ITAC 2015: Webstercare takes out top prize as stalwarts join hall of fame

Medications management and pharmacy systems specialist Webstercare has taken out the top prize of ICT company of the year at the 2015 Information Technology in Aged Care (ITAC) awards on the Gold Coast for RxMedChart, its computer-generated version of the National Residential Medication Chart (NRMC).

Organisers also took the unusual step of naming two new members of the aged care ICT Hall of Fame in industry luminaries Rod Young and Suri Ramanathan. Mr Young is a former CEO of the Aged Care Association Australia (ACAA) and a member of the Aged Care Industry Information Technology Council (ACIITC). Mr Ramanathan is also a member and former chair of ACIITC.

Wesley Mission Brisbane won the best implementation of the year award for large providers (over $30 million in income) for its mobility strategy, which includes the ability to access its cloud-based clinical information system, Leecare’s Platinum 5.0, on mobile devices.

The ICT Innovative Entrepreneurial of the Year Award, which recognises successful individuals, partners or start-ups who have designed and developed marketable technology-driven products or services, was won by Anne Livingstone of Community Resourcing for leading the development of the Community Care Smart Assistive Technology Collaborative platform.

Webstercare’s RxMedChart system is the first computer-generated medication chart which is also valid as a prescription under PBS regulations. For doctors, it means they can prescribe medications on the chart without the need to write a separate script.

The chart acts a single source of information for a resident’s medication profile to all members of the healthcare team and integrates information across all software used to manage medications by doctors, pharmacists and nursing staff.

It can be used to document a resident’s medication profile and by the pharmacist to dispense medications, as well as solving the problem of prescriptions owing from RACFs.

High recognition in the ICT company of the year category went to:

Best Implementation of the Year for facilities with less than $5m in income went to Flexicare for the implementation of an IT solution that allows case managers and podiatrists to access client information remotely on tablet devices.

Best Implementation of the Year for facilities with between $5m and $30m in income went to Adssi Home Living for a quality management system from Thoughtware.

Best Implementation of the Year for infrastructure (hardware/software) went to Sundale for moving its data centre from a local server at its base in Cooroy on the Sunshine Coast to a NextDC managed service in Brisbane.

International health IT week in review: October 25

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

Record sharing: TPP and Emis integrate
Digital Health News ~ Thomas Meek ~ 21/10/2015

England’s two major GP clinical system suppliers are about to begin trialling a direct integration between their systems to allow GPs to share patient records more easily.


Interoperability across various settings focus of UCSF, Cisco partnership
FierceHealthIT ~ Susan D Hall ~ 22/10/2015

The University of California San Francisco and Cisco have teamed up to create a platform to enable data-sharing from multiple sources among health systems, providers and application vendors.


First GPSoC integrations live
Digital Health News ~ Rebecca McBeth ~ 22/10/2015

Two subsidiary GP systems suppliers have integrated their systems with those of principal suppliers for the first time under the latest GP Systems of Choice framework.


Mobile ultrasounds take a step forward with image-sharing
mhealth News ~ Eric Wicklund ~ 22/10/2015

A portable ultrasound device recently used in Africa is making its way to the U.S., giving clinicians the ability to conduct, store and share images at the point of care.


Athenahealth, Epic lead in EHR interoperability, KLAS says
Health Data Management ~ Greg Slabodkin ~ 22/10/2015

Electronic health record vendors athenahealth and Epic tied for first place with the highest interoperability scores in a survey of nearly 250 providers across inpatient and ambulatory settings.


EHR song parody pokes fun at serious usability frustrations
HealthcareITNews ~ Michelle Ronan Noteboom ~ 21/10/2015

The latest video by doctor/rapper ZDoggMD may not win a Grammy, but it likely strikes a chord with clinicians frustrated by the inefficiencies of their EHRs.


Pharmacy fined for selling patient data
Digital Health News ~ Thomas Meek ~ 21/10/2015

An online pharmacy part-owned by Emis Health faces a £130,000 fine after it sold customer details to a direct marketing company.


Can vendors make health data interoperability a reality without government force?
FierceEMR ~ Marla Durben Hirsch ~ 21/10/2015

It’s only fitting that the new trailer for the next Star Wars movie–“The Force Awakens”–was released just as the Empire–the EHR vendor community–strikes back in the battle for health data interoperability.


