Fiona Stanley Hospital still struggling to stabilise IT systems

Western Australia's Fiona Stanley Hospital is still struggling to overcome serious problems with its IT systems and infrastructure a year on from the hospital's opening.

Fiona Stanley Hospital

The state parliament's education and health standing committee today tabled its report into the transition and operation of services at the hospital.

The hospital has battled through high-profile errors and IT mismanagement since it opened last October, which has resulted in delays and huge cost blowouts, and limited full operation of the facility.

It has already been the subject of several inquiries and reports, which identified governance failures resulting in, among other things, software that was siloed and did not meet the hospital's needs.

Today's committee report [pdf] aimed to find out whether the hospital's initial teething problems were confined to the implementation phase or whether something more systemic is wrong.

It found hospital staff are still struggling to overcome technological issues with platforms ranging from the central medical record system and the ICU IT system to paging and communications.

The BOSSnet medical record platform sits at the centre of daily operations for hospital staff, running key clinical and administrative functions like filling out medical and admission forms and access notes and referrals delivered from other healthcare providers.

But staff have complained about the effectiveness of the digital medical record, claiming it can take up to 15 minutes just to admit a patient.

The Australian Medical Association told the committee the system frequently crashes or freezes and doesn't interact with the hospital's other applications. 

The WA Department of Health told the committee the system had failed 40 times since January this year.

Complaints also continue about the clinical information system in the hospital's intensive care unit, which is not compatible with the systems used in general wards.

Hospital staff are forced to print off and scan a patient's medical record once they transfer out of the ICU as there is no ability for the ICU system to export files to BOSSnet.

"Manually transferring this amount of clinical information, fundamental to safe and effective patient care, to a paper based record system, is time consuming and can result in illegible entries, transcription and omission errors and incomplete clinical records," the committee complained.

Two-way radios

A constantly failing communications system in the hospital is forcing night staff to resort to using walkie-talkies and two-way radios to communicate, the committee heard.

The problem is exacerbated by a well-known mobile black spot within the hospital.

Issues with the hospital's network infrastructure were first identified in August last year as part of a gateway review, which found the wi-fi network was unlikely to be able to support the intended operational number of devices active at one time - a big problem given hospital pagers are reliant on the network.

Since then the department has implemented upgrades to make the system more robust, but the committee has nonetheless asked the Health Minister to report to parliament on the reliability of the paging system for the three months following today's tabling of its report.

It has also asked for detail on the uptime of the systems and dates and lengths of outages.

The IT environment at the hospital is managed by Serco and its subcontractors, covering everything from servers, storage and backup, end user devices, corporate wi-fi, IP telephony, AV and entertainment systems.

The Health department provides connection to the wider health network as well as the hospital's clinical applications.

Governance problems at the core

The committee said it was clear that the IT problems experienced since the hospital's opening were a direct consequence of scheduling and project management issues in the lead‐up to its launch.

While it noted the department had attempted to recover the time lost and improve system stability, it hadn't been able to avoid delays to the hosital commissioning, increased costs and problems with interfacing with service providers.

The committee said it had sought information from the department about the impact on clinical activities of ICT failures or under-performance - as recently as the past few weeks - but claimed the agency had not been forthcoming with a response.

"FSH has been impacted a number of times over recent weeks by Department of Health-managed clinical ICT systems which may have potentially impacted clinical services," the committee wrote.

"Unfortunately, the department did not provide additional information about the problems or their potential impact upon clinical care in its response. 

"It is entirely possible that the problems encountered were minor, and that their impact on clinical service delivery was insignificant, but the answer in no way assures the committee that this is the case."