E-health urgency required to overhaul industry

Former Queensland Health CIO, Peter Grant, picks apart the problems in health informatics

A former CIO of Queensland Health has called upon the health informatics industry to rethink the way the way health IT and e-health projects are implemented.

Speaking at the World Computer Congress 2010 in Brisbane, Peter Grant, who spent eight months in the role during 2007, warned the focus was in the wrong place for his successors and equivalents in the industry.

“When you’re the CIO of health your job isn’t to make the hospital work properly, it isn’t even to make a network of hospitals to work properly,” he said. “It’s to make the whole ecosystem work properly, so you’re dealing with all of these other professionals and all of these other organisations outside of your organisation, and we just haven’t been thinking that way. Each hospital thought of themselves as the only centre of the universe.”

Grant, who was also a CIO of the Queensland Government, called for greater care to be taken in the way projects and systems are deployed, comparing the health industry with the way plane crashes are reviewed and investigated.

“Whenever there’s a plane crash, whenever even one or two people are killed, the [Australian Transport Safety Bureau] starts a huge review, we look at what’s happened and we go fix it up so it never happens again. We don’t allow ourselves to make mistakes in airline travel.

But in health we don’t seem to mind. In Australia every couple of months we take out one of these [planes] through bad access to information, and no one investigates anything.”

Grant’s comments come shortly after the release of a scathing report from the Queensland Auditor-General, pointing out the aspects contributing to the failed implementation of a payroll system from shared services government agency, CorpTech, and IBM. The failed project, which has since become a key example of poor IT governance, led to the Queensland Government abandoning its shared services model in favour of more isolated procurement and deployment policies.

During his contentious address to attendees of the conference, Grant labelled discharge summaries at Queensland public hospitals “probably the most farcical project in my entire IT career that I’d ever seen”, and called upon the Australian Computer Society (ACS) - who organised the conference - to partake in a debate about intellectual property and ownership rights of e-health medical records. He also disregarded normal information systems practices, such as business administrative processes and relational databases, as a failed mission in the health sector, which would be unlikely to sway doctors and other end users to change the way they worked.

Grant’s talk came on the last day of the conference, and at the end of a scathing stream of presentations from health informatics professionals, many of which called for a rethink in change management for the sector due to “technophobic practitioners”. Consensus among professionals indicated most were sick of the privacy debate which has often held back e-health projects such as the unique health identifier and the Federal Government’s proposed voluntary, personally-controlled health records, with Grant pointing out that most were willing to put more sensitive information on their Facebook profiles.

“It’s really hard to fix things up, but the key is that we have a conversation about what’s broken and what some of the options might be,” Grant said, adding that those in health informatics had “the hardest job in the world”.

“They’re facing some of the more complex problems than we’ve got in the industry across the country.”

Nevertheless, Grant said two-year rollout schedules for information systems wasn’t urgent enough.

“We could have the health industry revolutionised in just about as quickly,” he said.

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