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The device will help detect disease biomarkers in patients' blood.

Australian Competition and Consumer Commission says the combined entities would face competition from generics.

The health insurer says its CancerAid can help patients and caregivers make necessary behavioural changes.

eHealth NSW in Australia has announced that it will be working with a number of industry partners to enhance the safety and quality of patient care, with clinicians at one of the state’s major rural hospitals harnessing the power of digital tools in two proof-of-concept (PoC) projects. At the 325-bed Wagga Wagga Base Hospital in the state’s south-east, eHealth NSW and Murrumbidgee Local Health District are partnering on two PoC projects which combine the expertise of Alcidion, CSIRO and Evidentli and use Apple products. PoC 1: Mobilising data to improve the safety and quality of care during a patient’s hospital stay The first PoC project is exploring how critical test results can be shared securely and in real time via mobile devices to support enhanced clinical decision-making. For Dr Stephen Wood, Director of Wagga Wagga Base Hospital’s Emergency Department (ED), this PoC has the real potential to assist clinicians with making decisions about the diagnosis and treatment of patients in time-pressured ED environments. “We want to give clinicians fast access to meaningful data insights which can help them to identify patients at risk of deterioration, and provide more timely mobile access to pathology results and X-rays,” Dr Wood said. A team of 10 ED clinicians is trialling mobile notifications of real-time pathology results and risk indicators, via Alcidion’s Miya Precision Clinical Decision Support (CDS) tool. Notifications will be delivered through Apple products, including iPad, iPhone and Apple Watch. The Miya Precision platform uses the Fast Healthcare Interoperability Resources (FHIR) to map data to standard terminology. This can form a basis for integrating other Artificial Intelligence and Predictive Analytics algorithms to monitor and detect safety problems. “The platform is able to deliver additional clinical insights including deteriorating kidney function, coagulation management, antibiotic stewardship, management of gram-negative bacterial infections, low blood glucose and sepsis monitoring,” said Kate Quirke, Chief Executive Officer of Alcidion Group. In order to prove these capabilities, the CSIRO’s ED re-admission risk algorithm will use the data supplied and make the results available via the Miya Precision platform. CSIRO is Australia’s national science agency. David Hansen, Chief Executive Officer of CSIRO’s Australian e-Health Research Centre, added: “It’s exciting to work with NSW Health to bring new technologies into everyday use in healthcare. Data-driven healthcare is very much the future of innovation in healthcare – this project is part of that transformation.” PoC 2: Creating an open platform for digital innovation in NSW Health The second PoC aims to create an open platform that provides access to simulated data, which researchers and developers can use to test functionality and feasibility of their models in a safe environment and without putting patients’ privacy at risk. Multiple yet anonymised datasets are being mined, via the Miya Precision platform, to cover common health challenges such as diabetes, cancer and cardiovascular disease. Cloud software company Evidentli is using its Clinical Research Automation software, Piano, which connects to a variety of data sources and provides security and workflows to automate research. Best-of-breed statistical, analytic, and documentation tools will enable Murrumbidgee LHD to perform clinical research in a fraction of the time it has historically taken. And, because Piano transforms data into open standards and automatically documents methods, research is immediately reproducible and ready for peer review. The platform, said Dr Wood, is “an incredibly powerful research tool which accurately captures activity to give insights into factors such as a patient’s risk of readmission as well as compliance with clinical pathways and the provision of clinically appropriate care”. “The digitisation of healthcare is ramping up and all clinicians need to embrace it with a view to developing a platform that improves access to the information they require to deliver timely and appropriate clinical care,” said Dr Wood. “We are excited to be a part of these six-month projects and I hope that both prove to be successful.” Recent digital health-related developments in Australia Earlier this week, CSIRO and GenesisCare announced a A$5.1M research partnership which focuses on an emerging area of science called theranostics to develop new therapies against some of the most fatal and difficult-to-treat cancers affecting Australians. The federal government of Australia recently announced that it will invest A$5M to facilitate the implementation of PainChek’s pain recognition app in Australian residential aged care centres (RAC’s), according to a Mobihealth News article.

