Case Study: Canterbury DHB

Improving Patient Flow Through Automatic Allocation of Referrals

THE STORY

With an ageing population, the Canterbury District Health Board (DHB) referral intake centres were under intensifying pressure as numbers and complexities of referrals increased. Strata Health was tasked with streamlining and automating the referral process so that simple referrals could be sent directly to the most appropriate service provider. Consequently, freeing up the central intake centres to better manage the remaining small fraction of complex referrals.

THE GOALS

• Maintain equal market share amongst providers with an even referral distribution
• Honour existing provider relationships, catchment areas, and specializations
• Reduce intake provider’s workload, while increasing services and number of referrals
• Increase efficiency; reduce processing and wait times
• Move away from faxed referrals and paper ledgers to become paperless
• Reduce the number of referrals managed hands-on by intake to under 2%
• Provide referral updates and outcomes to senders

THE SOLUTION

Powered by Strata Health’s sophisticated matching algorithms, the streamlined referral process automatically triages referrals coming from primary (and soon secondary) care to providers for the following community services:

• Home-Based Support Services (HBSS)
• Community Nursing – Urban
• Community Nursing – Rural
• Specialist Community Nursing Services
• Falls Prevention Programme
• Medication Management Service
• Older Persons Health (OPH) Community Teams
• Older Persons Mental Health (OPMH) Community Teams
• Community Rehabilitation Enablement & Support Team (CREST)

“One of our Canterbury Health System aims is to support patients to stay well at home and in their communities, using strategies that waste less of their time by ensuring the patient journey is smooth and seamless. Managing referrals from our primary care clinicians and hospitals well is key to making the most of everyone’s time.”

– Carolyn Gullery, Executive Director General Manager – Planning, Funding and Decision Support for Canterbury and West Coast DHBs

THE RESULTS

Immediate impact on intake provider’s workload and market share of Home-Based Support and Community Nursing referrals.

Since launching in December 2019, the Strata Health tool has automatically sent over 4200 GP referrals, while maintaining nearly perfect equal allocation of referrals for the Home-Based Support and Community Nursing services.

Canterbury DHB’s automated distribution process has reduced the burden on intake providers, which previously required staff to process all of the incoming referrals, thereby reducing wait times and improving provider experience through equity.

In the first month, Strata Health was able to automatically direct 40% of referrals to the most appropriate provider. With continuous improvement in the workflow and refinement of the business rules, that number is now over 80%.

THE BENEFITS

• Patients: Reduced wait times and quicker access to time sensitive services
• Intake: Reduced processing burden, leading to complex cases being dealt with more efficiently
• Clinician: Paperless, improved productivity and the ability to track referral outcomes
• Processes: Autonomous and streamlined, reducing bottlenecks and providing great access to care

THE HOW

Strata Health tracks previous and active relationships between patients and providers, going back six months. This history informs the algorithm, setting primary and secondary relationships, which factor into the distribution. In the absence of a relevant relationship and barring other inclusion / exclusion criteria (clinical, catchment, etc.), the referrals are distributed equitably between local providers.

Through a configurable recommendation algorithm, plus a flexible interface engine, Strata Health automated the complexities of the referral pathway and helped Canterbury DHB achieve its goals.

NEXT STEPS

Rural Community Nursing referrals, which are still directed to the intake for distribution, are due to be deployed by the end of 2020. Given the positive impact of the project so far, Canterbury DHB is extending to additional rural service providers to streamline the process across the entire health region.

With any change of process, especially when moving towards an automated workflow, the business rules must be clear and precise. Strata Health first deployed the tool for GP referrals, which account for only 30% of the total community referrals in Canterbury. Both Canterbury DHB and Strata Health wanted to ensure the logic and processes were refined before scaling to secondary care referrals, planned for early 2021.

The ultimate goal will be to automatically allocate 98% of the referrals to the providers with only 2% going to the intakes.

ABOUT STRATA HEALTH

With almost 20 years of experience in the health technology sector, Strata Health is the leading provider of intelligent, digital tools for resource allocation, patient transitions, and patient flow innovation across the care continuum. Strata Health supports healthcare clients on three continents, helping over 12 million patients worldwide get the care they need faster. Strata’s software solutions are improving the healthcare experience for patients, clinicians, and health jurisdictions around the world.

ABOUT CANTERBURY DISTRICT HEALTH BOARD

Canterbury DHB covers an area of the East Coast of the South Island from Kaikoura District in the north, to Ashburton District in the south, as well as the Chatham Islands. It is responsible for the health of an estimated 558,830 people. Canterbury DHB owns and operates five major hospital facilities in Christchurch and Ashburton, and almost 30 smaller rural hospitals and community bases around the region. On top of providing health services to its own population, Canterbury DHB provides many specialized services to people referred from other DHBs where these services are not available. Canterbury DHB is a global leader in integrated care and eHealth, widely recognized for its efforts towards a truly coordinated care system.

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