The ACT government has released its 10-year digital health strategy, the centrepiece of which is the development of an integrated digital health record that will act as a single digital source of truth for clinical information and be accessible by clinicians in inpatients, outpatients and the community.

The ACT will also aim to boost its electronic medical record adoption model score, which it calculates is currently sitting at 1.5 out of a possible score of 7, and focus on implementing standards to allow integration with national digital health services to support wider sharing of information.

Global health IT security system vendor Imprivata is collaborating with Microsoft to develop what it calls the first cloud-based, end-to-end identity and access management (IAM) for clinical users.

The platform will combine Imprivata's single sign-on (SSO) capabilities with Microsoft's Azure Active Directory to allow both clinical and non-clinical staff to access apps on shared clinical workstations and mobile devices without having to repeatedly type in usernames and passwords.

New Zealand Health Minister David Clark has appointed former director-general of health Karen Poutasi to run the Waikato District Health Board after the majority of the board resigned amid the DHB's worsening financial and governance crisis.

Nine of the 11 board members resigned last month following sharp criticism from Dr Clark over the board's performance, which has seen a deteriorating financial position and problems recruiting a permanent CEO.

GPs who currently participate in the Department of Veterans' Affairs' Coordinated Veterans’ Care (CVC) program are being encouraged to register for an associated pilot program that is testing whether a clinical coaching app developed by Clevertar can help veterans manage mild to moderate mental health concerns.

The CVC pilot is being coordinated by technology provider Tunstall Healthcare, which is providing technical and clinical coordination through registered nurses who will monitor and triage the data from the app.

Wellington-region primary health organisation Tū Ora Compass Health has expanded its Piki trial for youth mental health support, adding the use of Melon Health's wellness app and a self-referral website in the second phase of the program.

Piki is an early intervention program that offers free access to personalised therapy at a convenient place and time, using 24/7 support through phone and web services along with the Melon emotional wellness app that helps young people access support and track their progress.

Pulse+IT's weekly round-up of international health IT news for the week ending May 5: Epic and Cerner dominate EMR market share, UK image exchange portal open to patients, Facebook health support groups, fast fibre for NHS, beyond EMRAM goal, hardware as a service, MedicAlert in real time, smart app for diabetic retinopathy, portal reduces DNAs

KLAS: Epic, Cerner still lead EHR pack
Healthcare IT News ~ Mike Miliard ~ 01/02/2019

Most health systems that signed on for a new electronic health record install in 2018 – be they large or small, government-run or private-sector – opted for Cerner or Epic, according to the new market share report from KLAS.

Image Exchange Portal to be extended to patients across in England
Digital Health News ~ Andrea Downey ~ 30/04/2019

Patients are set to receive increased access to their own medical images after the national network Image Exchange Portal (IEP) was extended.

This week's big, although not unexpected, news was the announcement that HISA and ACHI were thinking of getting together for a bit of formal cooperation. The move has been rumoured for some years, and it makes a lot of sense. For such a small industry there are quite a few different professional organisations if you include HIMAA and wider groups like AIIA as well.

ACHI has always considered itself the peak as an academic college but it has suffered in the past from a lack of administrative support, relying as it does almost entirely on volunteers. HISA on the other hand has an extremely good organisational structure and has proved itself adept at managing the various conferences and local networking events it runs.

The use of wearable fitness technology added to a coaching program helps to improve the amount of physical activity done by cancer survivors, a new study shows.

Cancer Council Victoria is running the ACTIVity And TEchnology (ACTIVATE) trial, which is studying the use of the Garmin vivofit 2 device as an intervention for breast cancer survivors, and last week published a new study in the journal Cancer that showed wearing a fitness band increased levels of physical activity by more than an hour a week, as well as decreasing sitting time.

The federal government has provided $5 million in funding to give residential aged care providers a licence for one year to use the PainChek facial recognition app for people living with dementia.

The app, which is able to detect micro-expressions indicative of pain in people with moderate to severe dementia who are unable to verbalise their pain, is already being used by the 150 consultants at Dementia Support Australia (DSA), which provides federally funded Severe Behaviour Response Teams.

ASX-listed PainChek, which was formerly known as ePAT Technologies, has also recently signed agreements with RACF providers SwanCare in Perth, Churches Of Christ in Queensland and national provider Allity Aged Care.

Former South Canterbury District Health Board chief medical officer and orthopaedic surgeon Steve Earnshaw has been appointed chief clinical information officer of the three Wellington region district health boards.

Dr Earnshaw spent almost 15 years at South Canty, where he was director of orthopaedics at Timaru Hospital. He was also director of clinical services for two years, and clinical lead of IT for another two.

Former Jobs for NSW CEO Karen Borg has been named as the new CEO of Healthdirect Australia, which runs a number of online and phone health information lines as well as the National Health Services Directory.

Ms Borg takes over from Colin Seery, who has moved on to become CEO of Lifeline Australia. Mr Seery was CEO of Healthdirect for over seven years.

Two of Victoria's most widely used secure messaging services have seen volumes of exchange between each system increase by 15 per cent per month over the last year following a decision to support each other's directories and identity management systems.

Telstra Health, which markets the Argus secure messaging system, and Global Health, which runs ReferralNet, first got together in 2016 to try out message exchange between each system. In 2017, the two companies had a breakthrough when they achieved two-way secure messaging, with users of ReferralNet able to send messages to Argus users and vice versa.

Latrobe Regional Hospital in Victoria's Gippsland has gone live with Allscript's Sunrise electronic medical record in its 30-bed emergency department, with a roll-out in inpatient wards and outpatients scheduled for early next year.

In what is thought to be the first implementation of an EMR hosted in Microsoft's Azure cloud computing platform in Australia, the ED roll-out is the first phase in a wider project by the Gippsland Health Alliance, which awarded Allscripts a tender for an EMR and community health solution in 2017.

