This audit examined the clinical information and communications technology (ICT) systems of eight public health services in Victoria to see whether they were appropriately planned and implemented and whether expected outcomes and benefits are being realised.
It examined the HealthSMART clinical ICT systems implemented at four health services and clinical ICT systems implemented at four other health services.
The Department of Health (DH) failed to complete the expected implementation of clinical ICT systems across 19 Victorian health services due to poor planning and an inadequate understanding of system requirements. It significantly underestimated project scope, costs and time lines, as well as the required clinical workflow redesign and change management efforts.
In contrast, non-HealthSMART sites have used their own internally generated funds and implemented clinical ICT systems at a fraction of the cost of implementing HealthSMART.
Clinical ICT system implementations are complex and like any other transformational ICT project, unexpected and unforeseen issues can often emerge. In the case of HealthSMART, the introduction of electronic medication ordering and management has been the most difficult and complex component of the clinical ICT system program.
This audit found evidence of a number of potential clinical risks at three of the HealthSMART sites. In the absence of appropriate controls and effective mitigations, these issues could pose serious patient safety risks.
As a result, there is a continuing potential risk to patient safety that needs to be closely monitored by both DH and the relevant health services. However, DH has not established processes to oversee either the management of risks, or the performance of installed clinical ICT systems, at either HealthSMART or non-HealthSMART sites.
The installed clinical ICT systems do not currently deliver interoperability across the Victorian public health sector. Both HealthSMART and non-HealthSMART clinical ICT systems do not enable patient data to be shared across Victoria’s public hospitals.