Pessimism, Computer Failure, and Information Systems Development in the Public Sector. (Public Administration Review 67;5:917-929, Sept/Oct. 2007, Shaun Goldfinch, University of Otago, New Zealand). Cautionary article on IT that should be read by every healthcare executive documenting the widespread nature of IT difficulties and failure, the lack of attention to the issues responsible, and recommending much more critical attitudes towards IT. link to pdf
Here's what's about to "go down" (no pun intended) Down Under, this time in the Australian state of Queensland:
Queensland Health eyes software system despite red flags
From: The Courier-Mail
September 21, 2011 12:00AM
QUEENSLAND Health is poised to sign a multimillion-dollar contract for computer software similar to that labelled "defective" by an IT expert who audited its use in southern hospitals.
University of Sydney's Professor Jon Patrick said electronic medical records systems built by Cerner Corporation for the NSW Government crashed frequently and risked patient safety.
A similar Cerner system installed by the Victorian health department also has been plagued by glitches and is five years behind schedule.
Dr. Jon Patrick's detailed forensic analysis of a Cerner ED system is at this link and has been a subject of numerous posts on this blog.
"I don't think there's any reason for optimism that they can be improved," Prof Patrick said.
Leaked internal documents have surfaced detailing problems already looming within Queensland, as bureaucrats negotiate with US-based Cerner to build a $243 million electronic medical records system in Queensland hospitals.
Technical information for the proposed Cerner system and existing IT platforms that it must work with was "often incomplete, not-comprehensive, inaccurate and out-of-date", a leaked position paper found.
Another email addressed to chief information officer Ray Brown, released to the State Opposition under Right to Information laws, warned of the increasing need to document potential risks "even if we can't find the resources to remove them" in case of disaster and patient death.
I guess dead patients can't complain about that, unless provided with underground megaphones.
"The no-surprises rule may be applicable and would help in a Coroner's Court," the clinical adviser wrote.
But, in a written statement, Mr Brown last night backed Cerner, which he said had successfully operated systems at the Royal Brisbane and Women's and Princess Alexandra hospitals for more than a decade.
A few anecdotes of success, let's ignore those pesky anecdotes of problems, and - WHAM! - let's spend billions and roll this out statewide/nationwide.
The problem with this (il)logic was well-explained by another physician Down Under who chooses to remain anonymous. See my August 2011 post "From a Senior Clinician Down Under: Anecdotes and Medicine, We are Actually Talking About Two Different Things" at this link. Read it carefully....
Mr Brown said Queensland had learnt from interstate problems and would implement an "end-to-end solution", rather than trying to marry different systems across hospitals.
Independent experts had verified the rollout and more than 4000 staff had been consulted, indicating their support for Cerner software, he said.
The debate came after The Courier-Mail yesterday detailed Opposition claims that Queensland Health bureaucrats deliberately changed an independent report to favour Cerner when hunting for software suppliers in 2009, which QH vehemently denied.
Prof Patrick, chair of Language Technology at the university's School of IT, said problems with Cerner's NSW and Victorian systems were well documented in 2009.
He said Queensland bureaucrats likely knew of the faults, which should have served as "red flags".
Cerner did not respond to a call for comment.
May I suggest that "red flags" often get ignored when the color green is present, at least in the U.S. (I don't know the colors of Australian currency.)
Dr. Patrick notes this at his aforementioned university page:
3.13 Statement on 22nd August 2011. I attended the HIC conference in Brisbane in the beginning of August and at a dinner hosted by IBM on the 2nd August I met Mr Greg Wells, the CIO of HSS, and the person responsible for the FirstNet roll out in NSW. He stated that Cerner had provided new software that would solve all of the User Interface problems and it was being rolled at the present time in the Northern Area Health Service region. He said all installations across the state would have this solution by Christmas this year. We shall watch with interest.
I guess solving problems like these simply takes a lot of pizzas and Coca-Cola.