HealthEngine shakes up online booking with free AGPAL deal

Online appointment booking and directory service HealthEngine has struck a deal with Australian General Practice Accreditation Limited (AGPAL) to offer its online booking system to AGPAL-accredited practices for free.

HealthEngine, thought to be the market leader in the consumer online medical appointment sector, will also identify practices that meet AGPAL quality accreditation in its online directory. AGPAL accredits about half of the estimated 7000 general practices in Australia.

HealthEngine CEO Marcus Tan said he did not expect the deal to be a big hit to the company’s revenue, as the majority of revenue comes from other offerings such as its directory and the marketplace. The company is Google’s premium partner for healthcare-specific search engine marketing in Australia.

“We provide other services to practices that we can generate revenue from, so we don’t feel that this will be a huge hit to our revenue from that perspective,” Dr Tan said.

Dr Tan said the main aspect of the deal was to help drive patients to accredited practices and help them understand what accreditation means. For practices, he said easier access to healthcare was part of providing a quality service and online appointments are part of this service.

“We’re willing to almost offer this up as a key piece of infrastructure, like a phone line or a fax line or an email,” he said. “This is something that quality practices should have, so we’ve negotiated a deal with AGPAL to provide that for patients as part of their accreditation.”

HealthEngine’s online booking system is integrated with PracSoft, Best Practice, Zedmed, Genie and Practice 2000, and it offers a plug-in for each practice’s website to make appointments available online. It also has a practice-specific app called Get Better that practices can offer to patients, as well as its consumer-based HealthEngine app through which consumers can search for local healthcare providers.

The company says practices can save up to $20,000 a year through online bookings in terms of less time wasted on the phone for practice staff, extra bookings and fewer no-shows. Most of its rivals charge a monthly subscription, while HealthEngine charges per appointment.

The deal only involves the online booking system, with added extras still commanding a fee.

“[The online booking system] is part of a productivity suite that we offer, including marketing, to fill gaps within the practice,” Dr Tan said. “Whether it’s on Google or whether it’s on HealthEngine or whether it’s through a directory, we’re basically offering that suite of services to practices and that’s where we derive a significant amount of our income.”

The move reflects a intensification of competition in the online booking market, which has traditionally been marked by a differentiation between practice-focused players such as Appointuit, OzDocsOnline and Clinic Connect.

New players include DocAppointments and HotDoc, along with HealthEngine’s main rival in the consumer search segment, 1stAvailable.

More recently, the market leader in GP clinical and practice management software, MedicalDirector, announced that it was set to launch its own online booking system, integrated within PracSoft. However, MedicalDirector will also offer an application programming interface (API) that will allow practices to continue using third-party appointment booking services if they wish.

Klaus Bartosch, managing director of 1stAvailable, said HealthEngine’s move was a strong signal that the Australian health industry is ready to embrace online appointment booking systems.

“However, the challenge for the market is to carefully consider which provider is aligned to doctors’ priorities of maintaining a continuous patient/doctor relationship and how this technology can enable their business and not disrupt it,” Mr Bartosch said.

“Given this is a new area of a health professional’s business, it’s important the market understands that not all online appointment booking solutions are the same. Each of the three leading solutions in the GP market vary radically and we believe ultimately that healthcare providers will be swayed by what is best for both their own practices and their patients.”

Practice owner and co-founder of Appointuit, Gordon Cooper, said that while there are many online appointment models, Appointuit’s approach was firmly based on the RACGP standards (1.1, 1.3 and 1.5), which concern understanding the patients’ healthcare journey of access, continuity of care and preventative healthcare.

“While there is a place for a search and find marketplace directory model, for one-off, last-minute appointments, patients and practices benefit far more from the continuity of care model,” Mr Cooper said.

“Practices recognise the business and practice efficiency value and patients have embraced our model resulting in Appointuit being in the top 10 Appstore rankings every single day in 2014, making it the most popular medical appointment app downloaded in Australia.”

Central PHO rolls out ManageMyHealth for shared care

Central PHO has funded the roll-out of a shared care record using Medtech Global’s ManageMyHealth platform to general practices in the MedCentral district, with 18 practices currently participating in Horowhenua, Manawatu, Otaki and Tararua.

