2.1 Current state assessment, top down approach (2/2)
While our LHD has, over the years, utilised technology to improve delivery of care and enhance operations, many opportunities still exist to utilise digital technologies to better enable delivery of our strategic plan and focus areas. These are the key digital impediments to advancing our strategic plan as perceived and articulated by our staff.
Responsive and adaptable organisation
Engaged and empowered workforce
► The ICT team has developed good relationships and partnerships with the clinical, operational and administrative parts of the organisation. However, they are limited by a combination of capacity constraints, capability gaps (e.g. IT operations, project management, business analysts etc) and lack of automation for example within the IT operations team. Furthermore, better integration between the ICT teams is needed to be able to provide more holistic support. ► Governance surrounding demand management, project work and service prioritisation could be enhanced. This creates a perceived lack of transparency with the business, who aren’t prepared for the impact of any technology changes or investments and don’t often see visible progress on their requests. It also stops the ICT function from providing maximum value to the business by aligning their pipeline to business objectives. ► Additional focus and continuous investment is needed to foster a more cyber aware culture and continuously improve our cyber security posture. Continuing to advance our partnerships with eHealth NSW in this area is critical. ► The relationship between eHealth NSW and the local ICT function works well but can be improved. For example, more representation of local clinicians is needed so eMR workflows are designed with as many representatives as possible. Another example is service management, and inefficiencies of a two-tier support process; ideally support tickets between the local and the statewide service desks should be automatically transferred to the relevant team to action, so the end user does not need to repeat the entire process when a ticket is transferred between service desks.
► The usability of many clinical systems requires focused investments to be more intuitive, to enhance staff productivity and improve user experience. For example, many eMR forms ask for the same information previously entered, instead of reusing data. They also ask many silly questions (e.g. pregnancy for male patients) instead of using basic logic to skip things. In the future, interactions with the eMR should feel more streamlined, less demanding on users for data entry, and enhanced with decision support that goes beyond basic alerts. Our staff should feel empowered in using the eMR rather than feel that it is the laborious part of their job. ► Mobility is improving, however more focus is needed to enable native applications so clinical, operational and administrative work can be completed on the go using the right device for each job. In some settings (e.g. mental health), smart mobile tools (e.g. voice dictated notes) is the only way to remove the hybrid paper record that currently exists due to the nature of the setting. In addition, real time clinical collaboration, including the ability to attach images is an ongoing issue that must be resolved urgently. ► There is a need for continuous training including an uplift in digital literacy across the LHD so people can become more comfortable with technology. Training is rolled out during the system implementation, but evaluation of the effectiveness of this training is seldom undertaken. More work is needed in diagnostics around culture and capability and then on focused training plans to those issues. ► Empowering our staff also means listening to their feedback, and responding promptly. This builds trust, confidence and an engaged workforce trying to solve problems collectively.
► Improvements are also needed in the area of benefits realisation.
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