Qld's ieMR set for third release but HBCIS still on drawing board

Existing implementations of clinical systems are the main beneficiaries of the funding announced for eHealth in last week's Queensland state budget, although the long-awaiting replacement of the HBCIS patient administration system is still in the planning stage.

The Queensland government allocated $179 million to clinical and administrative support systems in the budget, a small reduction from the $200m the previous year, with the majority going towards the continued roll-out of the Cerner integrated electronic medical record (ieMR), the Mosaiq integrated oncology management system and an interoperability platform for information sharing.

(Pulse+IT incorrectly reported last week that extra money had gone to the continued roll-out of the intensive care clinical information system, iMDsoft's MetaVision. A Queensland Department of Health spokesperson said no additional money had been allocated to this roll-out, with any future release of functionality set to be funded through ongoing recurrent costs.)

Two of the first sites for the Cerner roll-out – Princess Alexandra Hospital and Cairns Hospital – are set to go live with what Queensland Health is calling the “Digital Hospital” release of the ieMR this November.

This is the third tranche in what has been a very careful and staged roll-out of Cerner to nine hospitals, beginning with a medical record scanning function for five hospitals in stage one and the introduction of electronic orders and results, and allergies and adverse reactions in stage two.

The spokesperson said that following the Digital Hospital ieMR release at PAH and Cairns, other sites will be invited to express their interest in implementing it.

Cerner is currently being used at Townsville, Mackay, Royal Brisbane and Women’s, the new Lady Cilento Children's, and Gold Coast Hospital and Health Service sites at Robina, Southport and Carrara.

Queensland's The Viewer technology, which allows access to clinicians across the state to a clinical data repository holding a range of information such as referrals, alerts, diagnoses and clinical notes, has also been integrated into the ieMR.

The Viewer also provides access to the national PCEHR system and is live in over 200 sites in Queensland, with just some aged care and primary healthcare facilities in North West HHS still without the capability.

The Queensland Health spokesperson said a number of facilities in Cape York and the Torres Strait had recently become visible on The Viewer, providing clinicians with access to pathology and radiology data. Relevant mental health information is also available following the integration of The Viewer into the consumer integrated mental health application (CIMHA).

“With the recent integration of The Viewer in ieMR, patient safety and quality of care will be greatly improved with the ability for clinicians to instantly access to a patient’s full medical history,” the spokesperson said.

A replacement for the HBCIS PAS, on the other hand, is still in the planning stage. HBCIS is approaching 25 years in operation and was identified in Queensland's 2007 eHealth strategy as needing to be replaced before it reached technical obsolescence this year.

Originally estimated to likely cost between $250 and $350m, a Queensland Audit Office (QAO) report in 2012 revised that cost up to over $440m.

HBCIS is managed by CSC, which inherited it following its acquisition of iSoft, but former Queensland Health CIO Ray Brown told a parliamentary inquiry in 2013 that CSC was likely to stop providing direct support this year.

Mr Brown said that a hardware upgrade was likely to be able to support HBCIS until 2019 or 2020, but warned at the time that the replacement would be particularly complex as the system was used for a range of functions besides patient administration.

Mr Brown told the inquiry that there were 165 separate HBCIS instances across the state that shared or integrated with over 80 other clinical and business systems.

The Queensland Health spokesperson said the replacement of HBCIS was one of the key ICT priorities for the department. “Funding has been secured to commence an implementation planning study to support the development of a detailed plan and preliminary business case,” the spokesperson said.

In addition to the ieMR and oncology system, funding from the 2015-2016 budget has also gone towards the critical infrastructure asset replacement program, involving telehealth equipment, telecommunications, National Broadband Network migration and storage.

There is also the contemporary workspace program, involving authentication and authorisation, active directory and Microsoft Office migration, and funding for an interoperability platform.

“[This] will enable information sharing to be leveraged in a more efficient, flexible and agile manner that will help to reduce costs, improve the quality of patient care, and support technical, corporate and clinical innovation,” the spokesperson said.

Posted in Australian eHealth

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