It’s been a tumultuous 10 years for Queensland Health with the fallout from a $1.2 billion payroll disaster – which led to a Commission of Inquiry – doing very little to retain the public’s trust in its technology infrastructure.
Queensland Health’s CEO and CIO Dr Richard Ashby told CIO Australia in July that the department applied one lesson learned from the debacle to all its current and future tech projects: that having applications, hosting, and managed services undertaken by one organisation is very beneficial.
This has certainly been the case at Queensland’s Metro North Hospital and Health Service, which comprises the Royal Brisbane and Women’s Hospital, The Prince Charles Hospital, Caboolture, Redcliffe, and Kilcoy Hospitals in Brisbane’s north.
These hospitals were brought under one organisation by the previous Campbell Newman government to reduce costs and gain the necessary efficiencies required to improve patient care.
Consolidating the disparate and ageing IT infrastructure run by these hospitals was the challenge faced by Metro North’s solutions architect Antony Batrouni when he joined the organisation just over two years ago.
“The mandate that came down hellip; was how do we consolidate four datacentres across the hospitals into one highly available platform without the duplication of spending,” Batrouni told CIO Australia.
Metro North’s IT services are now provided from a highly resilient primary site run by eHealth Queensland at the Royal Brisbane Hospital and a remote disaster recovery site at Prince Charles.
The organisation has deployed the Nutanix Enterprise Cloud Platform, a ‘hyperconverged’ system that integrates server, storage, networking, and virtualization resources.
Batrouni said the types of systems the organisation was running now are more complex than ever before. Its biggest core application is a patient flow management system that improves efficiency by tracking the time each patient spends at hospital from diagnosis to discharge.
This is tied to an electronic management system which is used to allocate services like meals and record any allergies a patient may have. Duress systems and patient referrals from GPs to hospitals are also digitised, he said.
“We’ve just started to get into the age of digital hospitals hellip; our first implementation on this front is electronic medication management,” Batrouni said.
“Surprisingly, there’s a lot of theft [of prescription medications] so having these vault-like systems that are completely computer-controlled that track everything is necessary.
“The technology behind them is phenomenal. They will rotate drugs based on expiry dates and make sure that the ones that are going to expire are pushed to the front and label them as they come out. It is literally not susceptible to human error at all,” he said. “This goes right down to the bedside as well – no more paper trails, it’s all electronic.”
The organisation has also built a new enterprise service bus, which will be used to integrate clinical applications going forward, said Batrouni.
“Prior to that, we had a lot of point-to-point connections between applications and it was really quite a mess,” he said.
The migration to a centralised platform was fairly straight forward, said Batrouni, with 95 per cent of the group’s workload moved across to the new platform in the first six months with no outages or impacts to patients and clinicians.
“Prince Charles Hospital has been a bit trickier because it’s a very big hospital with a lot of [IT infrastructure] on site,” he said.
“In any hospital environment, there are a lot of images, a lot of data, so trying to centralise that and move it away from a local site has implications around WAN link sizing and bandwidth,” Batrouni said.
“So there’s a lot of networking that’s been done in the background to facilitate the move to a centralised model. We are now at the point where we have upgraded our WAN and server links hellip; and we can do DR as seamlessly as possible.
“Both our datacentres now look like one logical datacentre even though they are geographically dispersed – we spent a lot of time getting this right,” he said.
“The transformation that has occurred in the time since I have been there is absolutely phenomenal and to try and plan for that would be almost next to impossible,” Batrouni said. “Health changes so frequently, especially with the change in local governments, which can in itself affect the direction that we are heading in.”
Why no cloud?
Batrouni said when Metro North Hospital and Health Service first went to tender for new IT infrastructure, the organisation quickly realised it wasn’t mature enough to leverage cloud services. This is despite the QLD government having a ‘cloud-first’ strategy.
“Our own internal processes were so lacking that if we tried to put them into the cloud, it was going to be a recipe for disaster,” said Batrouni.
He said there are several reasons why organisations shouldn’t move services to the cloud.
“If you don’t understand your workload and what it is doing, if you don’t understand what’s coming, you can very easily get burnt hellip; because of the way they [service providers] charge and the costing model – you’re paying for data in and data out,” said Batrouni.
“If you don’t have the processes for people to go through some mechanism even to provision services hellip; it could very quickly sink you as an organisation if people start spinning up VMs (virtual machines) ‘willy nilly’ without any financial approval.
“You are also moving from a capex model where you might have a set budget for an amount of money to an opex model where all of a sudden your costs might triple or quadruple over time. It’s all too easy to go in there and spin up as many VMs as you like so you get that virtual machine sprawl.”
Still, Batrouni expects that Metro North will adopt a hybrid cloud model at some point in the future. He said there are certain workloads that would benefit from the ‘elasticity’ that cloud provides.
“But at this point, we are not quite there yet,” he said.
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