Can ICD-10 be this smooth or has reality not struck?
Health Data Management ~ Joseph Goedert ~ 21/10/2015

Preparing for ICD-10 was difficult for two-physician Girgis Family Medicine in South River, N.J., and Linda Girgis, M.D., did not appreciate the lack of preparedness of multiple insurers and its clearinghouse when the compliance date came.


EHR vendors agree to uniform interoperability metrics
Health Data Management ~ Greg Slabodkin ~ 20/10/2015

Executives of 12 major electronic health record vendors met earlier this month and have agreed to interoperability metrics that participants are calling Consumer Reports-like in their design and the first of their kind for the healthcare industry.


Use of virtual health tools could shave $10 billion a year from primary care costs
FierceHealthIT ~ Susan D. Hall ~ 20/10/2015

Using virtual health technology in primary care could save $10 billion a year and allow treatment of more patients without the need to train more doctors, according to a new report from Accenture.


KLAS interoperability report examines what providers, vendors are doing to connect
FierceEMR ~ Katie Dvorak ~ 20/10/2015

Poor vendor coordination, trouble finding records and limited parsing abilities are among the biggest barriers to interoperability of health information, according to a new study from KLAS.


mHealth changes the game for transitional care
mhealth News ~ Eric Wicklund ~ 20/10/2015

Two years ago, two New Jersey hospitals using DocView mHealth Solutions’ text message-based platform reported no readmissions among 10 stage C heart failure patients over three months. Their conclusion? Sometimes the best solutions are the simplest ones.


EHRA to ONC: Don’t jump the gun on ‘information blocking’
FierceEMR ~ Marla Durben Hirsch ~ 19/10/2015

The Office of the National Coordinator for Health IT and policymakers may be overstating the problem of information blocking and “run the risk of overreaching to what appear to be isolated incidents,” according to HIMSS’ Electronic Health Records Association (EHRA).


Fed adoption could spur more use of Direct messaging software
Health Data Management ~ Joseph Goedert ~ 19/10/2015

Federal agencies in 2010 started work to create the Direct Project secure messaging protocols as a simple and standard way to exchange encrypted health information.


Johns Hopkins, Microsoft partnership to bring interoperability to med devices
FierceHealthIT ~ Katie Dvorak ~ 19/10/2015

In a joint effort, Johns Hopkins University School of Medicine and Microsoft are developing a health IT system that can better help medical devices communicate.


Report: Consumers turn to Internet for majority of health info
FierceHealthIT ~ Katie Dvorak ~ 19/10/2015

Most consumers turn to the Internet for health information, strongly feel that they should be in control of their data and personally are purchasing wearable devices to track their fitness.


IBM completes $1B acquisition of Merge Healthcare
Health Data Management ~ Greg Slabodkin ~ 16/10/2015

IBM this week completed its $1 billion acquisition of medical imaging software vendor Merge Healthcare with business goals directly tied to Big Blue’s Watson supercomputer.


HiNZ 2015: Nursing, but not as you know it

Health Informatics New Zealand (HiNZ) will live-stream the keynote speakers at its upcoming conference in Christchurch in addition to the sold-out National Nursing Informatics Conference being held the day prior.

Titled ‘Nursing but not as you know it’, the nursing informatics conference will this year feature presentations from three experts with hands-on experience in developing or implementing IT systems for the nursing workforce.

Sheree East, director of nursing at Nurse Maude in Christchurch, will discuss nursing documentation in an EHR. Ms East, who recently completed her master’s thesis on the Omaha system in New Zealand community nurse settings, has been involved in the development of HealthOne – formerly known as Canterbury’s electronic shared care record view (eSCRV) – the Nurse Maude clinical information system and a project looking at the use of telehealth in community care.

Andrea McLeod, chief operating officer for Plunket, will discuss the development and implementation of the new electronic Plunket Health Record (ePHR), a cloud-based system designed to replace paper forms used by Plunket nurses when visiting mothers and babies at home.

Jane Brosnahan, director of nursing at South Canterbury DHB, will discuss the implementation of the national maternity information system, first trialled in Palmerston North and now live in five DHBs.

HiNZ will live-stream the plenary presentations at the full HiNZ conference, including a presentation by Health Minister Jonathan Coleman, who will discuss the national health strategy, and National Health IT Board director Graeme Osborne, who will provide an update on national health IT programs.

