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A controversial health patient record system will return to the Northern Territory's busiest emergency department in two weeks, 20 months after it was switched off due to patient safety concerns. Following several delays, NT Health has confirmed Acacia will be reintroduced to Royal Darwin Hospital's (RDH) emergency department on November 13. It comes as staff using Acacia in other sections of RDH said it was putting lives at risk. The IT project was established in 2017 to integrate four patient record systems into one across the NT's health facilities. But the rollout has been plagued with problems, despite $320 million being spent. The Department of Corporate and Digital Development (DCDD) has been responsible for implementing Acacia, with input from NT Health. The system was meant to provide frontline staff with more comprehensive patient information and deliver it faster. But after just two months of use at RDH's emergency department — the NT's largest — it was switched off in January 2024. The retreat from NT Health followed pressure from senior RDH emergency department clinicians, who declared it a threat to patient safety. During the two months it was operational, Acacia was incapable of showing each patient's location inside the emergency department, unlike similar software systems across the world. Hospital staff were therefore unaware where the most at-risk patients were, and basic clinical information was also hard to access. An NT Health spokesperson said DCDD and senior NT Health staff had since been working in partnership with developer InterSystems, to "co-design a fit-for-purpose system that meets the dynamic and unique needs". "Royal Darwin Hospital emergency department staff have been undertaking training and user testing in preparation for the re-implementation," the spokesperson said. "Additional support from experienced Acacia users will be provided during system implementation, and for as long as needed post implementation to ensure successful integration into work practices." Once Acacia returns to RDH's emergency department, it will be in use at all NT hospitals, having gone live in Alice Springs and Tennant Creek in August. 'Everything takes about 10 times longer' with Acacia Although Acacia has not been used inside RDH's emergency department for 20 months, all other sections of the hospital have continued to use it. One staff member not authorised to speak publicly said Acacia remained "very difficult to use" and "everything takes about 10 times longer than the old paper systems". They also said patient referrals would often go missing. "We've lost triages and lots of people have fallen off outpatient lists as a result," they said. "A patient who is being referred with a condition that would normally be triaged as a category one, means they should be seen within 30 days. "With patient referrals falling off the list, the patient will potentially not be seen until the referral is found." The staff member said the consequences of Acacia's failures could be devastating. "People could potentially die if their triages are lost or their outpatient appointments are missed, or the system's losing patient referrals," they said. "People could die, need more urgent surgery or miss the opportunity to intervene at an early stage and prevent expensive later treatments if they aren't seen in appropriate time frames."
