644 - Improving Patient Journeys: Clintel Systems and the Future of Digital Health in Australia

0:00Peter Birch: Have you ever heard a term in digital health and just quietly had to Google it later? The Talking Health Tech Glossary has got you covered. We've got hundreds of terms in plain English explanations, written for our industry, and all free to use. You don't even have to sign up for anything. Just go to talkinghealthtech.com slash glossary. Welcome to the Talking Health Tech podcast. My name is Peter Birch. Today on the show, I'm joined by Nick Cuthbertson, the CEO of Clintel Systems, which is the Australian digital health company behind CareRight. G'day, Nick. How are you going? Good, Pete. How are you?

0:34Peter Birch: Nice. I am doing really well and looking forward to this conversation with you. We've seen a little bit about CareRight and Clintel through the Talking Health Tech website as partners and looking forward to diving in and learning a little bit more about what keeps you busy and what it's there for and all of that. So for those unfamiliar, tell us about you, Clintel, and the work you do, and we'll go from there. Okay, great. Look, I'm CEO of Clintel. I've got a background in business system design and improvement. Initially, with Price Waterhouse, and then after that on my own. I've been in the business some 20 years.

1:16CareWrite's our flagship product. and when we designed Careite we we looked to design a product with all the core features patient administration EMR billing and claiming but the thing we did differently we we built it on a foundation and that's a workflow business process foundation and what that's allowed us to do is configure the system to meet various service delivery models. And that's fundamentally one of the key aspects of CareRide and why it's been able to address this sort of connected care model very well.

2:02Peter Birch: I think that piece around the way hospitals work will probably, you know, become more apparent as to how that shaped what you do and the decisions that you make as well. So if we think about hospital care, you know, we say, oh, what area are you in? Like from a hospital point of view and people, even when you say a hospital, people think of different things and maybe 10, 15 years ago, it's pretty easily defined on here's a bricks and mortar thing that you go to. If you were defining a hospital these days, what are the kind of things that come to mind? Yeah. Well, officially, of course, it is still a place and that's one of the big conflicts out there in the industry at the moment trying to manage that change.

2:45But look, we see it as it can still be a bricks and mortar, but increasingly it's perhaps a coordinated set of clinical capabilities which are delivered wherever the patient is.

3:00Peter Birch: And so what is that like? Why is that though? Like the, you know, we've gone from, we had a pretty good, you know, thing going on where people understand what a hospital is and it's a physical thing. And then we've now where we feel the need to define it more based on capability and the things it pulls together. Like what's brought that about? Well, I think it's an evolution and the fundamentals behind that are first and foremost, digital technologies have enabled the change and in one sense enabling it and partly driving it. Secondly, resource management, resources are scarce. And so the concept of being able to deliver care in the home or elsewhere that in that sort of said environment is attractive and has economic value.

3:57and then you've also got on top of that patient demands that sort of patients of 30 years ago would put up with and live with certain ways doing things that they just won't do that anymore. So there's sort of this inexorable demand for change and led by digital technology capability to be able to deliver that. Yeah.

4:23Peter Birch: And do you think that digital technology piece has, you know, either created opportunity or complexity for that matter, given that, you know, when someone goes to the hospital, usually there's a thing that they're looking to, like, there's obviously a reason why they're in hospital, but maybe they don't know what the thing is that's going to happen to them. and they may need to have multiple things done to this, like investigations and procedures and dealing with various departments within a hospital. And obviously those familiar with the healthcare system don't mean to patronise. But if I was to compare it to, I'm going somewhere with this, you know, you're getting lunch at a restaurant or something, like that's pretty clear.

5:03Peter Birch: You go to the restaurant, you get your meal, and maybe there's, you know, a few kind of processes and you've got to pay. But in a hospital setting, like we refer to it as a journey through a hospital. So like that, by definition, suggests that there's a lot of moving parts and we've added digital to it to try and address some complexity. But also maybe that's created some too. I don't know. What are your thoughts on the connected hospital kind of case? Well, technology always has the capability to increase complexity. But overall, I think what it's aiming to do is solve the complexity problem and the disconnect problem in hospitals and care and recognize that care is a multidisciplinary, ongoing, quite often ongoing factor.

5:53so that the old way or the traditional way of doing things just doesn't work. And we now have a capability to change that. So that's what's happening.

6:08Peter Birch: And what does that actually look like then? Because, you know, you've got the, I like to talk about the front door or the digital front door of a hospital. And then, you know, there's technology that touches patients through all the process through, you know, discharge and follow-up after they've left the bricks and mortar and all of that. How does that, you know, and particularly for the work that CareRite and Clintel do, what does that technology look like and add value in that connected hospital care pathway, I guess? Well, I guess what we aim to do is if you talk about that journey, that end-to-end journey or that healthcare continuum, what we aim to do is with one record, enable through the system itself and its integrations to manage the process end-to-end, capture the data in one record, but also recognize that each of the elements of service delivery are quite different.

