Alcidion partners with Fujifilm for cardiovascular care

Adelaide-based health informatics and technology specialist Alcidion is set to deploy the new intelligent Cardiovascular Information System (iCVIS) it has developed in association with Fujifilm Medical Systems in full operational mode at Melbourne's Western Health at the end of September.

iCVIS, which was the overall winner in the health category at the iAwards earlier this month, is based on Alcidion's Miya health informatics platform, which forms the basis for a number of clinical and patient management applications used at Western Health as well as by the departments of health in the Northern Territory and Tasmania.

Miya is the brainchild of Malcolm Pradhan, an adjunct professor in health informatics at the University of South Australia, and Ray Blight, former CEO and chairman of the South Australian Health Commission.

The company's technology is being used to build advance care planning capabilities for aged care providers in Tasmania as part of the PCEHR roll-out and provides the foundation for an intelligent patient journey system presently deployed at Western Health. Called Miya Patient Flow, it will also be rolled out at the Royal Darwin and Alice Springs hospitals this financial year.

iCVIS, which Alcidion and Fujifilm have been developing over the last 18 months, has recently passed user acceptance testing (UAT) and is about to go into full operation at Western Health's cardiology department, Mr Blight said. Fujifilm came up with the concept of the new system, and after a search for technology partners, chose Miya as the underlying platform.

Mr Blight, who co-founded Alcidion with Professor Pradhan in 2000, said Miya has been designed as a health informatics platform that is able to extract information about a particular patient and highlight their clinical risk factors in order to provide real-time clinical decision support – what many in the health IT sector consider the nirvana of healthcare technology.

“The Miya platform is about helping the clinician understand a patient’s clinical risk so they can make the best possible decisions,” Mr Blight said. “We are able to gather expert knowledge about a particular condition and present that in the context of a specific patient, so the decision-maker can execute the treatment in the best manner.

“It has been designed to gather the relevant data to highlight clinical risks, not the extraneous data. We can then present the medical and clinical risk data and provide relevant guidance as to the best care options. The clinician still makes the decision, but once they have done so Miya can track the implementation of the decision.”

One of Miya's main differences is it can extract data from any clinical, administrative or logistics system in a hospital, including point-of-care devices, and marshal that data in a way that makes sense in terms of mitigating the patient's clinical risk, he said.

“For example, if the patient has been admitted with chest pain, there’s no point presenting the data that you might have had from a previous episode which had nothing to do with cardiology. If the patient was in for a broken leg, then much of that information may not be relevant for the patient’s current clinical risk.

“Miya harvests the data and then prompts the best practice clinical protocols for chest pain to remind the clinician of all the different parameters that they need to consider, and then records the decision made, such as whether this patient has got to go off for an ECG for example. It then monitors the fact that an ECG actually gets booked, actually gets carried out and makes the results of the ECG available to all members of the care team.

“So, we’ve set off to build this monolithic platform that can support any healthcare problem resolution, regardless of which medical or surgical discipline is caring for the patient.”

iCVIS has a cardiology-specific electronic medical record that also includes logistic information as well as clinical risk factors for that particular patient, all in one system and available to the clinician instantly. This includes information on when they are booked for an intervention such as catheterisation, but will display to the clinician that the patient hasn't completed their fasting period, meaning not only are their risk factors apparent but also saving precious resources in having to cancel or delay interventions.

Alcidion has also built a series of clinician dashboards that highlight these critical issues in the cardiac lab and ward, Mr Blight said. “It’s essentially a bespoke application of the Miya platform to the clinical risk, workflow and logistic issues that are encountered in every cardiology lab.

“The idea is that you treat the most urgent patient who’s ready for the treatment first and the team doesn’t get distracted by doing unnecessary work, or doing work at the wrong time, or doing work in a sub-optimal sequence. The idea is that this is going to save the cardiology lab a huge amount of professional time, but really the pay-off is that the patient services are safer and the patient is processed in the optimum time.”

Another point of difference for the Miya platform is that it is able to interoperate with patient administration systems such as CSC's i.Patient Manager, commonly used in Victorian hospitals, but also with radiology, imaging, pharmacy and pathology systems.

