Digitising public hospitals

Tabled Report 10: 2018–19

Tabled date

2018-12-04

Report year

2018-19

Health Information technology

Entities audited

• Queensland Health

Recommendations

1. QAO's text Addressed to: the Department of Health and the hospital and health services that have implemented the ieMR solution (Note 1)

   continue to work together to identify the actual cost to date of implementing and operating ieMR. (Chapter 2)

   The Department of Health should:

   • use this information to update the Cabinet Budget Review Committee on the actual program cost to date. The information should form the basis for a more reliable estimate of what it will cost to complete the program and of the longer-term costs of maintaining the ieMR solution
   • in consultation with HHSs, consider whether the level of investment by HHSs to implement the ieMR solution is appropriate.

2. QAO's text Addressed to: the Department of Health

   completes its refresh of the eHealth investment strategy based on the revised cost of the ieMR program and any impacts it has on the strategy for other programs (Chapter 2)

3. QAO's text Addressed to: the Department of Health

   provides the Cabinet Budget Review Committee with:

   • updated timing for the realisation of benefits
   • a balanced assessment of benefits realised (and dis-benefits) across hospitals from all hospital and health services that have implemented the ieMR (Chapter 3)

4. QAO's text Addressed to: the Department of Health

   provides greater assurance that it is obtaining ongoing value for money from its ieMR vendor by:

   • investigating options for demonstrating value-for-money pricing, including conducting comparative vendor price analysis where possible
   • assessing and documenting the ieMR vendor’s performance across its service contracts, with input from hospital and health services.

   This should occur at appropriate intervals and, at a minimum, before each contract extension decision (Chapter 2).

5. QAO's text Addressed to: the Department of Health

   re-visits the governance arrangements for the program as it moves from building, configuring, and implementing the ieMR solution to business-as-usual and optimising the solution 

   This should include:

   • re-visiting the focus and roles of the eHealth Executive Committee, eHealth Queensland, and other areas of the department such as the Clinical Excellence Division
   • continuing to obtain an independent review of program benefits periodically. (Chapters 2 and 3).

6. QAO's text Addressed to: the Department of Health

   develops and implements an engagement strategy for all current and planned eHealth programs to assess the effectiveness of its engagement with hospital staff and clinicians and the effectiveness of the system implementation (Chapter 2)

   This should include:

   • specific actions, performance measures, and data sources to enable the department to assess how effectively the department engages hospital staff and clinicians
   • gathering information about concerns, risks, or dis-benefits that may inform the program about changes or modifications that need to be made to the program.

7. QAO's text Addressed to: the Department of Health

   continues efforts to refine the business intelligence strategy and approach, and rollout solutions to hospital and health services to maximise the benefits from the ieMR implementation at each site (Chapter 3)

8. QAO's text Addressed to: the Department of Health

   improves the preventative security controls of ieMR user accounts (Chapter 2).

   This should include enforcing password complexity requirements and implementing a change management process to educate clinicians on appropriate password settings.

9. QAO's text Addressed to: all hospital and health services participating in the ieMR program

   report regularly on their total ieMR project costs and broader costs associated with their digital transformation (separated from ieMR costs) to eHealth Queensland as well as to their own hospital and health service boards (Chapter 2)

10. QAO's text Addressed to: all hospital and health services participating in the ieMR program

    improve their employee termination processes to ensure they promptly remove an employee’s ieMR access when an employee or temporary staff member terminates their employment with their hospital and health service (Chapter 2)

11. QAO's text Addressed to: all hospital and health services participating in the ieMR program

    implement a process to monitor whether reviews of inappropriate user access to ieMR patient data are completed (Chapter 2)

12. QAO's text Addressed to: all hospital and health services participating in the ieMR program

    report dis-benefits to the program so the program can learn from these and if necessary, modify the solution or implementation approach (Chapter 3).

Authoritative report — Queensland Audit Office

Report PDF on QAO