HiNZ will also record the other sessions, which will be viewable on demand within 24 hours. The webcasts will present both the speaker and their slides and features a search function using keywords that will allow users to be taken directly to the point in the presentation where the keyword was mentioned.

HiNZ is offering the virtual registration capability for $NZ149, which includes a one-year membership of the organisation and access to 10 years of its archives.

Virtual registrations will also provide full access to the one-day National Nursing Informatics Conference, which is being held on Monday, October 19 at the Wigram Air Force Museum in Christchurch. The event is sold out.

A full-day FHIR workshop will also be held on Monday, October 19, followed by HiNZ proper on Tuesday and Wednesday, October 20 and 21. Further workshops and a site visit to the Canterbury DHB Design Lab will take place on Thursday, October 22.

See the HiNZ website for more information.

Queensland Health rejects insider claims of ieMR cost overruns

The Queensland Department of Health has rejected claims by an insider that there are major budget overruns in its integrated electronic medical record (ieMR) project and has defended the four-stage release strategy for the system, which is seeing one hospital pay $175,000 a month for medical record and document scanning.

A Queensland Health source has told Pulse+IT that while the project was on track as recently as August 2014 to deliver the ieMR for approximately $190 million to seven hospital and health services – involving nine hospitals in total – the former Newman government’s statewide ICT renewal program had disrupted the plans, with senior staff involved in the roll-out leaving the Health Services Information Agency (HSIA) and the establishment of a new Chief Health Information Office separate from HSIA causing further disruption.

Queensland Health confirmed last week that the ‘Digital Hospital’ release of the ieMR, which is based on Cerner’s Millennium suite, would go live at the 780-bed Princess Alexandra Hospital (PAH) in November, but that the planned simultaneous go-live at Cairns Hospital will not go ahead, with Cairns to go live in February next year instead.

HSIA chief technology officer Colin McCririck said this would allow Cairns to learn from PAH’s experience and would not delay the implementation of the release at the other hospitals in the roll-out, which includes Mackay, Royal Brisbane and Women’s, Lady Cilento Children’s, Townsville, Gold Coast University Hospital at Southport, Robina Hospital and the sub-acute facility at Carrara Community Health Centre.

These nine hospitals represent more than 60 per cent of patient throughput in the state.

Queensland Minister for Health Cameron Dick announced recently that as part of the state’s $1.26 billion health ICT strategy, another 12 hospitals would be added to the ieMR roll-out in future, along with four small regional hospitals that will receive a ‘lite’ version of the system, at an estimated cost of $376 million over 20 years.

These are Rockhampton, Bundaberg, Sunshine Coast Public University, The Prince Charles, Redcliffe, Caboolture, Logan, QEII Jubilee, Toowoomba and Ipswich hospitals, with lite versions at Thursday Island, Roma, Longreach and Mt Isa.

The Queensland Health insider claimed that while the program had been on track to deliver to the nine hospitals for $190 million, the program office has had to go back to Treasury to ask for more money to deliver the original scope of the project.

“The $300 million that Queensland Health has asked for [as announced on September 3] to complete the electronic medical record roll-out, which Treasury has agreed to, is to backstop the cost overruns within the original project scope,” the source said.

Queensland Health rejected this, saying the eHealth investment strategy outlined $376 million to implement the ieMR across Queensland.

Queensland Health provided a breakdown of the total amounts budgeted and spent on the ieMR each financial year, starting from 2009-2010. The total cost so far is $167.5 million, with the ieMR budget for 2015-16 still to be finalised.

The source also claimed that the decision to implement the roll-out in four stages – R1 involves scanning paper medical records while R3 is the Digital Hospital release, and R4 will include medications management – rather than one hospital at a time was wasting money, particularly in terms of the considerable costs of running a scanning team at each site.

“Instead of following … best practice by implementing the Cerner product one hospital at a time in a hospital-wide implementation, Queensland Health has decided to break the implementation into four components (R1 – R4),” the source said.

“This has led to considerable costs whereby scanning of physical medical records which would normally only take place for the three months whilst a full medical record implementation [took] place.

“This has continued on for more than 18 months. [PAH is] paying around $200-$300,000 per month to maintain their scanning team whilst they wait for the full implementation of the Cerner product.”

