an EMR from Portuguese vendor Alert Lifesciences currently being rolled out. This is being accompanied by a powerful EMR support application called Epistemonikos and a bespoke temporal query system called ClinicalTime, which is being developed by UC physician-health informatician Daniel Capurro.

One of the strengths of the eHealth projects within UC is that the planning and constant evaluation is driven by the university faculty and the patient care departments, not government health departments. The EMR supports data collection and healthcare measures required by the government, with this data a direct byproduct of clinical care processes.

Because the EMR is clinically focused, doctors, nurses and other clinicians use the system for patient outcomes rather than for billing services, which have become the necessary adjuncts to the clinically directed project.

The EMR system permits real-time adjustment of applications and modules without significant disruption of day-to-day clinical use.

In my opinion, the successful direction of this project must go to the clinical leadership of Associate Professor Capurro, who has enlisted the active and enthusiastic support of his clinical staff and IT personnel. The teams leading this project meet up to twice weekly to discuss its evaluation and the overall adherence to the implementation time schedules.

Attending these meetings, it was obvious that the core enthusiasm and drive demonstrated by the participants revealed a strong belief in the value of this project. Development was not driven by an imposed external system, and this team and the clinicians “owned” the project.

The combination of frequent end-user driven goal definitions, evaluations and clinically focused applications with an adaptable system application infrastructure complies with many of the core success factors that were defined by researchers Paul Biondich and Burke Mamlin from their work in low and middle income nations.

Clinical decision support

I was also present at an educational meeting at a UC regional hospital called Clínica UC San Carlos de Apoquindo, where the Alert EMR was about to be implemented. The hospital director addressed the meeting and all individuals involved in the system’s implementation and uptake had a voice in the proceedings. This includes both the objectors and the supporters.

The EMR has an excellent user interface, with real-time patient triage to care transitions and e-directed (guided) care management, such as patient-specific IV infusion times and rates and medication administration compliance schedules.

The system provides direct feedback on waiting times for patients in the emergency department – there was great concern that one patient had been waiting for 48 minutes!

I observed clinicians actually using the system to enter care plan protocols that supported their current care plans.

However, because clinicians are able to enter care plans, there is some variation at this stage of development. Dr Capurro is currently undertaking a project to refine the creation and design of clinical order sets to improve clinical workflow compliance and reduce the variation in care delivery.

In the development and design of clinical order sets, access to up-to-date knowledge and research is critical. The UC is using a powerful EMR support application called Epistemonikos, which was developed by the Epistemonikos Foundation, a not-for-profit organisation led by internal medicine specialist Gabriel Rada and created as a spin-off from UC and funded through international research funds.

The application is a free, multilingual database of the best available health evidence, and the UC team intends to integrate this system with the order sets management.

From my perspective, the Epistemonikos system is an ideal adjunct to the order sets program because it provides a functionality that, as former CEO of the California HealthCare Foundation Mark Smith put it, can “remove ourselves from the ‘unscientific, non data driven personal recommendations’ for care”.

And as Andy Kanter of the Millennium Villages Project says, “The ability to feed back immediately to the people at the point of care … is critical for measuring and improving the quality of care.”

Dr Capurro and colleagues are also developing a conjoint system called ClinicalTime which measures patient trajectories using time-dependent clinical and laboratory data. This has demonstrated that coded clinical data provides more accurate and dependable data for measuring healthcare than standardised coding using ICD-9.

Dr Capurro describes ClinicalTime as “a temporal query system” that is a valid method to add to the currently available ones to identify patient phenotypes in patient databases and improve the ability to re-use routinely collected electronic clinical data for secondary purposes.

Another potential benefit is in the use of clinical data to provide the early detection of those patients in an ICU environment who are likely to develop acute kidney injury (AKI). This is a clinical state which is often overlooked until late in the disease evolution in the ICU clinical environment.

Outpatients

The EMR has become the core patient care system in UC’s outpatient clinics and the emergency department, which became paperless just over three years ago. This change occurred with minimal disruption after going live overnight.