“At Western Health, they have the Fujifilm product set, so that’s been straight forward,” Mr Blight said. “We have to integrate with the pathology system, which we’ve done, and usually we integrate with the pharmacy system for discharge meds when the patient’s ready to leave the cardiology ward.

“It is part of the Alcidion technology set to have the integration tools to do those connections, but we also have a medical terminology service, so that when we are bringing data in from other systems, we can map them to SNOMED-CT and therefore ensure that the informatics systems are not introducing any clinical risks.”

Expansion plans

While Alcidion has been around for over a decade, it has often flown under the radar in the health IT sector. With iCVIS, that is probably about to change. Another change is a new member of the board of the company, Perth-based technology entrepreneur Nathan Buzza.

Mr Buzza, who joined the company last month and is also playing an active marketing and communications role, is best known for his time at Commtech Wireless, which developed clinical alert notification middleware. Commtech's technology has been deployed at over 8000 locations around the world, Mr Buzza said, and in 2008 was acquired by Amcom Software. In 2011, Amcom Software itself was acquired by Spok.

Mr Buzza stayed on at Amcom for 18 months as general manager before moving back to Australia, where he set up private equity firm Allure Capital. This firm then became the second largest shareholder of publicly listed Azure Healthcare, a nurse call and clinical workflow company that owns both the Austco and Sedco nurse call brands.

Mr Buzza then took his time to look out for another healthcare technology firm to invest in. After reviewing dozens of businesses, Alcidion was one company that really stood out from the crowd, he said.

“After spending the past 25 years in healthcare technology, you see lots of technologies being deployed which are either poorly implemented or don’t quite hit the mark,” he said. “One of the greatest challenges in healthcare is providing a high quality of interoperability with the myriad of clinical systems that are installed throughout the global healthcare ecosystem, and that’s what Alcidion has done exceptionally well with the Miya platform.

“It’s consolidating all of those data sources, selectively processing the highest quality and most clinically appropriate data, and when parts are missing from those sources, matching them together to provide an extremely high quality electronic health record and then passing it through to the clinical decision support engine.”

With Mr Buzza on-board and the iCVIS project now complete and rolled out, Alcidion is looking at further expansion. Mr Blight said one of the benefits of working with Fujifilm is that it is not only the dominant national player in cardiovascular radiology systems, but that it counts about 75 per cent of Australian hospitals as its customers.

As part of the partnership, Fujifilm gets the benefit of being able to offer cutting-edge technology to its customers without having to build the technology itself, while companies like Alcidion can leverage Fujifilm's large domestic market and global reach to bring Alcidion's technology to the world, Mr Blight said.

Back home, Alcidion is continuing its work with three major clients – Western Health, NT Health and the Tasmanian Department of Health and Human Services. For the latter, in addition to the advance care planning technology it is providing as part of the Cradle Coast PCEHR project, the department has also contracted Alcidion to deliver Miya Patient Flow, as well as an integrated outpatient system.

For Western Health, Alcidion has used a Victorian government innovation grant to develop the intelligent patient journey system (iIPJS) that is being used at Footscray, Sunshine and Williamstown hospitals.

“Halfway through that proof of concept project, we had made such great progress that the Victorian government decided that we didn’t need to innovate any further and what we should do is turn it into a production system,” Mr Blight said.

“Again Western Health was the pilot site, and we’ve now got running a patient journey system that provides any doctor or clinical team member with a complete clinical view of any of their patients, with particular attention being paid to their clinical risk factors and any service barriers that are holding up the completion of services for that patient.”

The system is now being deployed in every ward in Western Health’s three acute hospitals, with three modes of clinician dashboard involved.

“We’ve got a desktop view, which is most commonly used at the nurse work station or ward work station, but we’ve also got a very large display panel view which is excellent for clinical handover where you might have half a dozen members of the care team standing around, reviewing patients one by one,” Mr Blight said.

“It can also be accessed directly from iPad Minis so that any clinician can go to the bedside, review the patient at the bedside, record their actions, record their decisions, and by early next year they will then be able to place orders for pathology and radiology over those mobile devices, direct from the bedside.”

Mr Blight said the proof of concept finished on June 30 and the company was now implementing it across the three Western Health hospitals. It has since received an order from NT Health to deploy the intelligent journey system through the Royal Darwin and Alice Springs hospitals in the next financial year.

Posted in Australian eHealth

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