Queue Management System
Queensland Health approached Health IQ to develop a revolutionary patient interface for Outpatients at Redcliffe Hospital. It had become apparent that people attending Redcliffe’s Outpatient clinics were not being attended to adequately or efficiently at peak intake times. This was a direct consequence of the processes used around their HBCIS Patient Administration System (PAS).
Queensland Health needed an innovative and smart solution. They wanted to speed up the Outpatient queuing process and address data flow and collection simultaneously. It was also apparent that a simple but inventive communication system was needed, one that was capable of smoothing out the Outpatient arrival processes at Redcliffe Hospital.
Queensland Health commissioned several large screen kiosks with barcode scanners. This allows the Outpatient to scan their appointment letter upon arrival. When scanned, the barcode signals through Health IQ PAS Link to relay to HBCIS PAS that the patient has arrived and is confirmed as “in the building”, awaiting review. This information is displayed to the appropriate Outpatient Clinics alerting doctors of the imminent patient’s arrival. If the arrival time does not match an appointment time in the HBCIS PAS, the patient is then directed to the front desk.
Health IQ then systematised the procedure further with the development of a prioritisation screen to handle additional patient services. For example, if the Outpatient requires pathology, the plaster room, X-rays, these departments are alerted. The system first notifies them of the patient’s arrival and then advises the particular department of the order that their services will be required.Health IQ has increased usability by replacing the old green screen technology with a colour coded, procedural Windows interface. The simplicity of the colour coding makes it very easy to monitor the patients’ progress. Doctors are also provided with hand held scanners to reduce data entry and ensure that it is easy to report back into the system with systematic accuracy.
An additional card swipe was also attached to the kiosk barcode scanner for Medicare and Department of Veterans Affairs members. When the card is scanned, the information is relayed and confirmed as matching the PAS records. This notifies the appropriate clinic that the patient is a confirmed Medicare or DVA member.
In conjunction with Queensland Health, Health IQ assisted with the development of a simple but innovative communication system to smooth the Outpatient arrival process at Redcliffe Hospital.
Several screen kiosks were commissioned with barcode scanners that enabled the Outpatient to scan their recently received barcoded appointment letter upon arrival.
When scanned, the barcode signals through Health IQ’s PAS Link, the new interface system, to relay to HBCIS PAS that the patient has arrived and is confirmed as “in the building”, awaiting review. This information is displayed to the appropriate Outpatient Clinics alerting doctors of the imminent patient’s arrival. If the arrival time does not match an appointment time in the HBCIS PAS, the patient is then directed to the front desk.
To systematise the procedure further, Health IQ developed a prioritisation screen to handle additional patient services. For example, the Outpatient may need pathology, the plaster room or X-rays. These departments would be alerted, firstly that the patient had confirmed arrival and secondly in sequence, when they would be in need of their services. These alerts were displayed on large screens placed in easily visible positions throughout the Outpatients area in the hospital and on PC’s in the clinics.
Health IQ increased usability by replacing the old green screen technology with a colour coded procedural Windows interface. The simplicity of the colour coding made it extremely easy for all to understand and to monitor the patient’s progress.
Doctors were also provided with hand held scanners to reduce the requirement for data entry, and ensuring ease of reporting back into the system.
An additional card swipe was also attached to the Kiosk barcode scanner for Medicare and Department of Veterans Affairs members. This notifies clinics whether the patient was a confirmed Medicare or DVA member. When the card is scanned, the information is relayed and confirmed as matching the HBCIS PAS records. Should the card numbers not correlate, the patient is alerted to attend the front desk to amend their record.
Not only is the system installed at Redcliffe Hospital revolutionary, it is also very easy to use. This innovative system has completely changed the way that patients move through the Outpatient clinics at Redcliffe Hospital. From the first day of installation, 80% of outpatients had scanned their letter and utilised the system, the uptake after 3 months has now increased to 90%. The timesavings associated with these new admission procedures are significant and the efficiency of the patient journey has dramatically improved, particularly at peak times. This process has also meant that patient data has also been effectively captured, recorded and displayed for greater benefit claims for the hospital, such as interrupter charges.
At Health IQ we get excited about providing health organisations with smart, simple and efficient solutions to complicated organisational and patient administration issues. The time and financial savings associated with Queensland Health’s new patient queuing system are significant. Queensland Health and Redcliffe Hospital now benefit from efficient data management and the systematic tracking of outpatients, which in turn has freed up staff for more productive activities.
DASE Project - Patient Flow Manager
Queensland Health were faced with implementing a lengthy and arduous procedure for the Delayed Assessed Separation Events (DASE) process at Princess Alexandra Hospital. The effectiveness of this process is vital to hospital performance as it provides detailed information about the patient journey. Faced with this complicated data management problem Queensland Health approached Health IQ to develop a simple and effective solution, one that utilised technology as an enabler for the data capture process.
