Vic health system 'too big' for HealthSMART

The secretary of Victoria’s Department of Health, Dr Pradeep Philip, will today write to the state’s hospitals and health services to formally end central government control over their selection of core IT systems.

The decision to abolish mandatory participation in the HealthSMART program follows from the recommendations of an expert panel commissioned by Victorian health minister David Davis to look into the now cancelled initiative, which were made public today.

They echo doubts that were expressed by Davis back in May 2012, when he announced the troubled program would cease, but apparently never acted upon.

The Victorian government launched HealthSMART in 2004, with the intention of implementing common corporate and clinical solutions across Victoria’s dispersed public health system.

A uniform cluster of IT products, or “statewide footprint” consisting of Oracle’s eBusiness Suite, CSC’s i.PM, Intersystems TrakCare and Cerner’s Millennium solutions was established for general adoption.

But by 2006 uptake of the footprint was lagging behind expectations, and the Department of Health decided to push the project forward by making adoption mandatory.

This, the panel found, was a critical error from those in charge of HealthSMART, and contributed to the initiative being cancelled in 2012, unfinished despite receiving $330 million worth of government capital funding.

“This has been contentious as no one solution fits the needs of each sector participant,” the panel’s report, released today, said. “Not all health services are the same.”

The imposition of a single solution on top of a whole range of idiosyncratic business processes within dozens of Victorian health organisations was unrealistic and often disruptive, the panel said.

“The panel understands the philosophy behind this approach, but the result is an over-engineered product that is not agile enough to adapt to changing business needs and ignores the differences between health service providers.”

Smaller health services in particular found the financial systems selected far exceeded their relatively humble needs.

Health services could not claim exemption from the footprint even when they had found a cheaper solution, meaning “boards are conflicted between doing what is best for their service and using HealthSMART to optimise the benefits to the health sector, even when it may cost more to do so.”

“The panel does not believe that the costs of maintaining the participation policy and the statewide footprint approach are justified,” the report stated.

It is expected a number of the larger health services operating in Victoria will continue to use components of the HealthSMART footprint that are already in place, but many more will now be empowered to adopt systems more appropriate to their specific needs.

In order to avoid a proliferation of new and uncoordinated systems in response to the handover of authority, the government has also agreed to set up a ministerial advisory body to inform the development of statewide ICT priorities and to develop a Victorian health ICT plan before the end of Q1 2014.

The Department of Health will take a step back and adopt the role of scrutineer rather than micro-manager of the public health system.

“The role of the department is to stipulate priorities and objectives, not mandate specific systems or products,” the panel advised.

The seven-member panel was made up of a collection of clinicians, academics and health administrators, chaired by Dr Andrew Perrignon, a former CEO of Victoria’s northern health service.