Two of Australia's leading health informatics organisations are hoping to join forces as a single peak body for health informatics and digital health, planning to take a merger proposal to members for a vote later in the year.

The Australasian College of Health Informatics (ACHI) and the Health Informatics Society of Australia (HISA) will open a two-month consultation period on the proposal today, calling on members and the wider digital health community for their views.

MedicalDirector has added the IMgateway herb-drug interaction checker to its AusDI medicines information system, with an API allowing users to access it on the AusDI sidebar menu.

The iAward-winning IMgateway was first developed by UnityHealth and includes information on conditions, herbs, supplements and drugs, including supplement-drug, herb-drug and food-drug interaction reports.

Pulse+IT's weekly round-up of international health IT news for the week ending April 28: Real-time data on iPads for ambos, FHIR 4 ready for use, bipartisan call for VA's $16b EHR, Robert Wachter on privacy, Hancock under fire, insurer telehealth service, FTC sues Surescripts, medical device security, patient-oriented discharge summaries, TEFCA draft

London ambulance staff to be given real-time access to patient data
Digital Health News ~ Andrea Downey ~ 23/04/2019

Developed by NHS Digital, it will use Camden Ambulance Station as its initial base, with around 60 medics having access to patients summary care records (SCRs) on secure iPads.

How FHIR 4 will drive interoperability progress in healthcare
Healthcare IT News ~ Bill Siwicki ~ 25/04/2019

Experts from across health IT, including members of the HL7 board and advisory council, say the new standard can do big things for data exchange, but it's not a cure-all.

The Royal Australasian College of Physicians was in the news this week with the release of its pre-election statement outlining what it thought should be on the policy agenda for the incoming government. There were some quite excellent suggestions in the document about preventative health and financial levers for improving chronic disease management and the obesity crisis, as well as a few long shots that have no chance of getting up.

Ideas like a tax on sugary drinks and volumetric taxation for alcohol are extremely unpalatable to the two major parties and would incite enormous rounds of pearl clutching from the anti-nanny state types, the very people who were responsible for encouraging the abolition of the Australian National Preventative Health Agency in 2014, which the RACP now wants re-established.

The West Australian government has set up a ministerial council to advise it on how to develop and support precision health initiatives in the state, with members coming from the genomics, phenomics, informatics and geographical information systems sectors.

Precision health uses new and emerging technologies to enhance disease prevention and early detection and is aimed at developing treatments tailored to patients' individual genetic profiles and their responses to the environment and lifestyle.

Melbourne's Peter MacCallum Cancer Centre has appointed UK-based cancer nursing specialist Shelley Dolan as its new CEO, taking over from Dale Fisher, who left last year to head up Silver Chain.

Dr Dolan is currently chief nurse at King’s College Hospital but spent most of her career at the Royal Marsden, the specialist cancer hospital in London.

Specialist physicians are calling for incentives similar to those offered to general practices through the Practice Incentives Program eHealth payment (ePIP) to encourage more participation by specialists in the My Health Record, along with funding for the minimum interoperability standards project and the removal of the distance requirement for telehealth consultations as part of its pre-election recommendations.

The Royal Australasian College of Physicians (RACP) has also called on the next government to expand chronic disease management models of care beyond GP services to long-term roles for specialists, nurses and allied health practitioners, suggesting reforms to the MBS or other financial incentives could be used to better encourage direct communications between GPs and specialists in the management of patients with chronic disease.

Victoria's Department of Health and Human Services (DHHS) is running a one-year trial of fully subsidised access to an online emergency response planning tool (ERPT) for up to 500 general practices in rural and regional areas.

The tool was developed by Healthpoint ANZ in association with the RACGP and last month went live with a new cybersecurity module, identifying practical steps to take if an incident occurs.

Pulse+IT's weekly round-up of international health IT news for the week ending April 21: European health record rolls on, interns swamped by EMR work, digital red book for kids, potential DICOM security flaw, Alexa at Boston Children's Hospital, Cerner on FHIR, half of US doctors burning out, digital for allied health, out phishing, FDA investigating concussion apps

Croatia to start the exchange of ePrescriptions and patient summaries
eHealthNews.eu ~ Staff writer ~ 16/04/2019

Croatia will dispense ePrescriptions for Finnish citizens and allow the access of Czech patient summaries, while Croatians travelling to Estonia can get their ePrescriptions dispensed there.

Study finds first-year interns spend 43% of their day on EHR
Health Data Management ~ Greg Slabodkin ~ 16/04/2019

Internal medicine residents devote 87 percent of their work time away from patients, about half of which is taken up interacting with electronic health records.

The Department of Defence will issue a request for quotation for the initial elements of its $150-$350 million JP2060 Phase 4 Health Knowledge Management (HKM) solution in May, which will include a replacement primary care practice management system, a critical care patient management system and a new Defence eHealth Record for all Australian Defence Force members.

The plan is to first roll out a new foundational record and primary care system to the 50-odd garrison sites in Australia and two overseas sites by December 2022, replacing the existing EMIS-based system implemented by DXC Technology, followed by an extended capability with analytics for deployed field hospitals by June 2025.

InterSystems has added a Provider Directory module to its HealthShare health informatics platform, describing it as a master data management solution that automates the process of collecting, consolidating and publishing accurate healthcare provider information.

The new module is part of the HealthShare 2019.1 release, available now, which also sees HealthShare Information Exchange renamed to HealthShare Unified Care Record to better reflect the functionality of the technology.

The currently paper-based national bowel cancer screening program will transition to the electronic National Cancer Screening Register (NCSR) from this November, and integration with GP practice management software is also on the cards from next year.

