ICT HEALTH REFORM ICT PROJECTS BY CATEGORY Category BASIC INFRASTRUCTURE Project 45 Infrastructure Technology Refresh Cost $m What

is the project? Why is it critical to delivering an electronic health record?

To ensure that Health has up to date and effective infrastructure in place to support The program is a strategic management of technology where the Department of the new enterprise based initiatives Health leverages the advantages of its economies of scale, collective buying power, and consolidation strategies. Maintaining a base level of ICT infrastructure is a critical enabler of all health applications. Upgrade of Health WAN including core switches and routers to cater for current and future requirements including refresh, includes the provision of management software and all telecommunications requirements Provide a standard Department mechanism for network-based traffic to be prioritised according to risk profile and usage prequirements. The program will continually review the state of the Departments telecommunications infrastructure to ensure that it provides optimum delivery, is cost effective, applies appropriate telecommunications standards and is scalable. To ensure that Health has up to date and effective WAN in place to support the new enterprise based initiatives To ensure that Health has the web capacity and throughput in place to support the new enterprise based initiatives To ensure that Health has the telecommunications infrastructure in place to support the new enterprise based initiatives

47 WAN Upgrade 14 Web Capacity Management (QOS) - S&S $60.7m 60 Telecommunications Review

64 RAH IBM Survival 44 PC Fleet Implementation Project

Ensure IBM mainframe continues operating until being decommissioned post PAS Failure of the IBM mainframe will result in critical hospital systems failing. implementation. Establish standardised IT operation with a structured procurement and life cycle To minimise the cost of purchase, implementation and support of the departments asset management program for desktop PCs and notebooks across the Health PC fleet. Portfolio Implementation of an ICT Governance Framework to manage and govern all ICT capital Programs / Projects. This will include the development and ongoing upgrade of an ICT Governance Steering Committee, Policies and Standards Review Board, Program Management Office and Program Governance Board. It will also review and update all required processes on an ongoing basis to ensure that the level of governance is appropriate. Whole of Health replacement project for PAS and Financials Management System/s. Statewide implementation and retiring of several obsolete PAS applications. Integrating the OACIS platform into the replacement pharmacy system to enable decision-support, minimise pharmaceutical wastage, reduce adverse events, and standardise processes statewide To provide an effective ICT Governance Framework to manage ICT projects as required by the Auditor General and the Office of the Chief Information Officer (OCIO).

GOVERNANCE $1m

43 DH ICT Governance & Methodology

HOSPITAL APPLICATIONS

52 PAS 24 Pharmacy - Electronic Medication Management 21 OACIS Metro Rollout (S&S)

To replace obsolete critical applications and provide a basis for standardisation and across Health access to information To enable decision-support, minimise pharmaceutical wastage, reduce adverse events, and standardise processes statewide

Application technical refresh plus introduction of the ability to deploy OACIS to any The ongoing rollout of OACIS across the metropolitan area. This will include site via the web regardless of location. interfacing hospitals that are not utilising current OACIS functionality to OACIS, replacing legacy hospital applications with OACIS functionality and the interfacing of required Transformation is the business process review, process re-engineering and new process implementation required to optimise and standardise the Patient Administration, Finance and Materials Management Systems across the department. The Transformation process needs to commence prior to the applications systems design stage of the PAS Replacement to ensure that the PAS applications systems design takes into account any new business processes that have been identified for each hospital. The transformation process also needs to continue through the life-cycle of the PAS Replacement Program to ensure that any business processes that could not be altered until the new PAS system has been implemented, are implemented as part of the new system go-live cycle. The transformation process also has to ensure that all hospitals to be upgraded utilise enterpise wide standard terms, codes, types to ensure that the "value-add" of the new system is realised. Without business transformation and standardisation, the implementation of an enterprise-wide system cannot succeed. This business transformation will also provide the basis for the delivery of the standard data and information required to implement a state Electronic Health Record.

$225.6m

51 PAS Business Transformation (S&S)

26 Nurse Management System 29 OACIS vCD rollout to country Hospitals 30 OACIS metropolitan enablement 32 PACS

As per the Nursing Enterprise agreement of Feb 2001, replace obsolete product Excelcare across 14 hospitals in both the metropolitan and country regions. This project will implement the provision of OACIS functionality to Country Hospitals and achieve a statewide view of clinical information. Upgrade of OACIS clinical information system to web-based version. Implement a statewide Picture Archiving and Communications system for medial images.

