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230K negative test results sent

2 weeks to launch COVID-19 solution

1K+ clinical staff
days saved

Challenge

Enabling a fast-paced, coordinated response to meet urgent community healthcare needs

Established over six years ago, New South Wales Health Pathology (NSWHP) — an Australian statewide health organization that delivers reliable pathology to the public — provides services to New South Wales' forensic, criminal, environmental health, maritime units, and other local government bodies. Its highly specialized staff are driven by their purpose to create better health and justice systems and guided by its principles of having a caring, connecting, and pioneering spirit.

The organization employs 5,000 people, operates more than 60 laboratories, 150 pathology collection services, and conducts more 100,000 clinical tests per day. Behind the scenes, the NSWHP’s IT systems were siloed — making it difficult to deliver on key initiatives that would improve patient outcomes, maximize taxpayer benefits, and build a foundation for change.

NSWHP is at a pivotal point in bolstering its core business objectives and critical health services with highly efficient, innovative, and standardized statewide Information and Communication Technology (ICT) platforms and solutions.

Objectives

Improving patient outcomes and experiences, delivering cost and operational efficiencies, and building a foundation for change

NSWHP sought to efficiently integrate data to deliver time-critical initiatives, including:

  • Digitizing pathology results to speed up access to patient data and make clinical decisions faster
  • Reducing cost and effort associated with transportation and testing
  • Building a foundation to rapidly respond to change and urgent demands, including COVID-19

Solution

Integrating pathology data to deliver enhanced interoperability

Improving health outcomes with Point of Care Testing (PoCT)

To deliver key healthcare initiatives, NSWHP needed to deploy a technology platform capable of supplying its integration needs quickly. “We needed to move away from unsustainable point-to-point integration and worked with Gartner to support our integration evaluation. MuleSoft’s Anypoint Platform emerged as the best integration and API provider for our hybrid needs and strict regulatory requirements. Deloitte worked with us to stand up Anypoint Platform in only a month,” said Timothy Eckersley, Enterprise Architect, NSWHP.

NSWHP’s initial project with MuleSoft sought to expand testing from laboratories to healthcare facilities so patients can get quality-endorsed results faster.

To set up the testing process, NSWHP took an API-led approach and used MuleSoft to integrate 350 testing devices from its health facilities to systems across its 60 laboratories within three months. NSWHP’s engineers and architects leveraged APIs as building blocks to securely connect Point of Care (PoC) devices to electronic health record (EHR) systems, which contained each patient’s pathology results. Now, every provider has a 360-degree view of their patients and can provide them the best possible care.

Using MuleSoft’s HL7 Connector, NSWHP can quickly and securely route HL7 messages between state and federal health platforms and its lab systems. This EHR integration is used to reliably transmit, map, and transform complicated clinical messages for millions of test results. Reliability is critical when it comes to processing millions of test results and can make the difference between clinicians missing or identifying and treating a serious illness.

The NSWHP team then pulls HL7 feeds from various labs into an Observations API, which detects whether additional clinical tests are needed — driving more timely, personalized care. Previously, it took weeks to sync pathology results to EHR systems; today, the EHR integration takes a matter of minutes.

Anypoint Platform’s flexible deployment options were also factors in NSWHP collaborating with MuleSoft. “We were one of the first health agencies in New South Wales to use the public cloud. MuleSoft’s flexible and light-weight deployment options allowed us to combine the best integration technology with the best infrastructure technologies of the cloud to meet the stringent security requirements required by NSW Health policies,” said Eckersley.

“As the largest public pathology provider here in Australia, we rely on massive clinical and non-clinical IT infrastructure to deliver essential health services. MuleSoft’s Anypoint Platform allows us to reliably, securely, and confidently transmit sensitive patient data to where it’s needed.”

James Patterson New South Wales Health Pathology CIO headshot

James Patterson
CIO, New South Wales Health Pathology

Accelerating testing for COVID-19

The success that NSWHP, MuleSoft, and Deloitte have delivered to-date has created the foundation for an architecture that is agile, resilient, and responds quickly to unexpected demand on the state's pathology services. 

“We couldn’t have anticipated the scope of the COVID-19 pandemic or the impact it would have on our organization — clearly, no one did,” said Eckersley. “Working with MuleSoft, Microsoft, AWS, and Deloitte has enabled us to respond quickly to efficiently deliver time-sensitive projects and new services to meet unpredictable patient needs.”

COVID-19 brought new challenges in patient testing. First, hospital staff must contact patients to share test results, a burden that became ever greater as cases of COVID-19 cases increased. Second, due to the volume of testing and the fact 99% of patients are testing negative — some patients were waiting up to a week for results. NSWHP realized that a secure and direct to patient result system would reduce anxiety and get essential workers in isolation back to work faster — particularly those working at the frontline of healthcare.

NSWHP quickly released a new solution that addresses these challenges, made possible by work on previous projects already completed with MuleSoft and Deloitte. NSWHP identified an opportunity to reuse APIs and integrations produced for a variety of previous projects, from billing to clinical integrations.

The NSWHP team reused ten existing APIs — such as the Observations API, OmniLab System API, Cerner System APIs, and Auditing Service API — to rapidly build and deploy a solution in just two weeks that automatically delivers test results to patients.

“We are focused on building a foundation for change, so we can respond swiftly to patient needs and an ever-transforming health system. By harnessing reusable components, we can create the foundations for greater agility. MuleSoft's API-led approach is enabling us to be more responsive and release new solutions and services faster, to deliver better health outcomes for NSW,” said Patterson.

Results

5-minute sync to EHRs and faster COVID-19 testing

MuleSoft is helping NSWHP to improve patient experiences and lessen their anxiety by digitizing health results and delivering on time-sensitive projects for COVID-19. 

For NSWHP's first project with MuleSoft, the agency digitized pathology results. “PoCT devices are now connected to NSWHP laboratories and the results are integrated with LIS and EHRs so clinicians can make decisions and correctly contextualize patient results. With MuleSoft, this data is synced in near-real-time, often in less than five minutes,” said Eckersley.

Using PoCT devices also helps lower costs by making patient transportation to an approved laboratory unnecessary.

The agility and reusable APIs that NSWHP has built with MuleSoft created a foundation needed to respond to disruption. NSWHP has been able to put this foundation to work by responding to the COVID-19 pandemic quickly and effectively.

“We launched the new COVID-19 solution in just two weeks. We could not have launched so quickly without applying reusable APIs or building blocks developed in Anypoint Platform,” said Eckersley.

Today, NSWHP can provide COVID-19 patients with test results in just 24 hours, in most cases. Patients can receive their negative results automatically via a text message or by using the Service NSW app or website. Patients who test positive are contacted by phone directly by clinicians. Additionally, clinicians now have easy access to a database of their patients’ results.

More than 230,000 patients have already registered for the service and received their negative test results via text message. Hospital staff have been saved many thousands of hours by no longer needing to call patients directly with their results.

“When a crisis erupts you have to move fast, and technical debt doesn’t allow you to do that. Working with MuleSoft meant we were able to pivot our priorities quickly to release our COVID-19 testing solution. Anypoint Platform has changed the game for our team, and we can now provide patients with the efficient, personalized care they expect,” said Patterson.