Queensland Health said the scanning team at PAH was costing about $175,000 a month, and that scanning of paper records was an important part of preparing for the Digital Hospital implementation.

The source also said it was widely believed within Queensland Health that some of the ieMR budget had been used as part of the ICT renewal and contestability program initiated by the Newman government last year.

The source claimed that the emphasis on the ICT renewal program had “gutted” the ieMR program team executive, with the program chief Dean Dimkin moving on following the departure of Queensland Health CIO Ray Brown in July 2014.

Former Queensland Health director-general Ian Maynard – who stood down following the election of the current ALP government – then invited Mater Health CIO Mal Thatcher and Queensland Health’s senior director of program delivery Paul Carroll to temporarily act as chief health information officer (CHIO) and chief technology officer (CTO) for a year.

Mr Dick has since announced that the CHIO’s office, which is responsible for ICT strategy and enterprise architecture, and HSIA, which focuses on operational ICT and projects, will merge to form eHealth Queensland. He also appointed former Healthshare NSW/eHealth NSW CEO Michael Walsh as the new director-general in June.

Mr McCririck said the ICT renewal program was a government priority at the time but that “organisations evolve over time and changes in staffing and project requirements are to be expected. The departure of the two executives was their own personal decision.”

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WA to delay opening of Perth Children’s Hospital if necessary: Hames

The West Australian government will delay the opening of the $1.2 billion Perth Children’s Hospital (PCH) if necessary as it seeks to avoid the same problems experienced with the commissioning and opening of Fiona Stanley Hospital (FSH).

WA Health Minister Kim Hames told ABC News today that he was “nervous” about whether the hospital would be completed on time. The opening of the hospital would be delayed if construction was not completed by November 30 as the government would take five months from whatever date it received the keys, Dr Hames said.

The opening of the hospital has already been delayed by several months. Originally scheduled to open at the end of the year, Dr Hames informed parliament in March that it was more likely to be in April 2016.

The West Australian reported reported today that the project managers could not guarantee when it would open, except to say it would be in the first half of 2016.

Fears have been raised about the ICT systems being planned for the hospital, which is due to open with the BOSSnet digital medical record (DMR) being rolled out throughout WA rather than the integrated electronic medical record (EMR) originally envisaged.

This year’s state budget showed that of the overall $179.15 million allocated for ICT at Perth Children’s, over $100m was spent last year with $46.85m budgeted for this year.

As with Fiona Stanley, Perth Children’s was expected to open with a fully integrated EMR, a tender for which was released last year. The tender has closed but there is no word as yet on the chosen vendor.

It has been widely rumoured that the preferred option of clinicians involved in the tender is Epic, which is used in both paediatric and adult hospitals in the US and is set to roll out at Royal Children’s Hospital in Melbourne shortly.

In the meantime, Perth Children’s will open with Core Medical Solutions’ BOSSnet DMR, which came in for heated criticism at a parliamentary inquiry into the commissioning and opening of Fiona Stanley last week.

FSH intensive care specialist Ian Jenkins told the inquiry that the system would often freeze and had caused a “significant reduction” in efficiency. He also said it was untried in major Australian hospitals.

In its defence, industry sources have pointed out that BOSSnet is installed at Barwon Health’s Geelong Hospital, a tertiary hospital with 400 beds, along with Western Health’s Sunshine Hospital, which has 600 beds, and Footscray Hospital, which has 290. It is also being rolled out at the Epworth group of private hospitals in Melbourne.

Industry sources also told Pulse+IT that the problem of the system freezing was thought to be due to the virtualised environment rather than the software.

Dr Jenkins’ criticism at the parliamentary inquiry followed an independent review released last month that said it often took 15 minutes for all of the applications required to manage a patient to open in the clinical system.

Pulse+IT’s industry sources, who refused to be named, said the BOSSnet DMR was being blamed for lacking functionality that it was not contracted to provide.

However, Dr Jenkins told the inquiry that the problems at FSH were not just teething problems but a systemic issue.

“[It] goes right back to the meaningful engagement of clinicians, whether they be doctors or nurses, right back at the beginning,” he said.

“With a modern hospital, you start with planning your workflow and then you design your IT around that, and then you put the bricks and mortar around that to keep the cables and the servers dry.