Australia’s national science agency CSIRO and GenesisCare, one of Australia’s largest cancer care providers, today announced a A$5.1M research partnership which focuses on an emerging area of science called theranostics to develop new therapies against some of the most fatal and difficult-to-treat cancers affecting Australians. What’s it about According to the Theranostics Australia website, theranostics uses specific biological pathways in the human body, to acquire diagnostic images and also to deliver a therapeutic dose of radiation to the patient. A specific diagnostic test shows a particular molecular target on a tumour, allowing a therapy agent to specifically target that receptor on the tumour, rather than more broadly the disease and location it presents. Treatments successfully designed in the project will be trialled locally in Australia through GenesisCare's clinical network, giving Australian cancer patients access to new treatments sooner, rather than waiting for treatments to be developed and trialled overseas first. Access to this form of treatment has historically been limited globally, and it is hoped this investment may help spark a new theranostics industry in Australia to ultimately improve patient outcomes. GenesisCare is building a network of clinical centres to support research into new therapies, and is providing compassionate access to treatment for patients who have exhausted conventional treatments for prostate cancer. Currently GenesisCare offers theranostics treatment in Hurstville (New South Wales), Perth (Western Australia), on the Gold Coast (Queensland), and in Windsor (UK), with plans to introduce the treatment to more centres in 2019. The new research project forms part of CSIRO's Probing Biosystems Future Science Platform and builds on CSIRO's expertise in cancer biomarker research. What’s the trend Cancer remains the leading cause of death in Australia, with almost 50,000 deaths from cancer estimated in 2019, including 3051 deaths from pancreatic cancer, 1549 deaths from brain cancer, and 1046 deaths from ovarian cancer anticipated this year alone. On the record “We're targeting cancers that are currently the most 'untreatable', such as brain, pancreatic and ovarian cancers and metastatic cancers, because that's where we think we can make a profound difference,” CSIRO project lead Professor Stephen Rose said in a statement. “We’re exploring a very exciting approach called theranostic cancer treatment, which is a type of precision medicine that finds and attacks individual cancer cells in a person’s body – rather than attacking both cancerous and healthy cells.” Associate Professor Peter O'Brien, Chief Medical Officer at GenesisCare, said the project builds on research and ongoing clinical trials using theranostics. "We've seen a rapidly developing body of evidence in theranostics in prostate cancer and neuroendocrine tumours, and this partnership aims to accelerate the time it takes to bring findings from the lab to the clinic for other hard to treat cancers," he said. 

The global electronic health record (EHR) market size is proliferating, with Australia contributing to a large portion of that growth. According to a report by Global Market Insights, the EHR market size in Australia was valued at US $526.3 million in 2018 and is expected to witness over 8.5 per cent in exponential growth rate (CAGR) from 2019 to 2025. Australia’s EHR market size growth contributes significantly to global numbers expected – Global Market Insights estimates this to be US$38 billion by 2025. Global Market Insights report authors Sumant Ugalmugale and Ajay Devgire said the healthcare system in Australia is equipped with the necessary infrastructure to launch a national EHR program as 85 per cent of Australians and over 95 per cent of general practitioners have access to the internet. “In addition, healthcare associations such as the Royal College of Australian General Practitioners, the Pharmacy Guild of Australia and the Australian Healthcare and Hospital Association (AHHA) believe that adoption of EHR systems will reduce cost and improve safety, quality and efficiency of healthcare in the country,” they said. “Government initiatives such as My Health Record, aimed at maintaining the health records of all the Australian citizens will also drive growth of various digital health systems platforms in the country.” However, they warned that the potential threats for data breaches and privacy leaks will continue to impede the Australian EHR market growth over the coming years. On a global scale, the report identified that numerous emerging countries are recognising the importance and benefits of EHRs and are increasingly investing in such technology. “EHR offers enhanced patient care and management along with significant cost savings. EHR assists the practitioner in management of patient data and streamlines workflow that should positively impact EHR market size,” the authors said. Specifically, the web/cloud-based EHR software product market is expected to have large uptake. It was valued at US $12.5 billion in 2018. “Web-based EHR provides improved speed and flexibility to the end users in terms of its operability,” the authors said. “Access to many users simultaneously and wide network access further adds to the advantages of cloud-based EHR software. Moreover, web/cloud-based EHR software considerably saves cost that should escalate its adoption over the forthcoming years.” [Read more: Opinion: Is there a smarter way for the controversial My Health Record system? | Monash Health and SCHS commence EMR rollouts] In addition, the patient management segment of the EHR market is estimated to progress at six per cent CAGR during the forecast timeframe. “EHR offers systematic and timely scheduling of patient data. It enables safe and reliable documentation with time-effectiveness. In addition, the flexibility of management of vast data points regarding the patient will offer momentous growth opportunity for patient management EHR application market,” they said. The authors also identified that clinics’ EHR usage accounted for more than 17.5 per cent in revenue share in 2018. “EHR provides seamless access and interface for clinic facilities at any location. Presence of clinic management software further enhances patient and practice management that will drive its adoption rate clinics over the forthcoming years. Furthermore, expanding healthcare infrastructure across emerging nations will increase clinics EHR end-use segmental size in the upcoming years,” they said. However, according to the authors, along with the strong growth rate of EHR, there will also be a lack of skilled professionals to handle the sophisticated technology. As such, they urged the healthcare industry to prepare for this change.

