Auckland PAS first to capture iwi and gender

eHealthNews.nz: Clinical Software

Wednesday, 6 March 2024

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NEWS - eHealthNews.nz editor Rebecca McBeth

The new patient administration system being implemented at Health NZ Te Toka Tumai Auckland will be the first hospital PAS to capture standardised iwi affiliation and preferred pronouns and make the distinction between sex and gender for patients.

Auckland chose InterSystems in 2021 to deliver its TrakCare PAS, supporting around 145,000 inpatient and more than one million outpatient visits per year.

The system is due to go-live across the whole organisation in the middle of this year.

The PAS project has been gifted the name Tū Pono Āroha, which translates to ‘loyal to all services with compassion’.

Nick Lanigan, project director, says the PAS is fully compliant with the new HISO standard on iwi affiliation and preferred pronouns and gender will be included on patient wrist bands.

If a patient identifies as Māori, a Health NZ algorithm will bring that to the top of the list of ethnicities and make it visible to staff throughout the system.

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Greg Williams, project SRO, says the focus is on taking the product as much as possible ‘off the shelf’, without heavy modification.

However, development has been required to accommodate the local public sector environment, such as integration with ACC and the National Health Index (NHI), as well as the work to capture a patient’s iwi, preferred pronoun and gender.

TrakCare is replacing three PAS’ in use, one that was built inhouse and is now over 25 years old, and two legacy systems that are out of support.

Together these cover all the core patient administration functions such as demographics, bed management, scheduling and theatres. These have previously been divided over three different software platforms, driving diversity in the way they have been used.

Williams says consistency, such as standard use of code sets, will mean systems no longer rely on key people knowing how to run a particular process.

“We have had to take the organisation on a journey to think about how are we going to use this new product and reduce variation and all the myriad different processes we have had to date,” says Williams.

He adds that this is the largest digital project Te Toka Tumai has undertaken over a number of decades with about 77 staff in the project team, working alongside InterSystems. The project is now being led by the Health NZ data and digital team.

Lanigan says integrations is a huge area of work as the PAS is ‘bolted on’ to 61 internal systems, requiring new interfaces to be developed and tested.

“We are now finishing our internal testing of integrations and functionality from TrakCare and looking at starting user acceptance testing later on into March,” he explains.

“The other area of heavy lifting is around reporting: PAS reporting, data warehouse reporting, all sorts of dashboards, self-service, and the integrated operations centre. We are doing a lot of work renovating all of that focusing on what is really core to keep the hospital running.”

When migrating data, they have chosen to complete transacting events that have finished in the legacy systems and ensure that this information flows properly to the national collections, and anything new from go-live onwards will be on TrakCare.

“This provides a great opportunity to cleanse our systems, standardise and move to best practice,” he says.

There is also a large change management programme as “this is a big change for this organisation, in terms of the hearts and minds, as well as the more mechanical things like training”, Lanigan says.

There are about 1000 users classed as high touch whose job is predominantly based around using the new system and who require training.

Williams says the intent of the project was always to build something scalable, so it could be used in other parts of the region or country.

“We have support to continue the project on the basis that this is something that is readily scalable, both from the architectural and technology point of view. It is a modern cloud-based platform using all the modern integrations such as FHIR,” he explains.

TrakCare is an ‘evergreen’ product so they will be consuming multiple updates a year.

“We have had to design how we maintain and support the system so that we consume those updates frequently and we benefit from the global roadmap with continuous improvements,” Williams says.

“We can improve the way we do things and get better care outcomes, and we can get the multiplier effect, because when people are using the same process and you find a better way of doing something, then you can extend that across multiple services,” he says.

Darren Jones, InterSystems country manager ANZ, says they are partnering with Te Toka Tumai to build a platform which unlocks the power of patient administration data to support Auckland’s equity and other healthcare improvement objectives.

“They can generate better insights into how patients are flowing, what their journeys look like and the level of patient engagement,” he says.

“Instead of building dashboards, that data will be instantly available and visible in InterSystems TrakCare and they will have a platform that can scale up for future innovation, whether that be analytics, AI, electronic medical records, or digital patient engagement.”