This program has suddenly got itself into the news.
Yesterday we had this:
Health myki faces axe
Kate Hagan
January 24, 2011
THE state government is considering abandoning Victoria's trouble-plagued $360 million health technology program, with Health Minister David Davis admitting he faces ''a genuine dilemma with 'the myki of the health system' ''.
The HealthSMART program - five years late and $35 million over budget - is supposed to link computer systems in hospitals and introduce processes such as electronic prescribing.
But clinical applications are only partially running in just four hospitals, and doctors say patient safety is compromised by inadequate procedures that causes them to duplicate paperwork, chase test results and compete for access to computer terminals.
In a state budget submission, the Australian Medical Association has called for a further $328 million to be invested on health technology over the next four years, with a focus on providing ready access to patient records, test results and medication details.
AMA Victoria president Harry Hemley said health technology in Victoria bordered on the embarrassing, and ''patients would be appalled at the lack of IT, computers and connectivity between different areas of the health system''.
Mr Davis said the HealthSMART program, launched by the former Labor government in 2003, had been ''botched in its introduction'' and was tens of millions of dollars over budget without achieving its stated aims.
''The new government faces a genuine dilemma with the myki of the health system,'' he said. ''On the one side we have large sunk costs, and on the other a system that has failed to meet expectations.''
Mr Davis said technology was ''a critical part of improving the performance and quality of our health system'', and the AMA's submission would be considered as part of the budget process.
Dr Hemley said many promises had been made about HealthSMART's ability to revolutionise technology in hospitals, but the project had been bitterly disappointing despite hundreds of millions of dollars in investment.
''HealthSMART still has potential to deliver a vastly superior health IT system but it needs to be seen as an ongoing investment,'' he said.
More here:
http://www.theage.com.au/victoria/health-myki-faces-axe-20110123-1a17g.html
and here:
Health IT program Healthsmart faces the axe
- Jessica Craven
- From: Herald Sun
- January 24, 2011
THE future of a $360 million program designed to improve care in Victorian hospitals is under a cloud.
The Australian Medical Association has called for an additional $260 million to be invested in the botched HealthSMART program, which is five years late and $35 million over budget.
More here:
http://www.heraldsun.com.au/news/health-it-program-faces-the-axe/story-e6frf7jo-1225993351106
This was followed by these today:
System is sick, not dead
Dr Harry Hemley
January 25, 2011
FOR those unfamiliar with computer systems in Victoria's public hospitals, you would probably have to cast your mind back to the early 1990s to realise just how poor the information technology networks are in our supposedly world-class health program.
We're talking paper-based records, people queuing to use the available computer terminals and the difficulty sharing information with off-site colleagues. For patients in our public hospitals, the ramifications of poor IT systems are serious.
The problem starts from the time a person is treated in the emergency department and doctors and nurses aren't able to get access to the person's history of care with their general practitioner.
In the absence of a central health database that stores the history of patients' illnesses, treatments and medications, medical staff have to piece together this information from the patient's own memory in a process that requires trial and error.
On a good day, the patient will have a list of their medications and illnesses but typically their memory extends more to the colour of the tablet and a vague recollection that the name of the drug begins with an N.
Once the patient is admitted, staff on the wards have to queue to use a computer so they can access the patient's hospital records and diagnostic information. When staff are finally able to get on a computer, the system is slow and clunky and crashes all too common.
The lack of connectivity between different areas of the health system means medication lists, tests, scans and other diagnostic tools are often repeated. Health dollars and clinicians' time are wasted chasing results and duplicating services in an already stretched public hospital system.
The quality of care is compromised and patients are at increased risk of mistakes being made in their treatment, diagnosis and prescription of medication.
More here:
http://www.theage.com.au/opinion/politics/system-is-sick-not-dead-20110124-1a2y4.html
and this:
'Too late' to kill e-health program
Kate Hagan
January 25, 2011
THE state government should stick with Victoria's bungled $360 million health technology program because it was finally starting to deliver some benefits, an e-health expert has argued.
Mukesh Haikerwal, who is the federal government's clinical advisor on e-health, said the HealthSMART program had ''a long tortuous history'' but cost savings would not be made by ditching it, only to start again from scratch to build an electronic system to share patient information in hospitals.
The Age revealed yesterday that the state government was considering abandoning the program, which is five years late and $35 million over budget.
Health Minister David Davis said the new government faced ''a genuine dilemma with the myki of the health system''.
HealthSMART, originally due to be completed in 2007, replaced existing financial management systems in hospitals. It was also supposed to introduce clinical systems for electronic prescribing, ordering tests and reporting results to Victorian hospitals, but those programs are now partially running in just four hospitals.
More here:
http://www.theage.com.au/victoria/too-late-to-kill-ehealth-program-20110124-1a2w2.html
There is also coverage today in the AFR and a few other places.
For those that are interested I have been on this case for a while now:
See here:
http://aushealthit.blogspot.com/2010/06/despite-some-successes-healthsmart-in.html
and as far back as here:
http://aushealthit.blogspot.com/2008/04/healthsmart-pretty-bad-report-card.html
and here:
http://aushealthit.blogspot.com/2007/06/is-healthsmart-as-smart-as-it-claims.html
There are a few facts that need to be clear:
First the program is way behind time and over budget.
Second it seems that there has been pretty intense resistance to many clinical applications from the clinicians who are expected to use the software.
Third if the program is to continue as it is presently planned there are a few years to go before key clinical functionality will be universally available - and remember this was the key goal.
Fourth non HealthSMART initiatives like PACS have gone pretty well as have a range of administrative and basic operational systems.
The bottom line is that all this should not be thrown out - that would be nonsense. What is needed is a clinician focussed in-depth review to establish what is needed to obtain genuine clinician commitment to adoption and use of what is presently on offer for clinicians - with the live option of starting again - with another vendor - in this domain if the present vendor cannot demonstrate they can deliver what clinicians believe they actually need.
This review needs to be externally facilitated, independent and not controlled by the Program in any way. Clinicians need to know their needs are understood and will be answered.
Indeed they need to know they can veto the whole clinical program, by some reasonable democratic process, unless their legitimate needs are actually addressed.
If this is not done - and fast - the entire fiasco will collapse and lead to much increased cost and time wasting. Having come this far and spent this much it is vital that whatever is needed is done to sort out the area of the program where most of the benefits will ultimately flow from!
I note that even after 1 day it is clear this weeks poll is going to say that right now the Program is a total mess!
The national implications for e-Health also should not be ignored, as they are pretty substantial.
David.
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