The 2014 eHealth year in review: part four

In what was a big year of budgets, reviews and belt-tightening, it was the major investments being made by Telstra Health that caught the attention as the year came to a close. Health IT is a sceptical industry at the best of times and its people will reserve their judgement, but it is hard not to proclaim 2014 as the year of Telstra.

In early October, UnitingCare director and noted reviewer Richard Royle got to show off his $96 million baby when St Stephen's Private Hospital in Hervey Bay opened. The fully integrated hospital predominantly runs off a suite of clinical software from Cerner, a set-up that Mr Royle compared favourably to the best of breed approach taken at another landmark hospital that opened this year, Fiona Stanley in Perth.

St Stephen's would receive notification in December that it had achieved HIMSS level 6 due to its super-duper, closed-loop medications management system. It also received special dispensation from the federal government to trial paperless prescribing.

The tiny towns of Tara and Wandoan in the western Darling Downs joined Dalby, Chinchilla and Miles as part of the Centre for Online Health's Health-e-Regions project, allowing patients and local clinicians to video conference with specialists from hospitals in Toowoomba and Brisbane.

In mid-October, the long-awaited boundaries for the 30 new Primary Health Networks (PHNs) were released, the number a little higher than expected. We speculated that many regional sub-offices will need to be established for rural areas in WA, SA, Queensland and western NSW considering the vast distances the PHN will be responsible for. (The individual PHNs can be viewed on the National Health Performance Authority's My Healthy Communities website.)

There was plenty of action in the online appointment booking market this year, with MedicalDirector announcing back in August that it plans to offer an online appointments booking module fully integrated into PracSoft in its next release.

Launceston-based DocAppointments added a number of new features to its various offerings throughout the year, including a patient demographics and survey app and a customised app service, but the big shake-up in the market came at the end of October, when market leader HealthEngine announced it would offer its online booking system to AGPAL-accredited practices for free.

The second half of the year turned out to be a relatively quiet time for the primary care software vendors, which would have come as a relief after the huge amount of work they have been asked to do in preparing for the PCEHR and the requirements of the eHealth Practice Incentives Program (ePIP) over the last couple of years. Most vendors were able to turn their attention to developing new features and attending to the needs of their users, although they were briefly threatened with having to drop everything to prepare for the proposed $7 GP co-payment. Most vendors we spoke to weren't having a bar of it.

In aged care, things got interesting as the sector became increasingly nervous about the Department of Social Services' (DSS) plans for the Aged Care Gateway and the associated central client record. Back in July, a room full of aged care movers and shakers at the ITAC conference got a bit het up about the ”policy silliness” of the possibility that they'd have to deal with two eHealth records rather than one.

In November, DSS tried to hose down concerns by saying that the central client record would not include medical information, but it also admitted that the record would go live without a link to the PCEHR. What the aged care sector wants is to see the two records integrated through the same platform, or better yet, a single record.

In acute care, a few problems were emerging. A bug was discovered in the MetaVision intensive care software package being rolled out in several Brisbane hospitals with the potential to cause serious harm. It turned out that a fix was being prepared but that didn't stop some from going to town on the situation.

In South Australia, the grumblings about the implementation of the new Electronic Patient Administration System (EPAS) from Allscripts grew to a bit of a roar with the release of a report by the SA Auditor-General, Simon O'Neill. Mr O'Neill warned that the delay in the system's roll-out, mounting costs and a backlash from clinicians at at least one of the three hospitals it is installed in would have a serious effect on the design and build of the new Royal Adelaide Hospital, due to open in 2016.

EPAS also turns out to be the reason why the three hospitals have had to switch off PCEHR functionality for the time being.

News on the PCEHR was predominantly confined to the ongoing drama that is the design of a model to upload pathology and diagnostic imaging reports, as well as how to get the private hospital sector on board. A few eyebrows were raised – not the least in the aged care sector, which has received no incentive to partake – when funds, small as there were, became available to connect private hospitals.

As reported in August, it appeared that the Department of Health had decided to drop the previously favoured authority to post method for uploading pathology reports in favour of an automatic upload with a seven-day delay before consumers could see them. This reared up again in late October when the new RACGP president got wind of it and arced up a bit.

To allay some of the fears of general practitioners, DoH said it was working on a way to ensure that a method was devised so that sensitive reports didn't go up or that uploads could be prevented if a consumer withdrew their consent.

Debate still rumbled, however. Pulse+IT had the pleasure of publishing a very timely article prepared by the Australasian College of Health Informatics' (ACHI) program evaluation sub-committee, which involved a review of the evidence of benefit or harm from allowing patients to view their test results.

The RACGP put forward its view, as did the Consumers Health Forum, but as it turns out, release five of the PCEHR went live with a spot for pathology and DI reports anyway. (Not that any reports will go up any time soon, as the high-level design for the model is not yet complete.)

