Wednesday, February 16, 2011

I Wonder What This Says About the Australian E-Health System Providers?

A major contract for the Australian Defence Force’s e-Health was announce a few days ago.

Software group provides healthier outlook for military

Published on Thu Feb 10 12:59:30 GMT 2011

HEALTHCARE software group EMIS has won a major contract to monitor and help improve the health of Australia’s armed forces.

The Leeds-based group, founded by two North Yorkshire GPs in 1987, yesterday revealed it has been appointed by global technology giant CSC to supply a new electronic health information system for the Australian Defence Force (ADF).

Under a five-year contract, CSC Australia use EMIS’s clinical software to deliver a health records system covering all personnel in the ADF, called the Joint e-Health Data and Information (JeHDI) system.

The new system, which will be based on EMIS’s clinical software – will create a detailed electronic health record for each ADF serviceman and woman, featuring data from recruitment to discharge.

EMIS, originally called Egton Medical Information Systems, said JeDHI will support better and more efficient healthcare, and also allow the ADF to map health trends across its three armed forces.

EMIS chief executive Sean Riddell said: “As well as being the UK market leader in primary care systems, EMIS is also highly experienced at providing military healthcare solutions and our systems are already widely deployed across the world.

“This prestigious contract further extends EMIS’ international reach and reinforces our credentials as a world-class provider of e-health information systems.

“We are delighted to partner with CSC Australia on this project and look forward to working together to make a positive difference to the care of thousands of Australian servicemen and women around the globe.”

More here:

It is hard to understand just why a system from the UK would be selected for the ADF.

While I have no problem with EMIS being selected but the fact does rather beg the question about what is going on locally that this gap cannot be filled by an Australian developed system.

It would be interesting to read the evaluation report and to know which Australian providers submitted a tender.



Anonymous said...

"It is hard to understand just why a system from the UK would be selected for the ADF".

I don't get your drift. The ADF application is quite small by comparison with the Victorian or NSW Health systems. Even so, how is the ADF decision any different from the USAs Cerner product being selected for HealthSmart and NSW Health?

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

Well EMIS is just a Primary Care System - a good one I know - but we do have a few of our own!


Anonymous said...

Hi David, there's no such thing as "just" a primary care system these days...there is a great amount of customisation that happens over and above basic clinical note taking and prescribing to make software fit for purpose in the Australian context, just as is the case in NZ, Canada, the NHS and even in the quagmire that is the US. Yes, most of this is to do with billing/claiming which could be stripped out in an ADF context one imagines, but why to even go to this amount of effort when a big consulting firm will always out gun you in the proposal stage?

Australian clinical software vendors have more than enough to get on with without worrying about chasing unicorns.

And is the ADF really going to take a 10, 20 or 100 man outfit seriously, even if these are the sized businesses that are behind the software running the entire primary care sector in Australia? The turkeys defending us can't even keep 3 landing vessels in operation, submarines out of dry dock nor purchase a decent aeroplane with a pocket full of blank cheques.

What chance do they have of understanding e-health purchasing? Much easier to pick CSC and defer the responsibility to someone else - even if no one seems to know what CSC has done in Australia to deserve its reputation as a go-to partner.

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

I see this contract as being company transforming given the size for an Australian System. For EMIS with their 40%+ of the UK market - just a nice addon.

We don't seem to do much these days except dig stuff up!


Anonymous said...

You could be right - do you know when the tender came out or who put their hat in the ring?

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

Nope - secret as usual in this very sad situation we find in e-Health.


Anonymous said...

"no one seems to know what CSC has done in Australia to deserve its reputation as a go-to partner"

Interesting comment. Does anyone know? They were not on the scene 2 years ago and now they seem to be everywhere, running the show, despite from memory, a less than rosy outcome from their NHS contract.

Anonymous said...

And throw in Delloite while we're putting the big consultancy groups under the microscope.

