Finnish Doctors criticise new US digital patient system

Doctors working at the country’s main Helsinki University Hospital have claimed that the new electronic patient data system from American Epic called Apotti should not have been released for testing. According to these medical professionals serious problems exist and patient safety is at risk.

The Hospital also admits that in the first 5 months of Apotti have actually slowed down work and frustrated the staff. 

The costs of the system runs in to the hundreds of millions of Euro’s as well as absorbing huge amounts of time and resources to correct these errors and inefficiencies.

On the 15.10.2016, FinnishNews published a report on the newly approved Apotti system, and it was clear then that there would be major problems with this IT system.

So much for taking massive closed  IT systems from outside American suppliers who are represented by American consulting companies like Accenture. The system has been originally designed for the American market which is totally different from rather well managed Finnish public healthcare system. The OECD continues to rank the Finnish healthcare system to be one of the ten best in the world, and ranks much higher than the US system.

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Taxpayers will certainly be hit hard for healthcare IT costs…

Published by FinnishNews on 15.19.2016

Big IT projects often fail – It is common knowledge that big IT systems are seldom delivered on time and within budget. This is especially true of big national systems involving the public sector. Size, complexity and over-optimistic salesmen and buyers in both the private and public sectors have seen these problems with almost all such projects.

The government’s social and healthcare reform (SOTE) is cooking up some interesting and disturbing competing projects and costs, which appear are outside their control. 

The government has announced that it wants its own IT system for the SOTE reform, but the municipalities have already started huge investments that are either a waste of money or projects that the government will have to buy from the municipalities when the government takes over the healthcare systems from the municipalities.

Several competing municipal systems will cost hundreds of millions of Euros, and there is no guarantee that they will be ready on time. There is no guarantee that they will be within budget. There is no guarantee that they will work seamlessly with one another.

This is a consultants’ paradise because they stand between the suppliers and the buyers, so delays and increased costs just increase their percentage for longer!Two huge projects – There are several projects that are on-going and they are expensive, closed systems that will only work together at great cost.

Apotti & Helsinki – Helsinki, Vanta, Kirkkonummi, Kauniainen, HUS, (possibly later, Tuusula and Kerava) have a jointly owned company called Apotti Oy which is planning to have an Electronic Health Record (EHR) system up and running between 2018 and 2021. They have chosen the American giant as a system supplier called American Epic, and Accenture is Epic’s partner in Finland.

Although this is tried and tested in the USA and a few other countries, it is an expensive and closed system. Apotti have estimated that the first phase will cost between €350-450 million and the final cost after 10 years around € 575 million, with an annual cost saving of €123 million. 

Naturally the figures are over-optimistic, especially when cast savings can be so precisely presented.The government is said to be looking at the Epic system, but if it is adopted what will they pay the municipalities and, if not, who will foot the municipalities’ sunken costs? The software is being used by many American healthcare bodies, but its transfer to an entirely different Finnish system will be challenging. There has been a fair number of failures and bad experiences with this system in the UK and in the US. As a closed system, sharing information across all of the nation’s healthcare suppliers, private and public will be challenging.

UNA & Espoo – A second system called UNA is being put together by Espoo, Finland’s 2nd largest city and some 20 other groups of cities and municipalities. They have rejected the Apotti/Epic system because, in their opinion, it is too expensive! So they have recently signed a joint UNA framework agreement on procuring a new EHR system.

This UNA project is big, and will end up as big and as important as the Apotti project. According to the UNA agreement, the initial start-up costs will be in the region of €40 million and involve hundreds of people from the public sector, lawyers, management and IT consultants, as well as the suppliers of the various parts. 

It is doubtful that the costs will be significantly lower than Apotti because the same types of consultants and suppliers will be asked to bid for the works. There is no information yet on what type of system and whether it will be compatible with other systems.

In conclusion it will be interesting to see how the present government will manage the SOTE reform when various groups of municipalities are competing to set up new complex IT systems in their own regions. The big questions of cost control and timetables are open to significant vulnerabilities because none of the suppliers are working on a fixed cost turn-key basis to deliver the systems.

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