Quote Of The Year

Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

Wednesday, May 13, 2009

NSW Health Continues to Grossly Underperform in E-Health.

When do you imagine we can get rid of the team running NSW Health? – to say nothing of the incompetent Government they report to.

Their effort this week as reported locally and by the ABC.

Hospital records system fails twice in one week

Posted Fri May 8, 2009 7:37am AEST

Emergency doctors at Nepean Hospital in Sydney's west are scaling back a new electronic records system because of two failures in the space of four days.

Hospital management says there was a slowdown in the system for two hours on Tuesday, following a widespread outage on Saturday.

Staff at the Nepean Hospital have now stopped using some parts of the system, saying they have lost confidence in it.

Medics will in some cases go back to using pen and paper to record patients' progress.

The chief executive of the Sydney West Area Health Service Professor Steven Boyages has apologised to staff, but says the problems could continue for a year and a half, while the technology is being rolled out.

More here:

http://www.abc.net.au/news/stories/2009/05/08/2564180.htm

and here:

Electronic medical records putting patients at risk – Nepean Hospital

Posted 07/05/2009 at 05:12 PM by StreetCorner

Staff in the Nepean Hospital Emergency Department have banned the use of the new electronic medical records system after it failed for the second time in three days on Tuesday, putting patients at risk, Shadow Minister for Health Jillian Skinner said today. According to Jillian Skinner, medical officers have revealed the latest shut down at the Nepean Hospital ED on Tuesday lasted for two hours, leading to staff deciding on Wednesday they no longer had faith in the new system.

.....

Skinner reported that emergency staff at Nepean Hospital decided yesterday to pull the pin on using electronic records and are now working with pen and paper because they don’t trust electronic medical records system.

Full article here:

http://www.streetcorner.com.au/news/showPost.cfm?bid=10391

What can one say.

The only way you can wind up in a situation like this is to under plan, under scope, under configure to local workflows and need, under test and under train your staff.

The CEO who says that staff might have to put up with being messed around for the next 18 months is clearly in la la land and needs to be replaced at the earliest possible date. The staff will vote with their feet long before then!

Mr Della Bosca (NSW Health Minister) who announced just one week ago that $100M was to be spent on the eMR must be just furious to be let down so badly.

A very bad career move for the CEO to not make sure the basics of Health IT implementation were followed! (Assuming s/he knew them in the first place - Health IT skills are so undervalued there is no certainty that was the case!)

Jinx even! Just amazing, but sadly typical of what seems to be the norm for NSW Health.

David.

4 comments:

Anonymous said...

I suspect “stories” like this are why NSW Health has just quietly got on with implementing Cerner eMR in 20 hospitals in the last six months without bothering to seek any publicity. This is a story about a power failure which has been turned into a story about eMR by politicians for their own ends. No journalist seems to have asked whether Nepean had a previous system – they did - and guess what, it would have been affected in the exact same way by the power failure. But of course it gets more press to blame the new system which was in the papers the previous week with the Ministers name attached to it.

Dr David More MB, PhD, FACHI said...

I am interested to hear from others who were there with all this. More important to me is the reaction of the CEO saying expect more problems - and not really talking of power outages? Power failures are totally different from implementation 'mess ups'. Which was it that triggered these reports? The second I think.

David.

Jim Cocks said...

Oh dear me...18 months of waiting because of a power outage...I don't think so...more likely because the last time I saw a data flow diagram (admittedly 24 months ago)of the NSW Health trials of eMR it resembled a diagram of the intestines of Monty Python's celebrated sketch concerning the Anglo French sheep

Anonymous said...

The power outage is likely to be the staw that broke the camels back and there is always more than just one reason.

However we should realise it is only partly about the system and the data flows but it is all about THE PEOPLE using the system.

Many issues are obviously about the system, it has to be able to support clinical care and administrative processes of the people working in the organisation to which it is being deployed. However to make this happen is a very complex task.

I have worked in the UK deploying IT systems into health organisations as a private sector consultant for the past 5 years, in the companies I have worked there have been attempts made at delivering what has been called "business change" identifying how the systems will change the way the people and the organisation work and prepare the staff for this.

This has always been an imperfect science, not always done well, and there will always be issues but a plan of a clinical business change running before, during and after deployment will help.

It may seem obvious to say but the most important issue in a health organisation is clinical engagement and support for what your doing. This can be done by developing structured stakeholder engagement and communication plans but also by clinicians paerticipation in a clinical business change process.

A few things to consider:

Understand the clinical vision, direction and other concerns of the organisation.

Prepare the organisation - set expectation and understanding of what is to come and assess the organisations readiness for a project the scale of a new IM and T system

Do a structured stakeholder engagement and communication plan that focuses on engaging clinicians and staff and get them to participate and help lead deployments

Understand current clinical and administrative processes - work with groups and process map what they currently do. Not just on computers but how they work as clincians and admin staff. Then work with the system to develop a new process that will support and improve the way they work. Document these postential changes manage and support the more complex changes and develop a training process from these

Apply a benefits management approach over the process but don't go overboard. Identify the visions, clinical concerns of large staff groups and see what practical things the system can be measured and improve to add clinical benefit to staff and patients.

While this is not easy and takes time and consideration. While these approaches should be used over a new system deployment organisations could use some of these to analyse current issues and improve the usage of deployed systems.