Exploring by Country: Canada

Thanks to everyone who sent in their ideas for blog articles for 2013, as part of our “Win a Gourmet Lunch” competition this week.   A $100 restaurant voucher is winding its way to each of the following winners as I write:

• Judy Leishman, Practice Manager at Manly Medical Centre, would like to read more articles about updates in technology, comparisons between different systems, legislative requirements re health information and anything that would make her life easier in administration.
• Jane Ireland from HealthShare suggests we write more in 2013 on primary and secondary integration, regional initiatives and innovative learning.
• Dave Mitchell from Pegasus Health wants to read more about privacy with regards to shared care.
• Rex Browne from Anne St Medical says it would be interesting for prospective cloud immigrants to know what cloud platforms support which HealthLink accessed services.

Happy Christmas!

It’s now only 8 more sleeps until the big day and if you’re anything like me, after a busy and productive year, you’ll be wondering where 2012 went!

The HealthLink team and I would like to wish you and your family a wonderful Christmas day and holiday season and a 2013 full of good health, success and happiness.  And of course, a big “thank you” for your continued support and custom over the year.

Win Lunch On Us!

As a special thank you to you our readers for supporting our blog this year, we’re giving away three gourmet lunch vouchers worth $80 each, redeemable at a wide selection of top restaurants.  To go in the draw, simply email us at: blog@healthlink.net with your name, postal address and phone number and tell us what type of information and articles you would like to see on our blog in 2013.  Be quick though – to be eligible, your email must be received by 5pm Wednesday 19 December 2012! Winners will be notified directly by phone or email by 5pm Friday 21st December.

PS.  We will be open on every working day throughout the holiday period providing you with customer support.

Photo by Simon Clark/FarmerClark.com

It certainly seems a long time since I was a young Telecom exec,  setting up HealthLink as a specialised Telecom service!  We are now doing rather a lot of healthcare sector integration, delivering over 65 million items of clinical information per year, across New Zealand, Australia and now Canada.  With our recent expansion into Canada and growing demand in Australasia, the future looks bright.  But our key focus is still on service quality rather than service expansion.

You can read more about HealthLink’s origin and history in this week’s NZ Herald article, as well as learn about our three newest services, CareConnect eReferrals, CareInsight and eLab.

January provides the opportunity to reflect on the previous year and the experiences we enjoyed and learnt from, both in our working and personal lives.  What experiences in 2011 enabled you to grow and develop?  For me, it was leading a team of Diocesan students to victory in a Dragon Boating Challenge.

I started coaching Dragon Boating in 2007 after being invited by Busting With Life, a woman’s breast cancer survivor’s team. I had just spent the previous year as their sweep, working with the coach of the corporate dragon boat team I had been a member of for seven years. Apart from five years of waka-ama outrigger canoe training, I had little coaching experience to offer but trained under an excellent coach. With a little trepidation, I then proceeded to take Busting With Life to win three consecutive nationals competitions.

Dragon Boating and breast cancer research has an interesting history which can be read in the Canadian Medical Association Journal. Besides the physiotherapeutic benefits researched here, I can attest to the social benefits, and I have no doubt there are psychological benefits to a team sport amongst members who have gone through traumatic experiences and live in fear of its reoccurrence.

Sean Ogden leads the Diocesan School for Girls Dragon Boating team to victory

Over the years my team of women have become family. One is the sister-in-law of Jo Robertson, the Leadership Programme Director of Diocesan School for Girls. When I was asked if I could help with coaching year 10 girls in a Dragon Boating Challenge, I was more than willing. Not only was this an opportunity for the girls, the Auckland Dragon Boating Association (ADBA) and the sport in general, but it was an opportunity for me to test my abilities to convey what I had learned in leading a dragon boat team. This was not just a coaching exercise. I was not being asked to baby-sit. I was being asked to teach these girls what it takes to succeed.

Leadership is a quality that HealthLink actively encourages in its employees and since the Dragon Boating event was in syngery, HealthLink had no problem donating my time to the cause.

