The $327 million Digital Health Record (DHR) program has been tracking red, or not under control, for months after a decision to close the program and transition to business as usual, the Canberra Liberals say a Freedom of Information request has revealed.
Shadow health minister Leanne Castley said the DHR program had tracked red every month from January to May, after which program reports including project status reports on DHR stopped being produced.
“As at the last program report in May, DHR was still having difficulty with data quality and external reporting and had 35 open risks, 10 with a high rating,” Ms Castley said.
“Other risks included slow access to the Clinical Record, insufficient clinical engagement, slow decision making, pathology results sent to the wrong doctors and cyber attack.”
Ms Castley also said a decision to close the entire DHR program from 24 March and manage outstanding work as business as usual was “premature”.
“In January, the DHR Program Board meeting rejected a request to extend the program’s Business Intelligence and Data (BI & D) project – that part of the DHR program having problems with external reporting – until November 2023.”
“By February, the BI & D project was itself tracking red, trending worse and 77 per cent complete, placing all delivery dates for core activity data at risk. By May, it was still tracking red, trending worse and still stuck at 77 per cent complete.
“Months later, data reporting is still a fiasco. The recent ACT Budget was missing 12 pages of 2022-23 strategic and accountability indicators for Canberra Health Services due to the DHR reporting debacle.
“Emergency department and elective surgery wait times data has been unavailable, despite the Minister in February saying it was a ‘month or so’ away, that CHS was working towards restoring whole-of-organisation reporting before May, and in May saying a better dataset would be available ‘before too long’.”
Ms Castley said a lack of oversight and transparency compounded problems with external reporting following closure of the DHR program.
“Incredibly, the Health Minister ceased receiving formal monthly program reports on DHR after transition to business as usual,” Ms Castley said.
“The Minister was warned prior to go-live in November 2022 about the high risk to external reporting but blames officials for not escalating their concerns. Now we have the revelation of yet another breakdown in oversight on this Minister’s watch.”
ACT Government response
“The Digital Health Record (DHR) is not closed or proposed to be closed,” an ACT Government spokesperson said. “The system is live and operating on a daily basis across the ACT public health system. It has already demonstrated improved efficiency in our hospitals and health services and is empowering patients with access to their own information through MyDHR.
“Full implementation of the DHR was always expected to take time. In 2020, the ACT Government entered into a 10-year contract with a world-leading electronic health record provider, Epic, to deliver a Territory-wide DHR. The first two years of the project focused on the DHR system implementation program, which was completed when the system went live in November 2022.
“Transitioning to business as usual occurred over four months from November 2022 to March 2023, and included a ‘hypercare’ period where there was significant additional resources across the health system to support implementation of the DHR system on the ground. This is a standard process that major projects and programs undertake to transition work from project staff and a project governance structure to ongoing staff and governance arrangements.
“The ACT Health Directorate Digital Solutions Division’s monthly report identifies that a range of areas are monitored on a continual basis within the division. The team supports the DHR system by performing monthly small updates and six-monthly larger upgrades to continue to uplift the function of the system and keep it current with best practice.
“As with any large project, a key function of the DHR Program Board was to understand, monitor and address risks. During the formal DHR Program, risks were flagged with the DHR Program Board and mitigation strategies were identified and implemented.
“The Business Intelligence and Data Project was closed by the DHR Program Board in March 2023 because the Board believed at the time that the ongoing work could be managed through the business as usual (BAU) processes and resources.
“With the benefit of hindsight, the Government recognises that transitioning this BI and Data project to BAU in March may not have been the right decision and that the transition to BAU could have been better managed in regard to structures, governance and oversight. At the same time, we acknowledge that data teams have been working diligently across both Canberra Health Services and the ACT Health Directorate to address the identified issues, with a primary focus on ensuring operational data is available to support management of the hospitals and health services.
“The ACT Health Directorate is currently working on the submission of 2022-23 Strategic and Accountability Indicators for Annual Reports, which are always expected to provide a more accurate picture of financial year outcomes than Budget Papers because they allow for end-of-year data to be collated and cleansed. Data reports will also be submitted to the national bodies as per their timeframes and the ACT Health Directorate is in regular contact with these bodies to advise of progress.
“The DHR is operating across public health services each day and accessed by consumers through MyDHR. It is providing clinicians and consumers with important information that can be accessed at any time at one of the ACT’s public health services. This is reducing the need for additional tests, improving access to pathology results and alerting clinicians to duplicate orders, to name a few practical benefits.”
