Why do IT projects fail in the health sector? The question, posed by Archie Galbraith, head of Accenture’s healthcare division, grabbed the attention of delegates at the recent GS1 healthcare conference in Dublin where the PPARS (personnel, payroll and related systems) controversy was still on everybody’s minds.
The answer lay in a lethal cocktail of vendors that over-promise, projects that underachieve and a failure to deliver value for money, according to Galbraith. As in most branches of medicine there are no easy cures but there are ways to help realise the benefits of IT projects, said the man from Accenture. Know exactly what you want, agree outcomes, start with the end vision and work backwards. And always think about context and the larger system.
With the last point in mind, Galbraith stressed the importance of working with standards that are transferable. “Until we move more to a space where proprietary solutions are considered wrong and industry standards are accepted as the only way to go, we will have limited success,” he warned.
He talked of a silo culture where different agencies pursue their own agenda with their own tools. “People in the medical world are not comfortable with the standardised model,” he said. And he warned of the perils of isolated IT projects that appear to be sound investments but turn out to be obstacles to broader integration.
On the subject of a single patient record, the hottest IT topic in healthcare, he said it was a nonsense that a person in the community should not have their information shared among the multiplicity of agencies that deal with them. He said it was time to rethink attitudes to privacy and security, and the rules that get in the way of unified records.
A core theme of the conference was about increasing efficiency and accuracy using track-and-trace technologies. Dr Barry White, director of the National Centre for Hereditary Coagulation Disorders (NCHCD) at St James’s Hospital has led a pioneering project that proves IT can make a positive difference. The objective was to ensure the safe delivery of haemophilia care after the Lindsay Report had highlighted how infected products had infiltrated the supply chain.
Using the GSRN (the European global service relationship number) as the patient’s unique identifier and a set of barcode standards to tag and label medicines that are supplied in hospitals and at home, the NCHCD has built a stock management and supply system that operates down to vial level. Following a successful pilot of the project at St James’s the plan is to roll it out to other hospitals.
According to White, the success of the project is down to a new approach that every healthcare professional must adopt. “Clinical excellence does not exist in isolation,” he said, “it needs to be provided in tandem with logistical excellence. And ultimately it’s about operational excellence.”
He argued that healthcare was now a business process, albeit one with a different value chain. At the top are patients who come in and engage with healthcare workers and treatment is prescribed.
Project manager Fergal McGroarty said having access to all available information means the hospital can initiate a comprehensive recall if it had to, a requirement of the project from the outset, but other benefits include a drop in medical wastage that went from costing the service €120k a year to zero and a reduction in documentation errors.
A state-of-the-art agency with an integrated patient care system, electronic records and transparency in patient service delivery: it’s not all bad news for Ireland’s health service.
By Ian Campbell