Is it time for a rethink on NOS?

Return to eHealthNews.nz home page

Picture: NZHIT CEO Scott Arrol

Regular column by Scott Arrol, CEO of New Zealand Health IT (NZHIT)

With further work on the National Oracle Solution project suspended pending a review and further business case development, does this provide an opportunity to revisit the option of a cloud-based solution?

There’s been plenty of activity and news surrounding the National Oracle Solution that clearly raises more questions than it answers.

The recent news that the solution is performing well where it has gone live at the first four DHB sites shines some positive light on what has mostly been viewed as a worrying story. Of course, it’s far too early to know whether there are any positive results to be shown from the use of the solution as yet.

Despite whatever PR spin is put around this, time will tell if the promises made in the original business case, or revised business case, will be achieved or exceeded. In other words, will the savings achieved in the back-office functions ever translate through to frontline services to the actual benefit of patients?

Not a resounding success

Even the Minister of Health has indicated frustration that there is “little to show” for the $100 million investment and has suspended further work on the system while his officials “review a plan to develop a business case by NZ Health Partnerships”.

In addition to the published $100 million, it would be assumed other investments in resources involved from each of the four DHBs have been on top of the amount that’s come from NZHP.

Without getting into the pros and cons of the Deloitte review, followed by the Audit Office review, it would be a fair assumption to make that the past six years of this project cannot be considered a resounding success.

In fact, the opposite is clearly the case and the health sector community remains highly sceptical that the actual outcomes will be achieved. Given examples of other large taxpayer funded IT projects it’s understandable that trust and confidence becomes eroded for those people at the coalface delivering healthcare services on a daily basis.

This isn’t because the IT solution itself is not capable of doing the job. Nowadays it is seldom about the ability of technology to deliver on expectations.

The Oracle solution is sure to have the ability to perform, if and when it has the opportunity to do so. However, six years is a long time when it comes to technology, especially as we’ve all become used to technology creating constant change within a blink of an eyelid.

Leadership lacking

Leadership has been a common denominator when it comes to inconsistency throughout the history of this project to date. It was originally conceived and commenced under the auspices of the then Health Benefits Limited and then was inherited by NZHP.

During this time there have been three health ministers, two boards of directors, three CEOs and the various senior executives that seem to accompany organisations such as this.

Four DHBS and $100 million later, we’re all now expected to wait for the next business case iteration. At the very least this will expect $30 million to keep the project going and another five years or more before we know for sure if the promised gains will fully be achieved.

Leadership often has to make tough decisions and then be prepared to remain accountable for the results. Rhetoric is one thing, but actual outcomes are always the real measure of success – especially in healthcare where people’s lives are involved.

A cloud-based solution?

So, with the business case being redeveloped, is now the time to stop the current project altogether and revisit the option of a cloud-based solution that was mooted back in 2012?

As stated, a lot has changed over the past six years and none more so when it comes to the cloud, our understanding of its capabilities and the government’s push for Cloud First software as a service (SaaS) solutions.

We now know that cloud-based solutions can offer multiple gains, including significantly improved return on investment, improved efficiencies in project timings and implementation costs, reduced project risk and functionality that can reach across the supply chain.

A cloud-based solution could utilise knowledge and learnings to date from NOS and reuse these where practical. This could be done at a lower capital cost with flexible operational expenses and ‘sweat’ the historical equity in existing DHB ERP systems, while being driven by service level arrangements.

Such a move provides an opportunity for health sector collaboration and engagement across community, primary and secondary care, as well as performance benchmarking on inventory control at national and international levels. Smaller and focused projects are easier to establish and manage in the cloud, and would be future-proofed and sustainable as technology changes rapidly.

Perhaps it’s far too late to be proposing a complete rethink of the situation, and perhaps the current crop of leaders are too locked into the status quo. There are obviously existing contracts to also be considered.

However, given the significant amount of investment that will still be required and the length of time to deliver, surely now is the opportunity to make sure we’re not still talking about this and shaking our heads in the year 2023. Let’s hope not!

Scott Arrol is the CEO of New Zealand Health IT (NZHIT)

Return to eHealthNews.nz home page