The NCSR, designed and managed on behalf of the departments of health and human services by Telstra Health, currently handles the cervical cancer screening program, including reminding patients when they are due for a screen, providing screening histories to healthcare organisations and allowing laboratories to send test results to the register electronically.

Children’s Health Queensland Hospital and Health Service is looking for a new imaging informatics solution, comprising a commercial off the shelf product including a radiology information system (RIS) and a multimedia management solution (MMS).

The solution will support imaging services at Queensland Children’s Hospital (QCH) and its community health services, the latter for review only.

Both elements must already be implemented in a production capacity and should be able to integrate with electronic medical records such as the hospital's Cerner ieMR. The two elements will be assessed independently.

SA Health plans to trial a number of priority care centres in target postcodes across metropolitan Adelaide, working with selected general practices to offer bulk-billed services for low-acuity care cases to try to reduce unnecessary presentations in emergency departments during the winter months.

The plan includes the use of the My Health Record to upload patient episode records and GPs will be given access to SA Health telehealth facilities and other eHealth systems for clinical decision support.

ASX-listed patient infotainment software vendor Oneview Healthcare plans to go to the market to raise $25 million to help fund the launch of its new aged care product later this year and to accelerate sales of its core inpatient product, which is used in 55 hospitals.

The Irish-headquartered company announced last August that it was entering the aged care market with its first customer a new 120-bed Thomas Holt facility at Kirrawee in Sydney.

GPs practising on the Gold Coast and in northern NSW will be able to view their patients' imaging results from Gold Coast University Hospital and Robina Hospital through a new online viewing application being rolled out this month.

Gold Coast Health is implementing a $12.8 million medical imaging informatics solution (MIIS) as part of the upgrade to the digital hospital version of the Cerner integrated electronic medical record (ieMR).

The MIIS project includes the replacement of Gold Coast's old Agfa picture archiving and communications system (PACS) with a web-based solution from Canadian vendor Intelerad Medical Systems.

Pulse+IT's weekly round-up of international health IT news for the week ending April 14: 100 hospitals open to Apple, UK call for app regulation, rad AI studies not validated, Apple's healthcare ambitions, $1.2bn telehealth fraud, medical marijuana breach, patient and clinician views of NHS App, eRehab prescription, Microsoft HealthVault, HIPAA-compliant Alexa, unsupported OS risk, access to addiction histories

Community Health Systems makes Apple Health Records available at 100 affiliated hospitals
Healthcare IT News ~ Nathan Eddy ~ 11/04/2019

The iPhone app enables patients to access data about medications, immunizations, labs and receive notifications.

Patient safety charity calls for regulatory standards for medical apps
Digital Health News ~ Andrea Downey ~ 11/04/2019

A patient safety charity has called for consistent regulatory standards to be applied to medical apps.

It didn't come as much of a surprise so soon after the news broke that Microsoft was dropping support for its Microsoft Band and Microsoft Health Dashboard apps that it was also canning its HealthVault personal health record. While HealthVault was a pretty good product, it really never got the uptake outside of the worried well and corporate wellness markets that it needed to survive.

There are still plenty of PHRs and similar sorts of apps on the market and Microsoft itself is recommending customers have a look around for alternatives. One is Get Real Health, which is offering to let HealthVault users migrate their data over to its Lydia platform and keep the same credentials. For those who have long memories, when Google pulled the plug on its Google Health product it told users to shop around, with one recommendation being HealthVault.

WA's auditor general will conduct a performance audit on PathWest's $42 million laboratory information system replacement following a request by the WA Department of Health.

The auditor says the objective is to assess whether PathWest has effectively managed the LIS replacement project and whether operations of PathWest are appropriately supported during the transition to the new system.

The University of Adelaide’s Robinson Research Institute has received $1.2 million in funding from the federal government and the Jean Hailes for Women’s Health organisation to build a digital health platform for endometriosis research and support.

The project will include a range of research disciplines including health informatics, biomedical and clinical research expertise, along with women's support networks and patient-generated resources.

NSW Health has signed a 13-year, $85 million contract with Swedish medical imaging vendor Sectra to roll out an enterprise radiology imaging solution across 11 local health districts and speciality networks.

Sectra was chosen as the preferred vendor last year and worked on a proof-of-concept with Kestral to replace the current GE system. NSW Health has now signed a long-term contract for the replacement and ongoing servicing over 13 years.

Gippsland Primary Health Network (PHN) is subsidising a two-year subscription to the Digital Health Guide app directory for general practitioners and allied health providers in the region.

The guide, developed by Semantic Consulting in association with Healthcare Software on behalf of Primary Health Tasmania, is a searchable directory of hundreds of health and medical apps that GPs and other practitioners can use to prescribe an app for patients.

The West Australian government has endorsed the final report of the independent Sustainable Health Review (SHR) panel, which calls for an investment in data analytics, a phased and prioritised roll-out of electronic medical records across the WA health system, and a target of 65 per cent of outpatient consultations for regional patients using telehealth by 2022.

The review was called in June 2017 by the new McGowan government to find solutions to the under pressure WA health system, which was facing a future of health spending overwhelming the state budget, very poor staff morale, the delayed opening of Perth Children's Hospital and several years of bad press over the IT systems used at the flagship Fiona Stanley Hospital and WA Health's centralised computing contract.

The review panel, headed by former NSW Health director-general Robyn Kruk, submitted an interim report in February 2018, which among a host of recommendations highlighted investing in a statewide EMR, closer ties with the Australian Digital Health Agency on the My Health Record roll-out and an immediate expansion of telehealth provision. It also recommended closer ties with primary and aged care through integrated care strategies.

There has been a notable improvement in security awareness training and documented procedures among Australian health services, a new survey from the Health Informatics Society of Australia (HISA) has found.

