Tuesday, July 29, 2014

It Looks Like South Australia Has Caught The Very Problematic Hospital IT Roll Out Disease. What A Disappointment.

This appeared a few days ago:

Minister puts future of $422m SA eHealth system in doubt

Paris Cowan

EPAS still on hold.

South Australian Health Minister Jack Snelling has refused to commit to the continuation of the state’s $422 million electronic patient administration system (EPAS) rollout, which is currently on hold as the government works through funding and performance issues.
“We are having a look at it at the moment,” Snelling said, when challenged by opposition MP Duncan McFetridge to guarantee the rollout during an estimates hearing late last week.
“We have obviously put a pause on the rollout, which has partly been driven as a result of the federal cuts."
The SA Government paused a cluster of capital works programs within the health portfolio in response to a fall in revenue from the Commonwealth Budget.
But the halt on EPAS work has also come as the result of user headaches plaguing the implementation.
“It was sensible also, for the moment, to pause on EPAS while we have a bit of a rethink about it,” Snelling said.
The opposition raised anecdotal evidence of ambulance service dashboards displaying no data for months, and of doctors who have to click through up to 40 screens to admit a patient.
McFetridge claimed 300 medication errors in one hospital were made by the system in its first few weeks, with staff forced to return to paper until the system was able to operate safely.
“There is no arguing that we have had difficulties with the patient administration side, in particular with the billing module. They are things that are being rectified by Allscripts, which is the provider of the software,” Snelling said.
More here:
In September last year all seemed to be going OK.
See here:
However there had been some rumbles earlier in the same year:
But the SA Health CIO had come out, again in September last year, saying all was OK:
See here:
It seems now that wheels are looking a little rickety!
The oldie of a US Billing system not working in Australia seems to have also popped up. Those of us who have been around for a while have seen all this before - as we have also seen the other issues raised.
Sadly SA seems to be joining Victoria, Queensland and WA in having Hospital IT problems. I wonder is NSW going as well as its brochures and web-sites claim?
David.

6 comments:

Anonymous said...

This bodes well for other overpriced US hospital software programs ... like the Children's in Melbourne (EPIC - $48m+) and The Mater Brisbane, more EPIC and all those hugely cost-effective Cerner implementations ...

Anonymous said...

The supplier says we have implemented our system in many hospitals/regions and it’s very adaptable to the clients needs. What they mean is: we don't use standards and we don't know why you do the things you do; we have the system so flexible that we need to re-invent the metaphorical "wheel" every time and that means poor design; more mistakes; more time wasted, more money wasted.

~~~~ Tim C

Anonymous said...

US they may be but let's face it what are the options for a large (mega) hospital system: EPIC, CERNER, ALL SCRIPTS, TRAK.

They all sell off the shelf - we'll tailor to your needs and charge accordingly.

Our bureaucrats gave away the opportunity to develop in Australia for Australia and beyond many years ago. Just like the car manufacturers - going, going, gone. And what of ship building / submarines, almost going, maybe going.

We don't invest in nurturing and building advanced technology skills in Australia - it's our culture you know - we're convict stock - not good enough - poor self image, down trodden. Get something from overseas and increase the national deficit.

Anonymous said...

It does depend on what is meant by ADMIT A PATIENT - however it seems inconceivable that doctors would have to click through up to 40 (FORTY) screens to ADMIT a patient.

Surely ONE or TWO screens would capture all the basic demographic details which presumably would be entered by ?? clerical staff ?? or maybe the interns are also the clerical staff.

The opposition raised anecdotal evidence of doctors who have to click through up to 40 screens to admit a patient.

Clerking a patient, ordering investigations (pathology, imaging, etc), prescribing medications, completing a referral (social worker, physio,chaplain, etc), scheduling the patient for theatre surely cannot require 40 screens.

CONCLUSION - the dills who ordered the system were conned by slick sales demonstrators. HUBRIS reigned supreme with everyone seduced by the excitement of the moment - we are leading the way with the biggest and the greatest, money is no object, there is nothing better around, we know we've looked, as for IMPLEMENTATION, DEPLOYMENT, PROJECT MANAGEMENT - don't you worry about that - that's our responsibility said the vendor - we know how to do it - you just sit back and enjoy the ride. Same old story, year after year, and guess what ----- same old outcomes.

Anonymous said...

"The oldie of a US Billing system not working in Australia seems to have also popped up."

Don't worry, if the current government gets its way, a US health billing system might just fit!

Anonymous said...

From day one it looked to be a problem. Google of Allscripts just after they won the EPAS tender revealed a company which had only just formed from two different software suppliers in the US Health System. Each supplied different packages prior to the merge and the dream was the merged company would be able to do a complete electronic hospital package. The evidence even then was rumours of dysfunctional management in Allscripts and a dissatisfied workforce with high staff turnover.

The reality of EPAS has been extreme cost blowouts, clunky technology and unfulfilled promises. The EPAS Program is a meld of at least 26 earlier programs, stitched together with code - the result is an unwieldy mess; different pages have different functionality, menus are dissimilar, limks are unclear.....
Many existing documents have not been catered for online, so hard copies are completed, scanned in and are then almost impossible to retrieve due to poor labelling and search functions.
Medical staff were promised automatic checking of drug doses as they typed, but it turns out the checks are only for a limited number of drugs and it is still quite easy to order a totally inappropriate (potentially lethal)dose of an inappropriate drug.
Every location where it has been rolled out has experienced significant difficulties and a noticeable reduction in productivity.

If EPAS is to survive in SA it will need a major rewrite; and can you imaging THAT cost blowout?