The most widespread and comprehensive IT program ever undertaken by the Victorian Public Health System is running behind schedule and has only installed a quarter of the planned applications, despite spending over half its budget, according to the Victorian Auditor-General's Office.

In 2003 the Victorian government's Department of Human Services established the Office of Health Information Systems (OHIS) to implement the HealthSMART program; a $323 million program to replace archaic and unsupported applications in Victorian health care agencies with industry standard products. HealthSMART was originally expected to be fully completed by June 2007.

The Victorian Auditor General's Office issued a report this week stating that the original milestones for the program were too ambitious, and will not even be finished by the current planned completion date of June 2009. The Auditor-General also questioned the ability of the DHS to manage HealthSMART's implementation.

"The original HealthSMART budget, involving health agency co-funding capacity, was not realistic. Lack of certainty across health agencies about costs and funding sources have inevitably led to delays in implementation," Victoria's Auditor-General Des Pearson said in the report.

The report stated that DHS had spent $184 million, or 57 percent, of the approved HealthSMART budget as of December 2007. However, only 24 percent of the planned application installations have been completed.

"HealthSMART is now nearly two years late, and the highest benefit clinical applications have yet to be delivered. The Department of Human Services needs a concerted focus on outcomes and benefits, to ensure that the state's investment in process engineering by harnessing technology is realised as planned," Pearson said.

Implementation delays have led to underspend forecasts, and because the OHIS does not have a reliable basis for estimating or monitoring agency expenses for the HealthSMART program, the Auditor General doubts the reliability of its cost-to-completion forecasts.

"Had there been more realistic estimates of the capability of the sector to implement technological change in a compressed period and a better appreciation of the poor state of information technology assets in health services, the Department of Human Services would have more effectively managed expectations around the timing of the roll-out of the strategy," Pearson said.

Despite the drawbacks the report identified, Pearson said that HealthSMART still has the potential to fulfill the original vision of a patient-centric model of healthcare, supporting public sector health clinicians with knowledge and technology.

"However, to date, that vision has yet to be fully realized," he said.