Outpatient and Clinic Services across Australia are ripe for change. An accelerated uptake of digital health technologies, shifting cultural attitudes and a drive to focus on the patient experience mean the ‘status quo’ is no longer an option for many Outpatient and Clinic Services. 

Outpatient and Clinic Services are an important part of the health system. When managed effectively, they can reduce demand across the system and streamline access to acute care for the community, supporting patients to access healthcare as they need it. However, the well-known systemic pressures on the healthcare system, such as the ageing population, increasing rates of chronic disease, and rising patient expectations, set a challenging backdrop for Outpatient and Clinic Services. 

With demand for Outpatient and Clinic Services increasing from 34.9 million non-admitted patient service events in 2014-2015, to 39 million in 2018-20191, it’s clear that a combination of external pressures and internal challenges are driving healthcare leaders responsible for Outpatient and Clinic Services to consider how they can adapt to meet this rising demand and improve the patient experience.

What we have learned from working with healthcare organisations

Digitisation is an enabler of Outpatient and Clinic Services improvement, supporting healthcare organisations to manage demand, meet state-wide reporting requirements,2-4 and help deliver an improved patient experience. 

Here are some of the insights we’ve gained from the digitisation projects we’ve been involved in:

1. The patient experience is paramount

The patient experience should be at the centre of attempts to improve service delivery, including through digitisation. Understanding the patient experience and journey, can help you organise your Outpatient and Clinic Services, leading to maximising efficiencies and utilisation.

Consider how technology can support patients to manage how and when they receive care, communicate essential information to patients both before and after their care experience, and reduce Did Not Attend/Failure to Attend rates.

2. Improvements start with primary care

When considering how to improve Outpatient and Clinic Services, starting with referrals from primary care helps to consider the full patient journey. By empowering GPs to deliver appropriate referrals through health information portals or questionnaires to build the relevant information required for effective triaging creates multifaceted benefit. Overall, this leads to better management of referrals and demand for Outpatient and Clinic Services.

3. The needs of the clinical teams must be met

Clinical teams increasingly expect a level of digitisation and recognise the inefficiencies of manual processes. Digital solutions need to support your processes, promote ease of use and deliver the required level of functionality, so your clinical teams can focus on managing and providing care. Digitising is not just about automating manual processes but using technology to innovate on ways of working to create further efficiencies.

4. Interoperability enables visibility of the patient journey and better connects your Outpatient and Clinic Services

Assessing for interoperability between existing and potential future investments for Outpatient and Clinic Services can enable an interconnected digital health infrastructure between your Outpatient and Clinic Services and the rest of your organisation.5 

Your clinical teams can view the overall patient journey (for example, when an inpatient transition to an outpatient), access accurate and historical clinical information, proactively manage the department and improve service delivery. Solutions that are based on open technology standards rather than proprietary technology standards can help you secure your investment over the longer term.

5. Using virtual care solutions to transform the way care is delivered to your patients 

Virtual care solutions can help transform the way care is delivered in Outpatient and Clinic Services by enabling equity of access to care, help explore new models of care delivery and ultimately reduce travel / wait times, and costs for your patients. Identifying, prioritising and methodically addressing the existing inefficiencies within your clinic and redesigning your processes to align with virtual models of care in Outpatient and Clinic Services is a great place to start. After setting the foundations for virtual models of  care, you can then maximise the benefits to be gained.6

How to start your digitisation program

Based on our experience, we believe healthcare organisations should start their Outpatient and Clinic Services digitisation program by considering the following focus areas:

How to start your Outpatient and Clinic Services digitisation program

1. Define pragmatic objectives for digitisation

Why?
Defining your objectives help you, your stakeholders and program resources clarify what needs to be achieved. This helps with planning your digitisation project, as well as assessing the extent to which objectives have been met following implementation of the technology.

