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Despite major investment in a new Oracle ERP platform, significant disconnects remain between Health NZ and its 21 district health boards charged with delivering frontline services.
Health NZ deputy commissioner Roger Jarrold told Parliament’s health committee last month the organisation had done an excellent job of rolling out a modern Finance, Procurement and Information System (FPIM), based on Oracle’s E-Business Suite.
However, efforts to marry a matrix of 21 district health board systems across the new platform were ongoing.
“That has been quite a struggle in getting accounting information out in a timely manner to managers,” Jarrold told the committee.
Health NZ was tackling that problem by overlaying Snowflake’s business intelligence systems to assist managers get timely information.
“So it has been a work in progress, but the foundation has been built with the FPIM system, we’ve just got to make it work,” Jarrold said.
In order to monitor cash flow information, for example, Health NZ still has to go back to the the accounting systems of the 21 district health boards.
“So we’re working hard to get that, but … we actually do watch cash flow daily and report on it, and the team’s responding really well to those new disciplines.”
Health NZ CEO Fepulea’i Margie Apa said expectations of what the amalgamation could do given the systems in place needed to be realistic.
“I’ve presented to the committee before about people are our largest cost and they’re also our most important part of delivering healthcare,” Apa said.
Even over the past year some quite complex changes like pay equity and Holidays Act changes needed to be managed on a “very fragmented” payroll systems.
“They’re examples of systems that we also need to be quite realistic about how we go from stabilising what we have to then being able to bring together or amalgamate so that we get consistency across the country,” apa said.
Health NZ commissioner Lester Levy told the committee the organisation did not have a clinical portal where clinicians could input data to support safety.
“We don’t have an integrated system,” Levy told the committee. “Now that’s not acceptable, so we’re having to reprioritise because if we say that clinical safety [is] our number one issue, we should be able to have it reported really quickly.”
While the system was fragmented, progress could be made in “quite quickly”, Levy added.
“We should have a portal, we should have an integrated system … The cadence about everything is far too slow,” he said.
“We want to have more of a focus on leading indicators than lagging indicators, because lagging indicators are easy to measure and hard to do much about,” Levy said.
“Leading indicators are hard to measure and you can do something about them. So we’re trying to change that focus as well.”
In April, 2023, the Auditor-General called for major improvements in ICT controls at some of NZ’s former District Health Boards.
Deficiencies identified included lack of appropriate monitoring processes for privileged accounts, the need to establish formal processes to manage and monitor segregation of duties and improvements needed for password and authentication settings for both the financial reporting and payroll systems.