RECORDS ROLLOUT: Staff input patient medical records at a nurses' station.
RECORDS ROLLOUT: Staff input patient medical records at a nurses' station. Contributed

Glitches in state's $600m electronic medical records system

QUEENSLAND Health's $600 million electronic medical record system rollout continues to be plagued with problems, placing patient safety at risk, frustrated doctors say.

Documents obtained by The Courier-Mail reveal medication errors and test results failing to register in the system are among a litany of complaints.

The incidents include cases of drugs not being administered to patients or incorrect doses being given.

Some medical specialists also complain the process for ordering blood tests is error-prone.

Their concerns are at odds with Queensland Health bureaucrats, who insist patient safety has markedly improved under the integrated electronic medical record, or ieMR, citing a notable reduction in medication mistakes.

But while doctors acknowledge the ieMR has benefits, they insist it introduces new problems and errors that need to be recognised and addressed by Queensland Health.

A Digital Patient Safety Communique, obtained by The Courier-Mail, shows an issue with cervical screening results not registering in the ieMR, a software program developed by American health technology company Cerner.

"The cause of the issue is being investigated as a priority," says the communique, dated December 6.

"Until resolution, the ieMR and message centre may not contain all available cervical screening cytology results."

The communique says the results could be viewed in AUSCARE and AUSLAB, pathology information systems used by Queensland Health.

Affected hospitals include Cairns Base, Townsville, Mackay Base, Ipswich and Metro South sites, such as the Princess Alexandra Hospital.

In a statement, Queensland Health denied the "issue around cervical screening results" was an ieMR problem, adding it had resulted from a code change in the AUSLAB pathology system.

Australian Medical Association Queensland president Dilip Dhupelia has called on Queensland Health to set up a statewide online forum, allowing doctors to discuss problems with ieMR, and potential solutions, saying this had been denied by the department.

"Patient care must not be jeopardised or compromised in order to roll out Queensland Health's digital system," Dr Dhupelia said.

A Queensland Health spokeswoman said an online forum was already under development after the department had made a commitment to the AMAQ.

"Staff are also able to engage in discussion about ieMR on already available digital forums such as Yammer and Sharepoint, and we have an online help line in place," she said.

Health workers' latest gripes with ieMR follow a recent Auditor-General's report into digitising the state's public hospitals revealing a $250 million blowout for Queensland Health to complete its roll out - an increase of 42 per cent.

The report also highlighted concerns that Queensland Health had not negotiated with Cerner to obtain the best possible price for taxpayers when the vendor's contract was extended in 2017.

"The department has limited leverage when negotiating with the vendor when contract extension options are due," the report said.

"This is because the department has not sought alternative ieMR options and shows no indication of doing so. As a result, there is no competitive tension placed on the vendor.

"Although eHealth Queensland regularly meets with the vendor to discuss performance, there is no evidence that it summarised and analysed the vendor's performance thoroughly before deciding to extend the contract."

The Auditor-General's report cited UQ Business School research which found ieMR benefits including faster access to records, and more legible records, across hospitals.

"Digitising Queensland's public hospitals is delivering benefits in terms of improving health service delivery and patient outcomes," the report said.

But it also found Brisbane's Princess Alexandra Hospital was the only site "actively monitoring disbenefits", or problems with ieMR.

"We found other sites did not have a mechanism in place to monitor and manage the disbenefits," the report said.

Former AMAQ president Richard Kidd called on governments to better fund hospital and health services as they roll out the ieMR to help them cope with the digital "disruption".

"There are a lot of positives that we can see in digitising hospitals and interconnecting them," Dr Kidd said.

"But there are also risks and the biggest thing in all of this, the government - not just the Queensland Government, but the Federal Government too - have again and again shown that they just don't understand that when there's disruption, they really need to invest very significantly in change management.

"There needs to be processes where you have existing systems continuing while you're training people and preparing for switching over to the new system."