To replace the current obsolete systems that reside on out of date and unsupported technology and operating systems To provide OACIS functionality to country hospitals resulting in access to patient clinical information not currently available to country clinical staff. To provide an OACIS front end that is both quich and low cost to implement. The provision of a statewide Picture (x-ray) Archiving system will result in clinical staff having fast / timely access to patient x-ray information from remote (other hospital) sites.

25 Nurse Management System - Bus Trans (S&S)

Transformation is the business process review, process re-engineering and new process implementation required to optimise and standardise the Nurse Management System (NMS) across the department. The Transformation process needs to commence prior to the applications systems design stage of the NMS Replacement to ensure that the NMS applications systems design takes into account any new business processes that have been identified for each hospital. The transformation process also needs to continue through the life-cycle of the NMS Replacement Program to ensure that any business processes that could not be altered until the new NMS system has been implemented, are implemented as part of the new system go-live cycle. The transformation process also has to ensure that all hospitals to be upgraded utilise enterpise wide standard terms, codes, types to ensure that the "value-add" of the new system is realised.

Without business transformation and standardisation, the implementation of an enterprise-wide system cannot succeed. This business transformation will also provide the basis for the delivery of the standard data and information required to implement a state Electronic Health Record.

56 Clinical Costing System (Trendstar) replacement 57 Pharmacy Management System (Ascribe) 53 HAAS Emergency Department System Replacement 35 Cardiovasular System Rationalisation

Implementation of a modern system that will facilitate hospital product costing in an output based budget environment which is consistent with current commonwealth and state initiatives. Replace absolete system which meets ANZ and HL7 standards and is able to be interfaced with Oacis to enable Oacis POM implementation. Major upgrade / replacement of the current HASS ED application to ensure maintain n-1 industry standard. To rationalise and standardise the public hospital cardiovascular system to ensure that data consolidation and interface developments can occur. To realise these objectives electrocardiograph systems and cardiovascular investigation systems should be standardised across health. Major upgrade of the ProAct application to ensure maintenance of n-1. Migration of platform to SQL version. Replacement of obsolete whole of Metropolitan Health implementation of Radiology Management System To rationalise and standardise the public hospital respiratory system to ensure that data consolidation and interface developments can occur Transformation is the business process review, process re-engineering and new process implementation required to optimise and standardise the PACS across the department. The Transformation process needs to commence prior to the applications systems design Upgrade the current HASS Operating Room Management Information System (ORMIS) which is increasingly becoming unstable and out of date. Whole-of-health food management system to replace outdated Buckeye system Utilisation of multimedia monitors to enable clinical access at the bedside, subsidised by patients Development of Hospital Infection Control Management and Reporting System that can track infections across OACIS footprint (currently metro only) See item 52, PAS

To provide a modern system that facilitates hospital product costing in an output based budget environment which is consistent with current commonwealth and state initiatives. To reduce the risk of obsolete system failure that currently cannot interface with OACIS. To ensure that the system has appropriate venro support. To ensure that data consolidation and interface developments can occur. To realise these objectives electrocardiograph systems and cardiovascular investigation systems should be standardised across health. To ensure maintenance of n-1. Migration of platform to SQL version. To reduce the risk of failure of the obsolete the whole-of-Metropolitan-Health implementation of Radiology Management System To ensure that data consolidation and interface developments can occur Without business transformation and standardisation, the implementation of an enterprise-wide system cannot succeed. This business transformation will also provide the basis for the delivery of the standard data and information required to implement a statewide approach To reduce the risk of failure of the current HASS Operating Room Management Information System (ORMIS) which is increasingly becoming unstable and out of date. To reduce the risk of failure of the current outdated Buckeye system To enable clinical access at the bedside, subsidised by patients To increase infection control across the OACIS (multiple hospital) footprint.

