An inquiry into a controversial health patient record system has heard the Northern Territory health department regards its rollout as a "resounding success", despite medical staff raising serious concerns about its impact on patient care.
The NT parliament's Public Accounts Committee concluded an inquiry into the Acacia Digital Patient Record System on Tuesday, which also covered the project's huge cost blowouts and claims of a "toxic" workplace culture.
Acacia, which was designed to replace decades-old technology and integrate multiple NT Health patient record systems, was implemented in the Royal Darwin Hospital (RDH) emergency department in late 2023.
It was suspended in the emergency department after just two months, but has continued to be used in other areas of RDH as well as in hospitals in Palmerston, Central Australia and the Barkly region, despite some medical staff claiming the system is a threat to patient safety.
The system was reintroduced in RDH's emergency department late last year.
During Tuesday's hearing, Australian Medical Association NT president John Zorbas said the union had serious concerns with Acacia, saying its records showed deceased patients booked for operations and showing incorrect next of kin.
He also said Acacia had caused triage times in the RDH emergency department to blow out "well above national benchmarks".
"There are tickets [complaints] in the hundreds, … that is not hyperbole, that are attributed to Acacia and how they impact patient care," he said.
"The example we use in our submission is a head-injured patient in the emergency department who had to wait for 60 minutes while a record was locked, leaving us unable to access his clinical record."
'Tremendous and transformative difference'
The inquiry also heard the cost of Acacia had blown out from a $186 million budget in 2016 to a current costing of $323 million.
In a joint submission to the inquiry, NT Health and the Department of Corporate and Digital Development (DCDD) attributed the increased cost to COVID-19 and delays in the opening of Palmerston Regional Hospital.
The departments said they forecasted at least another 24 to 30 months of work required to complete the full rollout of Acacia, with the project currently in stage two of five.
Despite the cost blowout and patient concerns, NT Health chief executive Chris Hosking described Acacia as making a "tremendous and transformative difference" when he fronted the committee last month.
"While it has not been perfect — no project with this level of complexity is ever executed perfectly — it has been a resounding success," he said.
Mr Hosking said some of the statements made by doctors about Acacia's impact on patients were "very broad and not substantiated by evidence".
"Nonetheless, when you hear them in the public domain they are cause for concern and they concern the public, so we take those things very seriously," he said.
Nadarajah Kangaharan, a doctor who worked on the clinical side of the rollout, told the committee he did not think Acacia had caused direct harm to patients.
"Any delay in assessing a patient in the emergency department could potentially harm, but does not mean that harm was done," he said.
During Tuesday's hearing, Dr Zorbas said he recognised the need for a new health patient record system, but disagreed with Dr Kangaharan's assessment of Acacia's risk.
"Our doctors would reject this statement wholeheartedly," he said.
IT staff allege 'toxic' workplace contributed to failures
The inquiry also examined workplace culture at the DCDD, which was in charge of rolling out Acacia, and the death of one of its employees in August last year.
Kara Joyce, who worked on the rollout team alongside her brother Shaun, told the inquiry on Tuesday she believed management failures contributed to her brother's death, as he had been working extremely long hours and was burnt out.
"While Shaun is just one person, he is symbolic of broader issues which have led to the failure to deliver," she said.
Ms Joyce told the inquiry members of the team, like her brother, were routinely ignored.
"They were disregarded, it would happen all the time, and often it meant that the program bled expertise because anyone with half a brain would leave and say 'I'm not putting up with this'," she said.
In the DCDD's submission to the inquiry last month, chief executive Catherine Webber said the department was aware of the claims related to Mr Joyce, after media reporting last year.
"With the public complaints that were aired in the third and fourth quarter of last year, I am undertaking an investigation into those specific complaints," she said.
She also said Acacia staff satisfaction surveys — which did not include contractors — showed a 60 per cent staff satisfaction rate.
André Snoxall, who was contracted by the government to work on the rollout of Acacia, said the system should have been the responsibility of the health department over the DCDD.
"They should not be providing leadership to the agencies in how they use technology or what they use tech for, their job should be providing tech at the lowest possible cost and the highest possible quality," he said.
Mr Snoxall said the concerns he raised about the Acacia rollout had been dismissed.
"You would stop getting invited to meetings, I would hear through the grapevine people had been told to stop speaking to me," he said.
"My experience is that you don’t question DCDD. You don’t question, you don’t argue, because they don’t want to hear [it]."
He said he believed there was a clear link between the "toxic" workplace culture at DCDD and the rollout of Acacia.
The Public Accounts Committee will prepare a report from the hearings, including its findings and recommendations.
