NT doctor predicts three-year delay in full rollout of the $259m digital electronic health record system

A ‘temporary’ delay to the rollout of the Northern Territory’s $259m digital hospital record system Acacia could blow out to a three-year wait.

A ‘temporary’ delay to the rollout of the Territory’s $259m integrated electronic health records system within the emergency department could blow out to over three years. Picture: Pema Tamang Pakhrin

A ‘temporary’ delay to the rollout of the Northern Territory’s $259m integrated electronic health records system within the emergency department could blow out to more than three years.

The NT coroner heard the launch of the Acacia health record system within the emergency ward last year was aborted after just two months due to “challenges” that posed a risk of harming patients.

During a three-day inquest into the “unexpected death” of a 48-year-old woman in March 2022, coroner Elisabeth Armitage heard the Royal Darwin Hospital’s system was “not fool proof” and reliant on stacks of bound paper medical records following patients around the wards.

As part of NT Health’s institutional response, the Director of Anaesthesia Brian Spain said issues, including lost paperwork, would be fixed once the “unified” digital health record was complete.

Royal Darwin Hospital Director of Anaesthesia Brian Spain leaving Darwin Local Court following a coronial inquest. Picture: Zizi Averill

However, Dr Spain said “realistically” the Acacia rollout was three to four years away due to “challenges”, specifically in the emergency department.

“It was identified some of these shortcomings, we thought, were potentially causing harm in the emergency departments,” he said.

Dr Spain said the $259m healthcare software — which was launched in 2020 — was sent back to development teams, both locally and in the United States.

He estimated Acacia would not be operational until at least 2027.

When the ED’s digital woes were first reported in February, the NT News was told the health system bugs would take up to six months to fix.

The Department of Corporate and Digital Development confirmed Acacia was in used in non-emergency wards at Katherine, Gove, Royal Darwin and Palmerston hospitals, with a May 2025 rollout expected for Tennant Creek and Alice Springs hospitals.

A DCDD spokeswoman confirmed that the emergency departments in Darwin and Palmerston had reverted to the 20-year-old CareSys system “as a temporary measure”. Picture: Che Chorley

A DCDD spokeswoman confirmed the emergency departments in Darwin and Palmerston had reverted to the 20-year-old CareSys system “as a temporary measure”.

“(The emergency ward changes) are focused on making the system more intuitive and easier to use and delivering improved situational awareness for clinicians in this very busy and complex environment,” she said.

DCDD said the emergency ward presented around 10 per cent of Royal Darwin Hospital Acacia users.

A DCDD spokeswoman said it was “not-unusual” for some aspects of Australian patient care to remain paper-based, but Dr Spain said health professionals from other jurisdictions maintained “we write nothing on paper”.

“It’s currently a blend of paper and electronic records which provides its own unique challenges, that some of the key documents are only on the electronic record and some are on the paper record,” Dr Spain said.

The DCDD spokeswoman defended the three-year expected delay to Acacia’s full rollout.

“Careful, methodical implementation is critical to ensuring the new system is fit-for-purpose and system users are well trained and prepared for the transition to the new system,” she said.

“Getting it right is really important and this takes time.”

She said since the vendor was working on a fixed price contract, any additional costs due to the emergency department bugs would be borne by the government department.