SA Health is expected to scrap and reconstruct its troubled electronic patient records system following an independent review of the program. 
 
The EPAS Independent Review found that the beleaguered Enterprise Patient Administration System (EPAS) failed as it “contrasts with other successful EMR implementations in Australia”. 
 
This conclusion was reached after an expert panel assessed the software solution supplied by Allscripts, its configuration and management by SA Health, and the implementation and governance of the program. 
 
The report identified that SA Health chose to implement the system without the assistance of “expert organisations including the Allscripts vendor” resulting in the billing module not being fit-for-purpose. 
 
In addition, it found that EPAS has a flawed governance model with “accountability for outcomes poorly understood and managed” and a lack of current governance arrangements empowering clinicians to be key decision-makers. It also found the governance model doesn’t enable the implementation of the system to be tracked, measured or managed, amongst other determinations. 
 
“The Review Panel concludes that all three factors have contributed to EPAS not meeting user expectations,” the report stated.
 
The South Australian Government commenced implementation of EPAS in 2011, which it expected to deliver by 2014 at a cost of $421.5 million. But, by 2018, it claimed that 78 per cent of the funds for the original scope “had been expended.”
 
Following public debate and change of government in March 2018, the rollout of EPAS was paused to commission an independent review to inform decisions on the most appropriate way forward, which resulted in the EPAS Independent Review.
 
“The review finds that the EPAS program has been a failure and should be discontinued and replaced. The review has determined that the EPAS program should not continue as planned,” the South Australian Government said in response to the review. 
 
“The review recommends that SA Health completely overhaul the program, reconfigure the underlying information technology and commence a roll out at two exemplar sites before a final decision is made on whether to continue to use the Allscripts suite of products.” 
 
 
The EPAS Independent Review also made 36 recommendations for a proposed way forward. 
 
“Every effort should be made to optimise the underlying elements of the EPAS program,” it stated. 
 
This includes improvements to Sunrise EMR (Electronic Medical Record), an integrated suite of clinical and financial solutions that is also used by hospitals and health systems in the US, UK, Canada and Singapore, and Allscripts PAS (Patient Administration System) implementation – terms that will replace EPAS. 
 
Allscripts ANZ General Manager Todd Haebich said the company welcomes the independent review into EPAS. 
 
‘We look forward to working more closely with SA Health to fulfil what it has set to out achieve –
the establishment of a state-wide electronic medical record,” he said in a statement. 
 
Other recommendations include the creation of an SA Health Digital Strategy with a Digital Health Board and “significant governance reforms” that put control into the hands of clinicians. 
 
“The Government will transition from the EPAS project to a new electronic medical record project, which will utilise two Allscript software programs, a patient administration program and an electronic medical record program,” the South Australian Government said.   
 
“Deployment to the exemplar sites will be the focus of immediate action for Government, with deployment to take place during 2019.”
 

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