Telstra Health building the bridge that will take telehealth mainstream

Telstra Health is moving into the second phase in the development of the National Telehealth Connection Service (NTCS), which will allow hospitals and external healthcare providers to hook into health-grade telehealth networks through a common platform that also handles scheduling, referrals and clinical document exchange as well as a virtual meeting room for video conferencing.

Telstra Health was contracted last year by the Northern Territory government to begin the first phase of the project, which involved proof-of-concept technical and clinical trials in two Aboriginal communities to build them a private, secure video connection service solely for telehealth.

Those two communities – Santa Teresa, about an hour out of Alice Springs, and the Anyinginyi Health Aboriginal Corporation in Tennant Creek – are now up and running with dedicated services that connect into NT Health’s existing telehealth network via NTCS to allow hospital-based specialists to provide remote medical services such as outpatient clinics.

The South Australian Department of Health has also come on board to provide remote video consultations from its hospital specialists to NT patients as a part of moves to make it a truly national service and reduce the need for clinicians to travel north and patients to head south.

The project is now moving into a new phase, in which non-government healthcare providers such as GPs, aged care facilities and Aboriginal Medical Services and consumers themselves can also access health-grade networks, no matter which proprietary equipment they currently use. Scheduling, referrals and store and forward functionality are due to be added shortly, followed by the capability to share a patient record and the integration of various billing systems and payment methods.

The aim is to build a platform that provides a virtual meeting room that providers and patients can dial into no matter what internet service or video conferencing equipment they use, that also handles scheduling, billing and data exchange, and contains a directory of telehealth providers for referral purposes. In effect, the idea behind the NTCS is to finally take telehealth mainstream.

According to Telstra Health’s chief health information officer David Doolan, the NTCS is primarily an initiative of the National Health CIO Forum, which allocated funding to NT Health to go out to tender for a proof of concept for a telehealth connection system. Telstra Health won that tender in late 2013.

Dr Doolan said the underlying issue for the NT, just like the other jurisdictions, is that while it has fast, health-grade telehealth networks operating in public hospitals and between sites, there are numerous community-based healthcare providers who don’t have the technical capability to access those networks.

There are also complex challenges in how telehealth services are paid for and how to do referrals and scheduling of appointments.

“In the NT’s case, there are quite a lot of non-government Aboriginal Medical Services that are basically small businesses with variable internet connections,” Dr Doolan said.

“The first priority in the Northern Territory was to reliably connect to Aboriginal Medical Services that weren’t on the government network. We spent some time trying to find the right partners because at the end of the day it was a technical concept but we didn’t want to do it where there were no patients who would benefit. So the two sites picked were Anyinginyi near Tennant Creek and Santa Teresa, which is just out of Alice Springs.”

Dr Doolan said Telstra Health and NT Health worked closely with the the Aboriginal Medical Services Alliance Northern Territory (AMSANT), which has extensive experience in telehealth and eHealth and which provided technical, facilitation and other services on the project.

“In the first instance, the sites wanted a dedicated connection as well as a reliable way to do telehealth,” Dr Doolan said. “The NT people wanted to be able to use whatever video endpoints and whatever bridges they are using on their side, and to dial in as if they were dialling into their own network. They also wanted the people on the other side to use whatever equipment was in place there.

“The other issue was that these two sites wanted a dedicated connection and wanted bandwidth dedicated to video. They wanted us to provide quality of service (QoS) across that connection so that when they are running video, we give them guaranteed bandwidth on that pipe to connect to the service so if someone started using the internet to download a PACS image or whatever, it didn’t interfere with the video.”

Dr Doolan said the two sites had their existing hardware upgraded and they now have a private, secure, cloud-based video connection service. “We stood that up in health-grade infrastructure with all of the usual fail-overs and security, and then we directly connected to the Northern Territory health network, which meant that any endpoint or any site provided by NT Health could use the service,” he said.

“Then we directly connected to Anyinginyi and Santa Teresa, because they were running on their own local area network. Once that was established in the second half of last year, we started a clinical proof of concept going into May this year and they are using it to provide clinical services at those sites.”

