An IT leader with freshly expanded authority, a clinical technology champion and a brand new strategic health organisation will form the foundation of the NSW government’s new blueprint for e-health.
The five year roadmap, formally launched today by health minister Jillian Skinner, makes good on a 2011 commitment to establish a standalone IT body that will oversee the strategic direction of e-health across hospitals and health districts.
Speaking to iTnews, NSW Health director-general Dr Mary Foley said the new eHealth NSW body would be formed from a lift and shift of IT staff out of the department’s current corporate support agency Healthshare NSW.
The announcement reflects the elevation of technology up the state’s list of priorities.
“What we are saying is that e-health is not just a support service like food or linen or payroll. It is a critical piece of design,” Foley said.
It also reflects the Ministry of Health’s efforts to maintain a tighter grip on the quality of health IT across the state's 17 local health districts – where inconsistency has been an issue in the past.
“We need to make sure that we don’t discover too late - as at times we have - that some districts don't have enough bandwidth to implement complex systems," Foley said.
"[Or that they have] very primitive existing systems, while their neighbours might have made deep investments in this space and [rolled out] really fancy solutions as a result."
The state’s controversial emergency department system FirstNet fell victim to this disconnect, according to Foley.
“When we looked closer we found that some districts had a lot of smarts and invested in FirstNet, and as a result their people had made it a top system," she said.
“Other districts had just taken the off-the-shelf system. They didn't have a lot of money and they didn't focus on the implementation side and as a result the clinicians got a clunky product that they don't like to use."
One better than a CIO
Before eHealth NSW can begin operations, however, it will need a leader – and the two most likely candidates are no longer an option.
In September this year, health CIO Greg Wells and his boss, Healthshare chief executive Mike Rillstone, were both poached by the Department of Family and Community Services (FACS) to help it set up its own state-wide structures for the national disability insurance scheme.
Foley said while sad, she was diplomatic about their departures.
“FACS needs to go through the same process we had to go through to get these building blocks in place,” she said.
“Those two people's leadership really got us to the point where we are at now, so that is exactly what FACS wants and needs.”
The vacancies, however, have given Foley the opportunity to set up a paired chief executive/CIO position that will oversee eHealth NSW, with an appointment due by April 2014.
The department will also be on the look out for a practicing clinical “who is also very IT savvy” to take up the role of chief clinical information officer.
A leader in e-health?
The blueprint will strive to put weight behind Minister Skinner’s claim that NSW is “leading the way in e-health”.
It unveils the second stage of the state health system’s mammoth electronic medical record (eMR) scheme, which forms the foundation of NSW’s contribution into the national personally controlled electronic health record (PCEHR).
One of the big features an upgraded eMR will offer is voice recognition, designed to allow clinicians to navigate clinical systems and dictate instructions into the record using only their voice. Voice recognition tools are currently being trialled at Manly Hospital.
The blueprint also charts the expansion of HealtheNet, the digital bridge between hospital-based eMRs and the PCEHR, which Minister Skinner described as her “favourite development”.
She described the interface, which has been built in partnership with the health districts, as “typical of the approach we are adopting as we roll out e-health further.”
Impact of the PCEHR review?
Foley doesn’t expect the recommendations of a national review into the PCEHR project to threaten any part of her department’s technology-enabled vision.
“I think that review is very conscious of what has already been built in the states,” she said.
“All of the chunky building blocks are now in place - secure messaging, system of identifiers, and a system of standards and rules. All that is missing is what will bring it all together and make it work.”
She hopes this “glue” will become the target of the PCEHR review team, with the update and increasing usefulness of the system to be allowed to snowball forward.
“The PCEHR is clunky, it's got some useful things on it like immunisation records, but it still has not got a great deal uploaded," she said.
“But with tools like HealtheNet we are beginning to populate really informative discharge summaries into the system, which means GPs will be able to access them. That will quickly put some very valuable information for GPs on there, and then they will begin to see the value in using it more and more."