Coming up trumps in EMR funding

We had to chuckle at a cheeky comment on our top story this week on the riches raining down on Melbourne's Parkville precinct, where after the disappointment of last year a consortium of three hospitals came up trumps in this week's state budget to the tune of $124 million to roll out an EMR.

While no one mentioned the E word you can be assured that the vendor is Epic, as the business case for funding was built to mirror the successful implementation at the neighbouring Royal Children’s Hospital and the long-held plan has always been to have a precinct-wide EMR. The executive director of the Parkville EMR project is Jackie McLeod, who led the roll-out at RCH.

The rival vendors usually keep quiet about this but Meditech's Rob Barley said what most others were probably thinking when he queried the price tag and cheekily offered to provide one instead at a fraction of the cost. $124m for three hospitals – Royal Melbourne with 570-odd beds, Peter Mac with 100 overnight beds and a similar amount of day beds, and the Women's with 200 beds – does seem a little steep.

Other examples in Australia include EPAS in SA, which is costing about $470m for 10 hospitals – although that includes a PAS as well as an EMR and other assorted odds and ends – and Cerner in NSW and Queensland. We don't have exact breakdowns for the EMRs in those states, but NSW has received close to $1 billion over 16 years for a combination of an EMR, medications management and an ICU system, and it has about 200 hospitals, including a couple with 1000 beds.

We do wonder at the high cost of all of these projects and will see if we can get a copy of the Parkville business case to see what it's all being spent on, but in the meantime, in a week in which Epic has scored in Australia, a new Epic installation is set to go live at Mayo Clinic's main campus in Minnesota to the tune of $US1.5 billion overall.

Rival Cerner's big win for its MHS Genesis project for the US Department of Defense in 2016 has been costed at $4.3 billion, but that is all overshadowed by the recent announcement that an extension of MHS Genesis to the US Department of Veterans Affairs is now expected to cost an extraordinary $16 billion.

That contract, which was originally negotiated by Donald Trump's son-in-law Jared Kushner, still hasn't been signed because Trump keeps firing or losing people, including former health secretary Tom Price, former VA secretary David Shulkin, and two weeks ago the VA's CIO, Scott Blackburn. Trump's nomination for a replacement for Shulkin, presidential physician Ronny Jackson, also had to pull out.

The delay in signing that contract led Cerner CEO Zane Burke to lament that revenue for the first three months of the 2018 financial year was below expected levels, at a paltry $1.3 billion. We feel for you, sir.

Back in our neck of the woods some of the other big news this week included the purchase of Auckland's Konnect NET by the Clanwilliam Group, the Irish outfit that is part of the immense Eli Global corporation. Clanwilliam ANZ also includes secure messaging vendor HealthLink, which has big markets on both sides of the Tasman, NZ's pharmacy dispensing system market leader Toniq, and anaesthetist billing system vendor Medical Business Systems, which it bought in February last year.

We were pondering the similarities in strategy between Clanwilliam and Canberra-based Citadel Group, which is also gathering up some interesting assets, including its own anaesthetists' practice system in Queensland-based Anaesthetic Private Practice (APP) just this week. Citadel is adding that to its other health IT properties, which include oncology software specialist Charm and laboratory information system Auslab.

It's interesting to compare the activities of these two firms with that of Telstra Health and even Hills, which has its own Health Solutions division created from a number of technology companies it bought in 2016. While Telstra Health and Hills have tended to take their new purchases and merge them under one big banner, Clanwilliam and to a lesser degree Citadel are inclined to allow their new assets to continue to flourish as discrete entities.

And finally this week we got confirmation that the Australian Digital Health Agency plans to put out a request for information for ideas on whether the My Health Record can be and should be re-platformed. The 10-year contract with Accenture will be up in 2020 and new, more agile technologies are increasingly coming to the fore.

We understand that the RFI will be issued in the next few months or so, and in the meantime everyone is waiting for the health minister to get his backside into gear and announce the start of the opt-out period. He has to do it by September but we hear it is much more likely to be towards the end of this month.

That brings us to our poll question for this week: Do you think the MyHR can be re-platformed? If so, let us know what you recommend in the comments below or sign up to our weekend edition.

Our poll last week asked if you thought more than two per cent of consumers will opt out of the My Health Record, or less. This was a reasonably close run thing: 56 per cent said more, 44 per cent said less.

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