The 2020 Australian eHealth year in review: part one
Details about the novel coronavirus cluster in Wuhan began to emerge as the new year began, but that the cluster would herald a catastrophic global pandemic was not yet apparent. By March, it most certainly was. Social distancing, flattening the curve and lockdown were suddenly part of everyday speech and everyday life.
In more innocent times, the eHealth year kicked off with the announcement that the members of the Health Informatics Society of Australia (HISA) and the Australasian College of Health Informatics (ACHI) had overwhelmingly endorsed a merger proposal. The new Australasian Institute of Digital Health launched into a tumultuous year, ending in a month-long virtual digital health summit in November that featured well over 200 speakers connecting in a new, virtual world.
Secure messaging interoperability was another big topic this year, as it has been for quite a few years past. In January, the state, territory and federal governments agreed make it a mandatory requirement that secure messaging interoperability standards are referenced in future procurements. South Australia referenced the standards in its tender for a statewide secure messaging system in 2019, which was awarded to HealthLink in a $1.5 million contract.
It proved to be a monumental year for Coviu, the spin-out from the CSIRO's Data 61 that developed a WebRTC-based platform specifically for healthcare. In 2019 it was rolled out by Healthdirect Australia for its Video Call service, which is used by some states and territories for hospital-based telehealth. When the pandemic struck demand soared and a number of primary health networks opted to provide general practices in their catchment with free use of the system, including the WA and ACT PHNs. Coviu also partnered with a number of other companies to integrate their systems, including 1st Group for bookings, ScriptConcierge for script fulfilment, Medipass for payments, and Pearson Clinical for remote speech pathology assessments. At the end of the year, it managed to raise $6m to fund its international growth plans.
Also in January, the Australian Digital Health Agency was touting the growth in the number of My Health Records containing actual clinical information – 13m of the 22.7m records – although most consumers still appeared to be uninterested in actually looking at them. The total number of records accessed by a consumer was 2.07m since the system launched in July 2012. Nearly half of those were accessed more than once between March and October 2019. Melbourne Pathology began uploading pathology reports in February, joining fellow Sonic Healthcare subsidiary Sullivan Nicolaides, and towards the end of the year the first two Healius subsidiaries – Dorevitch Pathology in Victoria and Abbott Pathology in South Australia – also connected.
Little did it know what was to come, but the AMA was lobbying in February to have item numbers for telehealth added to the MBS. This was part of the AMA's pre-budget submission and was one of its regular calls for MBS rebates for telehealth, particularly for aged care. As the pandemic began to get serious in March, Australia's chief medical officer Brendan Murphy told a Senate hearing that telehealth and telephone triage services would be deployed in the event of a large outbreak amid plans to direct the majority of people with mild symptoms to respiratory clinics and away from hospital ED. In mid-March, the Department of Health duly rolled out temporary items numbers for telehealth services provided to patients at risk of COVID-19. GP groups called for the items to be extended to the whole population; this was agreed to at the end of March.
InterSystems was one of the first big players to roll out a screening tool for COVID-19, releasing global functionality in its TrakCare unified healthcare information system to screen and support patients with the novel coronavirus infection. The functionality enabled clinicians to screen patients using World Health Organisation (WHO) guidance, and included a link to the Wuhan Coronavirus Global Cases tracking app provided by the Johns Hopkins Center for Systems Science and Engineering in the US. Orion Health also sprang into action, developing a virtual care pandemic outbreak monitoring platform allowing patients and healthcare workers who have been exposed to the coronavirus and are quarantined at home to communicate with their healthcare provider and have their condition monitored.
2020 saw some pretty big action in the private equity sphere. After Auslab vendor Citadel Health announced it has raised $127 million to fund the purchase of UK radiology and maternity software vendor Wellbeing Software, parent company Citadel Group was then snapped up by Pacific Equity Partners (PEP) in a $503 million deal. It also got a boost from existing customer Queensland Health, which has upgraded to the latest version of Auslab, having terminated its $64m lab system replacement project with Sunquest.
Pathology, imaging and medical centre operator Healius announced it was looking to sell the medical centres business and had also received a $2.1 billion offer from a subsidiary of Swiss private equity firm Partners Group to buy the whole business. That bid was rejected, and Healius later sold the medical centres to ANZ private equity firm BGH Capital for $500 million. Those deals left Healius as a pathology, radiology and day hospital operator, having sold off its MedicalDirector software business to Affinity Equity Partners for $155m in 2016.
Sydney Local Health District hit a serendipitous note when it launched a trial of 24/7 virtual care for patients in the community from Royal Prince Alfred Hospital (RPA), dubbed rpavirtual. rpavirtual started operations in a purpose-built space on the hospital campus and was providing care by phone, video calling and remote monitoring of patient data through the CarePro platform. It massively ramped up its activities as the pandemic hit and had managed to care for almost 500 COVID+ patients remotely by May. It is now also using the Miya Precision platform to support the delivery of virtual care, allowing the rpavirtual Care Centre to remotely monitor patients by displaying their status in near real-time alongside other relevant data drawn from the Sydney LHD's Cerner EMR.
