‘Too much for the system to bear’: SDPR leaders rethink rollout

The original plan to simultaneously roll out NSW Health’s $2bn digital patient record across four health districts in November has been abandoned after senior executives concluded doing all four together would be ‘too much for the system to bear’.

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Acting Single Digital Patient Record Implementation Authority chief executive Wendy Hoey met with chief executives of the affected local health districts last Friday to discuss the planned Tranche B rollout, ahead of the decision to dramatically scale back the November implementation.

The original schedule would have seen the Epic electronic medical record rolled out across Northern Sydney, Central Coast, Mid North Coast, and Northern NSW local health districts in November, alongside the remainder of the Laboratory Information Management System North network.

Instead, Northern Beaches Hospital will be the only Tranche B site to proceed in November, with the timetable for the remaining districts yet to be determined.

According to an anonymous source, Ms Hoey and other senior managers told an internal SDPRIA meeting this morning that the four remaining LHDs could not simply be separated into individual implementations because of the architecture of their existing electronic medical record systems.

Northern Sydney and Central Coast must go live together because they shared an EMR platform, while Mid North Coast and Northern NSW were similarly linked.

However, attempting both pairs simultaneously was now considered too great a burden on the system.

“You can’t do the four together, can’t do the two centre instances together. It’s just too much for the system to bear,” the meeting was told.

Northern Sydney indicated it would like its rollout with Central Coast to proceed around March 2027, although no final decision was made beyond rolling out Northern Beaches Hospital’s integration in November.

“Northern Sydney would love to still go around March,” the meeting was told.

“If there’s capacity, money, if we can do that even, they would love to do that, but we don’t know whether they could do that or not.”

Senior management discussed developing an options paper examining how the revised rollout could proceed and the advantages and disadvantages of different approaches.

Beyond Northern Beaches, however, there was currently no settled timetable.

“As for the rest of it, the message to the system is that we don’t know yet because we’re taking this pause to rebase it and think clearly about what’s the best way forward,” the meeting was told.

“We’re not going to make any quick decisions. So we’re just stopping and thinking at this point in time.”

The comments provided new insight into the decision revealed by Health Services Daily exclusively this morning to split Tranche B following a Go-Live Readiness Assessment.

SDPRIA chief executive Dr Teresa Anderson – who as of tonight is on four weeks’ annual leave – told staff the phased approach would allow the authority to apply lessons from earlier implementations and support continuing stabilisation and optimisation work, while NSW Health deputy secretary Elizabeth Wood said it would help ensure the capacity and wellbeing of teams implementing Tranche B and subsequent stages.

This morning’s internal meeting also revealed the demands successive go-lives and post-implementation “hypercare” periods were placing on SDPRIA staff.

“Everyone recognises that the hypercare put a huge demand on all of our staff,” the meeting was told.

Management said future schedules would have to take account of the authority’s workload and the amount of time teams needed to recover between implementations.

“How long do we need between sort of hypercare and a go-live to give everybody a little bit of downtime and a little bit of a life,” one senior executive said.

The workforce pressures have emerged as a significant issue for the program.

A recent psychosocial risk assessment of SDPRIA found 84% of participating staff were “struggling or unwell”, while 73% reported feeling emotionally exhausted for a large part or all of the time and 65% reported physical exhaustion.

Management also acknowledged the authority itself needed time following its first go-lives to embed operational procedures and structures before proceeding with subsequent tranches.

“We need the time to embed those practices,” this morning’s meeting was told.

“So, it’s not just about the go-lives, it’s actually about operationally structuring ourselves, managing all of those services and planning for those next tranches.”

Executives said there were reasons to expect some subsequent deployments could prove less difficult than Hunter New England LHD, which moved from paper-based processes.

The next LHDs were already using Cerner electronic medical records and were described at the meeting as “digitally literate”, meaning they were not expected to experience the same scale of practice and workflow changes.

But management said the experience of the initial deployments meant the time required for implementation and hypercare – and the downtime needed before teams started again – had to be carefully considered.

The decision to split Tranche B left Northern Beaches Hospital scheduled to go live sometime in November, with the precise date still being worked through.

“Northern Beaches will be going at some time in November, as early as possible,” the meeting was told.

Planning for the two remaining paired deployments – Northern Sydney LHD with Central Coast LHD, and Mid North Coast LHD with Northern NSW LHD – would continue as the SDPRIA worked through its revised schedule.