27 Nursing - Proact Upgrade 33 Radiology Management System (Kestral) 34 Respiratory Medicine Standardisation 31 PACS Business Transformation (S&S)

54 HASS Operating Room System Upgrade 55 Hospitals Food Management 28 Patient Bedside Monitors 23 OACIS Infection Control System 50 PAS Business Case Development 8 Booking Management Systems (S & S) 16 CME Upgrade 19 Cancer register 17 Cervix Screening

To ensure that an accurate business case is developed prior to PAS options being evaluated. To increase the effectiveness of patient bookings across hospitals resulting in optimum department wide bed management

NON-HOSPITAL APPLICATIONS

An online enterprise wide patient booking service to allow patients to be booked into any metropolitan hospital via a standard booking system with a view of all available beds vacancies.

Provide a web-enabled application for use in mental health and community health An out-of-hospital business application for usage which must be able to be integrated with the information broker to enable information to be gathered to compile a holistic health record. Replacement Cancer Registry application that complies with legislated A business application for niche usage which must be able to be integrated with the requirements and with the requirements of the Australasian Association of Cancer information broker to enable information to be gathered to compile a holistic health Registries. record. Replacement of the existing application is required in order to rectify the current inefficiencies in the application and database software, cope with the continual growth of the database, enable new functions to be performed and strive towards achieving a paperless Register. Implementation of a comprehensive application to manage breastscreen patients across the state. State-based funding commitment to Federal government A business application for niche usage which must be able to be integrated with the information broker to enable information to be gathered to compile a holistic health record. A business application for niche usage which must be able to be integrated with the information broker to enable information to be gathered to compile a holistic health record. To assist in the provision of the connection of health providers in the private sector to both other private providers, and the Department resulting in effective sharing of patient health information

$20.6m

18 Breastscreen 15 HealthConnect

6 Prisons Electronic Health Record 36 Infection Control Surveillance - Central Office

Replace paper-based records with modern application to manage prisoner health Prisoners health information is currently highly disparate and not readily available to information providers upon release from prison. This project will develop the new Infection Control Service Surveillance System To minimise the risk of the spread of communicable diseases. (ICSSS) that will support both preventing cases of communicable disease and for minimising the spread of disease once an initial case has been identified. Consolidation of the many disease surveillance systems, written in FoxPro, into a To provide a single contemporary technology system that will facilitate the collection single contemporary technology platform. This system will facilitate the collection of electronic notifications from pathology laboratories and provide sophisticated data collection and analysis capabilities. of electronic notifications from pathology laboratories and provide sophisticated data collection and analysis capabilities. An application used to identify areas of high and possibly inappropriate antibiotic usage, and to assist with planning and evaluation of intervention programs to modify antibiotic usage patterns. The ultimate aim is to control or reduce the emergence and dissemination of antibiotic resistance within health-care institutions. To enable the identification of areas of high and possibly inappropriate antibiotic usage, and to assist with planning and evaluation of intervention programs to modify antibiotic usage patterns. The ultimate aim is to control or reduce the emergence and dissemination of antibiotic resistance within health-care institutions.

37 CDCB Disease Surveillance

38 CDCB Antibiotic Utilisation DB Upgrade

STRATEGY

39 Business Intelligence Strategy

The implementation of standards, applications, databases, data warehouses, and To provide executive with the appropriate business intelligence to effectively manage infrastructure required to provide executive with the appropriate business the Department of Health. intelligence to effectively manage the Department of Health. The ongoing funding of NEHTA ICT initiatives, including data, application, messaging, interstate national connectivity standardisation initiatives. A summary-level health record that can be accessed by authorised providers. This record is to be based on NEHTA standards once released (2008). Development of a comprehensive ICT systems architecture to facilitate planning and prioritisation. Investment in investigating and seed-funding the application of modern technology to improve the Health business The initial creation and the ongoing support of an ICT Standards Framework. The framework will manage all ICT Standards including the initiation, development, change management and approval of all ICT Policies, Methodologies, Procedures, Work Instructions Product management strategies to ensure that key enterprise systems such as OACIS are delivering as expected. This will also include evaluation and recommendation on system version and new application upgrade requirements. The initial creation and the ongoing support of an Enterprise Architecture Model that defines the Department's ICT Architecture. To ensure that the Department of Health utilises and is able to connect to national health iniatives as they evolve. In accordance with the eHealth national objectives, a summary-level electronic health record is an early deliverable of the program. This will begin as provision of access to a centrally-held separation summary. To provide a basis of overall accurate infrastructure review and update To ensure that ICT Services are aware of, and in a position to implement the most appropriate technology. To ensure that appropriate standards are in place to support the strategy implementation

5 NEHTA 4 Electronic Health Record 48 ICT Enterprise Architecture $15.5m 49 R & D Seed Funding 42 DH ICT Standards Framework

22 Product Management Strategy - Peter Sanderson

To ensure that OACIS is aware of and in a position to implement the most appropriate upgrades or developments to support the business.

