Google CEO coughs up Australia Health plans

By: Liam Tung

Google CEO Eric Schmidt said yesterday he hopes to deliver Google Health to Australia by the end of the year -- but local representatives say discussions haven't even started yet.

Australia's various state-based e-health record initiatives could be set for a shake up this year if Schmidt's plans for Google Health in Australia are realised.

Yesterday the Google head acknowledged tough regulatory hurdles would need to be overcome first, but said he hoped to bring the service to Australia by the end of the year.

Google CEO Schmidt (right) talks up health plans Credit: Builder AU

"Because of the way health regulations work, we have to roll out Google Health on a per country basis. And so we would hope to bring it to here later this year, subject to us meeting regulatory requirements," Schmidt said.

Google Health was announced in the US last month and aims to allow patients to access medical records such as X-rays, CAT scans and other health data over the Internet.

The service, though not yet fully implemented in the US, will aggregate over 200 separate repositories of health records into one online portal through Google Health.

The system stores all the health records of a patient and enables users to import records from different health provider systems, as well as search for doctors and get information on conditions from Google Scholar, discussion groups, and other sources.

In Australia, similar initiatives have been undertaken by some state health departments.

One such initiative was announced by the South Australian Health Department earlier this month, with the launch of an online health record service although access to the system is limited to healthcare professionals.

Likely partners to Google Health in the US are Walgreen, Aetna, Wal-Mart Stores, the University of California at San Francisco, the American Heart Association amongst others. However, in Australia it's too early to say which organisations will partner with Google for a similar service, a Google Australia spokesperson said.

"We're going to focus on getting it right in the US. And then we need to do all the due diligence to ensure it complies with all Australian requirements," the spokesperson told ZDNet.com.au.

Schmidt may have even jumped the gun by announcing Google's health plans for Australia yesterday, according to the spokesperson.

"It's fair to say that discussions haven't started yet in Australia," the spokesperson said.

Melbourne leads AU$10m Victorian e-health rollout

By: Suzanne Tindal

Two community health agencies servicing the western suburbs of Melbourne and Bendigo have implemented Intersystem's Web-based TrakCare healthcare information system, the first deployments in a AU$10 million rollout across a number of Victorian health agencies.

In a first for Victorian community health, TrakCare will allow patient information to be captured within a single electronic medical record, allowing patients to only register once for most services including general practice, mental health, physiotherapy and occupational therapy.

Previously, the health centre had a "large number of systems," according to Clare Amies, CEO of Western Region Health Centre -- which has 13 different sites around inner and outer Melbourne -- making it necessary to repeatedly enter patient information into the various systems and databases for each site.

In addition to the reduction of duplicate entry of data, the system also allows the centre to better coordinate patient's appointments, according to Amies.

This has lead to significant cost savings, for example, by having appointment information in a single location. This has allowed the health centre to book interpreters over many appointments, instead of booking them individually for each one -- which often occurred while using the previous manual system. The change allows the health centre to avoid paying the minimum tariff of one and a half hours work for only one sitting.

The TrakCare system also allows the healthcare centres to create reports about referrals within and outside the organisation. The reports can aid in identifying when a patient can't be referred to a specialist service within the centre, such as when waiting lists are too long, for example, and where else they can be referred to externally.

TrakCare also helps identify in the meantime what other services are available that could be of use to patients on waiting lists, Amies said. For example, a diabetic wanting to see a booked-out dietician could have access to a diet educator, who might be giving a seminar in a clinic or who could point the patient to other relevant resources.

The allocation of resources will now receive a leg up from TrakCare's information, according to Amies. "We now have tangible data to take to the Department of Human Services -- we've been live for a year and we're just starting to collect some really good information," she said, allowing the health centre to "respond to the needs of the community and plan better".

The system has been built to adhere to privacy legislation, a spokesperson for the Department of Human Services said, adding: "There are processes in place to make sure privacy is upheld."

Patients are able elect whether or not to make their data available across the different sites and services, Amies said. "Sometimes people don't consent to everybody and sundry reading their notes," she said, but added: "Not many elect out. Most people are happy that it's secure in that people can't access it unless they're authorised."

Ten other health agencies are currently implementing TrakCare and intend to go live between now and the end of 2008. Another 12 agencies have entered into an expression of interest stage which should see them implement TrakCare by the end of 2009.

Implementing TrakCare is part of the Victorian government's AU$360 million HealthSMART program.

