Vic rethinks e-health

By: Karen Dearne

VICTORIA is ruling a line under its patchy HealthSmart IT rollout, and has returned to the drawing board with plans for a new whole-of-health ICT strategy for the period 2009-2013.

When the now-$427 million program began in 2003, it was hoped that the ICT refresh and rebuild across the state's public hospitals, rural alliances and community health providers would be complete within four years.

But in April this year, Victoria's auditor-general Des Pearson said HealthSmart had been overly ambitious in its targets, and was at least two years behind schedule.

More than half of the original budget had been spent with only 24 per cent of the planned installations complete.

The audit office found that HealthSmart had failed to get the cornerstone Cerner clinical system working at any of its sites, and had replaced only one of 10 HOMER hospital systems which were obsolete when the program began.

Mr Pearson said the project judged most at risk, but with the greatest potential benefit, was Cerner's Millennium suite of e-health records, appointments scheduling, diagnostic services, results reporting and e-prescribing applications.

A $79 million deal with Cerner was signed in March 2006, but costs had risen by $17 million to $96 million in 2006 - the biggest price blowout so far, the audit office found.

"According to the original timelines, the acute hospitals in 10 health agencies should be using the clinical sysytems by now, but even if funding negotiations are concluded shortly, the first four agencies are unlikely to meet the June 2009 completion date," Mr Pearson said.

The department and the Office of Health Information Systems _ which has led the project _ have weathered repeated criticisms over technical and vendor aspects, including contract probity concerns raised in the state parliament.

It's also understood many of the state's health boards have raised concerns over the selection of systems and the likely cost to agencies of adopting the strategy.

Human Services secretary Fran Thorn defended the program at the recent Health-e-Nation conference in Melbourne(September 3), saying the first implementation of the Cerner suite would "formally commence" in October.

"Engagement with the next round of health services is underway in anticipation of rolling out to agencies over the next two years," she said.

HealthSmart was also rocked by early concerns over vendor iSoft's financial status and ability to deliver its next-generation software architecture, Lorenzo, as promised.

IBA Health Group bought out iSoft, and has taken over its contracts to supply the existing integrated patient and client management system, iPatient Manager.

To date, four agencies have implemented iPM, Ms Thorn said, and nine standalone health services are now using the client management system, TrakCare.

"Eight health services and 22 community health services will have these systems by this time next year," she said. "The integrated products support the management of patients across acute and community services, rather that just sharing data."

Last month, the Victorian Government allocated a further $104 million for HealthSmart in its 2008-09 budget.

Ms Thorn said HealthSmart would give the state ``one of the most up-to-date and capable health ICT infrastructures in Australia, ready for the future and able to adapt'' to a changing environment.

``Indeed, HealthConnect Victoria is leveraging off the investment in infrastructure and applications,'' she said.

``In partnership with our federal colleagues, a Shared Electronic Health Record project has been established to prototype a limited SEHR system across a number of public hospitals, primary and community care providers in the Bendigo Loddon/Mallee region.''

This project has received more than $1.5 million in federal funding, from October 2007 until June 2009.