news Queensland Health’s beleaguered IT operation has turned its focus to a sizable IT replacement project slated to cost the state up to $438 million and see a 22-year-old patient administration program replaced, as the fallout from its billion-dollar botched payroll system upgrade continues to be felt in the state’s public sector.
The system, known as HBCIS for the Hospital-Based Corporation Information System, has been in use for several decades in the state’s many hospitals and is used to administer patient information. It is a critical tool used by medical specialists in their work; without it or an equivalent tool being in place, clinical outcomes would be severely impacted.
However, Queensland Health believes the system is in urgent need of being replaced. In September 2011, for example, the state’s then-LNP Opposition tabled a leaked extract from Queensland Health’s ICT portfolio plan, which included a strategy to replace the system, at a projected cost of $438.8 million.
The work to replace the system needed to start from July 2012; if HBCIS wasn’t replaced, then its obsolescence could result in “the inability to register, admit, transfer and discharge patients as well as effectively manage clinical and financial patient information”.
As first reported by iTNews this morning, Queensland Health chief information officer, who has been on deck at the department since September 2009, was interviewed in early August by the Queensland Parliament’s Health and Community Services Committee, which was seeking answers from the public servant in relation to Queensland Health’s e-health program following an audit of the issue in 2012. Brown’s testimony to the committee is available online in PDF format.
In his opening statement to the committee, Brown noted that significant progress had been made within Queensland Health on a range of IT initiatives over the succeeding years since the department first initiated its e-health program in 2007.
For example, he noted that new systems relating to radiology, discharge, viewing of clinical data repositories, mental health, breast cancer screening, anesthetics record-keeping, intensive care management and emergency department management had been initiated.
Brown said: “In 2007 the Queensland government provided funding of $396 million excluding depreciation to implement an eHealth program. As a result of this, the eHealth program was established within what was then Queensland Health to support clinicians across the Queensland public health system and to improve communications with private providers. This move towards electronic healthcare solutions for Queensland’s public hospitals is being undertaken in a considered, staged approach to ensure a successful transition from paper based medical records to electronic patient records for clinicians supporting staff and, in particular, patients.”
“The first phase of the eHealth agenda saw not only the delivery of speciality clinical systems to meet an immediate need and growing demand but also the laying of foundations for the delivery of an integrated electronic medical record to support a more sustainable public health system for Queenslanders into the future.”
However, the HBCIS replacement appears to be a trouble spot for the department, with most of the department’s successfully delivered IT platforms over the past several years having been ancillary systems supporting specialist areas, rather than addressing the centralised HBCIS platform. The July 2012 date for replacement of the platform to kick off has already been passed.
Said Brown: “The department has commenced a patient administration system investment planning project to deliver an implementation approach architectural framework and business case to guide the selection and implementation of a new patient administration system for Queensland. The department is focused on implementing a solution that will provide a foundation for future innovation in health service delivery and enable greater collaboration between healthcare providers across the state whilst addressing the risk associated with the current system. The development of the implementation approach architecture framework and business case will be completed by January of 2014. The work will be structured to enable review, input and approval at multiple points.”
“The HBCIS replacement activity is particularly complex, as HBCIS is more than just a patient
administration system. It also includes a range of additional functionality associated with managing
the registration and flow of patients. There are 165 separate HBCIS instances with local
configuration to support the business processes of 202 business units across the state. There are
over 80 clinical and business systems that share or integrate with HBCIS. The department will be
recommending the appropriate approach to address the replacement of HBCIS following the
completion of the investment planning project in early 2014.”
Brown noted that the replacement of HBCIS would incorporate recommendations from recent reviews into his division, as well as other audits such as the Commission of Inquiry into Queensland Health’s massively botched payroll systems implementation.
Queensland Health’s initial plan to replace HBCIS has also been pushed aside by more recent work.
“We did have a draft business case prepared for this,” the CIO told the comittee. “Again, that approach has been totally reviewed in light of the recent reviews, reports, audits and documents that have been provided. All of those documents are being reviewed and a new approach is being documented as part of having those documents ready by January 2014. The intent is not to have this as an in-house application as it currently is. The intent will be to have it as a form of a managed service.
The difficulty around HBCIS is that there are many layers to the onion, and we have to start
to unwind some of the functionality that has been incorporated into that system over many year — it has been in place for 22 years—and then really get things back to what that core patient
administration system is. There is nothing that just replaces HBCIS or a service that does exactly
what HBCIS does today. The planning activity around that is going to be significant, but the intent in terms of the ICT as a service model will be moving to that approach.
News of the imminent HBCIS replacement comes as a number of recent audit and ombudsman’s reports published into state government IT projects right around Australia have shown a marked inability by state governments to deliver IT services or major IT projects on a competent and sustainable basis.
The Queensland’s Government’s first comprehensive ICT audit published in June, for example, found that ninety percent of the state government’s ICT systems were outdated and would require replacement within five years at a total cost of $7.4 billion, as Queensland continues to grapple with the catastrophic outcome of years of “chronic underfunding” into its dilapidated ICT infrastructure.
Queensland Health. A major ICT project replacing a central system which has been in place for two decades. A budget in the hundreds of millions of dollars. What could possibly go wrong? This should be fine, right? Right?