Best Practice buys NZ software vendor Houston Medical

General practice software vendor Best Practice has acquired Houston Medical, the New Zealand-based software company behind the package predominantly used by specialists and allied health practitioners.

Houston Medical is headquartered in Hamilton but has an office in Sydney and while it is used by both GPs and a range of specialists, it is particularly well known as a leading supplier of clinical and management software to ophthalmology practices in the South Pacific region.

Best Practice co-founder Lorraine Pyefinch said the acquisition would allow BP to offer a full range of products to GPs, specialists and allied health.

“We've done very well in the GP space and we feel we've provided them with an excellent product and good service,” Mrs Pyefinch said. “Along the way we have had many requests for products that might be suited more for specialist doctors and also allied health. That hasn't been our area of expertise – we've always concentrated on GPs – so we felt that this was one solution of providing something for those inquiries.”

BP was first established by Mrs Pyefinch and her husband Frank in 2004. It has since garnered an estimated 40 per cent of the GP market in Australia, with over 12,000 doctors in 3000 practices using the system. Its main rival is MedicalDirector, which was also originally developed by Dr Pyefinch.

Houston Medical was founded in 1989 with present owner Derek Gower as sales manager. Mr Gower purchased the business outright in 1996, and it has since grown to have a staff of over 20. The software is used by many ophthalmology practices as well as physiotherapists and some GPs in New Zealand.

Houston Medical integrated with online accounting software Xero in 2013 following a recommendation from one of its customers, the Sydney Eye Specialist Centre.

Mr Gower said the interface with Xero was one of Houston's finest recent achievements.

“We are still the only medical software package in New Zealand or Australia that is a fully approved Xero add-on,” he said. “That was a six-month job but the accountants are absolutely loving the fact that they can go in now and the doctor has a fully updated balance sheet and P&L at breakfast time.

“Houston just does an automatic export overnight and in the morning you've got your P&L, your balance sheet, all your debtors and creditors, all of your health funds and everything divided up between all of the doctors, all there for you automatically. You don't even have to press a button. The scheduler just says 10 o'clock tonight, run the export and it does it.”

Houston Medical also has a great deal of experience in integrating with specialist medical devices such as those used in ophthalmology, and was also one of the first to harness the power of the cloud for remote hosting of the software.

Mrs Pyefinch said BP also had relationships with device manufacturers but the expertise of Houston in device integration was one of the reasons her team was most attracted to it.

“We are not re-inventing the wheel – we've got people who already have experience creating that functionality and they have relationships with those device manufacturers, so we see it as a positive addition,” she said. “We like the way that they have dipped their toe into integration with Xero and we think there are some opportunities there as well.”

This is the first acquisition by Best Practice, which has its main office in Bundaberg and recently opened a new office in Brisbane. Mrs Pyefinch said the deal would suit both parties, as Mr Gower was looking towards retirement and her team was looking to expand into the specialist and allied health sector.

“We felt it might be an opportunity for both to achieve what we were looking for,” she said. “As [Mr Gower] described it to us, he was looking for a pair of safe hands.”

Mrs Pyefinch said Houston Medical's staff would transition over to Best Practice in the next few months, bringing BP's total staff to about 75 in four locations in Australia and New Zealand.

Mr Gower will remain with Houston Medical for the next six months to help with the transition and to assist Best Practice staff to familiarise themselves with the New Zealand health system. But after 27 years with Houston Medical, he is not necessarily going to retire.

“I'm not allowed to go and work for another software company for two years but after that, if anybody wants to hire me as a consultant in the health area that is not competing with Best Practice, I might be available,” he said.

Lose the fax

Mr Gower said that in those 27 years with Houston Medical, the greatest leap forward he had seen was the development of the HL7 messaging standard but the greatest disappointment was the continued use of fax machines.

“I said five years ago they'll be out in the garage with the telex, but the fact that people are still wedded to their fax machines, I find absolutely, mind-blowingly stupid,” he said.

Mr Gower clearly remembers the day in 1993 that Tom Bowden, a good friend and CEO of secure messaging provider HealthLink, came for a visit and encouraged him to look at the HL7 standard from Duke University.

“We had two competing pathology laboratories in Hamilton at that time and both were trying for customers and trying to influence doctors to get referrals. We persuaded [one pathologist] to put his pathology results with the HL7 standard onto a floppy disk, which he then put into the courier bag along with the paper results, and that went out to the doctors.

“One of the doctors said to me, 'Derek, you have finally given me a reason for putting a computer on my desk. This is saving me hours of filing every week.'

