The long-awaited statewide project moved one step closer this week with the release of a formal EOI.
WA Health has formally asked for expressions of interest from vendors and integrators to develop and implement a statewide electronic medical record and patient administration system solution for the state.
The EOI follows a registrations of interest request last October and a long line of reports, reviews and other calls for information from the vendor community going back to 2019, when the department released its Sustainable Health Review report, in which the original recommendation for statewide EMR and PAS was made with a timeline for rollout of 2029.
In the 2023 WA budget the government set aside $100 million for the first stage of the EMR project.
In the same budget $8.2 million was allocated for the smart eReferrals project which was awarded in February last year for $8.4 million, but just a few weeks ago collapsed with the major tender parties Deloitte and SalesForce removed from project in a move to reduce the project’s complexity and simplify delivery.
This week’s EOI says that WA Health is specifically seeking to “gain a more detailed understanding of the market interest, and the range of EMR Solutions that are available”.
The documentation provided to vendors is extensive in terms of background and requirements and in this respect WA Health sees the EOI as an opportunity for vendors and integrators to provide more detail on why they might make a good partner in the project.
“The people of WA expect the WA Health system to use technology to improve the safety, quality, equity, and sustainability of their health care,” states the EOI.
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“There is opportunity to meet these expectations through implementation of a single configuration, statewide Electronic Medical Record (EMR) Solution, with a Patient Administration System (PAS).
“The Department of Health is seeking to purchase a mature, tested, and proven solution, provided by a Contractor with established methodology, which include all applicable implementation activity (solution build, data migration, testing, integration, change etc).”
More than 30 consultants, software vendors and various other parties are listed as having taken part in building out the project to date, including helping to formulate the extensive documentation for this EOI, including the likes of InterSystems, DXC Technology (now Dedalus), Deloitte, EY, KPMG, Nous, PwC and The Checkley Group.
The breadth and complexity of the project are perhaps best summed up by the long list of legacy systems and applications provided in the document that the new EMR would need to contemplate some sort of integration with. The list totals nearly 220 applications from clinical decision support to laboratory management systems, virtual health systems, diagnostic imaging, community health information (Communicare) all the way through to a fax management system.
Of the 220 identified, 90 are listed as definitely being impacted in some way by the EMR project, and the rest are to be decided.
Notably there is no specification for the implementation to talk to major GP patient management systems, Best Practice and Medical Director, although no other enterprise state-run EMRs do at this point of time. Apparently NSW is considering a link to GP systems through its new EPIC project and Cerner is experimenting with an integration to Best Practice in Victoria.
WA currently uses a variety of older clinical record systems, many of them still paper based. One key recent system introduced is known as Opal DMR from Altera Digital Health, formerly known as BOSSnet.
Opal DMR was first rolled out at Fiona Stanley Hospital in 2014 and has been positioned as the first phase of the entire statewide EMR transition – a paper-to-digital-record precursor – with implementations in about 25 WA hospitals by last year.
That may or may not make Altera one of the early frontrunners when the tender is eventually is put out given they have a range of cloud-enabled midsize hospital EHR systems and a range of smaller hospital and remote community health solutions.
A key issue for the project is the significantly skewed demographic of rural and remote vs big city hospital implementation that would be required of the one system.
As far as hospital patient care is concerned, WA is Perth, and then the significantly remote rest, something that is well articulated in the EOI document with the below chart.
This sort of dichotomy might make bids by some of the major global EMR vendors such as Oracle (Cerner) and EPIC difficult as these systems are expensive and tend to be implemented across Australia only in big city or large regional hospitals.