Do you promise to feed it, and walk it every day?
Once a health service goes digital, keeping those digital assets up to date, efficient and useful is a long-term cost and commitment that needs to be given more consideration at procurement, says an expert.
Speaking at last week’s Wild Health Summit in Melbourne, Dr John Lambert, the CCIO of NT Health, said the relatively small clout of his jurisdiction, compared with one the size of New South Wales, gave him a unique perspective.
The Northern Territory’s need for fusing on interoperability throughout the procurement process was underscored by the fact that the territory is responsible for only 1% of Australia’s population, he said.
This means it doesn’t have a lot of weight to throw around when sitting at the table with vendors compared to other larger states who can buy and implement a single digital patient record far more easily.
Dr Lambert also highlighted the potential pitfalls of only thinking that procurement – and the total costs of ownership – related to the early stages of digital health implementation.
“Everybody thinks about the cost of buying something at the beginning, and everybody forgets that procurement is actually about asset management throughout its lifecycle – from procurement [through to] disposal,” said Dr Lambert.
“Most of our IT problems in the Northern Territory right now are being caused by lifecycle management failure.
“People have bought stuff but haven’t thought about having to keep it running, and people like Microsoft have made a very good job of making sure that we keep continuously paying for stuff that we used to have on paper.
“Once you wrote on a piece of paper, you didn’t have any more costs other than storage, which really wasn’t significant back in those days.”
The shift to a digital environment meant there was now a constant need to pay to update hardware and software as vendors roll out regular upgrades and improvements. Dr Lambert felt the introduction of AI would only make things worse.
“Software that used to run on 256 bytes now takes three gigabytes just to say ‘hello world’ – it’s just insane. And AI is going to make that 4000, probably 4 million times worse with the computing power [it requires].
“We’re not really thinking about the long-term consequences of what we procure.”
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Dr Lambert drew parallels between long-term procurement and management of physical and digital assets.
“This stuff’s [going to be] here for 20 years, and we [need] to start thinking about it as a 20-year asset. That’s where infrastructure building is really relevant, because you wouldn’t like building [a house] without thinking it’s going to last for 40 years.
“Some of the software we have has to last 40 years. And in the Northern Territory, the data we collect in our software has to be maintained for 100 years. I don’t know [of] any software system we’re building that can do that.”
Interoperability and information exchange was a clear need for the Northern Territory and its healthcare system, according to Dr Lambert.
“In [the] Northern Territory, we can’t function without our ACCHOs, our GPs, our private specialists, and all the other providers.
“We have four different retrieval services and transport providers. So, we have to integrate with other agencies to get our job done… our whole life lives and dies on the quality of the integration,” he told delegates.
Wild Health’s Connected Care – From Here to Modernity was held in Melbourne on 22 October.