HISA’s 2018 Cybersecurity in Australian Healthcare survey showed an increase over the previous year in security awareness training (59 per cent, up from 36 per cent) documented procedures (68 per cent versus 45 per cent) and evaluation of systems at procurement (51 per cent, up from 36 per cent).

ASX-listed healthcare software and services provider Alcidion has become a reseller for Slovenian IT solution vendor Better by Marand's OPENeP closed loop medication management system in the Australian, New Zealand and UK markets.

OPENeP is part of the company's Better Platform, which is built on openEHR specifications, and is designed to replace paper-based processes for prescribing, medication administration and pharmacist reviews.

Alcidion plans to offer the product alongside its Miya Precision health analytics and clinical decision support technology along with its Patientrack early warning system and Smartpage clinical communications system.

A decade after its launch, Microsoft has announced it is closing down its HealthVault personal health record (PHR) system, following its move to drop support for other consumer-oriented ranges such as the Microsoft Band and the Microsoft Health Dashboard.

While Microsoft never made HealthVault commercially available in Australia or New Zealand, locals could sign up to the UK site through a VPN. The move follows the failure of several local PHRs including Medibank's $7.5 million Healthbook, which closed down in 2014, and global efforts such as Google Health.

The federal government is funding a $29.2 million, nationwide trial of a reablement model used in Western Australia and Victoria to help older people remain living in their own homes for as long as possible.

Five regional assessment service (RAS) organisations will be funded to assess clients applying for services under the Commonwealth Home Support Program (CHSP) to see if they can take advantage of specialised CHSP services such as greater access to basic aids, equipment and assistive technologies before being referred for ongoing CHSP services.

Data solutions vendor Pen CS has added a new automated notification to its Topbar decision support tool that can alert Queensland GPs if a patient is eligible for a cardiovascular disease risk assessment under the Queensland government-funded My health for life program.

Pen CS has trialled the app in seven general practices in Brisbane and north Queensland to test its usefulness in routine consultations.

Melbourne-headquartered digital health design agency Curve Tomorrow has expanded its reach to Perth, buying local health software and app start-up Progressive Medical.

Curve is best known for the work it does in partnership with the Murdoch Children's Research Institute (MCRI) and its Bytes4Health initiative, along with the Perth's Telethon Kids Institute.

Pulse+IT's weekly round-up of international health IT news for the week ending April 7: HIPAA skills for Alexa, Cerner on FHIR R4, X plans for NHS, DoD's Genesis EMR, WhatsApp time bomb, hack forces practice closure, FDA on medical AI, nurses happier with EMRs than docs, Scribble scribe, Epic Twitter parody, wall of shame update

Matthew Gould confirmed as new CEO of NHSX
Digital Health News ~ Hannah Crouch ~ 04/04/2019

Government digital policy chief, Matthew Gould, has been announced as the new CEO of NHSX and will be responsible for setting the national technology agenda for healthcare.

Cerner touts adoption of normative FHIR R4 standard
Healthcare IT News ~ Mike Miliard ~ 04/04/2019

The vendor, one of the first to use the new version of the HL7 standard, is also offering advice for how providers can take advantage of the spec for better interoperability.

In what was a highly charged week in Australian politics featuring the final sitting of the 45th Parliament and big numbers being boasted in budget speeches, the appointment of a few new faces to the board of the Australian Digital Health Agency flew very much under the radar.

The announcement doesn't seem to have made any waves anywhere else apart from Pulse+IT, where we reported it the day before the official announcement was released, having been told by a very officious type at the Department of Health's media unit to mind our own business when we inquired about it earlier in the week. That of course just confirmed what we suspected.

The proposed regulation of software as a medical device by Australia's Therapeutic Goods Administration has been rejected outright by the local industry, which cites the RACGP and Pharmacy Guild as supporting its stance.

The TGA is currently holding consultations on the regulation of software as a medical device (SaMD) in light of the explosion of health apps, artificial intelligence and machine learning in diagnostic software and its potential effect on patient safety.

Adelaide Primary Health Network (APHN) is sponsoring a six-month, statewide trial of Global Health's MasterCare platform to enable allied health professionals to contribute to the My Health Record.

Allied health practitioners currently using paper records or their own electronic systems will be able to use Global Health's updated MasterCare+ patient administration platform for free to gain access to My Health Record.

A partnership between Green Cross Health community pharmacies, Kiwi multidisciplinary skin cancer and dermatology centre Skin Institute and technology provider Firstcheck to improve access to skin cancer screening over the summer is being hailed as a success and there are hopes it will now be rolled out to other pharmacies.

The collaboration involved pharmacists from Unichem and Life Pharmacy taking photos of suspicious lesions or moles using Firstcheck's technology while the customer was in the store, with magnified images sent to skin cancer doctors from Skin Institute for assessment and digital reports sent back to the patient usually on the same day.

South Eastern Melbourne Primary Health Network CEO Elizabeth Deveny has been appointed as the new chair of the Australian Digital Health Agency (ADHA), taking over from inaugural chair Jim Birch.

The federal government announced a new board today that includes Medical Software Industry Association CEO Emma Hossack, Ocean Informatics co-founder and Northern Territory GP Sam Heard, UTS professor of health economics Mike Woods and CEO of the Australian College of Nursing Kylie Ward.

Telehealth expert and professor of medicine Len Gray has called for a rethink of Australia's telehealth strategies and policy, saying there was still very patchy uptake despite mounting evidence of its value to patients and to health outcomes.

Professor Gray told the Australian Telehealth Conference (ATC 2019) in Brisbane today that a big discussion on telehealth had not taken place since about 2010-11 and Australia was way behind North America and Europe in allowing patients to electronically communicate with healthcare professionals.

