An IT system that can more easily track patients if they move across DHB boundaries will be introduced at Auckland City Hospital, after investigations into recent maternity deaths found the most vulnerable women often move addresses.
The overhaul is a forerunner to the challenges in the Government’s plans to scrap the country’s 20 district health boards in favour of a single organisation.
The women’s health IT system was discussed at a recent Auckland DHB board meeting, including in the context of an ongoing review into the deaths of four women during or soon after pregnancy last year.
According to minutes of the meeting, elected board member Peter Davis “commented on the statement made that the IT system was technically and functionally obsolete, saying it was depressing to hear this yet again”.
Dr Rob Sherwin, the director of women’s health at the DHB, told the meeting the Ministry of Health had approved replacing the IT system.
“The lesson learned from the recent maternal deaths revealed that the most vulnerable women often move domicile between the different DHBs and the new system allows sharing of information between those different DHBs and to protect and care for these most vulnerable women,” the minutes state.
Auckland DHB maternity services came under scrutiny after the deaths of four mothers last year. An overarching review into those deaths is ongoing, but internal documents show “lack of access or co-ordination of care” was a problem in three of the cases.
Better IT is expected to make coordinating care easier, but the Herald understands the current system has not been identified as a factor in any of the 2020 maternal deaths. The reference to it being obsolete refers to the fact the software will soon not be supported.
New Zealand’s health system is currently divided into 20 district health boards, with more than 100 different IT systems covering various services. That can cause delays or problems when patients move address – even across greater Auckland’s three DHBs: Auckland, Waitematā and Counties Manukau.
The silos of information and different systems can also make it hard to get a proper picture of where services are struggling or there are gaps. A recent Herald investigation found the Ministry of Health doesn’t know how many people are missing out on diabetic eye screening that can be crucial to preventing sight loss, for example.
Last month Health Minister Andrew Little announced plans for a historic reform of the health sector, including replacing DHBs with one new centralised Crown entity, Health New Zealand.
The new organisation will be based in Wellington, it will have four regional offices in: Auckland and Northland, South Island, the Central North Island and the Lower North Island. Each office will be responsible for hospitals in its region.
The changes would end examples of so-called “postcode lottery” care, Little claimed, where access and quality of treatment can depend on what DHB boundary somebody lives within.
The plans to upgrade the IT system at Auckland DHB come amid a wider overhaul of maternity services, with changes that could be considered including reducing the high elective caesarean section rate, and restricting the numbers of women living outside DHB boundaries – mostly in West and South Auckland – who choose to give birth at Auckland City Hospital.
The overhaul was planned before the four maternal deaths in 2020, but findings from those cases will now inform the review. A paper outlining proposals is expected to go to the board around the middle of the year.
Associate Minister of Health Ayesha Verrall this week told Stuff there are “acute” issues within maternity care, and pledged funding for a “maternity safety officer” in every DHB.
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