Concentrated effort and investment is required to mitigate the risk of information system failure within the Ministry of Health and the broader sector it administers, according to a Ministry report seen by Reseller News.
The Ministry is taking stock of its legacy IT systems to help it develop a long-term plan to mitigate the risks, it says in a response to a performance review published by the State Services Commission late last year.
"The Ministry is dealing with ageing applications and platforms and increasing technical debt, as the cost to replace legacy systems increases as replacements and upgrades are delayed," the report, which was released on Friday but provided to the State Services Commission in April, states.
"This reduces our capacity to deliver new solutions; does not provide effective, modern tools for the end user, nor the agility to deliver change rapidly; and limits our ability to provide a single, guiding approach to become a more digitally-enabled health system."
The need for IT investment and to deal with a host of other issues itemised in the report comes as District Health Boards face increasing projected budget deficits, forecast to reach $225 million this financial year.
The report was written to inform the new Director-General of Health, who was appointed last month. Dr Ashley Bloomfield will have to grapple with the scale, pace and level of investment directed to support the Ministry’s response to the performance review.
"The work programme outlined in this report and accompanying work packages are therefore intended to capture the direction of change, rather than prescribing activities, to provide maximum flexibility," the report states.
Furthermore, the report adds that "fragmented and ageing" technology assets are a barrier to progress within the sector.
"Current systems suffer from instability and cannot easily be leveraged to gain value from the data within them or to deliver innovation," the report states.
"The Ministry will need to consider how best to improve the functionality of the technology and digital architecture supporting the Ministry and underpinning the health and disability system as a whole."
Fit-for-purpose
Among a long list of needed investments is fit-for-purpose integration to support analysis of the valuable data the system already generates; enhancing interoperability to share data and enable consumer-based healthcare models, and; changing the current model around Application Programming Interfaces (APIs) to an open system in which the Ministry will define standards and architecture.
Key systems such as screening and identity management need to be re-platformed to a customer relationship management (CRM) system while cloud-based systems are required to help reduce technology debt from ageing systems and to help simplify the sector's technology landscape.
On top of all the, the Ministry wants to embed security by design and modernise internal technology to give end-users modern tools.
"Digital health has the potential to increase access to care and equity of outcomes, but we need the infrastructure to enable this," the Ministry states.
A new Information Systems Strategic Plan (ISSP) will help ensure investment does not result in the deployment of siloed and disjointed technologies.
New investment in the sector will partially address some of the concerns, the report says..
"The focus of Budget 2018 on rebuilding and reinvesting in public services, including health, will help enable this response, but substantial, concerted effort from all parties in the health and disability system, as well as additional investment and time, will be required to move towards a future-focused and sustainable health and disability system.
Developments already under way include the deployment of a new financial management information system, based on the Oracle Cloud solution, and a new planning and budgeting tool, based on the Adaptive Insights tool.
The Ministry has also developed a statistical model that forecasts health service costs and health loss over time.
"Continued effort in this area will need to continue to ensure the health sector has a strong view of performance and can make the case for new or alternative resources when they are required," the report states.
A new business intelligence tool, QlikSense, is also being rolled out throughout the Ministry from 1 July.
"QlikSense provides access to data through interactive and intuitive dashboards, and will reduce the time analysts typically spend establishing base datasets for analytical projects, allowing them to spend more time on exploring the data and discovering insights," the report adds.
"This tool will also create the ability to create and share trusted data models, analytics and visualisations with the wider health sector to support improved sector performance."
In a separate announcement, the Ministry said it had contracted Deloitte for the initial planning and design phase of the new National Bowel Screening Programme IT system, with work is expected to be completed in late July.
"Subject to Deloitte’s performance, and approval of the business case, the Ministry will either continue with the provider or select another for any subsequent implementation and build phase," the Ministry said.
Deloitte subsidiary Team Asparona has been working with DHB-owned New Zealand Health Partnerships' in the overdue and over budget National Oracle Solution project, which was originally budgeted at $65 million but may now cost closer to $90 million.
Deloitte itself has been commissioned by the Ministry of Health to review that project, prompting questions in Parliament about potential conflicts of interest.
