As Hospital in the Home, virtual hospitals and hybrid models extend hospital-level care, the harder health IT question is no longer what runs inside the hospital. It is how information keeps up with the patient, writes Tim Macdonald.
Tim Macdonald.
Health IT has spent decades optimising the hospital as a place. Patient administration, bed and theatre management, clinical documentation and billing were built around a patient who arrives, stays and leaves.
That model is loosening. Hospital in the Home, virtual hospitals and connected hybrid models are extending hospital-level care into the community, and specialist care is increasingly shared across hospitals, clinics and virtual consultations. A single episode might begin with a digital referral and remote pre-admission, continue through an inpatient stay and several clinical disciplines, include a virtual specialist review, and carry on after discharge.
The patient experiences that as one journey. Behind it sit multiple teams, locations, applications and processes. Every handover between them is a place where information can stall, and every new model of care risks becoming a new point of fragmentation.
The design brief has moved
For health IT teams, this changes the brief. It is no longer enough for the inpatient system to work well on its own terms. The questions become which parts of the journey the core platform should own, which it should connect to, and how continuity is kept across the boundary.
Our company’s approach is to provide a cloud-based, configurable core spanning patient registration, referrals and digital pre-admission, patient administration, bed and theatre management, clinical documentation and workflows, multidisciplinary care, billing and claiming, reporting, discharge and follow-up, and to connect outward from that core rather than try to absorb every specialist capability.
Transitions are where interoperability earns its keep
Discharge shows why. Discharge planning, correspondence, referrals, follow-up and communication with other providers are all transition points where information needs to travel with the patient instead of stopping at the hospital door.
With CareRight for example, information can move beyond the inpatient environment through My Health Record and secure messaging, a patient portal, online assessments with escalation workflows and electronic care pathways. Integrations with Coviu and Microsoft Teams bring virtual interactions into the same journey.
At South Pacific Private Hospital, General Manager Leah Hammond described to me what that connection means in practice:
“For us, having information connected across the patient journey is critical. CareRight gives our clinical and operational teams a shared foundation for managing patient information and supporting coordinated care. Connecting that information with services such as My Health Record has further improved access to critical information, reduced administrative burden and helped our teams make more timely, informed decisions.”
Treated this way, discharge becomes a hand-off between settings rather than the end of the record.
One record, many access models
A shared record raises an obvious governance question: who should see what? Multi-site organisations, and the multidisciplinary teams within them, rarely want uniform access, and often should not have it.
With our solution, access and activities are configured around locations, groups and roles, and assessments, forms, workflows and tasks are configured around the teams responsible for completing or progressing them. The record is common; the views and responsibilities are not.
Gillian Gilchrist, who acted as Digital Transformation Lead at Jericho Road, the organisation behind Allowah, told me this matters most where needs are complex:
“For an organisation supporting people with complex needs, having current information available across the team is incredibly important. CareRight has given us a more centralised view of each client’s care, with clinical and operational information brought together in one place. That has helped improve visibility, interdisciplinary coordination and the way important information is captured, shared and acted on by our teams.”
The goal is not to collect more data. It is to put relevant information in front of the right people and tie it to what needs to happen next.
Configuration, not proliferation
A familiar failure mode in multi-service organisations is a separate system for each service line, each with its own patient list, interfaces and reports. The alternative is one foundation configured around different workflows, forms, roles and access requirements, so a day hospital, a specialist clinic and an allied health service can share patient information while each keeps the workflows its model of care needs.
Another of our customers, Julia Hannan, Chief Financial Officer at Ngala Community Services, pointed to the data benefits of that approach:
“Digital transformation at Ngala is not simply about technology; it is about improving the way we support families. CareRight provides a modern, integrated platform that connects our services, people and information, enabling a more coordinated and personalised experience for clients. The system enhances data integrity, improves reporting and insights, streamlines processes, and reduces duplication, allowing our teams to focus more of their time on delivering high-quality support. As Ngala continues to grow and evolve, CareRight provides the scalability and flexibility needed to innovate, strengthen service delivery, and improve outcomes for the communities we serve.”
Integrate the specialist layer
Hybrid models will keep drawing in specialist technologies, with remote patient monitoring an obvious example. The pragmatic architecture is not for the core platform to rebuild those capabilities, but to integrate with appropriate technologies and partners while keeping the patient, the clinical record and the workflow continuous.
That is the role our company sees for a core platform: patient administration, a shared clinical record, configurable workflows, multidisciplinary care, billing and claiming, reporting and interoperability as the foundation around which a more diverse ecosystem of care connects.
Four questions for health IT leaders
For teams planning for care beyond the hospital walls, four questions help test whether a platform will hold up:
• Does information follow the patient across transitions such as discharge, referral and virtual care, or does it stop at the edge of the system?
• Can access be configured by location, group and role without splitting the record?
• Can different services keep their own workflows on a shared foundation?
• Where specialist capability is needed, can it be integrated rather than replaced?
One platform need not mean one rigid workflow. One record need not mean unrestricted access. And connected care need not mean every component comes from the same vendor. What matters is a foundation that keeps the patient, their information and their care teams connected wherever care happens.
Viewpoint articles are the author’s opinion, produced without payment or sponsorship.
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