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Speaker 1: Was promoted as taking the Northern Territory health system into

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Speaker 1: the digital age, but it's been plagued with delays, cost

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Speaker 1: blowouts and clinical concern around patient safety. Despite this, anti

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Speaker 1: health officials have defended the more than three hundred million

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Speaker 1: dollar system. Now this week, more hearings have been held

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Speaker 1: by a parliamentary committee into the rollout of ACACIA, and

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Speaker 1: one person who gave evidence to the Public Accounts Committee

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Speaker 1: is the head of the Australian Medical Association's Northern Territory branch,

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Speaker 1: doctor John Zorberst. Good morning to you.

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Speaker 2: John, Good morning Katie, Good morning to everybody listening this morning.

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Speaker 1: Thank you so much for your time this morning. Now,

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Speaker 1: you gave evidence earlier in the week about ACACIA. What

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Speaker 1: did you want to get across to the committee.

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Speaker 2: The feedback that we get from our doctors is that

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Speaker 2: the way that clinical governance is being done, the way

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Speaker 2: that we look at patient safety risks, just really isn't

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Speaker 2: working for the front line. So when we see issues

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Speaker 2: on the ground that are being reported, they're not being

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Speaker 2: escalated in the way that we'd expect. It's more about

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Speaker 2: the technical rather than the clinical, and we think that

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Speaker 2: that's the wrong way around for a project like ACACIA.

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Speaker 1: Tell me more about some of the concerns, some of

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Speaker 1: the you know, some of what's happened as it's been

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Speaker 1: rolling out. And what's the feedback being from people you

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Speaker 1: know within the health department that are there on the

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Speaker 1: ground working.

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Speaker 2: Yeah, so we get feedback every day around usability processes

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Speaker 2: that usually were fast under the old legacy systems. And

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Speaker 2: let's be clear, the legacy systems, they're done. You know,

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Speaker 2: there's nobody supporting those anymore. We have to transition away

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Speaker 2: from those. That was the whole point of this back

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Speaker 2: in twenty sixteen. But nonetheless, the new system is much

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Speaker 2: slower than the old system. They're running into errors like

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Speaker 2: people being misidentified as far as next of kinner concerned,

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Speaker 2: or the wrong people being booked for clinics. Now it's

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Speaker 2: not resulting in harm because so as a human is

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Speaker 2: catching the problem and a human fixing the problem. But

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Speaker 2: that costs money and that takes up time. So these

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Speaker 2: are doctors, nurses, support staff who otherwise should be working

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Speaker 2: in our areas of the health system, who are having

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Speaker 2: to fix problems created by the software.

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Speaker 1: John, talk me like so as it currently seats have

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Speaker 1: all the old systems been phased out and you have

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Speaker 1: to use a CASHA or how does it currently seat.

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Speaker 2: Yeah, so it's a mismash of systems. Now you bring

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Speaker 2: a new system online, there's always going to be a

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Speaker 2: transition period. And in the inquiry I mentioned it's you know,

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Speaker 2: at once a casia started, we started walking across quicksand,

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Speaker 2: and you need to keep moving, and you need to

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Speaker 2: move fast. What we have at the moment is a

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Speaker 2: bit of a mixed situation where we still have to

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Speaker 2: use multiple systems at once, so our doctors will have three,

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Speaker 2: four or five systems open to find the information that

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Speaker 2: they need. That's a pain point that's always there in transition.

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Speaker 2: But right now we've implemented part of akasha. We've essentially

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Speaker 2: hit the pause, but there's no further funding or not

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Speaker 2: enough funding to actually complete a KASHA, and so these

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Speaker 2: legacy systems, some of them are still running, some have

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Speaker 2: been switched off, but a lot of still running and

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Speaker 2: we're standing still on the quicksand. That's the worst place

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Speaker 2: to be. Whether we finish a CASHA as it was

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Speaker 2: envisioned back in twenty sixteen, or whether we have a

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Speaker 2: new solution, you know, either or but we can't stay

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Speaker 2: where we are.

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Speaker 1: John, Look, what are some of the biggest issues that

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Speaker 1: you are dealing with when it comes to AKASHA and

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Speaker 1: some of the issues that you feel are really impacting

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Speaker 1: patient safety.

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Speaker 2: Yeah, we exist to be the voice of doctors. That's

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Speaker 2: the whole reason the OMA exists. And I think i've

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Speaker 2: you know, the statement two weeks prior to when I

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Speaker 2: spoke to the inquiry saying there are no patient safety

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Speaker 2: concerns associated with a CASHA really really hit a pretty

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Speaker 2: negative chord with doctors. There are hundreds of concerns that

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Speaker 2: have been raised. Now I'm not saying all of these

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Speaker 2: concerns are resulting in front page headlines. But the problem

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Speaker 2: with risk in the clinical world is everything's just managed

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Speaker 2: by workarounds, right, So the risk is there. Even the

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Speaker 2: best systems have risk, but there's always humans bailing the

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Speaker 2: system out. As those humans get busier and busier, we

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Speaker 2: start to see things slipt through the cracks, and then

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Speaker 2: you've got a headline, and then you know someone has

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Speaker 2: come to harm who shouldn't have come to harm. Because

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Speaker 2: let's remember, this isn't just about doctors using a piece

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Speaker 2: of software. This is about doctors providing care to some

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Speaker 2: of the sickest people in the country. We need the

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Speaker 2: best systems that we can to be able to provide

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Speaker 2: safe care.

