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Thursday, September 10, 2015

It Seems That Really Big Changes Are Underway In E-Health In Queensland. Or Are They?

Two big pieces of news this week.
First we had:

Qld Health on the hunt for super-CIO

By Paris Cowan
Sep 3 2015 11:42AM

Thatcher completes one-year stint.

Queensland is looking for an IT chief to lead its new consolidated electronic health division, after former chief health information officer Mal Thatcher completed his year on secondment.
The successful candidate for the vacant position will take over one of the most scrutinised and notorious IT environments in the country.
The health department is advertising the re-jigged role at the same time as its IT dirty laundry is once again aired in public, with a legal battle between the state government and its former payroll systems integrator IBM awaiting judgement in the Supreme Court.
Queensland Health Minister Cameron Dick last month announced the establishment of eHealth Queensland, a new organisation that brings together the operational and strategic arms of health IT.
It will support the state’s 16 independently-operating hospital and health services as well as the health department.
The new recruit will join eHealth Queensland as its CEO, and will also serve as the department's CIO. He or she will answer directly to Queensland Health director general and former NSW Health CIO Michael Walsh, and will assume a seat on Queensland Health’s leadership team.
“The role will lead all aspects of developing, implementing and maintaining technology initiatives, assuring high performance, consistency, reliability and scalability of all technology offerings,” according to the job ad.
The new eHealth agency’s initial to-do list includes the delivery of a state-wide electronic medical record, digital networking improvements, and “smart software”.
Thatcher, who filled the top tech role for the past year, had signed up only for a 12 month stint, which he completed at the beginning of this month.
In a Linkedin post, he said he hoped he had left "a few small footprints behind for the new chief executive of eHealth Queensland to track against".
He will return to his main role as CIO at private hospital operator Mater in the new year, after taking the rest of 2015 off to work on a PHD in IT governance at the Queensland University of Technology.
Then we had this from the Health Department.

Health system to enter digital age

Friday 4 September 2015

The Queensland Government’s newly released eHealth Investment Strategy is set to bring Queensland’s health system into the digital age.
The strategy identifies future ICT requirements over the next 20 years to ensure the state’s health system can continue to provide essential services to Queenslanders.
It is predicted that future health ICT requirements are needed in four primary categories – clinical systems, business systems, ICT infrastructure and the digital future of Queensland Health. 
An estimated 1000 jobs will be created with the progression and implementation of the eHealth initiatives detailed in the strategy.
The next big ICT project in the Queensland Health system will be at the Princess Alexandra Hospital (PAH), which is planning to be a “digital hospital” by the end of the year.
This will involve not only the upgrade of core infrastructure and new technology to support digital workflows, but also elements such as rapid access tap-on-tap-off for all computers, which will save clinicians 30 minutes each day.
There will also be additional technology to support digital workflows – 200 additional work stations on wheels, 770 barcode scanners, 250 pathology label printers and 160 patient wrist band printers.
There will still be a very limited requirement for some paper applications, but having the ability to quickly transfer patient data and clinical notes between treatment teams will keep patients at the centre of the hospital’s work.
For clinicians, it will streamline what is currently called 'paperwork' and will free them up for direct care and engagement with patients.
Once the system is proven to be clinically safe, it will go live in November.
Over the coming years, all Queensland hospitals will move towards this level of digitisation, making what happens at the PAH an important role model for the future.
The eHealth Investment Strategy can be viewed at https://publications.qld.gov.au/dataset/ehealth-investment-strategy
Here is some press coverage:

Qld eHealth strategy to create 1000 jobs, minister says $300m for ICT infrastructure

