Delayed e-medicine card latest in long line of problem projects

Report finds that new review guidelines can help reduce cost overruns and delays when state implements new technology projects

While the public sector is no stranger to delayed computerisation projects, patients’ rights groups are worried that the most recently announced delay could wind up costing lives.

The fears come after the announcement of futher delays in the introduction of the Fælles Medicinkort, a card which was supposed to save hundreds of lives every year by preventing people from receiving the wrong prescription. After intially being scheduled for rollout in 2011, the system is now due to come online in 2013.

Lars Engberg, the head of patient advocate group Danske Patienter, greeted the news of the delays with dismay. He pointed to statistics showing that 60 percent of all error complaints in the health service are due to wrongfully prescribed medicine.

“It’s completely unreasonable. Hundreds of thousands of Danes are prescribed more than six different types of medicine at the same time and these people need to have a better way to keep track of their medications,” Engberg told Politiken newspaper. “The health service has interns, doctors, nurses and physicians that don’t have the time to contact everyone to get an overview of a patient’s medicine, and that’s when the risk of error increases.”

The Fælles Medicinkort project was launched five years ago with a budget of 200 million kroner. Once implemented, all hospitals in the Zealand, Central Jutland and Northern Jutland regions will be a part of the system, but due to technical issues, no hospitals in the Greater Copenhagen Region and only 20 percent in the Southern Denmark Region will use the card.

A recent report by Digitaliseringsstyrelsen, the state agency responsible for coordinating digitisation in the public sector, described the Fælles Medicinkort as “a programme that consists of many projects”, and suggested it was delayed because of its complexity.

“A number of projects are currently in the deployment phase, such as Fælles Medicinkort at hospitals and at doctors’ offices, while it is still being developed in the councils (home healthcare). Overall the programme is not deployable,” Digitaliseringsstyrelsen wrote in its report.

The Fælles Medicinkort is just one of a number of public computer and infrastructure projects that has been bogged down in the development stage. The most notable has been the IC4 trains and the continuing problems associated with the Rejsekort electronic travel card system.

The report found that of the 56 state computer projects that cost over 10 million kroner, 20 have been delayed and 12 have ended up costing more than originally anticipated.

Since February 2012, the delays have cost the state an additional 457 million kroner. In particular, two projects being carried out by tax authority Skat were singled out for their delays and budget overruns.

While the Digitaliseringsstyrelsen said that information was sparse about why the two Skat projects had stalled, it indicated that the primary reasons other projects wound up costing more than projected were because their scope had been expanded, because they had been delayed or because the contractor failed to deliver as promised.

The report also found that 13 projects were launched after the 2011 implementation of guidelines requiring that all computer projects expected to cost over 10 million kroner be evaluated by Statens IT-projektråd, a national oversight body, before being approved. 

It was these projects, according to Digitaliseringsstyrelsen, that were most likely to be over budget.

It pointed out, however, that many of the newer projects were still in their early phases. “It will be interesting to follow the projects in the future and see whether risk assessments and the increased focus on project finances will influence the key project figures in the long run.”

On the positive side, three projects have finished sooner than expected, and nine projects wound up costing a combined total of 69 million kroner less than budgeted.

Read the Digitaliseringsstyrelsen report (In Danish only.)

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