How?
Start by considering the areas for improvement and where digitisation can enable those improvements. Then consider how your program will contribute to your broader organisational strategy, and the patient journey, to determine the priority areas. For example, consider the following questions when developing program objectives:

  • What are our aspirations for Outpatient and Clinic Service digitisation
  • What problems is the digitisation program seeking to address?
  • How can we improve the patient and the clinical teams’ experience?
  • What are our funding requirements to help us achieve our objectives?
  • Will our approach help us to meet state and territory guidelines for Outpatient and Clinic Services?
  • What have others done and what lessons can we learn from them?
  • How will we measure improvement?

2. Collaborate with the right partners

Why?
Finding a partner (or a group of partners) with expertise, solutions, tools and capabilities, can improve your chances of success. 

How?
Assess potential partners alignment to your strategic goals, organisational footprint, partnership structure, and prior evidence-based Outpatient and Clinic Services transformation experience.


3. Keep the patient experience in the forefront of digitisation

Why?
Digitisation is not an end in itself – meeting patient needs, and expectations should be the focus, both in terms of improving patient experience and outcomes, and delivering patient-centric care.

How?
Engage with patients during the design process to understand their needs. You could do this through focus groups, design workshops, patient interviews or patient ‘tag alongs’. Once the solution has been implemented, support patient engagement components with an effective marketing campaign to increase adoption; and consider further engagement to understand the impact on the patient experience and the extent to which improvements have been achieved.


4. Understand the needs of your clinical teams and colleagues in primary care

Why?
You will be able to develop a solution that meets the needs of your clinical teams and key partners such as primary care, achieve buy-in, and increase adoption of the solution.

How?
Engage your clinical teams and key stakeholders such as GPs early in the project and provide ongoing opportunities for them to discuss how workflows and processes can be redesigned and effectively supported by technology.


5. Drive rigorous governance across your program

Why?
Having rigorous program governance increases the chance of program success. It enables clear decision making, effective communication between key stakeholders, and helps you control program outputs and outcomes.

How?
Develop a governance framework for your digitisation program at the outset – with clear roles, responsibilities, accountabilities, and information flows among program stakeholders. Consider how program governance will report into existing organisational governance structures.


6. Target incremental improvements

Why?
Targeting incremental improvements lets you manage the impact on the clinical and administration teams and changes to processes and workflows, to minimise disruption and manage change fatigue.

How?
Consider how you can digitise using an agile approach, that focuses on delivering improvements to your service and incremental process changes that’s supported by technology. 

Understand what other digitisation initiatives are happening across your organisation and make sure your approach is aligned to the broader organisational approach and supported by effective change management.

This blog article is informational in nature and is not intended to be a substitute for professional advice.


References

Australian Institute of Health Welfare, 2018-2019, ‘Non-admitted patients’ https://www.aihw.gov.au/reports-data/myhospitals/sectors/non-admitted-patients

Victoria State Government, 2020, ‘Access to specialist clinics in Victoria’ https://www2.health.vic.gov.au/hospitals-and-healthservices/patient-care/specialist-clinics/access-policy

NSW Health, 2019, ‘Outpatient Services Framework’ https://www1.health.nsw.gov.au/pds/ActivePDSDocuments/GL2019_011.pdf

Western Australia Health, 2016, ‘Specialist Outpatient Services Access Policy’ https://ww2.health.wa.gov.au/About-us/Policy-frameworks/Clinical-Services-Planningand-Programs/Mandatory-requirements/Outpatient-Services/Specialist-Outpatient-Services-Access-Policy

Moritz Lehne, Julian Sass, Andrea Essenwanger, Josef Schepers and Sylvia Thun, 2019, “Why digital medicine depends on interoperability”, Journal of Digital Medicine

Linda Sturesson and Kristina Groth, 2019, “Effects of the Digital Transformation: Qualitative Study on the Disturbances and Limitations of Using Video Visits in Outpatient Care.”, Journal of Medical Internet Research

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