Hospital IT booking system ‘putting lives at risk’

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blog It’s getting pretty hard to overestimate just serious the problems being caused by problematic IT platforms in major Victorian institutions are. Late last month, after all, the Victorian Auditor-General revealed that the Department of Human Services’s client information system was putting children’s safety at risk, and the month before that, Victoria Police partially blamed the failures of a policing IT system for an 11-year-old boy’s death. But let’s continue with the litany of disasters, shall we. Perhaps at some point, someone will take these issues seriously. This month’s issue is at the Austin Hospital and Olivia Newton-John Cancer and Wellness Centre in Melbourne. The Age tells us (we recommend you click here for the full article):

“Staff at one of Melbourne’s largest hospital networks say a new computerised booking system has wreaked havoc over the past year, causing untold distress for vulnerable people and putting lives at risk. “Numerous patients have suffered, there is no question of that, we just hope no one has died,” said the staff member who did not want to be named.”

At this point, with reports of problematic IT systems (especially in Victoria) having the potential to cause actual risks to life or people’s health, you have to start questioning at what point Australia will start taking the governance process involving the development of these sorts of IT platforms seriously. You wouldn’t build any sort of major building without proper architectural plans and very solid underlying foundations. But it appears that new IT systems, which are easily as complex as any building work, continue to be rolled out in Australia in what I can only describe as a neglectful manner.

The disturbing thing is that we don’t seem to be learning from our mistakes. As a nation, we keep on repeating the same cycles when it comes to poor governance of IT projects. One wonders what it will take for the cycle to change. Another IT disaster of the scale which occurred during Queensland Health’s payroll systems replacement, perhaps? Or three?

7 COMMENTS

  1. Architectural plans (aka the waterfall model) has been thrown away in favour of the “Agile”‘model. I’ve seen quality, architectural designs & processes thrown away in favour of untested designs and processes. And it’s because inexperienced people make the decisions and then when they hire people, the select graduates who don’t challenge the status quo and then learn the same techniques from their existing staff. Then when an eternal company comes in, it’s like being on a gravy train even if it’s a bad job.

    I think they’d be best to outsource all of the development to local companies and supply 1 or 2 knowledgeable people. I’ve delivered many critical projects on time and without fuss. I don’t think the government can pull it off with the current culture.

  2. The fact that the Department and numerous hospitals are still on windows XP with no roadmap will serve in time to be a much greater issue.

  3. ICT projects are not like buildings, there are many reasons, but some which are relevant here are: ICT systems have much shorter life cycles, the complexity of ICT systems increases exponentially with interconnectivity and for large organisations ICT complexity easily dwarfs large construction projects, the technology landscape changes at an incredible pace etc. So likening the two is just adding to the problem.

    @Adam Without bashing a particular ICT engineering model (each has their place), the key problem is not the lack of plans for a particular system as I’m quite certain the large failures were drowning in documentation. In my opinion, it is size of the projects which is the single biggest contributing factor. With competent business requirements management, a department wouldn’t need to build one system to rule them all. Instead a less fragile approach of building smaller components and adapting them to the ever changing business needs would prevent catastrophic failures that have become common place. Perhaps we could even use all those standards out there to achieve system interoperability :-)

    • I think you’d be surprised at how poorly the requirements for these systems are documented before they start work on it.

      You can’t expect a large systems to be created without proper documentation that shows exactly what the outcomes will be and exactly who is responsible. Why else do they continue to get in such a mess while no one is ever held accountable? I’ve worked on colossal sized projects – they were easy, well designed and successful because they were documented well and people were held responsible.

  4. I can comment with a little inside knowledge. As being a patient of the Austin since 2009, I have seen these changes take place late last year. I ‘missed’ an appointment I was told, that I didn’t even know about as I wasn’t notified by mail, email or telephone call. I live 2 hours away from the Austin. After defending myself to the staff involved that I didn’t know about said appointment 4 weeks before hand, they quietly whispered ‘you are not the first this has happened to, even had country patients turn up that thought they had an appointment and infact there was no record in the new system that they were coming’. even when they had a letter of appt. in their hand. I wrote a complaint form out and received a letter that basically said ‘its for efficiency etc etc blah blah’, and all it seems to have done is raise the backs up of the staff, and I was told it was all being driven from one particular department.. Anyways, that’s my insight into it, and why they changed it is beyond me, the old system may not have been perfect ( not that id know from my end ) but this new one seems to be a pitfa ( at least from my end, and others it seems aswell ).

  5. You know, I’ve read that article a couple of times, and I just don’t see how this is an ICT issue. It seems somewhat sloppy journalism to lump this in with other correctly identified ICT failures, without reading between the lines.
    I can’t be certain, as I don’t work there (I do work in IT in health through) – but this looks like a seriously bad management call – that they could wipe all existing bookings, and simply send ‘letters’ to ask people to re-book.
    For all we know, the booking system probably works fine, to specification – just the human interface of the changeover was completely botched.
    Having people who understand the customers at the coal face is critical for any project that involves change .. possibly missing here….

    • Definitely a management issue, not ICT. I am in health IT too, at a large hospital. I’ve watched new management waltz in, throw their weight around, not listen to experienced under-management, and push their own agendas (with their newly recruited cronies). All the very best, long-standing people in this organisation have been pushed out because of this. Then, at the end of the day, the havoc they’ve caused means nothing to them because they just up sticks and move on to another job.
      This disastrous booking system is no surprise to me .. you can see arrogant, inexperienced management written all over it.

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