NSW hospitals rate FirstNet last for patient care

Rigid IT

The study criticised the application of enterprise-wide IT systems in clinical settings, believing such systems were not flexible enough to deal with the different ways that clinical units worked.

"In clinical settings a crucial mistake is to assume staff can be coerced to do some particular work process," the study said.

"If it negatively affects their strategies for caring for the patient they will workaround it. So an enterprise system will fail if it doesn't serve the clinical need.

As enterprise systems technology is currently defined by relatively fixed ways of work processing they inevitably will be circumvented."

Professor Patrick said that part of the issue was a "clash of cultures" between NSW Health and clinical staff, although there was also a "deeper" IT architectural issue at work.

"There's definitely a real difference in attitude between Health and all the clinicians," he said, noting that other parts of the clinical community had also complained about FirstNet.

The study suggested an IT architectural overhaul via the creation of what he called a Generative Clinical Information Management System.

Such a system was "one where all information systems are generated from the one system and all data is known and understood across all generated systems.

"Under such architecture an emergent property is interoperability, that is, the system doesn't have to be designed for it. It is intrinsically achieved in each local system, which has the capacity to know about all information in all other systems when it is passed to them," the study noted.

Such a system also potentially dovetailed into another of Patrick's research focuses – natural language processing for clinical content.

"What we're trying to do is embed our language processing technology into clinical information systems," he said. "Otherwise, people can't use [these systems]."

In the meantime, Patrick saw the potential for the creation of an "inbetween world" for Health.

"If people are prepared to recognise issues with the current IT rollout, what they can do is improve them in the interim before we go onto the next quality improvement in technology," he said.

"[But] I think that's an open question."