Acacia EHR rollout hits a snag in the NT

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Emergency departments are struggling with the new IT system which promises improved continuity of care.


The Northern Territory’s $259 million digital health transformation may be temporarily rolled back as clinicians say the system is not working for them and may pose a risk to patients.

The Acacia electronic patient record, which has been used in some territory hospitals since 2022, is likely to be temporarily suspended in emergency departments of Royal Darwin Hospital and Palmerston Regional Hospital.

Clinicians told Nine News Darwin there were concerns for patient safety as clinicians had been struggling with the functionality of the system.

Associate Professor Robert Parker, from the Australian Medical Association, said patient care has always been the primary issue.

“IT systems are always secondary to that so if the IT is not fitting in with patient care they have very sensibly decided to roll it back for a while, to focus on the glitch, to make sure patient care isn’t compromised,” he said.

“That amount of money invested from the government really has to work for the future of health in the Northern Territory. Sensibly, they’ve decided to roll it back for a while they work on it.”

Selena Uibo, the Territory’s new Health Minister, said meetings were being held this week about what actions can be implemented to further improve the system.

“If it’s a hold on the current system in a short period of time, then we’ll look at that but there definitely were discussions that are being had to make sure that we have the best patient care possible,” she said.

NT Health told HSD that the problems stemmed from some of Acacia’s workflows in ED which “have impacted the workload of staff due to volume and complexity of presentations”.

“Some improvements have already been implemented to workflows. However, to perform some system improvements for the emergency departments, temporarily reverting to the use of the previous system within one department of Royal Darwin Hospital and Palmerston Regional Hospital is being considered,” a spokesperson said.

“Should this occur, the emergency departments at Royal Darwin Hospital and Palmerston Regional Hospital would temporarily revert to the older system as a temporary measure while further improvements are undertaken to the Acacia system.”

NT Health is still backing the Acacia platform, a solution by Intersystems, and said that it is “a modern, contemporary digital health system to support the delivery of public health services across the Northern Territory”.

“(Acacia) delivers a range of benefits over the older systems that it is replacing,” the NT Health spokesperson said.

The NT Health spokesperson said the Acacia team was working closely with clinicians to ensure successful implementation of the new system.

“They are listening carefully to implement changes that improve the functionality of the system and enhance user satisfaction. Further system improvements to Acacia have been identified based on advice from users from across the hospitals, mostly from within the emergency department,” said the spokesperson.

The Acacia system continues to be used across all the other parts of Royal Darwin Hospital and Palmerston Regional Hospital, and also at Katherine Hospital and Gove Hospital.

NT Health data transfer breached patient privacy

The Acacia electronic health record (EHR) first went live in the Katherine Hospital in August 2022 as stage one a $259 million core clinical systems renewal program. Acacia is based upon InterSystem’s TrakCare health information system and replaces six ageing legacy clinical programs.

InterSystems told HSD that they were “actively working in partnership with the Northern Territory Government to meet the requirements of clinical users, including those working in challenging areas like emergency departments, and ensuring their requests for system enhancements are implemented as quickly as possible while maintaining the highest levels of patient care and safety”.

A coimpany spokesperson said Intersystems was fully committed to the successful ongoing deployment of the Acacia digital health system across the Northern Territory’s public health system and noted that the rollout “is already delivering significant benefits to patients”.

This is not the first glitch that NT health has had with its digital transformation project. Between 2018 and 2019, thousands of private, patient files containing ‘high-risk’ information were received by InterSystems as part of a software system upgrade by the territory government.

“InterSystems took immediate action to locate, quarantine and destroy the data across all of its systems and devices, in accordance with Australian data privacy regulations,” the company said in the statement to HSD.

Former NT Chief Minister Natasha Fyles, who was also Health Minister at the time, did not make the incident public, choosing instead to refer the matter to Information Commissioner Peter Shoyer.

The incident report also found that no data governance framework had been set up by NT Health or the digital transformation project team before the files were transferred.

The rollout of the Acacia platform has been delivered in a phased approach starting with the Acacia read-only electronic patient record that was rolled out in late 2020.

The digital transform project includes staged rollouts of Acacia’s Patient administration+ system, platforms for medication management, electronic orders and results. Future implementations include solutions for primary health care to support community, urban and remote primary care processes. Client and healthcare provider portals were also in the plans.

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