The General Contracts Committee has recommended to the Government to proceed to enter into an agreement with ACS Healthcare Solutions to provide products and services for the first phase of the Integrated Health Information System (IHIS) which will include the provision of the Information Technology needed to support the operations of the Mater Dei Hospital.

ACS Healthcare Solutions are a leading healthcare IT services provider, delivering business process outsourcing services across the United States of America. ACS has over 4,000 healthcare clients and employs directly 2,300 dedicated IT-healthcare employees.

ACS Healthcare Solutions is a fully-owned subsidiary of US-based ACS Inc. which is a leading end-to-end business process outsourcing and IT solutions provider in the United States. The company employers over 50,000 employees and during 2006 it generated revenues exceeding USD 5 billion.

ACS is not a software or hardware vendor but a systems integrator, hence supporting multiple applications and a wide range of IT services.

The Government of Malta announces its intention to enter into an agreement with ACS to provide the hardware, software, expertise and maintenance needed for the following systems:

A Laboratory Information System: The system manages the filing and tracking of orders made to the laboratory for tests; labels and tracks specimens; conducts automated analyses using specialised laboratory equipment and supports pathological analyses of results; provides physicians with results that are electronically distributed to them or to hospital wards; and manages the distribution and archiving of reports from laboratory tests.

A Radiology Information System: The system manages the filing and tracking of orders made for radiology examinations as well as the scheduling of appointments; it tracks and provides automated support for the drawing up of notes and documentation related to the examinations; provides assistance to radiologists dictating reports; and manages and distributes exam results.

A Picture Archiving and Communications System: This system integrates with the Radiology Information System and abolishes the costly need of film when acquiring images over medical scanners using an entirely electronic process; images are stored electronically; the system allows radiologists to interpret the images when still in electronic form; it allows for more advanced processing of images – such as with the use of 3D technology – permitting more accurate interpretations to be made of the information gathered in the scanning process; and distributes images to the physicians and health-care providers over electronic channels allowing more than one viewer to access the information at the same time cutting on delays in the provision of timely medical service.

The integration of the above with the upgraded versions of systems used in the management of Mater Dei Hospital.

The new systems will provide patients with a faster, safer and more accurate medical and healthcare service. They will help doctors, nurses and other healthcare providers with the latest technology, meeting and exceeding standards existing anywhere else in the word. This technology will be a vital tool to reach more successful and more accurate diagnoses of patients’ conditions.

On 16 January 2007, the Ministry for Investment, Industry and Information Technology directed the Evaluation Committee that was then leading the evaluation process for an Integrated Health Information System (IHIS) to suspend its activities. This was done after the Ministry was informed that a MITTS Ltd employee who was acting as a technical consultant in the evaluation process was under Police investigation over alleged irregularities in that process.

Following the Attorney General’s advice, the Government directed the Department of Contracts to abort that evaluation process altogether.

At that stage the Government took immediate action to ensure that the aborting of this procurement process does not jeopardise the timely delivery of the Mater Dei Hospital.

During May 2007, the Government decided to upgrade its current Patient Administration System which enabled it to:

Upgrade these systems to current standards;

Transfer them to Mater Dei Hospital where they have been already been licensed and installed;

Provide for the technological updates necessary to integrate with new laboratory, radiology and picture archiving and communications systems.

On 8 March 2007, the Department of Contracts approved the sourcing of the new systems needed for the initial operations of Mater Dei Hospital through a negotiated procedure. That procedure was initiated by procuring advice from established specialised global consultants Gartner who and short-listed 12 systems integrators who then received an invitation from the Government to express interest to provide it with these services. Tenders were invited from the 4 potential bidders who expressed interest in the process.

Negotiations were conducted with ACS by a negotiating team appointed by the Government for the purpose led by the Ministry for Investment, Industry and Information Technology and including experts from MITTS Ltd and Mater Dei Hospital. The team was assisted by Cammilleri Preziosi as legal advisers and included an observer appointed by the General Contracts Committee.

The team negotiated on the provision of the services listed above as well as the maintenance and onsite support for a seven year period, gradually transitioning the ownership of the support function from ACS to Mater Dei Hospital staff. Following negotiations, Government managed to obtain a price that was 39% lower than originally quoted in the ACS bid in spite of additional requirements made by the Government’s negotiators and more onerous guarantees and penalties burdened on the service provider. In fact, the contract with ACS provides for delivery-times for the services and technologies required of it with very high daily penalties associated with late delivery. In fact the first deliverables are expected to come online in 8 weeks after signing with the full project completed by the end of the year.

Though ACS integrates products and services provided by sub-contractors the Government’s relationship is directly with ACS meaning that should any of its sub-contractors fail to deliver, ACS remains responsible to guarantee the continuity of the services.

In parallel with this the Government, through MITTS Ltd, has completed a state-of-the-art corporate data centre which shall not only provide data centre and related services to Mater Dei Hospital but shall also serve as a disaster recovery centre for all Government information systems.

The timely implementation of all these functions within the context of a highly complex programme ensures that notwithstanding the serious set-back which the project suffered in January 2007, the IT required for the commencement of operations of Mater Dei Hospital shall be in place and without excessive delay.

The Government’s actions in this case have once again tangibly demonstrated that irrespective of the ramifications arising out of its actions, the Government adopts and practices a zero-tolerance approach where corruption (proven or alleged) is involved. This reflects the integrity of the Government. The fact that, notwithstanding the planning implications of these decisions, the Government still manages to attain its targets demonstrates the competence and ability of the Government to execute effectively, without compromising this integrity.

The next step in the sourcing process will now be the issuance of an open international request for proposals for the provision of the remaining larger share of functionality which was included in the original tender and which was then aborted. This functionality shall be integrated with the existing functionality hence providing for the ultimate aim of a fully Integrated Health Information System. The tender document for this functionality is expected to be issued by the end of August 2007.

Following the commissioning of these critical processes, the Ministry of Health, the Elderly and Community Care and the Ministry for Investment, Industry and Information Technology will proceed with the publication and implementation of the Government’s medium- to long-term eHealth strategy that will continue to improve the tools used by healthcare providers to provide patients of Mater Dei and the Maltese health-service with the highest standard of medical care available anywhere in the world.

The investment being made in the Integrated Health Information System provides for an unprecedented improvement in the management of the health care information on patients. The integration of the information systems with the state-of-the-art digital medical equipment present in Mater Dei Hospital completes the framework of a quantum leap in the delivery of health care in Malta. This confirms the wider objective and clear commitment of the Government to attain the highest quality of patient care possible for all Maltese citizens.