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Transition to NOS “fraught with difficulties”

Friday, 6 December 2019  
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eHealthNews.nz editor Rebecca McBeth

 

Implementing the National Oracle Solution was “challenging” and has resulted in both benefits and tensions for district health boards, Canterbury DHB’s chief digital officer told the HiNZ Conference 2019.

 

Stella Ward presented on the NOS project on behalf of Canterbury DHB finance and procurement systems manager Lynne O’Donoghue.

 

The National Oracle Solution was implemented in four DHBs – Bay of Plenty, Canterbury, Waikato and West Coast – in July 2018.

 

This covered all types of DHB, from almost the biggest to the smallest, rural and metro, and using both inhouse and outsourced supply chain.

 

Ward described it as a “challenging implementation”, as it involved moving from a system that allowed the DHB to set its own priorities and adapt to suit its needs, to a single national system.

 

The July go-live was only just achieved due to a lack of time, money and resource, coupled with political pressures and nursing strikes. 

 

“There was no shortage of challenges and the odds were stacked against us,” she said. 

 

“And it wasn't the fairytale ending, either. The past 18 months have been fraught with difficulties as the DHBs transition to working in different ways, as part of a bigger machine that turns slowly but produces good quality data.”

 

So why move to a single national system? Ward asked.

 

The promise from the experts was that it would pay for itself by producing high quality consistent data that would allow the DHBs to think about how they negotiate contracts. The reality is there have been benefits and tensions.

 

“It’s a challenge implementing any new system, especially to design a national system. Add to that developing national data standards and then agreeing a national operating model,” Ward said. 

 

While only four DHBs have so far gone live, all 20 participated in the design of the solution and development of the data standards.

 

Nationally agreed standards provide a basis for quality data and the DHBs benefit from robust systems and good internal controls, she said. 

 

Canterbury DHB is already seeing benefits in having consistent data that allows for better analysis and evidence-based decisions.

 

However, a national system is slower to deliver as more requirements across more parties are taken into account and it is also slow to create data.

 

“We’re still defining what is national versus local data and talking about whether the same standards and high cost and control applies to all the data,” Ward told attendees. 

 

“We are yet to truly understand and define our data ownership, stewardship and governance. There is a long way to go to data maturity in this space.”

 

NOS has been superseded by the Health Finance, Procurement and Information Management System. A new business case for the FPIM was endorsed by all 20 DHBs and approved by Cabinet in June 2019.

 

While NOS was intended to replace all 20 DHBs finance and procurement systems, FPIM will be delivered to only 11. 

 

However, all 20 will use a national catalogue of products and services, common chart of accounts, national data standards and data repository being developed to support procurement benefits.

 

If you would like to provide feedback on this news story please contact the editor Rebecca McBeth.

 

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