“Whereas we had it the other way around: we had the building designed, it needed to look good, and then IT put in some whizzbang things, and a huge amount of time was wasted by planning workflow and so forth by people who were not necessarily experienced in it.”

Dr Jenkins was scathing in his criticism of Serco, which is responsible for all non-clinical operations at the hospital, and also drew attention to a problem with duress alarms that is plaguing mental health clinicians.

He also said the lack of fax machines at Fiona Stanley was limiting communications with GPs, and that one of the main problems was lack of interoperability between the DMR, standard WA Health systems like the patient administration system, pathology systems and GP systems.

“Interlinking the IT products that we have got now is the first step,” he said. “I think it is probably too late to turn the ship around at the new children’s hospital because of the time imperatives, but it is not an electronic medical record, and I think linking with GPs in a meaningful way is another big step.”

The Health Services Union, which represents many allied health professionals and clerical staff working at the hospital, submitted a survey it had carried out to the parliamentary inquiry. In addition to surveying members about their views on certain aspects of the hospital’s operation, the HSU also included comments.

Some of the highlights include:

Australasian health week in review: July 25

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

Hospital crisis: delays across the state, patients not admitted, as hospitals struggle with winter surge
Sydney Morning Herald ~ Amy Corderoy ~ 24/07/2015

The state’s hospitals have been thrown into crisis by huge emergency department delays leaving ambulances stranded for hours and delaying patient care.


Doctors spend 15 mins opening Fiona Stanley Hospital software
iTNews ~ Paris Cowan ~ 24/07/2015

Staff at Perth’s new Fiona Stanley Hospital have told a team of reviewers it can take up to 15 minutes to admit a patient using the facility’s new digital medical record.


‘Incredible potential’ for telemedicine project
Radio NZ ~ Lois Williams ~ 23/07/2015

A company headed by the Kaitaia GP Lance O’Sullivan has scooped up a $30,000 grant for a pioneering telemedicine service for children.


Calls for DHS to compensate providers for online claims debacle
Australian Ageing Agenda ~ Natasha Egan ~ 23/07/2015

Aged care peak bodies are stepping up their advocacy over more than 18 months of online claiming issues with the Department of Human Services, which one peak says has resulted in millions of dollars in outstanding payments for some providers.


Reluctance to participate in study to identify any patient harm in practices
NZ Doctor ~ Liane Topham-Kindley ~ 23/07/2015

General practices have been reluctant to participate in an Otago University study reviewing anonymised electronic records to establish whether any patient harm has occurred in general practices.


Practices could face big bill for Foundation Standard IT
NZ Doctor ~ Liane Topham-Kindley ~ 23/07/2015

General practices could be hit with a bill of more than $800 per year for three years to pay for a new IT system enabling them to work through the RN­ZCGP’s Foundation Standard process.


Rebate freeze backlash begins
Medical Observer ~ Julie Lambert ~ 22/07/2015

Doctors are stepping up campaigns against the Medicare rebate freeze, warning it will result in more patients burdening the hospital system as political leaders struggle to resolve a crisis over public health funding.


Claims CPAP companies misdiagnosing sleep apnoea
Australian Doctor ~ Tessa Hoffman ~ 22/07/2015

Leading sleep doctors are warning that patients are being incorrectly diagnosed with sleep apnoea by companies selling CPAP machines to treat the condition.


AMA boss slams ‘offensive’ Medibank policy
SBS ~ AAP ~ 220/07/2015

The head of the doctors’ union has slammed health insurer Medibank Private for its “offensive” refusal to cover costs for women who die during childbirth.


Smart slippers: new tracking devices for elderly?
New Zealand Herald ~ Jamie Morton ~ 21/07/2015

We’ve got smartphones, smartglasses and smartwatches – but how about smart slippers?


Link between electronic records and accreditation in focus
Australian Ageing Agenda ~ Natasha Egan ~ 20/07/2015

An electronic health records system is a strong indicator of whether an aged care facility will pass or fail accreditation, according to research to be presented at an upcoming national e-health conference.


Telstra invites AMA to tour its telehealth site
Australian Doctor ~ Serkan Ozturk ~ 20/07/2015

Telstra has invited the AMA to tour its controversial GP hotline facility following claims the company is setting up in competition with GPs.


