Client Story
Innovative technology partnership is powering a growing cloud-connected community health network
Interoperability and access to information - a perennial challenge
South Western Sydney Primary Health Network's (SWSPHN) innovative Integrated Real-time Active Data (iRAD) interoperability project has enabled healthcare organisations to share patient-consented health records across the continuum of care. This case study examines the rationale for the implementation of iRAD, the innovation that drives it and how it may become Australia's most comprehensive connected network of practitioners.
One of the biggest challenges facing healthcare delivery is the sharing of clinical datasets from multiple services and disparate systems. It is broadly accepted that easy and timely access to patient information across different sites-for example, the patient records of a general practice and a hospital situated in the same community-enables clinicians to be better informed, leading to improved patient health outcomes.
Interoperability in the Australian healthcare system continues to stagnate. But, as we look towards the summit of healthcare, efforts have been put in place to remedy this-ensuring a continuum of care is a major priority in Australia and around the globe.
Driving timely communication between primary care settings and hospitals
Aggregating and harmonising patient-consented data from disparate systems, delivering trusted information to clinicians in a usable and actionable format at the point of care
South Western Sydney - the setting for Project iRAD
SWSPHN is one of 31 Primary Health Networks (PHNs) across Australia. Funded by the federal (national) Department of Health and Aged Care (DoHAC), these nonprofit organisations were established to improve patient care and to, generally, make healthcare in Australia more efficient and effective. They support local doctors, health workers and patients in the communities they serve and commission health programs, services and CASE STUDY Innovative technology partnership is powering a growing cloud-connected community health networkCase Study initiatives according to local health needs. Primary healthcare is generally the first line of service in the Australian healthcare system-typically, general practitioners. One of the major objectives of Primary Health Networks is to improve the links between local health services and hospitals.
SWSPHN serves a population of 1.1M people spread across seven government areas. Its footprint comprises six public hospitals, seven private hospitals, 70 Aged Care facilities and just under 400 general practices.
About Project iRAD
In 2017, SWSPHN partnered with Altera (then Allscripts) to develop Project iRAD. iRAD is now pioneering open, connected health communities in Australia-a flagship project committed to achieving better patient outcomes that reflects the enthusiastic willingness of a diverse range of health service providers to share key clinical information by default in Australia. The project is also validated by the willingness of patients to participate, with consent recorded on a patient and healthcare-setting levels.
Altera's role in iRAD is in the delivery of its interoperability platform, the dbMotion Solution, which is available to the Australian market through the cloud via Microsoft Azure. iRAD is the first implementation of dbMotion in the Asia-Pacific region and is also the first implementation globally on the Microsoft Azure platform.
The dbMotion platform solves the problem of scattered patient health information across many systems and sites. It aggregates and harmonises patient-consented data from Australian primary care clinical information systems, delivering the information clinicians need in a usable and actionable format at the point of care.
iRAD was established to enhance the sharing of patient information, typically, when the patient is accessing services in more than one setting. These incorporate general practices, outpatient services, antenatal shared care sites, after-hours clinics, residential aged care and palliative care services. iRAD shares a host of patient and clinical information datasets, including:
- Demographics
- Diagnoses
- Medications
- Allergies
- Pathology
- Radiology
- Immunisations
- Vital Signs
- Consultations
- Surgical Procedures
- Documents
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For clinicians, the benefits of iRAD includes access to reliable health information through a simple and intuitive system that aids informed clinical decision-making. iRAD also reduces the administrative burden by saving time and limiting duplication.
iRAD is a welcomed change for patients, who no longer have to explain their health issues to multiple clinicians or have duplicate tests undertaken unnecessarily. Patients can also rest assured that their privacy is respected and safeguarded through the secure hosting of patient information in the cloud through Microsoft Azure. Easier access to information also means that patients with low health literacy or language barriers also benefit.
The pilot phase of the iRAD project, which successfully concluded in mid-2020, included a number of innovative general practices and an after-hours service.
iRAD in Practice - enabling the My Care Partners Program
My Care Partners (MCP) is an innovative new program for general practices in South Western Sydney. Eligible general practices joining MCP become part of a medical neighbourhood, providing enhanced care to patients with chronic and complex conditions who are at risk of frequent hospitalisations.
MCP aims to:
- Improve coordination between the patients' medical home (their regular general practice), primary and community services and acute care
- Improve outcomes for patients with complex and chronic conditions who are at risk of potentially preventable hospitalisations
- Improve the patient and provider experience by encouraging continuity of care and team-based care to reduce the risk of omission or duplication of services
My Care Partners was co-designed by South Western Sydney PHN (SWSPHN), South Western Sydney Local Health District (SWSLHD) and members of the community.
The program is delivered jointly between care coordinators at SWSLHD, care enablers at SWSPHN and a consented-patient's care team at their participating general practice.
When doctors, care enablers and clinical staff can more readily access patient information, they are able to deliver a higher standard of care. Care coordinators and care enablers have reported the following benefits of iRAD:
- Increased efficiency
- Access to GP information that completes a better picture of hospital information
- Fast access to care plan
- Ability to view the Covid-19 vaccination status for upcoming appointments
- Ability to see baseline vital sign results and current appointment vital signs results (e.g., blood pressure)
- Ability to see the entire care team, not just the GP who has referred the patient to MCP
Likewise, when patients understand the benefits that consent brings, they are more likely to encourage others to share their information in the interests of producing better health outcomes in the community. The following table highlights some examples of how iRAD has contributed to better patient care and health outcomes.
Wound Management-A patient attended a GP practice and the GP saved wound images to the medical record. The hospital care enabler was able to view the images and support care accordingly.
Fast-Tracking Delivery of Medicine-A patient presented to an Emergency Department and was admitted to ICU with urinary sepsis. The LHD care enabler was able to view the iRAD record and identify that the patient had attended the GP two days prior for a Urinary Tract Infection. From the clinical information and the pathology results available in iRAD, the care enabler could provide the pathology result from two days prior to the ICU team. This fast-tracked the ICU team's ability to identify the correct antibiotic and begin treatment immediately. Prior to iRAD, the hospital team would have needed to wait up to 24 hours for the Urinary Tract Infection sensitivity results. iRAD supported the fast delivery of the required care to the patient.
Better Patient Care-During a conversation with a patient, a care enabler identified that the patient had Covid-19 symptoms. Access to iRAD provided the care enablers with information to understand the patient was immobile and had no access to transport. The care enablers were able to quickly arrange mobile Covid-19 testing by the LHD through a home-testing team. iRAD Information helps care enablers prompt the patients for follow-up actions. For example, if they note that a GP has prescribed tablets, they can follow up to ensure the patient has been taking them. Likewise, care enablers can confirm that scheduled appointments with, for example, a podiatrist, have been arranged as requested by a GP.
iRAD's Growth and Development
iRAD continues to expand with the intention of becoming the primary care Health Information Exchange (HIE) solution for Australia. By the end of August 2023, SWSPHN had rolled out iRAD to more than 100 compatible sites, including general practices, after-hours clinics and specialists. More than 20,000 patients have consented to their health information being shared across the iRAD ecosystem of providers. As iRAD continues to scale and expand in 2023, the team embarks on benefits realisation, informed by focused and impactful use cases
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