The E-health Strategy may have been a reasonable document (in late 2008), but that was basically a re-write of the contributions of folks with real expertise, including everyone's favourite blogger I'm led to believe. Any journalism student could have done such work under these parameters, particularly if you paid them 30K per published page.

"Give me your watch and I'll tell you the time" as they say.

Does this report (despite ultimately being unpalatable and effectively shelved the minute it was released) qualify them to hang around NEHTA like a bad smell? Can someone define their ongoing role in e-health?

Anonymous said...

"We don't seem to do much these days except dig stuff up!"

Well, writing and marketing software is hard work for 'making money' right? Compare it to:

- Natural Resource extraction
- Speculation on Markets (Property is a Aussie favourite)
- Importing stuff from overseas and selling it

You can probably think of others. Unfortunately, we are becoming a nation of and being run by 'Transaction Managers' (glorified street traders, Corporate Cowboys and sporting 'heroes'. Its probably more desirable to be an accountant now, compared to those hey-days of Computer Wiz Kids and '2 guys in garage' entrepreneurs. Think what are the role models of success these days? Also what do you expect when our political leaders are imitating the success of Sarah Palin/Tea Party political culture? (Yes, they are doing it, because it works, eventually...)

Anonymous said...

Just a wild guess... but since EMIS is used by the UK Ministry of Defence, defence specific domain experience may well have had some trifling bearing on its selection.

"Sean Riddell, chief executive of EMIS Group, said: “As well as being the UK market-leader in primary care systems, EMIS is also highly experienced at providing military healthcare solutions and our systems are already widely deployed across the world."

Anonymous said...

The decision to select CSC (and hence EMIS) is not surprising given Defence's approach to tendering. Like other Defence RFTs, it was only the big end of town that was likely to be considered. That immediately gets it down to CSC, EDS, IBM, Fujitsu and the like. Then add the fact these multinationals pay lip service to supporting Australian SMEs but actually do very little to support them and you get EMIS!

The real scandal of this tender is that Defence (well you and me actually) is spending $56 million on a health record system for a relative handful of clinicians and just 70,000 patients (40,000 initially) - the patient population of a couple of large GP clinics!

Anonymous said...

I wonder if the Defense Department will continue this trend in the future of outsourcing, particularly overseas, and just employ Mercenaries instead of Australian Citizen Soldiers?

Think of the benefits, no Aussies at risk! No EMIS would even be needed!

Just a cheeky thought! (I hope!?)

Anonymous said...

The unofficial, official, reason for EMIS is in fact a military interoperability matter. Our diggers get treated by US forces in Afghanistan; the Yanks use a NATO EHR PAS system, The Brits use the NATO system via EMIS; ergo the decision was based on this premise. Why CSC is the better question? Happily though PILS IS a component part of JEHDI and PILS is true blue Ozzie built IP.

Anonymous said...

CSC claims to be the world's largest health systems integrator. One can only assume those credentials have something to do with being chosen. Accenture and Fujitsu's high profile exit of the NHS probably worked against them here, and as one of the comments above suggests there are only a few companies that could have gone for this work. As long as CSC makes use of this international expertise then lets not over analyse this.

I'm more interested in how this will link to the PCEHR. I've seen in some of the media reports on this that the JeHDI work has involved discussions with DOHA/NEHTA. Lets hope something actually happens here so that this doesn't become yet another siloed repository.

Anonymous said...

"PILS is true blue Ozzie". What is PILS? Who is behind it?

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

It is an Australian Medication Management System used by Defence to cover all their staff. Has been very successful and really has made a difference I am told for Defence.


Anonymous said...

Went to a talk at HL7 WP meeting about JeHDI, and heard that Australian defense force medicine is now largely outsourced, so the bigger question is, how do they get the information out of vanilla PMS into JeHDI, and they have not decided on a secure message delivery vendor yet, so there is another cost.

Mozman said...

Looking into this further, it is apparent that one of the premises of updating the JeHDI EHR is use of NASH, IHI and SMD from NeTHA. Look at the document listed below section 27.2
This is definitely a long term project then.