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Quotes Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"


H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Thursday, May 10, 2018

It Seems EMR Systems Are Getting Really Expensive – I Wonder Why So Much?

This appeared last week:

Vic government to spend $124 million on digital patient records

EMR system to cover four health services
Rohan Pearce (Computerworld) 01 May, 2018 12:32
Victoria’s 2018-19 budget will earmark $124 million for the rollout of electronic medical records at three health services, the state government revealed today.
The Victorian government said that the EMR rollout at the Peter MacCallum Cancer Centre, Melbourne Health and Royal Women’s Hospital will see the records linked to the currently operating EMR system at the Royal Children’s Hospital.
The rollout will reduce avoidable errors and duplications as well as help patients receive faster care, the government said. Once implemented, the measure is estimated to save  $34.1 million a year.
Over a 12 month period the EMR system at the Royal Children’s Hospital cut prescribing and administration errors by 27 per cent the government said, boosted the immunisation rates of children in hospital by 4 per cent, and reduced by more than 6700 and 2400 respectively the number of pathology tests and medical imaging examinations.
More here:
There is also coverage here:

Vic govt commits $124m to e-health records

By Justin Hendry on May 1, 2018 10:12AM

Three hospitals receive budget windfall.

The Victorian government has set aside $124 million to bring digital health records to three major Melbourne hospitals.
Minister for Health Jill Hennessy and Special Minister of State Gavin Jennings announced the funding ahead of today’s state budget.
The funding will deliver electronic medical records (EMR) to three health services in Melbourne's Parkville Precinct: the Peter MacCallum Cancer Centre, Melbourne Health and the Royal Women’s Hospital.
It will bring “all of Parkville’s major hospitals onto one system”, giving clinicians access to “a patient’s complete and up-to-date medical record … wherever in the precinct they receive their treatment”, the government said.
The three hospitals will also be linked with an e-health records system already running at the Royal Children’s Hospital, which is provided by US health software vendor Epic and was partially funded with $48 million by the government in 2014.
The government expects the new e-health records system will save $34.1 million each year by providing clinicians with the real-time information “needed to provide the very best care, every step of the way”.
“It means faster care, as doctors will no longer wait for paper records and test results to wind their way through the system, from one department to the next,” it said.
“And fewer unnecessary, duplicated tests, less frustration and waiting for the patient who just wants a diagnosis and a treatment that works.”
More here:
One would imagine this is an extension of the Epic deal with the Royal Children’s Hospital who are physically located nearby.
It all seems sensible other than what seems to be a pretty large cost to me.
Does anyone have any suggestions as to why so expensive?


Anonymous said...

Maybe because they always announce how much they have to spend first, rather than creating competition, basing decisions on the best solution.

Bernard Robertson-Dunn said...

Maybe because it isn't a simple matter of installing and configuring the software.

And this is a bold promise: "'a patient’s complete and up-to-date medical record … wherever in the precinct they receive their treatment', the government said."

A friend of mine is in a rehab hospital and the nurses are amazingly slack about recording data. When giving drugs, one nurse managed to put two different times down for when meds were given. One in the patient record, one in the medicines record.

On one occasion the patient's blood pressure was 88/50. They took it again shortly after and it was 101/70 so the nurse recorded the second but not the first. The patient went off for rehab and nearly fainted.

On another occasion, the nurse took the patient's blood pressure and said - do you want me to record it lower than it was, so you don't have to go to rehab?

You won't get "a patient’s complete and up-to-date medical record" just by installing an eMR. The risk is the staff will believe the computer, just because it's in the computer.

You know, one of those risks ADHA won't be mentioning on its website.

Anonymous said...

The planning is universally undertaken by the vendors to ensure projects are expensive. We seem to pay for whole cohorts of external resources who role it is to generate revenue from us tax payers through change. Our governments do not staff the projects with skilled teams to ensure change is managed and costs are kept low.

Anonymous said...

Agree Bernard it is more than just flicking a few lights on. What we should ask is why these always end up costing 3-4 times the original costing when the project was funded quite handsomely from the start