Case study – National Blood Authority
BloodNet LIS Interface
The BloodNet LIS innovation is an integrated supply chain management platform for Australia's critical blood stocks. It utilises a bi-directional interface between the various pathology laboratory information systems (LISs) used in Australian hospitals and BloodNet, the supply chain management system developed and operated by the NBA.
Globally unique, the interface automates the real-time exchange of hospital blood inventory levels and the status of each unit, freeing up hospital pathology laboratory staff from laborious double and triple keying of critical data allowing them to respond to patient needs in a more timely and efficient manner. The data that is now collected, processed and managed in accordance with the agency's Information Governance Framework, enables the NBA to more accurately predict supply shortages, respond to product shortages and to perform real-time benchmarking across the Australian blood sector.
The National Blood Authority (NBA) is a statutory agency within the Australian Government Health portfolio that manages and coordinates arrangements for the supply of blood and blood products and services on behalf of the Australian Government and state and territory governments. The key role of the NBA is to provide an adequate, safe, secure and affordable supply of blood products for all Australians. In undertaking this role, the NBA administers an annual budget exceeding $1 billion.
The concept for this innovation arose following feedback from users of BloodNet after a post incident review of the activation of the National Blood Supply Contingency Plan which identified a need to collect real-time inventory level data from hospital laboratories in times of blood supply shortage without impacting on the workloads of those already under stress in managing such situations.
The objective of the project was to ensure the reliable, real-time capture, processing and ongoing management of critical information relating to the blood inventory levels of all Australian hospitals. This was delivered in a manner that is compliant with the relevant software standards, the NBA's Information Governance Framework and the requirements of the Archives Act.
The project was carried out in 2 broad phases.
Phase 1 (now complete) involved a Proof of Concept trial with three laboratory information systems (LISs) – namely eBlood, Ultra and Auslab. The purpose of this was to undertake technical investigations, feasibility assessments, determine the governance arrangements of such interfaces; and to develop and implement the interfaces. The active engagement of the NBA’s Information Manager and team throughout this phase enabled the NBA to deliver a system that was designed from the beginning to meet the requirements of the Archives Act.
Phase 2 involves the further expansion of the interface to cover 100% of national supply by June 2017.
All staff involved in the specification, development, testing and operations of the interface are either current professional members of the Records and Information Management Professionals Association or the Australian Computer Society.
Over the two years of operation of the interface, availability has exceeded 99.9% and user satisfaction as measured by surveys in December 2015 exceeds 99.6% (n=307). Should the interface be unable to communicate for an end laboratory information system for any reason, the system is designed to queue the relevant messages at each end and to then transmit when full service is restored. In this manner, no records are lost due to outages (scheduled or unscheduled). To ensure that patient care is not compromised in such situations, manual fall-back procedures are in place.
The NBA information governance framework has been updated to reflect the governance outcomes that occurred in Phase 1 to ensure the data is fit for purpose and delivers optimum benefits throughout its life while ensuring appropriate controls such as privacy compliance obligations are met.
Laboratory operations in relation to receipt and management of blood and blood products have been completely transformed. Staff have achieved significant time reductions (for example one large laboratory in Sydney reported staff savings of 17.5 hours per week following adoption of the interface), data quality and capture has increased significantly and data is available to all in the sector. Once fully implemented, it will release over 30 full-time equivalent staff positions nationally (1% of the total workforce) in laboratories. Once fully implemented, the pay back to Governments from the initial investment will be realised within 18 months of completion just on staff savings in laboratories alone.
The interface also enables the NBA to manage the blood supply chain using real-time, accurate data which is central to the Agency meeting its primary policy objectives. In times of normal supply this data is used to model inventory levels and decrease wastage. In times of supply shortages, it enables the NBA to make informed decisions to divert blood or to curtail blood-use (such as elective surgery) without burdening laboratory staff with constant requests for data.
The BloodNet-LIS interface is a showcase example building a culture that values digital information throughout the Healthcare sector. Following on from the success of the Phase 1 project similar interfaces have been established between BloodNet and other blood sector systems such as the Blood Service’s NBMS. This proves the concept of entering data once into one system and then flowing through to other systems in an automated manner is achievable and can be highly successful.
Output from the interface will also be used from July 2016 by the Blood Product Authorisation System (BloodSTAR) to track and record in real-time, the infusion of 4,021 kilograms of intravenous immunoglobulin to ~12,000 individual patients, tracing $205 million worth of product.
In summary, the project when completed in 2017 will have delivered $11.15 million of direct savings over six years to governments (based on a total investment from governments of less than $3 million). Further indirect savings through a substantial reduction (just under 50%) of wastage of blood products of $24.57 million will be delivered. Progress towards these targets to date have already exceeded the savings targets for the first three years.