Blacktown Hospital test blood-and-guts proof PCs

By: Suzanne Tindal

Blacktown Hospital has run a trial of a tablet PC designed specifically for the healthcare industry — even blood and guts won't slow it down.

The Motion C5 in action
(Credit: Motion Computing)

Technically-savvy Blacktown hospital has invested a lot in its IT infrastructure — the whole hospital is wireless, including the back-end. Having introduced electronic medical records years ago, the hospital says it's always on the lookout for better ways for medical staff to record patient information on the go.

The Motion Computing C5 tablet — designed together with Intel for the health industry and available in Australia from late last year — is the latest system the hospital has trialled over three months earlier this year. The device is completely sealed, meaning a spill of urine, blood or just tea will not cause it to collapse or cross-infect other patients — it can even be wiped down with disinfectant.

The health professionals in the hospital needed to benchmark the new tablets against the running system: computers on wheels, nicknamed COWs, and their smaller brethren — calves.

The clinicians took to the Motion C5, according to Professor Steven Boyages, chief executive for Sydney West Area Health Service, with the greatest advantage being the mobility, such as being able to sit on the bed with the patient while holding the device.

The tablets' portability, however, does have one negative aspect: "The downside with these devices is they will walk," Boyages said.

The hospital has been working with Intel on answers to the problem, including using a proximity device with RFID technology built into it to deactivate the tablet when it moves out of a specified zone. Another solution is for clinicians to each have their own device and take personal responsibility for it.

A drawback to the tablet per clinician solution is the price tag, which sits around AU$3,000. "That's the other disadvantage at the moment," Boyages said, although he added that he thought the price would come down with time.

The Motion C5 also has an RFID reader and digital camera built in, although neither were tested in the trial, because the hospital doesn't have RFID or barcoding set up and its electronic medical records cannot currently store images.

However, Boyages believes these features will be very useful in the future: the RFID scanner can make sure the right drug finds its way to the right patient once the drugs and patients are tagged while the camera can measure information difficult to capture in words, such as the "size of an ulcer, the state of a wound".

Boyages sees the camera being particularly useful for community nurses who visit patients previously seen by a different nurse. In this case, to ascertain if a wound is getting better, the nurse usually asks the patient, and in typical Australian fashion, they'll often say "Yeah, I think it's better". A less subjective method of finding out how the injury is going is by looking at an image from the previous session.

The next step, according to Boyages, is to use the device in a new testing centre which is set to be opened, where the problems flagged in the trial can be ironed out.

Patients won't suddenly see all Blacktown hospital medical staff sporting the devices in the future, Boyages says, adding that technology often reaches past what enterprise systems can do, and changes need to be made before the technology can work properly in the hospital.

Flying doctors spend $2.7m on bush health records

By: Suzanne Tindal

The Royal Flying Doctor Service (RFDS) has entered into a five-year AU$2.7m contract with IBA Health to create a standardised system for its electronic health records.

(Credit: Royal Flying Doctor Service)

The new system will help the Service's health professionals with its 12,000 annual clinical appointments across regional Australia.

Clinicians will be able to remotely access a patient's medical history, including allergies, immunisation records and current medications, via the internet-based system, and update the information during check-ups.

In time, it is hoped the system will also be accessible in aircraft. The RFDS Queensland operations are already using Telstra Next G to achieve this.

Some areas the RFDS visits don't have internet access. For these places, the RFDS will work together with IBA to develop a customised system which will allow "briefcasing" of medical records — taking files that are needed on laptops and synchronising them with the system when the clinician again has an internet connection.

(Credit: Royal Flying Doctor Service)

Ideally, the files will be briefcased from a central location, according to Gary Oldman, RFDS acting national ICT manager, but it depends on the amount of bandwidth required by the application. The Service has a server room in Sydney which could be considered as the central location, however, he said nothing has been finalised.

To have a network on which the system can run, the RFDS has to link together its separate Wide Area Networks. The Service has four areas of operations: South East (NSW, Tasmania, Victoria), Queensland, Central, (South Australia and Northern Territory) and West (Western Australia). The Service has received a draft proposal from Telstra, which is looking to connect the regions via extranet.

The national network will form the backbone for other things, according to Oldman. "Once we've got an infrastructure, we can run other national programs: a national HR system; a national finance system; a national intranet."

