The Integrated Electronic Medical Record (ieMR) upgrade by US company Cerner is being adopted across almost all hospitals. It will integrate almost every patient record to an online system — including real-time vital signs — from heart rates to the amount of drugs being administered.
Queensland Health chief’s secret concerns about hospitals digital upgrade revealed in recordings
As senior bureaucrats roll out the biggest digital health upgrade in the state’s history, a leaked recording reveals Queensland Health director-general Michael Walsh admitting there are problems with the $1.5 billion program.
But a recording obtained by ABC News details talks between senior health staff in April, with Mr Walsh saying concerns had delayed the rollout.
“Just as a paper-based arrangement in hospital is not perfect, a digital platform is not perfect,” he said.
He admitted problems were causing delays in the system’s rollout because doctors were worried about its safety.
“The problem that we have, that always occurs, is that I can go and have those discussions with clinicians — and they’re real discussions and they’re real issues — and unless people are confident about the safety of what they’re doing, it [the rollout] doesn’t happen.
“But it’s not a perfect world and people know that they’re doing work-arounds.”
In the recording, several staff raised concerns with the director including glitches with the software, increased costs to local hospital and health services, and that some staff were so stressed they were thinking of leaving Queensland Health.
‘It’s delivering benefits and blah, blah, blah’
Mr Walsh was also recorded saying he had been forced to speak positively of the upgrade in public.
“As soon as you get outside that environment, you get in to the public, you get forced into this ‘black and white’,” he said.
“Taking a message out to the world — it’s not perfect, but people are working to ensure that it’s safe for people, that’s really what’s happening.
“So I often get caught into having to speak more positively publicly, because you get put into a situation of having to say, ‘The system’s going to do this and the auditor-general said that it’s delivering benefits and blah, blah, blah’.
“And that’s not the reality in our day-to-day — it’s messy.
“If there are safety issues, that’s paramount and we don’t do it.”
The State Government wants the system in almost every public hospital within the next two years — but the director-general acknowledged the process was not going smoothly.
“Up until now, there have been, there are problems and issues, all of which clinicians either say, ‘We’re not actually turning it on or are not doing it until we’ve got a way of dealing with it that we believe is safe’,” he said.
“And I will never put pressure on anybody to actually do that, so in two circumstances a ‘go live’ has been delayed.”
Thousands of new computers needed for rollout
In the same recording, another senior bureaucrat explained that thousands of new computers — beyond what was budgeted — would be needed to help with the upgrade at a handful of hospitals.
“What we’re seeing is digital hardware is becoming frontline care,” she said.
“That mindset is something that perhaps we’re not used to yet and I certainly found it hard to accept it and the cost that goes with that.
“We made the decision this morning that we’re going to have to replace 10,000 PCs in Metro North … so it is, I think, that sort of light bulb moment where you go, ‘It’s actually part of frontline care’.
“When we are asking our teams to use them, we need to give them the best equipment the same way I’d give you the best forceps or the best steriliser.”
Last year, Queensland’s auditor-general found the cost of the upgrade would blow out by a further $250 million.
Reports of system failures in regional hospitals
Earlier this year, the Australian Medical Association called on the State Government to halt the rollout because senior clinicians believed there was a risk to patient safety.
The upgrade has already been installed at 13 major Queensland hospitals and partly adopted at three, with plans to connect the remaining 13 within the next two years.
Earlier this year, Queensland Health told ABC News the upgrades had thus far “been a major success”.
“Our priority is patient safety and care and we are confident this has not been compromised,” a spokesman said.
Several senior health staff recently told ABC News of concerns with how the new system is interacting with software used to track the administration of anaesthetic, known as the SurgiNet Anaesthesia module.
ABC News has been told of at least two occasions where the software has failed in regional hospitals, forcing senior staff to record details on paper.
A Queensland Health spokeswoman said it was now under investigation.
“Queensland Health is aware of functionality and useability matters raised by staff in respect to the SurgiNet Anaesthesia module,” she said.
“As with all clinical software applications the patient is the priority.
“Patients are continuously monitored during an operation with their clinical data being recorded and available within the patient record — this has not changed with the introduction of the SurgiNet Anaesthesia software.”
‘Actually improving the safety of the system’
After being contacted by ABC News about the contents of the recording, Mr Walsh said the upgrade would provide better health outcomes.
“As we move from a paper-based system to a digital platform, we’re actually improving the safety of the system, we’re ensuring that information is available to clinicians in a timely fashion,” Mr Walsh said.
“Moving from a paper-based system to a digital system is very challenging — people have to change the way that they interact with the record from handwriting to digital, they have to integrate that into their pathways of care for patients to ensure that we improve the safety and provide better outcomes.
“So describing that as challenging and messy is reasonable, because it’s about ensuring that people make those changes and interact with their patients and move to a new system.
“What we know is — and the Auditor General has indicated — is that rolling out the digital platform is improving patient outcomes for people in Queensland.”
Cerner has also been contacted for comment.