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This is a quick and somewhat belated sign off for the end of 2011.  We will close our office tomorrow afternoon (Friday 23rd December) but we will be open on every working day throughout the holiday period, providing support for 9000 plus medical centres across Australia, New Zealand and the Pacific Islands.  So while you are holidaying relax, because we are on the job.

While it has been a very hard working year, we have also enjoyed considerable success and it is very gratifying to look at what has been achieved. Some highlights on the New Zealand front are…

• eLab: The Aotea Pathology eLab system is now used by more than 400 referring doctors in the Wellington region and nearly 20,000 electronic pathology requests have been sent.  The rollout continues apace and should be completed in early 2012.
• CareInsight: The Care Insight system has received very good feedback from the Hawkes Bay DHB’s clinical council and we anticipate getting sign off for it early in the New Year.  Care Insight is also live in Nelson.
• eReferral: We now have eight DHB regions using the HealthLink eReferral system.  The latest and most sophisticated installation the Auckland Regional DHB eReferrals system is now live on a number of practices, more than 300 referrals have been sent and rollout is commencing in early January.

In Australia, we have had a very busy and successful year too and we are involved in a major messaging project in readiness for the Personally Controlled electronic Health Record project which rolls out in July 2012.  In Vancouver, things are underway for a rollout early in 2012.

I would like to thank you for your continued support over 2011 and hope that you, your colleagues and family have a safe and enjoyable Christmas Break.  Happy Christmas!

Many procedures in medicine rely on an agreed “standard” approach to problems. These “standards” must evolve over time as the practice of medicine evolves. Health information systems are no different and they need to embrace appropriate standards to remove the need to reinvent IT systems again and again with consequent wastage of scarce resources.

At the recent HINZ 2011 conference, my colleague Colin Simmons and I presented a poster paper on a standards-based approach used to develop an electronic pathology ordering system known as eLab.

eLab enables medical practitioners to electronically order pathology tests and have them delivered to the appropriate laboratory.  With eLab, we utilised standards to provide a consistent user interface experience, regardless of which Electronic Medical Record system users order from. Standards also provided an accurate and consistent way to identify the patient, healthcare providers and the tests being ordered, resulting in a highly efficient and useful new tool for the sector.  The use of standards in eLab helped us to achieve a faster implementation by allowing us to leverage off work done elsewhere and focus our development efforts on a high-value, low-risk solution.

To learn more, download and read our short paper on health information standards in action.

eLab has been launched at Aotea Pathology in Wellington and is now being rolled out to the greater Wellington region.

Learn more about HealthLink’s use of standards to deliver eHealth solutions.

At HealthLink we pride ourselves on our support for – and our adherence to – standards. But how do standards actually help in the delivery of solutions? More practically – how does the use of standards improve clinical outcomes?

Recently at HINZ, I presented an endorsement of the standards-based approach to developing solutions that span multiple systems.  The case study that supports my proposition is Auckland eReferral under the CareConnect brand. The standard in question – “the standard” in the rest of this presentation – is HISO 10014.2 Online Forms Architecture Technical Specification.

Standards based solutions have been good for Auckland eReferral, good for vendors and good for the sector as a whole.

The CareConnect project was a challenging one, spanning many different systems, many different vendors, 300 odd general practices in Auckland and three of New Zealand’s largest district health boards – Auckland, Counties Manukau and Waitemata.  Between them, these DHBs send almost a million referrals annually, faxed in manually.  Key problems we needed to address using eReferral were lost and duplicated referrals. Having physical printed referrals also meant there was no “single source of truth”. A referral has a life after it is faxed, with information added or changed, other documents clipped-on or stapled and notes scrawled on it by clinicians . With multiple copies these additions and amendments could be across numerous documents and could easily contradict each other.

To address these challenges we wanted to take the work done on standards and use it to clear benefit in a real project.  Furthermore, we knew that the eReferrals solution involved tying data from Primary Care into clinical workflows that took place in Secondary care. So, working in collaboration, HealthLink and Orion set up the “Open Health Consortium” so we could jointly propose a standards-based solution for eReferrals in the Auckland region. The Open Health Consortium combined HealthLink’s long experience and broad presence in Primary care with Orion’s known expertise in Secondary care.

