Hawke’s Bay radiology staff exhausted by 'inadequate' IT

eHealthNews.nz: Clinical Software

Hawke’s Bay radiology staff exhausted by 'inadequate' IT

Tuesday, 15 August 2023

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NEWS - eHealthNews.nz editor Rebecca McBeth

Radiology staff at Te Whatu Ora Te Matau a Māui Hawke’s Bay are “exhausted by information systems that hamper their efforts to provide safe and efficient care to their patients”, a newly released report says.

An external review of Te Whatu Ora Te Matau a Māui Hawke’s Bay Radiology Services says feedback from staff is that the regional Radiology Information System (RIS) and Picture Archiving and Communication System (PACS) are “not performing adequately for safe and efficient practice”,

The review was commissioned due to concern about the clinical risk related to the IT issues, which included staff missing clinical results, delayed or missed communication of results, reduced clinical capability due to lack of integration, and poor performance of the system.

It describes the RIS as the ‘engine room’ of the radiology department and say clinicians have endured more than a decade of poor performance, frequent workstation crashes and unsafe processes.

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“What presented during the site visit was a culture of learnt helplessness and general acceptance of inadequate technology which has impacted clinical practice,” the report says.

It makes 18 recommendations related to stabilising the RIS and having it ready to perform as a regional system, strengthening process steps related to e-order and sign off of diagnostic results, and addressing concerns related to clinical governance, leadership and culture.

Te Whatu Ora says six of the 18 recommendations have been implemented/completed, 10 are in progress and two have been accepted in principle, but are pending.

Te Whatu Ora Hawke’s Bay, Whanganui, MidCentral and Capital and Coast are using the Central regional RIS and PACS reporting solution on the Philips Vue imaging platform.

A planned roll-out to Hutt Valley and Wairarapa Hospitals was halted in September last year while an ‘intensive effort’ was undertaken to fix issues with the solution.

The report says any further implementation of this technology within the Central Region needs significant consideration.

“However, this process must not prevent continued investment in the current RIS/PACS given the ongoing safety and efficiency issues which need to be addressed,” it explains.

The review says issues were raised within the previous DHB structure, but the seriousness of these were not acknowledged and staff have developed manual workarounds over many years.

“There have been issues with it being ‘too customisable’, being the first implementation within Aotearoa and of note there are still multiple logged issues that remain unresolved years after being identified,” it says.

The report says the support model - which involves the local PACS team, local DE team, regional PACS, TAS, NZ vendor, global vendor - is complex and has “not facilitated good progress in application development, operational support, issue resolution and delivery of the strategic benefits”.

Prior to moving to a regional system, there was a direct relationship with the vendor and weekly hui, but there was now no direct relationship and issues were addressed via TAS.

Fionnagh Dougan, national director hospital and specialist services, said the Hawke’s Bay RIS as implemented has significant limitations and a specialist regional team was established to resolve issues highlighted by staff.

“The work of this team resulted in material improvements to the responsiveness of the system as well as a reduction in the clinical workflow risk, although these remain elevated and the subject of close scrutiny,” she said.

“An upgrade to stabilise the system has recently been carried out and the RIS is now operating as expected across the Central region. We are now focussing on other steps to further strengthen the safety and stability of the system.”

A Philips spokesperson said, “we have been working closely with Te Whatu Ora and their clinical teams on matters raised in the audit report.

“Patient safety and well-being are at the heart of everything we do at Philips. We will continue to support our customers and clinicians to ensure critical radiology services are meeting patient needs.”