6 May 2008
There are myriad problems in the delivery of much-needed infrastructure.
Picture an average Australian office in the 1970s. There were typewriters and card indexes but most of our work was done by pen and paper or on the phone.In the 21st Century we can’t survive without technology. Email allows us to communicate instantly with people around the world and the internet offers endless information.
For most of us, this networked, computer-assisted workplace is the norm. Except in our public hospitals.
We spend billions of dollars a year on public hospitals yet the infrastructure is so poor, some computers at a Victorian hospital still operate on MS-DOS and can’t even support the use of a mouse. We still send hand written carbon copies of patient notes to GPs.
Two recently-released reports have revealed serious problems with information systems and support in our public hospitals.
The Auditor-General released Delivering HealthSMART, Victoria’s whole of health ICT strategy. He found that the six-year, $323 million plan was running two years late, and that the most beneficial clinical applications have yet to be delivered.
The Auditor General’s report was painful for a government still smarting after the poor publicity surrounding Myki.
The delay in implementing HealthSMART is in part due to the lack of basic IT infrastructure in our public hospitals. In order to build high quality ICT systems, we need a solid IT base.
Other IT problems are outlined in the Ministerial Review of Victorian Public Health Medical Staff, which found that, “Clerical workload, poor information systems, absence of clinical support and decision making systems .., poor access to computers and computers being slow and obsolete were a common complaint and a major source of frustration of medical staff at all levels.”
I’m one of the frustrated doctors, but it’s not just problems with the implementation of HealthSMART that causes my frustration.
I run the Urology Department at Western Health. I don’t have an office and I share a PC with 150 other senior doctors.
The Ministerial Review notes gaps in the provision of health IT infrastructure and support that is necessary for modern, effective, efficient, safe and high quality care. The Auditor General and the Ministerial Review make sensible recommendations about how to move forward. Some recommendations are fairly simple, like making sure that all doctors have access to a computer. Some recommendations are more complicated, and will need more time and investment.
The response to the Ministerial Review has been disappointing so far, so I hope the Auditor General’s report receives a better hearing. ICT has the potential to improve not only communications and management, but also clinical decision making in our public hospitals. It can and will make our public hospitals safer.
It’s time government took ICT in hospitals seriously. High quality care required high quality ICT. If doctors don’t have the computers to work with, then multimillion dollar ICT systems are a waste of time and money. While waiting for the many benefits of HealthSMART, doctors need some basic IT support to care for their patients.
Dr Doug Travis is president of AMA Victoria
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