Auckland City Hospital's new IT system replaced three inhouse systems which were up to 30 years old. Photo / Michael Craig
THREE KEY FACTS
Auckland City Hospital began rolling out its new IT system, TrakCare, in October.
Some staff say the $95m project has been plagued by problems, which have led to delays in transferring or treating patients.
Hospital leaders said teething problems were expected with any large-scale, complex IT implementation and many of the problems had been solved.
The rollout of a new $95 million IT system at Auckland City Hospital has been criticised by staff as “incredibly stressful and traumatic” after causing treatment delays, increased workloads and nurses using a whiteboard to keep track of patients being “lost” in the system.
It had reportedlyled to delays in some patients getting treatment at a time when Health NZ - Te Whatu Ora is trying to make the healthcare system more productive.
Auckland City Hospital introduced the new patient administration system, called TrakCare, at the end of October. It replaced three inhouse systems which were between 25 and 30 years old and aimed to provide a more streamlined, consistent service. TrakCare manages all core patient data, including personal details, medication, and any scheduled treatments.
NZ Nurses Organisation (NZNO) delegate Ben Basevi said the IT system was the “central nervous system” of clinical care at the 1200-bed hospital and connected a “vastly complex” network of applications.
There had been a series of problems since it was introduced, which in some cases had led to delays in patients being admitted, discharged, or treated, he said.
That had increased busy nurses’ workloads.
“If I’m a nurse in a ward and ED rings me up and says I’m handing over a patient and he’ll be up in your ward in five minutes, the nurse can’t admit the patient into the ward because the systems aren’t talking to each other.
“Everything becomes a nightmare because the patient data needs to be on the ward. So it can make a day become ghastly.”
A problem with patients’ wristband labels meant that laboratory and radiology results were not being directed to the correct clinician, potentially delaying diagnosis or treatment, he said.
Dawn Barrett, a surgical nurse, said she managed a theatre where up to 30 patients were treated a day.
“So we have a lot of people coming in for surgery and going out the same day, possibly. And TrakCare really isn’t up to that. You can’t really find your patients and manage them that well.”
Barrett said that when patients moved between two parts of the hospital, they were sometimes “lost” in the IT system and could not be allocated a room or moved to the next stage of their care.
Over the last month, her wards had been using a whiteboard to keep track of patients. She said that the system had improved over that period for some departments, but they were still using a whiteboard for general surgery patients.
Clerical staff were spending an extra two hours each shift to schedule operations for the following day, she said.
“It has been incredibly stressful and traumatic for all staff.”
Auckland Hospital group director of operations Dr Mike Shepherd said “teething issues” were to be expected with any large-scale, complex IT implementation.
“We have identified issues needing to be remedied and have worked through many of them in conjunction with our clinical teams,” he said in a statement.
“We are working hard to address and resolve any remaining issues and continue to train our staff.
“Patient safety is paramount, and we have workarounds in place to ensure we continue to deliver the care our community needs and keep patients and staff safe until all underlying issues are resolved.”
TrakCare was developed by the company InterSystems, which won a tender process in 2021. The IT system began implementation in 2022, and was scheduled to go “live” at Auckland Hospital in July before being delayed to October.
Shepherd said the launch timing was based on “project readiness” and the optimal time of year.
So far, $47m has been spent on the project. Its total budget is $95m for the first 10 years.
Shepherd said TrakCare was chosen with the intent that it could implemented at other hospitals and connect with other systems around the country. At this point, there was no plan to introduce it elsewhere in New Zealand.
The switchover to a new system coincides with major upheaval within Health NZ’s data and digital workforce. The Public Service Association said a net 1120 jobs were being cut, which was nearly half of the sector’s staff.
Isaac Davison is an Auckland-based reporter who covers health issues. He joined the Herald in 2008 and has previously covered the environment, politics and social issues.
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