The newly opened Macquarie University Hospital (MUH) may boast a number of Australian firsts in technology, but its IT infrastructure is a "spaghetti" of systems, according to chief information officer (CIO), Geoff Harders.
The $250 million hospital, which opened on 15 June with a single patient, was part of two year project which saw owner, Macquarie University, set up an advanced medical school as well as negotiate the move of Cochlear Limited's global headquarters to the university campus. The 183-bed private hospital expects to be fully operational by the end of July, with 12 operating theatres and specialised clinics in radiology, pathology, radiotherapy and oncology.
However, many of the firsts it boasts - the first Australian Gamma Knife, a completely paperless hospital and a combined PET/CT molecular scanning clinic - are marred by a complicated mess of IT systems, applications and infrastructure as the result of decisions made by former partner, Dalcross Holdings.
(Check out the technology behind the hospital)
Infrastructure at MUH currently includes a number of applications offered through medical providers iSoft and Stryker, as well as Cisco networking and room-based thin clients from Siemens. It stores data on two data centres - one within the hospital and another in the North Ryde area with two 10Gbps links back to the hospital.
Four independent fibre backbones within the hospital serve different applications from patient entertainment to clinical systems, with an external 10Mbps WAN link provided by Optus serving the entire hospital. It can piggyback off Macquarie University's 1Gbps AARNet link as a backup, but Harders said he would prefer to boost the main external link as a first course of action.
"The partner pre-determined a lot of the software we bought," Harders told Computerworld Australia. "If we had our time again, possibly there would be some things we might not have done."
Macquarie University bought Dalcross Holdings' 38 per cent stake in the hospital and became the whole owner of the hospital in August last year, but the systems and applications contracted by the former partner continued to be implemented up until 4 January this year. Harders, an IT veteran in the public health sector, joined in March, only once the existing systems had already been implemented.
"It's spaghetti; it's not something that you would necessarily do," he said. "But we were left with that, we needed to get it open, and that's where we needed to move to."
Some media reports claimed MUH had significantly overblown its budget during the build, based on a report from NSW Auditor-General, Peter Achterstraat, which estimated the final building cost of the hospital stood at $160 million on completion, up from the $112 million budget and with borrowings of approximately $118 million. The Auditor-General recommended the university "review its processes for the selection of business partners and the identification of project risks".
Macquarie University vice-chancellor, Steven Schwartz, maintained the hospital build or change in partnership hadn't "adversely affected" the university's finances, despite calling on other departments within the university to cut budgets by five per cent.
While Harders was unable to provide a full costing of the complete IT infrastructure in the hospital, he said they were "well within budget". The CIO wasn't worried either; he already has a plan to move away from the workarounds staff currently use, to a more integrated environment.
"We've already started talking to some of our suppliers, and also had discussions with NeHTA and other groups about where we want to go and our environment," he said.
Harders' plan is based on a system he developed in 2003 while at North Western Health, but the lack of funding and commitment in the general public health sector lead him to put the proposed environment to one side. The plan, which distinguishes between application systems and enabling infrastructure, is still viable and applicable to MUH despite its age, according to Harders.
The move to an integrated environment "won't be a big bang", but there is at least a rough timeframe for the transition.
"It's gotta be less than four years, because I'm retiring then."
(Have a look at an interview we conducted with Harders during his time at North Western Health)