From densely populated Melbourne to tiny rural communities, the 6.7 million residents of the Australian state of Victoria rely on the Department of Health (DoH) for their healthcare needs. The DoH serves more than 300 hospitals and health services throughout the state, including public and private facilities of all sizes.
For many years, DoH relied on Oracle’s Java CAPS (JCAPS) enterprise application integration (EAI) engine to manage healthcare data within and between facilities throughout Victoria. Over time, Java CAPS came to support hundreds of interfaces across 16 agencies that serve millions of patients.
So when Oracle announced it would not support JCAPS beyond Windows 2008, DoH officials concurred that continuing to run JCAPS posed a significant operational risk, and set out to replace JCAPS with Rhapsody.
Meanwhile, the need to share information between agencies was growing, particularly as DoH worked towards statewide initiatives like My Health Record, improved care coordination, and other programs charged with improving how residents access and manage their healthcare.
DoH needed a solution that could support the growing data volumes, standardize how the agencies used the integration engine, and provide a foundation for future projects with the latest integration technologies, such as HL7 and FHIR.
Each of the 16 agencies had evolved their use of JCAPS in unique ways — and each was using common systems and message definitions differently. Not only was Rhapsody unable to benefit from the anticipated re-use, Rhapsody also delivered optimization and standardization, without the implementation process requiring changes to end systems. Rhapsody’s migration strategy ensured no system downtime when migrating interfaces from JCAPS to Rhapsody and had no impact on patient care.
The Solution: Rhapsody
As the team got to work, they encountered a few surprises. For one, many of the agencies were running significantly more interfaces than originally indicated. Additionally, while each agency was using JCAPS, they had evolved their use and supporting processes in dramatically different ways over time.
The Rhapsody team worked methodically, tackling a few agencies at a time and applying lessons learned to each subsequent agency. Early successes bred trust and confidence, smoothing the way as the project progressed. Rhapsody Project Manager Julie Hainsworth, who managed a large number of the projects, explains, “By the time we got to the latter sites, the teams already knew of our reputation and trusted us from the initial engagement.”
Andrea Kelly, Rhapsody’s Vice President of International Solution Delivery, adds, “They knew we would deliver on time and to an excellent quality level, avoiding the sort of issues that lead to costly project delays.”
All 16 agency projects were completed in the timeframe required by the DoH, even with the impacts of the COVID-19 pandemic. For the majority of the projects, the Rhapsody team worked remotely.
Results: 1. 1 billion monthly messages reliably exchanged, with less IT effort
Today, the 16 DoH agencies are exchanging a combined 1.1 billion messages per month through Rhapsody, with minimal support cases logged since each agency’s go-live.
Zoran Naumoski, Manager of Application & Integration Services at Melbourne’s Austin Health, notes, “Most of our monthly service level reports come back blank — and that’s a good thing. It shows that the product is very stable.”
Standardizing the agencies’ EAI engines has greatly simplified maintenance for each IT team. In one agency where a complex interface had ballooned to more than 1,000 lines of code, the equivalent Rhapsody replacement had just 50 after non-executed code was removed and optimization applied.
Rhapsody’s Andrea Kelly explains, “We were able to take everything that had been done over 10 to 15 years, by different people, and standardize it all to Rhapsody best practice. That consistency provides a massive benefit in terms of efficiency and maintainability.”
This simplicity, combined with Rhapsody’s dashboard monitoring and alerts, allows the IT teams to more easily notice and respond to any third-party system issues that arise. Julie Hainsworth notes that some agencies refer to Rhapsody’s alerts as a “canary in a mine shaft,” notifying IT teams when up- or downstream systems stop sending or receiving messages. With earlier warnings, IT can fix problems before clinicians notice and patient care is affected.
Rhapsody connects to each agency’s core enterprise systems. At one of Victoria’s largest healthcare providers, Rhapsody is connecting their EMR, scanned medical records, referrals, data warehouse systems, business intelligence, and clinical systems, including pathology, radiology, pharmacy, endoscopy, subacute, sleep labs — even the patient entertainment system.
Rhapsody is also connecting patients across agencies throughout Victoria. The interoperability streamlines care coordination through the state-based enterprise master patient index (EMPI) and health information exchange (HIE), the patient-facing My Health Record, and Victoria’s HealthLink eReferrals service.
Rhapsody as the foundation for digital healthcare transformation
Beyond the statewide interoperability goals, each agency is embarking on its own digital transformation initiatives, confident that Rhapsody can handle anything. Rhapsody supports the latest integration techniques, including HL7, HL7 CDA, HL7 FHIR, CSON, JSON, and web services, with periodic updates that will continue to support DoH well into the future.
This empowers IT teams to take on ambitious projects that can transform clinical care.
Elsewhere in Melbourne, Austin Health clinicians who see the results of early integration projects are now approaching IT to improve their own workflows. Naumoski says, “No one likes working from multiple systems. They want all that patient information, the referrals, the notes together in one place. Now that all that data is being integrated using Rhapsody, we’re working with the businesses to digitize more processes.”
Rhapsody’s Julie Hainsworth has encountered similar experiences throughout the state, noting, “Now that the clinicians and the business stakeholders have seen Rhapsody in operation, their demand for integration is increasing significantly. As they realize, ‘Oh, integration can do that,’ now they bring these great ideas to IT. In the JCAPS era, that ability to transform wasn’t there.”
Rhapsody also trained IT teams throughout Victoria to build their own interfaces. Andrea Kelly adds, “We’ve enabled the whole state to be able to use Rhapsody. We’re there if they need us, but they’re very confident in their abilities. They own it. That was our goal: wanting to do a great job so that our customers are successful.”
As the agencies move forward, they’re poised to find new ways to improve care for Victoria’s growing population, connecting residents with health providers and services to improve healthcare delivery — and outcomes.