The IBA contract includes the licence for the software, implementation, customisation, support and maintenance. Implementation work will start in July and continue to June 2009. Once the new system is in place, the old Service records will be migrated, Oldman said.

(Credit: Royal Flying Doctor Service)

The Service chose IBA Health because it had the bells and whistles but would also speak to other internal and external systems including State hospital, pathology and X-ray records, according to RFDS national health program manager Robert Williams.

"There are various products out there. However, the IBA iSoft product had the most functionality and met NEHTA standards," he said.

NEHTA is responsible for unifying medical records across the nation.

IBA picks up $3.5m NZ work

By: Liam Tung

ASX-listed e-health vendor IBA Health has secured AU$3.5 million worth of contract extensions with three New Zealand district health boards through its subsidiary iSOFT.

Waikato, Lakes and Tairawhiti District Health Boards (DHB) have separately signed deals to extend contracts with the e-health vendor for its i.Patient Manager and HealthViews software, according to a statement to the ASX today.

Waikato's three-year extension covers its use of i.Patient Manager software, installed at several of the district's hospitals in April 2007. The deal was signed following iSoft's agreement to add functionality to the current system, according to IBA Health.

Meanwhile, Lakes and Tairawhiti DHBs have signed five-year deals following joint reviews of existing iSoft systems at the boards' hospitals. Waikato's implementation will be a template for future system improvements at Lakes' and Tairawhiti's hospitals.

"The solid relationship with Waikato, Lakes and Tairawhiti, gives all parties the certainty and confidence to agree to long-term commitments and us the ability to offer favourable commercial terms," Gary Cohen, IBA Health's CEO and chairman said in a statement.

NEHTA appoints new CEO

By: Suzanne Tindal

The National E-Health Transition Authority has nicked a top technology executive from the National Australia Bank to be its new chief executive.

Peter Fleming will take the reins at the nation's peak e-health agency on 29 September, relieving acting chief executive Andrew Howard, who has been seconded from Victoria's Human Services Department for the past few months, where he was CIO. He will be returning to that role after he has conducted an extensive handover, according to a NEHTA spokesperson.

Fleming is currently general manager technology, business integration with NAB. He has also held a CIO position with both Mayne Group and Colonial Group.

NEHTA's previous long-standing CEO, Ian Reinecke, quit the group in early April this year.

The appointment of a new CEO followed that in July of a new chair, David Gonski, who said the board was looking forward to working with Fleming.

Also in July, NEHTA held the first meeting of its Stakeholder Reference Forum which aimed to improve the organisation's engagement with key stakeholders, including state health agencies, the Department of Health and Aging and several other clinician stakeholder groups and consumer representatives.

The Forum was set up in part as a response to a review by the Boston Consulting Group published last year.

Members of the forum signed a non-disclosure agreement which bound them from talking about specific topics, however some information was released.

The major priorities agreed upon at the first meeting were the development of an e-health business case for consideration by the Council of Australian Governments meeting in October this year, as well as devising a five-year plan.

The first major e-health implementations the group wanted NEHTA to focus on were developing systems for electronic discharge summaries, pathology reports, specialist referrals and medication management.

Liam Tung contributed to this article

Objective tops Tower for SA Health deal

By: Liam Tung

ASX-listed software company Objective has won a new electronic document and records management (EDRMS) contract with SA Health, leaving rival firm, Hewlett-Packard-owned Tower Software, eating its dust.

"Objective will deliver an enterprise-wide EDRMS to underpin SA Health's key business processes, improve business efficiencies and assist with legislative compliance," the vendor said in a statement today.

The system currently in use by SA Health currently consists of a range of databases housed on various local systems. Under the new system to be implemented by Objective in the coming months, users will access a centralised records database via a Web page.

"Objective Corporation has been selected from across the government EDRMS Panel after a rigorous evaluation process. It was determined that Objective's electronic content management solution offered the greatest capacity to meet the SA Health's current and future needs for records and document management," John O'Connor, executive director of SA Health's finance and administration said in a statement.

Objective CEO, Tony Walls

The roll out of systems and new business rules for records will occur in three stages, first targeting paper records, followed later by a replacement of the agency's electronic records system. The system will initially be rolled out to 800 staff at SA Health's central office, followed by the remainder of staff at other offices.

Two document and records management vendors competed for the work, according to a spokesperson for Objective. It is understood the other competitor for the work was incumbent records management system provider, HP-owned Tower Software. SA Health's panel of approved EDRMS suppliers consists only of Objective and Tower. The panel is set to be reviewed in 2009.