The outpatient system was impressive. As a patient you can make your clinic appointment on the phone or on the internet in advance of attending. Patients can pay their accounts online in advance while making the appointment.

When arriving at the clinic, the patient or their carer enters their unique Chilean ID number at the kiosk in the foyer or they can swipe their card with this number. This unique ID number and card have been a part of the Chilean health system for decades.

The kiosk can display educational materials but the main purpose is to direct the patient to their designated clinic and its location. If you have not paid in advance you go to the cashier and pay there.

At your clinic location the kiosk provides an ID number for that visit and the room number. These are clearly displayed on TV screens and this information is supported by voice-over instructions.

In the consultation the clinician has access to the patient’s record and associated reports. The information is in both coded and document formats. At all stages the clinician is functionally looking at the one system.

The clinicians must enter the details of the clinical encounter into the record. In the wards, a dual e-record and paper coexist but the intention of the project governance committees is to have complete electronic integration in the not too distant future.

The Chilean government introduced legislation three years ago that states that all patients must be given a copy of their own record. The actual mechanisms for this are evolving.

The waiting lists for these clinics can be up to one to two days for chronic disease. A ‘long’ waiting period is one to two months, which is considered not to be completely efficient!

The UC EMR is also used as a data resource for capturing administrative healthcare data and is able to provide this in real time. For example, DRG data is captured on a daily basis.

The system was set to go live at an allied regional hospital of around 100 beds, with support staff living in for a period of time and providing 24/7 support, as I was leaving Chile. On-site training will occur in the ward location immediately adjacent to the emergency care wards.

While the cost of the EMR is confidential, it is significantly less than comparable implementations in many Australian hospitals.

My observation is that a significant eHealth project based on an appropriately designed EMR can succeed on a moderate budget as long as the objectives and design are driven by the direct patient care process.

Dr Terry Hannan is a consultant physician at Launceston General Hospital, a clinical associate professor at the University of Tasmania’s School of Human Health Sciences, a fellow of the Australasian College of Health Informatics and a visiting fellow at Macquarie University’s Centre for Health Informatics.

HiNZ goes big for collaborative conferences in 2016

Health Informatics New Zealand (HiNZ) is one of 12 organisations coming together to stage a massive collaborative tech sector conference in Wellington next July.

ITx 2016 is thought to be the largest independent tech-related conference in New Zealand in many years, with more than 1200 delegates expected over three days. The organisers, the Institute of IT Professionals (IITP), said it is also likely to be the largest collaboration that the tech sector has ever seen in New Zealand.

HiNZ has also joined forces with the Australasian Telehealth Society and the University of Queensland’s Centre for Online Health to hold three conferences in one week in Auckland in November, involving HiNZ 2016, Successes & Failures in Telehealth (SFT-16) and Global Telehealth (GT 2016).

ITx 2016 is aimed at those working in the software and IT industry, and in addition to health IT, will focus on testing, tech education, agile, communications, innovation and the internet, IT project management, professional practice, open source, exporting and commercialisation.

IITP CEO Paul Matthews said the ITx concept was born from a three-conference collaboration in 2014 and the model of bringing the wider tech community together while maintaining specialisations had been successful.

HiNZ CEO Kim Mundell said ITx was a great opportunity for those involved in health IT to get together to hear about the latest in both health informatics and the sector as a whole. “This is the best of both worlds,” Ms Mundell said.

ITx 2016 will be held at Wellington’s TSB Arena and Shed 6 complex from July 11 to 13.

HiNZ 2016, SFT-16 and GT 2016 will be held from October 31 to November 4 2016 at Skycity Convention Centre in Auckland.

Healthcare robots become part of the family for elderly people

University of Auckland researchers are set to publish new results from a study of the use of healthcare robots in the homes of elderly people living in rural areas, showing that robots may lessen social isolation but also help with the provision of medical care.

The researchers, led by Elizabeth Broadbent from the university’s department of psychological medicine and Bruce MacDonald from its department of electrical and computer engineering, have been running a project in association with Gore Health to assess the robots for several years.