The shared care record includes details of health history, prescribed medicines, allergies, immunisations, reminders, test results and discharge summaries held in general practice systems.

It is accessible to clinicians at after-hours GP services, hospital emergency departments, hospital inpatient and outpatient services and aged care facilities in the region, including City Doctors and Radius Accident & Medical in Palmerston North and the Horowhenua after-hours clinic in Levin.

All patients enrolled with the Central PHO general practices are eligible for a shared care record but can opt-out completely or choose not to allow specific information from being shared.

Central PHO executive clinical director Chiquita Hansen said there was a high demand from patients for this sort of service and many were surprised it wasn’t already available.

“The transition of patient care through different times of the week, between health providers and across a range of medical centres has traditionally been a challenging area in health care but the shared care record is a positive step to smoothing the patient journey,” Ms Hansen said.

The Shared Care Record project is also being implemented in other areas of the MidCentral DHB as well as in the Wairarapa and Capital & Coast DHBs.

Ophthalmic manual sets sights on top app award

An app designed to help GPs and optometrists to more easily diagnose eye disorders has been named as a winner in the New Zealand Private Surgical Hospitals Association’s (NZPSHA) Leaders in Quality Awards.

The Auckland Eye Manual app is a comprehensive ophthalmic diagnostic resource that provides a reference guide across all sub-speciality eye diseases.

It explains the appropriate methods for taking an ophthalmic history, and along with the use of colour photos, aids in identifying important signs for over 100 common eye conditions. Immediate and longer-term management and referral guidelines are also included.

Designed originally as a print resource for GPs by specialists from private ophthalmology clinic Auckland Eye and its surgery arm Oasis Surgical, the manual was then turned into an app to make the manual even more accessible to GPs and optometrists.

The app is now used by the University of Auckland as an educational tool for all fifth-year students.

The Auckland Eye Manual app is available iOS and Android devices for free for New Zealand users.

One million hits for New Zealand Formulary

Total visitor numbers to the New Zealand Formulary and the Formulary for Children have breached the one million mark since the resources’ launch in July 2012 and November 2013 respectively, new figures show.

The New Zealand Formulary (NZF) has been adapted from the British National Formulary (BNF) and provides an up-to-date, comprehensive and NZ-specific medicines information resource.

In addition to full drug monographs, it uses information from the New Zealand Universal List of Medicine (NZULM), which details medicines approved for supply in NZ, whether PHARMAC subsidies apply and any restrictions or conditions that apply.

Publicly accessible online and on portable devices, the plan is to fully integrate the NZF into prescribing and dispensing software.

HIMSS Analytics reveals new continuity of care maturity model

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

The Health Information Management Systems Society’s (HIMSS) analytics division unveiled a new maturity model for healthcare organisations in February that goes beyond the highest level of its EMR adoption model. For Australian healthcare organisations, the new continuity of care maturity model provides a way to benchmark progress and capabilities in interconnectedness and continuity of care against other organisations on a global scale.

The HIMSS Analytics electronic medical record adoption model (EMRAM) has been hugely influential in guiding organisations around the world in their implementation of electronic health records, but EMRAM was never designed to address the sort of national, regional or community-based technology issues that governments and healthcare organisations are grappling with as they share electronic health records.

So when the new HIMSS Analytics continuity of care maturity model (CCMM) was unveiled at the HIMSS14 Conference and Exhibition in the US in February, a number of healthcare organisations and technology providers, InterSystems amongst them, voiced their support. With seven stages that build on EMRAM, CCMM is a global model for healthcare providers that focuses on information exchange, care coordination, interoperability, patient engagement and analytics, with the ultimate goal of holistic individual and population health management.

In a presentation at HIMSS14, the executive vice president of HIMSS Analytics, John Hoyt, detailed the seven stages and associated criteria of the new model and how it can drive transformation in individual and regional health systems globally. “This is the direction the market is headed and we are happy to provide a tool healthcare delivery organisations and governments can use to gauge their progress towards a more efficient care delivery approach,” Mr Hoyt said.