Diabetes model improves outcomes but is not cost-effective

An evaluation of the three-year, $33 million Diabetes Care Project (DCP) showed that while it did see an improvement in blood glucose levels and other clinical indicators in patients in one arm of the study, the funding model used was not cost-effective and was unlikely to be able to be scaled up nationally.

The DCP began in July 2011 with funding from the federal and Victorian governments and was intended to measure a number of innovations, including the use of an electronic shared care planning tool, flexible funding models including capitation-style payments to GPs based on the idea of the medical or healthcare ‘home’, as well as the use of care facilitators working to coordinate patient care with a number of general and allied health practices.

The DCP had three arms: a control group that received business as usual care; Group 1, which tested improvements through the use of the cdmNet shared care planning tool from Precedence Health Care as well as continuous quality improvement processes; and Group 2, which tested those components along with flexible funding based on risk stratification, payments for quality and funding for care facilitation.

It was a big trial, involving 184 general practices in three states and 7781 people with diabetes, and its primary clinical endpoint was the difference in the change in HbA1c levels between treatment groups at the end of the project.

Secondary outcomes included changes in other biochemical and clinical metrics, incidence of diabetes-related complications, health-related quality of life, clinical depression, success of tailored care and and economic sustainability.

The evaluation of the trial found that for Group 2, there was a statistically significant improvement in HbA1c levels compared to the control group and clinically modest secondary outcomes, but that came at a higher cost. It cost $203 more per person per year than the control group, with increased costs in payments to GPs and allied health practitioners offset by reductions in potentially preventable hospitalisations.

However, the evaluation found that while the cost difference was not statistically significant, “it is unlikely that the particular funding model implemented in the DCP would be cost-effective if rolled out more broadly”.

Participants in Group 1 did not experience a significant improvement in HbA1c levels or other clinical metrics, aside from a small improvement in renal function. (Previous research had shown otherwise, with a smaller study involving Precedence Health Care showing significant improvements in clinical outcomes for patients on a general practice management plan created using cdmNet.)

“The DCP demonstrated that improved information technology and continuous quality improvement processes were not, on their own, sufficient to improve health outcomes,” the evaluation found. “However, combining these changes with a new funding model did make a significant difference.”

cdmNET had some additional functionality included for this project that could be harnessed in future, the report says, including patient registration, automated risk scoring, care planning and clinical protocols, provider bookings and eReferrals, care tracking, a common patient record, a patient portal, performance management and analytics, and billing management.

The study found that most of the information recording for the DCP was done by practice nurses and practice managers rather than the GP, and use of the patient portal was not high. Only seven per cent of patients in Group 1 and 18 per cent of patients in Group 2 accessed the portal.

However, the report found that cdmNET was an enabler of greater collaboration across care teams and was used much more frequently by Group 2 versus Group 1. This may have been due to the use of the tool as part of the flexible funding model. In Group 2, GP and allied health activity was tracked at the per-patient level so funding could be allocated to the provider.

“In Group 2, GPs used the tool twice as often, practice nurses used it three times as often, and [alled health] used it six times as often as their respective counterparts in Group 1,” the report found. “A large proportion of these encounters with the tool involved entering information that was shared across a patient’s multidisciplinary team.”

Funding models

In addition to shared care planning using cdmNET, the DCP also investigated different funding models, including quality-based payments to GPs and the ability of GPs to allocate funding to an allied health practitioner such as a podiatrist.

The DCP actually grew out of a much bigger plan first announced by Labor’s health minister Nicola Roxon in March 2010, who put aside funding of almost $450 million over four years to investigate the flexible delivery of services to people with diabetes by their general practices.

Both the AMA and RACGP kicked up a bit of a stink about this idea, including the concept of pay-for-performance targets for general practice. Ms Roxon subsequently reduced the scope of the original plan and decided to fund the pilot of the DCP instead.

In this trial, both GPs and allied health practitioners received funding on a tiered model according to risk. General practices received payments on a quarterly basis of between $130 and $350 per person per year.

These payments were paid on a population basis and were not tied to activity. While GPs did not claim MBS items for creating care plans and TCAs, they were able to continue to claim for standard consultations and other items.

Allied health funding remained tied to activity but the amount was tiered based and there was a broader range of consultations that could be funded, including short consults to see a podiatrist to get toenails cut and payments for phone consults.

There was also funding available to GPs for quality improvement based on improved clinical outcomes, improved clinical processes and patient experience.

