IBM saw future in health services

Press, 6 September 1983, Page 23

IBM saw future in health services

Last week’s announcement by the Minister of Health that an IBM mainframe will be installed in the Christchurch data centre of the department’s data-processing division has been a shot in the arm for Christchurch personnel of the division.

It has been two years since work began on drafting a request for proposal and almost a year since the request for proposal was released to hardware and software suppliers.

Now the decision has been announced the datacentre staff can immerse themselves in the large conversion project and look forward to the day when they are able to accommodate the needs of hospital boards who cannot currently use the centre’s services because of a lack of processing capacity. Despite a shaky start, the data-processing division is now successfully providing computer services to many hospital boards throughout the country. There is a large backlog of requests for service, unable to be satisfied on the current equipment. Effectively, the division is a bureau providing computer services to hospital boards, which are free to choose these services or make other arrangements for their data-processing needs.

Of 29 hospital boards in New Zealand, the division has 17 using its payroll system and 17 using its

admission - and - discharge system. More boards want to be added to the systems, but the DECsystem-10 mainframes have run out of capacity. Illustrating the new enthusiasm for its services, three boards last year signed on to the division, leaving private-sector bureaus. The new IBM mainframe is the first stage of a new strategy to meet the backlog of requests for service and extend the health computing into new areas, particularly with the aim of decentralising health computing.

The origins of the existing facilities go back to 1973, when an American firm of consultants, Touche Ross and Company, made a number of recommendations for the establishment of a “centralised computing facility.” Touche Ross subsequently got the prime contract to establish computer centres in Auckland and Christchurch equipped with DEC-system-10 mainframes from Digital Equipment Corporation and a network reaching out to hospital boards based on PDP-11 minicomputers. In the early stages, Touche Ross was effectively managing the project. Mr Evan Watson, the present manager (services) of the data-processing division of the Health Department, joined the division in 1977 and was soon given the job of developing an organisation that would run the Christchurch operation.

In Mr Watson’s view, Touche Ross greatly underestimated the potential scale of a national health computing system. Technical problems prevented the original systems from achieving their planned objectives. According to Mr Ivan Shipp, director of data processing services for the division, based in Wellington, the DEC mainframes have also not kept up with developments in data-processing.

Three major “core” systems were identified in the initial development: payroll, admission and discharge, and minicomputer systems for hospital laboratories. “The laboratory system was ill-fated,” says Mr Watson. “It was a superlative product that was overtaken by technology.”

It was decided to discontinue the laboratory system. (New plans for the division resurrect laboratory proposals.) The payroll system is largely a batch system and is operating for 17 boards, with a further two boards introducing it, two requests for implementation, and a further three boards considering requesting the system. About 25,000 hospital staff are now paid by it. Payroll was developed largely at the Auckland centre, before a decision was made to base all development in Christchurch, with just a computer centre in Auckland. Christchurch staff are proud of their admission and discharge system, which

manages waiting lists for hospital treatment, registers incoming patients, provides follow-up services, holds a record of “medical alert” conditions, and keeps statistics on health care. The Christchurch computers now hold information about 500,000 New Zealanders on their files and process 5500 transactions a day through the admission and discharge system. Medical alert information is held on 9200 people. Subsequent to the wellknown Auditor-General’s report on Government computing activities, an advisory board on health computing services was formed which released strategy documents. The documents became recommendations to the Minister’s department, culminating in the decision to issue the request for proposal. “The request for proposal was a very comprehensive document,” says Mr Watson. -“It stated, ‘This is what we have, this is what we intend to do, how do you propose to do it?’ ”

A wide-ranging request, it attracted responses from 41 companies, 13 of them major proposals and the remainder proposing hardware or software that could satisfy specialised areas of the projected systems.

When the deadline came there were “cubic yards” of paper work making up the vendors’ responses, according to the manager (conversion), Mr Mike Long, who was responsible for much of the Christchurch component of the request for proposal.

“There was a hell of a lot of work done by the vendors," says Mr Watson. The successful supplier, IBM. had started working on the sale well before the request for proposal was started, two years ago.

“IBM had two people working full-time over three years,” says Mr Ewen Bell, manager (production) in Christchurch.

IBM was one company that recognised that there was a lot of business in health services computing in New Zealand. If New Zealand spent the same proportion on computing as is spent in parts of the United States the expenditure would be at least SSOM a year, which is many times more than the present budget.

When the division can provide a better service, the division managers believe, the hospital boards will see the justification in spending a larger proportion of their budget on computing. “We are a bureau,” says Mr Shipp, “and we have had an instruction that we must be self-funding. We have five years to do that.” Funding for the IBM mainframe is from the ?9M voted to the division out of the Government’s computer equipment programme. The money is not coming out of the health vote.

“There is no way we can spend all that money this financial year,” says Mr Shipp. “The Government will reduce that in September in the Supplementary Estimates.” The value of the contract to IBM has not been released. Estimates have been submitted for expenditure over the next three years from the computer equipment funds, according to Mr Shipp. However, stages in the project are subject to adequate justification for each stage and the estimates will be reviewed annually.

IBM is the first to benefit from the Government’s burst of generosity. An IBM 3083 mainframe will be installed in the Christchurch centre in a few weeks. The 3083 is the entry level machine to IBM’s large mainframes and is rated at 4.5 mega-instructions per second. It will be supported by 14,000 megabytes of disc storage, four tape drives and other peripherals. IBM will also supply the first batch of terminals for the new network. The network will be based on IBM’s SNA network architecture, which will become the standard architecture for the division.

In accepting IBM’s proposal, the division has also accepted IBM’s software solution. IBM proposed a

package called the Patient Care System, which consists of a development tool and application packages. Christchurch’s admission-and-discharge system will be merged into a new patient-management- system developed with the Patient Care System, and the new system will encompass applications such as scheduling of nurses and an outpa-tient-scheduling system. The payroll system will be converted over to the IBM system. Mr Shipp estimates that it will take six to nine months to carry out the conversion to the IBM mainframe. During this time work will start on adding the users on the waiting list. The 200 terminals in the network will be replaced and, depending on hospital board acceptance of the division’s expanded services, Mr Shipp estimates there will eventually be from 1000 to 5000 terminals in the network within three years.

As well as the IBM contract, negotiations are taking place for a further contract—for communications equipment in the network—and tenders will soon be issued for a financial software package and for microcomputers. The strategy expounded by the Minister, Mr Malcolm, last week includes a central computing site, a standard interface network, microcomputer-based hospital and financial systems, minicomputer-based hospital systems starting with laboratory applications, and regional centres compatible with the central site. The marvellous microcomputer now becomes an important part of the health computing strategy. But so also does the “fourth generation tools” that are the darling of the computer industry.

Mr Shipp is enthusiastic about the “information centre” concept promoted by IBM which allows noncomputer people to gain access to the computer’s information using these tools.

Mr Long hopes that this access will start almost immediately. “It will allow the users to implement their own needs that may not be so pressing at a nationwide level.”

Fourth-generation software is included in the initial contract with IBM.

Mr Watson and his staff are excited by the new plans. They point to tremendous potential for computing to efficiently manage resources and manage patient data, thus improving health care in the country.

“Within four years we will have the largest network in the country,” says Mr Watson.