Having an EMR system brings to a healthcare organisation an integrated system. However, it may not suit individual department needs or workflows, an industry expert has warned. Speaking at the recent Australian Healthcare Week in Sydney, Sydney Local Health District Assistant District Director of Pharmacy and CPIO Rosemary Burke said in the chase to adopt EMR, many organisations end up having multiple electronic systems within an organisation. “Do you go for a best-of-breed system where the functionality is tailored to the environment where it is working, its business needs and workflow for a fairly easy for user adoption?” she questioned. “But then it gets challenging when you have a number of silos within an organisation, in addition to the silos that exist between the hospital sector and the community sector. Terminologies and functionalities can be different as well, so it can be very confusing.” According to Burke, many healthcare organisations traditionally went with best-of-breed systems as automation of care and electronic systems were about creating electronic health records and providing comprehensive views of patient data. But going forward, Burke stressed the need for systems that all talk to each other, address data leaks and provide analysis of patient data. “The use of multiple systems aren’t usually strategically planned. Some are led by clinicians, while others are led by the organisation. And sometimes, as things develop, the other groups weren’t even aware of these system developments,” she said. “Access and handover of care become a challenge. Healthcare practitioners don’t understand the complexity of the various systems, resulting in complex workflows and duplicated data in multiple systems. “There’s also fragmentation of patient information, which becomes a safety concern.” [Read more: Monash Health and SCHS commence EMR rollouts | SA Health upgrades its EMR system following review] As such, Burke suggested that EMR implementations should be done in accordance of the needs of an organisation and include: A system that speaks the same language, and have the same character-field limits  A secure, integrated system that works across the entire organisation  Staff training across the entire organisation  “What we need to do is create seamless continuity of care across the organisation; enable systems for patient safety, quality and outcomes; and have systems where we can extract data from so that we end up with better analytics, better research and better outcomes for our patients,” she said.

Artificial intelligence (AI), neural networks and machine learning can be ethereal concepts to the average punter, but when applied to the health sector their benefits come into sharp focus. When technology can save a life, it suddenly becomes meaningful. Magnetic fields and radio waves took on a new meaning with the introduction of the MRI machine, and the same will happen with the application of today’s technologies in the health sector. We’re just starting to see the impact AI and image recognition can have on healthcare, but it is poised to be the technology’s biggest contribution to society yet. Earlier this year, a group of Chinese and US researchers developed a program to automatically diagnose childhood illnesses including meningitis, asthma, gastro and the flu. This AI program works faster and, in some cases, more accurately than doctors. However, as in the early stages of every new discovery, there are obstacles to navigate. Privacy concerns, investment requirements and regulatory issues are just some of the hurdles that need to be overcome. Despite the challenges, there are potential benefits. Doctors are an invaluable part of society, but they are still human, and misdiagnoses happen. According to research, there are approximately 140,000 cases of diagnostic errors in Australia each year, with 21,000 resulting in serious harm and more than 2,000 resulting in death. Modern AI promises to solve this issue through the power of neural networks. Unlike traditional software that only does what it’s told, neural networks can teach themselves new skills with enough training data. By reviewing mammograms with and without cancerous cells, for example, a neural network can learn to identify malignant cells in new mammograms. In 2016, a research team achieved just this. The Houston-based team built a program that analysed mammograms 30 times faster than a human, and with 99 percent accuracy. More recently, Maryland researchers used AI to diagnose cervical cancer with 91 percent accuracy, vastly improving the 69 percent human success rate. These diagnoses were all made without an expensive medical professional, and without the cost of a clinic. The upshot is AI could offer better diagnosis, to more people, for less money, in less time, allowing doctors to focus on patients that truly need their care. Not only can technology improve current diagnostic methods, but it can also create new ones; neural networks will eventually identify links between symptoms and illnesses that human researchers would never have found. Unfortunately, the AI healthcare revolution has a down side, and a price many Australians seem unwilling to pay. To be effective, neural networks need the training data of many thousands of people in order to learn which symptoms correspond to which diagnoses. In the China/US study, 600,000 Chinese health records were used as training data, a feat possible thanks to the sheer size of the country, as well as China’s less stringent privacy culture. In Australia, we’re far more protective of our data and cognizant of the implications of sharing too much. Privacy aside, there are challenges around getting consistent data, both to teach programs and to feed them for diagnosis. Inconsistent standards are used across the private and public sector, even between doctors in the same clinic. While getting clean data is technically possible, it could be a regulatory and administrative nightmare. Despite the obstacles, AI’s potential benefits to healthcare are not just worth pursuing, they should be a priority. Just as governments are now (rightly) planning for the arrival of self-driving cars, we need to plan for an AI powered healthcare system today. Standards on access to data need to be agreed upon, along with a transparent and open opt-out process. A standardisation of medical data is also long overdue. More than just setting us up for the benefits of AI, patients would see immediate benefit from more consistent data recording. It’s a long road between here and a world of automated and accurate AI powered healthcare, but it’s one we should start preparing for today. Without this preparation we’ll see more noble but half-baked ideas launched before they’re ready, eroding public trust. It’s a world we can see, but one we can only reach with a clear-eyed vision of the journey ahead. Allan Waddell is the Founder and Co-CEO of Kablamo

