Limited funding and a potential change of philosophy among CIOs are encouraging moves towards regionally shared information services in the health sector.
This could in time lead to a wider, possibly national sharing of applications and expertise between regions, say some of the regional prime movers. Auckland Healthcare, Waitemata Health and Counties Manukau Health are exploring the benefits and possible snags of shared services.
“There is a desire among district health boards to work collaboratively. We may be able to achieve economies of scale in an environment of shortage of funding,” says Auckland Healthcare information chief Pamela Nobbes.
There is already some commonality among the Auckland-region boards in application and network use, but also significant differences. All use the Delphic laboratory system and pharmacy systems are common. On the networking front, all three use the NZ Health Information System’s health intranet. But last month, the advisory board of the nationwide Wave health IT initiative decided against trying to push for a common network for all health providers.
The key step in regional co-operation is to finalise business needs, Nobbes says. From that, software is chosen, and at this point there can be an eye to what other boards in the region have chosen or are likely to choose.
Following studies earlier this year (Computerworld, April 23) Auckland Healthcare has made a decision to acquire package software where possible, and to take the emphasis off bespoke development.
Health Waikato information chief David Menzies says his board and four others in the middle of the North Island already have a shared service agency for recruitment and drawing up of contracts for doctors, and they are exploring whether this approach can be “leveraged” into IT.
Several options exist, from a shared processing centre, through shared contracting arrangements for staff or software development, to sharing expertise and working collaboratively on internal IT developments.
So far, one shared project on training is under way. The boards’ shared service centre will be responding to a request to tender for payroll systems which will emerge from “a number of district health boards” next month.
Menzies says there is definitely promise in sharing IT knowledge, even to the extent of selecting hardware and software on the basis of what other boards have. If a board seems to be doing well with a certain part of its operations on “vendor A”, he says “we might look at deciding that everyone uses vendor A for that job”.
Open tender and due process will still be employed, but wide use of a given system would be a significant influence on the choice.
The changes in approach come about partly due to changes among IT executives. “There is a new breed of CIO in the health sector,” Menzies says. “A lot of us haven’t been in the job for long, and don’t remember the old competitive days. So we’re taking a more collaborative approach.”