Doctors are afraid they will lose their jobs if they speak up about massive issues with the Acacia IT system and have no faith in departments or whistleblower protections to shield them from retaliation, the Australian Medical Association said in a startling new submission to the inquiry into the flawed project, while also revealing that real data about the extent of the system’s failures have been hidden from the committee investigating it.
The AMA NT submission filed last week suggested the Territory currently finds itself in the “worst position” possible with a partial rollout of the digital patient record system that has cost $335 million to date, but with no clear path forward, adding Acacia had come at an “inexcusable cost” that prevented healthcare workers from efficiently carrying out their duties.
Question: What do we have in the Northern Territory that nobody else has?
InterSystems , the developer of what we call “ACACIA” have successfully rolled out their medical systems over hundreds of locations globally including the leading Hospitals of Asia.
Then they came to Darwin and met the young men and women of the Northern Territory Public Service.
Right upfront I will declare that I was employed by InterSystems for the implementation of the TrakCare product as “ACACIA” in the Northern Territory. I was employed as an Application Specialist for the rollout of this system, that as Prabesh stated, had already been performed in other locations globally. I also need to declare that previous to my employment with InterSystems, I had been integrally involved in the development and implementation of the existing legacy Community Care Information and Primary Care Information Systems (CCIS & PCIS), that were also intended to be replaced by TrakCare within the Core Clinical System Renewal Program in phases of the project that have not been initiated yet.
The NT government Public Accounts Committee (PAC) are currently conducting a review of this program status (success or failure?) that has been underway for over a year. Their findings will hopefully be published in the near future.
There is an insinuation in your comments Prabesh that the Northern Territory Public Service could be a contributing factor for the problems referred to in the article, as they were supposedly not encountered in the other “successful” rollouts? There are undoubtedly some senior NT Public Service employees that need to take some responsibility for the projects shortcomings, but this should not apply to the Public Service sector as a whole. As an information system analyst with experience in the Northern Territory healthcare environment, it would be very naive indeed to expect a system that was successfully implemented in leading hospitals in Asia could be replicated in the Northern Territory environment without significant consideration of clinical practices adopted to best suit different demographic and geographic factors.
When I was an InterSystems employee I was surprised to learn that there was such a gap between the existing standard functionality within the TrakCare product and what I knew existed in CCIS and PCIS. When I raised this with my InterSystem reports at the time, I was told plainly that I could not openly discuss this with NT Health. I resigned from my employment with InterSystems shortly after that. Therefore, I am not surprised that the project has ended up in the state it has. The senior leadership from DCDD knew early in the project that it was going to face a significant challenge of persuading InterSystems to customise their COTS TrakCare product for the Acacia implementation to be successful at the clinical coalface. Evidence now suggests that both InterSystems and DCDD were never really interested in accommodating this reality – DCDD certainly never acquired the program management skills and experience necessary.
We all await the findings of the PAC investigation with bated breath.
Rod McDonald thank you for that superb overview!
I am very experienced in using CCIS/CARESYS/PCIS and all ther other JADE SOFTWARE products that they made for NTG Health and can clearly state they are substandard products that are not used anywhere in the world. Another note, I was young when they announced the “Acacia” project and they woud implement in a few years! I am not young anymore.
At a Health convention I asked a lecturer why every other Hospital in Australia (theirs over 300 Hospitals in AustraLIA) use off the shelf systems. The lecturers referred to the NTs medical it system as garbage,
JADE Software has never previously built medical software and never continued after implementing the CCIS/CareSys/PCIS! There was no prexisting medical history and no after at that company.
Territorians should personally thank the then CIO of Health, for these low quality , custom built (at much expence to the Tax payer ) medical IT systems.
Territorians should personally thank the current (or former) manager of ACACIA, for these low quality management of the roll out (at much expence to the Tax payer ).
Those of you know who know the LINK , know the link.