Operational funding for the Australian Digital Health Agency has been reduced by over $50 million for the 2019-2020 year, reflecting the end of the My Health Record expansion program.

ADHA expects to have lower costs in 2019-20, with supplier expenses reducing from $232.5m in 2018-19 to $175.5m in the coming year.

The chair of the Australian Digital Health Agency, Jim Birch, is not expected to continue in the role when the board's current term expires, with South Eastern Melbourne Primary Health Network CEO Elizabeth Deveny touted as his possible replacement.

The board's current term expires on April 20 and an announcement of some new faces by Minister for Health Greg Hunt is expected imminently.

The federal government is promising a new scheme to support patients with chronic diseases that includes extra funds for flexible care models that include non face-to-face consultations with the patient's general practice.

Yesterday's federal budget promised $448.5 million over three years from next year for the voluntary enrolment scheme, which will initially be aimed people over 70 but will be available for high-needs patients.

It will allow general practices to provide consultations, referrals, scripts and test results remotely, with usual services continuing to be rebatable for the patient under Medicare.

Secure messaging technology vendor HealthLink and Hobart-based eHealth firm Healthcare Software have won a contract to take the first steps in building a statewide electronic referral system for Tasmania.

The two companies have been asked to develop standardised, statewide digital templates that can be auto-populated with key referral details from within GP practice management systems and sent to hospital outpatients departments as well as between private practitioners.

Taranaki District Health Board has expanded the range of mobile digital forms it has rolled out for its public health nurses, adding in 10 forms commonly used in its child therapy unit.

The system is able to pre-populate forms by linking to the DHB's webPAS patient administration system and allows nurses to collect data on a mobile device. They can then send the form electronically to doctors or other clinicians for approval, and then save it to the patient's record.

Taranaki first trialled the system in June 2016 using Samsung 8-inch tablets, through which nurses can also access their email, calendars and GPS while visiting patients.

The SafeScript real-time prescription monitoring system has gone live across Victoria, following a six-month introductory roll-out in the western part of the state.

The Victorian government says SafeScript has alerted health professionals to around 4500 patients at risk of harm of overdose from visiting multiple clinics or pharmacies since last October.

Flinders University spin-off Clevertar has entered voluntary administration but is continuing to trade with the hope that its affairs can be restructured.

Clevertar designs and develops intelligent virtual agents or avatars that are used as health coaches in a number of community health programs, providing low intensity cognitive behavioural therapy and chronic pain coaching. Clients include several Primary Health Networks and health insurer Bupa.

Pulse+IT's weekly round-up of international health IT news for the week ending March 31: US HHS interoperability rules, Amazon active in image analysis, Israel's digital health system, AI in the real health world, digital health in east Africa, big pharma's digital options, secure messaging medications, sleep app on the NHS, phishing in Oregon, security of cardiac devices

Industry voices concerns about proposed HHS interoperability rules
Health Data Management ~ Greg Slabodkin ~ 27/03/2019

Making electronic health information accessible to patients and providers is the goal of two proposed Department of Health and Human Services rules. However, stakeholders question whether the aims are achievable as currently written.

Amazon is turning its controversial Rekognition software to medical image redaction
MedCity News ~ Kevin Truong ~ 22/03/2019

Amazon has demonstrated the ability to combine its Comprehend Medical software service with its Rekognition image analysis to help automate medical image de-identification.

As we alluded to last week, the Australian Digital Health Agency has come back to the table this week with a bit of cash for clinical software vendors that weren't involved in the two secure messaging proof-of-concept trials it sponsored in Victoria to update their systems to incorporate new standards for interoperability.

While the money on offer was the headline, no one is under any illusion that this is the end of the road for what has been an intractable problem for well over a decade. In fact, pretty much everyone agrees it's just the start. Pulse+IT has written numerous screeds about the many challenges – technical, financial, cultural and practical – that face the healthcare industry in achieving a secure system of electronic communication so we won't repeat them again, but we will point you to an opinion piece we published yesterday by by Peter MacIsaac, who does a great job outlining some of the many challenges that remain, particularly around aspects such as message content and vocabulary adoption.

Nelson Marlborough Health has gone to market for a replacement for its legacy electronic patient letter management system (EPLMS), looking for a new solution that can integrate with the South Island's regional solutions such as SI PICS and Health Connect South, along with NMH's local patient administration system.

The current EPLMS was built in-house but is now operating on an unsupported operating system. It is used by clerical staff to type patient letters dictated by senior medical officers and sent to Health Connect South as well as by secure messaging and by post.

Children’s Health Queensland Hospital and Health Service CEO Fionnagh Dougan is returning to New Zealand to take up the role of joint CEO of the Capital & Coast and Hutt Valley District Health Boards.

Ms Dougan was a member of the leadership team guiding the National Children’s Digital Health Collaborative in Australia, which is working towards a national digital health record for Australian children.

IT services provider NEC Australia has won two contracts with WA Health to transition its wide area network services in metropolitan and regional areas to the GovNet unified communication network, part of the GovNext-ICT transformation program that is moving WA government services to the cloud.

NEC is one of three suppliers on the GovNext-ICT panel, along with Atos Australia and Datacom. Atos recently won a five-year, $124.3 million contract with WA's Health Support Services to take over the old Fujitsu contract to provide data centre and cloud services for WA Health clinical and non-clinical applications.

The work of the secure messaging vendors on the FHIR-based proof of concept trials is to be congratulated and is a key step in improving existing interoperability for delivery of point to point electronic communication.

As every GP knows, millions of secure messages such as discharge summaries and test results are being successfully exchanged daily, using the services of a small number of secure messaging vendors and direct sending of orders and results between some pathology providers to their referrers.

Veteran eHealth expert George Margelis has been appointed as the independent chair of the Aged Care Industry IT Council (ACIITC).

