Power failure lasting 36 hours cripples hospital care

By: Kate Benson

DOCTORS at more than 100 hospitals in the state could not access patient records or vital test results for up to 36 hours last weekend after a power failure crippled NSW Health's computerised database.
Some records were lost, X-ray and pathology results could not be accessed and staff were forced to use whiteboards to keep track of emergency patients after the main server shut down at 9am on Saturday because of a faulty circuit-breaker.
Back-up power from the Cumberland Data Centre, which provides computer access to the Greater Western, Greater Southern and Sydney West area health services also failed, plunging some of the busiest hospitals in the state into chaos.
Thousands of patients were affected, with doctors and nurses forced to take notes on paper and go to other parts of the hospital to collect hard copies of results, extending treatment times and adding to the confusion.
Some staff, who did not want to be named, said the weekend was chaotic and a shambles. One surgeon said it was fortunate no lives were lost.
The chief executive of Sydney West Area Health Service, Steven Boyages, said hospital blackouts that lasted more than 30 to 60 minutes were unacceptable, but the Health Minister, John Della Bosca, insisted patients were not put at risk. "At no time was there any threat to patient care or safety," he said yesterday.
The Opposition spokeswoman on health, Jillian Skinner, said the blackout was "a serious failure" with great potential for disaster.
"Hospitals affected not only lost access to patient records, some lost some patient records altogether … and couldn't access X-rays unless they physically went to the X-ray department for a film copy," she said. "John Della Bosca should explain why the patient records system lost power, why back-up systems also failed, and whether patient safety was compromised."
A spokesman for Mr Della Bosca said workers doing routine maintenance at the data centre had triggered the outage. No patients had reported problems connected to the blackout but a full investigation would be launched. "If necessary changes will be implemented to prevent a recurrence," he said.
with Louise Hall
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Hospitals at Westmead, Auburn, Blacktown, Nepean, Lithgow, Mount Druitt, Cumberland, Blue Mountains, Dubbo, Bathurst, Orange, Mudgee, Parkes, Bourke, Albury, Queanbeyan and Goulburn were affected.

Paper patients' notes out, digital records in

By: Louise Hall

BY THE end of next year, every public hospital in NSW will move from paper patient notes to electronic medical records that can be accessed by any health worker, the Government has announced.
The Minister for Health, John Della Bosca, said the $100 million project to digitise 250 hospitals will save money by eliminating duplicate diagnostic tests and imaging. It will also improve patient safety by alerting staff to a deteriorating patient and reduce the likelihood of errors.
Mr Della Bosca said doctors, nurses, allied health and social workers will be able to access a centralised repository of a patient's medical chart, laboratory results, prescriptions and referrals, no matter where the patient enters the health system.
Peter Garling, SC, recommended an urgent roll-out of electronic medical records (eMR) in his special commission of inquiry into acute care services, which found NSW's record-keeping system is "a relic of the pre-computer age" that puts patient safety at risk.
He said various hospitals and community health centres have established ad hoc databases but they were "spasmodic and patchy". The inability of distinct IT systems to synchronise with each other and lack of IT support staff meant clinicians had to rely on incomplete data to make important medical decisions and spent time chasing information.
Mr Della Bosca said the Government would make implementing information and communication technology within its capital works program a priority, which will make NSW Health the biggest IT user in Australia.
A basic eMR system that allowed clinicians to order diagnostic tests and view results online was successfully trialled at St George, Calvary, Sutherland and Lismore hospitals last year and by last month 20 hospitals were using it.
"Prior to the introduction of eMR, some requests for medical imaging and pathology could require referral back to the requesting clinician due to incomplete or illegible hand-written records," Mr Della Bosca said.
"This technology will improve the efficiency of hospital care and free up doctors and nurses to focus on patients and not paperwork, which will further improve patient safety."
The next step will link hospital-based records to primary care providers, such as GPs, by way of an electronic discharge summary.
But the Health Action Plan For NSW, released in March, revealed the Government would not meet Mr Garling's 18-month deadline for a digital radiological imaging system. This is to be set up in every public hospital to electronically transmit medical images to remote locations.
And an electronic health record, which would extend patients' information beyond hospital walls to all GPs, specialists and health systems in other states, was not possible without a national e-health strategy, it said.
A report commissioned by the Federal Government last December found state and federal governments have spent $5 billion on electronic health initiatives over the past 10 years but have made little progress towards creating a national system for sharing information.
NSW Health has admitted that two previous attempts to implement electronic medical records in 1991 and 1999 had failed, at a cost of $12 million and $30 million respectively.
The National Health and Hospitals Reform Commission has recommended an individual patient-controlled electronic health record owned by the patient who decides which health care providers can access it.

NSW a silent success in e-health

NSW is leading the country in e-health with both doctors and patients benefiting from new technology, but why wont Health Minister John Della Bosca tell us about it, writes Bryn Evans.

When will some really good health news get some coverage? While the media has recently been fixated by the world financial crisis, political backstabbing, or the misdeeds of the latest rogue doctor, real progress has occurred in NSW e-health that will bring far-reaching benefits to everyone in the state.

On 1 October last year, St George Hospital implemented an electronic medical record system (eMR) for some 2300 clinicians across its emergency department, all wards including pathology and radiology, nine operating theatres and more than 300 outpatients clinics, and allows electronic discharge forms to be sent to general practitioners. The project has been hugely successful, and is the start of a state-wide program by NSW Health to introduce the eMR to every hospital in the state.

The eMR system was first deployed at the St George Hospital in the South Eastern Sydney & Illawarra Area Health Service (SESIAHS), followed by Calvary and Sutherland hospitals, and will be rolled-out to each hospital in the Area Health Service for some 1.3 million people.

All hospitals in the Illawarra region will go live in the next two months, followed by the Northern Coast Area Health Service which is in the middle of its eMR roll out.

In time eMR will spread state-wide.

Some Area Health Services with earlier, less comprehensive eMRs, are planning upgrades.

So why does NSW Health Minister John Della Bosca not tell us about it?

The eMR rollouts mean that patients treated in SESIAHS will have their patient details, medical history, test results and treatment notes updated and instantly available to any clinician attending to them.

No more tedious and inefficient questions such as “Which hospital and doctor did you last see?”, “What did your last test results state?”, “What medication are you on?”, or “Do you have your ultrasound scan with you?” that drive every patient to distraction.

There will be an immense improvement to patient safety as the eMR becomes available everywhere in NSW.

Adoption of an eMR on this scale is the most ground breaking IT project undertaken in Australian healthcare, and NSW Health is leading the way. It is the first step in a journey to provide electronic information that better supports clinicians and brings improved care to patients. Work procedures and practices will be fundamentally transformed as knowledge is shared to provide better patient care.

The eMR finally brings the benefits of ubiquitous online access, akin to electronic banking, within the reach of clinicians and health consumers. It also provides the foundation of information for the personal electronic health record, which health consumers could access over the Internet within the foreseeable future.

But why cannot NSW Health tell the public about this success?

Maybe they are scared of success, and the resulting demands by the Garling Inquiry for more funds to speed up deployment.

For once NSW Health have some really good news. It is following best practice, and has got it right, so they should tell us about it!