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.

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."