CIO direction

Telstra Health is building the NTCS under the direction of the National Health CIO Forum, which involves all of the state and territory health department CIOs, and the National Telehealth Reference Group, which has recently been re-established to provide direction on what technology should be pursued, what functionality should be built and what sectors are the priority.

For the NT government that is the Aboriginal Medical Services (AMS) and Aboriginal community-controlled health services. As part of Telstra’s reconciliation action plan, Telstra Health is working with NT Health to connect 15 more AMSs to the network next year.

“We are also in conversation with other providers at a government and individual health service level across Australia,” Dr Doolan said.

While he can’t discuss the details of those conversations, Telstra Health is more than aware that it must build scale and sustainability in order to achieve the goal of taking telehealth mainstream.

“A lot of people have relied on pilot money for this but it has to get to the point where it is so easy to do and so mainstream that people just do it,” he said. “That’s what we are pushing towards, both in making the technology approachable and flexible and you don’t need training to use it, and making things work.

“We are steering right away from proprietary technology. We are using open standards-based technology, so we don’t care what one sort of technology is on one end and the other has on the other end. As long as it is adhering to a certain standard, then we can scale right down to a consumer.”

While the initial impetus in the Northern Territory was organisation to organisation connections, Dr Doolan said the company is working to open up access to the service via the internet, so small providers and consumers themselves can use it.

Telstra Health won’t be able to guarantee the same QoS that a health-grade, dedicated channel provides as it can’t control the final end of the pipe, Dr Doolan said, but it can provide the same experience in terms of standards-based, single points of access, as well as providing scheduling capability on the platform itself so users can schedule events and notify each other using email or SMS notifications.

Email and SMS are not secure enough to swap clinical information, so the next phase of functionality that the telehealth reference group has asked Telstra Health to build is a platform on which clinical data and medical images can be exchanged – both physically by moving data and virtually by displaying the data on the screen – and the all-important referrals.

“We’ve got a strong belief, and this has been validated by others, that clinicians don’t want telehealth referrals to be different to any other referrals – they want to make it mainstream,” Dr Doolan said. “They say, give me the option of referring to telehealth upfront and then give me and the patient the option of whether we want to do it, but don’t make it special or separate, otherwise we won’t use it.”

Virtual meeting rooms

Telstra is also working to ensure that its own existing and new telehealth services, including the ReadyCare service for GP-to-patient telehealth, the Anywhere Healthcare service it purchased from Medibank Health Solutions for GP-specialist-patient consults and the MyCareManager telehealth-enabled device it has built for aged and community care are all compatible on the same platform.

“We don’t want a situation where if we have provided a device for someone in their own home to let them monitor their vital signs and do video when required, we don’t want that consumer to have a different experience when they are accessing a specialist,” he said.

“We are putting all of this technology and functionality on the same platform on our side in order that people can have a common experience.”

That will mean using a standard approach of virtual meeting rooms so participants can meet in the middle and do away with the requirement to know how to dial into the address at the other end.

“That also allows us to set up virtual waiting rooms,” Dr Doolan said. “At the end of the day when people see providers face to face there are a whole lot of things that go on – scheduling, billing, exchange of data, whatever. All of that has to happen when you do telehealth and just because you don’t have a physical waiting room doesn’t mean that you can’t have a waiting room.

“You have to have a virtual waiting room so the providers know which patients are ready for a call and which aren’t. People have got around this problem in the past by having extra people and extra logistical resources running around organising telehealth and chasing phone calls, and some of that still will persist, but we need to minimise the number of resources that are required.”

Telstra Health also hopes to help overcome one of the biggest challenges: how the actual video consultations are paid for and who by. This is one of the most complex areas for telehealth considering the multiple funding streams available, from MBS-funded specialist consultations to privately billed GP services, different arrangements for residential aged care providers and those paid for by hospitals, as well as federal and state-funded patient transport subsidy schemes.

“We are trying to get technology to a certain scale that the price point for it, people can consume it as a service and that make sense because it is saving them money or time or giving them convenience,” he said.