Seven stages of enlightenment

To many in the healthcare industry, the highest level of the new continuity of care maturity model, Stage 7: ‘Knowledge-driven engagement for a dynamic, multi-vendor and multi-organisational interconnected healthcare delivery model’, may seem like nirvana, a seemingly unattainable level of enlightenment.

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

Health information management driving the information highway

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

HIMAA is heading to Darwin for its national conference in October, teaming up with the University of Sydney’s National Centre for Classification in Health (NCCH) to provide a wide-ranging event that highlights how health information managers and clinical coders are driving the information highway.

In an historic coalition, the Health Information Management Association of Australia (HIMAA) has this year teamed up with the University of Sydney’s National Centre for Classification in Health (NCCH) to present its annual national conference.

HIMAA president Sallyanne Wissmann and NCCH director Richard Madden say that both the partnership and the conference theme were developed just after the change of federal government late last year, but they couldn’t have predicted then how appropriate the theme of Health Information Management: Driving the Information Highway would be.

The aim in offering a combined conference program is to extend the learning and professional development opportunity for the organisations’ respective and related constituencies, they say.

Ms Wissmann says health information is a fundamental component of the health system, with so many outcomes of the health system dependent on good quality, fit for purpose, patient, clinical and business information.

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

Epworth takes an incremental approach to digitisation

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

Rolling out a full electronic medical record in the acute care setting is notoriously fraught with difficulty, an exercise that is hard, expensive and ripe for failure. An alternative measure that can provide excellent results is a scanned medical record accompanied by electronic forms and diagnostic results viewing. That is the path chosen by Epworth Healthcare in Melbourne as it implemented Core Medical Solutions’ BOSSnet DMR over the last year.

Scanned medical records are nothing new and many hospitals and healthcare organisations have implemented a solution in various forms over the last decade or so, but the technology behind scanning solutions has improved enormously over that time and it now provides a practical, cost-effective way to digitise the mountain of paperwork that still proliferates in almost every hospital in the country.

Scanned medical records can act as a necessary tool to maintain historical records but with a few added extras, they can also be a step towards a full EMR. When joined with electronic forms, electronic ordering and results reviewing and an electronic medications management module, these pieces of technology can constitute what many regard as a full EMR, without the headaches of boxed solutions.

Epworth Healthcare in Melbourne has this year completed the roll-out of Core Medical Solutions’ BOSSnet Digital Medical Record (DMR). First installed at Epworth Eastern in late 2010, it has now been implemented throughout the hospital group, with the last facilities going live in March this year.

Epworth previously used a legacy, non-clinical scanning solution that needed to be replaced. Rohan Ward, CEO of Core Medical Solutions, says there was no discussion about trying to do anything other than fix something that was broken, but there was an eye on what BOSSnet could provide in the future as well.

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

Workshop on the business of IT for general practice at HIC

Melbourne-based GP Nathan Pinskier will lead a workshop covering the business processes and costs of IT infrastructure in general practice at the Health Informatics Conference (HIC) next month.

The workshop is aimed at both new and existing practices and will provide a cost-benefit analysis of IT in general practice.

“It is really an opportunity to talk about the capital costs, the operational costs and the ongoing maintenance costs of delivering and supporting IT infrastructure in general practice,” Dr Pinskier said.

“To many providers, the cost of providing the service is quite significant. It’s not just the national system but to meet all of the requirements around security, messaging, clinical software, clinical audits, practice administration, back-up – all of the functions required are a very significant undertaking.

“We are unaware that there has been any real attempt, certainly in general practice, to quantify those costs.”

Dr Pinskier said the workshop would include case studies and would challenge attendees to provide their own analysis on how a typical practice should operate and the associated costs.

Most practices these days must invest in IT as a matter of course, but cost is still a consideration, he said.

“A good example is back-up. Everybody should back up but very few organisations, other than very large mission-critical providers or companies, actually understand what back-up really means. How do I maintain uptime and how do I ensure data preservation?

“The answer to that is how long is a piece of string but we will be showing examples of how you can do it and what you need to think about. We will also do a little bit of work around benchmarking and providing some sort of cost-benefit analysis.”

