IT providers sometimes joke that if a new feature doesn’t work ‘it won’t kill anyone’. But when your system is the backbone for a healthcare provider, it’s no joke.
For community nursing, homecare and hospice provider Nurse Maude, technology is an important driver for improved productivity and better patient care.
Founded 120 years ago, Nurse Maude was New Zealand’s first district nursing organisation, and continues to provide nursing and specialist services across Canterbury, Nelson Marlborough and Wellington. Employing 1,500 staff, the organisation provides specialty clinics in diabetes and stoma care, school-based nurses, a specialist hospice and palliative care unit and a large home support team.
Looking for agility, flexibility and longevity
While Nurse Maude might be steeped in history, CEO Jim Magee is a firm believer in the value of technology to enhance services and improve patient care.
“Digital technology across both the back office and at point of care has a huge role to play in enabling us to be as productive and efficient as we can to maximise the impact of the scarce health dollar” Magee says.
Despite his enthusiasm for technologies benefits, Magee admits Nurse Maude’s technology had lagged behind in recent times. Its patient management system, introduced in the 1990s as a temporary solution, was showing its age and the organisation was keen to embrace more modern technology to enhance its services.
“With the growth and the increasing diversity of our services we needed better visibility, better control and certainly more efficiency,” Magee says. “It wasn’t just a matter of replacing an ageing system. It was a matter of replacing it with something that would meet our operational requirements over a number of years.”
Because the health sector is undergoing continual growth and change, Nurse Maude wanted a system which was easily maintained, flexible and versatile so it could reflect the constant change.
Technology for good
It also wanted to provide information to its workers at the point of care, whether in the hospital or in the community and was keen to automate some of the service co-ordination: With more than 600 nurses working in the community, each making multiple visits per day with patients requiring a wide range of specialty services, scheduling nurses’ appointments is a big task.
For Nurse Maude, the solution came via Microsoft partner Intergen and Microsoft technologies, including Dynamics 365 for Customer Engagement, Office 365, Dynamics 365 for Field Service including the Resource Scheduling Optimisation (RSO) add-on for Field Service, and Resco Mobility, a preferred third party solution providing advanced mobility functionality for Dynamics 365.
The cloud-based nature of the offerings was an important factor, ensuring the system was continually up-to-date, while the integration of the offerings was also important.
“Part of our goal was a comprehensive set of related and connected systems which would cater for all of our organisation,” Magee says.
The project was delivered in an agile manner, with Intergen ‘delivering early and delivering often’ to ensure the project was successful, says Bryce Newman, Intergen Solutions Architect.
The new platform provides Nurse Maude with a 360-degree view of the patient, more automated rostering to ensure the right nurse is with the right patient at the right time, and reduces reliance on paper in the clinical process, creating a digital record of interactions.
Referrals are allocated to the most appropriate nurse or support worker, taking into account staff workload, availability, location and skills. Client preferences can also be catered for. Schedules, based on the most effective geographic way to complete patient visits, are then automatically created for each staff member.
“The system learns from itself and we’re improving the automation all the time,” Magee says. “There is still some intervention, but it’s already doing a lot that previously would have had to be done manually and quite laboriously.”
The system helps provide more certainty on timing of visits to clients, improving visibility of where nurses are as they move through their daily case load and enabling Nurse Maude to stay in touch with clients who may be anxious if the nurse doesn’t arrive exactly on schedule.
Taking it to the point of care
When nurses and support workers head out for visits, they’re now fully connected too, with smartphones and tablets providing access to client and clinical information.
“It improves the record keeping and also provides more information at the point of care, which helps with both productivity and quality, particularly for our nurses,” Magee says.
Powell says the majority of nurses and support workers find the increased access to information a real benefit.
“Because staff have access to information before they see clients/patients, there is less need to revisit the same questions and patients can have more confidence that relevant information is shared appropriately,” she says.
“Nursing staff report efficiencies in being able to order replacement supplies for clients via the mobile device and this will be enhanced in future with the addition of bar code scanning for products using the Resco app,” she says.
Powell says Nurse Maude’s specialist services are also benefiting as they can see what generalist nurses have written in client progress notes. “The exchange of information between specialists and generalists is extremely beneficial to both staff and clients alike.”
Specialist input to client records is being extended, with contemporaneous documentation ensuring there is no delay in exchanging information about changes to care, aiding client experience.
But there’s another big benefit to the electronic record keeping: The potential for analysis to further help patient care.
“The CRM allows us to identify areas of excellence in care as well as those areas requiring improvement,” Powell says. “We now have access to far more information. The accuracy of our data has improved and will continue to improve, and the quality of care is also most likely to improve as more development is completed.”
Powell notes simple things like prompting users to complete care checklists stimulates training and improves care outcomes.
Magee says Nurse Maude is already looking at ways to use the data for research to get better outcomes for patients.
“Having the information electronically will help us understand better responses to treatments and outcomes. It will be a huge learning enhancement.”
The wider picture
Gabe Rijpma, Microsoft Senior Director Health and Social Services Asia, says Nurse Maude is a prime example of applying a broad digital change agenda to improve care in a sector steeped in traditional ways of doing things.
“Digital transformation is not a destination, it’s a journey. And it’s one that requires organisations to be willing to take risks, try new things, be willing to fail and also learn from it and continue to push into a due north direction,” Rijpma says. “Conviction, belief and seeing bold goals through has been key here.”
As for Nurse Maude, Magee is clear the platform is already enhancing patient care. “And we’re only just scratching the surface.”
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