DHS has many strengths as the Service Operator for the HI Service. They offer a familiar and well trusted brand which is important in engendering confidence in the community. Audits conducted by the OAIC have confirmed the effectiveness of DHS’s privacy framework and operational processes for the HI Service. Their ability to leverage well established data sources, PKI processes and policies has also been valuable. The organisation has extensive experience with operational functions, processing large transaction volumes and in front line customer service from a consumer and healthcare provider perspective.
The HI Service has introduced a system that directly supports clinical services into the portfolio. As an integral component of clinical systems, the requirements around availability, support, quality and timeliness of change requests are critical. Given the complexity of the clinical systems environment and the potential impact of system decisions on clinical processes, a good knowledge of the way the Service impacts clinical systems and its role in the broader e-Health context is also critical. This requires a highly collaborative development and implementation model between NEHTA and DHS as well as very robust stakeholder engagement processes and transparency in design, decision making and issue management processes. While NEHTA are responsible for managing stakeholder engagement activities and expectations, there need to be effective processes in place to feed back any stakeholder requirements and issues to DHS, if DHS are not actively involved in consultation activities.
Although the core service is operational it is still in a very early stage in terms of active use. As utilisation increases there will be an ongoing need to monitor the functionality of the system and the processes and policies that have been implemented to ensure they are appropriate and aligned with the requirements of the users of the Service and the objectives of the e-Health reform agenda.
One of the issues of greatest concern to stakeholders is the lack of control and input of major stakeholders in directing the content and timing of change requests and release content and schedules that have significant business impacts. It is particularly important that there are transparent processes to set priorities and release timeframes for development and change requests involving the end users of the HI Service, particularly the jurisdictions as funders and major users of the Service. While NEHTA is responsible for liaising with stakeholders to negotiate these priorities and reporting back progress and expected timeframes to stakeholders, NEHTA and DHS have a joint responsibility to define the release schedule taking into consideration the requirements of all programs.
The Review identified aspects of governance, stakeholder engagement, policy and processes that need further refinement and agreement between DHS, NEHTA, DOHA, AHPRA and the jurisdictions to support this complex environment. It is particularly critical that the communication between NEHTA and DHS is effective to ensure that proposed enhancements meet the business requirements specified by users of the Service. This engagement needs to occur at key points throughout the development lifecycle to ensure that planned releases address the highest priority issues for end users.
The availability of test environments, testing processes and co-ordinating emerging test requirements to support multiple programs were highlighted as an issue by many stakeholders. As the demands on the HI Service are broader than originally anticipated and the test environments were implemented in accordance with the original specifications, it would be valuable to review the test environment strategy and infrastructure to ensure it can meet emerging requirements.