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National Screening Solution delays a “risk”

12 September 2018

The initial planning and design phase of the National Bowel Screening Programme IT system is running behind schedule with national roll-out planned for March 2019.

A new independent review of the NBSP says the large-scale, complex IT project presents a risk to the screening programme as the build and roll-out may not be achieved within the tight timeframes or within budget.

If delivery of the system is delayed, “the roll-out of the programme may be delayed”.

The Ministry of Health announced in late June that it had contracted Deloitte for the initial planning and design phase of what is referred to as the National Screening Solution, saying work was expected to be completed in late July.

However, Ministry of Health director of service commissioning Jill Lane says it is taking longer than expected.

“This is because the Ministry wants to ensure the system is fit for purpose and able to provide a platform to support all our screening programmes long term,” she says.

“We are particularly focusing on making sure the design incorporates robust data security features.”

The Ministry is also reviewing the design to make sure it takes account of the recent recommendations of the Independent Assurance Review for the National Bowel Screening Programme.

The review says the IT approach for the new screening programme has been through several changes and delays have put pressure on timeframes, with national roll-out now planned for March 2019.

“The national roll-out represents a very large and complex change to processes for the Ministry of Health, DHBs, laboratories, colonoscopy units, GPs, PHOs, management of the NHI, NCC, RCCs, National Enrolment Service and the various complex IT systems that these entities are involved in,” the review says.

The delivery of the core IT solution should not be highly complex technically, but the risks lie in integrating this with all the other relevant IT systems. The panel says the Ministry appears to have a clear understanding of the integrations required and is planning how these will be achieved.

The review reports that the proposed NSS design will not integrate with GP systems, but will instead use an application programming interface to allow GP practice management systems to link in and obtain screening information about their patients.

“In the panel’s view, the NSS should be integrated with practice management systems so primary care providers receive information (push rather than pull) so they are aware of when their patient has been sent an invitation letter and can then monitor their progress through the NBSP,” the review says.

“Prioritising primary care integration with the NSS will also help future-proof the NSS for when it is rolled out to other screening programmes.”

The review says the proposed solution will use cloud technology, with the server based offshore, and public acceptance of this will be required.

It also emphasised the importance of clinical engagement in the IT development process and at an IT governance level.

The NSS was originally advertised as a five-year project when the Ministry called for registrations of interest in May 2017. The reported fee is $25 million - $50 million. However, Deloitte has only been contracted for the initial planning and design phase.
Subject to the company’s performance, and approval of the business case, the Ministry will either continue with Deloitte or select another company for any subsequent implementation and build phase.
Lane tells the business case has yet to be finalised and a decision on whether the Ministry will continue with Deloitte will be made once the design phase is completed.

IT readiness-related risks identified in the Independent Assurance Review were as follows:
• There is a risk that the NSS design, build and roll-out will not be achieved within the tight timeframes or within budget.
• NSS implementation may be delayed due to complications resulting from the considerable amount of work required to integrate the NSS with other IT systems.
• Public concern may arise about the use of cloud-based IT solutions and data sovereignty, which may delay the implementation of the NSS.
• The validity and reliability of the NES data have not been adequately reviewed, which may impact on the ability of the NBSP to undertake participant follow-up.
• There is a risk around the level of resource required to support eight DHBs using the BSP+ at the same time as developing and implementing the NSS.
• Further invitation issues cannot be ruled out, due to inadequacies with the BSP+ IT system, including the need for manual workarounds.



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