The drawn-out battle to get the national Electronic Reporting and Recording of Controlled Drugs (ERRCD) system up and running reared its head again, following the release of another coroner's report into a misadventure with prescription drugs. The AMA's Victorian branch kept up its lobbying for its introduction, this time to the newly elected Labor government, but in the meantime, electronic prescription exchange vendor MediSecure announced it might have a simpler, faster alternative. The RACGP announced it would prefer the ERRCD with a few changes, but was open to accepting an interim measure.

Adoption of the cloud for healthcare purposes got a massive boost in October when Microsoft announced it had opened two new data centres in Victoria and NSW for its Azure cloud platform. The hope is that the new Azure Australia geographies will encourage the government to do more in cloud services if data sovereignty is assured. Telstra and Dimension Data also announced in December that they were both launching government-centred cloud services.

Things that caught our eye at the end of the year include:

  • CSIRO research shows that patients recovering from heart attacks are more likely to successfully complete rehabilitation when they do it at home using a smartphone app
  • Data management specialist Arcitecta and supercomputing giant SGI announced they were working together to build customised research platforms for the national Research Data Storage Infrastructure (RDSI) project
  • Data visualisation specialist Qlik released a self-service version of its software called Qlik Sense that it says will allow any information worker to do data analytics more easily and on any device
  • Wireless communications specialist Ascom Integrated Wireless launched its new Myco mobile device, which is specifically designed to improve nurse workflow and reduce alarm fatigue
  • MedicalDirector added a vaccine ordering app to theWidget Store on its sidebar
  • Melbourne's Western Health gave a broad overview of its eHealth initiatives, including a project to securely deliver notifications from its hospital systems directly into GP desktop practice management software through an eMessaging Gateway designed by Alcidion
  • Online referral service MEDrefer added new functionality for practice managers to its system, allowing them to handle incoming referrals for all of a practice's specialists
  • And rounding out the year, eRx published a new report detailing progress in electronic prescriptions since its establishment in 2009, showing that 80 per cent of all prescriptions are now dispensed electronically rather than manually.

The Year of Telstra

As Pulse+IT's list of our top 20 news stories for 2014 shows, a huge amount of interest was garnered by the various doings of Telstra Health, which kept on coming in the final quarter of the year and lets us safely name 2014 as the Year of Telstra.

Evidence of that interest was felt with Telstra Health's attendance at ITAC and HIC but it built to a crescendo when the business unit had its official launch in Sydney in October, where it announced a number of new ventures, not the least of which was the establishment of a new telehealth service called Telstra ReadyCare, which will allow patients to consult directly with GPs over the phone or by video conference, 24 hours a day.

The move did gain some criticism from the AMA and ACRRM, but as Telstra Health managing director Shane Solomon explained, the plan was to offer the service to GPs, particularly in rural and remote areas.

Telstra also announced it had been chosen by NT Health to build a National Telehealth Connection Service to become a foundation for connecting video consultations around the country.

Then the investments and acquisitions began to flow. In addition to last year's investments in firms like HealthEngine, Fred IT, Verdi and HealthConnex, and July's acquisition of Medinexus, in quick succession Telstra announced:

  • a $20 million investment in Orion Health when it listed on the stock exchange
  • the acquisition of aged care software vendor iCareHealth
  • the acquisition of acute care vendor Emerging Systems
  • and finally, the acquisition of primary care vendor Cloud9, which also markets software and systems for the acute care sector.

Telstra Health now has a portfolio of companies, products and investments that reaches into every facet of Australia's healthcare system, from GPs to pharmacy, community care, residential aged care, hospitals and telehealth. Next year, it will be fascinating to see what comes of it all.

Posted in Australian eHealth


0 # Rob Starling 2014-12-19 09:19
Many thanks Kate for this series of brilliant Review articles.
0 # Rick Wegener 2014-12-19 11:03
Thank You Kate, this is a great summarisation of 2014. I look forward to the content in 2015.!
0 # Steve R 2014-12-19 15:13
With Telstra's share price nudging $6, it seems the market is liking all these investments in e-Health, as well as the NBN of course. One assumes there is some careful strategy behind all these investments, which will surely be good for shareholders, like myself, in the future.
But right now, it appears to be a random assortment of eHealth companies with no apparent synergies to be found.
The other side to that coin, is with Telstra's track record, what is good for Telstra, is bad for its customers (think of the monopolies of the past.) Telstra is clearly setting itself to hold the government of the day to ransom thru its web of eHealth acquisitions.
0 # Joy 2015-01-12 09:36
Likewise, thank you Kate for summing this all up like this. I also appreciated your highlights of innovations and apps that have been developed. Looking forwards to the first quarter summary for 2015 in March??

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