Ambulance Victoria deployed a data solution Telstra helped deliver in 2014 to gain better visibility on bed capacity in hospitals across the state. This solution enabled Ambulance Victoria and its service Adult Retrieval Victoria (ARV) to connect patients in ambulances with the right hospitals for the care they need faster and more efficiently. It also freed ARV’s clinical coordinators and retrieval specialists - who handle around 4,000 cases annually with 150 hospitals across the state - from the time and effort required to manually perform individual hospital surveys for bed capacity.

“The old system we were using provided no real-time functionality. Frontline workers did not have a clear overview of an open patient case and data was potentially out-of-date, as the system needed to be manually refreshed after new information was added,” said Jason McClure, Director, Adult Retrieval Victoria.

As the COVID-19 pandemic started to surge around Australia, Ambulance Victoria needed more than data on bed capacity - they needed to be able to track and monitor the number of ICU beds, ventilators and other equipment, patient status, and personal protection equipment (PPE) available. The early investment in technology presented an opportunity for Ambulance Victoria to meet new challenges by building on the original solution and explore the latest technology to fill in the gaps.

If successful, the new solution had the potential to help provide early intervention for and save more lives not only in Victoria but across the country.

Key issues

• Lack of up-to-date data. Regularly updated, accurate data is critical in ensuring patient health and welfare—and Ambulance Victoria needed a system to see, in real-time, bed and resource capacity to efficiently get people to the right hospital for the right treatment. Getting this right is a matter of life or death for critical patients.
• Inflexible technical system. The initial web-based system that Ambulance Victoria used was hosted in their data centres, making it difficult to scale and expensive to run.

Solution

Telstra Purple built the Retrieval and Critical Health (REACH) Information System to help make connecting a patient with a hospital for the right level of care a simple and effective process. The platform is a real-time, web-based bed occupancy reporting tool that provides a statewide and hospital-level view of critical care and incident-specific bed capacity.

The system had to be built with the user at the centre, so Telstra Purple worked closely with Ambulance Victoria, as well as doctors, nurses, ambulance officers, and other frontline workers to build a real-time dashboard that addressed their needs – with the upmost care taken to design for optimal usability.

As COVID-19 surged nationally, the Australian Government sought healthcare solutions to help monitor the situation and manage patients and resources more effectively. The Australian and New Zealand Intensive Care Society (ANZICS), with support from the Federal Government, eventually chose the REACH platform as the best existing platform that could be redeveloped to meet the urgent need for a reliable solution.

ANZICS, Ambulance Victoria, and Telstra Purple worked together to utilise the REACH platform’s IP and expand it to capture additional data required for a more effective COVID-19 response. The solution was required to provide a national view of critical equipment for intensive care, including PPE, available hospital beds, and the number of ventilators for critical and non-critical use.

“Having a dedicated tracking system means we can strategically analyse and plan for the likely impacts of a disaster event, helping frontline workers efficiently distribute acute and critical patients to the right hospital with the right resources," said Jason McClure, Director, Adult Retrieval Victoria.

With REACH originally built on-premises, scaling the solution required an agile, cost-effective platform for the necessary application migration and modernisation - Microsoft Azure was selected for its security and compliance features, supported by its Canberra-based datacentre.

As part of the process we:

• Ran an assessment of the on-premises solution REACH
• Undertook a series of refactoring to clean up the code, ensuring not to break any of the original application’s critical integration points
• Revised the data structure to allow for multi-tenancy use
• Implemented the appropriate security access controls to address the different access levels such as federal, state and hospital users
  

Telstra Purple used the power of Microsoft Azure platform including the following services:

• Azure DevOps for build and deployment
• Azure App Services with staging slot for production
• Azure SQL Server managed instances
• Azure KeyVault
• Azure Front Door to secure the application
• Azure Storage
• Azure Monitor
• Azure Application Insights
• Canberra-based Government datacentre to adhere to government compliance
  

Within just seven days, Telstra Purple was able to scale out the REACH platform, leading to the launch of the new Critical Health Resource Information System (CHRIS). The result is a cloud-native application on Microsoft Azure, built entirely from PaaS offerings to power the engine behind the application and support the demand for Australia and New Zealand.

Outcome

CHRIS enables health services, the Department of Health, and all related third parties in Australia and New Zealand to record and track suspected and confirmed COVID-19 patients in real-time. Having a view of where patients are and where they are being transported helps all involved parties to be adequately prepared while keeping everyone safe.

Through the expansion of this service, CHRIS now provides visibility of public and private intensive care resources across the country as well as managing surges in demand ahead of time.

• 191 active hospitals and growing. Sixteen hospitals used the REACH platform initially, but a week after the CHRIS launch, 60 hospitals were using the new platform. In two weeks, an additional 191 hospitals started using CHRIS, with the number growing daily
• Joining the platform made fast and easy. Telstra Purple automated the process for joining the CHRIS platform, allowing ANZICS and Ambulance Victoria to support new hospital profiles in minutes, with minimal effort.
• Excellent usability. All hospitals that have adopted CHRIS were able to use the platform “right out of the box”—intuitively and without additional training. Feedback from frontline workers is positive: nurses report that it is extremely easy to use, with simple screens for data input and real-time results available to all users.
• Equity of care. The REACH and CHRIS platforms helped enable Ambulance Victoria and ANZICS to bring patients to the care they need and resources where they are needed. With a national view of critical resources, facilities, and equipment, more lives are saved by connecting people and hospitals to what they need in the shortest possible time.