HNZ Digital Services helpdesk: Has anyone here managed to provide feedback that led to a palpable change for the better and how did you go about that feedback to HNZ Digital Services helpdesk & its masters? Particularly keen to hear from clinicians with any success stories. Feel free to stop reading here as what follows is a rant-moan.
Issues just in the last 24h (Northern region - in case it matters):
- No notification that a whole category of Pt care documents was suddenly removed from viewing on Regional Clinical Portal in my DHB [using “DHB” deliberately as neighbours up and down the road use a different document type so were not affected]. All Anaesthesia assessments / Care Pathways type documents suddenly became invisible to healthcare staff for ALL patients in a quaternary hospital one fine Friday morning. To be clear they were visible at 3am when I was at work. They became invisible shortly after the working day for normal people started, which points to active work in the back end of Care Pathways and the team working there must have known that the visibility was gone for portal users. Yet no alert from anyone, emailed or otherwise. No timings (e.g. is it likely to be restored by the weekend?). No advice re: use of failover business plan (there is one, nobody at helpdesk seems to know about its existence or location). Nothing. Cue multiple colleagues, including my Clinical Director, messaging on WhatsApp, mostly to clarify if it is “just them”. It is interesting in its own right that 90odd SMOs and registrars default to “it’s just me” when they are suddenly & randomly unable to see something on RCP. Not “this is a system problem and everyone else can’t see something that they should be able to.” Call to helpdesk - response: oh we have been advised this has been resolved (no). No understanding re: effect of the problem and urgency. And took 3(!) agents until the 3rd one finally documented the extent of the problem correctly. Don’t get me started on having to provide my name and phone number and start my story from scratch every single time the phonecall gets disconnected - usually after the agent moves away to investigate. Gently, I actually have work to do which does not involve either being on hold to helpdesk or repeating myself ad nauseam. The only person who could have helped troubleshot this faster in-house had their access removed by higher powers beyond our DHB CEO, without notice (the lack of basic human curtesy there is also astounding). So we only had the helpdesk number for “help”. The minimisation of problems by people who do not understand the implications is phenomenal to the point that you give up trying.
- Ability to file a ticket with screenshots via “Kapehu - Service Now” - technically is available but is closed to me in practice. Took a few months to discover that it’s my specific profile that’s the problem. So, now I have an active ticket since ?February? that my profile is denied access to the correct link in the portal. Ticket still open, nothing done. Intermittently gets closed and then I reactivate it. So current age of ticket is apparently 28 days but actually it’s 28days x3. Our team PA has rechristened the service portal to “Kapehu - Service Never”.
- Extremely variable service when you ring - from everything gets “passed on to the relevant team” (and by the time you hear back from anyone with sense you are not at the desktop that has the problem anymore) to the person fixing issues on the fly (amazing!!! … but too little too far between. I would gladly send kudos to these folk so that they get recognised for their skill but I actually have no avenue to do that - any hints, anyone?).
- Particular mention of email migration process - assignment of TeWhatuOra addresses seems hotchpotch at best. Lots of grandstanding about which rules will be implemented and then have addresses starting with “firstnameonly”@tewhatuora, “firstinitiallastname” and other permutations. Troubleshooting afterwards is another world of pain - a lot of the time you are told that nothing can be done until all of the account is migrated, not just your email. None of the guides provided work in practice - they do until you complete the steps you are given but after all that, your Teams will still malfunction and your Outlook will likely need profile deletion and re-do by someone with admin rights (not you). You will discover this next time you sign in to the machine you thought was sorted. In short, individual asset(!) sort out is constantly required by most migrated users. The migration appears to be designed for 1 person = 1 machine but that is absolutely not the reality of modern hospital. And vdi/ remote desktop is again a separate entity that may or may not be able to be tackled by the agent you are dealing with. The only things that work fine are Outlook on my own laptop and Outlook on my own phone. DHB devices continue to require multiple troubleshooting phonecalls. Since changing my email I spend half my precious non-clinical time logging in to every single thing separately - open a Word attachment? (sign in), open Excel (sign in), open a link (including a link from this forum - oh no, has to be done in edge browser where edge has you logged in with TeWhatuOra account, not the DHB account one that you are supposed to use). Shared mailbox? - both of mine were renamed with the wrong region prefix. Have tried to pre-empt the second one being migrated to the wrong prefix as spotted incorrect alias yesterday (it is due for migration next week hence alias info only just added) - rang migrations helpdesk => “oh we can’tdo anything until it has been migrated”. Revelation: they can’t do anything after it has been migrated either, just request not to use the mailbox until the problem is sorted by yet another team; previous shared inbox took a couple of weeks to get the prefix fixed.
This sort of thing really does not help the “image” problem that health IT already has. Yes, I can rant all I like about lack of funding and the backroom staff being cut, but that’s a separate topic. The staff who miraculously remain in-house try their hardest to do their job and more, but being kneecapped by higher powers is supremely unhelpful (especially when it is blindingly obvious that the kneecapping is happening because there is a new manager somewhere in the ether who probably hasn’t quite got to grips with the job and hasn’t quite realised the value of inhouse expertise).
To be clear, I do my best to put my money where my mouth is, try not to complain, work with what I have available to me in my organisation, mostly in my own time, and try to generate interest in health IT from clinicians. I personally teach a basic introductory session on health informatics to training registrars in my specialty about matters that would be pertinent to them as SMOs (and yes, put up with the annual complaints of “mwah, it’s not in the exam”) because I honestly believe that if we are to improve anything, more (all) clinicians should have a basic understanding of the health information landscape.
However, the constant lottery of technical support, every bit of improvement requiring a fight and gazillion business cases, reinvention of the wheel with every reshuffle, people (who should know better) telling me with authority that, for example, Businees Admin software will take care of Clinical Audit when only the Business component of that software was bought into and it was never intended to take care of “clinical”, it is just exhausting.
We have so many near-breaches sitting right under the surface. It is terrifying that I am fully aware that clinical audit for a major specialty is being run on google docs with patient identifying info being manually entered and passed around who knows where, complex elective surgery waitlists are being managed via multiple disconnected excel spreadsheets, even the lack of an organisation-wide, let alone national, solution for clinical guidelines makes them so hard to find that actual patient harm is occurring. (Yes I have filed reports to flag problems, I am told “yes we hear you” and “watch this space”, I have now been watching for some years). There is very little I and others in this space can offer in return to make it better and so, like everyone else around me, we close our eyes (because, at the end of the day, audit on google docs is better than no audit) and try to encourage hope that things will improve. Problem is, after yesterday, I think I have lost that hope. Hence my question - is there any avenue to providing feedback that might lead to improvement at least in the communication space of technical support? Or maybe, more saliently, is there any point?