Interesting comments Prabesh. However, I do not think this is the proper forum to discuss the quality of the legacy systems. This article was in relation to the AMAs concerns about the flawed project to replace these dated systems, and they also provided evidence of data failures in using the new system.
Anyway, you have not provided any details of your qualifications to justify your accusations. You have only used emotive terms like substandard and garbage with no evidence of any specific failings. Products that have not been enhanced for twenty years are now definitely going to have capability limitations, so any more specific criticism you could probably offer would only be stating the obvious?
The only point I can really glean from your response is that you have a dislike of some current or former personnel within NT Health or DCDD? Once again, without further qualification to how this contributes to reviewing the (alleged) project failings, then that really is of no significance here.
In summary
-Just providing history to how the garbage IT Medical systems that have served the NT so well, came about!
-Just providing interstate IT Medical lecturers opinions on their opinion of NTs medical systems as compared to the many Off The Shelf Medical IT systems the other 300+ Australian hospitals went with!
-Just stating nobody else in Australia or the World is using the garbage IT Medical systems that NT is blessed with.
-theirs many reasons why “Acacia” is replacing the garbage IT medical systems.
-Theirs NO valid reason why Acacia is so delayed and over budget.
Repeat for Dept Justices SERPRO system.
Repeat for Courts IT system.
Repeat for Asset Management System which was killed off.
It would be in the public interest for the AMA to provide its submission and any other information it has to ICAC.
Back in Jan 2018, I was employed as the data architect for the NT Health enterprise data warehouse (EDW) Phase 1. Back then, each NT department had its own IT section and DCIS (forerunner of DCDD) was a completely different organisation. Phase 1 of he EDW involved the reviewing the existing reporting systems, source applications, business requirements, etc. As part of those activities, I developed a high level conceptual data model of all key entities across the entire NT Health business operations – back then we called that a Common Information Model (CIM).
In early Feb, 2018, and as a rough guide, we wanted to have a look at how the data architectures of the combined schemas of Caresys, PCIS and CCIS compared to the physical schema of Trakcare. When the schemas were mapped against the CIM (from memory), the combined legacy systems hit around 60% of key entities whilst Trakcare hit about 40% – at the enterprise level, obviously Finance, HR and other odds and ends would not be covered by the legacy systems or Trakcare. Note that this was a rough comparison and development of the CIM was still in early days. Nonetheless, it indicated data (and hence functionality) gaps. So we set up a meeting with Intersystems to discuss progress and start investigating closing of the data gaps. Intersystems were very positive and we looked forward to further meetings. However DCIS heard of the meeting and immediately slammed the door against any further meetings.
Phase 1 of the EDW finished Apr, 2018. Phase 2 was delayed by budget and legal issues and didn’t start until Feb 2019. As an aside, in Feb 2018 I gave an early and incomplete copy of the CIM (V0.2 from memory) to DCIS representatives during a meeting. This early CIM came back to me unchanged (and obviously wrong) in 2023 as a key deliverable by DCDD.
During Phase 2, I developed the NT Health enterprise data model (EDM). Which is a logical model, but when the EDW non-functional requirements are added, basically becomes the EDW central repository physical model. The team added all metadata definitions to the fully attributed physical EDW model, master data values, business rules, ETL mappings, data integration requirements, etc. The presentation or semantic layer was developed in (what was then) Business Objects.
An EDM is very useful for data migrations and (in conjunction with a message broker) development of the ESB for synchronisation of master and subscription data across participating applications. As such and with the full understanding that Trakcare was having problems, I personally offered to work with the Trakcare team on areas of overlap – of which there were many because our project was looking at the whole of NT Health business operations. On every occasion however, we were rebuffed.
To cut a long story short, the EDW became (and still is) a successful project, meeting all deliverables and coming in under time and budget. Accordingly, I sometimes wonder if the Trakcare / Acacia project would have had a better outcome if everyone could have worked together.