Pulse+IT Blog

Has the worm turned for hospital EMRs?

Coming hot on the heels of our poll from last week that asked whether the very large sums being spent on digitising our hospitals were justified – close to 60 per cent of you said yes – came the news late last week that InterSystems had snaffled the huge contract to roll out its technology for the Northern Territory's public health system.

We always had our money on InterSystems, a relative quiet achiever that has seen real progress with its TrakCare suite, which it markets outside of the US. Trak has had a few other high-profile wins in our part of the world, including for the new hospital at Bendigo and the replacement of a number of best-of-breed systems at Macquarie University Hospital in Sydney a couple of years ago, but this implementation will be watched more keenly than most.

Budgets go big in eHealth bonanza

We must admit to being momentarily gobsmacked when we received a joint press release from the NSW Treasurer and Minister for Health last Saturday proclaiming that the state was spending $536 million on eHealth over the next eight years, with a portion of the money starting to flow this year. We double-checked the figures on Monday morning just to be sure there was no double counting, but right it was.

When added to the approximately $400 million shelled out by the Coalition since 2011, we're looking at close to a billion dollars, and that's just from the current government. Granted, that money is spread over 16 years, but it's still a massive number, even among the eye-popping overall annual budget for NSW Health of $23 billion.

Age-old problem of lack of interoperability

In a week in which many of we colonials took a day off to celebrate the birthday of an elderly but still very chipper lady in England – excluding New Zealand, which took it last week; WA, which has to wait until September; and Queensland, of course, which holds it in October, while the lady in question was born in April – it was good to see a new report being launched with much fanfare at Parliament House offering up a roadmap for how technology should be deployed to help support older people to remain independent for as long as possible.

The report was a very worthy one but to be honest, we have seen these things before. There was the 2012 Pathfinder project, which investigated what would be required to connect the aged care industry to the PCEHR, and which sank without a trace, and after that there was the 2014 Digital Care Services IT blueprint, co-written by Accenture, which also fell into a hole and never came out again.

Déjà vu all over again

Remember 2012? No, neither do I, but this time five years ago the biggest deal in eHealth was the imminent launch of a fab new national IT project that heralded the dawn of a new age in healthcare. This system would link health professionals together, improve the flow of information throughout the entire health system, save the government eleventy billion dollars in needlessly duplicated lab tests, and better yet, allow patients to see their own health information for the very first time.

And it was just four years ago that the minister for health at the time, Tanya Plibersek, fronted up at the HIC conference and announced a massive $8 million grant to NEHTA to get pathology and diagnostic imaging onto the system. This was greeted as big news by Pulse+IT and by everyone else. Test results were going to be the deal breaker, the game changer, the thing that would put the PC in the PCEHR.

We have to get better at the cyber

As noted cybersecurity expert Donald Trump warned just last year, we all have to do better on the cyber, and we certainly have to get tough on cyber and cyber warfare. As the self-described father of a 10-year-old who is unbelievable at the cyber, Mr Trump accepted that it “might be hardly doable” because the security aspect of cyber is very, very tough, but nonetheless we do have to try.

Quite right, Donald. Just last week we were discussing in these very pages the global fright caused by the WannaCry scare, and we asked the local health IT industry if it thought our hospitals were prepared for a large-scale ransomware attack.

Big week for health IT bigwigs

It was a big week for Australian Digital Health Agency CEO Tim Kelsey, who in addition to being able to announce a pretty big deal for the My Health Record – Sullivan Nicolaides Pathology is about to start uploading pathology reports to the system for people living in northern Queensland – also had the thrill of attending Senate Estimates hearings in Canberra, where we imagine his bum went numb while he waited interminable hours for some plodders to get through questioning the ever-patient John Skerritt from the TGA about the state of medicinal cannabis.

Professor Skerritt's interrogation took hours on Monday night, but it could have been worse for Mr Kelsey and his gang of EGMs from the agency, who apparently also turned up in Canberra but were not called upon to answer anything. Senate Estimates enthusiasts are still recovering from the oddities of years gone past, such as former senator John Madigan's fixation on the TGA's appalling attitude towards the deleterious effects on citizens of Lyme disease and wind turbine sickness, one of which doesn't exist in Australia and one of which doesn't exist at all.

Late in the evening Mr Kelsey was able to get one very short word in edgeways before health technology proceedings were wrapped up after about 25 minutes. Most of the interest in the brief session was on the claim in the federal budget that the government expects to save $305 million over four years through “health system efficiencies” and fewer duplicated lab tests due to the MyHR. Senator Lisa Singh remained unconvinced by Paul Madden and Bettina Konti's arguments about this, and to be honest, so do we.

Also having a big week were the CIOs of our most populous states, with Zoran Bolevich from NSW, Andrew Saunders from Victoria and Richard Ashby from Queensland fronting up for a chat with Mr Kelsey at a conference in Sydney on Wednesday. It was nice to hear from Dr Bolevich about the relatively smooth progress of the Cerner Millennium roll-out, which in NSW is known as eMR2. As those who have been around the traps a bit will remember, the first attempt at rolling out Cerner was a bit of a disaster, not helped by a very long and detailed report on the failings of the system by Jon Patrick in 2011 which received wall to wall coverage in the local newspapers.

We vultures in the media pounced on that report ravenously, but some who have stuck around later learned that the system wasn't as bad as it was made out to be. We hope Dr Ashby in Brisbane has also recovered from his travails over the last few weeks, when the local newspapers smelled blood about the hiccup with the Cerner ieMR up there. The Courier Mail had four reporters covering the story at one stage, which seems a bit much for a yarn about slow log-ins to a computer system. However, Dr Ashby should thank his lucky stars that he doesn't have to put up with what Bill Le Blanc does in Adelaide. That's pure torture, that is.

As Cerner is rolled out in NSW and Queensland, and has a good foothold in Victoria, it was interesting to read a report from US analysts KLAS this week that showed that while Cerner and Epic are dominant in the US market, with Allscripts, McKesson and Meditech not far behind, outside of the US it is InterSystems that has racked up the most wins in the last couple of years.

Here in Australia, InterSystems has a reasonable footprint in Victoria with TrakCare and is set to roll out at the smashing new Bendigo Hospital later in the year. It has also been implemented at Macquarie University Hospital in Sydney, where it displaced a best-of-breed conglomeration. All eyes next week will be on the Northern Territory, where an announcement on its big core clinical systems renewal program is imminent.

Our money is on InterSystems. We hear that of the four shortlisted vendors, Telstra Health was the first casualty, with Allscripts and Epic asked to park their bids while TrakCare was put through its paces. The dotted line is about to be signed in what is the biggest ICT contract in Territory history so we trust they'll get it right. Otherwise it could be the NT News going after NT Health CIO Stephen Moo, and considering its predilection for crocodile yarns, that could be truly terrifying.

Our poll last week asked: Do you think the healthcare workforce is adequately prepared for the digital health revolution? A brave few said yes, but an overwhelming 92 per cent said no.

Big boys don't WannaCry

As the dust began to settle on last week's interesting federal budget and we began to digest the interesting news that the My Health Record will become opt-out earlier than expected, news suddenly started to erupt about the WannaCry ransomware attack, which caused a flurry of outraged squawking when it seemed to knock a whole lot of UK hospitals offline.

As soon as the news broke out so did the heroes of the day, the masked infosec avengers who took to social media to tut-tut about how terrible it was that the NHS still seemed to run on Windows XP. It later emerged that it doesn't really and that the affected hospitals seemed to have their business continuity plans in order, but that didn't stop every alleged expert from demanding that hospitals update all their software to Windows 10 overnight, just like they do on their home PC.

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