Waikato District Health Board embarks on user-driven clinical workstation

CIO Darrin Hackett says involvement of clinicians was a top agenda in the rollout.

For Darrin Hackett, CIO of the Waikato District Health Board, the adage that "IT has no purpose if it doesn’t enable someone else to succeed, or allow people to do things more efficiently" plays a big part in deploying one of its biggest business technology programs – the installation of a clinical workstation (CWS).

The system will go live on 1 April, following a six-month implementation timeframe. The date is set so the project complies with a government security direction for all systems connected to other government systems to be using Microsoft Windows 7/Office 2010.

Thus, the CWS rollout coincides with the shift to Windows 7, as Microsoft ends support for Windows XP on 8 April.

Waikato DHB covers almost 8 per cent of New Zealand, from northern Coromandel to close to Mt Ruapehu in the south, and from Raglan on the west coast to Waihi on the east. It takes in the city of Hamilton and towns such as Thames, Huntly, Cambridge, Te Awamutu, Matamata, Morrinsville, Ngaruawahia, Te Kuiti, Tokoroa and Taumarunui.

Hackett says the CWS is a regional project that will eventually link up with other members of the Midland District Health Board – Lakes, Tairawhiti, Taranaki and Bay of Plenty.

“What we are doing is five months go from nothing to moving the whole DHB across the new platform,” says Hackett.

The first month – November – was used to perform the functional review and the remaining four months to test and integrate the system.

The Windows 7 migration is also phased, with nine different “waves” of implementation. Each group has its own business champions who identify who are the heavy users and who might need more training.

He says key to the installation is the strong involvement of users – in particular, the clinicians, right from the review of the product.

“They are the ones we have to focus on,” he says. “Instead of seeing the new system as technology, how does it make them more efficient or more effective in what they are doing?”

For the CWS rollout, a group of clinicians are among the decision makers of “what makes sense and what doesn’t”.

For instance, a CWS requires a results viewing and management system, and the IT team had anticipated using the Orion product, which was also the provider for the CWS.

But the medical staff preferred a different system called Éclair because it is known and used elsewhere in the region. Thus, the Éclair system will be used. “From a clinical point of view, it is the right thing to do,” says Hackett.

“The intent is we will install it for Waikato but we will put it in place so that other DHBs in the region can start to come on board and we end up with a consolidated way forward," says Hackett.

“The focus is trying to spend it once but with multiple benefits,” he says. “It is quite like a jigsaw that is coming together, making sure we continue to integrate.”

We will put it in place so that other DHBs in the region can start to come on board and we end up with a consolidated way forward

Darrin Hackett, Waikato District Health Board

Embracing change

He says the move to Windows 7 before the April 8 deadline when support ends for Windows XP, was one of the catalysts for the new system.

“In the process, we realised we have to upgrade our current clinical workstation to make the thing work," says Hackett. "It was a choice of saying well, we can spend this money knowing in essence you are throwing it away, or we can do the change."

Related:healthAlliance retires Windows XP and moves to Windows 7

Working on a major project like this involves building relationships across the organisation.

“We spent two years getting the relationship right across the business and across C-levels,” says Hackett, who joined the DHB in December 2011.

“We have put the ground work in so we had, from a clinical point of view, from a corporate point of view, from an IT point of view, the relationships and the methodologies in place to deal with quite fast-decision making, and the quick ability to understand what are the key risk points and then deal with them.”

He says there are some principles in the book Speed of Trust that apply to business technology projects like this.

“If you want to build things quickly, you have got to put the time into building relationships and integrity so you can do things fast, but done with the knowledge and confidence of the people,” he says.

So when the IS team started working on the clinical workstation, it was very clear that clinical leadership had to be part of the deployment.

The system can be enabled in the IT sense, but the clinicians reviewed the product and made sure it works, and identified the gaps with the catalyst team, explains Hackett. The latter includes process analysts and IT business analysts who were clinical focused.


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