Digitalizing Care in the Outback
Queensland covers an area of 1,730,650 square kilometers. The nearest pathology lab may be 500 kilometers away and roads can be impassable for months.
Imagine the challenge of connecting and managing 300 point-of-care testing blood gas analyzers operated by over 8,500 users at more than 250 sites spread over an area the size of France, Spain, Sweden, and Germany combined.
This was exactly the challenge Queensland Health faced. The health system operates and administers the public health system for the state of Queensland in Australia. Its point-of care testing analyzers run approximately 4,500 tests per day, producing large volumes of patient and quality control test result data that must be validated and transmitted to the headquarters lab information system in Brisbane. A major challenge was the relative lack of resources and support in areas further inland from Queensland’s east coast.
Point of Care Coordinator Cameron Martin explains: “We work across many [regions]. If you are living on the coast, you have access to big hospitals, modern equipment, lots of support for pathology and radiology. The further you go from the coast, the thinner that support becomes.”
In 2001, Queensland Health began deploying handheld devices to some of the remote areas, amid concerns about monitoring the quality of the testing done and the challenge of how to keep the systems up to date. These issues grew more prominent as the number of operators increased. Cameron remembers: “We hit the [4000-operator limit] on each analyzer, so our solution at the time was to split the system and then we considered splitting the system again, but we really wanted to try and keep things together and add the capability to put other instruments on.”
Testing quality was a real problem in the more remote areas. This was largely due to the mobile, transient nature of the operator workforce, many of whom were hired through staffing agencies and moved frequently from job to job. Cameron recalls that it was difficult to keep them trained and to track their training, and testing quality suffered as a result.
Oversight of instruments used across the different sites in the Queensland Health system was also weak, with many instruments unaccounted for. Cameron describes a common situation in which site personnel would purchase an analyzer, use it for a time, and then due to poor oversight abandon it in favor of something else. The result was “orphan” systems lying unused and essentially forgotten due to not being accounted for in a data management system.
In 2014, after much consideration, Queensland Health chose the POCcelerator system to consolidate their middleware. Ensuring long-term stability with no performance issues throughout such a widely distributed network required a carefully planned IT infrastructure. The Queensland Health point-of-care and IT teams and the LIS manufacturer worked together with the product specialist to identify a system that would meet the needs of all stakeholders. IT experts then employed the POCcelerator platform and its integrated Meditrac technology to design a tailor-made solution.
Increase Workforce Productivity
After years of seeing error rates rise, Queensland Health was able to install an online training program in 2010. Now, by adding the POCcelerator system, they can not only train operators remotely but also manage operator access and precisely track their training, so they know which operators are current and which are not. Cameron explains: “They get three warnings through POCcelerator. If they ignore them or they don’t do it, then they find that their enrollment gets shortened, so they’re forced to go back and redo the training program. That’s been a fantastic tool because we’re managing operators by exception, rather than blindly targeting everyone.
Optimizing Clinical Operations
Queensland Health sought to identify and implement a solution that would seamlessly connect and manage a range of instruments, from handheld to lab systems. These include blood gas, urinalysis, and diabetes testing systems from a variety of manufacturers.
Since installing the POCcelerator system, Queensland Health has realized significant economic benefits, including a five percent increase in cost recovery through reimbursements. Also, with the addition of the POCcelerator system to their IT infrastructure, Cameron estimates that, between the three point-of- care staff members at Queensland Health, they’ve gained back the equivalent of a full eight hours a week of coordinator time.
Transforming Care Delivery
The installation of the POCcelerator system has not only improved the operations of the Queensland Health system but has improved access to care across the country. By creating a reliable Point of Care Ecosystem instruments in the remote areas are used more frequently and the results are recorded more accurately.
In a region where the nearest pathology lab is 500 kilometers away and roads can be impassable for months, the ability to reliably produce quality assured test results locally is critical in improving patient outcomes. As Cameron says, “By making the system perform better, we can help deliver them a more reliable service in those areas.”
With better tracking of operator training the POCcelerator platform has created better trained operators which produce higher quality results. Cameron explains that since point-of-care can never be 100 percent accurate, they must rely on operators to reduce errors.
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The outcomes achieved by the Siemens Healthineers customers described herein were achieved in each customer’s unique setting. Since there is no “typical” hospital and many variables exist (e.g., hospital size, case mix, level of IT adoption) there can be no guarantee that others will achieve the same results.