Wednesday, November 24, 2010

SA Health Takes A Risky Path. A Recently Merged Company With Little Australian Experience.

The following press release appeared a few days ago.

http://www.prnewswire.com/news-releases/south-australias-public-health-system-selects-allscripts-as-vendor-of-choice-for-80-hospital-electronic-health-record-project-108659804.html

South Australia's Public Health System Selects Allscripts as Vendor of Choice for 80-Hospital Electronic Health Record Project

SA Health Cites Allscripts Success with International Healthcare Organizations

Sunrise™ Enterprise Implementation to Provide Foundation for Improved Quality, Efficiency of Care


CHICAGO and ADELAIDE, Australia, Nov. 17, 2010 /PRNewswire/ -- SA Health, the public health system of South Australia, today named Allscripts as the Vendor of Choice (VOC) for a strategic initiative to improve patient care, satisfaction and clinical workflow across its network of hospitals and health clinics. SA Health plans to deploy the Sunrise Enterprise™ 5.5 suite of advanced clinical, access management and financial solutions.

SA Health's 80 metropolitan and rural hospitals and numerous health clinics serve a population of 1.6 million in an area approximately 40 percent larger than Texas. The selection of Allscripts as VOC is part of the Government of South Australia's $300 million (AUD) initiative to implement an integrated Electronic Health Record (EHR) that will improve patient safety and the health system's efficiency by providing a single, secure, electronic patient record across all SA Health facilities.

Allscripts has been selected to provide the project's central hub, called the Enterprise Patient Administration System (EPAS), which will give healthcare professionals timely, secure access to a patient's vital information wherever and whenever they need it.

"We selected Allscripts to implement the foundation for South Australia's e-health record system because of their excellent track record delivering health information solutions for organizations around the world, including the Asia Pacific region," said SA Health's Chief Medical Officer, Professor Paddy Phillips. "Sunrise from Allscripts will help us improve clinical safety and efficiency by providing a single patient record across all of our facilities, as well as integrating all administrative, financial and clinical information for a standardized approach to care across all our health services."

Allscripts Chief Executive Officer Glen Tullman commented, "SA Health's decision to automate and connect over 80 hospitals demonstrates its commitment to provide world class health care to the people of South Australia. We look forward to finalizing this agreement, which will be one of Allscripts largest to date, and moving to rapid deployment."

An interdisciplinary team of SA Health physicians, nurses and senior management selected Allscripts as VOC after an exhaustive and highly competitive analysis of available health information technology solutions. The agreement between SA Health and Allscripts is subject to contract negotiations and final approval expected during the first half of 2011. Implementation is expected to begin in the second half of 2011.

The Sunrise Enterprise suite helps healthcare organizations save time, costs and lives by supporting best practices across the enterprise and the continuum of care on a single, integrated technology platform. As a result, the many individuals involved in a patient's care can share information seamlessly. Using integrated Sunrise solutions, information handoffs between providers, departments, shifts and facilities can be completed efficiently and accurately.

Along with the Sunrise Enterprise suite's advanced capabilities, SA Health also saw significant advantages in the Helios by Allscripts™ open architecture platform. Helios enables any healthcare organization to quickly and easily extend and integrate Allscripts solutions to communicate with other clinical, non-clinical and legacy information systems.

The Allscripts Sunrise Enterprise suite will replace more than 30 obsolete information systems and databases across SA Health.

More details on parties and links are here:

http://www.prnewswire.com/news-releases/south-australias-public-health-system-selects-allscripts-as-vendor-of-choice-for-80-hospital-electronic-health-record-project-108659804.html

The news was also covered here:

Allscripts picked for Southern Australia

19 Nov 2010

Southern Australia Health has named Allscripts as the Vendor of Choice (VOC) for a major project to upgrade clinical IT systems across the huge sparsely populated state.

Southern Australia Health now plans to deploy the Sunrise Enterprise 5.5 suite of advanced clinical, access management and financial solutions to its 80 metropolitan and rural hospitals and health clinics, which serve a population of 1.6m in an area approximately 40% larger than Texas.

The Allscripts Sunrise Enterprise suite will replace more than 30 obsolete information systems and databases across SA Health.

E-Health Insider understands that US Allscripts for was picked for the e-health project ahead of Cerner, Australia’s iSoft, and Intersystems Trak.

Full article here:

http://www.ehealtheurope.net/news/6436/allscripts_picked_for_southern_australia

The software being purchased and implemented originates from a company that used to be known as Eclyipsys and which was an entity that, as I recall, had a major focus on medical billing.

See here for merger news:

In depth analysis Allscripts Eclipsys healthcare merger, Goodbye Misys

By Amarendra Bhushanclose
Email: abdhiraj@gmail.com
Site:
http://ceoworld.biz/ceo/
About: A journalist, blogger and serial entrepreneur known for his work as Founder and CEO of ceoworld.biz and as editor of CEOWORLD Magazine
See Authors Posts (2178) for CEOWORLD Magazine Updated:June 9, 2010

Healthcare IT company Allscripts-Misys Healthcare Solutions said Wednesday that it will buy Eclipsys Corp. in a $1.3 billion all-stock deal. In another news, British software company Misys said it would cut its 55 percent stake in Allscripts health-care information business to about 10 percent and return more than $1 billion to investors.

