NSW takes a federated approach with $400m eHealth blueprint
NSW will take a federated approach that balances centralised IT decision-making with localised input as part of its Blueprint for eHealth in NSW, released today by Health Minister Jillian Skinner.
The blueprint formally establishes a new eHealth NSW division as a separate entity from HealthShare – which provides services such as payroll and linen and food services – within NSW Health. These developments were foreshadowed by Ms Skinner in July 2012 and most of the funds were allocated in the 2011 state budget.
The blueprint details how the government expects to spend the $400 million already allocated to ICT programs, including on existing roll-outs such as Cerner's FirstNet EMR, the enterprise imaging repository (EIR) and HealtheNet, the program that NSW Health is using to link hospitals to primary care and the PCEHR.
The EIR is expected to be live in all districts by February 2014. Former NSW Health CIO Greg Wells said trials were currently underway to allow private specialists to access the public repository.
New initiatives include the roll-out of what is being called the Intensive Care Clinical Information System (ICCIS) – the tender for which was won by iMDsoft and its MetaVision software and is worth $43 million – and a new Community Health and Outpatient Care (CHOC) integrated clinical and electronic medical record, costing $100 million.
They also include the $85m phase two of the roll-out of FirstNet to other hospitals and clinical specialties, which will include voice recognition capability, and new electronic medication management (eMM) systems, tenders for which are expected to be issued shortly and which have been budgeted to cost $170 million over 10 years.
An inaugural CEO of eHealth NSW will be appointed by next April, along with a chief clinical information officer (CCIO) to engage with clinicians.
The plan is based around the idea of adopting a federated, collaborative governance arrangement across NSW Health, with a balance between centralised and localised planning, and statewide ICT integration.
While statewide roll-outs are central to the plan, it also states that “Local Health Districts will now have the capacity to tailor new systems to local clinical practice within statewide requirements, jointly plan system roll out and timelines, alter work practices to match IT application improvements, and adjust arrangements even once they have been implemented.”
“Clinicians and Local Health Districts will not only be key to identifying eHealth strategies at a statewide level, but also take responsibility for successful implementation of key programs at the regional and community level as well.”
The plan also includes the development of a strategy for rural and remote districts, and the development of a Health Wide Area Network (HWAN), which will enable a clinical-grade network across 20 sites with significant increases in bandwidth to speed up the transmission of data.
There are also a number of corporate initiatives such as a new Asset and Facilities Management Performance Improvement Program (AFMPIP) costing $12m, the $89m automated rostering system called HealthRoster that will link to payroll and HR and is due for a statewide roll-out by the end of the 2014-15 financial year, and a new $22m Incident Information Management System (IIMS).
There will also be a single staff directory and the inclusion of health in NSW's all-of-government data centre reform program known as GovDC. When the corporate, infrastructure and clinical systems are combined, the 10-year NSW Health program will cost $1.5 billion.
In terms of milestones for clinical systems:
- the CHOC community and outpatient EMR, which will connect Aboriginal health, aged and chronic care, allied health, child and family, community home nursing, drug and alcohol, mental health and sexual health, is due for completion at the end of 2015-16
- phase two of the EMR roll-out (eMR2) will see improved functionality and a wider roll-out for the FirstNet system, as well as the inclusion voice recognition, pioneered at Manly Hospital, by the end of 2016-17
- the ICCIS intensive care system, which is designed to use multiple, real time electronic data, improved bedside interfaces, integrated medical records and medication management and increased use of intelligent devices and software to improve ICU management, monitoring and decision making, by the end of 2016-17
- and the eMM systems, which the LHDs are expected to be able to choose the most suitable from an approved panel, by the end of 2018-2019.
Ms Skinner said the NSW health system boasted one of the largest ICT portfolios of any agency or corporation in the country.
“eHealth NSW has enormous potential to transform healthcare delivery, whether by using digital and online technologies to assist the management of critically-ill patients in intensive care units or by reducing the need for patients to travel by providing personal eHealth records, tele-health and home monitoring,” she said.
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