Aligning business requirements with existing systems to deliver quality services

The implementation of i.Patient Manager for specialist palliative care services across Tasmania

The Brief

The Better Access for Palliative Care (BAPC) program is a four-year project funded by the Australian Government through the Tasmanian Health Assistance Package, to strengthen palliative care services in Tasmania. The objective of the BAPC program is to increase Tasmania’s capacity to provide access to palliative care for people with life limiting illness.

Two projects to be delivered under the BAPC program include:

  1. Better Access to Palliative Care – Policy Framework: Coordination and Collaboration
  2. Enhancing Specialist Palliative Care Teams (SPCTs)

Under each of the projects, IT infrastructure and systems are to be implemented in the Specialist Palliative Care services (SPCS); centralising patient information and identification, together with initiatives to enhance data capture and data quality.

MKM Health was initially engaged to complete a Business Analysis (BA) project to understand the current processes of the three regional SPCS teams across Tasmania.

After the initial project MKM Health was engaged to implement the proposed iPM based solution across the state. This included:

  • The business process mapping of current processes against iPM as a solution
  • The consolidation of diverse service delivery methods between the three regions
  • The confirmation of an agreed set of definitions around terminology and business process
  • The configuration of iPM for SPCS
  • The change management plan and execution
  • The coordination of training of all SPCS staff
  • The implementation and go-live support of iPM for SPCS across the state

Our Client

The Department of Health and Human Services (DHHS) is a Tasmanian Government Agency that provides public health and human services to over 350 sites and 480,000 Tasmanians across the state. The DHHS is responsible for delivering integrated services that maintain and improve the health and well-being of individual Tasmanians and the Tasmanian community.

The DHHS supports the executive and statutory roles of the Tasmanian Minister for Health and Minister for Human Services, as well as monitoring the performance of the Tasmanian public health system through the services delivered by the Tasmanian Health Service. DHHS improves, promotes, protects, and maintains the health, safety, and wellbeing of Tasmanians through service planning, managing, procuring, and delivering high quality health and human services.

As a system manager, DHHS has an important role as a steward and strategic partner in health and human services delivery. The roles and responsibilities of system management are shared across all operational and departmental groups.

The Situation

In 2015, the Tasmanian Government established the Tasmanian Health Service by amalgamating the three Tasmanian Health Organisations. The Tasmanian Health Service was established to improve patient outcomes by delivering better health services to Tasmanians. The establishment of a single state-wide delivery structure is to improve the coordination of services and reduce duplication in both administrative overheads and clinical support services.

A major challenge of the project was the diversity between the three regions. There was a core underlying business process but over the years, the decentralised regional model of service management meant that each area had developed their own localised business processes and definitions of like terminology.

MKM Health needed to bring all three regions together to agree on a shared business process and agreed definitions around terminology. There was no national minimum dataset that could be used as a guide, so it had to be developed state-wide, and closely in line with the Palliative Care Outcomes Collaboration (PCOC) dataset (a national palliative reporting framework that palliative services across Australia can elect to submit to twice a year). From this, a report on palliative services is generated which is used to give an indication of service levels and delivery statistics against peer palliative services across Australia.

This project was both a change management project and a technical project. There was a need to form an appropriate project team and to develop the relationships with the palliative services, ICT, vendors, and the PAS support teams. The project team consisted of a project manager, a community nurse as a clinical support and advocate for the palliative service, as well as skilled iPM technical, integration and reporting resources. The project team needed to engage not only administrative staff but also clinical staff, which included, nurses, medical specialists, and allied health staff. The project was technically challenging as the system needed to be configured so data entry by clinical staff would be as simple as possible; meaning the software components used were highly configured for palliative care staff.

The Solution

The scope of the BAPC – iPM Project included the successful delivery of an integrated information system with appropriate reporting capability to support the service delivery of specialist palliative care services in the north, north west and south of Tasmania. The team had to make the system especially user-friendly so as to engage the clinical staff who were not familiar with the information systems and technology.

“The approach taken by MKM Health for the iPM implementation project was an inclusive process, so that MKM Health and the project team became active members of the larger BAPC project team. This helped to instill a high level of trust in the project team and give further validity to what was trying to be achieved. This encouraged strong team work between the BAPC project team, the iPM project team, the support services, ICT and the service itself. In doing this, MKM Health was also able to leave a legacy of skills within the organisation that could be used in the future.”

BAPC project team

There have been many IT projects across multiple jurisdictions where IT systems have been implemented using a set of requirements as the guide and the business has been expected to change their processes to meet the requirements of the technical solution. However, MKM Health presented a solution that would allow business processes and technology to complement each other. This was achieved through a detailed configuration of iPM, which would only expose the modules that were required to support the processes, and then streamlining these modules with only that information required for palliative services. As a state-wide database, there were details that needed to remain available, such as reference values and mandatory fields, but this was reduced to the minimum. The modules that were implemented for SPCS in iPM included:

  • Patient master index
  • Alerts
  • Patient history
  • Referral management
  • Caseload management
  • Contacts
  • Assessments
  • Reporting

The Result

After a seven month implementation project, the system went live in November 2015 across Tasmania. In the following seven months, there were over 1800 referrals and over 25,000 contacts completed by SPCS staff.

The results from this project are based on the preparation, engagement, and technical competence of the project team to deliver the solution.

“These projects are now completed and have delivered much more than the outcomes identified in the BAPC funding Action Plan. To ensure and facilitate effective system up-take and stakeholder engagement there was a need to deliver maximum functionality from the iPM system. This was achieved by a very thorough mapping of business processes and providing options and solutions to support not only the business unit workflow and activity but to deliver service efficiencies and enhancements.”

Anita Reimann – BAPC Project Manager

The Better Access to Palliative Care program of work was looking to centralise patient information and identification, together with initiatives to enhance data capture and data quality. MKM Health achieved this by:

  • Understanding and documenting existing business processes in the three regions
  • Developing a new and agreed system process across the state for palliative services
  • One state-wide system that is used by both clinical and administrative staff
  • Increasing capacity to report service activity and allow for service level planning through better data capture
  • Developing PCOC data capture in standard business processes within iPM and removing the need to have the palliative care client and activity data captured in three separate databases
  • Contributing to the patient journey across the acute and community areas within the public health system
  • More informed patient care through access to patient and activity data within a centralised state-wide system

Through the understanding and documenting of business processes and aligning these processes across the state; we were able to (in a careful and considered configuration of the information system) take the SPCS team on a journey of transition from a mix of manual processes for clinical and multiple databases for admins, to a single solution and realisation of the associated benefits.

The Future

The planned future activity for the system is to have a sustainable and extendable solution that could grow with the needs of the service. There is also an intent to move other community based services onto the state-wide iPM database.