Shareholders of Eclipsys, based in Atlanta, will receive 1.2 Allscripts-Misys Healthcare Solutions shares for each Eclipsys share as part of the merger, the companies said. Based on Allscripts’ share price yesterday, the transaction values Eclipsys at $22.10 a share, or about $1.3 billion

Details here:

http://ceoworld.biz/ceo/2010/06/09/in-depth-analysis-allscripts-eclipsys-healthcare-merger-goodbye-misys

The risks I see in all this are:

1. As far as I know there are no other installations of Sunrise Clinical Manager in Australia and as such there is major risk in getting the system to align to Australian information requirements and Australian work-practices.

I know from experience these are not easy issues to address as Cerner has already discovered! These are by no means trivial issues and require considerable effort to be got right.

2. The software being purchased has been under development for a decade and while that implies maturity one would want to be sure it is not already technologically obsolete. (I am told it is a mixture of .NET and Java code).

All we can do is wish them luck over there in SA and hope they don’t replicate the implementation approaches seen with HealthSmart and in NSW Health. The risks if the imposition of a ridged implementation model must be well understood by all by now!

David.

20 comments:

Paul Fitzgerald said...

Oh dear....I am thinking NSW Health in the 80's....perhaps NZ in the 90's - a strong sense of deja vu....Until this tender was looking reasonably positive, the whole Eclipsys Asia Pac operations were being run out of Houston. Good luck to them! They'll need it.
Paul.

Anonymous said...

Some challenges they may have:
Australian billing rules
Australian national reporting requirements
Australian drug data, including PBS item codes and the AMT
Electronic claiming to Medicare and private health insurances
Aboriginal rules for patient names/ identification/ aliases
Australian messaging specifications
Implementing the national provider and patient identifiers
Being a very small part of their market, and having no influence over the changes required to suit Australia.
Deja vu indeed!

Anonymous said...

In the last paragraph you probably mean wish rather that with.

Dr David More MB, PhD, FACHI said...

Indeed!

David.

Anonymous said...

I disagree.

David, you wrote at length some months ago about how the Cerner system was an ancient monolithic application that has proven inflexible and attrociously cumbersome for clinicians and nurses to use. Yet it has been selected and deployed across NSW Health and VIC Health, even though few in VIC Health have actually adopted it.

I don't think you're correct about Eclipsys' lack of experience in Australia. Sunrise Clinicals have been deployed in NSW and West Australia for years - it's just that in an agreement with ISoft some years ago, ISOFT agreed to take over sales and marketing (including rebadging) of Sunrise in this region.

I would applaud them for stepping in to the void when ISOFT is so obviously crumbling. Eclipsys is also doing a lot of work in Singapore so from a support persepctive, I think they're in quite a good position in SA. Sure, there's a lot for them to do but Sunrise is a much better platform than Cerner to do it on.

A really risky approach is what Queensland is doing right now. The most poorly kept secret in the industry is that they've already chosen Cerner for the statewide clinical system and are now shopping it around clinicians top-to-bottom of the state extolling it's virtues. They failed to have the imagination or diligence to even look at alternatives from overseas before taking the 'safe' approach of implementing an ancient technology.

Competition is always good.

Dr David More MB, PhD, FACHI said...

I see, can you just mention a few hospitals where this is the case that Sunrise is in place? I am always happy to learn!

While answering with a list you could also confirm you have no relationship with Allscripts / Eclipsys. Just so we are all clear who is coming from where!

David.

Paul Fitzgerald said...

To the best of my knowledge, WA is the only state with any sort of Sunrise presence - and that is a pretty old version, which iSOFT inherited (I think). The only other Eclipsys instal was the old Motorola Emtek ICU system at Westmead Kids - again inherited. iSOFT as far as I know never actually sold Sunrise anywhere in Australia. Certainly when I was working there a few years ago, everything was focused on Lorenzo...but that's another story! I do agree that Qld is heading into very risky territory with Cerner - and it will only go to the 20 largest hospitals. What about all the rest of the 200 odd hospitals? And of course, now that they are about to spend a further $209 MILLION on SAP to try to fix the payroll debacle, one has to wonder if clinical systems will be again delayed.

Anonymous said...

I think you will find that isoft sold Eclipsys modified and rebadged as iCM in the UK. Not sure if any were sold in Australia

Paul Fitzgerald said...

iCM may have been sold in the UK, but I don't believe it would be many sites - I think in fact that the Eclipsys deal was done at an AP level, but may be incorrect on that. I am also fairly sure that there was little modification to the original Sunrise product. Having said that, I think this conversation is about South Australia, and perhaps more broadly the Australian market and the relevance of Allscripts/Eclipsys in the local market.