As we learnt, the success of a standard is dependent on adoption and uptake.  It needs to support clinical outcomes and be used in a meaningful way.  Pragmatism always trumps dogmatism in the application of standards.

View the video of my HINZ conference presentation below to learn:

• Why standards are great for facilitating generic, extensible, reusable integration in a multi-system solution
• Why HealthLink decided to take the standards-based approach with CareConnect
• Six key problems the standard solves:  multiple disparate coding systems, hard coded business rules, data quality issues, high cost of change to the proprietary interfaces, low pace of change and rogue forms that bypass the subscribing systems.
• How standards were designed and implemented specifically for Auckland eReferral (CareConnect)
• How eReferral has gone – an evaluation of the application of the HISO standard and the lessons we learnt

The video is 29 minutes long and follows the full length of my presentation.

View my presentation slides on Slideshare.

Your Feedback Helps Us Improve, We’d Love to Hear From You!

Auckland eReferral supplied as part of CareConnect is going into production as I write. However, this is a living project so we welcome feedback from those in General Practice for consideration in the next phase of this programme.

• What information do you want to receive about a referral after it’s made? Status Update messages in the inbox? A status summary that appears when you re-open the eReferral? A web portal you can login to that shows all the referrals – active and historical – that you or others at your site have made?
• The HISO standard supports the submission of eReferrals but once it’s implemented in a practice management system the addition of other forms is a relatively trivial matter – what other forms do you complete that could benefit from pre-population and online submission using the HISO standard?
• CareConnect eReferral will be available under the most recent releases of MedTech and My Practice – what other practice management systems do you use where you might need to raise eReferrals?
• We want eReferrals to mesh cleanly with practitioners’ existing workflows – what other steps could we take that would make eReferrals fit more seamlessly into your processes? For example, is there value in us requesting a daily reminder when you “Park” an eReferral? How about initiating an invoice?

To leave a comment, click on the title of this article or the comment link just below the title.  You will see the comment section at the bottom of that page.

Just for fun, we’ve put together a short video on why our GP and practice manager customers think communication within the healthcare sector is key.  These slogans were submitted as part of the competitions we ran at the recent GPNZ and PMAANZ conferences, 2011.  Thank you so much to everyone who entered, we hope you enjoy the video.  There were loads of interesting and insightful slogans and it was great to get so many perspectives on why communication makes such a difference within healthcare.

If you didn’t enter the competition, we would still love to hear why you think communication between hospitals, specialists, General practice, allied health, labs and radiology providers is key.  To leave a comment, click on the title of this article or the comment link just below the title.  You will see the comment section at the bottom of that page.

I am very pleased to introduce HealthLink’s new General Manager for Product and Service Development, Andy Tunnicliffe.  Andy recently joined HealthLink following a role in management in Auckland District Health Board’s IS department, as well as five years consulting within the NZ health sector.  Watch the short video below to find out about Andy’s background and the skills he will be bringing to his new role at HealthLink.

Key Points:

• Software development is always about the customer!
• Andy’s team at HealthLink is responsible for establishing and nurturing HealthLink’s growing range of services to health sector customers across the world.
• In addition to his health experience, Andy has also managed a successful Anglo-New Zealand software house and provided business and IS consulting services to a wide variety of businesses in both the UK and New Zealand.
• His young twins keep Andy well entertained and occupied when he’s not at work.  He previously established a boutique olive grove in Matakana, New Zealand, and was a founding director of the local olive growers’ co-operative.  But these days he’s happy to eat olive oil rather than produce it!

There have been a number of brave efforts to establish ways to use information technology within healthcare.  In 1998 the British government committed to spend six billion pounds to develop a national programme for healthcare information technology. In 2010 the US Government’s ‘Meaningful Use Programme’ allocated an even larger sum of money for the implementation of information technology within the US health sector.

What is behind these decisions is an urgent need to reduce the cost of healthcare delivery.  All around the world countries are finding the cost of delivering healthcare to aging populations is enormous and they (we) are scrambling to find solutions to this problem.  Use of information technology is seen as one way in which healthcare costs can be lowered.

A 2005 report produced by the highly influential US based RAND Corporation entitled, “Can HIT Lower Costs and Improve Quality?” , said the following:

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