Questions over company selected for national COVID vaccine booking system

The fine was handed down in August last year after HealthEngine admitted to engaging in ‘misleading conduct’, which included sharing the non-clinical personal information of more than 135,000 patients without consent, and publishing misleading patient reviews and ratings.
 
Despite this, the company has been selected by the Federal Government to create and run a national COVID vaccine booking system that is due to be launched alongside phase 1b of the rollout.
 
Dr Rob Hosking, Chair of the RACGP Expert Committee – Practice Technology and Management (REC–PTM), told newsGP he is ‘surprised’ by the decision. He said the RACGP raised concerns over the plan, even though the Federal Government did not consult the college. 
 
‘We suggested that that wasn’t going to work, particularly for the vulnerable members of the population who don’t actually use online systems,’ Dr Hosking said.
 
‘What we as a college have been pushing is that people should be getting vaccinated in their usual clinic in the usual way that they have other vaccines. We said it would be better if people used the usual booking systems that they have with their usual practices.
 
‘So, it was a surprise when this announcement came out over the weekend that HealthEngine is going to be promoted. We haven’t heard anything about the details of whether it was an open tender or what the selection process was. So, we don’t know how the decision was made.’
 
The system will be available to general practices, pharmacies and state-run vaccination clinics that have been selected to take part in the rollout, and will allow patients to locate and book appointments via a service finder based on the HealthDirect-run National Health Services Directory (NHSD).
 
According to HealthEngine, the platform can be used as a standalone booking option for clinics that do not already have an online booking system, or be integrated into a practice’s usual systems.
 
Dr Nathan Pinskier, a GP and digital health advocate, told newsGP it is not necessarily a question of the company’s competency and capability, but rather that they are getting a ‘massive leg up’ and that the decision has the potential to ‘undermine’ other vendors.
 
‘They get national marketing and national exposure, and that will make it very difficult for the other companies to compete – and obviously a reasonable financial return on this,’ he said.
 
‘The way it’s actually now being sold into the community and into the healthcare community is that this is the national booking solution … when, in fact, most GPs already have their own providers.
 
‘But if one provider starts to dominate the space, then the other providers may struggle to compete and that’s not healthy.
 
We don’t want a single-vendor solution. We want a healthy competition between vendors so that there’s choice.’
 
Geelong GP Dr Eric Hadinata is another who was ‘shocked’ when he heard that HealthEngine had been selected to build the national COVID-19 vaccination booking system.
 
‘We have many other alternative companies who have proven themselves to be capable of building such a system, both in the medical industry and outside,’ he told newsGP.
 
‘This decision to award contracts to HealthEngine will not only destroy public confidence in the COVID-19 vaccination national booking system, but will further erode trust in the national My Health Record future.’
 
But while Dr Hadinata is not alone in his apprehension over the Government’s choice, Emma Hossack, CEO of the Medical Software Industry Association (MSIA), says she has ‘faith’ in its decision.
 
Ms Hossack said the intention is not to create a new competitor booking system, but rather fill a gap for practices that do not have existing software in place, and that it will be ‘temporary’ until the vaccine roadmap is complete.
 
‘It’s definitely not meant to stop anyone using what they’re using. In fact, they’re discouraging that,’ she told newsGP.
 
‘[The Government] have advised us that they will not be authorising people to start using this in lieu of what they’ve already got [and] has agreed that the software won’t be made available freely to organisations that have got access to existing software.
 
‘It’s only for very unusual, perhaps new, situations where people haven’t got access to existing software.
 
‘The other really important thing is that everyone has agreed that the specifications that were given to HealthEngine will be made available to all of their competitors … who want to build to that standard.’
 
However, a sale representative at HealthEngine told newsGP that the platform will be freely available to all clinics, even those with existing software.
 
According to Ms Hossack, the Department of Health (DoH) asked the MSIA for insights on companies with the capability to scale up their offering, and on behalf of its membership put out a survey asking vendors if there was any interest. The findings were then presented to the DoH, which put out a shortlist tender based on existing capability.
 
‘The choice that they made, obviously, was entirely up to them and the strength of the response, which we didn’t see,’ Ms Hossack said.
 
But Dr Pinksier says the short notice at which the platform is being developed and unrolled makes it ‘high risk’, particularly given the lack of consultation with the RACGP and other key stakeholders.
 
‘This is our single biggest gripe with all software developments; they haven’t come to the college, they haven’t come to the GPs and others who use it to say: “How do you think this should work?”,’ he said.
 
‘If the users aren’t part of that process, inevitably it creates issues.
 
‘It may work for those providers who don’t have a software product or don’t want to invest in a software booking platform – proof will be in the pudding. But given the timeline that we had on this, this is something that should have been thought about last year, and probably was thought about last year but wasn’t implemented.
 
‘These things need months of lead-up and they need months of engagement with the right users and the right communities and the right stakeholders.’
 
But Ms Hossack says people should be reassured by the company’s extensive local experience.
 
‘Already HealthEngine integrates with virtually every clinical information system on the marketplace,’ she said.
 
‘So, there’s going to be no issue, and there is no way that they’re going to rollout anything that has not been first beta tested and then thoroughly tested in the usual course of their development.
 
‘This puts us ahead and, in my view, it will actually put us ahead of any country in relation to providing the rollout in a seamless digital way.’
 
When asked about concerns over HealthEngine’s past misconduct, Ms Hossack said the company was heavily penalised and ‘really learnt’ from its mistakes.
 
‘My view is that all organisations, in any industry, are at risk sometimes of making a foolish, but not malicious, mistake. In this situation that HealthEngine found itself in, it was really that,’ she said.
 
‘[HealthEngine] have actually spoken openly to all their competitors and all the industry about what happened, how it happened, what you should do to avoid it happening, and what they’ve done to remediate that.
 
‘And they’ve never ever compromised clinical information or sold that – that’s really important to remember.’
 
The DoH was contacted for comment but did not respond prior to publication.
 
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