InterSystems has included a unified provider directory as part of its HealthShare suite of connected health solutions, aiming to drive collaboration and innovation across the care continuum. HealthShare brings together health providers, patients and payers with a unified care record and the newest member of the suite, HealthShare Provider Directory – available as part of HealthShare 2019.1 – is a single source of information for provider demographic and professional relationship information. Specifically, it is a master data management solution that automates the process of collecting, consolidating and publishing accurate provider information. The latest HealthShare release also includes enhancements to its clinical viewer, expanded HL7 FHIR capabilities and out-of-the-box analytics functionality. The move follows recent news that InterSystems launched a new TrakCare clinical system that allows healthcare professionals to use touchscreen devices to create patient notes with swipes and taps, capture images and barcodes via camera, and add information by voice. According to the company, the upgrades to HealthShare enable users to more easily comply with regulations, enhance customer service and improve the efficiency of any business process that requires up-to-date and accurate provider information. InterSystems HealthShare Vice-President Don Woodlock said the latest version of HealthShare offers more functionality, scalability, communication and extended decision support. Woodlock added that inaccurate provider information has consequences for patients, payers and providers themselves as wrong telephone numbers and location information limits access to care. [Read more: InterSystems launches recruitment drive for its pioneering NT digital health system roll out | InterSystems lands $259 million Northern Territory healthcare IT project] In addition, he said inaccurate information propagated across multiple clinical and administrative systems at a hospital or integrated delivery network can negatively impact efficiency and cash flow. “Interoperability and information exchange are hot topics now, but technology can do better than simply moving data around,” he said. “If government initiatives are going to be the foundation for innovation in healthcare, organisations need to aggregate information and build upon a true unified care record – then put the data to use to improve patient care experience, drive down costs and improve the health of populations.” In addition, as part of the updated release, InterSystems has also renamed its flagship HealthShare product module, HealthShare Information Exchange, to HealthShare Unified Care Record.

Earlier this week, the Western Australia (WA) Government announced the establishment of a new Ministerial Council that will advise the State Government on opportunities to further develop and support precision health advances. Precision health uses new and emerging technologies to enhance disease prevention and early detection, and improve patient outcomes through treatments tailored to patients' individual genetic profiles, as well as their variable responses to the environment and lifestyle.  The Precision Health Council will be chaired by South Metropolitan MLC Kate Doust and is expected to hold its first meeting within the coming months. According to the official statement, the council will comprise stakeholder representatives from medicine, science, industry, Aboriginal health, patient organisations, medical research and commercialisation, as well as experts from key precision health-related technologies of genomics, phenomics, informatics and geographical information systems. Early priorities of the council will include identifying and enhancing successful precision health initiatives already operating in WA's health system, and determining key areas that could benefit from increased integration of precision health measures. On the record “Western Australia already benefits from emerging precision health initiatives such as the Undiagnosed Diseases Program of WA (which provides earlier diagnosis for people with rare and baffling medical conditions), and the Australian Genomics Cancer Medicine Program (which harnesses precision genomics technology to match patients with rare and untreatable cancers to tailored clinical trials).” “I look forward to being advised by the new council about potential advances in this exciting field,” said Health Minister Roger Cook in a statement.