CDO Interview: A journey of modernisation

VIEW - Trevor Delany, chief digital officer at Southern Cross Healthcare)

At Southern Cross Healthcare we have always understood the criticality of systems, data and technology to efficient care delivery.

Our electronic medical record journey to date has had a principal goal: to increase quality and safety of patient care through a comprehensive clinical information system.

Our objectives are to increase automation for pathway efficiency and data availability at each point of care, and to reduce the number of paper forms generated across the lifecycle of hospital-based care.

All of our 16 hospitals use Clinical Workstation, based on a product set from Orion Health. This contains our electronic patient record data, and supports operational workflows from pre-admission, through surgeries or procedures, and on to successful discharge of the patient.

We have seen significant uptake by our medical specialists. Secure remote access to observations and notes enables them to be connected to the status of the patient, and to work virtually with the onsite nursing teams to make informed care management decisions.

We estimate we have reduced core paper documents by about 90 percent. There are always some exceptions, but we are continuing to strive for a fully digitally enabled patient care pathway in our hospitals.

One of the high value enhancements our next phase will be improving medications management and medicines reconciliation.

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From transformation to modernisation

Two years ago, we started a journey of modernisation rather than transformation.

Transformation can often carry with it a perception of magnitude and an implication that there is a specific destination or definition of ‘done’.

To me, modernisation encapsulates an attitude of evolution and is inclusive of specific change initiatives as well as day to day operations.

Southern Cross Healthcare has a great network of people, facilities, specialists and joint venture business partners and we are exploring strategies for leveraging this position and partnerships.

As an organisation we've truly come to understand that modern digital capability is necessary to achieve those strategies: not as an enabler, but as a critical strategic pillar.

What that means for us is that it is not just about clinical information systems, clinical quality and clinical efficiency: it's about stepping back and asking ourselves how will we create effectiveness and value across our whole healthcare ecosystem that benefits our customers as patients, specialists and our own businesses?

That is a significant shift in mindset, and by the end of this year we’ll have that vision solidified and be starting execution.

A hybrid strategy
We have a strategy of first considering cloud or as-a-service solutions for all new systems and products.

When the physical infrastructure for Clinical Workstation was due for refresh, Orion Health pitched the benefits – for them and for us – of migrating to the cloud.

The migration from on premise to AWS went very smoothly. As arguably the most critical platform supporting care delivery in our hospitals, we planned from the outset to remove or reduce as much risk as possible throughout the five-month project.

We undertook extensive detailed planning with Orion, we sought direct engagement with AWS and introduced an independent technology risk advisor in project governance.

We successfully went live in early January and have not had a concern since.

Not all of our applications are yet optimised for the shift, so we understand that a hybrid model will be required for a while yet.

We have also just completed phase one of our data analytics modernisation strategy, shifting our analytics infrastructure into the cloud.

We're using some cloud-based tools and bringing in priority data sets from around our business. Data out of Clinical Workstation will be part of that journey towards better insights into our quality of care and performance.

In establishing a modern infrastructure with modern tools, we have set a platform to grow and are in a better position to be able to respond to opportunities significantly faster.

Engaging stakeholders
A digital team that is embedded in the organisation and immersed in the business is how we can best add value and stakeholder engagement is arguably the most critical indicator of success in this space.

The CWS development team is an exemplar of collaboration and co-design. It involves co-located teams from across the clinical business, digital services and Orion Health and is directed by visionary product leadership with a deep understanding of the business.

Our director of nursing, Carey Campbell, champions and owns the vision for Clinical Workstation and promotes significant engagement across our business.

We are constantly listening, learning and refining, particularly around clinical workstation, to ensure functionality evolves to truly meet nursing needs.

We have also used our CWS program team as the genesis of modern ways of agile working around agile sprint planning with a focus on clarity, pace and value.

I'm immensely proud of the team who have risen to the challenge of transitioning from a traditional waterfall sequential project delivery approach, to adopt modern agile ways of delivering value to our business.

If you want to contact eHealthNews.nz regarding this View, please contact the editor Rebecca McBeth.

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