Dental Firm Uses Hybrid Cloud Solution to Address Patient Records Challenge
Enabling different health service providers to seamlessly share patient data is one of the great IT challenges of today. Dental Corporation has pioneered a low-cost, minimal-disruption approach. By using a hybrid, cloud-based integration tool, Dental Corp allows its 220 practices to keep their preferred information and management systems, while extracting all the data it needs to develop smart services. With minimal intervention, the firm is building proactive, firm-wide, patient-focused healthcare.
"We’re taking the concept of intelligent, life-long healthcare a solid step forward, because one part of healthcare always knows what the other is doing."
Having grown rapidly, Sydney, Australia-based Dental Corporation struggled to consolidate finance and patient information from its 220 individual practices. Executives wanted seamless access to practice data to improve financial control and develop better patient services. Each practice used its own health records and finance system, however, and imposing a standard system on each practice would create enormous disruption.
In 2013, the firm teamed with cloud-solutions integrator, Breeze, to devise a fundamentally new approach to creating common electronic health records. By placing a simple data-extraction product on each practice network, Breeze developed a solution that draws all finance and patient data onto an integration database hosted by Windows Azure in the cloud. Breeze consolidates the data and sends standardized reports to Dental Corporation.With one of the first hybrid cloud solutions in the Australian health services industry, Dental Corporation and Breeze have broken new ground in health service systems integration. The solution leaves medical professionals with their own preferred systems, while generating the data Dental Corporation needs to make its businesses more efficient, and its patient services more flexible, accommodating, and proactive.
By sharing patient data in a way that results in minimal disruption, Dental Corporation is helping to pioneer seamless collaboration between health services organizations. And because the data integration function is hosted on Windows Azure, the solution requires little capital investment and is instantly scalable. Impressed by the concept, the firm’s parent company plans to adopt the solution to help build its integrated patient-care services.
The great electronic health records challenge
For almost two decades, the biggest challenge in health services IT has been how to make health records easily accessible to multiple healthcare providers. The goal is to create electronic health records that seamlessly follow patients from their local doctor, to consultants, to hospital admissions and therapists. The traditional approach involves some level of enforced standardization, but a fundamental problem remains for insurers and governments alike: how do you get disparate care organizations to use the systems that best suit you?
One company tackling the problem in a radically different way is a private Australian firm, Dental Corporation. Founded six years ago in Sydney, Dental Corporation has acquired 220 dental practices in Australia and New Zealand, and 50 in Canada. Dental Corporation takes responsibility for accounting, payroll, support staff, equipment, and maintenance, leaving dentists to focus on patients. The model is proving highly successful, but every time Dental Corporation acquires a new practice, it also acquires different practice-management systems.
“I arrived at Dental Corporation in October 2012 and my chief task was to figure out how to get all these disparate practice systems to talk to our head office,” says Kellie King, Executive Manager for Group Business Systems and Services at Dental Corporation. “Financial data arrived at head office in a myriad of formats, from email to spreadsheets. We needed 15 staff members to manually transfer the data, and even then we took six weeks to compile company month-end reports.”
For King, there was also a bigger picture—patient health. At the head-office level, managers knew very little about their patients. But King’s colleagues believed that just as in any business, the route to better services lay in customer knowledge. “We wanted to build an electronic picture of every patient’s dental health and habits: where they went; what they had done; how regularly they visited a dentist. If we could build more comprehensive patient health records, we could deliver better healthcare, but we could also turn from being a reactive to a proactive service provider.”
Leaving health providers with their own systems
King’s preference was for each dental practice to use one standard, networked application. Experience told her this was unrealistic. “Our dentists are very much attached to their own practice systems,” she says. “They usually adapted them for scheduling and staffing, as well as for finance and patient management. They liked their own systems, which worked efficiently. So I was facing a lot of backlash unless I found a way of getting the data I needed while leaving existing systems alone.”
King had a clear vision of how data should flow, rather than an actual solution. “I wanted something that could take data from existing practices without disruption, and then turn it into standard formats that could be understood by our databases.”