“In terms of providing billing, with our Anywhere Healthcare service where we facilitate consumer or GP access to specialist services, where those specialists are able to bill Medicare, we provide that billing platform. Where that service is being provided by some other mechanism, we provide a single reporting reconciliation, so people know what service has been provided and what they have paid for.”

Telstra Health intends to make the NTCS so easy to use that video conferencing will be as simple as clicking a few links, but it is also helping to build a national directory of telehealth providers for referral purposes.

It will use the National Health Services Directory (NHSD) – which Telstra Health’s subsidiary HealthConnex has designed and maintains on behalf of Healthdirect – as a directory to facilitate telehealth referrals, Dr Doolan said.

“Where the provider directory is more relevant is when you are referring a patient to someone else and it’s less important when you actually go to do the video conferencing. What we try to do is take that problem away by making people meet in the middle and providing scheduling, so when it is time, you use whatever piece of equipment you’ve got to join the virtual meeting room.

“A directory is less important at that stage but a directory is vital, however, when you are making the referral and making the choice. We are committed to using the NHSD, which needs ongoing development to facilitate telehealth as well as any other referral or access point for patients.”

Referrals

For the exchange of clinical documents and images, how the platform works will depended on the providers, he said. In the case of a scheduled event such as an outpatients visit or a multi-disciplinary team, it often comes about from a referral and you know that event is going to occur.

“In advance, as part of the referral, you make sure the right information gets to the right people. It is scheduled, you know it is going to happen and you can get organised in advance. That is different to an emergency or ad hoc service, in which case you need to be able to exchange data with people that five minutes ago you didn’t know you were going to call. That’s a bit more problematic.

“Sometimes it’s not sharing of content but sharing of screens – sending virtual images but the data is not really leaving one place and going to another. There is also a requirement that after that fact there is record of what happened, and obviously you need to share what a clinician on one end advised a clinician on the other end to do.

“That’s less of a referral or store-forward issue than it is an exchange of data in real time. In some instances it is easier if you don’t have to move data and you just need to share a view of the data, but if you really want to move the data around that is where things like a digital archive come in, which is technology that we have.”

The NTCS looks likely to be a long-term project that Telstra Health is just now having discussions with the other jurisdictions beyond NT Health and SA Health. Dr Doolan said the immediate value offering with the service was the ability to be a bridge between the state-run telehealth networks used by hospitals and with external providers.

“It is obviously very difficult for them to deal with the hundreds or thousands of GPs, aged care facilities and Aboriginal Medical Services so that is the first value offering,” he said.

“Ultimately we’d like to see a situation where people look at this sort of service and say they can use it for their own or some of their own platform, or if they have a certain cap on their volume to access our services.

“One example of that is we are working with a number of smaller providers at the moment who generally are only doing one telehealth event at a time but now and then they need to be able to scale up. They might want to do a multi-disciplinary team meeting and involve 10 endpoints instead of two.

“By using us as a service, we can say that on a regular basis you can have access to one virtual room, because that’s all you need, but you tell us when you need to scale up, which might be once a week or once a month, and we’ll give you the ability to scale up and down.

“Having said that, technology is not the important thing. It is the clinical workflows, the clinical networks and that’s why we work closely with the providers and the consumers to understand what it is they want, which isn’t necessarily what the technology does.”

Decision on OTC codeine rescheduling delayed

The Pharmacy Guild of Australia says it will move quickly to implement a real-time monitoring system for over the counter codeine sales following an announcement by the Department of Health to defer a final decision on rescheduling OTC codeine to prescription-only.

Last month, the Department of Health’s medicines scheduling delegate made an interim decision to support a proposal to re-schedule combination analgesics and cold and flu remedies from Schedules 2 and 3 (pharmacy and pharmacist-only) to Schedule 4 (prescription-only).

However, in an announcement from the Therapeutic Goods Administration (TGA) this morning, the delegate has decided to defer making a final decision until next year due to the large number of submissions received, the majority opposed to the proposal.

The deferral of the decision will allow the delegate the option to seek further advice, including from the Advisory Committee on Medicines Scheduling (ACMS) at its March 2016 meeting, prior to making a final decision, which will not be before June 2016.

