NSW Health seeks CIOs in restructure

news NSW Health has advertised two high-profile chief information officer roles, as the State Government’s plan to ramp up improvements in healthcare through the use of technology impacts the organisation and it’s eHealth NSW sub-division.

Up until late last year, NSW Health’s IT operations were led by its chief information officer Greg Wells, who had held the position for more than four years. However, it was reported in October last year that Wells had left to take up a position at the NSW Department of Family and Community Services. Wells’ LinkedIn profile states that he has become a consultant.

In late December, the state published what it described as a “blueprint” for eHealth in the state (PDF). At the time, NSW Health Minister Jillian Skinner wrote in the document’s foreword that ICT-led investments in clinical care, business services and smart infrastructure were already reshaping the way healthcare is being delivered in NSW.

“But as demand shifts from acute to chronic care – and from hospitals to communities – we need to move our ambitious eHealth agenda forward so that technology continues to advance healthcare delivery and connectivity,” wrote Skinner at the time.

Perhaps the most notable step taken as part of the new strategy is the formalisation of the creation of eHealth NSW, which Skinner said would lead statewide eHealth strategy and project delivery. There would be a new eHealth Executive Council to support the group, chaired by the Director General of NSW Health, and a federated decision-making model with local health districts that would promote “local partnership and innovation”.

“We also plan to refresh our vision for eHealth in NSW with a new eHealth Strategic Plan,” wrote Skinner. “It will steer the $400 million we plan to invest over the next five years building eHealth capacity across the state through both a consolidation and expansion of existing eHealth programs, and new, cutting edge initiatives.”

“In clinical and patient care this means advanced clinical information systems, integrated community and outpatient electronic records, sophisticated, high-tech functionality for Intensive Care and intelligent prescribing systems. From a business perspective we’ll invest in smarter systems to better monitor and manage the state’s health assets, match clinician skills to patient needs, and identify and notify system risks far more accurately.”

As part of the plan, NSW Health has advertised for a chief executive of eHealth NSW, who would also serve as the chief information officer of NSW Health. It appears iTNews first broke the story of the new appointment. The new CEO will report to the Director General, NSW Health, and be responsible for all aspects of eHealth NSW’s operations.

Supporting that role will be another new position, that of chief clinical information officer at eHealth NSW. The position description for that role states:

“Reporting to the Chief Executive, the CCIO provides overall clinical leadership of the clinical ICT program, and effectively manages the engagement of clinicians in the development and delivery of major ICT initiatives to improve the safety, quality and efficiency of healthcare for patients.”

“The CCIO is the most senior clinical ICT position in NSW Health and is accountable for providing advice of the highest quality, integrity and validity to the Chief Executive/CIO on matters pertaining to NSW Health clinical ICT program and driving clinical ICT improvements and clinician engagement in ICT adoption, innovation and management. Candidates will be able to demonstrate a strong understanding of clinical practice, particularly in hospitals, gained through experience at a senior professional level, as well as experience and knowledge in the use and adoption of information and communication technologies to improve clinical practice and an understanding of business practice and clinical workflow across the whole health system (including acute, primary, community and aged care).”

The appointment of a clinical CIO for eHealth NSW will do much to address one of the most common criticisms of Government eHealth projects — that they are not aligned with clinicians’ IT needs.

The news comes as e-health projects around Australia continue to experience sharp problems or fail completely. For exampe, Federal Health Minister Peter Dutton has received a review of Labor’s troubled Personally Controlled Electronic Health Record (PCEHR) project. Experts such as David Glance, director of the University of Western Australia Centre for Software Practice, have called for the billion-dollar scheme to be shut down.

Similarly, in May 2012, the Victorian State Government decided to walk away from its troubled central electronic health project HealthSMART, which has reached only a limited number of its goals over the past decade since it was initiated, despite soaking up several hundred million dollars worth of government funding.

And similar high-profile problems have been experienced in Queensland. In September 2011, it was revealed that Queensland Health needed a mammoth $439 million injection of government funding to fix its ailing patient administration system, according to explosive documents tabled in the state’s parliament by the Queensland Opposition at the time.

opinion/analysis
I don’t think we know enough yet about how NSW is going to progress with its new e-health strategy to be able to make a call on how it’s going or is likely to go, although we haven’t quite seen the same disasters in NSW as we’ve seen with respect to e-health in Queensland and Victoria, so perhaps that is cause for optimism. In general, I am quite pessimistic about the e-health scene at the moment. As I wrote back in 2012, when Victoria dumped HealthSMART:

“I think much of the difficulty in e-health at the moment is related to the relative immaturity of the technology platforms available in this area, coupled with a similar immaturity when it comes to the integration of those platforms in clinical environments.

Hospitals are complex environments with complicated, highly-specific business processes, and the feedback I have received repeatedly over time from many in the health IT sector is that often the available software platforms are not quite mature and flexible enough yet for the task at hand. And when you try and implement these platforms in hospital environments, the medical workers are often highly reluctant to change their work practices to accommodate the new systems. So you often get a worse of both worlds scenario — where the technology can’t quite adapt right to the needs of its users, and where the users themselves won’t quite adapt right to the needs of the system.

These are problems which every government health jurisdiction in Australia is grappling with, right now — and, no doubt, many private sector health organisations. And these are tough problems.”

I think this area is too complex to say what the answer is just yet. I suspect that the answer lies in several factors. Globally, or at least between State Governments in Australia, health organisations need to start standardising their business processes along the same lines. Those lines need to be developed with global e-health standards and platforms in mind, so that the relevant IT systems can be implemented more easily, without excessive customisation.