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Speaker 1: Doctors orbis like, we're too from here. Obviously, this parliamentary

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Speaker 1: inquiry is happening where all of the major concerns are

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Speaker 1: being heard. I think it's absolutely fundamental that these happens

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Speaker 1: so that, you know, so that those that are in

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Speaker 1: decision making positions in our Northern Territory Parliament actually understand

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Speaker 1: that this system is flawed and that people are really

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Speaker 1: very worried about it. But you know, we're too from

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Speaker 1: here because obviously, you know, we need to see to

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Speaker 1: be able to operate within our hospitals. But the one

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Speaker 1: that we've you know, this one that we're talking about

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Speaker 1: that it's meant to be taking us into, you know,

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Speaker 1: into the digital age, sounds as though it's been an

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Speaker 1: absolute nightmare.

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Speaker 2: To put it mildly, Yeah, this is a great opportunity

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Speaker 2: for everybody to just hit the reset switch, right. This

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Speaker 2: is a great opportunity for us to sit there and

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Speaker 2: say what we've got so far, where we are at

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Speaker 2: the moment, you know, that's where we're starting from. Where

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Speaker 2: are we going to and how are we going to

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Speaker 2: get there? In our submission to the inquiry, which is

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Speaker 2: publicly available on the Parliament website, we've we've got a

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Speaker 2: series of recommendations at the end, and a lot of

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Speaker 2: them are really just about looking at the budgeting, looking

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Speaker 2: at the clinical governance, so making sure that patient safety

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Speaker 2: concerns are fun and center and using this is a

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Speaker 2: bit of a moment to say, look, we can't just

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Speaker 2: keep pouring cash into something that doesn't seem to be

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Speaker 2: working as well as it needs to be right now,

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Speaker 2: how are we going to redesign this for us? From

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Speaker 2: where the doctor stands, you know, this is about the

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Speaker 2: clinical safety of the system, and that's where we want

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Speaker 2: to see input taken seriously and be part of whatever

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Speaker 2: comes next.

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Speaker 1: Doctors Orbis, have you managed to stay in there for

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Speaker 1: much of the other you know, for many of the

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Speaker 1: other people who've been speaking. I know that there was

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Speaker 1: a lot of concerns about culture of toxic you know,

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Speaker 1: toxic environment at work. Matt Cunningham had reported very extensively

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Speaker 1: about it. Contractor Sean Joyce, we know that he was bullied,

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Speaker 1: in harassed before his death. His family, I understand spoke

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Speaker 1: as well, did you hear any of that evidence?

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Speaker 2: So I had to go back to work, unfortunately, and

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Speaker 2: I wasn't able to stay. But I'm familiar with the

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Speaker 2: story and it's a really horrible tragic outcome for the

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Speaker 2: Joyce family and I really feel for them. While I

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Speaker 2: can't speak to the culture inside DCDD inside health at

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Speaker 2: the time that we first rolled a cashare out and

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Speaker 2: we had to roll it back, they were some of

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Speaker 2: the worst days for doctors. We had people who were

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Speaker 2: reduced to years, who were used to working in war zones.

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Speaker 2: It was really really horrible from a cultural point of view,

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Speaker 2: and the fact that they were able to take the

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Speaker 2: decision to roll the system back then and hit the resets,

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Speaker 2: which you know, I commend them for making that decision

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Speaker 2: because politically that was not a good decision to make.

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Speaker 2: They got beat up for it, but that was the

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Speaker 2: right thing to do. I can't speak to DCDD, but

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Speaker 2: I do know going forward, we should take those moments

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Speaker 2: to pause when things aren't working, When your frontline staff

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Speaker 2: are telling you things are wrong, you have to stop.

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Speaker 2: You have to take notice before you go too far

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Speaker 2: down a path that you can't come back from.

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Speaker 1: Well, doctor John Zorbis, I really hope that by you know,

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Speaker 1: this this inquiry happening, the committee looking more closely into Akasha,

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Speaker 1: that we you know, that we see those changes so

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Speaker 1: that doctors, nurses, everybody that is you know there inside

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Speaker 1: our healthcare system is able to use it and that

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Speaker 1: patient you know, patient safety is is front and center.

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Speaker 2: Yeah, one hundred percent. And look, Katie, I've been on

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Speaker 2: your show a few times talking about you know, we've

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Speaker 2: got to say glass half fall, and I am optimist

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Speaker 2: about this, like I don't think this is a recoverable

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Speaker 2: I think we can fix this going forward. Our doctors

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Speaker 2: are very keen to be part of that conversation. We're

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Speaker 2: ready to be part of what comes next. And you know,

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Speaker 2: let's move forward in a way that helps Territorians and

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Speaker 2: helps us deliver the care that we want to deliver

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Speaker 2: to our patients.

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Speaker 1: Well, doctor John Zorber's good to speak with you this morning.

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Speaker 1: I really appreciate it. I hear you're on night shift

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Speaker 1: last night, so I thank you for taking the time

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Speaker 1: to chat.

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Speaker 2: With us anytime, any time, having me.

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Speaker 1: Thanks so much,