Linking-systems plan upsets rivals

By ADAM GIFFORD

Auckland District Health Board has moved several steps closer to the dream of an Auckland-wide health organisation by buying the same theatre management and clinical software used by Waitemata and Counties-Manukau Health.

Chief executive Graeme Edmond said that before a "change freeze" takes effect on June 30 for the move to the new Auckland City Hospital in Grafton, the board would roll out:

* The theatre management module of Patient Information Management System (PiMS) from British firm iSoft, costing $2.8 million.

* A $1.3 million regional results reporting system from Auckland firm Delphic, which allows clinicians to electronically sign off laboratory and radiology results.

* A $1 million clinical workstation system using Auckland firm Orion's web-based Concerto tool to give clinicians a single portal to view information about a patient from multiple sources.

* Med Docs, a template-based medical document application to work alongside the WinScribe digital dictation tool. This project will also cost about $1 million.

Once the change freeze comes off in February next year, the board also intends to put in a $1 million electronic discharge system, and will look at buying the full patient management system, for about $8 million.

The decision to buy the software without going to a full request for proposal process has upset some local vendors, who feel they should have been given a chance to compete.

But Edmond said the regional alignment strategy took priority.

"If at the end of the day we came up and said 'this [competing] system seems to have advantages but it will require Counties-Manukau and Waitemata to throw their one out', that is a highly unlikely thing to happen."

The regional alignment strategy emerged during 2001, after the Health Ministry became alarmed that Auckland District Health Board was about to buy a major SAP system as a "silver bullet" solution to all its information systems woes.

Edmond said that concern "led to me intervening in the process and saying the weighing of regional alignment was not getting adequate attention and we could end up with a recommendation to board and Government to which they would turn around and say 'why are you doing this?"'

PiMS was one of the systems considered along with SAP.

It was bought by the South Auckland health authority in 1996 when it was one of the first Windows-based patient-management systems available, and was adopted by Waitemata when that board decided to align its systems with Counties-Manukau as part of the Health Alliance initiative.

That means by default PiMS became the frontrunner for adoption by the Auckland board.

Edmond said it was not buying the full PiMS at this time because it could not get it up and running before the June 30 change freeze.

The PiMS theatre management module, which interfaces with the board's legacy patient management system, has been successfully piloted in paediatric general surgery and urology, and is now being rolled out in other theatre suites.

He said the board believed that through better data capture the software would improve the utilisation and performance of its theatres, which for the first time would be centralised on one site.

"We have never had good data. All this data has been kept manually in large books - it's almost like a hairdressing salon," Edmond said.

"In our building programme we have to deliver $40 million in annualised benefits to pay for our new facilities.

"Theatre efficiency is one of the key contributors to do that."

By installing the new theatre and clinical management systems before overhauling its patient management system, the board must face the risk it may have to redo projects if it does opt for the full PiMS system.

Edmond said his priority had been to reduce and manage risk in advance of the move to the new hospital.

This is also why Auckland has held off formally joining the Health Alliance between Counties-Manukau and Waitemata, although it has signed up to an agreement to work towards common patient management and clinical systems.

"Patients and clinicians move between the organisations, it is a fact, and it is a very strong thing to have integrated, aligned systems.

"It makes sense economically doing it that way because you can get more sharing, but from ease of use it makes good sense too."

www.adhb.govt.nz

www.orion.co.nz

www.isoft.co.uk

www.delphic.co.nz