Irate IT staff a bitter pill for QLD Health

Department says IT in top health while employees gripe on management, policy

Queensland Health (QH) became a target for an outburst of mudslinging when people either close to, or inside the organisation, dished the dirt on its IT department and revolving door CIOs.

Heated criticism claiming the department is in disarray and lacks leadership erupted following an innocuous e-mail leaked on a Courier Mail blog that cited the appointment of Ray Brown as interim CIO in early December. Brown, who was previously QH’s information division executive director, replaced acting CIO Dr Richard Ashby in late January, and is now the department’s CIO 4.0 in just two years.

A string of failed projects aired on the public record over the last six years has set a shaky history for QH, which includes the axing of its last permanent CIO Paul Summergreene on alleged misconduct charges less than 12 months after he took the job.

Plans to fast-track the adoption of electronic patient records across the state collapsed in 2006, while in 2007 QH's technology partner EDS withdrew from the eHealth Alliance that is designed to buttress a now defunct clinical information systems project.

A QH spokesperson told Computerworld EDS withdrew from the alliance due to a “conflict of interest” arising from its acquisition by Hewlett Packard in August last year. The spokesperson said EDS is providing “some contract resources” to its IT department under arrangements.

After posting the internal e-mail on his Pineapple Politics blog, Craig Johnstone asked: “How goes the department’s E-health policy?” There was no paucity of opinion, with comments running hot and heavy claiming QH's IT department “is currently experiencing its worst period of operation with a distinct lack of leadership”. Other purported staff said employees had a lack of confidence in Dr Ashby.

“Ashby had no real interest acting as a CIO and largely left the role of running the information division to Brown,” one blogger wrote. “The notion that Brown is capable of running the Information Division is laughable. I can’t recall a more ineffectual CIO.”

The spokesperson refuted the claim, painting Brown, a former CIO at Queensland Police alongside Summergreene, as “highly regarded within the industry” and said he has had a “long and successful career in ICT service delivery”.

QH enacted a policy change after Summergreene's departure requiring all CIOs to have clinical experience.

However, the spokesperson did not respond to allegations made by one blogger that “QH’s eHealth program is in complete disarray, with eHealth capital funds significantly underspent, little progress whatsoever in implementing the strategy that was used to justify the allocation of capital to eHealth by Treasury, the resignation of EDS from the eHealth Alliance, a whole heap of activity around initiatives that fly in the face of the approach embodied within the eHealth Strategy, the complete turnover of all senior IT management in the last twelve months . . .”

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Irate IT staff a bitter pill for QLD Health

Of the 850 odd staff in QH Information Division about 80% wouldn't know what was happening with eHealth. I don't really see why their happiness is relevant to this article. Rather than ask QH whether staff are upset or not, Computerworld should ask QH some more inciteful questions like, "What portions of the eHealth Strategy have been delivered since $650 million was allocated to eHealth some 18 months ago?" or perhaps, "Does Queensland Health still plan to deliver eHealth as it was originally conceived? If not, what is the new plan?" Or perhaps, "With the departure of EDS from the eHealth Alliance, how does QH plan to develop capability in Enterprise Architecture, which is one of the key pillars of the eHealth Strategy?"



Ask the QH spokesperson about the funding status and future of specific Information Division projects, such as AARK (Automated Anaesthetic Record Keeping), or, even better, the Electronic Discharge Summary project. A while ago it literally had a few dollars left in the account, with staff not being told about the situation. ID projects are being culled left, right and centre and no-one is being told anything. Now a new plan is in the works.

On a better note, the communications area is being culled and being pulled back to Charlotte Street because the contractor leading the communications effort at ID was incredibly worthless. That'll take care of some of the 600 spin doctors that QH is lumbered with.

ID has some fantastically talented people in it, but the management doesn't have the first idea. Get the clinicians better involved so that solutions they actually need are delivered, rather than yet another useless ICT driven toy that sits in the Operating room unused and unloved.