The DASE system captures information about why patients are not moving effectively through the hospital system. If patients are not leaving hospitals within expected time frames, hospital management needs to know why. The capture of detailed information about the patient journey is therefore vital to the effective functioning of the hospital. It is also necessary as it provides information to Queensland Health allowing them to lobby government for more beds, access funding for transport and provide them with information about what other health system changes are necessary. The previous paper-based system had been laborious at best and had failed to meet staff and hospital requirements.
Health IQ worked with Queensland Health to investigate the myriad of options for DASE functionality. They determined that the best solution would be to incorporate DASE data capture into the easy-to-use Patient Flow Manager product as used by the Princess Alexandra Hospital and the Royal Brisbane and Women’s hospital.
Patient Flow Manager is currently installed in many of Queensland Health’s largest hospitals and offers a great opportunity for a DASE pilot.
The new DASE functionality implemented by Health IQ and the relevant reporting of DASE information met management’s requirements. This new system was simple, affordable and importantly very easy for hospital staff to use.
Following analysis, the solution for DASE functionality was developed and incorporated into Patient Flow Manager using an intuitive Windows style interface.
The DASE functionality allowed the input of additional data that was not being electronically captured by any other system, using a single tool.
Patient Flow Manager then interfaced with the HBCIS Patient Administration System using Health IQ’s PAS Link for the data retrieval and writeback interface to the PAS.
Patient Flow Manager also maintains audit tracking and enforced database integrity with easy interface integration.
This extra data capture meant that laborious manual processes were eliminated enabling reliable data collection as well as automated aggregation and reporting of DASE data to determine why patient discharges were being delayed.
Health IQ recognised that an affordable solution to the challenge of DASE functionality lay in the adaptability of Patient Flow Manager. This new and improved DASE functionality was introduced to Princess Alexandra Hospital and the Royal Brisbane & Women’s Hospital. Information that had previously been gathered manually through lengthy paper-based forms which had limited application and use, before being entered into the HBCIS Patient Administration System, was now captured in a faster and more economical fashion. This had a dramatic impact on both quality and quantity of data.
Users were happy to use the new system installed by Health IQ and as a consequence, compliance was extremely high and the results were outstanding. After only a three-month pilot, Princess Alexandra Hospital had already identified savings upwards of $200,000 per month as a result of improvements in identifying the reasons for the extended lengths of patient stays.
The nursing staff in particular, who didn’t have the time to enter complicated data by hand, found the colourful user interface simple and easy to use. Importantly, Health IQ’s innovative solution protected Queensland Health’s original investment in the DASE system.
Integration And Software
At Health IQ we are comfortable working within existing frameworks and we get excited about providing intelligent, business savvy solutions for VICNISS. In 2008 we were asked by VICNISS to provide them with an innovative data integration solution for their infection control system, SHIINe. They challenged us to develop SHIINe’s capabilities but crucially they wanted to minimise manual data entry and enable an automated database population.
The central aim of VICNISS is to manage the collection and collation of vital data associated with healthcare associated infections in acute care settings. Surveillance of infections is internationally accepted as a cornerstone of infection control. VICNISS also works with hospitals in designing and implementing interventions aimed at lowering infection rates.
VICNISS commissioned their original SHIINe application to provide them with the long-term electronic aggregation of data in a central repository. This, in turn, would provide relevant information to hospital Infection Control Practitioners (ICPs).
While SHIINe met VICNISS immediate needs, the integration and expansion of the application scope was considered vital to continuing to meet their long-term goals.
Health IQ implemented a smart integration solution based on the Java CAPS platform, a solution that is now capable of supporting the transference of data into the SHIINe application. This decision was based on HealthSMARTs state-wide support of Java CAPS as the preferred integration engine.
VICNISS required Health IQ’s solution to comfortably integrate with SHIINe’s reporting functionality as it allowed for ongoing automated data capture. Since the integration solution was installed in 2008 Health IQ has provided a managed support service to health agencies across Victoria for both the SHIINe application and the SHIINe Java CAPS integration environments.
Health IQ implemented an integration solution based on the Java CAPS platform to support the population of data into the SHIINe application. This solution choice was based on HealthSMARTs state-wide support of Java CAPS as the preferred integration engine.
Interfaces were developed for data extraction from the various systems currently implemented in Victorian public hospitals.
Wherever possible HL7 messages are used to source data from Patient Administration, Theatre and Pathology systems to feed the SHIINe application.
The Java CAPS Integration Engine manages and executes the flow of HL7 messages and non-HL7 information. A SQL eWay is used to populate the SHIINe SQL interface tables, resulting in rapid dataflow with configurable data lag and minimal maintenance overhead.
