The NSW Auditor-General has called for a more robust regime to manage investments in ICT and e-health – with calls to measure the ROI across the healthcare system.
A new NSW Audit Office report Focusing on health handed down by the Auditor-General says the peak body, eHealth NSW, needs to more closely review the management or projects and progress to date. This includes the broader investments in technology and e-health platforms.
In July this year, HealthShare NSW’s information technology functions were transferred to eHealth NSW. This entity was established to streamline governance, forward planning and managing the broader healthcare reforms.
Among the recommendations, the latest audit says that eHealth NSW needs more formal "post-implementation reviews" of key projects. These are to also assess if projects have achieved intended outcomes.
These reviews should be done as “soon as possible” to establish if management practices are effective and in sync with projects being delivered to time and budget.
At present, eHealth manages $400 million in planned investment over the next five years. This agency offers guidance over health planning, strategy, program implementation and supervision across a wide range of information and communication technologies.
These technologies include broadband connectivity, digital networking and investments in smart software to manage healthcare information assets.
The broader eHealth projects encompass several key initiatives. These include the electronic management of medication programs, a community health and outpatient care system and oversight of an intensive care clinical information platform.
The NSW government’s Whole-of-Government Data Centre Migration program comes under the auspices of eHealth,
Projects running behind schedule
However, the Auditor-General’s report notes that “almost half of eHealth NSW’s information technology projects are running behind time.” As a first step, eHealth needs to track reasons for the delays and lessons gleaned for future projects.
More broadly, information security issues represent 78 per cent of all technology concerns tracked during 2013-14. “The number of user administration process issues increased particularly around timely removal of user access, approval of new user accounts and review of user access levels. This increases the risk of unauthorised access to the financial systems.”
In relation to disaster recovery planning, five health agencies had completed a self-assessment of their disaster recovery planning and testing capabilities.
Moreover, since 2012, none of the agencies had fully tested their plans. “Without adequate testing, agencies have little comfort over the effectiveness of their disaster recovery plans in helping to restore their financial processes and systems in the event of a disaster.”
Daily spending on health tops $50 million
In an earlier industry presentation, NSW’s minister for health, Jillian Skinner, noted that the state’s annual health budget stands at $19 billion. Details at Health insights.
This state’s spending on health averages nearly $50 million a day, Skinner said. “Ours is the largest single component of the NSW state expenditure. We account for 28 per cent of the NSW government budget.”
NSW’s health system is experiencing a surge in demand for services. “This will largely be driven by increasing community expectations, a growing and ageing population, lifestyle-related chronic disease and the availability of new healthcare technologies.”
The investments in technology include $170 million for an electronic medications management system and $85 million on electronic medical records systems to integrate with the National Personally Controlled Electronic Health Record (PCEHR).
More than $90 million is earmarked to upgrade corporate systems and build new networks, data centres and messaging to connect staff across the NSW Health infrastructure.
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