Melbourne Health Breast Cancer goes live with RUTH II from iCIMS

Melbourne Health – Breast Cancer Service

Melbourne Health has upgraded its Clinical & Research information management system used by the shared Breast Cancer service of The Royal Melbourne and The Royal Women’s Hospitals. The new system, installed by Innovative Clinical Information Management Systems (iCIMS) is also designed to allow easy access from other institutions within the Parkville precinct.

The iCIMS system (RUTH II) is a full Clinical Information System (CIS) which enables the two hospitals to track the patient journey, manage the Multidisciplinary Team Meetings and transparently share patient information.

iCIMS RUTH II for Royal Melbourne Hospital

iCIMS used its advanced technology to enable a concept it calls Immediate Adaptability to very quickly prototype a system tailored specifically to the needs, workflows and outcomes required by the two hospitals.

One facet of Immediate Adaptability that sets iCIMS developed systems apart is the speed of user-driven system design changes. This speed, in turn, allows iCIMS to deploy a unique installation model; once the initial handover is completed, the client has three months to request system design changes without additional cost.  The result is a highly tailored, fit for purpose solution that has overwhelmingly high user buy-in from senior clinicians, nurses, data administration and ancillary services.

Professor Bruce Mann –   Director of Breast Tumour Stream, Victorian Comprehensive Cancer Centre (VCCC) has seen the effects of iCIMS’ Immediate Adaptability within his team; the MDM team has been very impressed that changes suggested during the MDM one week had been implemented and operational the following week.

As an example of the immediacy of changes, with the RUTH II system, there were 98 design changes requested by the clinical users as a result of them using the system in a live environment in the first three months. Of those changes, 93 have been delivered already with an average turnaround time of 3 days without any system downtime.

As well as the core functionality, the system has additional modules that produce:

  • End of treatment summaries and outcomes
  • A survivorship component
  • Breast audit data exports

RUTH II has been designed to be fully expandable into other tumour streams and other sites within the Parkville precinct and is already remotely accessible from the Peter MacCallum Cancer Centre (PMCC).

iCIMS Welcomes James Dwyer to the Advisory Board

James Dwyer

James Dwyer

iCIMS is pleased to have James Dwyer accept a position on the company’s Advisory Board.

James has been involved in the health and social care industry in Australia and the UK for the last 15 years.

He was formerly the General Manager of EMIS Health in Australia and New Zealand and is also a director of Pineshield Health and Social Care Services in the UK which he founded in 2001.

With a background in financial management in IT and Telecoms since the late 1980’s, James brings strong finance skills as well as personal experience in starting up and growing a successful health and social care organisation.

iCIMS Founder and CEO said that he was very pleased to have James join and believed the experience James has in both Health and Finance would be invaluable as iCIMS moves from start-up mode to a full commercial footing.

iCIMS Announces Formation of Advisory Board

iCIMS and HLA today are excited to announce the formation of a joint Advisory Board, which includes highly experienced executives from the Health and IT sectors, and the Government.

The board members are: Professor David G. Penington AO, John DeBrincat, and Denis Tebbutt. Their brief biographies can be viewed on our website.

Professor Jon Patrick, CEO and founder of iCIMS and HLA said, “To ensure that we continue to focus on developing leading edge health technology solutions, providing exceptional service to our clients, and expanding our footprint into various regions, requires guidance and mentoring by a team of experts who are not involved in the day-to-day business activities.

We are privileged to have David, John and Denis agree to join our advisory board which brings us an unparalleled wealth of experience and vision.”

The iCIMS solutions have been designed to allow clinicians to use highly modifiable and flexible Clinical User Interfaces (CUIs) which increase staff efficiency and patient safety, by implementing detailed but highly adaptable clinical workflows with a strong agile method.

The HLA system provides a unique facility to search, extract and code clinical notes, pathology & radiology reports and other medical texts using a highly efficient natural language processing engine designed for the medical profession.

Announcement: iCIMS-Charm Health Alliance

Charm Health, Australia’s leading provider of specialist oncology eHealth systems, and Innovative Clinical Information Management Systems (iCIMS), developer of a new generation of technology that produces tailored information systems for clinical teams, have announced a strategic alliance to leverage the core strengths of both companies to provide advanced functionality to support the delivery of quality comprehensive oncology services.

Charm Health and iCIMS will collaborate on the creation of transparent interoperability between their systems; CHARM and Patient-Centred Tumour Stream Suite (PTSS). The two organisations will work together to enhance data collection for multi-disciplinary team meetings with a focus on improving the workflows and data collection for individual tumour streams in preparing, conducting and recording outcomes specific to each stream.

