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Few organisations invest heavily in IT to make sure their clients use less of their product, but that’s the battle Australia’s National Blood Authority (NBA) is fighting – and winning – as it leans heavily on data and mobile technology innovations to optimise a real-time supply chain that involves most of Australia’s more than 1,300 hospitals.
That supply chain, which will get a big infusion of new supply during National Blood Donor Week from 12 to 18 June, has emerged in recent years as a long-term strategy that is based on a combination of infrastructure modernisation, telecommunications service upgrades and a shift from conventional desktops to virtual desktop infrastructure (VDI).
This strategy has helped the organisation streamline its operations and improve its responsiveness to the point where reduced wastage means demand for blood products has dropped by 20%. That translates to big savings from the organisation’s A$1.2bn annual budget – much needed by a government that is in the process of shaking out the bedsheets and looking under the couch for even the smallest operational savings.
Significantly, the savings have coincided with a simultaneous increase in service.
“It’s an unusual thing in healthcare, where you can decrease your spending but improve outcomes,” says NBA CIO Peter O’Halloran. “Blood is quite a high-cost product and, while we have achieved significant manufacturing cost reductions, it is still fundamentally an expensive business.”
As well as its cost, the blood business often runs into supply issues, as it did when a shortage hit the country two years ago and a lack of visibility made it harder to get scarce blood supplies where they were needed.
Efficiency improvements and cost savings have since flowed from the implementation of BloodNet, a supply chain management system that tracks individual bags of blood from their point of collection, through storage, to the hospital theatre where they’re used.
Saving lives with blood on tap
Rather than relying on a quick response to ever-changing demand for blood products, BloodNet has helped the NBA track supplies in real time and proactively move them to where they’re needed.
“It had gotten to the point where we were making decisions that were less than fully informed, because we were trying to keep out of the way of the hospitals managing patient care,” says O’Halloran. “Our decision-making suffered because we didn’t have up-to-the-minute data.”
This efficiency has proved invaluable for reducing wastage and logistical inefficiency across the blood products supply chain, with the equivalent of 20,000 extra blood donations, worth $A10m, saved through resultant reductions in wastage.
“We can now intervene using real-time data that doesn’t get in the way of hospitals doing their jobs,” says O’Halloran.
Years of technology investment have facilitated the agency’s data-driven turnaround, with extensive 10Gbps fibre-optic connections supporting a Nutanix hyperconverged infrastructure that recently replaced the agency’s storage area network (SAN) to manage an extensive VDI environment that has allowed NBA to condense nearly 20 rack units’ worth of equipment to just four.
The recent adoption of InterSystems’ TrakCare Lab Enterprise Laboratory business management system, for one, is further improving the movement of data between hospital environments and blood laboratory partners as real-time data exchange becomes the lifeblood of change in the highly specialised sector.
The transformation at NBA has been so fundamentally important that the team behind it was recently recognised at a national level, being named the Australian government ICT Professional Team of the year in the eGovernment awards at CeBIT Australia 2016.
The team also won the Government 2.0 and Overall Excellence in eGovernment category awards, on the back of a related system called the Australian Bleeding Disorders Registry (ABDR). This system built on the organisation’s transformational efforts to deliver a mobile-enabled tool for healthcare data collection, which has proven to be as useful for sufferers of bleeding disorders as it is in helping the NBA optimise its supply chain.
The ABDR, which is regularly updated by patients with haemophilia and other bleeding disorders through an app called MyABDR, is part of the NBA’s reinvention and has proved to be a popular way of collecting day-to-day data about the experience of blood-disorder patients.
Given their low incidence, using the app to reach new populations will increase the volume of data available to researchers, particularly since the NBA is currently rolling out the system to Canadian authorities as well. The Haemophilia Foundation Australia estimates that there are just 2,700 Australian haemophiliacs and some 200,000 people in the country with the genetically linked Von Willebrand disorder.
“Patient registries enable patients and their carers to share data on their health in real time,” says O’Halloran, noting that 90% of those using the registry use the mobile app rather than the web-based desktop interface to enter details of bleeds, medications they take and quality-of-life outcomes.
“Patients record details of bleeds because analysing this data is very important for clinical care and helping clinicians better target their medication levels,” he adds. “Patients are prepared to do many things, and provide a lot of information, if they can see a benefit for their health outcomes – and that’s what the application gives them.
“From a government perspective, it also lets us track what’s happening to A$150m per year of high-cost drugs.”
Meeting the needs of doctors and patients
The widespread praise of MyABDR reflects a growing user focus in the NBA’s technology-driven reinvention, which has also helped BloodNet surge to a more than 90% satisfaction rating among doctors and other medical staff who rely on the system every day in their hospital settings.
Although he admits it’s unusual for government agencies to have 24-hour contact with hospitals, constant consultation with healthcare providers has helped the agency keep BloodNet valuable and relevant in the clinical setting. That’s not always the case.
“No matter what hospital executives say, the reality is that people on the ground are going to do what works for them,” says O’Halloran. “Unfortunately, that often means there is a lot of wasted investment in systems because they don’t meet clinical and patient needs.
“Everything we’re doing with the IT systems and data sensors is aimed at improving outcomes,” he adds. “Users don’t want to bypass the system because it makes their job easier and quicker, and gives them more data.”
Aggregate data collections are feeding an even better understanding of the ideal movement of blood products throughout the country, with desktop modelling able to test the effect of tweaking levels of blood inventory in particular hospitals as demand changes.
Improving the utilisation of this data remains a key focus for NBA’s ongoing application development efforts. The agency will introduce a new environment to manage specialised haemoglobin products – extremely expensive and rare therapies that concentrate haemoglobin from 10,000 patients in a single treatment – across the supply chain.
“Every year, we are rolling out a major new system or a major upgrade,” says O’Halloran. “This also works for our stakeholders if we don’t give them change overload. And we do it on a staged basis, so we can learn from our roll-outs and tweak the approach accordingly as we keep moving forward.”
Read more about Australian government IT
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- Australia’s federal government has published a policy that mandates the consideration of open source software equally alongside proprietary products.