Dr Margelis' role will be to coordinate the sector's technology vision, which will in future include the alignment of the government's My Aged Care system with the My Health Record.

Clinical software vendors are being offered up to $30,000 to assist them in implementing new FHIR-based interoperability standards for secure messaging with the aim of boosting national take-up of the technology in all parts of the healthcare sector this year.

Following the success of two proof-of-concept trials in 2018 led by Telstra Health and Healthlink and involving major clinical information system and secure messaging vendors, vendors that did not take part in those trials will now be assisted with funding and technical advice from the Australian Digital Health Agency (ADHA) to implement the standards, which will allow health professionals using different platforms to securely send information to each other.

ADHA chief operating officer Bettina McMahon said vendors involved in the trials had all implemented the standards within their systems but there were a number who will need assistance.

Mildura-based Sunraysia Community Health Services (SCHS) will roll out Global Health's MasterCare electronic medical record for a number of its community health, alcohol and other drug and home support programs, along with some modules from Global Health's new mobile-optimised MasterCare+ solution.

The project builds on an implementation in 2018 by Bass Coast Health, which has integrated the whole MasterCare EMR portfolio into its systems.

eHealth Queensland plans to set up a temporary exhibition for contemporary digital workspace technologies in Brisbane to showcase new and emerging products that can enable Queensland Health staff to access apps and data from any device.

Dubbed the Customer Experience (CX) lab, the initiative aims to gauge interest and demand for digital workspaces within Queensland Health by showcasing competing products in real world environments and to demonstrate how to deploy and manage different platforms.

ASX-listed healthcare technology vendor HomeStay Care has begun a trial of two new apps for carers and clients at a St John of God Health Care smart home in Melbourne's East Brighton that is being developed as a blueprint for the charitable organisation's disability services.

The house is being fitted with motion sensors, apps, voice assistants and artificial intelligence for people with cognitive issues and secondary conditions such as epilepsy, cerebral palsy and blindness.

A predictive risk algorithm developed by the CSIRO and Precedence Health Care to identify patients in general practice who are at risk of hospitalisation in the next 12 months will be made available to the wider software market following its publication in the Nature journal Scientific Reports.

The algorithm is used in Precedence Health Care's Risk Stratification Tool (RST), first developed for the Health Care Homes project and in use by more than 175 practices nationwide.

The RST connects to GP clinical systems including Best Practice, MedicalDirector, Medtech, Zedmed and Communicare and scans the patient database, extracting the information needed by the CSIRO algorithm. It can be used to generate a report identifying the risk level for all patients in the practice, or to automatically scan an individual patient record when the record is opened, alerting GPs to the patient’s risk of hospitalisation at the point of care.

Pulse+IT's weekly round-up of international health IT news for the week ending March 24: FDA rules for cybersecurity and medical devices, Apple heart study early results, popular health apps and privacy, post-operative remote monitoring, fax server fail, remote monitoring at home, best of breed for infection control, NHS interop expert

Groups ask FDA to rethink some medical device cyber proposals
Healthcare Info Security ~ Marianne Kolbasuk McGee ~ 20/03/2019

The Food and Drug Administration is generally on the right track in updating guidance for the cybersecurity of premarket medical devices but various changes are needed.

Preliminary results are in from the massive Apple Heart Study
MedCity News ~ Kevin Truong ~ 18/03/2019

According to findings presented at the American College of Cardiology’s annual meeting, 0.5 percent of participants received a notification about irregular pulse and 84 percent of participants who received irregular pulse notifications were found to be in atrial fibrillation at the time of the notification.

As the hoo-ha over My Health Record dies down, this week the industry turned its attention back to a problem that has dogged the Australian healthcare system for well over a decade: secure messaging interoperability, or lack thereof, and the continued reliance on paper for clinical communication between different settings.

New Zealand is well on the way to solving this problem because it primarily uses one messaging service but also because its Health Information Standards Organisation (HISO) has managed to get consensus within the industry on standards for messaging along with code sets, security and privacy. New Zealand also has the benefit of a mature National Health Index (NHI) patient identifier and its associated health practitioner index.

ASX-listed pathology, diagnostic imaging and medical centre provider Healius has signed a contract with US laboratory information system vendor SCC Soft Computer to replace the ageing systems used by its SDS Pathology division.

SDS – which includes QML Pathology, Laverty Pathology, Dorevitch Pathology, Abbott Pathology, Western Diagnostics and Tasmanian Medical Laboratories – is one of the largest private laboratory providers in Australia and the largest provider of pathology services to public hospitals.

Healius, formerly known as Primary Health Care, plans to spend $100 million over five years on the program, which will see the replacement of the Ultra system originally developed by TripleG and an internally developed system with SCC's laboratory and genetics information management solutions, a suite that includes its LIS solution SoftLab, its microbiology solution SoftMic and other modules for cytogentics, molecular biology, immunogenetics, cytometry and biochemistry as well as reporting and analytics.

SA Health has upgraded its electronic medical record platform to the current version of Allscripts' technology, a key recommendation of the independent review released earlier this year.

Formerly known as EPAS, the system consists of Allscripts' Sunrise EMR and its patient administration system (PAS) and has been rolled out at several hospitals, including Noarlunga, the Queen Elizabeth Hospital, Port Augusta and the Repatriation General Hospital. The PAS is also being used at the new Royal Adelaide Hospital.

Adelaide Primary Health Network (APHN) and youth mental health service headspace are planning an upgrade to their existing MasterCare electronic medical record to Global Health's new MasterCare+ platform, which promises improved workflows, reporting and client engagement for the nine headspace centres around the state.

APHN uses the MasterCare EMR for mental health and alcohol and drug recovery services funded by the PHN, with headspace using it to support its clients, people under the age of 25.

