Official solutions a bit late to the vax party

We finally got to the bottom of exactly what has been going on with NSW Health’s vaccine booking system this week, discovering through the NSW tender site that a contract had been signed with ServiceNow Australia for a full vaccine management system way back in May. A new system has since been gradually rolled out to replace the hastily put-together appointment booking conglomeration our correspondent had struggled for several weeks to use, which we wrote about back in July.

The difficulties experienced by the general public in teeing up vaccine eligibility with actual vaccine availability and appointments has subsequently led to several attempts to streamline the process from tech experts keen to help, including Sydney geospatial engineer Ken Tsang, who has put in long hours of work to add vaccine clinic information and availability to his COVID-19 Near Me site.

It is now apparent that the people behind the official Australian site for finding vaccine clinics, HealthDirect’s Vaccine Clinic Finder, were aware of the data quality issues all along and have been working on a solution. On Monday, HealthDirect released a funding offer to the online booking system sector to roll out APIs designed to improve data quality and real-time exposure of appointment availability.

Work has obviously been going on behind the scenes for some time – and HealthDirect has also in the meantime poached some talent from the Australian Digital Health Agency to assist in the endeavour – but we go back to an argument we’ve raised before: surely this should have been foreseen far earlier, when it became apparent that a massive, national-scale vaccine roll-out would be required?

And it surely is a shame that the websites set up to plug the gaps, none of which are operating on a for-profit basis, are being excluded from any funding and in fact disparaged for generating high traffic loads on the commercial booking systems as they repeatedly scan for available appointments. New Zealand has at least put this rivalry aside by working with the aggregator sites as part of a concerted national effort to get everyone vaccinated as quickly and efficiently as possible. We only wish Australia could do the same.

And while some believe it’s great that the industry is being supported to improve interoperability standards, this is coming a bit too late to be of much use for the Delta outbreak. By the time the existing primary care vaccination clinics are all set up for real-time data feeds – the industry offer ends in December – the 80 per cent vaccinated threshold will have been met and it will just be booster shot appointment bookings next year that will benefit. We don’t know if that is money well spent.

In other news, our most popular story this week by far was about Melbourne’s Royal Children’s Hospital and the seriously impressive results it has achieved since it rolled out its electronic medical record in 2016. Early results on the effect on mortality rates were presented by CMIO Mike South at HIC in 2019 – in what was the second most read story on Pulse+IT for the year – and these results have now been replicated in a study in the Journal of Paediatrics and Child Health.

RCH rightly boasts that its EMR implementation has been exemplary and these results bear it out. Next week, we’ll have a few more stories on how EMRs are increasingly up to the job, including an upgrade to the Meditech EMR at Chris O’Brien Lifehouse in Sydney and how Cerner’s previously problematic EPLIS system for SA Pathology has now turned the corner.

That brings us to our poll question for this week. Last week, we asked if you thought there needs to be a standards-based, nationally agreed system for vaccine passports. Overwhelmingly, you agreed: 95 per cent said yes, five per cent said no.

We also asked an optional question about what a vaccine passport should be based on. The EU Digital COVID Certificate was the leading contender, although there was some love for the IATA system. “Whatever Grahame Grieve says” was our personal favourite.

This week, we ask:

Have our health departments been agile enough in adapting IT systems for the pandemic?

Vote and comment here or leave your comments below.

Comments  

0 # Kate McDonald 2021-09-24 14:57
Responses to this question were few, which might have been due to our putting in the wrong link in last week's blog. Apologies for the confusion. The good news is that there were a few responses, including one from a Social Darwinist, so that's something we suppose:

Good - NZ and ACT Not so good - Feds. OK - NSW Health

ACTHealth

It was good to read about the RCH results.
Back in Tasmania, the digital medical record is basically scanned hand written notes. Sometimes scanning can take weeks to catch up after admission. SO, when patients bounce back to hospital the notes from previous episode of care can be missing/hard to find.

18 months in, 100s of covid patients and 1000s of contacts, and my LHD is still using post-it notes in a manager's office...

ACT

NHS has done a good job of theirs

VaccineWA system has worked well but may have also been fortunate as it hasn't needed to scale up as quickly

Sydney LHD has done great while many like QLD H or even VIC hospitals were too slow or late. EHealth NSW in my opinion could have done a better job knowing that nsw has largest population and needs to be proactive. Seeing that Sydney LHD had a great system in place, eHealth should have just rolled it out vs. going for foreign companies like QLD and VIC. Spending millions of dollars for a system that underperforms vs giving local aussie companies a boost.

Overall all healthcare organizations did a poor job of proactive planning when we had enough time to do so.

In Australia - done it well - none; done it poorly - all states.

Nothing anyone has done has conquered the virus, not even that silver bullet favoured by naive politicians - IT. The only things that will allow us to live with the virus are vaccines, better treatment, behaviour and time. It's natural selection at work. The weak and the stupid will die off. It has always been so.

The pandemic itself has been agile & difficult to rapidly respond to

Well - south western Sydney : poor - northern Sydney

Hot Doc better than Health Engine for sure.

Victoria has been particularly bad

Canada (well)

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