The project involves small robots that can provide medication reminders, alarms in the case of falls and video conferencing through Skype, as well as a larger robot that can monitor health measurements such blood pressure readings and heart rate and transmit readings to the patient’s GP.

The researchers are set to publish results from a small study of five participants who trialled the robots in their homes for at least three months.

According to the university, the robots functioned as good companions, with some participants saying they enjoyed hearing the robot talk and others saying they liked its ability to remind them to take their medicine on time.

Dr Broadbent said the participants said they found comfort in seeing the robot light up, as they felt it was the robot’s way of interacting with them.

“They all reported that they would miss the robot when it went with one patient describing the robot as being part of the family,” Dr Broadbent said in a statement.

“The results suggest the healthcare robots were feasible for use with a rural population and may have benefits for some patients in reducing the need for medical care, increasing quality of life, reminding patients to take medicine on time, and providing companionship.

“An unexpected finding was the robot’s blinking lights – the lights enhanced the robot’s social presence which was reassuring to patients and helped them see when the surroundings were dark late at night or in the morning.”

The study also highlights several ways the robots could be improved to enhance the experience, including improvements in their design and functions, such as installing more familiar games for older people, a larger function screen with less sensitivity to accidental triggering, and a simpler Skype interface.

Associate Professor MacDonald said that despite encountering some technical issues, patients were mostly positive and accepting of the robots.

“These suggestions arise from real-world experiences and not a lab-based set-up,” he said. “Trialling the healthcare robots with patients in their homes is a strength of the study.”

Gore Health CEO Karl Metzler said having older people living independently in their own homes for as long as possible was the most favourable option and socially assistive robots may help achieve this.

“Especially for those living alone, managing chronic illnesses can be difficult and it can be hard for some to follow medication schedules as they get older,” Mr Metzler said. “Rural older adults also experience loneliness and concern about a loss of independence and institutional care.”

A/Prof MacDonald established the Robotics Laboratory at the University of Auckland and has a long interest in human-robot interaction, particularly for healthcare. Dr Broadbent is a former electrical engineer with an interest in the psychological aspects of robotics.

They have also previously published on the use of Paro the robot seal in residential aged care.

Photo: University of Auckland.

St John begins national roll-out of touchscreen ePRF

St John New Zealand has begun the roll-out of its new electronic patient report form (ePRF) using technology from Irish firm Valentia Technologies, as part of a national move from paper records to an electronic clinical record for ambulance transfers of care.

Valentia’s CareMonX ePRF suite went live last month in 60 ambulances in the Hauraki, Coromandel and Waikato districts, with the system to be rolled out to more than 600 vehicles by the end of March next year.

St John has already implemented Valentia’s resource mobilisation software CareMonX MDT in all ambulances nationally. The MDT provides a link between the ePRF and the CAD call-taking and response management system.

It also directly populates the ePRF with mobilisation and status data, according to Valentia.

The software is being deployed on Samsung Android tablet devices and will be used to create and transmit more than 400,000 digital care records annually, based on current incident volumes.

It has been integrated with NZ’s National Health Identifier (NHI) to enable continuity of care beyond the pre-hospital environment and will allow St John to share relevant and timely information with other healthcare providers, including hospitals and GPs.

The system complies with a new interoperability standard developed by HISO for an ambulance care summary report (ACSR). These summaries will be held in St John’s clinical data repository as PDFs that can be accessed online or printed out, and as HL7 CDA files that can be read by hospital clinical information systems.

In the future, the summaries will be accessible through the uniform clinical workstations being rolled out nationally in hospitals and through other shared care record systems. All clinical data is SNOMED coded and aligns to the NZ emergency care reference set.

St John is also using Valentia’s contract management and billing system for real-time costing and invoicing.

Auckland opens $23m medtech research centre

A new centre of research excellence (CoRE) for medical technology has opened at the University of Auckland with funding of $NZ23.6 million over five years.

Officially opened last week by tertiary education minister Steven Joyce, funding for the MedTech CoRE was secured by the Consortium for Medical Device Technologies last year.