Queensland's new eHealth investment strategy will create around 1000 jobs, according to the state's health minister, Cameron Dick.
The strategy (PDF) outlines five key top-line investment priorities for the state's health system:
• Investing in ICT infrastructure that can "support contemporary systems and increase the mobility of the workforce";
• A contemporary desktop environment for end users;
• A secure environment for exchanging information and images, including information interoperability with other systems;
• replacing enterprise systems, including those for patient administration, finance and laboratories; and
• investing in electronic medical records and enabling digital hospitals.
"The Strategy is the mechanism through which Queensland Health identified the need for a significant investment in ICT—more then [sic] a billion dollars—to support healthcare delivery in Queensland," the document states.
"The Strategy provides greater health system context around Queensland Health’s proposed investment in ICT and outlines our plan for investing in the digital future of Queensland Health. In Queensland there is a growing demand for, and cost in supply of, health services."
"We need flexible, cooperative solutions that share the risk of development and implementation with private sector," Dick said in remarks prepared for a CEDA lunch.
"I want to place on record an open invitation to industry to come to us with options and solutions to some of our complex problems."
The 20-year strategy envisages spending $300 million on ICT infrastructure, $100 million on business systems, $730 million on clinical systems, and $130 million on the "digital future" of the health system — information interoperability and eHealth foundations.
Underinvestment in ICT and poor ICT project delivery performance have resulted in out "out-of-date infrastructure, ageing technology, and highly customised and heavily integrated bespoke systems," the document states.
"These are costly to replace and difficult to sustainably support. Currently, inconsistency in the network speed and connectivity across the regions, coupled to ageing infrastructure and standard operating environments, impedes the ability to innovate and improve services. The uptake of commonlyaccepted peripheral devices is also limited."
Queensland Health's billion dollar payroll system disaster is still the subject of legal action, with IBM, which was contracted to implement the system, seeking to prevent the state government from suing the company.
Here are the Strategy Links

eHealth Investment Strategy

Strategy for a digital health system offering integrated services with timely, secure and reliable access to patient information across public and private care providers.

Publication and resources

·         eHealth Investment Strategy - full version  

Strategy for a digital health system offering integrated services with...
40 recent views 40 total views

·         Part 1 of 4 - eHealth Investment Strategy  

Part 1 covers - Cover page, Contents, A message from the Minister, A...
7 recent views 7 total views

·         Part 2 of 4 - eHealth Investment Strategy

Part 2 covers - Building a high quality sustainable health system, A plan for...
3 recent views 3 total views

·         Part 3 of 4 - eHealth Investment Strategy

Part 3 covers - ICT infrastructure, Business systems, Digital future
6 recent views 6 total views

·         Part 4 of 4 - eHealth Investment Strategy

Part 4 covers - Clinical systems, Improving our capability to deliver health...
3 recent views 3 total views
Here are the links:
First we can wish Mal Thatcher good luck with his PhD. Doing one of those is typically a pretty painful experience as I recall! Good topic though - hope to read his thoughts at some point!
As far as the Investment Strategy is concerned, while not being at all negative, I have seen so many clones of this document I am feeling just a little tired. Certainly what is proposed seems to me to be a cautious, sensible approach and there is no doubt the spend is needed to update Qld. All we can now hope is that the execution is up to scratch.
The strategy document is well worth a browse.


Anonymous said...

"The 20-year strategy envisages spending $300 million on ICT infrastructure, $100 million on business systems, $730 million on clinical systems, and $130 million on the "digital future" of the health system — information interoperability and eHealth foundations."

About 1 Billion Dollars. I doubt that will go far for IT Infrastructure in Australia, compared to the PCEHR, and HealthSMART and the Myki Public Transport Card in Victoria. There is trouble too in South Australia right?

Do you something is being seriously omitted or overlooked in this round figure?

Mal Thatcher said...

Thanks David for the well wishes on my doctoral pursuit! The topic of my thesis is a governance framework for IT adoption in acute healthcare delivery - something I am very passionate about :)

Regarding the eHealth Investment Strategy, timelines aside, the document is authentic in its identification of the issues that Queensland Health needs to focus us. Perhaps what is not self-evident is that this investment strategy is underpinned by an appropriately contemplated and holistic architectural approach to the enablers of eHealth, for QH and its healthcare partners. If QH establish these enablers of eHealth as outlined in that architecture vision, then I truly believe that Queensland Health can be a national leader in health IT.

The fate of course of the eHealth architecture and eHealth Investment Strategy rests squarely with the soon to be appointed Chief Executive, CIO of eHealth Queensland.

Kind Regards
Mal Thatcher
(Happy PhD Candidate)