As March progressed and social distancing and movement restrictions were introduced, health IT vendors also massively ramped up action to help healthcare providers deal with the crisis. Pulse+IT put together a COVID-19 resources page that listed the enormous number of new technologies that vendors were offering to help out with the pandemic, including for hospitals and health services, general practices, aged and community care, pharmacies and assorted appointment bookings, pre-screeing and telehealth applications.
In late March, as the pandemic locked down the country, the decision was made to postpone the go-live of the Epic EMR at the three Parkville precinct hospitals. Royal Melbourne Hospital, the Royal Women's Hospital and the Peter MacCallum Cancer Centre were due to go live in May after a two-year implementation project, using the Royal Children's Hospital's successful implementation strategy. The go-live was rescheduled for August, and despite the second wave of COVID then swamping Melbourne, it did so.
Microsoft ended support for Windows 7 in January and encouraged anyone still using it to upgrade to Windows 10. Our ad hoc survey of practice IT support services and vendors showed found that most health practices were prepared for the change, although the end of support for Windows 7 also spelled the end of Small Business Server, meaning practices needed to migrate their email systems. PMS vendors were all confident their users had been well prepared.
Fred IT was chosen by Queensland Health to build its real-time prescription monitoring system, which is being dubbed QScript. It is being based on the SafeScript system the Fred built for Victoria and was due to go live in the second half of the year. Fred is also building South Australia's system ScriptCheckSA, based on SafeScript. NSW Health then secured funding in its annual budget to build its system, saying it was working with Fred IT to link up to the National Data Exchange.
The $345 million, 344-bed Calvary Private Hospital in Adelaide opened, replacing Calvary's Wakefield Hospital. The hospital is using Vitro Software's digital medical record, which is integrated with other hospital systems such as DXC Technology's iPM patient administration system and MedChart electronic medications management system. Vitro is used in 11 of Calvary's private and public hospitals.
Central Hume Partnership (CHP) in Victoria rolled out DXC Care Suite patient administration system to replace the unconnected systems currently in use in the region's seven hospitals. It was one of three Victorian health services to sign with DXC in 2020. West Hume is also rolling out Care Suite in what is one of the first enterprise hospital systems in Australia to be delivered on an as-a-service cloud model. Albury Wodonga Health announced in November it would roll out DXC's Care Suite to replace several patient administration systems used on each side of the border.
Sigma Healthcare signed a three-year agreement with Scrypt Ventures to roll out its Scrypt HQ dispensary workflow and patient communication tool at Sigma's Amcal, Guardian and Discount Drug Store franchises. Scrypt HQ platform works with dispensing and dose administration aid software and is aimed at improving patient engagement.
Medication management software specialist Webstercare became the first vendor to integrate the new My Health Record pharmacist shared medicines list (PSML), helping Metropolitan Pharmacy Services in Sydney's Leichhardt to upload the first document to My Health Record. The PSML is created each time the pharmacist updates a client’s medication profile in Webstercare's Medication Management Software (MMS), and is then uploaded to the MHR.
The pandemic brought home the urgent need to support the elderly in their own homes through the use of technology. Companies like Umps Health, which markets smart sensors that plug into common household appliances such as the kettle and the fridge, and CareApp, a communications tool that gives families visibility of their elders either in residential care or living in their own home, were both launched by people with a personal interest in caring for older family members. Unfortunately, online resources such as My Aged Care did not appear to be of much use.
A large study into the use of activity monitors and wearables such as Fitbits in patients recovering from strokes, brain injuries, falls and fractures found that the digital devices improve mobility, particularly time spent walking. It also found that participants very much enjoyed using the devices, with Fitbits the most commonly used. Others such as Xbox, Wii and iPads allowed exercises to be more interactive and enabled remote connection with a physiotherapist. Remote monitoring and communication post-discharge was also found to be useful.
Some of the more interesting software, apps and new players in the market that caught our eye this year included:
- Philips Healthcare has won a contract worth $7.5 million over four and a half years to roll out a statewide system for patient reported experience measures (PREMs) and patient reported outcome measures (PROMs) in Queensland. Philips also partnered with UK firm Soliton to roll out a medical imaging informatics platform for Children's Health Queensland.
- EpiSoft rolled out its rebranded pre-admissions portal epi-me at Bethesda Health Care in WA and integrated with Global Health's MasterCare patient administration system.
- The Victorian Cancer Agency (VCA) funded a trial of patient narrative SMS messaging in five general practices in western Victoria to test whether it can improve rates of bowel cancer screening.
- The Australian Securities Exchange launched a new All Technology Index, which has been designed in association with S&P Dow Jones Indices to follow the performance of the region's expanding technology industry. Six healthcare technology companies were listed: Pro Medicus, Volpara Health Technologies, Citadel Group, ResApp, Pain Chek and Alcidion.
- Prescription exchange service eRx launched its MedView Flow script dispensing workflow tool that allows pharmacists to queue their workflow in one window. It can also handle electronic prescriptions, which became available later in the year, as well as active script lists, scanned paper scripts, online orders and those made through consumer-facing apps.
Want to know what happened next? We'll have part two of the 2020 Australian eHealth year in review tomorrow.
Posted in Australian eHealth