The consortium, which involves Auckland, Canterbury and Otago universities, Auckland University of Technology, Victoria University of Wellington and Callaghan Innovation, aims to be a single point of contact for NZ’s capability and resources in medical technology.

Areas of research focus are diagnostics and therapeutics, interventional technologies, assistive technologies, telehealth and health informatics, and tissue engineering.

Mr Joyce said New Zealand’s medical devices and health IT industries are an emerging sector involving around 150 companies with an estimated value of $1 billion.

“The growth of this industry can be accelerated with the help of innovation, research and above all, collaboration,” Mr Joyce said.

“MedTech will develop technologies for prevention, early diagnosis and management of disease.”

The MedTech CoRE brings together the roles of both clinicians and industry in developing health technologies, focused on areas where New Zealand can become world leading.

“By bringing together and developing a pool of talented academics and graduate scientists, the MedTech CoRE will help New Zealand’s medtech sector continue to grow and contribute to the New Zealand economy,” Mr Joyce said.

“In New Zealand and globally, we need affordable technologies with tested and measured health outcomes. The work done at MedTech CoRE will help make this happen more quickly.”

International health IT week in review: November 8

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

The long Read
Digital Health News ~ Thomas Meek ~ 05/11/2015

Read Codes are to be phased out across the NHS, and SNOMED CT must be used in primary care systems by the end of 2016 and in all IT systems by spring 2020.


Walgreens goes to Epic for EHR
HealthcareITNews ~ Bernie Monegain ~ 05/11/2015

Walgreens is poised to roll out Epic EHRs in its more than 400 healthcare clinics across the country.


ER workers unhappy with their IT systems, survey shows
Health Data Management ~ Greg Slabodkin ~ 04/11/2015

As emergency departments are becoming busier and struggling to manage the influx of patients, clinicians and staff say they are hamstrung by inefficient and poorly designed ED information systems.


NHS IT leaders say ‘paperless’ possible
Digital Health News ~ Jon Hoeksma ~ 04/11/2015

Two-thirds of NHS IT leaders say they are confident their organisation can meet the goal to become paper-light by the turn of the decade.


AMA, medical organizations call on Congress to ‘refocus’ MU Stage 3
FierceEMR ~ Katie Dvorak ~ 04/11/2015

The American Medical Association (AMA) is leading a campaign, along with 111 medical societies, calling for Congress to “refocus” Stage 3 of the Meaningful Use program.


OpenNotes shows success with medication adherence
HealthcareITNews ~ Jessica Davis ~ 03/11/2015

Patients with online access to doctors’ notes are more likely to adhere to their medication regimens, a two-year Geisinger Health System study reports.


Kelsey: lives ‘ruined’ by lack of data
Digital Health News ~ Thomas Meek ~ 03/11/2015

People’s lives are being “ruined” by the NHS’ inability to join up patient information, according to NHS England’s Tim Kelsey.


Treasury asked for £3-5 bn NHS tech fund
Digital Health News ~ Lyn Whitfield ~ 03/11/2015

The Treasury is being asked for up to £5.6 billion to support the NHS’ technology ambitions, as part of the spending review process that will conclude later this month.


NHS staff asked to rate EPR usability
Digital Health News ~ Digital Health News ~ 03/11/2015

NHS clinicians have been asked to rate the usability of their main IT system in a survey launched by Digital Health Intelligence and the CCIO Leaders Network.


MedAssets buyer sees chance to build ultimate HIM vendor
Health Data Management ~ Joseph Goedert ~ 03/11/2015

Pamplona Capital Management will pay $2.7 billion for MedAssets because it sees new opportunities by combining MedAssets’ large suite of revenue cycle management services with health information management vendor Precyse, which Pamplona already owns.


A new kind of house call emerges in NYC
mHealth News ~ Eric Wicklund ~ 03/11/2015

New York-based FRND is testing a new version of the house call that dispatches a nurse to a consumer’s home to collect vital signs and other information before remotely connecting – if necessary – to a doctor.