A spokesperson for the Pharmacy Guild said that should the final decision require an implementation date, it will not be before 2017.

“The Guild will move quickly to implement a real time recording system for codeine sales, as recommended in our submission to ACMS,” the spokesperson said.

“This system will help identify consumers potentially at risk, and provide clinical referral pathways. The Guild also supports mandatory front-of-pack warnings about the potential for addiction, and increased consumer education about the risks.”

Of the 127 public submissions made following the interim decision, 113 did not support the rescheduling proposal. An economic analysis commissioned by the Guild found that upscheduling codeine would cost the healthcare system $316 million extra a year.

The Guild has developed a prototype real-time monitoring system in association with its IT subsidiary, GuildLink, that will allow pharmacists to record the names of customers purchasing codeine-containing medications.

It will also allow them to check in real-time whether the customer has recently purchased other codeine-containing medications and to make a decision on whether to sell the products.

The Guild estimates the system will cost several hundred thousand dollars to build, and the same to maintain on an annual basis.

MIMS partners with C2C in the cloud

Newly launched cloud-based clinical and practice management system Clinic to Cloud (C2C) has added full MIMS integration to its offering, which is aimed predominantly at specialist practices.

C2C is hosted in Microsoft Azure data centres in Sydney and Melbourne and is designed to take care of scheduling, billing and reporting as well as clinical care.

It currently features integrations with Medicare, DVA and Eclipse as well as SMS reminders and an integrated voice recognition system using Nuance’s SpeechMagic technology.

Users have mobile access to their scheduler, patient demographics, clinical data and eTasks from their iOS or Android smartphone, and patients can register and interact with the practice through a patient portal.

Clinic to Cloud CEO Rafic Habib told Pulse+IT when launching the system that he expected it would appeal to specialists who not only want mobile access to their data but also to do without the hassle of buying software upfront or installing and maintaining hardware locally.

Mr Habib said adding MIMS was an imperative. “Our clinicians and customers are familiar with MIMS; they value and trust MIMS.”

Access to MIMS’ medicines information is also available in the cloud, and the C2C integration also includes MIMS decision support tool for allergy to drug and drug-to-drug interactions.

C2C allows specialist doctors who only prescribe a set amount of drugs to create a favourites list in the software.

MIMS Australia country manager Siobhan Murphy said the partnership with Clinic to Cloud consolidates MIMS’ position as Australia’s preferred source of medication decision support for both primary and acute care clinical software providers.

Australasian health IT week in review: September 19

Pulse+IT’s weekly round-up of Australian and New Zealand health, IT and eHealth news:

Australian security researcher uncovers serious iPhone flaw
Sydney Morning Herald ~ Ben Grubb ~ 18/09/2015

An Australian computer security researcher has uncovered a major flaw in Apple’s iOS mobile operating system that will make any user think twice about not upgrading to the latest version, iOS 9.


New Royal Adelaide Hospital delayed by seven months, will cost additional $34.3m
ABC News ~ Angelique Donnellan ~ 17/09/2015

The new Royal Adelaide Hospital will be delayed by seven months and will cost the State Government an additional $34.3 million.


Govt introduces bill for opt-out e-health records
iTNews ~ Paris Cowan ~ 17/09/2015

The federal government has introduced a bill into parliament that will enable it to transform its stalled e-health records regime by automatically creating a record for every Australian by default.


Senate demands release of NBN FTTP analysis
Computerworld ~ Rohan Pearce ~ 17/09/2015

The Senate has backed a motion from Labor’s Steven Conroy demanding that NBN release a number of documents including an analysis of the cost of an all-fibre rollout of the National Broadband Network.


Monash Health moves into Fujitsu facility at Noble Park
iTNews ~ Andrew Sadauskas ~ 17/09/2015

Monash Health has migrated its data centre operations into a co-located setup at Fujitsu’s Noble Park facility as it lays the groundwork for the introduction of electronic medical records


Almost no referrals’: My Aged Care cops criticism in parliament
Medical Observer ~ Julie Lambert ~ 17/09/2015

Referrals of elderly patients for assessments and aged care services have dried up because of the government’s flawed My Aged Care website, federal parliament has been told.


