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E-health riddled with problems: doctor survey


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A survey of doctors who are using South Australia’s new multi-million dollar electronic health system has found the majority are dissatisfied or extremely dissatisfied with its performance.

The Enterprise Patient Administration System (EPAS) is designed to replace paper-based health records in SA over 10 years at a cost of $422 million to taxpayers.

But the system has been dogged by allegations it puts patients at risk by causing medication errors, forcing doctors to queue for access to vital information and impeding clinical diagnosis.

Senior industrial officer at the salaried doctors’ union (SASMOA) Burnadette Mulholland said serious concerns had been expressed by medical officers at each site where EPAS had rolled out.

“We’re growing increasingly concerned that when this technology moves into these bigger hospitals, the potential (is) for some significant events to occur,” she said.

“On each occasion it’s been implemented, we’ve had significant issues raised by medical officers in relation to the system.

“There may be a poor outcome for a patient.”

InDaily has obtained a SASMOA survey of 35 medical practitioners working in facilities where EPAS is in use.

Most of those surveyed were senior doctors.

It reveals:

–          Thirty-three had experienced problems with EPAS;

–          Twenty-nine were dissatisfied or extremely dissatisfied with EPAS;

–          Twenty-eight had received inadequate training in EPAS; and

–          Twenty said their concerns weren’t addressed quickly.

Doctors made additional comments on the survey, including:

“Many problems need fixing and these should be addressed before further roll-outs in my view.”

“I received an email to say it was fixed. Not surprising. It’s not fixed and their solution doesn’t work.”

“I ring the help line. 2 days later they ring back asking me to clarify my concerns.”

Despite the dire results, the survey also found that 23 of the 35 respondents supported the introduction of an electronic patient administration system; only 4 did not*.

“The majority of medical officers are very keen for an IT system … because they see it as important progress to be made for appropriate healthcare,” said Mulholland.

“What they want is one that is workable, and one that provides timely, safe care.

“This system promises the world, and if that was to be provided, I don’t think you’d get any problem from medical officers.

“The fact that it’s not living up to its promise is what’s causing the angst.”

A spokesperson for SA Health said the implementation of EPAS was a major change for clinicians, which requires complicated training and planning.

“EPAS is currently being used by more than 4000 doctors, nurses and allied health staff across seven SA Health sites, this survey uses a relatively small sample size of 35 doctors,” he said.

“We will continue to work with our clinicians at every site and as the roll out progresses we will monitor the implementation and welcome feedback from staff.”

Former president of SASMOA David Pope told InDaily many of the problems with EPAS stemmed from its design, based on a US system which focuses on patient billing, rather than patient diagnosis.

“It doesn’t work in America; it doesn’t work in Australia,” he said.

“It misses out key information that’s required to be communicated from one doctor to another, and even from doctor to nurse and other members of the team.

“EPAS is enormously time consuming, so it takes away time from patients, it takes away time from other tasks.”

Pope said the system had been designed without enough input from South Australian doctors.

Health Minister Jack Snelling spoke to ABC 891 radio this morning about his trip inspecting hospitals around Europe.

The main lesson he learned overseas, he said, was the importance of consulting medical professionals.

“It has reinforced to me the importance of clinical engagement,” he said.

“We’re going to be asking a lot of the doctors who work at the Royal Adelaide Hospital in terms of having to basically change significantly the way they do their job and it’s very important that they have an opportunity to lead that process, because without them it won’t work.

Last month, InDaily revealed that Port Augusta Hospital doctors refused to use EPAS in February because, they claimed in a letter to SA Health, it risked patient fatality and caused medication errors, resignation threats and “rage attacks”.

“We are concerned that it is only a matter of time before there is a significant EPAS related mishap or fatality,” the letter said.

“The system is more prone (than the former, paper-based system) to medication errors and there have been several such errors.”

*The remaining eight selected ‘other’.


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