GUEST OPINION: There are not many countries which don’t have long hospital waiting lists. Australia is no different.
In 2022-23 in Australia 855,500 people were added to elective surgery waiting lists – an increase of 9.2% on the previous year. Unfortunately, 9.6% of patients waited more than 365 days for elective surgery, up from 6.7% the previous year.
According to the latest figures (September quarter) from the Victorian Agency for Health Information, 61,500 people were on the state’s elective surgery list.
Last year, the ABC provided some significant insights into hospital waiting lists in Australia when it analysed public specialist outpatient waiting times across the country. It showed some Australians were languishing on waiting lists for more than six years to see specialists such as neurosurgeons, ear, nose and throat surgeons, and immunologists.
That’s why when reading what Celonis is doing with the NHS in the UK I needed to share it.
With an annual budget of £190 billion ($AUD368 billion) and 1.3 million staff, the NHS is the second largest single-payer healthcare system in the world, and free at the point of delivery.
Celonis undertook a significant program with the University Hospitals Coventry and Warwickshire (UHCW) – one of more than 200 Trusts which make up the NHS.
Traditionally, the hospital would send patients text message reminders four days before, and then the day before their appointment. However, last-minute cancellations kept coming, and so appointments went unused and waiting lists got longer.
Thanks to the Process Intelligence provided by Celonis, the Trust understood that four days was not enough time to reallocate last-minute cancellations effectively. They made a subtle adjustment. They texted 14 days prior as well as four days before the appointment. In doing so, they are successfully educating patients to cancel appointments early if something comes up, and the hospital gets more time to fill slots that become available, making a significant dent in their waiting lists.
“What was quite surprising to us is how quickly we could get results with Celonis,” said Professor Andy Hardy, CEO of University Hospitals Coventry and Warwickshire NHS Trust and Deputy Chair of NHS England’s National Improvement Board
“The results are incredible!”
For a subset of patients visiting the Outpatients department, the Did Not Attend rate fell from 10% to 4.4% in just one week, avoiding 1,800 appointment cancellations.
The waiting list went from 73,100 to 67,780 patients within eight weeks, a reduction of around 5,300 patients.
Additionally, the Trust began to group medical appointments. With Celonis, the Trust could see that 12,000 patients followed more than one care pathway, meaning they were waiting for more than one treatment. It also observed over 18 months that 53,000 patients went to the hospital more than once in five days. If these appointments were grouped, so that patients had several appointments on the same day, hospital visits would be cut by 53%.
“Often, people need to see a number of different specialists,” explains Professor Hardy.
“Now we use Celonis to help us align all their appointments on the same day, rather than having them come on multiple days. Or, as often happens, if it’s parents and children, siblings, husband and wife, etc., we can schedule their appointments on the same day so they don't have to make multiple trips.”
The third improvement was by using Celonis’ object-centric process mining (OCPM) capabilities to get a dynamic, three-dimensional view of its in-theatre and out-of-theatre surgery processes.
With OCPM and the Process Intelligence Graph, companies connect various systems and processes to get an end-to-end digital twin of their processes and understand their business performance. In this case, the NHS Trust was able to analyse the patient journey from different angles — accounting for factors like lab results, drugs administered, surgery sessions scheduled, anaesthesiologists on-call, etc. — to identify the roadblocks that lead to surgery delays or last-minute cancellations.
“Operating theatres represent some of the hospital's most costly resources, so optimising their use is crucial,” explains Professor Hardy. “But more importantly, the more patients we're seeing each and every operating session, the quicker we can reduce the backlog of patients we've got.”
UHCW NHS Trust plans to develop other use cases to improve the patient journey in all hospital areas. The emergency department is one of them; cancer treatment pathways are another.
There is no silver bullet in reducing waiting lists, but the NHS is showing that there are steps that can be taken that can have tangible results on reducing waiting lists and thus the suffering of waiting patients.
Government and private healthcare providers need to start leveraging the power of Process Intelligence and AI in order to drive sustainable improvements in the longer term.