Apple delays watchOS 2 release after bug discovery
iTNews ~ Staff writer ~ 17/09/2015

Apple will no longer release its new Apple Watch operating system watchOS 2 this week as planned after it discovered a bug in development.


Turnbull’s ‘agile’ government borrows from his IT past
The Conversation ~ Robert Merkel ~ 16/09/2015

Malcolm Turnbull has had many high-profile careers, including as a barrister, merchant banker and aspiring media proprietor. By far his most lucrative, however, was in the IT industry.


NBN trying to cut cost of internet services to rural, regional Australia
The Australian ~ Mitchell Bingemann ~ 16/09/2015

The company building the government’s $49 billion National Broadband Network is talking to retailers and regulators about how the mammoth infrastructure project can provide more competitive internet services in rural and regional Australia.


Australia’s tech leaders optimistic with new IT-savvy Prime Minister
iTNews ~ Andrew Sadauskas ~ 15/09/2015

Australia’s technology and telecommunications industries have welcomed the appointment of former communications minister Malcolm Turnbull as prime minister, indicating optimism for the future based on his knowledge of technology-related issues.


Shared-care software firm goes under, days after CCMS tool sold
NZ Doctor ~ Virgina McMillan ~ 15/09/2015

HSAGlobal is in liquidation owing more than $4 million to creditors including HealthLink and ACC.


International health IT week in review: July 19

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

NantHealth acquisition targets data exchange, interoperability
Health Data Management ~ Joseph Goedert ~ 16/07/2015

NantHealth, which has designed genomic and protein-based molecular diagnostic testing services to support personalized cancer treatment, and recently aligned with software vendor Allscripts, has bought the commercial Healthcare Solutions unit of Harris Corporation.


Lane Fox to focus on digital health
Digital Health News ~ Rebecca McBeth ~ 16/07/2015

Internet entrepreneur Martha Lane Fox will develop proposals to improve take-up of digital innovations in health, the health secretary has said.


Global patient monitoring market grows to $31.4 billion
FierceHealthIT ~ Katie Dvorak ~ 16/07/2015

The demand for wireless and streamlined health devices has led to growth in the patient monitoring market, which currently boasts a global valuation of $31.4 billion, according to a report from Kalorama Information.


Merseyside shares 5.5m records in a year
Digital Health News ~ Thomas Meek ~ 15/07/2015

The GP records of patients in North Merseyside have been shared 6.5 million times with other health and social organisations in the region as a result of Informatics Merseyside’s iLinks Transformation Programme.


American public still skeptical about telemedicine
mHealth News ~ Eric Wicklund ~ 15/07/2015

According to TechnologyAdvice, consumers are growing more comfortable with certain aspect of telemedicine – but they’re still wary of seeing a doctor or getting a diagnosis online.


Why healthcare’s lack of interoperability is unethical
FierceHealthIT ~ Dan Bowman ~ 15/07/2015

The current lack of interoperability between medical devices and other healthcare IT tools represents both a safety dilemma and an ethical issue, according to leaders with the Center for Medical Interoperability.


Health professionals should push for better patient portal usability
FierceEMR ~ Katie Dvorak ~ 15/07/2015

Patient portal use in the healthcare industry has the potential to reduce disparities in care for minority groups and people with lower health literacy; however, that promise has yet to be realized, according to a paper at PLOS Medicine.


Making device data more meaningful
mHealth News ~ Eric Wicklund ~ 14/07/2015

A device that can’t synch to the underlying software, a platform that doesn’t play well with other apps or which meshes with only one EMR, won’t last long.


Proposed nursing home, long-term care rule moves facilities to EHRs, e-data sharing
FierceEMR ~ Marla Durben Hirsch ~ 14/07/2015

The Centers for Medicare & Medicaid Services has once again signaled its intention to move the health industry to electronic health records, this time in its sweeping proposal to change the Conditions of Participation for nursing homes and long-term care facilities.


ONC seeks input on health IT test tools
Health Data Management ~ Greg Slabodkin ~ 14/07/2015

The Office of the National Coordinator for Health Information Technology has renewed its call for developers and vendors to submit test procedures, tools, and data to be considered for approved use as part of the ONC Health IT Certification Program.


