The Human Element

Inevitably, the systems we create in health are as fallible as the people who create them and as strong as the people who wish to exploit them, but in the overwhelming majority of cases they work for the greater good, writes David Hutchins.

Burgeoning technocracies and the rise of the machine are often portrayed as threatening hapless humans who, like so many Dr Frankensteins, are able to spawn ever more powerful Prometheseus, but are terribly challenged in controlling them.

Often the marriages of gothic horror and science fiction have catastrophes falling at the feet of rogue politicians, mad scientists, or a flawed and cowering citizenry who must repent and unite to overwhelm the rampaging foe.

The point is that art often imitates life and in life the strongest and weakest link in any system is the human element.

Last year, at the end of November,  processing electronic medical records (eMRs) at six of Sydney’s eight metropolitan Local Health Districts was significantly disrupted because construction workers severed a power cable at its data centre.

Data Centres are usually expensive, over-engineered facilities, purpose-built with abundant redundancies to prevent power outages and guarantee supply of service. The story, in our News section on page six, notes hospital workers resorted to manual work-arounds through the failure.

Comment was still being sought from the NSW Dept Health at the time of writing as to whether it still considered its Data Centre strategy to be valid considering the outage and loss of continuity.

The detrimental potential of humans in other systems has also made news with reports of further charges being laid in the wake of the tragic NSW Quakers Hill Aged Care fire. As well, we report on the Queensland Crime Misconduct Commission, restraining $12 million worth of assets of former Queensland Health employee, and fake Tahitian prince, Hohepa Hikairo Morehu-Barlow.

The move is part of a response to allegations the fake prince perpetrated a $16 million fraud against Queensland health.

Queensland’s Premier Anna Bligh has stated that the courts will deal with Morehu-Barlow and she will deal with the systems that enabled him to get away with the alleged offence.

A response as ambitious as it is obligatory and optimistic given the existing checks, balances, watchdogs and commissions had failed to prevent the (alleged) fraud formerly known as prince getting $16 million out of the building.

The law of averages, basic statistics, and the frailties of human nature, make it inevitable that flawed people exist and coexist with the rest of us. It’s fortunate that they are in the minority and are but occasional blights on the good people around them. 

Like the great news on page six of Lars Ittner and his team of researchers at the University of Sydney edging ever closer to a vaccine for Alzheimer’s. This fantastic work will impact thousands more than any alleged robbery. 

In this issue, H&A presents three major features on Finance, Aged Care and Health ICT.

Finance commences on page 12 where we present an innovative strategy that the Peel Health Campus in Western Australia has adopted to improve its financial position. It’s called ‘demand response’ and relies on the hospital getting paid to run its back-up generators in preference to using energy of the grid

On 14 we have a provocative submission on the future of health funding by Jeremy Sammut, a research fellow at the Centre of Independent Studies, who suggests ‘magic pudding’ thinking has turned health into the nation’s biggest public policy mess.

The Dementia epidemic is here according to Alzheimer’s Australia President Glenn Rees on page 16. His message is blunt: the future is bleak unless the Government funds a $500 million, multi-tiered response.

Page 20 reports on Macquarie University Hospital 18 months old and claiming a series of firsts, not the least of which is being Australia’s first University-owned hospital. Chief operating officer Evan Rawstron reveals how the facility is realising its vision.

H&A is proud to have Professor Cliff Hughes, AO, on page 24. As CEO of the NSW Clinicial Excellence Commission, he shares how a childhood lifesaving drama influenced his development of his Between the Flags patient observation chart and protocol. Already in use in NSW hospitals, Professor Hughes is combining the well branded lifesaving maxim to help keep deteriorating patients within safe boundaries.

It’s a system enabling carers and clinicians to chart key patient observations such as respiratory rate, pulse, blood pressure, SaO2  (Oxygen Saturation), neurological assessments oxygen requirements and record them within colour coded zones. White is a “safe margin” and designated “Between the Flags” while yellow and red zones indicate intermediate and immediate danger.

It is reassuring that, like Professor Hughes, so many in health continue to work extraordinarily hard for the collective good, rather than individual gain.