A simple idea to replace the classic manila folder full of hospital records with a digital version has led to a successful business for its creator and propelled his company into the vanguard of healthcare.
Dr Ian Gillies is the CEO and founding director of IP Health, a company that has led the way in changing how medical records are stored and accessed in hospitals.
More than 25 years ago, Ian was working in the IT department of the Peter MacCallum Cancer Centre (PMCC) in Melbourne. Like many other hospitals at the time, PMCC was aware that a huge amount of critical information was locked away in different systems.
“We had different systems for patient administration, pathology, radiology, radiotherapy… for everything. And no individual had access to anywhere near as many of those systems as they needed,’’ he said.
“My experience with database access plus discovery of some new Windows technologies really got me thinking about how we could easily make this locked-up information more accessible and useful.
“We needed a single idea.”
The end result was the Verdi system, which has now been used by more than 5000 clinicians across the country.
“The old manilla folders — they could only be in one place at a time, their movements had to be anticipated and tracked around the hospital and sometimes they would go missing,’’ Ian said.
“You know, doctors might accidentally put them in their car and then forget to bring them back!
“We designed a system that didn’t put any demands on doctors, and I have to say, we would not have got far without the clinicians — without providing what they wanted.
“We started with the PC based system, which talked to a server acting as a broker between backend data and the user frontend, and, once we got it up and running, it was everywhere.
“Every nurse or doctor, everyone who was involved with patient care embraced it — its one stop access to clinical information was so useful.
“For example, research nurses love it — instead of delving through cumbersome folders, they have electronic access.”
Verdi soon became a commercial enterprise, although Ian admits that process has not been an easy one.
“Of course, doctors don’t hold the purse strings and when trying to align all interested parties — which includes, in addition to doctors, medical record people, IT staff, finance, boards, government, well, if they don’t all say ‘yes’ at the same time, then it’s a ‘no’,” he said.
“In recent times, we feel that private hospitals have become more suitable to us — they are careful with how they spend their money and we can get closer to the decision makers in the private sphere.”
Of course, technology is constantly changing and the advent of mobile devices has been another revolution which Ian welcomed with open arms.
“When I got my first iPhone, I saw apps like the ones for finance markets and the weather, and I thought, ‘these must be working the same way as our system, talking to a server somewhere’,’’ he said.
“Having a mobile app for Verdi, V-Mobile, enables access to patients’ records from anywhere clinicians need to be.
“I have seen doctors working back late, waiting on test results, but this means they can go home and still be involved in critical decision making for patient care.
“The mobile version is for phones and tablets. Tablets in particular are great — they can still be carried easily around in the hospital, yet the screen format is larger.”
Another aspect of mobile technology which has changed everyone’s life is being able to snap a photo, anywhere, anytime.
But this has caused problems for clinicians.
“I overheard a nurse talking about taking photos – using her phone – of an infected catheter wound,” Ian said.
“Due to the rapid increase in convenience and quality of phone photography, it has proved irresistible for clinicians to use this technology, even though it’s technically illegal.
“It’s illegal because the photo — and therefore someone else’s private information — is stored in your phone.
“So we thought about how we could add safe image capture to the convenience of having a miniature version of the old manila folder on your phone.
“And now, every aspect of patient care, including adding photos, is available on mobile devices, yet without any sensitive information being stored there.
“With our application, all information comes from or goes to servers, and from there it can be accessed by anyone in the system who needs it.
“Hospitals can use their own special legal caveats in the mobile app for their staff, for example providing information on whether patients gave consent for photos to be taken or if they were unconscious at the time.
“Once the ‘save’ button is touched, photos are sent to the server which then relays the data to storage locations of choice, inside the hospital, to research organisations etc, but they are never stored on the phone.
“We have added additional security layers for the context where clinicians are outside hospital wifi areas.
“There we have to make sure the system is doubly secure.”
Ian added that clinicians, “absolutely loved” the Verdi system.
“It hasn’t been easy, we’ve done it on a shoestring budget, but we are now looking for extended market opportunities, including internationally,” he said.
“We’re looking at strategic partnerships to enrich our application — for example with companies that might specialise in ordering systems and other workflow — and then those partners don’t have to worry about integration or mobile access to their systems, as that’s what we do.”
The imminent future for IP Health also includes a web-based version of Verdi, called V-Web.
IP Health is an APHA Major Sponsor.