Even before COVID-19 reached Australian shores, the effectiveness of systems supporting the delivery and management of healthcare services was limited by its disconnectedness. Systems facilitating the delivery of patient services, procurement of medicines and medical equipment, and management of staff and finances were siloed, creating workflow difficulties for both staff and patients.
“The challenge, historically, in healthcare is too many siloed systems,” Peter Williams, healthcare advisor with Oracle, explains. “That makes it very difficult to achieve the goal of a patient-centric approach. There’s a lot of integration and effort required. To have a patient-centric system, all systems – whether in a GP’s office, pathology lab, hospital or social service provider – need to be able to talk to one another and understand what is happening.”
Williams, who brings expertise including heading health enterprise architecture teams in two Australian states and as the former chair of the My Health Record jurisdictional advisory committee, supports Oracle in the understanding of industry needs as well as the technology options available. Today, he says, we are starting to get to the point whereby interoperability is technically feasible thanks to the work of the Australian Digital Health Agency and standards such as the Fast Health Interoperability Resources (FHIR), which supports information exchange and enables developers to build systems supporting better health processes.
And with COVID-19 putting demand on health systems to be more agile and responsive, it is capability that is in demand globally.
Supporting healthcare in the pandemic and beyond
The Oracle Health Management System is one of many tools available to help deliver more agile healthcare solutions; it has been used across continents including Australia, the US and Africa.
The system was offered for vaccine management as a donation agreement to Tasmania, and taken up at the start of 2021. It has been implemented to work specifically for the needs of Australia.
“An agile co-design approach was used, allowing software to be configured quickly to meet the specific end-user needs,” Williams says. An important function to support health rules that change quickly. “We have to have a responsive system.”
Combined with the Oracle Analytics Cloud, Tasmania can now take vaccine information and apply sophisticated analyses to it. The system is also being extended to support school health programs, and is transferable to a range of needs and geographies – Ghana, Rwanda, and Senegal are using the management system to support the delivery of COVID-19 vaccines, along with vaccines for yellow fever and human papillomavirus. But it is not just vaccine rollouts that require interoperable and agile systems and analytical capability.
“One of the things highlighted by the pandemic has been the need to have better-integrated business planning and execution,” Williams adds. “Being on top of supply chain cycles, timely financial insights, and the constant awareness of staff wellbeing. There has been a huge disruption to staffing; having that capacity to model and plan in the event that disruption occurs, and then being able to make adjustments when these things do eventuate, has really been a critical need.”
In Australia, Barwon Health needed a more efficient way to manage the changing response needs, including staffing and procurements of personal protective equipment. Migrating to Oracle Cloud ERP and Oracle Procurement Cloud in July and October 2020 helped them simplify processes, which increased the speed of operations, Victor Singh, strategy director, ERP and SCM cloud applications at Oracle, explains.
“During COVID-peak, we saw the utilisation of Oracle Procurement Cloud increase by 40-times. Many of these users had limited experience in engaging within the platform as they were front-line workers. We were able to … guide these users to complete their procurement of PPE materials in a timely and effective manner with minimal external help needed,” says David Morrison, Product Manager at Barwon Health.
The Mount Sinai Hospital in New York similarly moved its HR and finance systems to the cloud at the peak of its COVID-19 crisis to improve the hospital’s effectiveness.
For patients and staff alike, cloud-based modern best practise systems provide improved user-friendly services that are now expected as the standard delivery model. But they will also support the sector with emerging challenges – backlogs in elective surgery, the impact of long and drawn-out COVID variant cycles, and chronic diseases that have become critical from patients holding off diagnosis and treatment.
Changing patient demographics also requires new ways of thinking about healthcare service delivery.
“The ageing population, especially those in remote and regional locations, require access to timely and on-demand acute and welfare care without having to travel long distances,” Singh says. “The continuum of care they need should be delivered in a connected healthcare provider model that results in value-based outcomes and great patient experiences”
Care-coordinator roles are increasingly important for the provision of patient-centric services, and technology combined with cloud-based workflows and back-office applications that are connected to one another scale easily to make healthcare service delivery efficient.
“The pandemic has intensified the need for healthcare reform. Antiquated disconnected systems need to be replaced with digital health to deliver patient-centred outcomes and coordinated care through clinically integrated operations”, Singh says. Cloud-based digital applications that are seamlessly connected to one another work in tandem to eliminate redundancies and duplication in critical operations, including supply chain planning and timely replenishment, on-demand inventory and device traceability, and of course, procurement optimisation.”
In the UK, start-up company Yokeru has developed a system to regularly ring vulnerable healthcare patients at home to ask a series of questions about their welfare. Using Oracle’s cloud-based platform, the answers are analysed to triage patients, determine when in-home visits are required, and allocate resources. During lockdowns in London, this system saw a big increase in consumer satisfaction and can be scaled up to handle more than 10,000 calls in a minute.
What are the traditional challenges in healthcare?
Conservativeness in the healthcare sector has traditionally held back the innovation required to get ahead of these challenges.
“Healthcare has traditionally been a market that regards technology as a cost rather than an investment,” Williams said. “Going from on-premise to cloud is not just a technology change, it’s a fundamental change in operations.”
With on-premise systems, he says, every upgrade is complex, costly and a major effort. With the cloud, there are no upgrades. Instead, customers receive quarterly releases and get access to functionality that is provided to clients globally. This allows them to be more up-to-date and agile.
For many customers, a stepped approach is the preferred solution. Hybrid models allow some systems to remain on-premise while others can be converted to cloud solutions. With forecasting and planning becoming critical in healthcare, demand is high to convert enterprise performance management components of health systems to cloud solutions. Customers then learn the benefit of the cloud without a large, up-front investment.
Slowly, the value proposition of these systems that are agile and interoperable is becoming better understood in the market. The expertise of Oracle is providing additional assistance in the transformation of the health sector.
Oracle Modern Best Practice for Healthcare, available now to download, provides insights from Australia and internationally on ways healthcare organisations can “simplify, unify, and transform enterprise operations to make meaningful progress” in transforming administrative functions. The outcomes, shown in case studies, are improving the efficiency of health care services which enables more time to focus on saving lives.