10,000 patients using Emis PHR
Digital Health News ~ Thomas Meek ~ 13/07/2015

More than 10,000 people are recording personal health data using Emis Health’s personal health record, which runs on Apple’s HealthKit platform.


Epic at work on new tech to avert falls
HealthcareITNews ~ Bernie Monegain ~ 13/07/2015

Healthcare IT giant Epic is working on a clinical decision tool aimed at helping healthcare providers reduce the risk of falls in unsteady patients.


Study finds online symptom checkers inaccurate
FierceHealthIT ~ Katie Dvorak ~ 13/07/2015

Patients who turn to websites such WebMD, Mayo Clinic and AskMD for health queries more often than not get inaccurate information from the sites, according to a study by Harvard Medical School researchers.


Care Connect disconnected
Digital Health News ~ Rebecca McBeth ~ 13/07/2015

NHS England’s patient feedback service Care Connect is not in use anywhere in the country, more than a year after pilots were completed.


Docs’ views of EHRs still lackluster
FierceEMR ~ Marla Durben Hirsch ~ 13/07/2015

There’s still not much buy-in from physicians regarding their electronic health records, even though more of them are adopting the systems, according to a new survey from Physicians’ Practice.


Web-based tool for comparing Māori health indicators

Bay of Plenty District Health Board (BOPDHB) has launched a web-based monitoring tool that allows comparisons between DHBs on 16 different Māori health indicators.

The brainchild of BOPDHB doctor George Gray, the Māori Health Plan Monitoring Tool provides information on performance trends, disparities between Māori and non-Māori indicators, as well as links to seminars on best practice by the nation’s top performers.

The information is updated every 24 hours with the latest Ministry of Health data.

BOPDHB acting CEO Pete Chandler said the monitoring tool graphically demonstrated the disparity between Māori and non-Māori health outcomes in a way which had not been done before.

He said the tool had enjoyed universal support from national DHB CEOs and called for that to be translated into a lasting and tangible change for Māori.

Dr Gray said the intention was to make Māori health information more visible and accessible and to increase accountability.

“There are multiple examples of Māori having poorer health system experiences and that flows on to poorer outcomes and poorer life expectancy,” he said. “To change that requires ongoing performance improvement.

“This tool will give transparency to performance. DHBs can see whether the initiatives they are using against a certain indicator are working and if not they can try others.”

The development of the Māori Health Plan Monitoring Tool has been sponsored by the national Māori general managers group Tumu Whakarae and funded by the Bay of Plenty, Capital & Coast, Hawke’s Bay and Waitemata DHBs.

It is available at www.trendly.co.nz.

Wirelessly LINQed cardiac monitor wins medtech award

Medtronic Australasia has won the inaugural Medical Technology Association of New Zealand (MTANZ) Innovation Award for its Reveal LINQ insertable cardiac monitor.

The battery-sized heart monitor is aimed at helping doctors to diagnose and treat irregular heartbeats that may be related to unexplained fainting, and is suitable for small children.

It works by continuously monitoring, recording and storing a patient’s electrocardiogram and other health measurements for up to three years.

The device is wirelessly linked to the MyCareLink patient monitor so doctors can be notified remotely and quickly if a patient needs medical attention between regular appointments.

The Reveal LINQ is an implanted monitor measuring about the size of a paperclip or AAA battery and is designed to cause minimal disruption during implant.

The MTANZ awards were judged on the basis of the product’s significant contribution to improving patient outcomes by enhancing quality of life; as well as evidence of technical excellence and innovation.

The award judges were Callaghan Innovation’s national medtech sector manager Diana Siew, director of the Auckland Bioengineering Institute Peter Hunter and University of Auckland professor of surgery John Windsor.

HiNZ heats up for health hackathon

Health Informatics New Zealand (HiNZ) is holding a health hackathon in Wellington next week aimed at bringing together healthcare and technology professionals to brainstorm ideas and develop solutions for healthcare needs.

