This appeared last week:
NSW Health goes to market for statewide single digital health record
By Justin Hendry on Oct 9, 2020 12:35PM
Cloud-based system to replace fragmented clinical IT environment.
NSW Health has approached the market for a single digital patient record (SDPR) to replace the state’s fragmented lineup of core clinical and laboratory information management systems.
More than a year after revealing plans for the future electronic medical record, the department’s digital arm, eHealth NSW, on Thursday opened bids for the planned state-wide system.
The SDPR is slated to replace the state’s existing electronic medical record (EMR), patient administration system (PAS) and laboratory information systems (LIMS) with a modular cloud-based solution by the end of 2026.
There are currently nine different core EMR instances provided by Cerner and Orion Health and multiple PAS instances provided by Cerner and DXC across the state’s local health districts, which has led to fragmentation and high support costs.
NSW Health Pathology similarly suffers from a “complex and fragmented” IT environment, with a number of different LIMS systems from Cerner, Citadel (Auslab) and Integrated Software Solutions (OmniLab) in use.
“NSW Health is seeking to move from the current, fragmented EMR, PAS and LIMS environments to a single domain environment via a staged rationalisation,” expression of interest documents state.
“The SDPR initiative will deliver greater consistency, accuracy and availability of holistic medical information at the point of care.”
NSW Health said the SDPR will “drive the modernisation and transformation” of its core systems to “support the vision for a sustainable, digitally enabled public health system that is patient-centred and integrated”.
It pointed to the COVID-19 pandemic, which has “demonstrated the benefits offered by modern, integrated digital health technologies; and how they can be harnessed to deliver positive patient outcomes”.
“SDPR will utilise contemporary approaches to operational management, solution governance and interoperability to deliver significant, comprehensive capability enhancements across the state,” EOI documents state.
NSW Health said the SPDR will give clinicians “real-time, increased access to holistic, detailed medicare information at the point of care” that will ultimately drive improved health outcomes for patients.
Key features for the record include integration with medical devices such as ECG and other patient monitoring devices, a unique identifier for patient identification and patient information portals.
A full software-as-a-service (SaaS) approach will be adopted for the solution in line with the government’s recently announced ‘public cloud by default’ approach for all digital infrastructure.
More here:
At this stage we have an Expression Of Interest that is closing in November.
Unless I am confused this will be a huge tender basically to migrate the various EMR. PAS and Lab systems in NSW to one of each type, integrate them into a coherent whole, migrate them to the cloud and then have the whole lot delivered as a SaaS solution for use in the whole of NSW, by an outsourcing/ed entity. And all this is to happen by 2026!
I have to say it is hard to imagine all this happening in 5-6 years even with a major division of labor between work on “software environments”, implementation and hosting!
Also I am wondering just which vendors would be able to deliver across the whole functional scope of this plan. AFAIK there is no-one in Australia who could do it, so we are left with the Epics and Cerners of the world.
I have to say I am a little sceptical of the whole plan, despite some obvious advantages.
What do others think?
David.
6 comments:
I seem to recall that in the late 1980's NSW Health issued a statewide tender for 3 core (one-size-fits-all) systems resulting in the selection of Gerber-Alley for PAS, Cerner for LIMS, and Oracle for Financials. Gerber-Alley withdrew from Australia two years later. Now, approx. 30 years later, a statewide refresh and replacement EOI is underway, for PAS, LIMS, a SDPR (Single Digital Patient Record), a Clinical Information Exchange, Artificial Intelligence and Cloud-based SAAS delivery.
This looks like a decade long 'upgrade / replacement' for NSW Health. Will the incumbents hold the fort or will they be displaced by EPIC or some other US-based vendors.
@Oct14 10.33pm
Good recall but one small mistake in that the systems selected were for the larger Area Health Services (remember those?) were complemented with a regional solution for the smaller hospitals. The GA solution also was intended to provide basic clinical systems but I don't think they were ever implemented anywhere. The Cerner and Oracle systems were reasonably successful as I recall.
Eventually Cerner took the PAS / Clinicals role as we see today in the big hospitals but it took a long time!
David.
Getting stuff into the cloud will be straightforward, there are no shortage of tools and methods. The challenge is going to be customisation vs configuration. This will hit them with legacy and future.
Another challenge is availability. Cloud solutions have many centralised points of failure. A distributed solution with functionality close to the users is far more resilient.
It depends on what your priority is - cost saving or the safety of patients.
Just look at what happened to Coles supermarkets recently. They only lost money. Healthcare systems can lose lives and injure people.
Will the envisaged SDPR really eliminate fragmentation across the NSW Health system?
Where in the world can we see some compelling examples of a Clinical Information Exchange working?
All just part of NSW drive towards cloud. What the really have is a virtual private cloud, so not much different to current data centre hosting. Sounds flash but the solution will be simply moving to vendors ‘cloud’ architected applications, out with the old .net in with the new web based. A lot of dancing but not much to sing about I am afraid.
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