IT in Qld Health is the pinnacle of why IT is still seen as the worst of professions to deliver business outcomes.

Full of IT people who would like to quote standards and architectures and development methodology, open systems technical wonders and all things esoteric but none of them have ever delivered a rapid effective IT business outcome.

Barriers set up to ensure that it is almost impossible to deliver anything then applying processes which protect the bureaucratic public servant bottoms so it never gets back to them.

Backroom people who insidiously ensure that the technical holes are dug deeper and deeper all the while whittling away $100m's for no patient outcome. These people actually believe they know better about what patient care is and what clinical outcomes are than the business people - the absolute arrogance.

These same people will then a seek a leader to take them to the technical promised land and when they find out the leader wants to be more aligned to the customer they spend an inordinate amount of effort in ensuring their leaders downfall.

I pity any person who thinks they have a chance at this poisoned challice.

There will only ever be one way to fix this - remove them all and start from scratch with a business delivery culture; as these backroom, game playing technocrats will continually bring down even the toughest and most competent of leaders. They have so for the past 25 years that I know of.



Hey QH,
I've delivered a

Hey QH,

I've delivered a rapid effective IT business outcome - several of them.

And yeah sure - get rid of all the technologists, that will fix it! Put things in charge of clinicians - they know how to deliver new applications that serve patient needs and they have the time to do it as well. They'll just slot it in between 10 and 11 pm after they've finished seeing all of their patients and had some dinner. Forget that architecture stuff, that's just technology mumbo jumbo. Let's deploy a thousand applications that don't talk to each other. Good idea QH. Good idea!




This is the fruit of QH ID's "Transformation" program. A Management culture that is so risk adverse that it seeks to over-engineer everything to the point that projects become unaffordable and take forever to deliver, simple changes take months of paperwork to get approved and an "Enterprise" support model that sees most initiatives being out of scope.

Fortunately there are some smaller projects coming from the skunkworks within Districts and CASS.

Anonymous ex supplier IT mgr


More than some Talented staff

IT Management isn't that hard to explain.

When IT start a project that can't work, it is their fault.
When IT hire the wrong people, it is their fault.
When the project upsets the users and they sabotage it, it is still their fault.

When IT doesn't work for the organisation, and you've been through a complete set of IT management - <em>whose fault is it</em>?

There are many who have studied why large development projects fail but for this sort of <em>mess</em> you had better look to the very top of the organisation. <strong>Aren't they capable of supervising the IT projects?</strong>

Maybe there isn't enough money (commitment) in the world to get this sort of project finished in a hospital system. A pity because we need it.



Reasons EHR deployments fail..

Unlike many other sectors, healthcare CIO's are neutered by business executives. They are forced to explain costs for essential items because the people writing checks don't understand what is being purchased and why it is necessary.

Salaries for IT staff are preset for 'industry standards', guaranteeing that you can only afford to hire mediocre people at best.

This sends the CIO into a downward spiral where he/she must work without the aid of a clever team. This perpetuates the mindset that difficult puzzles such as an EHR deployment must be outsourced because the staff is seen as a bunch of drones. However, when outsourcing, there is no control over who is hired, and that team is most likely even less competent than your in house team.

Incompetent IT staff (CIO included) take a long time to complete tasks and often don't give, or even understand what the business needs. Frustrated caregivers end up buying and deploying their own applications and thus move the horizon of EHR and interoperability even further into the distance.

EHR is difficult, most CIO's (less face it) aren't clever enough to pull it off-- especially without a dream team to advise and support them.

So if you want to make EHR a reality, get in a CIO that demands that they are able to set their own salaries for staff (so long as they keep the bottom line the same, what's the difference?) and then get them to drill out all the decay of the rotting tooth and get in some competent people with as little outsourcing as possible. And make sure you find one that has proven themselves to get out into the field and meet stakeholders.. not just executives, but everyone at every level.

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