Couple of bingles over bungles

Orion Health CEO Ian McCrae didn’t hold back this week in a letter he penned to New Zealand’s Auditor-General John Ryan, asking Mr Ryan if his beancounters could take a close look at the procurement of the new Salesforce-based solution being rolled out to support the COVID-19 vaccination program.

Calling the reported expenditure of $38 million for the system scandalous, Mr McCrae took the NZ Ministry of Health (MoH) to task over what looks like a behind-closed-doors approach to the procurement as well as its expense, claiming he and his team could have had a system up and running in a month for 50 grand and a bit of spare change.

Salesforce is hitting quite a few winners at the moment in the healthcare sector and has set up a decent team to cover healthcare and life sciences in ANZ, with a few well-known faces in the local mix. Heading up the APAC healthcare division is former Cerner staffer Bryan Tan, a medical doctor who worked on Queensland’s iEMR program as well as the NSW eMR; PCEHR guru Andrew Howard, who has been working on Victoria’s implementation of Salesforce for contact tracing; and former Orion Health and DXC account executive Kelsey Grant.

That hasn’t placated Mr McCrae, however, who wonders why a New Zealand company or at least one with a good bit of healthcare experience wasn’t approached to help with the immunisation program. MoH’s Shayne Hunter demurs, and says the system being used is based on a public procurement from 2018 and has simply been repurposed a number of times. It is now up and running and helping out as we speak, Mr Hunter says. We’ll leave it to Mr Ryan to judge.

In the meantime, South Australia had its own bungle this week, with a worrying glitch affecting its medication prescribing and administration system and seeming to massively increase dosage levels on medication orders, which is a bit of a worry. Early reporting sheeted home blame to the state’s EMR, Allscripts’ Sunrise, which is used at five hospitals and is due to be rolled out to five more, but late reporting appears to suggest there is a problem with an implementation of Microsoft’s Remote Desktop solution.

A reader tells us that the issue has come about as SA Health is upgrading to Windows 10 version 1908 while also running Microsoft server 2016. If the EMR is accessed using the Microsoft Remote App feature, the problem of double keystrokes appears and the dosage level is upped due to duplication of the last digit. SA Health tells us they are not aware of any adverse clinical outcomes at this time, so hopefully it can be sorted.

Elsewhere, the figures on GP uptake of telehealth continued to take a hit, with numbers man Andrew Baird’s analysis of MBS data showing that just 0.6 per cent of GP Level A, B, C or D services were conducted by video over the last year. More than a quarter were done by telephone, but this is not exactly new technology and the Department of Health is set on reducing item numbers for this modality in future. Dr Baird and

Pulse+IT are very keen to hear more about why video use is lagging so much, particularly if there are any published, scientifically valid studies on this. We only have anecdote at the moment, and it pretty much comes down to the fact that telephone is easier. GPs say easier for older patients, but we get the feeling it is also easier for the GP as well.

And further afield, Australia’s federal budget will be revealed next Tuesday and as per usual, the government is getting on the front foot with some early announceables. The grandly titled Digital Economy Strategy – worth $1.2 billion over who knows how many years – includes $300m for My Health Record and $200m for myGov. Both of those figures are likely to cover at least two years and account for the operating costs for both, but it appears the My Health Record allocation also includes some money to pay for the previously announced work it will need, including its re-platforming and a new aged care transfer document being added. (Speculation in the industry is rife that the re-platforming itself is not going ahead and the Australian Digital Health Agency has gone back to Accenture for advice, so we’ll see if all of that money is required at all.)

The good news this week has been the slow but steady progress of a statewide system of eReferrals in Tasmania. The Apple Isle is lucky in that it has pretty much one health system and very few people, and its implementation very much resembles Auckland’s, where all referrals are now done electronically, either from within a GP’s or specialist’s PMS or through a portal. Tasmania is still printing out the referral after it is triaged in the state’s two largest hospitals and it would be great if that could be digitised, but all good things come to those who wait, particularly in ramping-prone Hobart.

Our poll question this week is:

Are governments paying too much for COVID-19 software?

Vote here and feel free to leave your comments below.

Last week, we asked: Would you use WhatsApp to order a script refill? Close to a 60:40 split: 59 per cent said nope, while 41 per cent were ok to go.

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