The hackathon is at the Victoria University School of Design from Friday, June 26 to Sunday, June 28 and is open to software developers, clinicians, health sector managers, patients and anyone with an interest in healthcare technology.

The event will open with networking and tips on pitching at 6pm. From 6.30pm, anyone with an idea for a product makes a one-minute pitch and seeks team members. Teams then work on solutions for the rest of the weekend, with mentors available to help out and offer advice.

Each team then has the opportunity to present their work on Sunday afternoon, which will be judged by a panel involving clinicians and start-up experts.

See the HiNZ website for more information.

Spok upgrades mobile app to integrate messages into EMRs

Critical communications specialist Spok has released version 4.1 of its Spok Mobile secure texting app, featuring a new mobile application programming interface (API) that will allow information contained in messages to be sent to electronic medical records and saved on the patient’s file.

The new version also features integrations with three popular mobile device management (MDM) solutions – AirWatch, MobileIron and Citrix’s XenMobile – as well as integration with cloud storage service Box.

Spok’s senior product manager for the Asia Pacific region, Jim Cikanek, said the company had a number of clients in the US that were starting to deploy Box accounts to their clinicians for workplace purposes.

What the new Box integration will allow is the ability to easily attach a document, image or video stored in a Box account to a secure message, he said.

Spok has also integrated with wearable devices such as Android smartwatches and is also working on a similar integration with the new Apple Watch. These integrations will allow clinicians to receive ‘rich’ notifications of a critical message and to respond to it on their wearable device, Mr Cikanek said.

“Any Android device that runs the Android Wear software – there is a whole list of those – our software will push rich notifications to those,” he said. “Rich notifications [for Android] gives you the ability to see the message on your device, accept or decline, and to reply. You are getting more than an alert that you have a new message.

“On the Apple side, as it is brand new we allow the notifications side but we don’t currently support rich notifications. Apple will be launching a new SDK shortly that will give it more functionality and allow us to build a separate application that actually rides on the wearable device. At that point we’ll be able to do the rich notifications just like Android.”

Mr Cikanek said Spok’s new mobile to mobile integration API was built with the need to integrate with EMRs in mind. Rather than integrate with a specific EMR provider, it became obvious that Spok was better off building an API to expose the Spok Mobile messaging application to any third-party mobile application, he said.

“What this allowed us to do is build one API that many third-party applications can call without us having to do many integrations or integrate multiple times to different EMRs,” he said. “The healthcare industry is becoming mobile and there are a lot of mobile applications out there.”

He said the key to the use of the Spok Mobile API for EMR providers was the ability to call the Spok directory straight from the third-party app. One of Spok’s points of difference, he said, is integration with staff directories and on-call scheduling systems as well as the ability to receive HL7 and Active Directory feeds.

“Content can be securely passed from that third-party application into Spok Mobile,” he said. “The same way that we use to pass messages from one mobile device to another, it uses that encryption when it is passing from one mobile app to another mobile app.

“You can then take any information from those messages and push it back through the API to that third-party application. So if it is an EMR, any patient information can be passed from the Spok Mobile application through the API back to that EMR and onto the patient’s record.”

Mr Cikanek said Spok had predominantly been working on this EMR integration with customers using the Epic EMR in the US, but has also been working with Allscripts and some customers using Cerner.

“We are just releasing this out so it hasn’t been widely adopted yet,” he said, “but we are working with some customers using Cerner who are looking to do things like pass images into the patient file.”

International health IT week in review: April 19

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

DeSalvo at HIMSS15: ‘True interoperability, not just exchange’
HealthcareITNews ~ Mike Miliard ~ 16/04/2015

In her keynote Thursday morning at HIMSS15, National Coordinator Karen DeSalvo, MD, said it’s now time to “focus beyond adoption” of health IT and create an interoperable, learning health system “upon the strong foundation we all have built.”


Value of apps and wearables questioned
EHI News ~ Thomas Meek ~ 16/04/2015

The potential for smartphone apps and wearable devices to have an effect on health outcomes has come under question in an article published by the BMJ.


HIMSS15: ONC grant to boost community health data sharing efforts
FierceHealthIT ~ Dan Bowman ~ 15/04/2015

Karen DeSalvo: Funding meant to advance ideas beyond the EHR and traditional players.


