Researchers at Imperial College released a report last year that stated NHS trusts are using at least 21 different electronic medical records systems which are unable to effectively share information. This means that the transfer of data from one system to another still heavily relies on manual processes. And whilst huge progress is being made with standards such as FHIR to help solve this challenge, direct data transfers may not always be possible. This was the case at Croyden University Hospital for this particular process. If we are to meet the interoperability goals then we should also be considering the role that process automation can play. The results achieved at Croyden are very promising.
‘Bots process mother and baby registrations six times faster than a human worker’
Peter Norris, Head of Integration at Croydon University Hospital, part of the Croydon Health Services NHS Trust, is a lead figure in the organisation’s interoperability strategy. He has been working with the Urgent Care at Home team to look at ways of supporting improved interoperability, alongside technologies that may help to reduce the risks associated with a critical process being supported by a specialised team that has no current fallback option.
One area which has been under recent review is how they process the details of new births into the relevant systems to support both acute and community interactions with mother and baby. They jointly identified that the information flow, content and its use, and the technology capabilities of the incumbent computer systems were such that it would not be possible to use a direct data transfer interface to fulfil the needs.
The Child Health Services team within the Urgent Care at Home have a responsibility to ensure all new mothers and their babies are seen by a member of the team within 24-48 hours of the birth. In order to allocate a care-worker to a patient, the mother and baby must be registered on the Patient Administration System (PAS) used by UCAH staff, and the required associated referrals added.
“The importance that this first stage happens on-time cannot be understated. Failure to do so will result in delayed appointments, exposing mother and baby to possible clinical risk,” Peter said.
Currently, this process is supported by the limited number of team members within the Child Health services. Having only a small dedicated team poses risks and challenges, and the working patterns of the team are such that time available for the task is limited.
Peter continues, “Even with the best of intentions, unforeseen factors such as illness, or staff unable to get to work for any reason (both of which could potentially affect one or all members of the admin team), processing the registrations and referrals can be impacted. Whilst the registration process is rules-based and methodical, it is also complex. Getting supply-staff to quickly understand it and complete the workload on-time and accurately would not be viable.”
Peter was in contact with Cloud21 who, as part of their portfolio, provide interoperability consultancy. One of the technologies for interoperability that they did not have in their existing toolkit was an process automation tool that supported application control. Process automation, is the term coined for the technology approach to automating the control of a computer. This technology allows users to train a software based “robot” to move a mouse cursor, press buttons, type text, read from screens and images, and interact with key productivity software and existing applications.
Due to the repetitive rules-based and methodical, albeit complex nature of the registration process, the investigation into whether this could be automated began.
The object of the registration process is to receive a spreadsheet of new births from a central resource, and for each new birth to be registered on EMIS Community Web, the incumbent Community PAS. Each row within the spreadsheet leads to the registration of mother and baby, a referral being added for both, the recording of the birth details, and finally record the relationship between mother and baby. This process is a multi-stage workflow involving decisions based on the outcome of prior steps.
The PAS is used and updated by multiple teams across the Croydon Health Services departments, so it is possible that:
- The mother and/or baby could already be registered;
- An active referral record for the mother and/or baby could already exist;
- Postcodes to identify the appropriate community team may not match.
The team explained that it took on average 10 minutes to process one row, and due to their Monday to Friday work schedule, meant a much larger task on a Monday morning to catch up with the weekend births.
Peter and Cloud21 worked jointly to train UiPath’s process automation solution to undertake all steps in the current process, allowing all appropriate records in the supplied spreadsheets to generate the appropriate tasks within the PAS.
Initial testing showed that a single work-item took approximately two minutes to complete. The variation of completion time depended on whether the data required the automation all or just some of the steps for each patient. Based on feedback from Peter, it was suggested that the robot was seen to be able to undertake the data evaluation and subsequent input at least six times faster than a human worker can per item.
“As soon as development started, our process automation solution rapidly took shape. Cloud21 delivered a robust and reliable automation of a vital workflow, ensuring that all new mothers and their babies will get the important follow-up appointments within the required timeframe. Additionally, the robots’ accuracy with speed of throughput will prove invaluable in many other key areas in our organisation.”
Peter continued, “As we continue to look for ways of increasing efficiency without detriment to services, process automation has clearly demonstrated itself as the way forward, and the UiPath platform has shown us a world of possibilities. This is certainly an exciting time for us and process automation.”
How was this achieved?
Cloud21 spent three days with Peter to scope the process and train the UiPath platform to undertake the process to achieve the successes needed. We used the freely available community edition of UiPath to support the introduction into process automation using the solution at a zero licence cost entry point. The team were able to utilise an existing standard-imaged PC to achieve both the training and execution of the automated process for this introduction purpose.
Could your organisation spare a computer and three days to support a goal of your interoperability strategy?