46 Health ICT Architecture

To ensure that ICT Services have an up to date and accurate understanding of the Health infrastructure architecture to facilitate the review and implementation of the most appropriate ongoing Health infrastructure.

SYSTEM CONNECTIVITY

7 Health Integration Broker 10 Authentication & directory 9 Interfaces between key systems

A software layer including configurable applications to enable multiple applications Broker (or middleware) software will enable the linkage of information quickly from to communicate and link data to otherwise disparate systems. This will form the existing systems rather than waiting for legacy systems to be replaced. basis for the ongoing delivery of an state EHR. Ability to legally identify a system user and define that users privileges and Enables legally binding digital signatures for information input, access and workflow. security rights. The ongoing interfacing and connection of key health applications as required to To ensure that the appropriate interfaces are in place to support new Health business support the business. This includes interface connections that will be required to iniatives as they evolve. support business initiates such as GP+, Chronic Disease Management and Mental Health, inclu Provide a standard Department mechanism for internal and external interfacing of A secure information exchange mechanism with providers outside the public system e.g.. GPs, specialists, private hospitals etc. is a mandatory requirement of a full web based network traffic to be based on standard messaging formats, and health record being made available. routing based on business requirements. The WSE is to be based on NEHTA defined standards that are ca Provide a unique, unchanging identifier for a client to be used throughout DH enterprise systems as the client identifier in all events through that system. Establish a single repository of addresses and location information for use enterprise-wide, including Australia Post identifiers and geocoding information. One unique number/code for every organisation that contributes to Health information including GL coding and reporting Clients must be able to be reliably identified in order to cross-reference the plethora of information systems that exist in Health. Without a unique identifier the compilation of an EHR would be virtually impossible. To minimise the risk of invalid patient identification

$27.9m

11 Web Services Environment (WSE) - S&S

2 Unique Client Identification 1 Unique Address Identification 3 Unique Organisation Identifier 58 DH Disaster Recovery

To minimise the risk of invalid support / supplier / partner identification

RISK & SECURITY

Establish and maintain disaster recovery facilities for Health (this is also an Auditor To provide a disaster recovery facility for key / critical Health applications as General recommendation). recommended by the Auditor General.

12 Web (DMZ) - Includes security 41 Archiving & enterprise data storage

Establish and maintain security controls protecting HSNet access and data The project will implement a storage and archive portfolio standard, along with a phased plan of action to evolve Health's storage infrastructure to a "common resource" to improve utilisation and scalability which will lead to a lower cost of storage and a more structured archiving/recovery environment. The establishment of a framework to provide DH systems identity management, including alternative logon methods (iris, fingerprint, smartcard) that will support single-sign capability The establishment of an ICT Test Environment (hardware / communications) to enable formal / controlled testing of ICT Services developed applications. Implementation of second/back-up PABX's - one at FMC & one at NHS for Disaster Backup / Business Continuity/Recovery purposes. Enable incident management across Health Portfolio

To ensure appropriate WEB interface security To provide Health with "common resource" storage to improve utilisation and scalability, which will lead to a lower cost of storage and a more structured archiving/recovery environment.