The value of the deal has not been disclosed.

Qld launches 'Tiny Tom' telepaediatric healthcare

By: Alex Serpo

The University of Queensland's Centre for Online Health (COH) and Royal Children's Hospital in Brisbane have launched a joint paediatric service for remote communities using an in-house developed videoconferencing system called "Tiny Tom".

COH deputy director, Dr Anthony Smith said the new service linked clinicians at Mackay Base Hospital by video with the neonatal intensive care unit at The Townsville Hospital.

"What this service essentially does is act as a bridge — it connects the babies and the parents ... but it also connects the Mackay clinicians with the specialists in Townsville, improving collaboration and communication in the care of babies," he told ZDNet.com.au.

Excellent close-up video images of baby "Rihanna" are shared real-time via video-conference.

COH researcher Nigel Armfield said the system was constructed from various components including a Sony video-conferencing unit, a battery, UPS and some remote management equipment.

"In hardware terms it's not rocket science, it's off-the-shelf things that have been put together to make a useful product," Armfield said. Tiny Tom includes remote control systems for diagnostics and testing, along with switching the system on and off.

Dr Smith said that together with the additional access to specialists, Tiny Tom also provides economic benefits. "In two of our sites we were able to demonstrate savings of about AU$600,000", he said.

Mining giant Xstrata has provided AU$335,000 over the past three years to the COH via the Royal Children's Hospital Foundation for the project.

The funding has allowed the COH to extend its "telepaediatric" service into a number of regional areas, including Townsville and Mackay for neonatal care; Gympie and Nambour Hospital for general paediatric support; and Mount Isa and Emerald Hospitals for specialist paediatric support.

Along with the expansion of the service, Dr Smith predicted telemedicine would become increasingly commonplace.

"I think our aim here is to do this type of work in a systematic way. Our focus is on developing these models which we suspect will not only be used for other paediatric centres, but also for other areas [including] geriatrics," he said.

Launch of the "Tiny Tom" mobile telepaediatric system in the Neonatal Intensive Care Unit at Townsville Hospital (27 June, 2008).

Vic HealthSmart IT chief quits

By: Karen Dearne

THE director of Victoria's $427 million HealthSmart IT rollout, Fiona Wilson, has resigned from the Office of Health Information Systems for personal reasons.

"Ms Wilson will be relocating to be closer to her partner in Auckland, and I can confirm she will be leaving the Department of Human Services towards the end of October," a DHS spokesman said.

"For quite a while now, Fiona has been travelling across the Tasman to do her work here, and also continue her relationship with her partner in New Zealand."

The spokesman said there had been no decision made on an interim or permanent replacement for Ms Wilson but her departure was a big loss to the organisation.

"She has been a big driver in health ICT reform, and she has been critical to all the achievements to date," he said.

Ms Wilson was appointed to lead the OHIS when it was established in mid-2003 to manage the department's HealthSmart program - a four-year $323 million ICT refresh and rebuild across the state's public health hospitals, rural alliances and community-based health providers.

The project was originally due for completion in 2007. It remains unclear when the project would be completely rolled out.

Meanwhile the first implementation of the long-awaited Cerner clinical system "will formally commence" next month, Victorian Human Services secretary Fran Thorn recently told the Health-e-Nation conference in Melbourne.

Cerner's Millennium suite provides e-health records, appointments scheduling, diagnostic services, results reporting and e-prescribing applications.

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

Last month, the Victorian Government allocated a further $104 million for the HealthSmart program in its budget for 2008-2009.

At the same time, the Human Services Department began consultations over a new whole-of-health ICT strategy for 2009-2013.

Meanwhile, Andrew Howard, who has been acting chief executive of the National E-Health Transition Authority, is set to return to the DHS following the appointment of Peter Fleming as NEHTA's CEO.

Mr Howard is the department's chief information officer.

Private e-scrips to launch

By: Karen Dearne

PHARMACIST Paul Naismith is taking a punt on launching a privately-owned electronic prescribing project, ahead of the release of a KPMG review on options being considered by the federal Government.

Mr Naismith, chief executive of pharmacy IT supplier Fred Health, said improving "basic safety" by reducing medication errors was too important to delay.

