CIO50 2022 #14 Alan Pritchard, Austin Health
As chief information and services officer with Austin Health, Alan Pritchard is unquestionably one of the most influential and respected technology professionals working today in the Australian health sector.
Based in Melbourne, he, his tech team and the broader staff spanning doctors, nurses, support and admin faced were arguably delivered a bigger punch in the guts than any other agency in the world as the city bore the brunt of the COVID pandemic, leading to a brutal wave of lockdowns.
Pritchard’s 14th place in this year’s CIO50 improves on his 2021 performance by one place, yet again reflecting our judges’ high regard for digital projects that help improve and save lives.
Over the past 12 months, he and his team implemented two major innovations using existing platforms, Microsoft Teams and Microsoft Dynamics, which have greatly simplified communications at the organisation.
“Clinical communication is complex,” Pritchard tells CIO Australia. “Structured communication happens when shifts change but at other times there is copious ad hoc communication between many roles.”
For instance, when a nurse needs to contact, say an orthopaedic registrar, a pharmacist and a “bed manager”, two major problems emerge.
One, finding the person working in a role is hard as rosters change constantly, and secondly, reacting to a pager or phone call interrupts clinical work, even if it’s not urgent, which is distracting and inefficient.
Responding to a pre-poll conducted by Pritchard and his team, Austin Health staff said they receive all the information they need in less than 25 percent of communications, that they are often incorrectly contacted about something, wasting time and effort. They also lamented needing to make multiple attempts to locate the right person in a role, estimating that being able to contact the right person at the right time would save them 30 minutes a day.
Working with a Microsoft Partner, 5P and led by Austin Health radiology operations director, Nicole Hosking, Pritchard and his team built a role-based communication tool (Baret) in Microsoft Teams. Baret lets staff to clock in to defined roles at the start of a shift, with anyone clocked in to the system able to message specific roles.
This has led to a far more efficient, and targeted system for communication between hospital staff, and most importantly about ‘patient’ condition. Users can contact the right role first time, eliminating ‘phone tag’.
Messages are marked with an urgency and always contain the minimum necessary information, while ‘patient search’ is fully integrated with the Patient Administration System (PAS).
Clinicians can read and respond to messages after they finish the clinical task at hand, reducing interruptions, and there is a full audit trail of messages and responses, with all threads persisting for the next person clocked into the role.
Pritchard notes that in the month to August 18 this year, 5,637 shifts were performed by 815 distinct users acting in 323 distinct roles, with 3,261 messages sent leading to 9,968 interactions (comments, acknowledgements etc).
“Initial informal analysis indicates that Baret may already be saving radiologists multiple hours per day,” Pritchard notes. Meanwhile, in August, the pharmacy team stopped using pagers and can now only be contacted through Baret.
Other agencies, including Monash Health have now adopted Baret with more expected to follow, hopefully leading to better inter-agency communications.
Referrals to outpatient clinics come from external and internal doctors, by fax, Australia Post, internal mail, or referral from GP software.
Until recently all were printed, registered in the PAS and couriered to doctors to triage. Doctors sent them back for waitlisting, manually scanning to the medical record.
In November 2021, Austin Health launched a Microsoft Dynamics solution which now send over 6,000 referrals a month on the one digital journey (registration, unit allocation and triage).
Amazingly, Pritchard says “nothing is printed” anymore, with all referrals auto loaded into the scanned medical record (SMR) as soon as they are processed.
Lost referrals are now a thing of the past, with 97% triaged within five days of receipt (a Department of Health KPI) in August 2022 compared to 86% June 2021. The organisation has also saved 1.5 FTE no longer required to scan paper into SMR, while saving $33,000 a year on paper.
The next step is automated communication with patients about their appointments through a secure Dynamics portal providing improved communication and major costs savings.
The Dynamics portal has already been developed for the cardiac surgery team to communicate with patients immediately before and after surgery. This typically involves messages about tests, procedures and medications which often change.
“It is complex and difficult to convey and can delay surgery if not communicated clearly and followed correctly,” Pritchard says.
It’s hoped that a small group of cardiac surgery patients currently using the portal will see a reduction in surgery postponements and better overall safety, before being rolled out more broadly.
It's been a complex challenge bringing about such simple and fundamental changes at Austin Health, Pritchard explains, not least of which in bringing together the various interested parties.
“The stakeholders are experts in their chosen field with strong views on how technology can help their patients," he says.
Ensuring that it’s not technology, rather people, that’s the “star of the show”, Pritchard has managed to bring the wider organisation along on a digital journey that is clearly articulated at every stage.
Messaging is supported with an easy to understand “strategy on a page” and a comprehensive 5-year transformation plan that is updated annually.
“Together these provide a framework for IT and the business to collaborate, problem solve effectively and make quality decisions. In building solid relationships, and communicating well and quickly, misunderstandings are eliminated, and common ground established," he says.
The upshot being that in 2020/21, Austin Health saw an array of pivotal activities delivered in innovative and agile ways with a speed and effectiveness not previously seen in healthcare.