7:11So the access needs are different and need to be managed. The way the data or the way the health is delivered and managed needs to be different. So it's got the backbone to capture it all, but the flexibility to allow that individual service delivery and clinician delivery in one end to end package. And yes, it starts that sort of digital front door and then in a hospital sense, you go through a discharge. But discharge is no longer kind of the end point. It's just a transition and transitions into other types of care and all of that can be managed. And, you know, in conjunction with the sort of work that's been happening with My Health Record and et cetera, we're heading for, hopefully we're heading for a world where all that information will be available and therefore it can be assessed and you can get a better result for the patient.

8:16Peter Birch: I think I've overdone this joke, but I'll use it probably for the last time. I feel like there's a potential for technology to put, you know, a department of Bunnings out of business because the sale of those big like plastic containers hopefully will go down. Because if you ever cared for someone or been in a situation with like multiple chronic diseases, often people will carry around, you know, various documentation within the back of their car or the, you know, putting in, you know, notes and all the other kind of bits and pieces. do you think you know and that joke was probably funnier 10 years ago but the um unfortunately it's still true and well yeah this is this is going to be my point too like do you think that we've got the capability or is there hope for that kind of you know decommissioning that that or maybe reusing those plastic containers for something else or is that still a long way to go i think it's a long slow process and there's you know there's There's lots of vested interests.

9:14There's lots of change management. It's a big job and it's happening and it's happening slowly and progressively and incrementally. And I think that's the best we can hope for.

9:27Peter Birch: So, yeah, digital health has got a pretty serious acronym problem and we've all got our favourites, but it's a lot, right? And you don't really want to be the person in a meeting that has to ask what something stands for after you've been talking about it for the past couple of weeks. That's why we've built the THT Glossary. It's a free, ever-growing library of digital health terms that we explain in simple language, written for people who actually work in the industry. So that's useful if you're brand new in the space, or you're one of the veterans that just want a refresher before a meeting, or maybe you want to check to make sure we've got everything in there.

10:03Peter Birch: It's all there for you. Have a look at talkinghealthtech.com slash glossary. Bookmark it. Send it to your team. It's the kind of thing that should exist. So we created it. Hope you enjoy. Now, that makes sense, Nick. And if I was then to think about the work you guys do at Clintel with CareRight as well, what does that actually look like within the solution that you built, given that there are many different kind of aspects and points of care, I guess, or steps in that journey for a patient? How does that translate into a solution to you? Yeah, sure. Well, of course, we do the traditional end-to-end hospital solution.

10:39But on top of that, we're at the sort of pre-hospital, for want of a better word, digital front door. We managed e-registration, online referrals, got a full patient portal enabling self-serve, pre-patient and pre-patient assessment. quite a quite a you know in the mental health space um quite often before the patient is accepted there's a sort of full review and assessment and we can our system allows that to be set up or to be automated to some extent to to be routed in a in a in a true workflows and so you've got this sort of full engagement and communication before the patients even become a patient when they're then they're perhaps just a potential patient.

11:28And then at the other end of the scale, once we go through discharge, sort of transition from discharge into an outpatient, we provide and manage the ongoing care. And it can be as simple as getting electronic feedback from the patient in terms of how they're feeling, ongoing pain scores, full discharge planning, follow-up and recall. Quite often we've got patients, clients, for example, who after a discharge might have a 3-, 6-, or 12-month program where they're monitoring various aspects of the patient. Well, our system can be set up to, on a regular basis, send out questionnaires electronically and securely, have the patient complete that information and return them.

12:25And then I think there's one other aspect I should mention. And so whilst we're doing all this from a hospital point of view, quite a number of our clients are more than hospitals. They have full outreach, community outreach components. they'd have medical specialists working within their environment and and providing consultations and our system of course can they then be configured not to just provide with sort of a hospital solution but it's providing a medical specialist solution the allied health solution the the community uh community solution as well so so almost sort of sort of horizontally and vertically, we're capturing and assisting the client to manage their patients.

13:13Peter Birch: And I'd love to hear about, say, the application or the use of some of those technologies that you build and the web flows, like the enablement that Care Act brings into like real world health systems. Are there, you know, sometimes when you're bringing new, whether it be new ways of doing things or new capability to health systems, perhaps you can teach them a thing or two, but But often I find it works both ways too. Tell us about some of those even lessons that you might have learned through some of your customers as well with any examples. Yeah, so we've provided a tool and our customers are utilizing it in a range of different ways.