Funding was also made available for care facilitators, who were responsible for the holistic care of participants and worked with a number of different general and allied health practices and on average over 280 patients each.

Their role involved reviewing patient data, booking case calls, scheduling home medicines reviews (HMR) or mental health reviews, or finding alternative allied health professionals for participants in the event of availability issues.

Care facilitators were also responsible for supporting and educating practices and participants to use cdmNet for patient registration, risk stratification and care planning.

Cost of care

As expected, there was a small percentage of patients who were responsible for most of the costs in the project. The evaluation found that the most costly five per cent of participants accounted for 62 per cent of potentially preventable hospital costs, 47 per cent of other hospital costs and 13 per cent of PBS and National Diabetes Services Scheme (NDSS) costs.

“The most costly five percent of participants had an average total cost of $48,623 per person per annum, compared to $16,560 for next 15 percent of the DCP cohort, and $4,670 for the remaining 80 percent of the DCP cohort,” the report says.

Costs for both Group 1 and Group 2 participants were higher than the control group – $718 and $203 per person per annum higher respectively – although this was not statistically significant. However, costs components such as GP and allied health rose, as did PBS costs and there was the new cost of the care facilitator.

Even when reduced hospital admissions and other acute care savings were taken into account, the evaluation found that the new funding arrangement was still not cost-effective.

“Measuring the cost-effectiveness of the Group 2 model of care is challenging because the main benefits of improved blood glucose control would be expected downstream in the form of reduced complications (i.e. outside of the 18-month trial period).

“These benefits were extrapolated (based on HbA1c and other clinical changes), along with costs, for an extended period … [but] overall, there is no evidence to suggest that the Group 2 model of care would be cost-effective if adopted for longer, with large uncertainties regarding both the net cost and benefits of the intervention.

“Were a scheme similar to the DCP to be rolled out more broadly, the funding model would need to be recalibrated to produce a greater likelihood of cost-effectiveness.”

The evaluation committee made three recommendations arising from the DCP:

In response to the release of the evaluation, Health Minister Sussan Ley has decided to extend the consultation period for the promised National Diabetes Strategy until the end of the month to allow the public to review the report, along with the Australian Institute of Health and Welfare’s (AIHW) Incidence of type 1 diabetes in Australia 2000-2013 report.

Tunstall monitoring devices approved for DVA rehab program

Three extra assistive technology solutions from Tunstall Healthcare have been approved for the Department of Veterans Affairs’ (DVA) rehabilitation appliances program (RAP), which provides subsidised personal response systems and other appliances to DVA Gold and White card holders.

In addition to Tunstall’s personal response system (PRS), which includes a base alarm unit and radio trigger pendant, Tunstall’s iVi fall detector pendant, PIR movement sensor and GPS watch are now funded through the program.

Earlier this year, the DVA merged the previous HomeFront program, which provided a free home assessment and funded falls and accident prevention devices, into the RAP. Several of those items have now been added to the RAP national schedule of equipment.

DVA Gold and White card holders must be assessed by a qualified health provider such as a GP, nurse, physiotherapist or occupational therapist.

Tunstall managing director Lyn Davies said Tunstall had been an approved DVA RAP provider since 2002 and was pleased to now be able to offer the additional range of solutions through the program.

“These additional care sensors can be used in the home to monitor risks such as falls, inactivity and wandering,” she said.

The iVi intelligent fall pendant is a lightweight device that can be worn on a neck cord, attached to clothing as a brooch clip or to the person’s waist through a belt clip. It automatically detects if the wearer has fallen and raises an alarm through the Tunstall medical alarm unit.

Tunstall’s PIR is a wireless movement detector that is installed in the home and programmed to detect activity or inactivity. It can be wall mounted and its beam can be raised above floor height to allow pets to wander freely.

While it has been added to the RAP schedule, Tunstall’s Find-Me Watch is currently unavailable as it is undergoing a revamp as part of Telstra’s move away from the 2G network. The company’s new 3G/Next G GPS watch is scheduled for release in August.

The Find-Me Tunstall watch is capable of sending an assistance alert and map location advice, dual directional voice communication, a programmable safe zone with pre-set parameters, and medication reminder alerts.

