From HealthClix for March, 2008 we learn the following.
“2008 promises to be an exciting year at HealthConnect SA, with all of our e-Health projects now well underway. A major initiative for HealthConnect SA has been, and will continue to be, the development of an electronic care planning system.
It is also an important initiative from a government perspective, as an effective electronic care planning system will help to address one of the government’s key health challenges, the growing burden of chronic disease.
I am very pleased to announce that Pen Computer Systems Pty Ltd have been contracted to develop Stage 1 of the e-Health Care Planning System (formally the South Australian Care Planning System). The name change reflects the need to identify this care planning system as an e-Health initiative, and to distinguish it from other care planning work being undertaken within South Australia.
We know from the findings of the Care Planning and Communication Trial completed late last year, that health care providers welcome the opportunity to collaborate more effectively in order to provide a more coordinated and efficient level of care to people with chronic disease.
An electronic care planning system is a tool that can assist health care providers in this process.
In this issue of HealthClix we outline how this system will be developed, and update you on our other important e-Health projects.
Andrew McAlindon Director
e-Health Care Planning System is underway
The development of the South Australian based e-Health Care Planning System is now underway! The e-Health Care Planning System will allow general practitioners to develop a web-based care plan for patients with chronic conditions, facilitating better collaboration between the health care team
to deliver more coordinated care to people with chronic conditions.
Who will develop the system?
Pen Computer Systems Pty Ltd, a leading Australian owned Health Informatics company, have been contracted to develop Stage 1 of the e-Health Care Planning System. Pen Computer Systems have delivered specialised health information systems to the primary health care sector in Australia for over 15 years, collaborating with public and private health care providers and research institutes to deliver customised IT solutions to the health care sector.
To find out more about Pen Computer Systems, go to www.pencs.com.au.
The development process
HealthConnect SA has chosen a staged approach for the development of the e-Health Care Planning System. Stage 1 will deliver a fully functional system prototype to enable stakeholder testing and approval in readiness for a full system build and state-wide deployment.
The benefit of a staged approach is that it will enable key stakeholders to be actively involved in the design and development of the system, so it meets the needs of health care providers and where possible interfaces with existing clinical software.
As part of the process, feedback will be sought from key stakeholders via HealthConnect SA’s Stakeholder Reference Group, Consumer Reference Group, the newly formed e-Health Care Planning System Development Group and Care Planning and Communication Trial participants.
What will be delivered?
Not only will the e-Health Care Planning System deliver a working prototype by September 2008, it will also offer health care providers the opportunity to access various “electronic support tools” via a specially designed computer screen side bar. These tools will include:
• Clinical Audit Tool – a software tool that operates in collaboration with the GP Clinical desktop system to present the GP and practice staff with meaningful clinical information from their own patient data, allowing them to more effectively target patients with particular needs or specific health risk profiles.
• Electronic interface with Lifescripts – Lifescripts provides GPs and their practice staff with tools
to assist patients to make healthier lifestyle choices. The program is currently being delivered through the Australian General Practice Network (AGPN) and via SA Divisions of General Practice (SADI) in South Australia. Further clinical support tools are currently being developed and will be announced shortly.
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The contract was signed on March 5, 2008 according to the HealthConnect SA web site.
In the RFP (of 10 months ago) the following timelines were laid out:
As such, the following timeframes for the SACPS are envisaged:
§ Issue of the RFP – Tuesday 8th May 2007;
§ Deadline for RFP responses Tuesday 12th June 2007;
§ Evaluation of responses and identification of preferred respondent by Friday 6th July 2007;
§ Detailed negotiation phase including an agreed scope of work and award of contract by the 17th August 2007 or earlier where possible;
§ Phase 1 implementation must commence as early as possible in the period between 17th August 2007 through to 31st March 2008 - based on implementing an agreed set of care planning functions. This timeframe is to allow for as much operational use of the SACPS by participating providers and consumers prior to a project evaluation occurring;
§ A project evaluation sometime between March and June 2008;
§ Formal support mechanisms commencing July 1st 2008 under the business model agreed during the negotiation phase; and
§ Phase 2 – Further functionality scoped and rolled-out post July 1st 2008, subject to securing ongoing funding.