The federal government next month will release a standardised schedule on which home care providers must publish their pricing information on the My Aged Care Service Finder following the failure of over 20 per cent of providers to publish their fees.

It has been a requirement since last November for providers to publish their pricing information on My Aged Care following complaints about difficulties in comparing prices. Providers were originally able to upload their data as a PDF or include a URL linking to their pricing schedule.

Queensland is on its way to implementing a statewide eReferrals system with the Sunshine Coast Hospital and Health Service partnering with the Sunshine Coast PHN to roll out the new GP Smart Referrals system for local general practices next month.

The Sunshine Coast is pioneering the external referrals element of the integrated referrals management solution, which has seen BPAC Informatics' SeNT solution integrated with practice management systems Best Practice and MedicalDirector to allow GPs to write and send an electronic referral from directly within their PMS.

Private hospital group Healthscope will roll out a package of security solutions from Unisys across its hospitals in Australia, including a security information and event management (SIEM) solution to protect critical systems.

While Healthscope does not use an electronic medical record except for a Telstra Health implementation at Sydney's Northern Beaches Hospital, the Unisys solutions will be used to help protect any device that is connected to the Healthscope network, including MRI scanners, patient scheduling systems, financial transactions and staff records.

The Stroke Foundation has called for cross-party support for the establishment of a national telestroke network building on the successful Victorian Stroke Telemedicine program and similar networks being rolled out in NSW, South Australia, Western Australia and New Zealand.

Victoria has run its program since 2012-2013 following a grant of $7.3 million from the federal Health and Hospitals Fund, which equipped 16 hospitals in regional Victoria with specialist stroke telemedicine carts and software from German company Meytec.

Under a statewide protocol for responding to suspected stroke, patients are rapidly assessed and sent for a CT scan of the brain and a CT angiogram, with ED clinicians able to video conference in real time with neurologist in Melbourne. The clinicians can then quickly decide on treatment, whether it is transfer to Melbourne for endovascular clot retrieval or treatment with clot-busting thrombolysis.

The Australian Digital Health Agency will not offer any new money to assist aged care or allied health software vendors to upgrade their systems to conform with the My Health Record, but incentives to integrate new secure messaging standards will be available, the agency says.

Aged care software vendors were given assistance in the early years of the PCEHR to make their systems conformant but allied health vendors were not a priority in the past, despite calls for financial support similar to that given to other vendors.

Clinicians from a range of health professions including medicine, nursing, allied health, midwifery and pharmacy have got together to set up a Clinical Informatics Leadership Network (CILN) with the financial and logistical support of Health Informatics New Zealand (HiNZ).

HiNZ says the group now has more than 70 members and aims to provide an online forum for members to share expertise and ideas as well as national networking events.

The Australian National Audit Office is conducting an audit of the Australian Digital Health Agency's implementation of the My Health Record system, and is looking for public contributions.

The ANAO says the objective of the performance audit is to assess the effectiveness of the implementation and will not be a commentary on the merits of the policy.

Pulse+IT's weekly round-up of international health IT news for the week ending March 17:Calls for action on social media anti-vax, WHO to open digital health dept, no quick Brexit for NHS, questions for your doctor, HIPAA-compliant medication dispensing booths, ransom paid to release med records before surgery, NICE evidence for digital health, criminal prosecution for snooping

AMA urges tech giants to combat misinformation about vaccines
MedCity News ~ Kevin Truong ~ 14/03/2019

In a letter addressed to the CEOs of Facebook, Pinterest, Amazon, Google, Youtube and Twitter, AMA executive vice president CEO James Madara wrote about the medical community's concern about the spread of misinformation on vaccines.

For those among us who have despaired at the bungled, fumbled, laborious roll-out of the My Health Record over the last seven years, have we got news for you! The Australian National Audit Office (ANAO) has decided to take a look at the implementation of the system in all its gory details, and you get to have your say.

The ANAO has announced it is holding an audit to “assess the effectiveness of the Australian Digital Health Agency's implementation of the My Health Record system”. The audit will not cover the merits of government policy, it says, but it does have a role in assessing the efficient and effective implementation of government programs. You have until April 14 to have a say, with a report to be delivered in October.

Eastern Melbourne Primary Health Network will extend its trial of the My Emergency Dr telehealth app to December, following early results showing 73 per cent of people using the service saying they would have called 000 or gone to hospital if it hadn't been available.

While the trial has been controversial in some quarters, EMPHN CEO Robin Whyte said that since offering the service for free to people in Melbourne’s east and north-east, patients had provided overwhelmingly positive feedback, and calls to the service are growing at a rapid rate. 

Residential aged care and in-home support provider Feros Care has launched a pilot program using the Google Assistant to allow older people living at home to use voice commands with the company's new MyFeros self-service portal.

Feros Care has developed the portal and app so clients living at home can use an internet-enabled device to do tasks that would normally require them to ring the contact centre, such as viewing upcoming visits by carers, managing their home care package finances and sharing messages with Feros Care staff.

Eastern Health and Monash University will tomorrow launch a new service for patients discharged from Box Hill Hospital to help them better understand their medications with the assistance of a community pharmacist and the My Health Record.

The DC MedsRec trial is one of 15 projects funded to the tune of $8.5 million by the Australian Digital Health Agency to test out digital technologies and their ability to be scaled up for national use.

Telstra Health has appointed former NZ National Health IT Board director Graeme Osborne as its head of hospitals, where he will be in charge of further developing the company's electronic medical record and hospital software division.

Mr Osborne spent close to seven years leading New Zealand's extensive eHealth program before moving to a position as general manager of system transformation at the NZ Government Chief Information Office in 2016, where he was in charge of the government's digital investment strategy.