See the highest-rated EHRs for usability
HealthcareITNews ~ Mike Miliard ~ 02/11/2015

The American Medical Association, alongside MedStar Health’s National Center for Human Factors in Healthcare, has launched a new framework to rank electronic health records according to their user-centered design, of UCD.


FHIRWorks rocks the Epic campus
HealthcareITNews ~ Bernie Monegain ~ 02/11/2015

There’s nothing like a developer event to get the crowd fired up. At least that’s how the hosts and the keynote speaker at the FHIRWorks’ event at the Epic campus last week described it.


Halamka: Stage 3 Meaningful Use should be eliminated
Health Data Management ~ Greg Slabodkin ~ 02/11/2015

John Halamka, M.D., chief information officer of Boston’s Beth Israel Deaconess Medical Center, was a critic of the Stage 3 electronic health records Meaningful Use program, even before it was finalized.


Patients prefer password-protected portals for most sensitive test results
FierceHealthIT ~ Katie Dvorak ~ 02/11/2015

Most patients prefer receiving results from medical tests–especially ones containing highly sensitive information–through password protected patient portals or websites, according to a recent study.


Digital doctor to review NHS tech
Digital Health News ~ Thomas Meek ~ 30/10/2015

Health secretary Jeremy Hunt has announced that a best-selling US digital health author is to lead a review of the digital future of the NHS.


Why interoperability initiatives are accelerating
Health Data Management ~ Fred Bazzoli ~ 30/10/2015

Industry efforts to achieve interoperability have exploded in recent weeks, as several initiatives are working toward ways to advance the exchange of healthcare information.


Telemedicine market to hit $2.8 billion by 2022
FierceHealthIT ~ Katie Dvorak ~ 30/10/2015

There are no signs the telemedicine market will be slowing down anytime soon, especially in light of a report from Grand View Research Inc. forecasting that the market will reach $2.8 billion by 2022.


Barcoding key to reaching HIMSS Level 6
Canadian Healthcare Technology ~ Dianne Daniel ~ 30/10/2015

When Toronto East General Hospital started its automation journey in 1997, the HIMSS Analytics Electronic Medical Record Adoption Model (EMRAM) didn’t even exist.


Halton’s new hospital employs state-of-the-art technologies
Canadian Healthcare Technology ~ Staff writer ~ 30/10/2015

The new Oakville Hospital, which opens December 13th after four years of construction, is using a combination of organizational innovation and technological wizardry to provide the best patient care possible.


Peak groups gang up to demand action on ERRCD

Prominent healthcare organisations have issued an open letter to the federal, state and territory health ministers demanding action on the slow roll-out of the Electronic Recording and Reporting of Controlled Drugs (ERRCD) system, calling for an implementation plan to be agreed at the next COAG Health Council meeting.

Real-time prescription monitoring has so far only been rolled out in Tasmania, where the precursor to ERRCD was first developed, with the other states and territories at varying stages in their implementations. This is despite repeated and very public calls for the urgent implementation of the system by a number of coroners, particularly in Victoria, South Australia and Queensland, following accidental deaths due to overdoses of prescription drugs.

Funding for a national roll-out was secured under the Fifth Community Pharmacy Agreement (5CPA) in 2010, a national licence was purchased on behalf of the jurisdictions by former health minister Tanya Plibersek in 2012, the system was made available for use to the jurisdictions by the federal Department of Health at some stage in 2013 and nationally consistent specifications for the system completed by the Medical Software Industry Association (MSIA) in April 2014.

However, as Pulse+IT reported last year, there are a number of barriers to a faster roll-out, with some states still weighing up whether their existing systems are adequate.

It is understood that since that report, NSW has made progress, as has the ACT.

However, documents recently released under Freedom of Information legislation show that the federal government itself recognises that some states seem to be dragging their feet.

In July last year, then health minister Peter Dutton wrote to all state and territory health ministers seeking an update on progress. Slightly different wording in the letters seems to indicate there were those that were well advanced – the NT, NSW, Tasmania, WA, SA and the ACT – and then there were the laggards that needed to take urgent action, namely Queensland and Victoria.

