Hospitals need new software
Years of under-investment is being blamed for the ‘‘ageing and fragmented’’ IT systems used by district health boards, with the Government eager to upgrade crucial systems.
Health Minister David Clark says the issue is a priority, with a new draft digital health strategy in the works. ‘‘The Ministry [of Health] is exploring options for co-investment with DHBs, with the intention of accelerating work to address these issues.’’
His comments come in the wake of a damning report into the Wairarapa DHB’s ‘‘weak IT system’’, published this week by the Health and Disability Commission. The report highlighted a series of IT problems which were, in part, to blame for an elderly man’s cancer symptoms going unnoticed for several months.
In March 2016, the 72-year-old presented at a public hospital in the region having injured his hip and chest in a 3-metre fall. An urgent scan was done. The radiologist who reviewed the images identified numerous enlarged rectal lymph nodes and recommended an endoscopic examination to rule out a rectal tumour. The radiologist’s recommendation was issued on a ‘‘sticky note’’ in the DHB’s picture archiving and communication system. Twenty minutes later another note was entered on the man’s file that did not mention the nodes.
The second note was the one emergency department staff acted on, with the first one not immediately visible. Several days later the man was discharged.
The report was not sighted until eight months later when a further investigation was initiated. The man was later diagnosed with stage IIIa cancer and underwent chemo-radiotherapy treatment and surgery.
Commissioner Anthony Hill found the DHB in breach of the Code of Health and Disability Services Consumers’ Rights, having not provided services to the man with reasonable care and skill. ‘‘[The] system did not allow for electronic sign-off and did not have a clear, effective and formalised system in place.’’
The Wairarapa DHB’s chief medical officer, Dr Tom Gibson, said the DHB had taken immediate actions to improve its processes. ‘‘We deeply regret that this incident occurred and have apologised unreservedly to the patient involved,’’ he said.
‘‘Safety and quality of healthcare services remain our top priority, and every effort is being made to ensure that this incident is not repeated.’’
The IT system was being upgraded to a new regional system, with electronic sign-off ‘‘high on the agenda for this complex upgrade’’, Gibson said.
Current IT practices, with regard to test results, vary significantly across DHB regions.
Capital and Coast DHB chief information officer Shayne Hunter said his organisation had utilised an electronic sign-off system for lab and radiology results since 2013, with any unsigned results flagged in a weekly report.
He confirmed the ‘‘sticky note’’ function was in use within Wellington Regional Hospital’s emergency department as well as the Kenepuru Accident & Medical clinic in Porirua.
Southern District Health Board chief medical officer Nigel Millar was confident in its ‘‘clear and effective electronic system’’ used for the reporting and followup of test results. He said ‘‘sticky notes’’ were not used.