Troubled IT rollout puts reputation and jobs on the line
The woman heading a multimillion-dollar project tasked with overhauling the region's health records admits her job is on the line.
After two false starts, changes in personnel, and an extra proposed $28 million injection, those working on the Midland eSPACE programme have been put on notice to deliver.
The IT programme is expected to create a single point of access for clinical information across the Midland region, including Waikato.
Once implemented, it will give a consistent view of patient records and medication.
The five-year project had an original budget of $47m but it has since swollen to $75m. That includes the $28m injection.
Waikato DHB approved the new budget at its March meeting.
Programme head Maureen Chrystall has been brought in to lead eSPACE and is confident of success despite the complexity of delivering IT change across five DHBs.
"It's a very high-risk programme. I don't think you can get anyone saying they are completely confident that we'll get to the end point with no deviations," Chrystall said.
"But I'm happy to sit in the chair where I'm the person who'll get fired if this doesn't work."
Chrystall, who is a member of the Waikato DHB's senior executive team, declined to say how much she's being paid to deliver the project.
eSPACE is being rolled out in three phases by the five Midland DHBs. Phase one of the programme is expected to be completed by July.
Those responsible for the two previous failed rollouts of eSPACE no longer work on the programme, Chrystall said.
The Health Ministry has made investment in clinical information systems a national priority.
The ministry's end goal is a single electronic national health record.
Chrystall said eSPACE would be compatible with other IT systems being implemented across the country.
Maintaining the status quo isn't an option, she said.
"The strategy is there will be a single electronic health record, and the clinical data underpinning eSPACE will be what we use to populate it. New Zealand has opted for slower change and more control over what we actually put in. The tools that we are currently using were developed in the 1980s and early 1990s and, because of the age of the tools, we can't get fixes for them."
Waikato DHB chief executive Dr Nigel Murray said the five Midland DHBs couldn't disappoint taxpayers and patients for a third time.
eSPACE was originally introduced in Waikato in 2014 but was halted due to unrealistic timeframes and a lack of functionality.
In 2015, the programme was implemented in Lakes and Tairawhiti DHBs, but was abandoned and the project reworked.
Although Chrystall was tasked with delivering the project, the responsibility for the success or failure of eSPACE sat with the Midland DHBs' chief executives, Murray said.
"The accountability to deliver is up to the chief executives who are the governors of the project. Maureen [Chrystall] is our agent to deliver it, but the chief executives can't be let off the hook here. It has to be successful because there is no excuse for not learning from your mistakes."
David Hallett, a chartered IT professional and company director of Hamilton software specialist Company-X, said there were a number of factors that could cause an IT project to blow its budget, including being caught out by changes in technology.
"When you try and do a large change project and do the whole thing right from the outset, rather than doing it in iterations, you can get caught out by the world moving on. You think you're where you need to be only to suddenly discover there's a whole lot more that you need to do."
Scope creep, although not common, could also cause costs to escalate.
"A project manager's job is to establish and understand what is in scope and out of scope," Hallett said.
"When things fall outside of scope, a project manager should be saying: That's really nice, we can put that on the backlog and do it another time."
The Waikato DHB is no stranger to IT headaches.
In 2013, the board launched a review after its website was allegedly hacked by an Algerian-based group and gang imagery posted online.
In 2011, millions of spam email messages overwhelmed an email server receiving DHB job applications.
It resulted in hundreds of job applications vanishing into cyber space.
Chrystall said eSPACE would be used by approximately 6000 to 8000 clinicians.
"Waikato DHB is a $1.3 billion organisation. If you add the other four DHBs, you're probably getting up to a $2.6b sector that we're implementing for.
"I know $75m is a lot of money in anybody's terms but if you think in that context, it actually starts to feel reasonable."
At a glance
eSPACE will provide a single point of access for clinical information across the Midland region
Will be compatible with the eventual rollout of a single electronic national health record