news The Western Australian Government has allocated a further $40 million in funding to the troubled IT systems of the state’s flagship Fiona Stanley Hospital, in a state budget which comes ahead of the similar, $187 million deployment of similar new IT systems at the upcoming Perth Children’s Hospital.
Fiona Stanley is a new, 783 bed hospital being build south of the Perth central business district. It is billed as a flagship hospital for Western Australia, and was originally planned to be a paperless facility, featuring the latest in medical and information technology. However, the project has gone off the rails. In June last year Health Minister Kim Hames issued a statement noting that the $2 billion project had run late and would open in October 2014 instead of April, although it was more than 90 percent complete.
One specific issue which continues to dog the facility’s construction includes the “advanced ICT system” which contractor Serco is putting in place at the facility. The platform is billed as being able to deliver new levels of patient care and convenience by managing administration, patient information, medical records, communications and patient entertainment, all through one central facility. Serco is handling the rollout and part of the IT systems deployment, while British telco BT is conducting the telecommunications rollout. The Department of Health itself also has substantial responsibility for some IT systems.
In a tense session in mid-February, the State Parliament’s Education and Health Standing Committee grilled current under-treasurer Timothy Marney on the delays and cost blowouts.
Marney confirmed that the $2 billion project as a whole had already suffered some $330 million in cost overruns, with about $151 million of that sum being allocated to ICT, including a portion going to another facility in Albany. Marney said that the project was currently “still in the throes of trying to finalise 48 separate [IT] systems”, so it was difficult to estimate what the remaining ICT over-runs might be on Fiona Stanley specifically. “I suspect the exposure is anywhere between $25 million and $50 million,” he said. “If things go really well, it will be $25 million.”
In budget papers released last week as part of the state’s budget and first reported by iTNews, Western Australia allocated another $40 million to ICT at the Fiona Stanley Hospital (PDF). The Department of Health’s budget in general received a boost of about $446.7 million.
The news comes as in late March, the Western Australian Government went to market for a provider to establish a project management office (PMO) to coordinate overall development activities between the Fiona Stanley Hospital build and its wider health department. And in mid-April, state parliamentary committee investigating the hospital’s problems told WA Health to end four years of acting appointments and hire a permanent chief information officer, in the wake of news that the lack of such an executive role in the department contributed directly to the fiasco at the state’s new Fiona Stanley Hospital.
The ICT funding section of WA Health’s budget made it clear that the next major area of expenditure which the department will focus on when it comes to ICT is the new ICT systems associated with the Perth Children’s Hospital. The State Government is currently shifting staff and services from the Princess Margaret Hospital to a new facility in the Nedlands.
The new hospital will be the sole dedicated children’s hospital for WA, providing the highest level of care to children from all over the state. According to its website, the construction of the hospital is on time, and the project is currently on budget and slated to open in late 2015. The PCH will have 298 beds, 48 more than PMH and the design of the building allows for future expansion.
However, the extra funding for the Fiona Stanley Hospital ICT systems also raises the same issue for the Perth Children’s Hospital. The issues with the setup of the IT systems may also have a potential impact on other facilities, given that it appears that Fiona Stanley was intended to act as a reference site for IT systems at other facilities.
In the budget (page 146), WA noted that it had allocated a total of $187 million to the setup of ICT systems at the PCH, with some $21 million of that to be spent before July this year and much of the rest slated to be spent in the year after.
In mid-February, Marney had told the State Parliament’s Education and Health Standing Committee that the situation with the PCH was not going to be a problem.
Marney told the committee: “The decision of cabinet, when it allocated the additional funds for ICT for Fiona Stanley and Albany, explicitly prioritised the systems investment for those two sites to ensure that they could open; therefore, if you like, deprioritising the rest of the system. Albeit there was substantial investment and that is a whole-of-system platform, and a number of the Fiona Stanley systems are also repeatable across other sites.”
“In terms of Perth Children’s Hospital, the approach taken to ICT for Perth Children’s Hospital is taking into consideration the lessons learnt with respect to Fiona Stanley Hospital. It means the strategy for the construction and deployment and training of systems in Perth Children’s Hospital is significantly different to that employed with Fiona Stanley Hospital in that the approach will be to seek to source an off-the-shelf product that can be easily adapted to the new children’s hospital rather than constructing 48 systems from scratch.”
However, the Western Australian Government has not yet clarified precisely how the ICT systems at the PCH will be deployed differently to those at the Fiona Stanley facility.
The news comes as other major eHealth programs around Australia have also suffered major problems in recent years. For example,University of Western Australia software academic David Glance has severely criticised the Federal Government’s personally controlled electronic health records scheme, stating the vast majority of those who have signed up have blank health records, despite the project’s half-billion-dollar cost. The project is currently under review.
Queensland Health’s eHealth project is significantly delayed, and in October last year the Victorian Government published a landmark review into the use of technology in the state’s health ecosystem, finding that its landmark HealthSMART program launched in 2004 had had its benefits, but that the state should devolve most decisions about IT back to individual health units such as hospitals and stop taking a strongly centralised approach to eHealth.
The Western Australian budget also contained several other items of interest to technologists; including a $25 million allocation for the WA Police to set up a new computer aided dispatch system, and $45 million towards fixing mobile blackspots.
opinion/analysis
The Western Australian Government is spending rather a lot on setting up the ICT systems of the Fiona Stanley Hospital and the Perth Children’s Hospital. But is it getting that setup right, and should this cost that much? I’d be interested to receive feedback from those who work in e-health as to whether this situation feels like it’s in the right ballpark or not. This can be done through Delimiter’s anonymous tips page if necessary.
If you’re not a part of the Solution, there is good money to be made in prolonging the problem…
I know a few people involved in the project and bearing in mind the ambitiousness of the project, and the quality of the outcomes, the overrun’s aren’t too bad for a government run project of this size. I am only aware of some of the new systems, but if the governance has been the same across other systems they should be pretty solid.It will be a great reference/template of ICT for other new facilities throughout Australia for the next 10-20 years. Don’t forget too, there are only so many suppliers of these systems that participate in the Australian sector, so the challenges in sourcing quality new systems was immense. The real benefits will be seen over the next couple of years, if this hospital can operate as efficiently as it should be able to with the new systems in place, the cost overrun’s will seem very, very insignificant…
Are we talking abut the same systems that the UK tried to adopt and burnt twenty billion, or the Victorians tried to set up and gave up after $450m or so or the same systems that NSW Health continues to poor money into on the vain hope and by some miracle they will work.
Nope, we are talking about different systems
Many of these health systems are no more than a large database with a few Web pages lobbed on top. None of them are patient centric, collaborative, project centric, etc. In fact the adoption of what is an ‘ERP’ approach to health systems will erode clinical support knowledge and much work, like in the ERP world, will be done outside these systems. Clinical systems built by clinical experts over the years will be swept aside to satisfy the administrators ERP wet dream. Sydney University produced an excellent report regarding the limitations of these systems and the challenges imposed on clinical staff in terms of using them – one step forward, nine steps back.
There is a saying in eHealth “If doctors won’t use it nothing else matters”. Here’s hoping that they have done their organisational change work properly and that the clinicians are on board.
Doctors are a small part of the overall workings of a hospital, outside of the medicinal systems & patient management systems, you have to target some key areas, theatre administrators, ward managers, store managers and implement effective systems in these places, this is what they are attempting to do
Such funding will definitely help revamp the management processes in healthcare institutions. And they really need that a great deal. Apart from medical treatment, patients need services such as bill reimbursement, new appointments and updates from hospital staff. This project is aimed at fulfilling such expectations by using ICT funding.
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