The creation of a statewide digital health strategy, improved data sharing and closer ties to My Health Record are among the recommendations of a scathing report into Western Australia’s health system that criticised budget blowouts and bungled implementations in the state’s transformation to digital health.
Past ICT delivery has been “poor”, according to the Sustainable Health Review interim report to the WA government, creating a “culture of distrust” in the management of projects.
“ICT investments across the WA health system have been beset with challenges and issues that have had a significant impact on delivery and created a culture of distrust in the management of ICT,” the report found.
The review helmed by Robyn Kruk, which was announced by the State Government in June 2017, delivered its preliminary recommendations following consultations with consumers, clinicians and staff in the WA health system, healthcare providers, non-government organisations and industry.
It found the government needs to address some “inconvenient truths” and introduce robust planning for ICT projects in response to the disastrous 2016 contract with Fujitsu that lead to an $81.4 million cost blowout, and delayed opening of the Fiona Stanley Hospital as a result of the troubled IT systems and infrastructure implementation in 2015.
“The WA health system’s track record in the delivery of information and communication technology has led to large amounts of money spent in areas that has not necessarily supported the system or improved health outcomes more generally,” the review found.
“The need to improve ICT systems across the WA health system is clear; the challenge is to mobilise and manage the upfront investment in ICT in such a way that it does not compromise the provision of other initiatives.
“Robust planning that supports greater use of technology and more contemporary approaches to health care and patient-staff engagement is required. Progress towards a digital health system – including an electronic health record – is critical, with more effective data sharing helping staff, consumers, carers, researchers and the community to make informed healthcare decisions.”
While technology had swallowed substantial monies in the state, the review stated that with improved management the benefits in terms of clinical efficiencies and patient care could be significant.
“The panel notes ICT investments have positively contributed to achieving safer patient outcomes. Evidence outlines that technological advancements are seen as means to improve efficiency both in terms of expenditure and effective service delivery. The need to improve ICT systems across the WA health system is clear; the challenge is to mobilise and manage the upfront investment in ICT in such a way that it does not compromise the provision of other initiatives.”
Describing the uptake of digital health systems as “critical”, the review’s recommendations for immediate action included greater use of technology, data and innovation to support consumers, clinicians and drive change. Within that, the review called for greater use of telehealth, improved interconnection with the Australian Digital Health Agency’s My Health Record and the implementation of a statewide digital strategy.
Recommendations for immediate action included:
Develop and implement innovative approaches to sharing of patient-level data across public and private providers, including a pilot to demonstrate necessary policy and technology approaches, commencing with pathology results, patient discharge information and medical imaging as an initial priority linked directly to work with the expansion of My Health Record.
Implement a pilot of the Emergency Telehealth Service Model in at least one other specialty in the country and metropolitan area.
Areas for further work included:
Develop a digital strategy for the WA health system.
Explore options for the implementation of a statewide electronic medical record. This should be initially developed in partnership by the Department of Health with one or two health service providers, subject to a robust business case and available funding.
Support the actions that occur as a result of the Department of Health’s Data Linkage Review.
Partner closely with the Australian Digital Health Agency to support the expansion of the My Health Record program in WA by raising awareness among clinicians and increasing the availability of patient information (including pathology, medical imaging results and discharge information) to My Health Record.
The government was advised to develop an implementation plan and provide oversight.
The final report and recommendations are due to be tabled with the State Government in November 2018.