A shared clinical system for genomics developed by the Melbourne Genomic Health Alliance is now available for use in clinical testing, with the alliance announcing that the Victorian Clinical Genetics Services (VCGS) will be the first lab to use the system as its primary tool for genomic interpretation.

GenoVic uses the cloud-based genome informatics platform DNAnexus along with Agilent Technology's Alissa Interpret software for clinical genetics and molecular pathology. It is run by an in-house genomic orchestration service and uses Amazon's Simple Storage Service (Amazon S3) to store genomic data for clinical and research purposes.

Former NZ Ministry of Health chief technology officer Ann-Marie Cavanagh is taking up a six-month secondment at the Department of Internal Affairs (DIA), where she will be acting as director of digital government strategy.

Ms Cavanagh was acting deputy director-general for data and digital at the ministry following a restructure of the department under new director-general Ashley Bloomfield.

Discharge planning and discharge summaries from Victorian hospitals have been rated as 'poor' in a recent survey of local GPs, with more than a third saying they were not informed directly about the death of a patient.

Overall, Victorian GPs gave a satisfactory rating for communication received from their nominated hospital or health service, but say things could still be much improved.

Pulse+IT's weekly round-up of international health IT news for the week ending March 10: EMR burnout, Berkmorgazon becomes Haven, US CHIO, Babylon goes to Canada, fears over DVA EMR, Philips buys Carestream, telehealth stresses UK GPs, Southampton's MyMR, FDA head leaves, vax data fears, Microsoft to shut Health Dashboard, Windows 7 support, Google Glass returns to healthcare

Judy Faulkner asked the press to dig into physician burnout and EHR satisfaction. So we did
MedCity News ~ Erin Dietsche ~ 07/03/2019

The Epic CEO contends there is not a high correlation between EHRs and doctor burnout, but discussions with physicians show the EHR has fallen short of freeing up doctors to better care for patients.

Healthcare’s big potential disruptor will be called Haven
MedCity News ~ Kevin Truong ~ 06/03/2019

The Amazon-Berkshire-J.P. Morgan healthcare venture launched last year and headed up by Atul Gawande has a website and finally a name: Haven.

It has been a bit quiet on the health IT front recently but things were enlivened somewhat this week with another eruption of the ongoing turf war between doctors and pharmacists. No sooner had a brief announcement of a partnership between health insurer Bupa and the newly merged TerryWhite Chemmart been released than the AMA decided to arc up, thundering about how it threatened the very foundations of general practice.

It's doubtful that there's really much cause for concern over a vague agreement on reducing some costs for medications and supplies for Bupa health fund members, combined with a bit of encouragement to take part in in-pharmacy health screening programs pharmacies and the promise of a dinky new health app, but the AMA let fly nonetheless.

Auckland-based secure messaging vendor Celo is targeting the Australian market with its healthcare-specific clinical messaging app, which aims to replace the unauthorised use of consumer apps such as WhatsApp in the healthcare sector.

The app allows clinicians to message each other securely, take clinical photos that can be synced to desktop systems or EMRs, and has the ability to get patient consent using a sign-on glass consent process.

Mental health research organisation the Black Dog Institute will roll out Global Health’s MasterCare EMR as its new clinical and practice management software.

The institute, based at the Prince of Wales Hospital campus in Sydney's Randwick, runs a number of clinical services including a depression and bipolar clinic, psychology clinic and child and adolescent health clinic.

The Australian Medical Association has slammed a partnership between health insurer Bupa and TerryWhite Chemmart pharmacies involving new services and a health app as an attack on general practice, even before the official announcement.

The “strategic partnership” is due to be launched in May and will provide Bupa's four million health fund members with a range of initiatives and “a health app aimed at providing significant value and personalised care” from TerryWhite Chemmart (TWCM) pharmacies around Australia.

Australian primary health networks (PHNs) are rolling out a new mobile-friendly interface for the HealthPathways platform, allowing it to be used on smartphones as well as desktop systems.

Hunter New England and Central Coast, South Western Sydney, Central and Eastern Sydney and Illawarra Shoalhaven in NSW have all recently announced they are adopting the mobile platform to allow users to access the system no matter what the device.

The five district health boards in New Zealand's Midland region have gone to market for expressions of interest in providing an electronic prescribing and administration solution (ePA), including medicines reconciliation, to standardise and digitise medication data across the region.

The chosen solution will need to integrate with the Midland Clinical Portal (MCP), which uses Orion Health's Concerto technology, to give clinicians a view of regional patient records and medications.

While licences are available throughout the country to implement DXC's MedChart medications management solution, of the five Midland DHBs only Taranaki has implemented the system in inpatient wards.

Fremantle Hospital in Perth is now live with the BOSSnet electronic medical record from Allscripts all inpatient wards, outpatient and community services, day patient areas, theatres and procedural areas.

Called the digital medical record (DMR) by Fremantle, the system promises to better support patients being transferred to and from Fiona Stanley Hospital, which has been live with BOSSnet since 2014.

Sydney-based nurse call system developer Vitalcare has released a low-cost wireless version aimed at small health and aged care facilities that can be self installed.

Dubbed Flora, the system has a desktop console with a touchscreen that is plugged into a powerpoint, with the system's call points able to be attached to walls or furniture using double-sided tape.

The NSW deputy state coroner has criticised a lack of urgency in implementing a real-time prescription monitoring (RTPM) system in NSW, calling for a scheme to be introduced in conjunction with other support measures to reduce accidental deaths from multi-drug toxicity.

The move comes as a public awareness campaign begins in Victoria in advance of the statewide roll-out of its SafeScript scheme next month, following a pilot in western Victoria. SafeScript is now integrated with MedicalDirector, Best Practice, Genie and Zedmed.