Having now had a chance to have a browse of what is planned, based on the documents I pointed out a few days here:
http://aushealthit.blogspot.com/2011/06/document-to-be-read-by-many-who-browse.html
It seems to me there are a few general points that can be made and some general conclusions that can be drawn.
The first is that the actual PCEHR system being proposed is BIG (Very Big) and COMPLEX. This was pretty clear when the April Version of the PCEHR ConOps was released but has now become clearer with the new document release.
The second conclusion - given that it seems unlikely a contract will be signed until early August or so (given how long these things always take!) - is that whatever is going to be delivered to meet the requirements will not be developed from the ground up - but rather take functionality that is already developed and proven and customise and localise it to suit the PCEHR requirements. Building this from the ground up would just take too long, although some of the more ‘twiddly bits’ might need a fair bit of local development!
The third conclusion is that overall the model being sought does fit well enough to make the US style Health Information Exchange a reasonable source of already standardised and possibly even open-source modules (as per the Connect Program being supported by the US Office of the Health IT Co-Ordinator - ONC).
If all this is about on the money then what the Tender will finally need to procure is a Design / Systems Integration Capability with access to as much of the base software capability as possible in the cleanest possible commercial way to suit Australian Government Contracting.
From here on you are left with some guess work. Who might prime this whole effort? My guess is that who-ever will need to be big and have a track record. This really means you are left with CSC, Fujitsu, Accenture, IBM, maybe Microsoft or Intersystems and then maybe some of the Australian SI houses with some capabilities in the health area - although the scale of this effort may just be too big for the time available.
On the basis the Tender closed on March 22, 2011 it is safe to assume that each of the major players has teamed up with a range of partners to provide all the capabilities requested. I have no idea what mix and matching will have happened behind the scenes, but you can be sure some clues are out there.
At least one of these is the following press release appeared a weeks ago.
Press Releases
June 02, 2011
dbMotion Increases Presence and Business Activities Throughout Australia
Connected Healthcare leader positions itself to lead the drive for
Australian healthcare information integration.
Sydney, Australia and Tel Aviv, Israel, June 2, 2011 — dbMotion, an innovative provider of connected healthcare solutions, today announced its increased interest and consequent investment in the Australian Healthcare IT market.
“Over the last year we have experienced growing interest from Australian healthcare organisations, that are now actively seeking solutions that connect disparate systems to improve patient experiences and outcomes,” said Ilan Freedman, dbMotion’s Vice President Asia-Pacific. “This is happening across the market and has recently been illustrated by the Australian Federal Government launching the procurement of the PCEHR Solution”.
Working together with industry partners, dbMotion fulfils the vision of connected healthcare. dbMotion’s solution enables healthcare organisations and health information exchanges (HIEs) to meaningfully integrate and leverage their information assets by placing an integrated patient record within clinical workflows. dbMotion closes information gaps between caregivers, enhances decision-making and drives improvements in the quality and efficiency of patient care.
The full release is here:
There are more details here:
http://www.dbmotion.com/Tech%20Presentation.aspx
You can watch a presentation from this link.
http://www.dbmotion.com/PresProdShort/player.html
Other product suites that seem to be mentioned a lot in the HIE context are:
Axolotl.
See here:
http://aushealthit.blogspot.com/2010/05/us-health-information-exchange-model.html
and Oracle’s offering:
See here:
http://www.oracle.com/us/industries/healthcare/oracle-health-info-exchange-212586.html
and also MedCity - Now owned by US giant Aetna.
See here:
http://infosite.medicity.com/Products/ForHIOS_HIES/
You can also guess Microsoft might be around somewhere:
See here:
http://technet.microsoft.com/en-us/library/ee409374%28BTS.70%29.aspx
Looking at the Tender requirements with the newly released documents there is no doubt someone is going to be attempting to do in very short order what has taken other countries many years.
Frankly, even with a range of already developed software, this is going to be a huge ask. Also remember with the drop-dead date of June 30, 2012 they are going to have to let us know pretty soon who is doing what and with whom. To delay makes the chances of delivery increasingly unlikely.
Remember it is not really all the technology but the people, process and change management that is going to be the trick here - and I am not sure delivering the technology is going to be anywhere near enough to make the PCEHR a success. The adoption, change management and clinician engagement issues are going to rank right up there!
We can all watch and wait I guess! Frankly it will be all guesswork until some formal announcements are made - hopefully reasonably soon!
David.