The workshop will also look at understanding the cloud, the NBN and other considerations for GPs who are planning a digital practice.

The workshop will be held on Tuesday, August 12, the opening day of HIC. Other primary care events on the day include a session on eHealth implementations and one on the benefits of certification in eHealth, led by David Rowlands.

The Health Informatics Society of Australia’s always popular Q&A panel, moderated by the ABC’s Tony Jones, will be held in the afternoon session. It will feature Department of Health CIO Paul Madden, Telstra Health’s Shane Solomon, the CIO of Healthscope, Paul Williams, and HISA board member Michael Gill.

DoH aims for pathology and imaging on PCEHR by December

The Department of Health is aiming to have pathology and diagnostic imaging reports available on the PCEHR by December, but warns that a move to an opt-out model for the system by January 1 is not achievable.

The department has released draft summaries of two workshops held earlier this month concerning progress towards uploading pathology and DI reports. The workshops covered where the discussions had got up to before work was halted late last year, when federal health minister Peter Dutton ordered an inquiry into the PCEHR system.

For the pathology sector, consensus seems to have been achieved around a short-term goal to upload pathology reports as immutable PDFs to the PCEHR and to proceed with a new authority to post (ATP) system, in which a general practitioner would review the report with the patient and then send a secure message to the pathology provider, who would then upload the report.

For the diagnostic imaging sector, however, there is disagreement, with discussions this month raising the possibility that radiologists could upload their reports directly. The argument is that diagnostic imaging providers often see patients in person and provide them with hard copies of the images rather than sending them first to the referring doctor.

The DI sector is discussing whether a report on the images can be sent directly to the PCEHR without waiting for an ATP.

In its summary of the pathology meeting, the department states that the ATP system is merely an interim step and will not be viable in the long term. Much work has been done by on standardising terms and measurements in two projects led by the Royal College of Pathologists of Australasia (RCPA), known as the PITS and the PITUS projects, but more will be required to ensure standard terms and measures are used before atomic data can be added to the PCEHR.

More work is planned on the ATP workflow and messaging process, with further meetings to be held early next month.

The summaries both concede that one of the prime recommendations of the PCEHR review, that an opt-out model be introduced by January 1, 2015, is not possible.

“Given the consultation required to work through the issues of moving to an opt out system with consumers and clinicians, the January 2015 implementation date suggested in the review reports is not achievable,” the department says.

“After the consultation process, advice will be provided back to government on the approach, cost and timeframe for implementation.”

NHI errors drop with more robust platform

The amount of duplicate National Health Index (NHI) numbers has dropped to below one per cent a year after the index was upgraded to a new technology platform, the NZ government says.

Health Minister Tony Ryall said the new system went live in May last year with better search functionality for healthcare providers to find the right patient.

“Everyone who uses our health services is assigned a unique NHI number to ensure their personal details are correctly associated with their patient record,” Mr Ryall said.

“Doctors, pharmacists and other health care providers are able to check the national system if they can’t find a patient in their own systems.

“Since the new system was introduced duplicate NHI numbers have been dropping. For the first time they have fallen below one per cent.”

“These excellent results are due to the new system’s improved search capacity, which makes it easier for health providers to create or amend NHI numbers to find the right patient quickly.”

New Zealand first introduced the NHI in 1979 – Australia followed its lead in 2010 – and National Health IT Board figures show 98 per cent of New Zealanders have an NHI number. About 150,000 new numbers are issued each year to newborns and migrants.

In addition to the NHI number, each individual’s name, address, date of birth, sex, New Zealand resident status, ethnicity and date of death are linked on the index. It is also linked to national Medical Warnings System (MWS), which contains alerts for allergies or sensitivities to medications, as well as alerts for significant medical conditions, contact details of next of kin and organ donor information.

Part of the National Health IT Board’s Health Identity Programme (HIP), the new system has also integrated the former Health Practitioner Index, which has been renamed the Health Provider Index, into a single solution.

The HIP saw a migration from an existing SSR gateway to SSL to reduce transaction response times, as well as new search functionality and new address batch matching capabilities that are important for capitation-based funding for primary care.