In developing the integration layer, Health IQ recommended that the SHIINe application be altered to abstract integration functionality from within the core application. This future-proofing approach was accepted as good design by VICNISS and re-development was delivered under the integration services contract at no extra cost.
Health IQ has implemented the SHIINe application, integration and reporting functionality across most Victorian agencies, meeting the goals of automated data capture and relevance to ICP’s.
Health IQ seeks to provide health organisations with economical and intelligent data solutions. Crucial to this is our coordination and strategic leadership role. Our work with VICNISS has resulted in an architecturally superior SHIINe application that is more stable, cheaper to support and easier to build upon. Given the nature of surveillance and the emergence from time to time of new infections which require monitoring, this attribute is an important feature of the application.
This updated and Java CAPS integrated SHIINe application is now being implemented in over 20 Victorian public hospitals and agencies and we have ensured that SHIINe’s data is now securely and efficiently derived from the source systems. Once SHIINe is implemented hospitals can do their own reporting when they choose rather than relying on VICNISS to provide data reports.
Our sophisticated knowledge and understanding of the health environment allows us to co-ordinate the implementation of SHIINe in hospitals more readily, providing these dynamic and changeable organisations with a much stronger installation base. Since the integration solution was installed Health IQ has provided 8 to 5, 7 day-a-week managed support service to all health agencies in Victoria who currently rely on the SHIINe application and the SHIINe Java CAPS integration environments. All on-site installation and integration is performed and managed by Health IQ.
The VICNISS and Health IQ partnership has been very successful and is a software integration that we are very proud of. Importantly it has has ensured the ongoing relevance and growth of SHIINe in Australian hospitals. This partnership has included a refactoring of the SHIINe data structure and redevelopment of the core application, ensuring easy extensibility and thus reducing future maintenance costs. This successful solution has been delivered with business and time constraints in mind, resulting in an affordable, dynamic and updateable infection surveillance system.
Performance Measurement Unit Upgrade
Melbourne Health was faced with the complex challenge of implementing a new Patient Administration System (PAS) under the HealthSMART program. Health IQ was brought in after it was decided that we had the appropriate high-level expertise, experience and products needed to make these changes.
Melbourne Health’s information flows were unable to deliver vital management information such as Executive Scorecard and Critical Reports. The existing information flow relied on hard-coded data mapping and direct queries from the legacy HOMER PAS, which was being replaced.
Health IQ was given a two-month window to work with Melbourne Health designing, developing and implementing crucial conversions of their internal applications. This included report development and accuracy testing. We were also charged with improving the Performance Measurement System, a system that had both speed and stability issues and was operating on soon-to-be unsupported technology.
Health IQ was enthusiastic about taking on this project as it presented a fantastic opportunity to work closely with one of Victoria’s most dynamic health organisations. Alongside Melbourne Health we were able to implement a program of innovative data management solutions. The process was thorough and involved a series of consultative steps that allowed for ongoing executive reporting capabilities.
Initially we provided a detailed analysis of the existing executive reporting structure to determine whether a complete rebuild of business intelligence system was possible in the time provided. Given the complexity of the system and its requirements we felt the most prudent and time-effective solution was to ensure that the data flow continued to feed into the existing Melbourne Health PMU Reporting Database.
Health Central provided the perfect solution as it supplied critical data in a secure, local and easily accessible format. This allowed for a redesign of the PMU System altering the flow of data from the legacy HOMER system.
Health IQ conducted data mapping exercises and we were able to resolve several hard-coding issues. This in turn allowed for a more configurable environment for future developments to be built upon. We also developed and implemented a strategy that addressed performance and reliability issues within the PMU technical environment. Finally, working with Melbourne Health’s IT Department, we updated the database software from SQL Server 2000, converting all ETL packages to the new technology.
Health IQ analysed the existing executive reporting structure to determine whether a complete rebuild of business intelligence systems was possible within the project timeframe.
The complexity of the system and sophisticated requirements meant that the most prudent and time-effective solution was to ensure that the data flow continued to feed into the existing Melbourne Health PMU Reporting Database,
Melbourne Health accepted Health IQ’s recommendation that a multi-step process was required to ensure continuous executive reporting capabilities.
The extraction of information to feed the PMU System was simplified by sourcing data from the Health Central Data Warehouse, instead of the application database.
Health Central presented critical data in a secure, local, easily accessible format, enabling redesign of the PMU System to alter the flow of data from the legacy HOMER system and feed the crucial data to Melbourne Health’s Reporting Database. The utilisation of this product also enabled independence of source system, allowing for easy change of key applications in the future.
Data mapping exercises were also conducted to resolve hard-coding issues, which resulted in a more configurable environment for future development to build on.
