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New South Wales Health

Accenture Helps New South Wales Health Transform Health Care Delivery and Achieve High Performance
Located in the southeastern Australia state of New South Wales (NSW), NSW Health is one of the world's largest health service organizations. Serving a community of 6.6 million people, NSW Health has approximately 100,000 employees and a budget of more than AUD$10 billion (or approximately US$7.5 billion). Through a network of eight Area Health Services, NSW Health is committed to improving the health of the people of New South Wales, providing high-quality patient care and equitable access to health services, and continually enhancing the effectiveness and efficiency of health care service delivery. Business challenge Accentures ongoing research into the characteristics of high-performance businesses in the health care sector reveals that many top performers adopt a patient-centered connected health paradigm, which not only places the patient in the center of all health issues, but creates an environment that promotes sharing insights and information to improve outcomes.

This commitment to patient-centric health care and information sharing requires mastery of several core capabilities, including the ability to integrate and effectively use clinical data. In its efforts to achieve high performance, NSW Health recognized the need to capture, track, monitor and use clinical information to promote better patient care and hand-offs from one health care area to another. NSW faced a major problem in that each of the organizations Area Health Services had implemented its own methods and systems for managing clinical processes and patient information. This made it difficult for NSW Health to gain an enterprise-wide view of its systems, reduce risk, increase integration and improve information sharing within and across each Area Health Service (and between the Area Health Services and third parties and, ultimately, patients). NSW Health knew that it was just a matter of time before these disparate clinical information models would impact the organizations ability to provide optimal health care services. To build its patient-centric connected health capabilities, NSW Health decided to launch an Integrated Clinical Information Program (ICIP), which would satisfy a number of important goals. It would enable common standards, systems and capabilities across the Area Health Services. It would enable the acceleration of core clinical system deployments across NSW. It would support clinicians in providing high-quality and safe care at all stages of the patient journey. And it would also provide a strong foundation for the organizations move to a model of clinical information management and patient care based on the use of electronic health records. For help in designing an enterprise architecture framework and implementation plan that would underpin the Integrated Clinical Information Program (ICIP)and, ultimately, the electronic health records programNSW Health turned to Accenture. There were several reasons for this choice. Accenture has deep industry skills, insights and proven practices that help health care organizations optimize health care delivery and patient outcomes. In addition, Accenture advocates an innovative patient-centered connected health approach that focuses on reengineering systems and processes based on patient needs and patient flows, rather than on organizational structures or departments. This model helps connect far-flung health care enterprises and enables them to overcome a broad range of challenges to achieve high performance.

How Accenture helped Accenture had already successfully applied its patient-centered connected health approach to help NSW Health tackle access block, defined as the percentage of patients admitted via emergency services that waited more than eight hours for an available inpatient bed. Within NSWs Hunter New England Area Health Service, Accenture worked with the organization to develop and implement a multi-year program that aligned patient services, care and support processes, as well as enabling technologies, around specific patient journeys. Among the many benefits resulting from this program, Hunter New England Area Health Service reduced access block from 47 percent to 22 percent, despite increased admissions. The solution also reduced patients average hospital stay by two to four days, reduced xray completion times from 60 minutes to just 14 minutes and improved pathology completion times by 30 percent. Given these accomplishments, Accenture was asked to help implement an Access Block Improvement Program across 10 major hospitals in Sydney. Again, the results were dramatic. Access block in the majority of hospitals dropped significantly, in some cases by as much as 45 percent. Length of hospital stay also declined between one and seven days, depending on medical ward.

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Buoyed by these successes, NSW Health asked Accenture to help roll out an Integrated Clinical Information Program (ICIP) solution across the remainder of the state. Accenture quickly teamed with NSW Health to conduct an Integrated Clinical Information Program architecture review, which helped the organization articulate its business objectives. The Accenture/NSW Health team began by identifying and consolidating organizational priorities into four major strategic areaseach with specific measures aligned to key performance indicators and each supporting a set of clinical applications that would become core components of the to-be architecture. The four areas included: Easier patient access to high-quality care Accelerated and improved clinical decision making and information sharing across settings More effective patient flow management Improved management accountability Key findings from the current-state assessment revealed that the existing ICIP governance model and investments were not aligned with a long-term architecture direction, clinical outcomes or a defined business strategy. Existing IT structures also posed a problem. Integrated Clinical Information Program systems used different combinations of software hosted on different platforms, resulting in blockages in the patient journey. In addition, the existing infrastructure was simply too complex, inflexible and costly to operate. Finally, the assessment evaluated NSW Healths Integrated Clinical Information Program implementation capabilities, determining that they were uneven, too costly and too slow. Armed with these assessment results, Accenture helped NSW Health design a goal state architecture that included: A clear business strategy and flexible architecture that mapped ICIP programs, funding and performance measures to clinical priorities and patient-centered, connected health outcomes. Governance processes that balanced front-line business needs and priorities with shared standards and a common architecture. An implementation strategy that accommodated different deployment and support models. Further, Accenture recommended a pragmatic, phased deployment plan for the Integrated Clinical Information Program architecture that would ultimately build a common level of capability across the state.

High performance delivered With Accentures help, NSW Health now has an ICIP, enterprise architecture framework that clarifies the organizational vision for clinical information management and defines the implementation strategy for this vision over the next five to seven years. Specifically, Accenture provided a clear understanding of the components needed to realize NSW Healths Integrated Clinical Information Program patientcentered connected health vision, a flexible clinical systems framework and a roadmap that will enable NSW Health to realize returns more quickly. Accenture also provided recommendations through which NSW Health can best achieve its ICIP vision.

2005 Accenture All rights reserved.

The recommendations included: Establishing an area-wide patient repository to support shared access to medical records among clinicians. Implementing a distributed health service provider directory for better patient access and support referrals between services. Deploying a single, area-wide clinical information system to enable improved clinical decision making. Building a strong integration capability and common interface to manage clinical information within and among area health services. Managing patient flows and information availability within and across settings via supply and demand tools and key performance indicator scorecards. NSW Health is now implementing the proposed recommendations, which will allow the organization and its stakeholders to realize a number of benefits. Patients will enjoy improved access to health care and better service. These benefits will be based on improved information-sharing among caregivers, a focus on streamlining the patient journey and tools that enable clinicians to make better and faster treatment decisions. Clinicians will be able to better identify and care for patients, access relevant patient history more easily, save time and coordinate clinical information sharing more effectively. And NSW Healths management will be able to improve patient flow, improve planning and configuration of clinical services, support front-line accountability, and establish better forecasting and demand management practices. By tapping Accentures insights, capabilities and best practices in these areas, NSW Health is well on its ways to achieving its vision for integrated clinical information management. It is also laying the foundation for a move to an electronic health record model of delivery, which will further improve efficiencies and quality of treatment in a connected health care environment. In short, through its long-term collaboration with NSW Health, Accenture is helping the organization take a significant step on its journey to high performance.

About Accentures Health Industry Practice Accentures health service group provides innovative solutions to both the private and public sectors of the health care industry, including integrated health care providers, health insurers, managed care organizations and public health organizations. The company has thousands of resources dedicated to helping organizations in the health industry achieve and sustain high performance. About Accenture Accenture is a global management consulting, technology services and outsourcing company. Combining unparalleled experience, comprehensive capabilities across all industries and business functions, and extensive research on the worlds most successful companies, Accenture collaborates with clients to help them become highperformance businesses and governments. With approximately 177,000 people serving clients in more than 120 countries, the company generated net revenues of US$21.58 billion for the fiscal year ended Aug. 31, 2009. Its home page is www.accenture.com.

2005 Accenture All rights reserved.

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