Fred Health and the newly established eRX Script Exchange are wholly owned subsidiaries of PCA Nu Systems, in turn controlled by parties associated with the Pharmacy Guild.

A Health Department spokeswoman said a range of approaches to e-prescribing were being explored, and the private proposal supported by the Pharmacy Guild "had been looked at". "The KPMG report is being considered as part of broader activities in progressing e-prescribing within Australia," she said.

Fred Health plans to deliver a nationwide e-prescribing transaction hub - eRX Script Exchange - by 2009, in partnership with NZ software developer Simpl and Microsoft Australia.

A similar initiative, ScriptX, foundered in July when the GP software maker Health Communication Network pulled out.

But Mr Naismith said pharmacists could not go on putting patients at risk when technology existed to prevent errors.

"We don't have problems reading doctors' handwriting now because scripts are mostly printed out, but there are still a lot of 'transcription errors', where instructions are misread or misunderstood," he said. "Part of the problem is that because scripts are printed, pharmacists don't spend the same time processing the information it contains."

Microsoft's managing director for Worldwide Health Neil Jordan, met federal health officials during his recent visit to Canberra.

Mr Jordan said Microsoft's Health Connection Engine (HCE) would underpin the eRX platform.

"This technology came out of a project by Simpl three years ago as a means of resolving inter-operability problems in health care," he said.

"We thought it a very elegant solution, and we bought the rights so we can make the HCE available to anyone, free of charge, under an open-source licence."

Mr Naismith said he chose the Simpl design after conducting a global examination of e-prescribing systems.

"Most are built around the US model, where the doctor has to send the prescription to the chosen pharmacy, so there's little consumer choice," he said.

Mr Naismith said there was no doubt they could build the system, but "the harder part is finding how private enterprise and government can work together in e-health".

There was considerable commercial risk that Medicare would try to build something itself, he said. And while Mr Naismith was happy to work with the revamped National E-Health Transition Authority: "I've got a tight timeframe, I'm paying the bills and I can't be waiting for ever."

Meanwhile, Microsoft is trawling local health IT developers for talent, hosting a second Austrade mission to its Redmond headquarters in November.

"This is about having an open dialogue between us and the Australian companies who develop and innovate on our platform," said Norbert Haehnel, Microsoft Australia's director of developer strategy.

State seeking e-health damages

By: Sean Parnell

THE Queensland Government has raised the stakes in its legal row with developer TrakHealth and is seeking almost $100 million in compensation for a failed e-health contract.

When Queensland Health scrapped a $30 million hospital software contract with TrakHealth three years ago, the company took Supreme Court action to recoup $18 million in losses and unspecified damages.

TrakHealth, which was to supply a patient administration system and a clinical information system, accused the government of compromising the project and damaging its reputation.

"Queensland Health's behaviour was unreasonable and unconscionable," a TrakHealth spokesman argued at the time, as the company sought work elsewhere.

In its defence, Queensland Health involved US-based InterSystems, which now owns TrakHealth, and database pioneer Terry Ragon, filing reams of documents in the Brisbane Supreme Court to demand $21.5 million in compensation.

Queensland Health argued that TrakHealth misrepresented itself and its product, MedTrak, ahead of an order being placed in 2003, while Mr Ragon, the founder of US-based InterSystems, failed to intervene to limit Queensland Health's losses.

Earlier this month, Queensland Health amended its defence and counterclaim to seek $98.2 million in compensation to cover the increased cost of delivering such software in the current market.

Queensland Health estimates it would cost $132 million to have a similar system installed now, not to mention the cost of keeping other systems going in the meantime, well beyond the $33.81 million involved in the original deal.

"To put Queensland Health in the position in which it would have been had the plaintiff performed its obligations under the contract, it would be necessary to procure from a different software supplier a product equivalent to that which the plaintiff contracted to deliver," court documents state.

A spokesman for TrakHealth, InterSystems and Mr Ragon declined to comment.

It is understood they have until today to file documents in the Supreme Court to respond to Queensland Health's amended defence and counterclaim.

A Queensland Health spokesman said e-health remained pivotal to the future of sustainable healthcare and the department had committed to a massive information and communications technology strategy.

"This strategy aims to create a consolidated holistic view of patient care by enabling ICT investment over the next four to seven years," the spokesman said.

"It will ensure Queensland is moving towards supporting the electronic collection, transmission, safe storage and access of patient and clinical information that supports the improvement of patient care."

