news A state parliamentary committee has told Western Australia’s Department of Health to end four years of acting appointments and hire a permanent CIO, in the wake of news that the lack of such an executive role in the department contributed directly to the fiasco at the state’s new Fiona Stanley Hospital, much of which has revolved around poorly delivered IT systems.
Fiona Stanley (FSH) is a new, 783 bed hospital being build south of the Perth central business district. It is billed as a flagship hospital for Western Australia, and was originally planned to be a paperless facility, featuring the latest in medical and information technology. However, the project has gone off the rails. In June last year Health Minister Kim Hames issued a statement noting that the $2 billion project had run late and would open in October 2014 instead of April, although it was more than 90 percent complete.
One specific issue which continues to dog the facility’s construction includes the “advanced ICT system” which is being put in place at the facility. The platform is billed as being able to deliver new levels of patient care and convenience by managing administration, patient information, medical records, communications and patient entertainment, all through one central facility. Serco is handling the rollout and part of the IT systems deployment, while British telco BT is conducting the telecommunications rollout. The Department of Health itself also has substantial responsibility for some IT systems.
In a tense session in mid-February, the State Parliament’s Education and Health Standing Committee grilled current under-treasurer Timothy Marney on the delays and cost blowouts. Marney confirmed that the $2 billion project as a whole had already suffered some $330 million in cost overruns, with about $151 million of that sum being allocated to ICT, including a portion going to another facility in Albany.
The issues with the setup of the IT systems may also have a potential impact on other facilities, given that it appears that Fiona Stanley was intended to act as a reference site for IT systems at other facilities.
Last week, the committee handed down its final report (the PDF can be downloaded here) on the organisational response within the Department of Health to the challenges associated with commissioning the Fiona Stanley Hospital. The report explicitly labelled poor project management and governance procedures as the cause for the IT issues experienced during the hospital’s construction. News of the report’s publication was first reported in the technology media by iTNews.
Several independent reports conducted over the past few years delivered successive warnings about the ongoing failure of the development of the IT systems for Fiona Stanley. In December 2011, the Solomon Report, an independent review of Information and Communications Technology projects across the Department of Health, concluded that the vision for a paperless hospital at Fiona Stanley Hospital was not feasible.
Separately, an independent review conducted by Fujitsu in December 2012 concluded that there was an unacceptable risk around the ability of the Health Information Network (part of the Department of Health) to deliver the work necessary to enable the provision of a functional and clinically safe Information and Communications Technology solution for Fiona Stanley Hospital by April 2014.
And a review undertaken by the Health Information Network in December 2012 concluded, with respect to the Information and Communications Technology (ICT) elements of the commissioning project, that even with a more pragmatic and less ambitious approach, a delay of between nine and 12 months was required in order to have all core ICT systems functioning and to reduce risk to patients.
It appears that the then-Director-General of the Department of Health, Kim Snowball, was aware of the issues but did not believe them to be as serious as the various reports alleged.
“The director general of the Department of Health seemed to be wedded to the scheduled opening date despite receiving various piece of advice that this was not possible,” wrote the committee’s chairman Graham Jacobs in the report. “In his mind, the commissioning project could be rescued by ‘ditching’ ICT components until they arrived at an ICT solution that could be delivered on time.”
This attitude came despite senior staff involved with the project threatening to resign. The report noted that Nicole Feely, the former Chief Executive of the South Metropolitan Health Service, was so concerned about ICT that she asked Snowball to terminate her contract if he was unwilling to transfer responsibility for Fiona Stanley Hospital ICT.
The reports may have been taken more seriously by the Department of Health’s leadership if it had had a permanent chief information officer.
The report published last week pointed out that the department’s previous permanent CIO resigned in March 2010, a date which coincided with the decision to release an ICT “services scope” to shortlisted bidders. Eventually the “digital vision” for Fiona Stanley would be included in the contract signed with Serco for overall construction of the facility.
“In the four years since March 2010, a series of acting appointments have been made to fill this important position at a time when DoH has been embarking on an ambitious ICT renewal program,” the report added. Some of the CIO responsibilities were handed to Alan Piper on an acting basis, despite the fact that Piper also had substantial responsibilities for other aspects of the project.
“We are … concerned that DoH’s senior management felt that [IT shared services group the Health Information Network] could be managed through a period of significant investment and change by an individual who was also leading the delivery of the $2 billion hospital infrastructure whilst also leading negotiations with Serco for the $4.3 billion contract to provide facilities management services at the hospital,” the report stated.
“We are also concerned that DoH has failed to make a permanent appointment to the position for over four years. In our view, such a sustained string of acting appointments is undesirable, particularly when HIN was supposed to be leading its most ambitious and challenging program of work undertaken to date. Dedicated leadership was needed in this period more than ever, yet this was compromised by the failure to appoint a permanent head for HIN.”
“Indeed, [senior project manager] Mr Giles Nunis told us that leadership within HIN was “left wanting” and “inexperienced” with regard to developing, program managing and implementing the technology component of the commissioning project; with his 20 years of ICT experience, it took him just two days to work out what the problems with FSH were and identify a path forward.”
The report stated that the Department “must ensure that a permanent appointment be made to the position of chief information officer, Health Information Network, as soon as possible”.
I have to say, I am absolutely shocked to find that a major IT project within State Government that was contracted without the formal approval of a department chief information officer and that suffered poor project management and governance controls has gone off the rails. Shocked, I tell you! I’m even more shocked that a department without a permanent CIO continually ignored reports (both internal and external) warning of the problems that were occurring with the project.
I don’t know, perhaps I’m ignorant. But these seem like novice mistakes to me. Do they seem like novice mistakes to anyone else? Who the hell are these people? And how could they possibly get away without appointing a CIO for four years, when they were in the middle of a major IT project development?