The day to day running of in-home health provider Silver Chain is more than a business imperative: it is literally a matter of life and death.
For more than 100 years the organisation has been delivering essential care services across Australia, and has grown to become one of the country’s largest providers. It’s a role that brings huge responsibility: providing care, dignity and independence to over 200 people a day in Perth alone through the home hospital service and last year caring for 94,399 clients nationally, who would otherwise be in hospital.
It’s also a role allowing no scope for error.
The gravity of the situation and valuable contribution made to patients and their families is not lost on the health provider, which has a focus on constant improvement through technology and innovation built into its business philosophy.
This focus drove the organisation to explore new ways of working after a jump in the number of in-home hospital patients demanded a review of existing systems and processes, said Dr Daryl Kroschel, Director Clinical Operations, Home Hospital, Silver Chain.
“Silver Chain needed a system that was robust. We are double the size of the next biggest home hospital in Australia,” Kroschel says. “So we are by far and away the biggest geographically and also the largest in terms of numbers.”
The prior process for named medical governance with a clear line of escalation and medication administration timing in Silver Chain’s home hospital service was based around an Excel spreadsheet updated by manual entry.
A platform that could be updated across the business in real time was necessary to not only ensure accuracy of data but also ensure rapid delivery of updates of its essential care services. Further, as an in-home health provider, Silver Chain has service level agreements with more than eight individual hospitals, and there was a need for a process which could better coordinate information between them, general practices and Silver Chain.
“We required a novel solution enabling us to take the information for various hospitals and provide our team of nurses with a line of sight of what was occurring on a day-to-day basis,” Kroschel says.
The biggest challenge was none of the off-the shelf technology options could address Silver Chain’s unique business concerns. Realising the need for something bespoke, Silver Chain chose Microsoft Dynamics 365 as it allowed unprecedented customisation. As a healthcare provider with access to medical records, it was also important Silver Chain chose a system with a focus on security.
“Given the significance of the work Silver Chain does every day, it was pivotal to have a system that tackled all of its pain points and enabled it to deliver premium service for its patients,” Dominic Nolan, GM of Delivery at Velrada, the implementation partner on the project says. “Working closely with the nursing staff at Silver Chain, the final system implemented is unparalleled in the medical community.”
The platform built combines Dynamics 365 and field services management through the Field Service solution on mobile devices to provide a single source of truth. It means Silver Chain has a central database interfaced with its enterprise system ComCare – replacing the outdated Excel spreadsheet – allowing real-time patient reporting and ensuring improved transparency of patient care.
“There is the risk that things can go wrong pretty quickly in our line of work. So the removal of clinical risk is very much the be all and end all,” said Brad Gaudoin, Group Manager, Business Systems, Silver Chain – who oversaw the implementation.
The Microsoft platform also provides an additional safety net to ensure patient care is seamless. If a scheduled action isn’t updated in real-time, the system issues an alert which requires a manual override to turn off.
“This measure is critically important when it comes to ensuring quality of care. Imagine a drug that needs to be given at a specific time; if it is delayed, then there is a drop in the level of the actual drug within the blood of a patient which can have significant health impacts. The Microsoft Dynamics 365 solution ensures this critical risk can be addressed with immediacy through the real time flagging of issues,” said Kroschel.
The system has eliminated a clerical data entry role for nurses too, allowing them to be out in the field rather than working behind a desk.
Since the system was launched, Brad says internal feedback has been positive, especially given how unusual it is within the healthcare system.
“For a doctor to say it is the only one like it in Australia is a huge vindication,” he says.
Kroschel says while the value it has provided is very apparent, very little praise has been made from patients themselves – which is a good thing.
“Our sense is it’s a bit like the umpires in a game; you don’t notice the system if it works and I think from a patient perspective it’s been seamless,” Kroschel says. “If you get good care and you’re looked after you don’t notice all the systems and processes that are set behind it.”
The results have been so successful Silver Chain is now looking at what it can achieve with data extraction, namely from an audit capacity to further improve services.
“We’re in unprecedented territory as no one else is doing what we’re doing as a service,” Kroschel says. “We couldn’t take an off-the-shelf solution to be fit for purpose. So I see this as version one. But what we’ve proven is this is a unique service and a unique solution which is also safe and robust.”