Queensland Health's priorities in the strategy are discharge summaries, results reporting, order entries, electronic clinical notes, statewide scheduling and comprehensive medication management.

The department, which plans to introduce new technology systems and capability "where necessary", has engaged alliance partners EDS (for enterprise architecture) and PricewaterhouseCoopers (for change and program management) to assist with this stage of the strategy.

In the Australian market, TrakHealth is most active in Victoria, but it also has contracts in Asia, New Zealand and Britain.

Rush to build personal e-health records risky

By: Karen Dearne

LOCAL software developers clamouring to build personal e-health records risk creating new silos of unconnected patient information, warns Neil Jordan, Microsoft's managing director of worldwide health.

While progress on a national e-health record system has stalled, Jordan says he is slightly concerned "that everyone I've spoken to here wants to build a personal health record (PHR)".

"That's okay, but don't build them all separately or you will end up with the same problem you currently have with e-health records - they're in a whole load of silos," he says.

"There's never going to be one personal health record in a country the size of Australia, because a diabetic is going to need something quite different from someone who is obsessed with fitness and does lots of monitoring while working out."

With most personal health records now held in GPs' computers, Jordan says the person "who is ultimately funding GPs is going to benefit by putting such a platform in place".

In Australia, that is the federal Government.

In recent years, Microsoft has put a large effort into health IT, particularly consumer health IT, mainly through acquisition of successful companies and technology.

Jordan says there is "huge" interest here in Microsoft's HealthVault, a consumer health web-based platform.

"HealthVault is a free platform that helps people collect, store and share health information with family members and healthcare providers," Frost & Sullivan analyst Priyanka Gouthaman said. "It also provides a choice of third-party applications and devices for fitness, diet and health. It is a definitive step towards making online information sharing a mainstream activity."

Jordan says most of Microsoft's work in the US with HealthVault has been "trying to corral" organisations that have patient record systems and get them to open up their applications so that information can be transferred in and out.

"We're not trying to create new records; rather we're trying to provide a platform that others can utilise," he says.

HealthVault cannot be launched in Australia until it complies with local privacy laws.

Microsoft's other big effort resulted in the development of the Connected Health Framework architecture and design blueprint, which the company offers free of charge to interested government and healthcare organisations.

Microsoft is basically trying to "commoditise access" to the underlying technology used in e-health and share the learnings more broadly.

The key platform is Health Connection Engine, a service-oriented architecture configured by Microsoft's New Zealand-based partner, Simpl, as a means of integrating plug-and-play applications from other global healthcare partners.

HealthSmart two years behind schedule

By: Karen Dearne

VICTORIA's troubled $320 million HealthSmart project has failed to get the cornerstone Cerner clinical system working at any of its sites, and has replaced only one of 10 Homer hospital systems, which were obsolete when the program began four years ago.

Auditor General Des Pearson said HealthSmart was at least two years behind schedule and more than half of the budget had been spent with only 24 per cent of the planned installations complete.

In a long-awaited review, Mr Pearson said the original budget, which involved health agency co-funding, was not realistic, and the targets were too ambitious.

Victoria's Human Services Department and the Office of Health Information Systems have consistently deflected concerns raised in the state parliament by vendors, industry observers and even an anonymous group of healthcare workers.

The project judged most at risk, but with the greatest potential benefit, is Cerner's Millennium clinical suite, which includes health records, electronic scheduling, diagnostic services, results reporting, and e-prescribing capabilities.

"The first release of the clinical system has been tested by various user groups and is ready for use, but none of the four lead agencies have committed to using the new system," the report says. "According to the original timelines, the acute hospitals in 10 health agencies should be using clinical systems by now, but even if funding negotiations are concluded shortly, the first four agencies are unlikely to meet the June 2009 completion date."

The $79 million deal with Cerner was signed in March 2006, but costs rose by $17 million to $96 million in 2006 -- the biggest price blowout in the program.

A Cerner spokesman yesterday declined to comment, citing contractual obligations.

Replacement of the antiquated Homer hospital system with a modern Patient and Client Management System has also been fraught. HealthSmart initially signed a $50 million contract with local firm iSoft in 2003 to replace the legacy system with iPatient Manager, an "interim" product that would in turn be replaced with Lorenzo, a highly capable next-generation suite.

ISoft ran into difficulties supplying systems to the British National Health Service Connecting for Health program, and was subsequently acquired by another Australian firm, IBA Health Group.