Anonymous said...

You do have to ask - what is wrong with the existing system that they have in South Australia? Isn't it Oacis or something like that?

Dr David More MB, PhD, FACHI said...

The issue is that the security management with OACIS is less than perfect - to say the least. They could have fixed that or replaced I am told. They chose the second path.

David.

Geoff said...

So let's get this right. Rather than finding what would at worst be a "work around", and at best could be an update/upgrade to an existing, deployed, clinical platform that is demonstrably working in a cross-organisational way across the State delivering improved patient outcomes .... they've decided to remove it and replace with an aging legacy product that is untried and untested in this country?

Are we deliberately trying to go backwards...?

Dr David More MB, PhD, FACHI said...

That puts it well. The privacy / security holes could have been fixed but they chose another and as you say possibly more risky approach.

We will know in a year or two if it was smart or dumb I guess!

David.

Anonymous said...

David and Geoff you are incorrect. The iCM system that is in place in 13 hospitals in WA was previously the SCM System from Eclipsys.

Eclipsys has 10 years of experience in Australia and SCM is so much more configurable by the customer then anything Cerner offers.

Maybe you should go and visit Singapore where the model of health care is so similar to Australia and the Dr all train in either the UK or US and see the success they have had. NSW Health and QLD Helath have made very poor use of IT in comparison to Singapore Health.

Anonymous said...

What is missed in the article and what is a MAJOR risk to SA, is that SA has already achieved an excellent EHR, which integrates all the major metropolitan systems housing data for 75% of the population of SA.

This system has been in since 2002 and has been extended to incorporate all inpatient and outpatients data, emergency data, operating theatre data, radiology reports and images, pathology data, electronic orders electronic referrals, state wide discharge summary and many additional features.

It is in use by well over 6000 clinicians who have been very happy with it. They are currently making it available via IPAD.

So the situation is much worse than what you have described above. SA has a lot to lose.

Anonymous said...

David your comments re the Oacis security are uninformed and inaccruate. There is serious effort to manage security, more serious than most systems

Dr David More MB, PhD, FACHI said...

So Oacis now has full role-based token secured security and the other attributes of a proper privacy aware system with full individual user audit trails and exception reporting - with segregation of results like HIV testing and so on from IMVS.

That was not the case when I last chatted to people in SA but if it is now true - great!

David.

Anonymous said...

It would be good if at some point people focused on the features and functionlaity required by clinicians to help them care for patients and stopped using security and privacy issues as excuses for the very poor adoption of IT that should have assisted with documenting treatment and tracking patient care. To all the MD's out there please, keep using paper, its great, it has the following features:
a)single point of access
b)single point of failure
c)little if any security
d)absolutely No audit trail
e)lots of clerical staff to find it for you
f) lots of pieces of paper missing in it (In clinic - where is that %^&%^& discharge summary???)

BUT it's got to be much better than any computer system. If only, I know lets scan it all in thats got to be a better solution...Oh forgot research, damn ok lets hirer lots of people to read the paper work and transcribe... what??? sorry (sigh) was that a patient safety issue???

Anonymous said...

12/166, 21 December 2012

DELAY IN COMPLETION OF THE EPAS DESIGN AND BUILD PHASE

The Enterprise Patient Administration System (EPAS) Program is one of the largest South Australian health care reforms ever undertaken in terms of its scale and impact.

The new EPAS system consists of several modules – Clinical Manager, Records Manager, Registration, Patient Flow, Scheduling, Patient Administration and Billing.

On Thursday 20 December 2012, the EPAS Program Board received notification from the vendor Allscripts, that there will be a delay in the delivery of some critical elements of the Billing Module. These elements are required to ensure the system is suitable for Australian financial needs, such as processing Medicare and Health Fund Claims.

While all of the remaining modules for EPAS have been designed and tested, all elements of the Billing Module are required to be completed for end to end acceptance testing to ensure the new system operates as it should prior to ‘Go Live’ at the first site.

As a result of this notification, the EPAS Program’s Design and Build phase will now be delayed for a minimum of two months, while the EPAS Program Office undertakes a risk assessment on Allscripts’ proposed timeframes to deliver the final elements of the Billing module.

Consequently a new Site Activation Schedule with updated Go Live dates for each hospital and health care site will be released in January 2013.

The EPAS Program Board is committed to ensuring that the Noarlunga Hospital, Noarlunga GP Plus Super Clinic, and the Repatriation General Hospital will remain the first sites to go live with EPAS.

For more information, please visit the EPAS Intranet site.


DAVID SWAN
Chief Executive

Anonymous said...

http://www.itnews.com.au/News/391183,sa-health-confirms-legal-spat-with-allscripts.aspx?eid=1&edate=20140820&utm_source=20140820_AM&utm_medium=newsletter&utm_campaign=daily_newsletter