$12.7m 61 DH Identity Management 62 ICT Test Environment Establishment 59 FMC / NHS PABX Redundancy 65 Heat Incident Management ADMINISTRATION 40 Document and Records Management System
To provide an identity management and single sign on facility to both increase the security speed up access to Health support systems in high access requirement areas (e.g., emergency departments) To ensure that ICT Services are able to appropriately test developed applications prior to production implementation To ensure that FMC & NHS have effective business continuity in place To reduce the overall costs of incident across the Department

The program will implement an enterprise wide document and records Health currently do not have an enterprise wide view of its documents and records management system to enable across departmental (enterprise wide) document resulting in significant overheads, duplication, gaps, including non conformance with management and access. The system will contain departmental policies, methods, the Records Management Act procedures, work instructions, articles, reference material and formal records. The program will implement an enterprise wide system to manage ICT assets, Health currently do not have an enterprise wide view of its ICT assets and is therefore including type, location, unique identification (serial number) purchase details, unable to effectively manage its ICT assets. replacement requirements and timeframes. As this is an ongoing requirement there is a need to ensure that is provided ongoing funding to support and upgrade as required. Replacement of the existing DH intranet and plethora of external web-sites with an To rationalise, reduce operating costs and support of the DH intranet and web sites integrated and structured content managed system. The Healthy SA website is in need of a technical and functional upgrade To provide an up-to-date Healthy SA website.

63 Asset Management $11.7m

13 DH Online Services 20 HealthySA Web Site Redevelopment Grand Total

375.6m

ICT Health Reform Indicative timeline # Primary Enabling Program Fin Year Fin Year Fin Year Fin Year Fin Year Fin Year Fin Year Fin Year Fin Year Fin Year Fin Year

2006 -2007 2007 - 2008 2008 - 2009 2009 - 2010 2010 - 2011 2011 - 2012 2012 - 2013 2013 - 2014 2014 - 2015 2015 - 2016 2016 - 2017 11.0 22.0 13.0 40.0 45.0 18.0 23.0 37.0 41.0 44.0 64.0 65.0 2.0 4.0 6.0 7.0 15.0 16.0 17.0 19.0 20.0 24.0 25.0 26.0 27.0 39.0 42.0 43.0 46.0 49.0 51.0 55.0 57.0 58.0 60.0 61.0 36.0 38.0 50.0 54.0 59.0 62.0 Web Services Environment (WSE) - S&S Product Management Strategy DH Online Services Document and Records Management System Infrastructure Technology Refresh Breastscreen OACIS Infection Control System CDCB Disease Surveillance Archiving PC Fleet Implementation Project RAH IBM Survival Heat Incident Management Unique Client Identification Electronic Health Record Prisons Electronic Health Record Health Integration Broker HealthConnect CME Upgrade Cervix Screening Cancer register HealthySA Web Site Redevelopment Pharmacy - Electronic Medication Management Nurse Management System - Bus Trans (S&S) Nurse Management System - (PKF Review Update) Nursing - Proact Upgrade Business Intelligence Strategy DH ICT Standards Framework DH ICT Governance & Methodology Health ICT Architecture R & D Seed Funding PAS Business Transformation (S&S) Hospitals Food Management Pharmacy Management System (Ascribe) DH Disaster Recovery Telecommunications Review DH Identity Management Infection Control Surveillance - Central Office CDCB Antibiotic Utilisation DB Upgrade PAS Business Case Development HASS Operating Room System Upgrade - Inc Country FMC / NHS PABX Redundancy ICT Test Environment Establishment x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x

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ICT Health Reform Indicative timeline # Primary Enabling Program Fin Year Fin Year Fin Year Fin Year Fin Year Fin Year Fin Year Fin Year Fin Year Fin Year Fin Year

1.0 3.0 8.0 9.0 10.0 12.0 28.0 29.0 48.0 52.0 56.0 5.0 14.0 21.0 30.0 31.0 32.0 33.0 34.0 35.0 47.0 53.0 63.0

Unique Address Identification Unique Organisation Identifier Booking Management Systems (S & S) Interfaces between key systems Authentication & directory Web (DMZ) - Includes security Patient Bedside Monitors OACIS vCD rollout to country Hospitals Enterprise Architecture PAS Clinical Costing System (Trendstar) replacement NEHTA Web Capacity Management (QOS) - S&S OACIS Metro Rollout (S&S) OACIS metropolitan enablement PACS Business Transformation (S&S) PACS Radiology Management System (Kestral) Resporitory Medicine Standardisation Cardiovasular System Rationalisation WAN Upgrade HAAS Emergency Department System Replacement Asset Management

2006 -2007 2007 - 2008 2008 - 2009 2009 - 2010 2010 - 2011 2011 - 2012 2012 - 2013 2013 - 2014 2014 - 2015 2015 - 2016 2016 - 2017 x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x

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