A system that’s supposed to revolutionize health care in Hawaii is costing the state’s taxpayer-supported hospitals more than double the originally projected cost at the Hawaii Health Systems Corporation — the quasipublic agency that runs the state’s primarily rural hospitals.
“We’re always at the legislature trying to find more money for our safety-net hospital system, said Randy Perreira, executive director HGEA, the state’s largest public worker’s union. “But at the same time it seems there’s a faucet running somewhere else that nobody’s trying to address.”
The faucet this time is the conversion to electronic medical records — a requirement of the federal Affordable Care Act that’s proving anything but affordable for HHSC.
“Our original cost was in the $50 million range,” HHSC’s West Regional CEO Jay Kreuzer said. “It’s now $109 million.”
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That’s $109 million over five years to covert HHSC hospitals to the system primarily Siemens was contracted to roll out.
Originally, the schedule would have had it done last year at half the cost. Why is it taking so long at double the initial price?
“It took us longer because we wanted to make sure — we call it remediation — that we worked through all the issues in West Hawaii,” the first site to roll out the system, Kreuzer said. “We had to add significantly staffing, just about double the personnel to our IT staff, to support the EMR, and originally we underestimated the staff it would take to run it.”
KHON2 asked what degree is the contractor at fault here vs. the state, HHSC or even the lawmakers?
“Whoever gave an estimate that was 50 percent too low is at fault,” said Sen. Josh Green, chairman of the Senate Health Committee. “I have no idea who could have made a mistake that low.”
Siemens Healthcare points out their original contract never changed, but that the hospitals kept asking for more and more, and that HHSC delayed the roll-out dates (see Siemens’ full statement at the end of this print edition).
Only one site is up: Kona Community Hospital. The second, Maui, is supposed to be next month, and some of the others are getting cold feet fast.
Already Kahuku told HHSC no thanks, and got a stern rebuke from HHSC interpreted as demanding a $2 million payout.
“I think that is really kind of dirty business,” Green said. “I don’t like that.”
HGEA also doesn’t like what it sees.
“Employees have long expressed upset at the number of private contracts that the HHSC has engaged in, the use of consultants,” Perreira said. “We’re seeing in some cases people making double of what a civil servant would make.”
“We have to support it after we go live and we didn’t have the staff to do that,” Kreuzer said. “We’re recruiting for 35 new full-time positions in IT department. Those are positions that are difficult to fill very quickly so we’ve had to supplement with some consulting work until such time that we get those positions filled.”
KHON2 asked HHSC: Are you confident those can be filled with civil service or people that don’t have to be hired as consultants at sometimes double the price?
“Yes,” Kreuzer said. “We are successful in recruiting the folks, it’s just taking a little more time to get them online, and without that backfill of consultants the project would be delayed even further.”
HGEA is also concerned about a Siemens employee serving as the HHSC’s chief information officer.
“It’s like the wolves watching the henhouse because in that case this individual is responsible for project oversight it would seem,” Perreira said, “and how do you watch the contracts that your company is responsible for?”
Date: February 11, 2014