Communications director Greg King said IBA Health was "comfortable tracking to the time frames set by HealthSmart" for completion in 2009.

"The procurement process took longer than expected and the project started nine months later than anticipated, so the department, lead agencies and we as vendor are doing quite well catching up," he said.

"We've got nine lead agencies in our portfolio. We already have three live, we have one in implementation and two others are in the planning stage, so we've only got three sites pending."

Mr King said it was "always good to have a third pair of eyes looking at large projects" such as HealthSmart.

"We don't see anything in his report that we have any major disagreement with," he said.

Oracle achieved the best result among technology suppliers, with its E-Business financial management system implemented in eight of 11 participating agencies. The remaining three were due for completion this month.

Mr Pearson found the Oracle project came in $500,000 over the original budget, at $26.8 million.

TrakHealth has set up its standalone Client Management System in two community health centres, and a further 10 sites wish to install the product.

Mr Pearson found there was "room for improvement" in the shared services arena, where underperformance had a knock-on effect on systems availability.

Meanwhile, a lack of interest by agencies in taking up the payroll system might "trigger" payment of a revenue guarantee to the vendor.

Victorian shadow minister for health Helen Shardey said the auditor's findings were not unexpected, but the extent of the project's failure was a surprise.

"We have supported this kind of technology to bring our health system into the 21st century, so the massive failure is a tragedy," she said. "The project has been completely botched, and it points to a government that is just not capable of delivering on these important projects."

SA pumps $17m in e-health

By: Jennifer Foreshew

THE South Australian government will provide nurses and midwives with instant access to patient records under a new $17 million web-based information system.

SA Health Department chief information officer David Johnston said the technology would provide faster access to patient information and lead to more responsive and informed treatment.

"All major public hospitals will be linked which will help improve areas such as patient care planning, care quality management and patient acuity, as well as workforce utilisation of our nurses and midwives,'' Mr Johnston said.

The project is part of the State's electronic health records system, careconnect.sa, which will link all clinicians and patient information within the next 10 years.

Developed by Sydney-based Emerging Systems, the technology will be introduced at Lyell McEwen Hospital in Adelaide first and progressively rolled out to 17 public hospitals across the State by the end of next year.

The system includes a risk assessment profiler for each patient and a variance tracking tool that uses a patient care guide to monitor treatment.

E-health goes back to basics

By: Karen Dearne

FEDERAL bureaucrats are back in charge of the e-health reform agenda, with the Rudd Government allocating $60.6 million to solving the "challenges" of complexity, pace of technology development and lack of consultation with stakeholders.

E-health has taken a budget cut of $4 million to $60.6 million in 2008-09

Budget documents say the Government, through the Health Department, "will work with the states, professional groups and consumers, to address the aspects of e-health requiring national leadership and coordination. This includes the development of a national e-health strategy".

The declaration ends the arm's-length approach to e-health adopted by the previous government, which created the largely ineffective National E-Health Transition Authority (NEHTA) to manage the issue then cut existing projects such as the HealthConnect nationwide patient record-sharing system.

Underlining the shift away from NEHTA, the Budget statement adds that the department "will specifically oversee the development of national standards to enable compatibility of e-health systems across the national health network. The department is working to ensure health systems are interoperable, and can safely and securely exchange electronic health information between health professionals with patients' permission".

NEHTA founding chief executive Ian Reinecke resigned unexpectedly in late March, amid increasing calls for a clear strategy and state health departments embarking on their own, separate, health IT projects.

Andrew Howard, chief information officer of Victoria's Human services department, is currently acting chief executive while an international search is conducted for a replacement for Dr Reinecke.

A formal review by Boston Consulting found the authority had failed to communicate with health and IT industry stakeholders whose support was needed to resolve complex technical and workplace reform concerns.

In contrast, the new government has promised to consult with "medical groups, the software industry, other professions and the community to ensure the needs of all are taken into account" and the benefits of e-health properly communicated.

It's understood NEHTA will be required to report directly to department officials, who will "ensure work is delivered within agreed timeframes".

However, e-health has taken a Budget cut of $4 million to $60.6 million in 2008-09, compared with $64.6 million in the previous year.

In 2006-07, the Howard Government left $41.5 million unspent out of $79 million allocated to national health IT projects, as it lost interest in e-health reform.

Meanwhile, Medicare is developing the Unique Healthcare Identifier service needed to support the introduction of a national e-health record system.

