SA could install legacy software at new Adelaide hospital

South Australian health bureaucrats will decide next month whether Adelaide’s newest hospital will run new patient administration software when it opens, or whether it will need to install a legacy solution as a back-up.

The state’s auditor general, Andrew Richardson, yesterday released his annual check-up on the rollout of SA’s enterprise patient administration system (EPAS) [pdf], revealing the government continues to sink money into stabilising its legacy acute patient management system (APMS) as a contingency for the new Royal Adelaide Hospital opening.

SA Health is due to decide next month whether the RAH hospital will be ready to take on the troubled EPAS before it opens its doors in November this year.

The recently completed implementation of EPAS at the Queen Elizabeth Hospital will act as a barometer for the system’s performance in a large and complex health environment and inform the nRAH determination.

So far, a May review into the Queen Elizabeth EPAS installation reported stakeholders were “quietly confident” about the work and “preparations were largely on track”.

However, Richardson has warned that if SA Health is forced to go with the legacy APMS solution instead, clinicians will face frustrating workarounds and a minimum 12 month wait until EPAS turns up on hospital computers, so as to minimise the change burden on employees.

“The period between July and October 2016 will be critical, with post-implementation support required at [the Queen Elizabeth Hospital] while also preparing for activation at the new RAH,” he wrote in his report.

Under the state’s original plan, the new Royal Adelaide Hospital should have already been operational and running on the EPAS system.

But in September, its opening was pushed back to November 2016, and the department decided to shift its focus onto implementing EPAS at the open Queen Elizabeth Hospital instead, a milestone it passed at the end of June.

The RAH delay is just one of the headaches the EPAS rollout has caused in the state. Originally signed off as a $408 million project, the latest cost estimate from the health department is around $451 million for the lifetime of the project, which the auditor warned has the potential to nullify the cost benefits attached to the project.

He also warned that the EPAS budget is $29 million short of what it actually needs to roll out to its remaining in-scope hospitals.

And even these latest estimates could prove to be dubious, the auditor cautioned.

“The program is yet to implement EPAS at a major hospital,” he said.

“We believe that the implementation effort required for each site will differ in complexity due to the nature of the [local health network] workflows, various legacy systems and specific site configuration requirements.

"It is therefore difficult to estimate the extent of effort required to complete all program activities purely based on average actual historic resource figures.”