30% More Patients with AWS-Powered WFM Suite

Business Challenge

Doc Abode was engaged by their existing partners in the NHS to develop a new Dynamic Scheduling module to support unplanned care (meaning urgent and emergency healthcare that is not scheduled activity) in its community.

Due to a lack of adequate products on the market, Doc Abode’s partners heavily relied on text messaging, phone calls, Excel, and Microsoft Teams to match their patients’ needs to the right members of their workforce, who were already busy managing their day-to-day workloads.

Following the successful launches of their On-Demand and Vaccine modules, which focused on making services more efficient at several partner organizations, Doc Abode was asked to develop a custom application that would:

• Reduce double-keying of patient information across systems
  Staff typically operate more than one system to document patients’ needs, schedule visits, and document treatment outcomes. As many of these systems are not integrated with each other, clinical staff spend a significant part of their time re-entering the same or similar information in multiple places.
• Optimize the use of scarce capacity and skills in the face of growing demand
  Traditional healthcare providers like GPs and hospitals have been augmented with new service models such as Urgent Community Care, Virtual Wards, and Hospital at Home with the aim of caring for patients in community settings, rather than clinical ones. The aim of this program is to prevent hospitals admissions, discharge patients more efficiently from hospitals to free up beds, and provide continuous care to the community. However, the size of the workforce supporting these models has not kept up with the growth in demand.
• Provide real-time updates on staff whereabouts and caseload progression
  While live tracking and status updates are common features for takeaway, parcel delivery, or transport companies, when it comes to where operators plan shifts for their workforce, healthcare still largely operates “offline”, receiving updates when staff returns to base at the end of their shifts. This means that when an urgent, incoming patient request is received, operators need to call up colleagues to get a sense of capacity before communicating changes in plans via follow-up calls or text messages, which is inefficient.
• Improve safety of both patients and staff
  Doc Abode’s clients work in the community and often alone. They do not have the safety of colleagues or formal settings like hospitals or GP practices to keep them safe or support them if a patient is in distress.

Solution

Doc Abode first engaged DataArt during the inception of its Dynamic Scheduling module. We were brought on board to provide business analysis (BA) and development services.

DataArt’s BA observed the existing business processes of Doc Abode’s partners for accepting new patients, matching patients and staff, scheduling initial and ongoing care, and dealing with capacity constraints. DataArt and Doc Abode’s technical teams jointly designed a system to digitize a significant part of these processes by:

• Parsing information from EMR and integrating with NHS Digital’s Personal Demographics Service (“PDS”) to minimize the double-keying of patient details
  Instead of manually retyping information already held in EMR, Doc Abode allows staff to paste the content of exported EMR data into a parser, which looks out for key markers and extracts relevant patient information.
  In addition, the integration with PDS allows staff to by-pass EMR entirely, simply pulling patient information from the national data set based on the patient’s NHS number. Staff then only need to confirm patients’ registered contact numbers and address details, reducing the overall effort to seconds.
• Building interactive dashboards to show the caseload and allow easier planning
  Coordinators have been given access to a Web Portal, which visualizes the total demand for a service in different ways, such as timelines, list views, and a map of all patient visits. Each of these dashboards shows live status information based on updates sent by staff in the field via the Doc Abode mobile app, e.g., when they toggle themselves “on duty” (staff appear as dots on the Map) or when they progress their patient visit (jobs categorized as “en route”, “arrived”, or “completed”).
• Introducing algorithms to evaluate patient preferences and staff demographics with intelligent warnings to allow the optimal allocation of staff
  Patients may have a preference to be visited by certain genders, or (in the future) have other preferences related to pet ownership or smoking status. It is also possible that patients are not native English speakers. To provide optimal care, the system evaluates staff demographics at the time of assignment, informing coordinators if the allocated staff member is not a good fit for the patient, or staff-patient compatibility is in doubt because demographic information is missing. Being able to proactively avoid a mismatch helps healthcare professionals to provide the best possible care experience for their patients.
• Leveraging iOS and Android’s built-in SOS Emergency capabilities to more quickly and efficiently highlight staff emergencies
  For years, Android and Google have offered SOS capability which can be used to inform emergency contacts of problems with the click of a button. Doc Abode offers each of its partner organizations a dedicated phone number to use in the event of emergencies. When staff trigger an SOS, Doc Abode receives the alert, parses the information, and prominently shows that a staff member is in an emergency, e.g., by highlighting their swimlane on the timeline, highlighting all their jobs on list view, or visually flagging the staff on the Map view.

Our Solution’s Key AWS Services

• AWS Lambda: This service was applied to make a highly scalable solution for handling sudden increases or decreases in traffic, guaranteeing manual infrastructure management to handle such changes. Lambdas are easily integrated with other services, making this solution a powerful tool for building serverless applications that utilize various AWS services. AWS Lambda is also an extremely cost-effective option for running services.
• AWS RDS: This service was chosen to scale database instances vertically or horizontally, meeting the application’s growing demands. Moreover, there is also a possibility to use point-in-time recovery to restore a database to a specific date, as well as multi-AZ deployment for disaster recovery.
• AWS Dynamo-DB: This service enabled changing the schema according to set requirements, without the need for additional server maintenance.
• AWS Cognito: This service was used for user authentication and authorization to securely access application resources. There was the possibility of creating a “user pool”, a directory for users that enables registration and signing-in. Using identity and access management (IAM) roles and policies, the team was able to manage access to application resources. Cognito provides a comprehensive set of monitoring and logging tools that help monitor user activity and security.
• AWS S3: This service allowed the storage of various unstructured data. It creates a flexible security system which helps control access to objects using bucket and object-level policies alongside high availability, scalability, and reliability.

Results and Benefits

After the successful deployment of Doc Abode's Dynamic Scheduling module, Doc Abode’s partners have seen substantial improvement in their use of resources and the quality of care provided to patients, including:

• The administrative effort to coordinate changes in schedule has all but been eliminated due to real-time communication between the base Controller interface and Mobile push notifications to users in the community.
• After-care for patients has been streamlined as staff in the community can easily leave comments on completed jobs and self-book follow-up work for patients, reducing the time of administrative handovers.
• Doc Abode's real-time scheduling capabilities have improved patient outcomes and significantly reduced costs.