Queensland Health delivers a range of integrated services including hospital inpatient, outpatient and emergency services, community and mental health services, aged care services, and public health and health promotion programs to more than five million Queensland residents. Through a network of 16 hospital and health services, they are committed to ensuring all Queenslanders have access to a range of public healthcare services.
Queensland Health partnered with Thoughtworks on an innovative transformation, increasing meaningful use of clinical terminology content in clinical and non-clinical applications as well as improving interoperability between Queensland Health and external solutions, thereby facilitating better delivery of healthcare services.
Overview
The Queensland Clinical Terminology Service (QCTS) is a statewide business service available to registered Queensland Health staff and integrated applications to access up-to-date clinical terminology and content. The QCTS is a centralized distribution platform for both national and international clinical terminology content, and an authoring platform for state-based clinical terminology content.
In its current capacity, the solution is used to syndicate and distribute terminology content artifacts including SNOMED CT-AU (including the Australian Medicines Terminology), LOINC and HL7 FHIR terminology resources such as CodeSystems, ValueSets and ConceptMaps. Additionally, the QCTS facilitates the creation of state-specific Fast Healthcare Interoperability Resources (FHIR) terminology resources for operational use throughout Queensland Health.
Key challenges
Queensland Health wanted a central repository into which national and international clinical terminologies could be hosted, and where they could author their own FHIR terminology resources for use statewide. On the back of previous successful healthcare projects delivered by Thoughtworks, Queensland Health approached Thoughtworks to design, build and operate the QCTS.
Clinical terminology impacts every Australian—each time an individual visits a doctor or hospital, a record is created in software that uses clinical terminology. This clinical terminology is used by a wide range of professionals in their day-to-day capacity when working in areas such as:
Hospitals
Medical practices/doctor surgeries
Primary care settings
Community pharmacies
Pathology providers
Health-focused research institutions and government agencies
With multiple healthcare professionals across various areas inputting data in different capacities, the flow of information and keeping terminology consistent throughout an individual’s health journey is a known global healthcare management challenge.
Key challenges:
Go-live was during the peak of the COVID-19 pandemic.
Navigating through competing priorities as development and rollout occurred during other department software projects.
Required multiple integrations into other government systems, both state and federal.
Accelerated timeline pressures.
Complex user interface (UI), user acceptance testing (UAT) and quality assurance (QA) requirements and considerations.
A solution to enable further innovation
The QCTS has become the future foundation for the syndication, distribution and authoring of terminology content across all facets of Queensland Health. The clinical terminologies authored and distributed via the QCTS are a fundamental building block in healthcare IT interoperability across Queensland Health. Ultimately, the integration of clinical terminologies from the QCTS into statewide clinical and reporting applications will aid in achieving a more efficient health service and better healthcare outcomes for patients.
Some benefits of the QCTS include:
Increased capability for interoperability between different clinical applications used throughout Queensland Health
High-quality and accurate data that is recorded using common standards resulting in information being understood and used with confidence
The QCTS utilizes several CSIRO products for authoring, syndication and serving of FHIR-based clinical terminology content. It is operated on AWS using a combination of serverless technologies to minimize ongoing maintenance and management costs while ensuring high levels of availability and reliability.
Queensland Health was looking to the future, and the Queensland Clinical Terminology Service was the first statewide, centralized clinical terminology platform in Australia. With the system in full operation, it now provides Queensland Health with:
Increased interoperability for clinical and reporting applications, resulting in increased efficiencies and decreased costs
An ability to forecast healthcare trends through normalized long-term data
Increased data normalization capabilities over time
Increased ability to perform data analytics on state-based healthcare
This system provides the building block enabling future innovation across healthcare for Queensland and other states to incorporate, leading with a core foundation for a world-class healthcare system.
Outcomes
A number of positive outcomes as a result of this project include:
Data is securely stored within Australia, preserving data sovereignty. The infrastructure for the solution consists of AWS services accredited in accordance with leading infosec frameworks, including ISO, PCI and IRAP.
Implementation of a fully-managed software as a service (SaaS) solution built and managed by Thoughtworks, reducing the internal IT footprint for Queensland Health with the potential to lead to cost savings, improved security, increased efficiency and a more agile IT infrastructure.
Futureproof healthcare IT assets through open standards, removing vendor lock-in to increase flexibility, reducing costs, and providing greater control over technology and future innovation
This has been a great initiative for the Department.