At the very least it would seem this project has been characterised by amazing delays! – given there will now not even be a working prototype available until September 2008.
A problem with all this is that it is pretty clear the HealthConnect SA team have chosen only to lock in Phase 1 because they are only funded till August, 2008 (see November 2007 HealthClix). Thus there will be little evaluation done before a new commitment is made on the basis of not much more than a bit of wishful thinking, or the project will be canned. Both of these are unsatisfactory outcomes.
Now I know the guys at Pen Computing and they, given the right circumstances, are sure to be able to make all this work, and work very well. If anyone can make it come together, they can, but I fear they are sailing into some considerable headwinds.
What worries me is that their customer seems to struggle a little with both delivery and with accepting the initial 12 month trial was really an un-remitting fiasco. It would have been nice to see a short public document from that HealthConnect SA team clearly laying out what went wrong and why, responding to the evaluation report and showing how that changed the requirements that now exist are planned to be met. (One certainly hopes that this document exists internally and has been shared with Pen Computing!).
One really has to wonder if the demand / need for electronic care planning is as great as is asserted by SA HealthConnect. The usage of the trial system was so low over the year trial that it might as well have been zero and was indeed declining rather than rising in the later months of the trial. Hardly a signal of massive demand, but it could have been that the low adoption and use was simply because the solution was too ‘clunky’ as implied in the evaluation! I know Pen can do a good job to address those issues.
Before anyone comments I do appreciate that there is the potential for great benefit if there can be effective co-ordination and information sharing between all those involved in an individual’s care. The best way to deliver this co-ordination is still to be defined, but effective linkages between GP, Specialists, Hospitals and Allied Health would have to be a good start!
I also wonder if the HealthConnect SA team have the depth to manage being the client of a software development project where the occasional set back and difficulty is inevitable. The project management of the procurement process has hardly been stellar.
My concerns about the lack of strategic coherence in a project of this sort going ahead while e-Health directions are under review remain but I wish them luck and I really hope it all works out!
If I seem harsh it is important to remember these people are spending public money, have been evaluated on the basis of a 12 month trial that essentially failed and are now planning to spend more of our money without a word of explanation or justification. Just announcing you are proceeding without showing the evaluation lessons have been learnt is really not appropriate.
I will check back in September / October to see how things have gone! I am hoping by then there will a prototype which addresses all the issues identified in the previous trial.
These seem to be clearly articulated in this paragraph from the Trial Report:
“However, GPs did not consider the benefits were sufficient to overcome specific issues of the system being trialled. The processes of completing Team Care Arrangements (TCAs) and General Practice Management Plans (GPMPs) were not quicker or easier, especially when many of the AHPs the GPs normally worked with were not registered on the system. For many GPs software limitations reduced system efficiency and increased the time taken to use it, which created substantial barriers to uptake. The software could not easily be modified to meet GPs needs, especially integration with current clinical software. “
This is the challenge Pen and SA HealthConnect need to address to be successful. We can only wish them luck, hope it works out and hope the SA HealthConnect team have learned the lessons of the previous debacle.
David.
2 comments:
Among some of the most important issues our national health system has to deal with today are a rapidly ageing population, a serious shortage of doctors, obesity and diabetes reaching epidemic proportions, and the clearest of needs to better manage the way we 'care' for our patients before they end-up in hopital.
This points to an increasing demand for systems which will help improve areas such as chronic disease management and care planning coordination. This means there is an urgent job to be done and someone has to do it. The SA tender is a wonderful opportunity to make some significant advances in ehealth in Primary Care.
The issue is if SA HealthConnect the team that can take advantage of the opportunity? Their track record suggests not..we will wait and watch.
David
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