Wednesday, July 15, 2015

It Looks Like The Issues Surrounding EPAS at The New Royal Adelaide Hospital Continue To Cause Concern.

These appeared last week. First this…

New Royal Adelaide Hospital faces a dud IT system, surgeons say

  • July 02, 2015 9:29PM
THE troubled $422 million IT system that is meant to run the new Royal Adelaide Hospital is “disastrous”, according to surgeons who have rejected State Government assurances that all is well.
The usually conservative Royal Australasian College of Surgeons has warned it could not guarantee patient safety under the planned system because of problems that include doctors being prevented from prescribing essential medicines.
SA Health’s planned Enterprise Patient Administration System (EPAS) was supposed to be introduced to hospitals across the state but is now in just three, including the Repatriation General Hospital – where medical staff have officially complained to Health Minister Jack Snelling because it is compromising patient safety.
The new RAH has been designed to operate solely with EPAS and there is no space for a paper-based records system.
This week, Auditor-General Andrew Richardson said the long-delayed IT system, which has blown out in cost, faces more blowouts. SA Health chief executive David Swan responded with assurances that EPAS would be operational in time for next year’s opening of the new RAH.
However, the Royal Australasian College of Surgeons said there was “still a long way to go” before they would trust EPAS. College SA chair Dr Sonja Latzel said the feedback she had received on EPAS was not positive. She added: “Mr Swan’s comments contradict what surgeons are telling us.
More here:
Then this very detailed and interesting article:

eHealth delays threaten new Royal Adelaide Hospital

Friday, July 3, 2015 - 11:02
Promised as a flagbearer for the brave new world of eHealth when it opens in April 2016, the $1.85 billion new Royal Adelaide Hospital (nRAH) will instead have to cope with a “hybrid” environment including paper records and workflow due to delays in a decade long program to implement a state-wide electronic health record.
Promoted as Australia's most advanced hospital, the nRAH is also facing supply chain issues due to SA Health’s a failure to complete a long running rollout of Oracle, initially commenced in 2010.
A report from the South Australian Auditor General handed to the Parliament this week says a 10 year, S214 million program commenced in 2007 to deliver a state-wide Enterprise Patient Administration System (EPAS) had “ambitious timeframes and an under estimation and lack of detailed understanding of the effort required. In particular, the underestimation of effort required to implement EPAS at a major hospital site.
“Although Audit has noted a number of improvements to the EPAS Program, challenges still
remain, including ensuring system readiness for the nRAH by 17 January 2016 for SOC
testing and commercial acceptance on 17 April 2016.”
All ICT for the nRAH systems must have testing completed prior to 17 January 2016, ready for State Operational Commissioning (SOC) involving testing of all new hospital operations ready for commercial acceptance.
In 2007, the state’s Department of Health (now Department for Health and Ageing) awarded a contract to Allscripts Healthcare Solutions Inc. (Allscripts) for the EPAS solution.
Initially scheduled for completion in mid-2014, this deadline has not been met and SA Health is due to report to Parliament in coming weeks on when this can be expected. Intended to be deployed state-wide by 2014, it has reportedly been successfully installed at just three hospitals.
While it was initially scheduled to be rolled out to the existing RAH in mid-2014, a decision has been made to not go ahead with this, although this has not yet been approved by Cabinet.
Lots more here:
You can read the full audit online HERE
What to say? It really looks like the SA Government has put all its money on red and if the EPAS project and all the associated integration does not work they will be major loosers.
Another project to keep a very close eye on.


Terry Hannan said...

David, I have commented elsewhere (Pulse +IT) on this SA project. Apart from not being a clinically directed system from the outset they have failed to understand/comprehend that ehealth implementations REQUIRE 'e' + paper for an extended period of time. The Marc Overhage posted quote, "your hospital will be paperless when your toilet is paperless" is appropriate and is founded in the realities documented by Lucien Leape in Leape LL, Berwick DM. Five years after To Err Is Human: what have we learned? JAMA. 2005;293(19):2384-90. Epub 2005/05/19.
eHealth is NOT just IT. It involves social and cultural change on a very conservative and culturally ingrained profession-doctors (clinicians).
As the song says "when will they ever learn?"

Anonymous said...


when will they ever learn - when such projects stop being supply side/IT driven. That requires a fundamental acknowledgement that there is both a supply and demand side aspect - ehealth to date has been driven by IT and the consulting fraternity.

The healthcare sector, medicos, clinicians should stop complaining to some extent they are getting the systems they deserve- as there is very little acknowledgement of the demand side aspects - and i don't mean change management which historically is about managing the pain of the IT implementation.