Australasian health week in review: April 25

Pulse+IT’s weekly round-up of Australian and New Zealand health and eHealth articles from third-party sources:

Campaign launched to help increase patient portal uptake
NZ Doctor ~ Reynald Castaneda ~ 23/04/2015

MedPlus Family Medical Centre in Takapuna, Auckland hosted the health minister Jonathan Coleman today to launch the IT Health Board’s patient portal awareness campaign.


Real-time monitoring vital: Avant
Medical Observer ~ Flynn Murphy ~ 23/04/2015

Diffuse regulation and poor legal knowledge about prescribing addictive drugs is putting patients in danger and leaving GPs open to legal strife.


Electronic triage on agenda as e-referrals roll out in South Island
NZ Doctor ~ Liane Topham-Kindley ~ 23/04/2015

Now that e-referrals are being used in all South Island DHBs, plans are afoot to introduce e-triage.


Doctors say patients are dying because of inadequate IT systems
The Age ~ Julia Medew ~ 22/04/2015

Victorians are dying because of inadequate IT systems for hospital staff to communicate crucial information about their care to GPs, doctors say – with many still relying on faxes.


Queensland Health poaches Suncorp IT exec
ITNews ~ Paris Cowan ~ 22/04/2015

Suncorp divisional chief information officer Colin McCririck has left the financial services organisation to lead IT service delivery across the entire Queensland health system.


Medicare review ‘not a savings exercise’: Ley
6minutes ~ Amanda Davey ~ 22/04/2015

Health Minister Sussan Ley insists a wide-ranging Medicare review will not be a savings exercise, but has confirmed the freeze on GP and specialist Medicare payments will stay put for now.


Ambulance Victoria adopts online system to save lives
CIO Magazine ~ Bonnie Gardiner ~ 21/04/2015

Ambulance Victoria is working with software company Readify to develop technology that helps treat people who are critically ill.


Coverage of free GP visits for injured under-13s questioned
NZ Doctor ~ Reynald Castaneda ~ 21/04/2015

The Government’s key election promise of free GP consultations for under-13s is being challenged, with the opposition claiming planned changes will only reach 90 per cent of this cohort.


Controversial doctor-rating website taken offline
Medical Observer~ Flynn Murphy ~ 17/04/2015

A mysterious doctor-rating website that used information from AHPRA’s register of practitioners without permission has disappeared from the web.


GP labelled a ‘meat inspector’ by PCEHR

This story was updated at 3pm, March 26.

A GP who created a shared health summary for a patient’s PCEHR was identified on the document as a ‘meat inspector’ rather than a general practitioner in an embarrassing fault that the Department of Health says has since been fixed.

A DoH spokesperson confirmed that the mislabelling of the profession of more than one GP was a known issue affecting a particular medical software vendor.

The vendor, Zedmed, has been approached for comment. Three other vendors contacted by Pulse+IT said they had not heard of the fault and had not been issued a patch.

“This is a known issue with a 3rd party software vendor product that connects to the PCEHR system,” the DoH spokesperson said.

“The software vendor has advised [DoH] that this issue has been fixed within their product.

“The system operator has notified the small number of affected healthcare providers of the issue, and provided advice on rectifying the incorrect tagging on PCEHR documents that had already been created.”

It is not yet clear how the error occurred, although Pulse+IT understands that it may have originated in a faulty library of taxonomies, such as a table of Australian and New Zealand Standard Classification of Occupations (ANZSCO) codes.

In an email sent to the GP in late February, a Zedmed representative said the problem could be remedied by upgrading to the most recent version of the software.

“NEHTA provides Zedmed with libraries containing occupations that are linked to IDs, in this case the ID given was incorrectly linked as it was pointing to a ‘meat inspector’ instead of a “General Practitioner”,” Zedmed said.

“Recently NEHTA supplied an updated library version to fix the problem, this has been fixed in Zedmed V23.4.0.1106 …”

However, Zedmed said it was not possible to fix the shared health summaries that were posted with the incorrect provider description.

It is not possible to edit a shared health summary stored on the PCEHR, so it is understood that the authors of affected summaries must replace them with new ones.

The DoH spokesperson confirmed that the Australian Commission on Safety and Quality in Health Care (ACSQHC), which oversees the safety of the system through clinical safety audits, is aware of the issue. However, a commission spokesperson said that the issue was a technical one and has not been referred for clinical safety review.

A screenshot of a PCEHR shared health summary created by a ‘meat inspector’.

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