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Sustainability of IT projects - Hospitals, clinics dump costly government project in Japan

Posted Oct 30 2008 3:21pm

The big question facing large IT projects (including provincial/regional funding for physician EMR systems is sustainability). Once a physician makes a decision to implement an EMR, it represents a fundamental change in the manner in which that practice will function indefinitely. The need to upgrade, support and pay maintenance software contracts becomes part of the manner in which that practice will do business from that point forwards.

Many of the funding programs for physician IT and EMR tend to be time limited and a benefit of contract negotiations between medical associations and governments - for example, the current contract in BC and the contract in Alberta for the POSP program. These have a maximum time limit on the funding because of the nature of the agreements, however one hopes that the benefits of widespread EMR implementation will result in greater investment in EMR and support moving forward.

One of the countries in which there is a system wide commitment to sustainability of EMR is the UK. EMR and physician computers plus connectivity are fully funded through the NHS as an integral part of the system. A funding commitment has been made without time limitation to support the 'new' way of doing business in the UK.

The article referenced below is an example of inadequate planning and thought being applied to a project that requires a sustainability plan.

As a physician, would you be willing to take on a greater degree of the cost of your EMR system if the funding is time limited? In other words, should your provincial funding process stop at some point, would you be willing to assume the operating cost of your EMR? In my opinion, there is a definite efficiency gain once the EMR is operating efficiently, there are less chart pulls, quicker access to information, enhanced ability to generate reports and letters and 'pay for performance' programs are put into place to reward good care and the meeting of healthcare targets. In a system that rewards good care with incentives, it is almost impossible to track in a paper world, however the question remains, would you be willing to pay without support from the province or region? Or, should we be aiming towards having a national program such as there is in the UK?

An Economy, Trade and Industry Ministry project that cost about (US )$51 Million has been abandoned in 14 out of 26 municipalities. The project, which began in fiscal 2001, involved the launch of an electronic system to share patients' clinical charts at medical institutions. Some medical societies and hospitals abandoned the system when the ministry terminated its financial support for the project after the first year.  Link: Hospitals, clinics dump costly government project.

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