Hospital computer system fails - again

The Dunedin Hospital ward block. PHOTO: PETER MCINTOSH
PHOTO: PETER MCINTOSH
A critical Dunedin Hospital computer system described as "shameful" was down for two hours yesterday morning, causing confusion, delays and risking patient care, staff say.

The outage of the computer system, called Citrix, affected the emergency department and medics’ abilities to look up medical histories, record care given and transfer notes between wards.

The breakdown contributed to about twice the normal number of patients in the emergency department, one clerical worker said.

It was the third time it had happened in a fortnight and had been happening monthly before then.

A member of staff in the IT support team said staff throughout the hospital used "under-powered, simple" laptops and other devices and then signed in to Citrix to access a virtual desktop hosted on an external server.

The Citrix system was "handy", the IT worker said, because it meant medics could use any available device, anywhere in the hospital, and pick up where they had left off - but when the system failed it prevented access to "absolutely everything".

"If you can’t get into Citrix you can’t get into anything. It is like Microsoft Windows. A Citrix outage is the equivalent of a power outage and it is an ongoing issue."

A patient administration programme called the South Island Patient Information Care System (SIPICS) - described by the staff member as "infamous" and previously reported on by the ODT as a problem system - launches through Citrix.

"Without Citrix, medics cannot access patients’ medical history. Wards really rely on it," the IT worker said.

An administrator in the hospital said outages "affected patient care. You do not know where a patient is, you do not have their paperwork. The administration falls over and stops - and when the system comes back up the administration still needs to be done".

Health New Zealand Te Whatu Ora (HNZ) plans to halve the number of employees working on computer systems, but sources from within the IT support team said their team was already stretched. They did not blame the IT team for the Citrix problems.

"It is not the Citrix administrator’s fault," an IT worker said.

"It is the poor level of resourcing of the IT team. It is all the cracks showing that are only going to deepen if we lose more staff."

It is understood only one employee is responsible for the Citrix system, despite some other health regions having teams dedicated to its maintenance.

There was a risk of vital specialism being lost when people left, an IT worker said.

A staff member responsible for another software system - Microsoft’s SharePoint and Teams - had already left and not been replaced.

An administrator supported the IT team not being cut.

"The IT team is very good. They answer the phone and do what they can. An IT team that was half the size would be very concerning."

The administrator said cuts were affecting their own team, too.

An administrator on the front desk of the emergency department had left and it had taken three months to get approval for a replacement to be advertised.

They said resourcing of IT and administration functions was "very important" for safe frontline care.

Staff said they were left without explanation from management about why the Citrix system had failed. It was now working again, but understood to still be having glitches.

"There are always hangovers after an outage," one IT worker said.

"I have had doctors say our Citrix system is shameful."

The IT team had made numerous complaints about Citrix outages to managers. One IT team member complained about risks to the health and safety of IT staff members, who were suffering stress trying to deal with breaking systems with too few staff. They were offered a course about managing their stress levels.

Concerns were expressed from within the IT team that the cuts would mean the retention of a service desk "as a facade of support, but with a growing graveyard of IT jobs and no specialists to do them".

Health sector lead for the Public Service Association Ashok Shankar said: "This is just more stark evidence of the government’s cuts to health which are harming patients and stopping clinicians at the frontline delivering the care patients need.

"The government is standing by and allowing Health NZ to nearly halve the IT workforce at Health NZ - it must step in and reverse these damaging cuts given IT systems are under extreme pressure."

HNZ Southern director of operations Hamish Brown said the "unexpected" outage was due to an associated Windows server and affected "some staff".

He apologised "for any disruption caused to affected staff during this time."

mary.williams@odt.co.nz

 

 

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