While the peak bodies have now formally agreed to work together and acknowledge that the jurisdictions face a range of technical, legal, financial and administrative issues, they emphasise that in the absence of such a system, “avoidable deaths involving prescription medicines continue to occur at an alarming rate”.

Signatories include the Australian Medical Association, the Royal Australian College of General Practitioners, the Pharmacy Guild, the MSIA, the Royal Australasian College of Physicians, the Pharmaceutical Society, the Society of Hospital Pharmacists and the Consumers Health Forum.

They call on the ministers to work together to implement ERRCD as a matter of urgent priority, saying the system will provide clinicians with a crucial tool to help them work with patients in a more collaborative and informed way to address the serious problem of addiction to prescription drugs.

“Each of our organisations has been advocating for the ERRCD and we have agreed to work together to ensure that it is implemented expeditiously,” the letter states.

“Consumers, general practitioners, physicians, pharmacists and the medical software sector consider the ERRCD system to be a crucial clinical support and intervention tool to help practitioners manage the prescribing, supply and management of drugs of addiction, and to prevent harm from inappropriate use of prescription drugs.

“We call on all jurisdictions to agree on a clear implementation plan and timeline for a national ERRCD system at the next COAG Health Council meeting, and to remove any roadblocks to achieving this outcome.”

In the meantime, prescription exchange service MediSecure has launched its own real-time monitoring system called Dr Shop, which has the benefit of not only alerting doctors to potential misuse of Schedule 8 drugs like opiates but also Schedule 4 drugs such as benzodiazepines, which have been consistently implicated in multiple toxicity overdose deaths.

However, Dr Shop is only available to GPs at the point of prescribing and not to pharmacists at the point of dispensing, and many GPs use the rival eRx system instead.

Telstra Health to buy EOS Technologies from Silver Chain

Telstra Health has entered into an agreement to acquire EOS Technologies, the technology arm of WA-headquartered in-home health and care provider Silver Chain Group.

EOS Technologies was first set up in Perth to develop and commercialise the ComCare community care management system used by Silver Chain nurses, which includes a desktop version and an Android-based mobile app.

It also has a portal for clients and carers through which they can view visit information, statements and package care balances.

Telstra Health’s head of provider applications, Michael Boyce, said EOS Technologies would be integrated into Telstra’s HealthConnex business, which also owns community and disability care software package TCM.

Telstra Health also owns the market leader in residential aged care software, iCareHealth.

“This acquisition aligns perfectly with our existing community care capabilities, and when combined with our HealthConnex and iCareHealth solutions, will allow us to provide the best community care and residential aged care eHealth platform in Australia,” Mr Boyce said.

“A key part of this is about delivering better care to Australians as they age. The number of Australians over 85 will more than triple from 2012 to 2050, and this is the primary group at risk of chronic disease requiring care services in the home to avoid hospital admissions or residential aged care support.

“This trend of directing care away from costly institutions is driving strong demand for solutions that can support community care providers and deliver better health outcomes for clients in their own home. The healthcare landscape is changing as consumers want to incorporate digital health seamlessly into their lifestyle routines and personal style.”

Telstra Health has worked with Silver Chain on a number of projects, including the development of the MyCareManager home telehealth solution, which Silver Chain is using as the basis of its Care Centre solution for the hospital in the home services it provides to clients in Queensland.

Both ComCare and TCM can be integrated with MyCareManager through a FHIR interface and client data viewed through its portal.

Silver Chain Group CEO Chris McGowan said the sale of EOS Technologies had been anticipated for some time, with Silver Chain content it had found the right partner.

“We recognised that to continue to develop and grow EOS in an exceedingly fast-moving eHealth market we needed to find the right partner to ensure they could commit to continuing to service our current clients, whilst investing in further development of ComCare,” Mr McGowan said.

“EOS makes a significant contribution to the way the industry functions and it was crucial to find someone who could take it to the next level so that the entire health industry can benefit from its development.

“We now have the opportunity to do that by leveraging Telstra’s communications technology and HealthConnex’s position as a leading community care solutions provider.”