13:54And they, of course, understand their patience. They understand the environment. And so they've been able to give effect to and utilize our tool well. And I guess some of the learnings from it are change management critical. When you're bringing systems together, and quite often for our clients, we've got a situation where they might be using three different systems. They've come into one system. So change management, incremental and progressive has generally been the way forward rather than a big bang approach. We've seen quite often they'll aim for low hanging fruit, get some initial wins that helps get people on board, that gets buy in.

14:43because, you know, of course, in one aspect, it's just technology, but the biggest single aspect in all of this is the people, both the patients, the clinicians, the administrators, getting all of them on board. And I think one of the big things we've seen is retaining flexibility and avoiding as some sort of, in general, avoided this doctrinal approach where everything has to be identical and everything has to be sort of pushed through in a very fixed manner. By adopting flexibility, we've seen clients been able to get the benefits where they're applicable, in other cases, left the system aligned.

15:30And that sort of mix and match approach has delivered results. We've seen it, you know, for our clients.

15:37Peter Birch: Yeah, I love that mentality because there's definitely a lot in any kind of process that should be standardized for efficiency and accuracy and all that kind of stuff. But there's a lot of healthcare that's messy, as we say, and requires personalization and workflows change. And then also, you know, the healthcare system providing services needs to connect in with a bunch of other things too. And so they may have, you know, bespoke requirements. And if we can kind of meet in the middle of that, ultimately means better patient care, more efficient health systems, then everyone kind of wins as well.

16:13Peter Birch: But then on that point of the healthcare systems needing to connect to other stuff, you know, whilst it would be wonderful if there was... Actually, I don't think it would be wonderful if there was one single piece of technology and one provider of that technology that did absolutely everything that was needed because you need that diversification. And also, I think you need technology providers to focus on the things they do well. Integrations, like how do you think about where your remit starts and ends and how you play with others? yeah well I think the point you make is a good one and we've seen examples out in the real world where they've tried to have one technology provider and one solution and generally they've ended in tears so you know we're a great believer in sticking to what you do well and integrate and interface and work with others and let people focus on what they're good at So our system, we integrate, we've got lots of internal capability, but one of their key factors is to integrate and interface with other providers.

17:28And we think we do that pretty well, and we're always working to make it simpler and easier. And we're on a journey to continue to improve that. But that's our philosophy. Stick to what we're good at. Don't try and copy what someone else is doing and doing well. Just work with them. And I think for the client, that gives them the kind of best of breed, best result possible. And if your system's designed with flexibility and configurability, that makes it a lot easier to achieve.

18:08Peter Birch: are there any because you touched on my health record earlier on in a different context but i imagine you know having connectivity and with that would be super important but are there any um you know other other vendors and partners that you know the team's got on speed dial or had the regular conversations with because they're doing so much together or is there like a um any examples of those integrations that you think really showcase what the needs are of um hospitals and that? We've got many integrations and in quite cases, multiple integrations. So, you know, if you're talking telehealth, you know, CoView, but also Microsoft Teams.

18:50So we all often try and provide the client, you know, options. So it's just called one integration. They can integrate. We're not trying to dictate to them where they want to go. We're trying to provide the integrations and they can choose what they want to do. But our philosophy has always been to be at Medicare and making sure we provide all the integrations with Medicare or My Health and then My Health, Allied Health and My Health Record. We aim to provide as much capability and flexibility for the client as possible.

19:29Peter Birch: That's a smart move. And lastly, Nick, thinking about directionally where the ball's going and where, you know, particularly when it comes to the new world of hospitals, hospital in the home, virtual care and all of that. What do you think hospital leaders should be thinking about right now, be it based on your experience in speaking with other healthcare leaders or just where you see in the crystal ball these are? Well, I think the evidence is that hospital in the home and virtual hospital makes clinical and economic sense. So it's just going to continue. It's going to become the norm. Of course, the bricks and mortar hospital is still here to stay and represents a key part of that hospital continuum.

20:16But for, you know, going forward, certainly from our own decision making and what we're doing, but what we'd say for anyone considering that they should always take into account now and any decision making should be thinking about virtual care, home care. The broader concept of a hospital has been some sort of capability network, coordinated network that delivers care and that care can be delivered in a bricks and mortar hospital, but it can be delivered in the home and many places. And that's just going to become the norm, I think.

20:56Peter Birch: No, it makes a lot of sense. It's been great, Nick, to just get to know more about CareRite and Quintel and yourself as well and all the details will be in the show notes of this episode and on our website too for people to learn more and get in touch. So, Nick, I really appreciate you making the time today. Thank you so much. Yeah, great. Great to talk with you, mate.

21:43Peter Birch: above and beyond this humble little podcast. Thanks so much.