We examined the activity (services recorded) and cost (benefits paid) of reimbursement associated with telepsychiatry services in the Australian public health-care sector. We reviewed the activity and costs administered through the government's Medicare Benefits Schedule (MBS) from July 2002 to June 2011. During this nine-year-period, almost 14 million psychiatric consultations were funded through Medicare at a cost of $1.6 billion. Of these, 8003 were telepsychiatry consultations which cost $934,000, i.e. the video consultations subgroup represented 0.06% of all psychiatric consultations provided and 0.06% of the total cost to the government for these services. Despite telepsychiatry being a widely reported and successful example of telehealth internationally, the uptake of telepsychiatry in Australia has been slow.

Convergence towards a viable universal solution for our electronic health records is not imminent and trust in e-health is fragile. Policies that data custodians follow need to be flexible and updated on a regular basis. Technological solutions are at best a stop gap to avoid the common hazards associated with access control and secure messaging. A wider range of analysis techniques to determine the key issues for a dependable health information system can derive longer term sustainable solutions.

We carried out a six month scoping study to ascertain current health service needs in the Queensland towns of Dalby, Chinchilla and Miles. The towns have a high proportion of their populations in the dependent age groups of over 65 years of age and less than 14 years of age. This implies a need for ready access to paediatric and geriatric specialist services. The hospitals in the three towns provided a range of health services, but patients still had to be referred to Toowoomba and Brisbane for specialist consultations. All three hospitals had videoconference facilities, but videoconferencing was mainly used for education, administration and training. General practitioners in the three towns did not use telehealth in their practice. The study reinforced the potential for telehealth services in three key domains: regional hospitals, residential aged-care facilities and general practice.

Health Information Systems (HIS) are being implemented in all aspects of healthcare; from administration to clinical decision support systems. Usability testing is an important aspect of any HIS implementation with much done to deliver highly usable systems. However, evidence shows that having a highly usable system is not enough. Acceptance by the clinician users is critical to ensure that the HIS implemented is used fully and correctly. A longitudinal case study of the implementation of the Community Health Information Management Enterprise System (CHIME) in NSW is used to illustrate the importance of ensuring clinician acceptance of a HIS. A mixed methods approach was used that drew on both qualitative and quantitative research methods. The implementation of CHIME was followed from the early preimplementation stage to the post implementation stage. The usability of CHIME was tested using expert heuristic evaluation and a usability test with clinician users. Clinician acceptance of CHIME was determined using the Technology Acceptance Model (TAM). The clinician users were drawn from different community health service departments with distinctly different attitudes to information and communication technology (ICT) in healthcare. The results of this research identified that a successful implementation of a HIS is not a measure of its quality, capability and usability, but is influenced by the user's acceptance of the HIS.

There is growing recognition among many healthcare researchers that a human-centered approach to the design and evaluation of health information systems is vital for the success of such systems in healthcare. In this paper, we survey the work of two human-centered research communities that have been active in the area of health information systems research but that have not been adequately discussed in past comparative reviews. They are cognitive systems engineering and usability. We briefly consider the origins and contributions of the two research communities and then discuss the similarities and differences between them on several topics relevant to health information systems. Our objective is to clarify the distinction between the two communities and to help future researchers make more informed decisions about the approaches and methods that will meet their needs.