Interview: Totalcare

Pulse+IT: What products does Totalcare develop for the health care sector?

Our primary product suite Totalcare is an integrated Administrative and Clinical system for GPs, Specialists, Day Hospitals and Hospitals. At its most basic, that means everything from registering a patient, booking appointments, all the billing, payments, claims, practice and statutory reporting and financial stuff, to prescribing, diagnostic requests, and the other tools for a comprehensive electronic medical record.

Ancillary to, and extending this, are a number of infrastructure modules such as document management, communications agents and gateways, and even a client relationship management module that records the source of prospective patient contacts, and then can track and analyse these contacts through to surgery.

Pulse+IT: What Totalcare features are new users attracted to?

That really depends on the type of client. I guess our experiences with different types of medical environments have refined several areas of the suite. Running 20+ user GP practices teaches you that you need to be able to book, track and bill patients quickly and accurately. Running a national call centre for specialist appointments hones your booking systems. Running a centralised day hospital group with over 100 concurrent users and several campuses teaches you all sorts of things, as does providing a complete integrated, admission, billing, scheduling, tracking and clinical systems for an overnight stay hospital.

So what does this distil to? Ease of use. Sheer functional power. Reliability.

Pulse+IT: Which competing programs can you import data from?

All the ones that we’ve been asked to! Over a decade and a half, that’s been a few. Systems change over time, so I guess the most current conversions we’ve done have been from Medilink, MSS, Rx, Shexie, Locum, PracSoft and Medical Director.

Pulse+IT: How is the data conversion performed?

In a couple of phases. Typically we run an initial conversion, analyse the results and then refine the process.

We’ve spent a considerable amount of money on virtual infrastructure in recent times, so we’ve been able to leverage this to build complete virtual test environments. This means that a client can see what their converted system will be like. The final conversion typically repeats this process from a dataset snapshot done at the close of business on one day, with all the data converted and loaded for “go live” the next business day.

Pulse+IT: Does Totalcare interface with other clinical or practice management solutions?

Yes. Some of the more common interfaces we have in place are for Medical Director, Best Practice, Locum and ProMed. We also have more generic HL7 ADT interfaces for In-Hospital environments.

Pulse+IT: Which secure messaging products does Totalcare integrate with?

All the usual suspects. Most closely however with Medical-Objects as they seem to have smartest tech around.

Pulse+IT: Does Totalcare make use of the Australian Health Messaging Laboratory (AHML) HL7 message testing facility, and do you have any plans to have the HL7 message generation and handling functionality of Totalcare certified by the AHML?

No, not currently, but it’s something that we’d consider in the future if the environment required it. Pragmatically, we’ve been working on HL7 systems for a decade in outpatient and inpatient settings across the country as both a recipient and generator of messages, so we’re reasonably confident that what we’re doing works.

Pulse+IT: Has NEHTA’s work program had an impact on the functional direction of your product, and the strategic direction of your business?

I think every vendor is keeping an eye on NEHTA - You tend to do that with the elephants in the room, particularly the ones with the smart people. I must admit to personally being unsure about whether NEHTA are trying to assist the industry to move forward in a timely manner, or trying to design and build the nation’s health records themselves.

From a functional perspective, hats off to their initiatives with SNOMED-CT.

Pulse+IT: From your perspective, which of NEHTA’s work program objectives are you most interested in seeing come to fruition?

We’re keen on the programs that promise simple interoperability. By that I mean, a standardised universal way to identify a drug pack, a diagnostic test or report, a patient, or a service provider. If these ‘simple’ things can be sorted out, I think that all the more complex compound objects such as health summaries and referrals will sort themselves out...and if not, well at least conversions between systems will be simpler and more accurate!

Pulse+IT: How is training and support provided?

We’re one of the few full service vendors, so we like to do these things well. Training is typically done onsite, though we have the facilities for both training in our offices, and for remote group presentation and training over the Internet.

Support is provided both by phone, fax, email and through our website. Almost everything we can manage remotely, and on the very rare occasions that a physical onsite presence is required, we can organise this too.

Pulse+IT: How many people make up the Totalcare team?

Right now, nine directly. Another 3 in contract roles. Admin aside, we have four software engineers and three on help desk, and perhaps surprisingly, none in sales yet. I say “now”, because we’re still advertising for more staff...so if you work for one of our competitors, you know your stuff and your clients love you, contact us!

Pulse+IT: Where are your staff and contractors located and what parts of Australia does your organisation service?

Our head office is in sunny Brisbane, Queensland. Most of our team are based there, with a few of our contractors based on the Gold Coast. We primarily service clients up and down the east coast of Australia, with the odd representations as far afield as Perth and Kuala Lumpur.

Pulse+IT: Overview your pricing structure.

Typically device/seat based. We have some large clients on ‘unlimited’ per facility licensing. The core Totalcare suite itself is tiered (Professional, Hospital, and Enterprise editions), with the professional edition starting at around $1500 a seat. We’re not the cheapest, but our value proposition for most clients is normally pretty compelling.

Pulse+IT: In addition to the Totalcare licences, what other costs may organisations have to meet?

For sites that prescribe, there are drug database costs - typically MIMS. We use commercial SQL relational databases, so these also come into the picture. Hospitals also need DRG Grouper software.

Pulse+IT: How frequently does Totalcare release program updates?

Our build release cycle is typically monthly. However, we are much more conservative when it comes to GA (General Availability) releases. We give our GA releases 4 to 6 months of field testing before widely deploying them. This gives us scope, if need be, to respond to the ‘early adopters’ group daily. In general, being at the bleeding edge of Health IT isn’t a sensible place for either our clients or ourselves to be.

Pulse+IT: Is professional IT assistance required to perform these updates?

Yes. This gets back to our notion of full service. IT is our core business. It’s not the core business of our clients. We don’t typically consider it a good use of a doctor’s time to be updating IT systems. In this instance, we can do it more efficiently and effectively.

Pulse+IT: What new features are you working on that Totalcare users should look forward to?

Lots! Expect more Medicare Online functionality for outpatient and inpatient centres. Unified communications. SNOMED-CT support. Clinical compliance, protocols and Surgical audit. This is on top of the ‘normal’ requirements for changes to state government and health fund extracts, ICD-10-AM Edition 6 and DRG 6.0 support.

Posted in Australian eHealth

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