The CIO of SA Health has spoken out in defence of the state’s Enterprise Patient Administration System (EPAS) after it was criticised in an inquest into the death of former Socceroo Stephen Herczeg.
South Australia State Coroner Mark Johns is currently inquiring into the death of Herczeg, who died at the Queen Elizabeth Hospital last September. The 72-year-old died from respiratory failure caused by a ruptured bladder and collapsed lungs after an oxygen tube was connected to his catheter.
According to reports of the inquest, Johns criticised the electronic patient record system’s inability to produce intelligible paper copies of records.
"I'd suggest that it is effectively preventing the coroner's court from being able to establish the truth of an incident involving a patient who died in very concerning circumstances ... that difficulty is entirely attributable to EPAS," Johns is reported by the ABC as saying.
Speaking to Computerworld, Bill Le Blanc, SA Health’s executive director eHealth Systems and CIO said that, while he couldn’t comment specifically on the case before the Coroner, EPAS records were never designed to be printed out.
“It was never designed to be used as a printed medical record,” he said. “We are working through issues identified with the printed record, and have made numerous changes to greatly improve the formatting and readability of the printed record.
“While we have already made significant improvements, the readability of printed records is an emerging issue across almost all jurisdictions using different electronic medical record systems and is not specific to the electronic medical record system used by SA Health.”
Confidence in security
The coroner also noted his concern that staff may be accessing the EPAS by using other staff members’ usernames and passwords. Le Blanc told Computerworld that SA Health was confident this was not happening.
“The trust between our patients and staff is the foundation of our high quality health system and we take any breach of patient confidentiality or privacy very seriously. Any staff found inappropriately and deliberately accessing or altering confidential patient information is disciplined or can have their employment terminated,” he said.
“Every time a staff member accesses, views or records information against a patient’s electronic health record, details of their access are recorded, providing greater transparency and security against the patient’s medical record. It is a policy that all staff use their individual login when accessing EPAS. We are confident that staff take these moral and ethical obligations seriously and South Australians should have the utmost level of confidence in the security of our health system.”
Increased accountability
EPAS has been the subject of controversy since before it was first rolled out at Noarlunga Hospital in August 2013. Since then the system has come against a number of setbacks, including a series of outages late last year. It has received sustained opposition from doctors and nurses unions, and the opposition Liberal government in South Australia who once called it ‘a case study in incompetence’. The overall cost of the project has blown out to more than $400 million.
Le Blanc, who was appointed to the role of CIO at the end of 2013, emphasised the benefits of EPAS compared to paper-based records.
“While I can’t comment specifically on the case before the Coroner, electronic medical record systems provide greatly increased accountability and transparency,” he said. “With electronic records, identifying the treatment a patient has received and the actions undertaken by medical staff is much clearer when compared to paper medical records. Using EPAS, patient safety is significantly improving as health care professionals have access to patients’ complete health records.”
Speaking at the CIO50 awards in November, Le Blanc said that he had not expected the system to come under such heavy criticism and media scrutiny.
“I never anticipated when I applied for this job I would have to go on radio, TV, the paper,” he said at the event. “People screaming that IT…is basically going to kill a patient.”
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