Charm Health will also take advantage of iCIMS’s strong capabilities in the design and commissioning of research systems, registries and translational data warehouses. Transparent interoperability between CHARM and PTSS will provide the capability to pass critical data onto research systems and registers connected by iCIMS’ patented native interoperability methodology.

Gary Lakin, CEO of Charm Health, commented, “We are excited by the potential of this alliance to deliver significant benefit to our clients – enhancing the data collection, research and reporting capabilities of our existing solution while providing very customisable solutions to meet the needs of various tumour streams.”

“We are delighted to form this alliance with Charm Health.” said Professor Jon Patrick, CEO of iCIMS. “We look forward to working together to further develop advanced capabilities that enables oncology teams to deliver real value to the patient journey, and add improvements to the delivery of CHARM’s chemotherapy information to the translational researchers working with their medical oncology and surgical colleagues”, commented Patrick.

Download the media release as a PDF.

APAMI 2014 Keynote Presentation Plenary Paper

Conference: APAMI 2014, Day 4, Scientific Programme
Date: Sunday, 02 November 2014, 08:30 – 08:50 (14:00 – 14:20 Sydney time)
Venue: Stein Auditorium, India Habitat Centre, New Delhi, India
Session Name: Clinical Workflow and Human Factors

IT as the Controlling Influence in a hospital department

Jon Patrick PhD MSc, BSc, Dip LS, Grad Dip BHPsych
iCIMS, Sydney Australia


An investigation into methods to improve the design and implementation of clinical information systems (CIS) was conducted by using a process of Clinical Team Led Design (CTLD). The process of clinicians studying their own workflow processes demonstrated the extent to which clinical work is controlled by the IT implemented in a department. The ability to break out of the straightjacket created by the IT can only be attained when the design of the IT itself can be manipulated by the staff and altered as required by their needs.

It is demonstrated that Best-of-Breed clinical information systems developed under the principle of CTLD creates more efficiencies in the workplace than enterprise EMR systems (EEMR).

An important aspect of clinical care is the need to change workflows and operating procedures as the environment around the work changes either due to new professional practices or shifting regulatory and administrative requirements. Hence, an ability to perform Continuous Process Improvement (CPI) is fundamental to the good practices of a clinical team. Rigid EEMR systems that are slow and highly expensive to change are a significant sea anchor in the pursuit of CPI and frustrate staff to the limit of their patience.

A technology has been created that supports a methodology for creating user designs with an incremental iterative feedback process. In this technology, an underlying software engineering architecture, we denote as Emergent Clinical Information Systems (ECIS), automatically compiles the run-time code directly from the user designs, hence no programming is required to move from design to implementation. The ECIS architecture is defined on the principle of Ockham’s Razor of Design, that is, the elements of design that are engineered for the designer are a minimum number of design objects with maximal generalisation. The CIS design is created by a principle of Agile Design where designs are created and tested incrementally within an iterative process.

With this functionality, the capacity to make near real-time adaptation of an implementation is made available, giving enormous power to the design team to explore alternative designs before commissioning a specific implementation. At the same time, the underlying data management for all CISs built in the ECIS paradigm is the same, and hence it has the unification of the code base and data stores in a single application. In essence, it is a Best-of-Breed solution on the user side and an enterprise system on the server side.

The ECIS model with real-time changeability, native interoperability to move data to where it has to be used, and in-built analytics to monitor the effect of change represents a much superior approach to providing effective methods for CPI in any clinical setting. As a technology, it is ideally suited to the creation of a CIS for any clinical specialty.

A local clinical team at Nepean Hospital, Sydney, Australia, designed a CIS for their hospital emergency department, denoted the Nepean Emergency Department Information Management System (NEDIMS) using the ECIS approach and compared it to the EEMR incumbent system in the department.

A process analysis for each of the 6 activity centres in the ED described staff roles of: Clerking, Triage, CIN (Clinical Initiatives Nurse), Fast Track, Acute Care, and Nurse Unit Manager (NUM). The process analysis formed the basis of understanding the design needs of the department. It was also used subsequently to identify the task types that needed to be used in the quantitative comparison between the two systems. A total of 43 task types were identified of which 27 were present in the EEMR system, 40 were present in NEDIMS and 14 were completed on paper.

The department staff were observed for 22 days where each task instance was measured for time duration and number of mouse clicks in live usage on the EEMR and paper forms. A total of 722 task instances were recorded from 43 task types. Subsequently, 374 matched observations of 17 task types were measured for those tasks that could be repeated in NEDIMS of which 332 were matched task instances between NEDIMS and the EEMR, the remainder being matched to paper forms.

The final analysis showed that NEDIMS was 40% more efficient and had 30% less cognitive load than the incumbent EEMR system. Modelling of staff work for an average patient load of 165 patients per 24 hours indicated the staff would save an average time of 23.9 hours per day using NEDIMS.