Tuesday, March 29, 2016

Dear Oh Dear! There Seems To Be Angst Regarding The SA EPAS Program.

This appeared a few days ago:

No end in sight for loathed electronic record system

18 March 2016
SA HEALTH is ploughing ahead with a much-maligned platform for electronic records that has been blamed for inducing “rage attacks” in clinicians.
Doctors remain concerned that the $422 million Electronic Patient Administration System (EPAS) remains user-unfriendly, despite assurances that bugs have been ironed out.
“The EPAS system will continue to evolve and improve over time and SA Health remains committed to working closely with our clinicians’ support (for) the roll out of EPAS”, SA Health told Medical Observer in a statement.
The Flinders and Far North Doctors Association (FFNDA) wrote to the department in January arguing that the system should be overhauled or junked.
“We would like to remind you again that the overwhelming majority of us work primarily as general practitioners, working in private practices,  that use electronic records 100% of the time,” the letter said. 
“We have for years embraced electronic medical records and their expected efficiencies. EPAS has been extremely disappointing in not delivering these efficiencies as would be expected of a contemporary program.
“Therefore, we ask again – please take EPAS away and completely remodel it into a more user-friendly, efficient and safe interface. Or, if that is not possible please replace EPAS with something much better.”
Earlier, in 2014, the group advised the department that the system caused “rage attacks” among clinicians and some doctors were refusing to work with it.
EPAS has been on trial for more than two years at Port Augusta hospital using consultants from Adelaide and the local GP workforce. 
“It had many teething problems that drove clinicians completely mad,” Dr Peter Rieschbieth, a vice president of the SA Rural Doctors Association tells MO.
“This was relayed to us because rural doctors are contracted to work in hospitals required to work with EPAS.”
The GP says he has not heard one clinician back up the department’s claim that the bugs have been ironed out.
However, senior doctors were reportedly giving their passwords to junior doctors or students, asking them to input data on their behalf.  
“Across the board, clinicians have been saying it’s not user-friendly, it takes much longer to use. Fewer patients are seen at outpatients, fewer patients are being operated on, because you spend so much time on it.” 
More angst outlined here:
What to say? While I am sure there are two sides to this story, at least to some degree, it is clear things are simply not working out with this implementation.
It would be good to see some Government commentary on just where this project is up to and just how the new Royal Adelaide Hospital is going to be provided with working and clinically acceptable IT - along with relevant plans for all the other large hospitals which seem also to now be all that happy.
It’s about time the Minister hopped out of his apparent state of denial and sorted all this out.
David.

3 comments:

Anonymous said...

I don’t know much about the situation in South Australia, but what I learned from being involved in the EMR implementations in New South Wales is that senior clinicians (doctors) don’t like changing their practices, because they have worked out ways to become very efficient over many years, often by getting other people to do much of the work for them – e.g. placing orders. Then a system comes along like Cerner, Epic or Allscripts, and suddenly they need to enter this data themselves, and they need to record notes themselves, immediately. They don’t like this change, and I can totally understand why. There is no doubt these systems impact on the efficiency of senior doctors in particular. That doesn’t mean there are no benefits of course. Information about the patient is available through the whole hospital to all, so the patient certainly benefits for one.
Compounding the problem, anyone who is working in health for any length of time understands that the press delight in negative stories about hospital boards and/or computer systems, and are not interested in good news stories – but that doesn’t mean there aren’t any. In New South Wales we had the bizarre situation of an “expert” academic stirring up trouble whilst busy building his own system. The press I am sure were aware of this, but it did not matter to them so long as there was a negative story to be had.
The good news for South Australia is that people do eventually get used to these new systems and new processes and the noise dies away.

Anonymous said...

1:39 PM .... The good news (for South Australia) is that people do eventually get used to these new systems and new processes and the noise dies away.

Perhaps that will be the case for the government's My Health Record-MHR system; .... perhaps.

Anonymous said...

It's when the patient dies that people will sit up and take notice.