“It took several years to encourage Promedicus to provide radiology results in HL7 for several large clients in Melbourne and Adelaide as the old PIT standard was not supported in Houston’s latest releases. So from 1993 to 2015 it has taken Australia to catch up with HL7.

“The big leap forward without any doubt is the electronic transfer of messages from pathology and radiology directly into doctors and specialists and the biggest disappointment is that it hasn't been picked up by more people for referrals point to point.”

Houston Medical was one of the pioneers of cloud-hosted software in the region, and Mr Gower believes the cloud is only going to become more prevalent. He also hopes that FHIR will fulfil the promise of HL7.

“The cloud is a big thing now and it's only going to get bigger, there is no doubt about that,” he said. “We've got 120 connections coming into our cloud system here in Hamilton so I believe that will just continue to grow. I can't see anything that is going to stop that.

“But for me, the seamless exchange of information, and to see the fax machine out in the garage with the telex, if that could happen over the next five years as I predicted it would happen over the last, that would enormously improve everything.”

Posted in Australian eHealth


0 # derek 2015-04-06 14:34
Very best wishes to all the valued clients I have met and the friends I have made over the last 25 or so years. It has been a great and very fulfilling journey!

Derek Gower
0 # Sandor 2015-04-07 08:06
Happy to hear the news, this would be great for both companies. Curious to know whats the value of this acquisition.

0 # Felix 2015-04-13 08:36
I very much agree that Fax should be banned, yet it is still widely used by practices. However, it is not used for pathology or radiology results. It is still used for sending scripts to pharmacies (how is that electronic prescribing progressing???) and to send full patient histories to referring specialists. This in particular is not something Best Practice (nor Medical Director) facilitates very well. Say I want to send a specialist last 10 years of patient history. You can export a complete patient record, but not a subset. How do we securely transmit that to the other party? What if they don't use Best Practice? PCEHR suppose to assist here, but it is to complex and I have not seen any GPs using it. HL7 does not support attachments as far as I know.
0 # derek 2015-04-13 08:44
Felix HL7 V 2.3.1 does support attachments but not all software vendors make it available. In NZ we use GP2GP for transferring large files between practices as all vendors are GP2GP compliant with hundreds of complete notes being sent every month. I should have also made mention of FiHR as perhaps being the future of HL7.
0 # Simon James 2015-04-13 08:48
Hi Felix, you actually can have attachments in HL7 messages. Clinical software handle these files in a range of ways though. In NZ they have an initiative called GP2GP which addresses some of the functionality you are after and cost their tax payers almost'v e mentioned what we've got in Australia at a cost of a little bit more!
0 # Felix 2015-04-13 10:12
Derek, Simon; thanks for the responses.
GP2GP sounds good and easy - why would Australia try and develop their own when perfect solutions are already available, what a waste of money.
Yes I have heard that HL7 can handle attachments, but I don't think we can use this in Best Practice (BP), something you may want to take up Derek. We also use Medical Objects a fair bit - unfortunately not integrated with BP and also not supporting HL7 attachments.
Thanks for your responses.
0 # Peter Jordan 2015-04-13 14:44
GP2GP is achieved via a Toolkit (client library) that is integrated into all four of our Practice Management Systems. This presents a common data model which is then rendered into an HL7 v3 CDA (Clinical Document Architecture) and transported in an HL7 v2 message. 95% of NZ practices use this utility and transfer rates can be as high as 30,000 in a single month. It's been an absolute pleasure working with Derek Gower and his team at Houston on this, and other interoperabilit y projects, over the past 5 years and I look forward to continuing that excellent working relationship with the new owners.
0 # Deborah Steele 2015-04-13 16:42
Re Pathology results and faxes. As a vendor (Sysmex) of Pathology and Clinical Information Systems (Delphic LIS, Delphic AP and Eclair) although HL7 is widely used for GP reporting and reporting to clinical data repository (e.g. Eclair), our products still need to support faxed pathology reports, both ad-hoc and scheduled, driven by customer demand. This is both in primary and secondary care. Is it because the push effect of fax is still too easy versus pull of looking it up on your computer or mobile device? Is it necessary for multiple report delivery methods/ technologies? Will paper ever be completely replaced? From an ongoing product development perspective it would be tempting to 'flick the fax', as long as no compromise to clinical workflow and patient safety.
0 # Kyle 2015-04-13 20:41
Hi Felix,

Call me at HealthLink if you want.
From the testing that we do, I can advise what can and can't be done with HL7 attachments in the real world.

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