Technology

A clinical information system (CIS) will be a vital tool in your practice. Your CIS should facilitate good clinical practice, including continuity of care, support for point-of-care decision-making, monitoring of critical events, and limiting/preventing clinical incidents and errors.

A CIS handles clinical and non-clinical information, and includes the following (often interconnected) systems:

• Electronic Medical Record (EMR) systems
• secure messaging
• electronic prescribing
• electronic transfer of prescriptions (eTP)
• clinical decision support
• telehealth.

When purchasing a CIS:

• identify all of its attributes, including software and hardware
• consider the effect each attribute might have on your practice’s staffing and finances
• choose a system that conforms with My Health Record.

Your practice will need systems to:

• book patients
• bill patients and issue receipts
• interact with Medicare, including submitting claims.

Your patient booking system is fundamental to your practice operation, as it allows you to manage patient flow. You may want to integrate this with your CIS.

Your patient billing system should include EFTPOS facilities and ideally be integrated with your practice management software to streamline your billing processes.

Interacting with Medicare is effectively managed through their online portal called Health Professional Online Services (HPOS). Using HPOS, you can:

• make online claims
• view reports
• manage your details
• access patient information
• access useful MBS and PBS functions
• apply for subsequent provider number locations or close a location.

To register for HPOS, you need a Provider Digital Access (PRODA) account that provides secure access to online government services, including HPOS and the National Disability Insurance Scheme (NDIS).

When deciding on your practice’s phone and internet services, you should:

• Choose an appropriate product and provider.
  Choose a business product (as opposed to one for homes) along with a provider that will provide technical support during all of your opening hours. 
• Consider NBN requirements and options.
  Is your practice already connected to the National Broadband Network (NBN)? If not, when will it be connected? As NBN connection can affect security alarm systems and lifts, consider this early in your planning. Having fibre to the premises (FTTP) will give you greater reliability than other types of NBN connections.
• Install a phone system.
  Choose a system that can handle the anticipated call volume, and/or can be easily expanded to accommodate growth in your business.
• Consider installing a VoIP.
  A ‘voice over internet protocol’ allows calls to be made using a broadband internet connection instead of an analogue phone line. This may be a less expensive option and may allow you to make and receive calls if there is a problem with your landline.

Cloud computing refers to the storage and accessing of data and programs over the internet (using a network of remote servers hosted on the internet) instead of using hard drives on computer.

Before moving your practice’s IT service into the cloud, analyse the benefits and potential security risks, and make sure you and your staff know how to use it effectively.

The RACGP recommends that you use online booking systems only for non-urgent, routine consultations.
Patients can book online using a web portal or an application. Ideally, choose a system that is integrated into your practice’s management software.

My Health Record (Australia’s national eHealth record system) is an online repository for documents and data that contain information about a person’s health and healthcare. The information can be accessed online by healthcare consumers and their healthcare providers.

Clinical decision support systems (CDSS) store sets of best practice rules or knowledge such as clinical guidelines, documentation templates, diagnostic support, reference information, alerts and reminders. When you enter specific information (such as clinical and demographic patient data), it checks the information against the best practice information, and displays guidance that can help you make clinical decisions.
A CDSS can be stand-alone or part of another system.

Your practice has a legal obligation to maintain the privacy and security of health information. Create governance structures, policies and procedures to protect confidentiality, integrity and availability of patient information.

Some practices choose to use a voice dictation system to, for example, record details of clinical observations and diagnoses, and write referrals and reports.