More controversy for SA Health’s electronic medical record, with the department forced to go cap in hand to Cabinet for an additional cash infusion, taking the total cost of the troubled system to almost half a billion dollars.

Pouring another $49 million into the Enterprise Patient Administration System (EPAS) will lead to a major system upgrade, according to the health department’s Deputy Chief Executive Don Frater.

“Forecast EPAS expenditure includes the implementation of a major system upgrade to increase efficiencies, provide more advanced security and faster overall system performance,” Frater said in a statement to InDaily.

Originally budgeted at $408 million in 2011 before blowing out to $422 million, this new funding injection takes the cost of EPAS to $471 million over the 10 years to 2021.

“Implementing the new system is an ongoing process and we continue to work closely with staff and clinicians to resolve concerns and make improvements to EPAS where necessary.”

Concerns from clinicians have been ongoing, and in August the state’s AMA claimed that if EPAS were a car it would be recalled. The doctor’s lobby group said a survey of medical staff suggested the system was “not fit for purpose,” and had led to pathology mix-ups, prescribing mishaps and difficulty in finding records when they are urgently needed.

[Read more: SA doctors claim the state’s EMR has caused errors and delayed urgent care | SA Government sued for $185m over delays with new Royal Adelaide Hospital electronic health record system]

A third of survey respondents claimed EPAS was directly responsible for “near misses” while nearly 20 per cent said the system caused adverse patient outcomes. Serious errors included charting medications for the wrong patient, critical delays in obtaining records on surgical patients and pathology errors such as mixing patients and specimens. Respondents also found the system slow and difficult to use.

But South Australia’s then Health Minister Jack Snelling, who resigned in September, claimed the AMA was a "serial whinger".

According to SA Health, EPAS has led to significant improvements in medication safety, with errors occurring in 5 per cent of prescriptions in SA hospitals before the system was implemented, compared to 0.003 per cent once it was in use.

The system, which is uses Allscripts technology, was expected to be ready to go live for the opening of the new Royal Adelaide Hospital in September but instead had a “limited activation,” with Snelling conceding to SA Parliament that paper records would also be in use. EPAS will be fully implemented in the state’s new major metropolitan showcase health facility by early 2018.

Next year SA Health also plans to roll out EPAS at the Hampstead Rehabilitation Centre, Flinders Medical Centre and Mt Gambier Hospital.

[Read more: Shock resignation of SA Health Minister catches government and healthcare off-guard | New Royal Adelaide Hospital opens: CIO talks clinical collaboration and ‘cool’ tech]



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