This audit examined the clinical ICT systems of eight public
health services to see whether they were appropriately planned and
implemented and whether expected outcomes and benefits are being
realised. It examined the HealthSMART clinical ICT systems
implemented at four health services and clinical ICT systems
implemented at four other health services.
The Department of Health (DH) failed to complete the expected
implementation of clinical ICT systems across 19 Victorian health
services due to poor planning and an inadequate understanding of
system requirements. It significantly underestimated project scope,
costs and time lines, as well as the required clinical workflow
redesign and change management efforts.
In contrast, non-HealthSMART sites have used their own
internally generated funds and implemented clinical ICT systems at
a fraction of the cost of implementing HealthSMART.
Clinical ICT system implementations are complex and like any
other transformational ICT project, unexpected and unforeseen
issues can often emerge. In the case of HealthSMART, the
introduction of electronic medication ordering and management has
been the most difficult and complex component of the clinical ICT
This audit found evidence of a number of potential clinical
risks at three of the HealthSMART sites. In the absence of
appropriate controls and effective mitigations, these issues could
pose serious patient safety risks.
As a result, there is a continuing potential risk to patient
safety that needs to be closely monitored by both DH and the
relevant health services. However, DH has not established processes
to oversee either the management of risks, or the performance of
installed clinical ICT systems, at either HealthSMART or
The installed clinical ICT systems do not currently deliver
interoperability across the Victorian public health sector. Both
HealthSMART and non-HealthSMART clinical ICT
systems do not enable patient data to be shared across Victoria’s