This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
Wednesday, August 29, 2012
More Of The Ugly Truth Seems To Have Leaked Out About HealthSMART. It Was Not Run Well!
The following appeared a few days ago.
HealthSMART system cavalier: Vic auditor
August 21, 2012 2:18PM
THE proposal for Victoria's abandoned $500 million e-health system was cavalier and more of a concept than a properly developed business case, a senior bureaucrat says.
The HealthSMART rollout began in 2003, costed at $360 million under the previous state Labor government, but is fully operational at just four health services across Victoria.
The coalition government scrapped it last May after $500 million had already been spent.
Victorian Auditor-General's Office performance audit director Paul O'Connor said the HealthSMART business case lacked implementation detail.
"I would say it was more of a concept brief rather than a fully written business case in terms of how we are going to implement this," Mr O'Connor told a Victorian parliamentary inquiry into the delivery of major infrastructure projects on Tuesday.
"One of the problems that has occurred in Victoria is that some business cases with very large amounts of money have been quote cavalier perhaps in the way they've been constructed but they've received large amounts of funds and seemingly very little oversight.
DELUDED, lazy bureaucrats in Victoria don't give ministers the advice they need, and large projects are retrofitted to match political announcements, the state's auditor-general says.
Auditor-General Des Pearson and his colleague Paul O'Connor delivered a scathing assessment of the relationship between the public service and the government in giving evidence to a parliamentary inquiry into infrastructure projects.
They argued no effective mechanisms were in place to stop hundreds of millions of taxpayers' dollars being tipped into dodgy rail and road projects.
Dr Pearson said government agencies were too reliant on external advice and often accept it without scrutiny.
Departmental staff often base their advice around what has been announced by a minister and don't take other alternatives into consideration.
''Often, when we're talking to departmental staff, they are sort of saying 'oh, the government announced' and they're using that as what I call a get-out-of-jail card not to provide frank and fearless advice,'' he told the Public Accounts and Estimates Committee.
VICTORIA'S abandoned multi-million-dollar e-health system implemented in just a handful of hospitals was overly ambitious and has not improved patient safety, an inquiry has been told.
The HealthSMART rollout began in 2003, costed at $360 million, under the previous state Labor government, but is fully operational at just four health services across Victoria, including Melbourne's Royal Eye and Ear Hospital.
Hospital chief executive Ann Clark said it would have been better to have different information technology systems to suit individual hospitals but develop a set of common rules so information could be shared.
She said the hospital faced significant complexities integrating HealthSMART with its outsourced pathology system.
Some quotes from the actual testimony of the Auditor General are just wonderful.
“Finally, I thought some contextual considerations were relevant, and again I pose a few questions there. Is adequate benchmarking and baseline data available to underpin the various projects we embark on? The next one is: are we punishing ourselves for cost overruns and not adequately managing expectations? There I relate — and we refer in our written submission — to the research by Professor Bent Flyvbjerg in 2009. Just to refresh your memory, he researched worldwide project outcomes and found for construction project budgets between 10 million and 150 million euros, the norm was a 50 per cent overrun and in IT projects it was up to 500 per cent on the target projects. In quoting that I am not saying it is all right to overrun, but it is a recognition that we are not alone in experiencing this problem. In my reading of his research, there are lessons to be learnt there of key lead indicators and issues to be addressed up-front in what I would call purposeful management.”
“I am very interested in Dr Flyvbjerg’s research, which you have referenced in your submission. It is quite frightening when you read that this is not just a Victorian phenomena, it is an international phenomena in terms of public sectors’ inability to deliver projects on budget and on time. I am particularly interested in what your views are of some of the propositions that have been adopted in other jurisdictions, specifically having peer-reviewed business cases or costings of projects, like they do in the UK with the National Audit Office. I also note Dr Flyvbjerg’s suggestion that there should be strong penalties, including criminal sanctions perhaps, for those who underforecast the cost of projects. And finally, I would be interested in your general comments around cultural change. What is it? Is it optimism bias? Is it that we have built the wrong political incentives and therefore that leads to the wrong bureaucratic incentives? What, culturally, do you think, would signify the greatest circuit break and give us more legitimate grounds for what you describe as purposeful management?”