Southern Health (Victoria) Staff Speak Out on HealthSMART.

The following rather long letter arrived – by post – in an unmarked envelope – last week.

The impassioned three page letter (scanned) can be accessed here.

http://moreassoc.com.au/downloads/SH%20Letter%20Jan%2031%202008.pdf

(Note the file is about 3.0 Megs and takes a few moments to load even on a broadband link)

While it is hard to know the exact truth behind all these claims enough of the thrust of what is being said makes very good sense, and to me the broad points ring true.

The three articles cited can all be found on the e-Health-Media Website.

The URLs are:

http://www.e-health-insider.com/news/3427/full_lorenzo_benefits_expected_2012

http://www.e-health-insider.com/news/3364/csc_fined_%C2%A35m_for_late_delivery_of_pas_systems

and

http://www.e-health-insider.com/news/3351/cameron_says_nhs_it_must_be_local

Leaving totally aside the specific claims being made about the respective Health IT Vendors (which may or may not be in any way justified) there are a few generic points being made which I believe need careful consideration and discussion by those managing HealthSmart.

The first is that to have even a small number of individuals sufficiently concerned to write to the State Auditor-General (and simultaneously express concerns for the job security for speaking out) strongly suggests there are some serious communication and consultation problems in the HealthSmart programme.

The second is that, as the UK Connecting for Health Project has learned at some cost, rigid national or state implementations virtually inevitably incite major resistance. This is almost certainly due, in my view, to the fact that despite apparent homogeneity within the various entities in these Health Systems, there are in fact wide variations in work practices and processes. To not recognise and adapt to these – as a centralised implementation approach does not – is perilous indeed.

The third is that if a ‘best of breed’ application selection approach is adopted then effective seamless interfacing and integration is vital. This does not seem to have occurred here.

Fourth you cannot expect hospital staff to work to implement one system while being told in that in a few years time you will have to do it all again when the new model arrives. This guarantees staff alienation.

On the basis of this letter I suspect HealthSmart needs to quickly smarten itself up (pun intended) and look to start effective discussion and dialog with those involved.

I think the Department of Human Services (DHS) should treat this letter as a ‘sentinel event’ and that it should prompt a careful review of what is happening that is creating this level of concern among some of its employees. Additionally, for people to be nervous about alerting DHS to problems, for fear of retribution, is a very, very sad state of affairs.

I look forward to the odd comment from those south of the border in Victoria.

David.