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
BLACKED OUT
Hospitals at Westmead, Auburn, Blacktown, Nepean, Lithgow, Mount Druitt, Cumberland, Blue Mountains, Dubbo, Bathurst, Orange, Mudgee, Parkes, Bourke, Albury, Queanbeyan and Goulburn were affected.

BI key to e-health, says SWAHS staffer

By: Suzanne Tindal

Using integrated business intelligence software can help harness the benefits of introducing electronic health records, according to a senior IT staffer at Sydney West Area Health Service (SWAHS).
The forklift's running around there in a fairly empty warehouse.
SWAHS staffer Trevor McKinnon
"The biggest issue you have with the electronic health records is that nursing staff are providing the bulk of the entry," SWAHS business intelligence and web development director Trevor McKinnon said in a recent interview with ZDNet.com.au. The nurses felt that they were not getting any of the benefit and doing all the work, he said.
Indeed, most of the advantages of having electronic health records were seen downstream, he said, when, for example, doctors were able to see the information nurses had entered.
He hoped that in years to come, business intelligence could alter this perception by running text analytics on the data from the electronic records to make nurses' workload less and not more. Business intelligence would use text analytics to "get into what's written" and pre-write a report which the nurse simply had to review, instead of creating.
"Business Objects certainly has the potential to do that," he said, although he didn't believe it would happen until 2011. NSW Health has a whole-of-state contract with Business Objects and uses the company's Xcelsius platform. McKinnon is one of the leading drivers of its use, taking on not just business intelligence for SWAHS, but for other area health services within the state as well.
Just as business intelligence would help electronic health record acceptance, the progression of electronic health records would help business intelligence. Although the groundwork for electronic records in NSW had been done, McKinnon said, only the emergency departments and intensive care were recording patient information electronically. In other departments nurses were still writing reports by hand.
This limited the breadth of data which McKinnon had at his disposal to run statistics using the business intelligence, with only information such as admissions and outpatient services available for use. "The forklift's running around there in a fairly empty warehouse," McKinnon said, although he admitted that the information being gathered already was prolific enough to keep him very occupied.
This data is currently used to measure performance for the hospitals, and Sydney West Area Health Service uses dashboards built on the information to benchmark how staff are performing. It also is used on the patient side. If a "frequent flyer" patient comes into the emergency department, the business intelligence application can inform the employees which professional the patient saw previously — this often allows cases which don't need hospitalisation to be given other treatment and sent home, freeing up beds.
McKinnon looked forward to when most patient records were being entered electronically so that business intelligence could carry out functions such as finding keywords in records which could alert a doctor to the fact that a patient may need attention, increasing the level of care. "We can't wait," he said.

Blacktown Hospital test blood-and-guts proof PCs

By: Suzanne Tindal

Blacktown Hospital has run a trial of a tablet PC designed specifically for the healthcare industry — even blood and guts won't slow it down.

The Motion C5 in action
(Credit: Motion Computing)

Technically-savvy Blacktown hospital has invested a lot in its IT infrastructure — the whole hospital is wireless, including the back-end. Having introduced electronic medical records years ago, the hospital says it's always on the lookout for better ways for medical staff to record patient information on the go.

The Motion Computing C5 tablet — designed together with Intel for the health industry and available in Australia from late last year — is the latest system the hospital has trialled over three months earlier this year. The device is completely sealed, meaning a spill of urine, blood or just tea will not cause it to collapse or cross-infect other patients — it can even be wiped down with disinfectant.

The health professionals in the hospital needed to benchmark the new tablets against the running system: computers on wheels, nicknamed COWs, and their smaller brethren — calves.

The clinicians took to the Motion C5, according to Professor Steven Boyages, chief executive for Sydney West Area Health Service, with the greatest advantage being the mobility, such as being able to sit on the bed with the patient while holding the device.

The tablets' portability, however, does have one negative aspect: "The downside with these devices is they will walk," Boyages said.

The hospital has been working with Intel on answers to the problem, including using a proximity device with RFID technology built into it to deactivate the tablet when it moves out of a specified zone. Another solution is for clinicians to each have their own device and take personal responsibility for it.

A drawback to the tablet per clinician solution is the price tag, which sits around AU$3,000. "That's the other disadvantage at the moment," Boyages said, although he added that he thought the price would come down with time.

The Motion C5 also has an RFID reader and digital camera built in, although neither were tested in the trial, because the hospital doesn't have RFID or barcoding set up and its electronic medical records cannot currently store images.

However, Boyages believes these features will be very useful in the future: the RFID scanner can make sure the right drug finds its way to the right patient once the drugs and patients are tagged while the camera can measure information difficult to capture in words, such as the "size of an ulcer, the state of a wound".

Boyages sees the camera being particularly useful for community nurses who visit patients previously seen by a different nurse. In this case, to ascertain if a wound is getting better, the nurse usually asks the patient, and in typical Australian fashion, they'll often say "Yeah, I think it's better". A less subjective method of finding out how the injury is going is by looking at an image from the previous session.

The next step, according to Boyages, is to use the device in a new testing centre which is set to be opened, where the problems flagged in the trial can be ironed out.

Patients won't suddenly see all Blacktown hospital medical staff sporting the devices in the future, Boyages says, adding that technology often reaches past what enterprise systems can do, and changes need to be made before the technology can work properly in the hospital.