New Zealand needs a nationally co-ordinated health sector IT plan, says independent consultant Penny O’Hara, who has consulted on healthcare IT for Deloitte and leaves for Britain next month to work on a massive health sector IT project.
“In Singapore, for example, the government has looked at IT from a national level and said ‘these are the packages you can implement and here’s the money’.”
In New Zealand, a central set of standards has been set by the Health Information Service, but adopting the Singapore model would avoid the mish-mash of incompatible systems that exists at present.
“At the moment [district health boards] are sitting on different platforms that are either old or highly customised.”
If a central government agency were to set a selection of packages that could talk to each other, many problems would be solved, O’Hara says.
“You need a national focus on health IT and to link it enough so you have uniform standards and all the systems can talk to each other.”
Establishing such a national framework “would take a huge chunk of capital and need to be government, not hospital-funded”.
There are promising signs of co-operation between DHBs in New Zealand, with Counties-Manukau and Waitemata DHBs’ healthAlliance (which may in the future also involve Auckland DHB) and Capital and Coast DHB’s work with its Taranaki counterpart. This “can only be good”, but a central, national body is the ideal, O’Hara says.
A national body would have less chance of being captured by vendors, she says, and DHBs need to be wary of vendors who “offer good deals or free implementations, but hit you for upgrades”.
Health sector CEOs need to be aware that in such cases the cheapest option isn’t always the best.
“You need open systems and clean technology such as Oracle or PeopleSoft at the core and twiddle round the edges with fancy systems, but don’t put rubbish in the middle.”
The same goes for implementation.
“Even if you choose a good core system, don’t just go for the cheapest implementation.”
Despite positives like the NZHIS standards and co-operation between DHBs, health sector managers need to increase their knowledge of IT, O’Hara says.
“The problem is, if you spend on IT, you’re taking money out of patient care.
“A new system means fewer staff nurses, especially with a heavily constrained budget.
“It’s hard for a CEO to justify IT spending — that’s the difference between long-term strategy and short-term planning.”
Spending too little is a common problem among health authorities in the Asia-Pacific region, she says.
“They’re [often] trying to get a good ERP system with a quarter of the money that needs to be spent.”
In New Zealand, managers and boards will “choose a system that’s a quarter of the price others because it’s cheap, without looking at the long-term strategic impact”.
O’Hara, a qualified dentist, left dentistry in 1990 and consulted for Health Waikato after completing an MBA. She later joined Deloitte, for whom she consulted on IT and other aspects of the health sector in the Asia-Pacific region.
In 2000 she left Deloitte and has been independently consulting since. Next month she travels to Britain to take up a role with KPMG — Atos-KPMG as it is there — to work with vendors on tenders by the consulting firm and vendor partners for supplying systems and services for a huge, multibillion-pound health sector IT project.
The project, titled Delivering 21st Century IT Support for the NHS, is set to run for the next three years and will involve 4.5 billion pounds being spent on technology to allow electronic booking, prescription dispensing and test result transfer between the National Health Service’s thousands of sites.
According to the NHS, the programme will allow “all the disparate elements of the NHS to be joined via a common IT link and support critical national services to help deliver a truly patient-oriented health service”.
The NHS has appointed former Deloitte consultant Richard Granger as its IT director general, a post that carries a 250,000 pound salary.
Granger will oversee the implementation of the programme.
O’Hara says she is “very excited” about taking up the post and that it offers huge possibilities.
“In Britain, the IT industry is in stunned mullet mode. It’s looking at all the money that needs to be spent on the project.”
It will be something new, “as there isn’t a history of big IT health projects in Britain”.
Despite not having the national strategy O’Hara recommends, New Zealand is ahead of Britain in some respects, she says.
“In terms of standards and infrastructure, New Zealand is ahead of the UK and NZHIS has been used as a model for other countries, including Singapore.”