Under a contract signed with NEHTA earlier this year, Medicare is working on a system that will generate individual identity numbers for patients, medical providers and healthcare locations such as GP surgeries, hospitals and clinics.

The Budget has provided $8.6 million over four years to streamline Medicare benefits claiming through electronic payments systems. GPs boycotted Easyclaim, introduced by the former government because it required practice staff to conduct Medicare claims functions and was difficult to use.

Human Services Minister Joe Ludwig said Easyclaim tied-up medical practices that wanted to do the right thing for patients in red tape. "This is the reason why, despite making $28 million available to drive take-up, the Liberals achieved rates of only 0.5 per cent of electronic patient claims".

And the Government has scrapped the Eclipse software system, originally developed by the Health Insurance Commission at a cost of $48 million to provide private patients with information about expected gap bills resulting from private health fund limits on doctors' fees.

The measure will save more than $20 million previously allocated to future development of the system, which is only used by a small number of private health funds.

Govt woes don't trouble TrakHealth

By: Ben Woodhead

MEDICAL software heavyweight InterSystems is eying big ticket hospital software projects in South Australia and Western Australia as it moves to capitalise on its acquisition last year of local firm TrakHealth.

But the company has acknowledged that the spectre of TrakHealth's legal battle with the Queensland Department of Health in relation to a failed patient and clinical systems initiative still looms over its meetings with other public sector organisations.

"Obviously everyone asks questions about it but moving on what's important is that we have a good product," TrakHealth chief operating officer Christine Chapman said.

Ms Chapman declined to confirm if the company was holding settlement discussions with Queensland Health over the hospital software project, which collapsed acrimoniously in late 2006.

TrakHealth subsequently said it would pursue $18.2 million in damages from Queensland Health but the health agency promptly fired back with a $21.9 million counterclaim against TrakHealth.

The matter is expected to go to trial in the Queensland Supreme Court this year if the two parties are unable to reach a settlement.

Ms Chapman said that InterSystems is now hiring software developers locally as it works to build up TrakHealth's development team following the acquisition in May last year.

The company has added six new developers over the past 12 months and has hired a full time recruiter to look for additional staff.

The hiring comes as InterSystems works to sell TrakHealth's TrakCare product into its international customer base, which includes a number of organisations with large healthcare operations such as the US Department of Veterans Affairs.

The company is also looking at public sector opportunities in Australia including Western Australia's $335 million eHealthWA project and a South Australia Department of Health patient software initiative worth tens of millions of dollars.

Ms Chapman said that InterSystems, a long time partner of TrakHealth, had acquired the company because of the strengths of its intellectual property.

She poured cold water on suggestions that the purchase was prompted by TrakHealth's weak financial position, which included losses worth more than $40 million over the last four years.

She also said that past financial performances did not reflect on the future sales prospects for the TrakCare product.

"Healthcare is a bigger company business," Mr Chapman said."(TrakHealth) was a small company and it was not able to bid on a lot of the bigger contracts."

NSW eMR Program

I was recently reading this old article announcing NSW's answer to an e-health solution. Since this project was supposed to be completed by the end of 2009 I thought I would do some further research into it's progress. So far of the 8 area health services that were supposed to be part of this program there is a total of ... wait for it ... zero that are live. Not surprising for a project of this magnitude and considering NSW and Sydney spent 129 million on bringing the Pope to town this year and only 40 million on this vital project. That being said, South Eastern Illawarra Health Service is set to "go live" at St. George sometime at the end of the month and North Coast Area Health Service is set for its first site to turn on in October. We will be watching.

The Lorenzo fantasy

All that we've been hearing from IBA (iSoft) since 2004 is that Lorenzo is going to change the world and fix all of our e-health problems. It sounds like a great idea but it has one problem - the product doesn't actually exist. The reality is that Lorenzo is shaping up to be just another web portal that interfaces in legacy systems and provides little to no intrinsic value overall. I'll give some credit to IBA's chairman and marketing department who have done a good job of ensuring that people are hearing about Lorenzo. Talking is unfortunately all that IBA has done. The issue still remains - when will we be able to actually see it working and "live" in it's full promised form. The sales pitches just aren't cutting it and IBA is looking a lot more like a failing company who is outsourcing it's development in labour cheap, quality poor India, promising a lot and delivering ... well ... nothing. So far at least.