Lib Dem manifesto promises GPs by Skype
EHI News ~ Lyn Whitfield ~ 15/04/2015

The Liberal Democrats have promised to open up access to GPs by using phone and Skype appointments in their manifesto.


The power of the spoken word (into the EMR)
HealthcareITNews ~ Eric Wicklund ~ 14/04/2015

How do you get physicians to adopt mobile technology? Tie it into something they already do – such as talk into their smartphones.


Texas Medical Board ruling strikes blow to telemedicine services
FierceHealthIT ~ Susan D. Hall ~ 14/04/2015

The Texas Medical Board has ruled that doctors must examine patients in person before they may order prescriptions for them, striking a blow to telemedicine provider Teladoc.


Geisinger sets SMART apps on FHIR
EHI News ~ Jon Hoeksma ~ 14/04/2015

US healthcare provider, Geisinger Health System, has unveiled an EnrG suite of interoperable software applications, able to link to multiple electronic health records, using common standards.


e-Referral Service ‘live on 15 June’
EHI News ~ Rebecca McBeth ~ 14/04/2015

The new NHS e-Referral Service will go-live on 15 June as part of plans to replace all paper-based referrals.


Tory manifesto re-runs access pledge
EHI News ~ Lyn Whitfield ~ 14/04/2015

The Conservative Party has promised to continue the NHS transparency agenda and to give people “full access” to their electronic health records in its manifesto.


Even as EHR proficiency rises, enthusiasm dips
HealthcareITNews ~ Tom Sullivan ~ 13/04/2015

Doctors have become better at using electronic health records software in the last two years but, fewer physicians believe EHRs actually improve care.


Health tools for Apple Watch arrive
HealthcareITNews ~ Eric Wicklund ~ 13/04/2015

The Apple Watch won’t be delivered to consumers until April 24, but several mHealth companies (including a few providers) are quickly developing their own apps for the trendy smartwatch.


FHIR showing promise in healthcare information exchange
HealthcareITNews ~ Frank Irving ~ 13/04/2015

Providers and developers will soon be able to start implementing the emerging interoperability standard.


Patient-led innovation
HealthcareITNews ~ Richard Pizzi ~ 13/04/2015

Enhance, expand and evolve. That’s what Walgreens is doing, and what the healthcare industry as a whole should focus on, said the keynote speaker at the 2015 HIMSS Conference & Exhibition on Monday.


Informatics nurses have huge impact on patient safety, workflow
FierceHealthIT ~ Susan D. Hall ~ 13/04/2015

The role of informatics nurses has expanded greatly, providing a significant impact on patient safety and overall care, as well as workflow and productivity improvements, according to the 2015 HIMSS Impact of the Informatics Nurse Survey.


Health CIOs catch on to phishing threat
EHI News ~ Jon Hoeksma ~ 13/04/2015

Cybersecurity has forced itself onto the agenda of US healthcare chief information officers and become a hot button issue for the healthcare IT industry at HIMSS15.


Labour manifesto fails to focus on IT
EHI News ~ Lyn Whitfield ~ 13/04/2015

The Labour Party has launched its manifesto for the upcoming general election, promising a more integrated health and care system, but not one that will make more use of IT.


Open source VNA fits digital ‘jigsaw’
EHI News ~ Sam Sachdeva ~ 13/04/2015

The UK launch of an open source vendor neutral archive is a “key piece of the jigsaw puzzle” to create an open digital health ecosystem, NHS England’s head of open source says.


Why DoD EHR modernization will fail
FierceHealthIT ~ Susan D. Hall ~ 10/04/2015

As the U.S. Department of Defense zeroes in on determining which bidding group will be awarded the coveted contract to modernize its electronic health record system, Loren Thompson, COO at the nonprofit Lexington Institute, says the effort is doomed to fail.


Cerner app on time for Apple Watch
EHI News ~ Thomas Meek ~ 10/04/2015

Cerner has developed a personalised healthcare data app to use on the Apple Watch, hailing the device as “the next evolution” in healthcare.