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Queensland Health partners with Alcidion and Rhapsody to streamline referral management

Customer

Queensland Health

Location

State of Queensland, Australia

Website

www.health.qld.gov.au

Organization type

State public health system

Product

Rhapsody® Provider Registry

The customer:

Queensland Health

Queensland Health is comprised of 16 Hospital and Health Services (HHS). Under the Hospital and Health Boards Act of 2011, Queensland Health is responsible for the overall management of the Queensland public health system. There are approximately 6,500 GPs working across Queensland as well as seven Primary Health Networks.

Annually, Queensland Health providers receive nearly two million referrals for outpatient services. For years, ensuring that high quality information was available in the transfer and continuity of care through the referral process was a challenge.

To combat this, the integrated Referral Management Solution (iRMS) program initiative was created. Alcidion partnered with Rhapsody (formerly NextGate) to deliver the foundational component—the statewide Referral Service Directory—to connect the primary health sector with tertiary referral centers across Queensland.

The challenge:

Increasing the speed at which the voluminous data is synthesized

In 2016, the then-Minister for Health and Ambulances Services for the State of Queensland in Australia convened two Waiting Time Summits to focus on solving the challenges they were facing around waiting lists. The challenge encompasses the whole patient journey – from General Practitioner (GP) referrals to outpatient appointments – while also considering any diagnostic procedures or any surgery and recovery requirements.

Solving the challenge was a major component of the state government’s specialist outpatient strategy aimed at improving the patient journey by 2020, part of the wider My Health, Queensland’s Future: Advancing Health 2026 plan. An investment of $268 million over four years was made by the government to make this strategy a reality.

The strategy covers numerous initiatives, including:

  • Funding for Hospital and Health Services (HHS) to provide more specialist outpatient appointments
  • Empowering GPs to easily manage and track a patient’s referral with consistent referral standards and electronic referral management systems
  • Providing GPs with greater understanding of the specialties and services available to their patients from the local health service
  • Providing patients with greater control over their healthcare through online booking systems
  • Establishing or enhancing alternative models of care, such as allied health and telehealth, to provide patients in rural and remote parts of the state with access to services closer to home
  • Enabling Queensland GPs to have access to real-time hospital information about their patient’s health and treatment needs

The integrated Referral Management Solution (iRMS) program initiative was created to deliver key elements of the Specialist Outpatient Strategy with the program being split into five projects. These five projects were led by four HHSs, with each HHS leading the development and implementation of their project on behalf of the rest of the State.

Key elements of the statewide program were:

  • A state-wide services directory – GPs would have access to an online state-wide directory of public hospital services to better inform and direct their referrals
  • Electronic referral management systems – GP referrals will be submitted by secure electronic messaging to Queensland’s largest public hospitals with the aim to deliver a smarter and an integrated patient referral system

As part of the iRMS program, Queensland Health was looking for a solution which would be scalable across the State whilst still delivering what was required at the local HHS level. The Referral Service Directory (RSD) is a critical foundation component of the iRMS program that creates linkages between other components of the proposed referral processes.

The RSD is an integral element of the iRMS Program and is required to underpin and integrate with other key system elements, including an external referral application with data lineage and tracking application, digital referral workflow application, and business intelligence reporting database.

The solution:

Rhapsody Provider Registry

Upon completion of the tender process, both partners signed a contract with Queensland Health to roll out the RSD as part of the state-wide iRMS program. The Rhapsody Provider Registry, hosted on AWS, facilitates the RSD by providing a source of truth for services, providers and systems that deliver health care across participating Queensland Health. Adopting a new digital approach to the referral workflow meant that the current process needed review. For example:

  • When a GP wanted to refer a patient, they would determine the most appropriate HHS service based on their existing knowledge or a website search
  • When completing the referral, there would be limited controls to ensure the information provided was adequate for assessment
  • When an HHS received the referral, it was reviewed and if the necessary information was included, it was triaged and allocated to the relevant service

The RSD provides the linkage between the referral system at the GP practice and the specialty service provided by the HHS. The RSD holds detailed information about each HHS (disciplines, conditions treated, services offered and capabilities, location, etc.) to help GPs and their systems identify the most appropriate HHS to direct their patients.

The HHS services needed a definition and structure to ensure the solution would achieve the objective of streamlining the referral processes. A comprehensive data model was developed to identify the relevant characteristics and relationships of each service.

At a state level, the partnership has seen the Provider Registry software established as a centralized authoritative regional registry / index that is a source of truth for services, providers and systems that deliver health care across participating Queensland Health care providers, for example, specialists and non-specialist outpatient services.

The RSD provides accurate and timely information to GPs while also allowing them reliable, up-to-date information, about these entities and access to referral information which means more informed decision making, enhanced workflows and increased patient and clinician satisfaction.

“The outcome of the RSD project acknowledges the strong partnership between Queensland Health, Alcidion, and Rhapsody and realizes the benefits of our combined expertise to successfully deliver this key component of the Queensland Health iRMS program.”

Kate Quirke

Alcidion, Managing Director

The results:

State of Queensland leverages Rhapsody Provider Registry to create integrated Referral Management Solution to streamline referrals for over 65,000 general practitioners.

Queensland Health implemented a statewide Referral Service Directory (RSD) to support its General Practitioners (GPs) with the most accurate, up-to-date provider information. The RSD solution, hosted on AWS cloud, ensures data is available to be shared as part of the electronic referral process.

This new solution streamlines referral processing and gives Queensland Health the ability to better assess waitlist times and direct referrals accordingly. This has resulted in a decrease in referral denials and improved patient and provider satisfaction.

The standardization of the information included in referrals has boosted the speed of triage so a timelier and more effective patient care can be planned and delivered. This has also facilitated better communication with the patient’s usual GP regardless of the provider issuing the referral.

“Made possible through our partnership with Alcidion, we are delighted to support Queensland with an accurate, up-to-date RSD to give GPs and other providers timely, reliable access to referral information for improved clinical effectiveness and workflow efficiencies,” said Gevik Nalbandian, vice president of software engineering at Rhapsody.

He continued, “We believe this foundational capability will continue to deliver benefits to the delivery of healthcare in Queensland well into the future.”

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