A proposal by seven district health boards to commission a shared patient administration information system (PAS) has come about without explicit central coordination, says Mid-central DHB chief executive Murray Georgel.
“It was what’s been called parallel discovery,” with several smaller groups of boards simultaneously realising the advantages of collaboration.
Three boards from the central North Island — Mid-Central, Whanganui and Wairarapa — decided last year to explore a joint development. They were then approached by the Nelson-Marlborough DHB that said it had been working with South Canterbury on a similar scheme. They seemed to be further ahead than the North Island DHBs, so the groups came together. The Canterbury and Northland DHBs joined later.
The seven boards jointly put forward a request for information (RFI) in December that was initially aimed at a PAS, but carrying implications of a certain degree of convergence in associated elements such as clinical support systems. They call the initiative the Health Management System Collaborative (HMSC).
This might evolve to include more boards, says Georgel. On the other hand, some may drop out in the future due to a conflict of priorities, he acknowledges. It’s possible that the group may want to do something and one of the boards says, “that’s not a priority of ours at present”.
There has been no active promotion of the concept to other boards, he says.
“We’ve just let them know that this is happening and that they’re welcome to think about joining us.”
Ministry of Health deputy director general of information Alan Hesketh says as the RFI is active in the marketplace, it is not appropriate to comment on the tender. However, he says the ministry “supports any collaboration between district health boards that, amongst other outcomes, improves people’s experience and safety as they use the services delivered by the health system”.
The clinical and business objectives of the planned PAS include: “increased efficiency, clearer treatment pathways, earlier intervention and overall improved health outcomes,” says the RFI document. When information is passed from a health practitioner in a different board’s area — inside or outside a hospital — a common system will help ensure all parties are accessing the same information about the patient.
In 2008 health and disability commissioner Ron Paterson reported on three particularly serious cases of poor health outcomes for patients, as a result of information being lost between one board and another (Computerworld, October 27). Paterson discussed the advisability of a single electronic health record.
A unified record may be an entirely virtual entity, Georgel explains.
“Just because we’re looking at the same information doesn’t mean it has to be gathered by the same system or stored in the same repository,” he says.
Other advantages of a common system design include staff familiarity with the system as they move between boards, he says. Common disaster backup, though not explicitly included in the current proposal, is a potential money-saver, Georgel says.
There need be no fears at this stage that the collaborative effort will create undue dependence on one provider, Georgel says.
“We’re only seven” out of a total of 21, he points out. There are several separate collaborative efforts among other DHBs already.