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SA's e-health rollout delayed further


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The rollout of the State Government’s troubled $422 million electronic health records system has been delayed again.

The Government revealed today that the Enterprise Patient Administration System (EPAS) will not be implemented at the Royal Adelaide Hospital (RAH) before the transition to the new Royal Adelaide Hospital.

In June last year, Health Minister Jack Snelling announced that the statewide rollout of EPAS would be halted, following complaints from doctors that the system caused threats to patient safety, “rage attacks” and resignations, and the May announcement of federal funding cuts to health.

Snelling told InDaily at the time that the government would ensure the system is functioning properly at the RAH before the transition to the new hospital, so as to avoid clinicians having to adapt to a new physical environment and changes to work processes required by EPAS at the same time.

Now, clinicians will have to do just that.

SA Health said this morning that a stabilisation phase for the system – “which had involved reviewing and resolving a number of key issues” – was now complete.

The Chief Executive of SA Health, David Swan, said that in the time now available, it was most appropriate to concentrate on having the system up and running at the new hospital, rather than the existing RAH.

“The original plan to implement the EPAS solution into the current Royal Adelaide Hospital and then the new RAH was reliant on having a stable technical platform,” Swan said.

“This stabilisation work needed to be finalised before we reviewed the EPAS implementation schedule, and this has now been successfully completed.

“Upon review, and with the timeframe available to us, it has become apparent that the most appropriate approach is to concentrate our resources on implementing EPAS directly into the new Royal Adelaide Hospital in 2016.”

Swan said staff would have access to a thorough training program to ensure they are able to use the system effectively at the new hospital.

“A comprehensive training program is currently being developed and will be made available to all staff well in advance of the move to the new hospital,” Swan said.

“This training will include reviews of workflows, workshops and practical simulation training to ensure all staff are fully conversant with EPAS well before it is activated at the new RAH.”

Some medical officers have complained that training to use the system at other sites has been inadequate.

Last year, InDaily reported repeated claims by doctors and nurses that EPAS slowed down patient care and caused increased medication errors, among other problems.

EPAS is currently used at Noarlunga Hospital, Port Augusta Hospital and SA Ambulance Headquarters. Some clinicians have warned that attempting to implement the system at a major hospital would increase risks to patient safety.

EPAS was designed to be an integrated, state-wide electronic health records system – an ideal which has broad support among medical professionals.

However, its implementation has been plagued with problems.

In November, Noarlunga Hospital doctors said they were using paper towel to take down patient notes, rather than using EPAS, because the system was too slow to be used safely in emergencies.

EPAS has also been linked to the hospital’s failure to publish emergency department waiting times.

The new RAH was designed to rely on EPAS for electronic patient records. Its design does not include physical space to house paper-based patient records, should the system fail.

In December, a report by the Auditor-General revealed SA Health was drawing up contingency plans to make sure the $2.1 billion hospital can function when it opens in 2016.

“SA Health recognises that, from an operational perspective, if EPAS was not rolled out to the nRAH, the current impact on the proposed model of care … is unknown,” the report says.

“Any alternative solution is expected to require modified processes and manual workarounds…

“… central paper record storage at clinics and wards and daily transport for paper records will be required.”

The report also revealed more than 4,800 separate defects with the system have been reported since the program began, and advice to state cabinet that the finances for the project had deteriorated.

A spokesperson for SA Health said the department would continue to consult with medical staff as it prepares for the rollout at the new hospital.

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