King contacted Microsoft Partner Network member, Breeze, a leading Sydney-based integration firm that specializes in using the cloud to solve complex challenges. “Kellie has a reputation for visionary thinking and her approach was unorthodox,” says Nicki Page, Chief Executive Officer at Breeze. “She didn’t want to define the solution at the outset; her goal was to create possibilities.”
With help from Breeze, King eventually resolved on a hybrid cloud model to enable Dental Corporation to extract essential data from each practice without altering their existing systems. Breeze would install Cloud Data Manager on each practice network. This product contained a data-extraction program coded in .NET that allows the appliance to identify activity on the practice network, replicate changes, and forward them via a URL to a service bus, hosted in the cloud with Windows Azure.
The service bus consists of a data-processing engine, powered by Microsoft BizTalk Server 2013 that integrates all the practice data. Then the data is staged, cleansed, and consolidated before being formatted into standard reports and sent from Windows Azure to a database at the Dental Corporation head office.
Because all the data integration occurs in the cloud, the solution is easy to expand. “The point is that our solution is cookie-cutter,” says King. “We put our energy into mastering the basic principle involved: an integration layer that is so flexible we can bolt it into any practice. Now, we can go into each dental practice and install one small appliance that the professionals don’t even notice. It means we can search for and extract all the data we need to run a multipractice health business—including patient records.”
Forging a single business from multiple practices
By September 2013, Breeze was stepping into each dental practice to install its network appliance. “It proved very easy to roll out and achieved exactly what we wanted,” says King. “At the dentists’ level, there was absolutely no pain, and therefore no resistance. And with the integration layer hosted by Windows Azure in the cloud, we can scale up without costly, large-scale IT projects—we are bringing practices in at a rate of 10 per month.”
Although King’s focus was on building potential capabilities, practical needs were immediately fulfilled. The first was consolidated financial reporting. With Breeze’s service drawing financial data from each practice, Dental Corporation can generate profit and loss accounts for each practice and consolidate them into firm-wide, month-end financial reports.
“The solution gives us far greater financial transparency,” says King. “We’re not just restricted to the reports that Breeze generates, however. We can interrogate the data, right down to the level of individual invoices processed within a practice. Now, we can see what is happening in each of the businesses we acquired. Once we get all the data into our own enterprise resource planning system, we will have a single source for all business reporting—exactly as if we had put our own systems into each and every practice.”
Making big health firms easier to manage
Another immediate beneficiary is the dental practitioner. Most join Dental Corporation because they want to be free of the administrative and commercial aspects of dentistry and focus on their patients. By connecting dentists with minimal fuss and leaving them in control of their preferred, established systems, Dental Corporation makes its business model more appealing.
The solution devised by King and Breeze is now attracting attention outside of Australia. In May 2013, Dental Corporation was acquired by the large, UK-based private health company, Bupa. According to King, this technical solution has generated intense interest. “We have instantly become a role model,” she says. “This is a perfect example of how a solution from one part of a business can be picked up and used elsewhere.”
In King’s view, the solution has the power to transform healthcare. She observes that governments and insurers have been struggling to get disparate healthcare providers to use standardized systems for decades. Without them, she points out, they cannot bring to healthcare the speed and responsiveness that integrated systems bring to business. “I know we haven’t solved the problem, but perhaps we don’t have to,” she says. “With this solution, we let each practice carry on using their software as long as they like.”
Intelligent, predictive healthcare
The new approach to practice integration heralds a potential revolution in patient care. “We have built a solution that doesn’t just reach into each practice, it goes all the way to the patient,” says King. “A patient can visit any of our practices and the dentist will have instant access to all relevant information. The usefulness of this data is the limits of your imagination.”
According to King, the healthcare industry is constantly striving to improve links between its different health units—the local doctors, hospitals, consultants, and therapists—so that each provider can seamlessly collaborate on a patient’s behalf. “We’re taking the concept of intelligent, life-long healthcare a solid step forward, because one part of healthcare always knows what the other is doing.”
King plans to go one step further. If a health organization can gain a sufficiently broad understanding of each patient, King believes it should be able to anticipate individual health needs. That would enable healthcare to become more proactive. “We haven’t created that solution, but we have created the raw capability to enable it to happen,” says King. “When it does, medical practitioners can start to realize the benefits of patient-focused, preventative medicine in ways that are impossible today.”