The Executive Scorecard and Critical Reports were tested by Health IQ and the PMU and were available for Go-Live of the new system.
In addition to the data flow requirement, Health IQ also developed and implemented a strategy to address performance and reliability of the PMU technical environment. Melbourne Health’s IT Department created a new virtualised operating environment on which Health IQ updated the database software from SQL Server 2000, converting all ETL packages to the new technology.
Health IQ seek to provide health organisations with the tools they need to operate as effectively and efficiently as possible, saving them both time and money. When it came to Melbourne Health we aimed to give the organisation timely access to the vital management information they needed within the two-month window required. Crucially, Executive Scorecard and Critical Reports were available to Melbourne Health from day one using the new Patient Administration System (PAS).
As with many of our business and IT solutions we sought to enable Melbourne Health to steadily migrate to more current technologies from appropriate sources, rather than employing a “big bang” approach.
Since the implementation of the new system the time taken to run End-of-Month processes has dropped by over 90%. We have dramatically increased the productivity of the Performance Measurement Unit through the implementation of a faster data environment and it now requires significantly less maintenance effort as it is a current and stable system. As a direct consequence of these factors PMU staff have been freed up and are now available for other more valuable activities.
Health IQ is proud to have worked with Melbourne Health to implement an effective, scalable, expandable, robust and fully documented solution for the organisation at a reasonable cost. Importantly we did this without disruption to either business functioning or reporting to upper management. Melbourne Health’s new PMU system has had a dramatic and positive effect on the way that information is delivered throughout the organisation.
Southern Health HL7 Integration Implementation
High Availability, Disaster Recovery and Managed Service
In 2008 Victoria’s largest public health agency, Southern Health were looking to upgrade their HOMER Patient Administration System (PAS). They approached Health IQ to come up with a business savvy and innovative systems integration solution. We were excited to be able to guide this dynamic agency through the maze of data management and integration as they implemented the iSoft i.PM PAS application and decommissioned their existing integration engine, Cloverleaf.
The transition to a new integration environment was complex. The integration architecture needed to be robust and flexible and able to support any future expansion of the system. Health IQ also needed to accommodate the numerous interfaces in the legacy integration environment as well as all existing data feeds from HOMER. It was also vital that the new integration environment support a variety of clinical data systems.
Health IQ’s team took on full project responsibility to design, redevelop and configure an intelligent solution for Southern Health. This was an extensive project that took over two and a half years and required a close working relationship with Southern Health as well as a detailed understanding of their data management interfaces. As a DHS HealthSMART initiative Southern Health utilised the latest Java CAPS integration engine as the basis for their architectural build.
Health IQ designed, developed and tested a High Availability and Disaster Recovery Environment for Southern Health. This new environment allows Java CAPS to continue to process messages in the event of hardware or site failure, ensuring that data is never lost and integration messages can always be replayed.
Health IQ was responsible for the Java CAPS/HL7 architecture and environment and encompassed a “Publish and Subscribe” model that enabled transformation between a variety of message format. This also encompassed all interfaces from HOMER and i.PM and including ORU transition to Java CAPS for Radiology and Pathology applications. Health IQ also migrated the existing Cloverleaf Application Transforms to Java CAPS.
Wrapped around this whole project was the provision of all support for the Java CAPS environment by Health IQ. The managed service provides 24 x 7 support for Southern Health’s integration system; upgrading software to Java CAPS Version 6; Java CAPS Message/Error Logging and the development of Java CAPS Message Replay capability.
Integration encompassed many supporting applications, including Symphony (Emergency), GE Centricity RIS/PACS (Radiology) Messaging, Labvision (Pathology), Medipath (Pathology), Merlin (Pharmacy), BOS (Birthing Outcomes System), Xcelera (Cardiology), GiScribes (Clinical System), Witt (Cardiology), Surgbase (Surgical Auditing/Theatre), Patient Select (Food Services) and Riskman (Risk Management).
We have provided Southern health with an innovative, cutting edge integration environment that is stable, scalable and flexible. On the way we developed the first and most complex High Availability/Disaster Recovery environment using Java CAPS in Australian health.
Health IQ was able to replace Southern Health’s integration system incrementally. This allowed for complete functionality throughout the process. Our provision of a 24 hour, 7 day-a-week managed support service has meant that Southern Health staff can concentrate more fully on other aspects of PAS implementation.
Health IQ met Southern Health’s extremely complicated Go-Live needs in a matter of hours with fluid results and no interruption to the function of the hospital data systems. The provision of Health IQ’s integration services has been described as “outstanding”, following the Go-Live of i.PM PAS. We continue to operate as Integration Project Manager for Southern Health and are providing further services for a number of new projects at including Billing and Cystic Fibrosis initiatives.