A cloud-hosted EMR for the Victorian  region of Gippsland

In November 2020, Altera Digital Health completed the rollout of its Sunrise EMR platform at the Latrobe Regional Hospital (LRH). The EMR went live in the Latrobe 30-bed ED in April 2019 and is fully functional across inpatient services at LRH and Community Mental Health services across the region. LRH is Gippsland's specialist referral and trauma centre, located 150km east of Melbourne, and is one of the region's largest employers with more than 2,100 staff. It is a purpose-built 300-plus-bed teaching hospital caring for a population of more than 260,000 people.

In Victoria, Altera Digital Health first implemented its EMR solution in Latrobe, one of the first EMRs in Australia to use Microsoft Azure. The scalability, cost efficiency and risk resilience achieved through increased security is enabling GHA to not only realise the benefits of a cloud-based EMR, but to also extend this across the entire Gippsland region.

"When clinicians have information on a patient's health status and history, they can make more informed decisions and provide a higher quality of care whilst also optimising scarce resources. This is about improving the quality of health service across a much bigger footprint in the Gippsland region and helps us deliver on our commitment to empower clinicians to deliver a world-class service."

Jon Millar
Chief Information Officer

Why Altera Digital Health and Sunrise on Azure?

Altera Digital Health won the competitive tender to deliver an EMR solution to the Gippsland Health Alliance in late 2017 and Latrobe Regional Hospital was selected as the first site in the Alliance to implement the Sunrise EMR clinical suite. Altera Digital Health's experience in the Australian healthcare sector combined with the operational benefits of the Sunrise EMR and My Health Record integration through the Altera Opal platform (already in use at GHA) were major factors behind GHA's decision to work with Altera Digital Health.

The primary benefits that GHA has realised through its Sunrise™ on Azure EMR include:

Scalability

• In the planning phases of the implementation of GHA's EMR, it was envisaged that the system would need to accommodate approximately 300 users, but by the time the system was completed, there were more than 400 registered users. In a system defined by physical infrastructure, this may have necessitated the management, purchasing and installation of additional servers, but with cloud-based system, this change in scope can be accommodated in a less complicated and costly manner.
• Likewise, the system offers enhanced flexibility, enabling the addition of temporary users in a safe and timely manner, such as is required in the healthcare sector when external physicians and clinicians are brought in on a temporary basis for a specific purpose.
• With Microsoft Azure, GHA is extending the reach of its EMR to incorporate other health sites within its jurisdiction, a process significantly expedited by the power of cloud hosting. In January 2021, GHA announced plans for the expansion of its Sunrise EMR across Gippsland. Phase 3 of GHA's EMR Community Health project will see the implementation of Sunrise Emergency Care (within the Sunrise EMR platform of health) at the emergency department facilities of the Central Gippsland Health Service, Bairnsdale Regional Health Service (servicing east Gippsland), West Gippsland Healthcare Group and Bass Coast Health, which covers the southern part of the region. Sunrise will then be rolled out across inpatient services at all four hospitals.

"We chose Altera Digital Health and its Sunrise on Azure because it was very important for us to have a fully managed service. We were looking for an organisation that could deliver all of the infrastructure, design and security as part of the solution."

Adrian Shearer
Chief Technology Officer

Cost efficiencies

• As well as fast-tracking extensions to other health sites through the convenience of the cloud, GHA is also realising the cost benefits of the Sunrise on Azure platform as it eliminates the significant outlay associated with the purchase, installation and maintenance of hardware associated with infrastructure-based systems.
• Similarly, when hardware associated with the system is upgraded, this can be accommodated within the cloud-based EMR at no additional cost.

Disaster recovery and data sovereignty

• In 2019, GHA was the victim of a sophisticated cyberattack that would have had far more disastrous consequences for an infrastructure-based system. The attack blocked access to major systems, including financial management. However, despite the severity and wide-ranging nature of the attack, there was no indication the hackers were able to access personal patient information. The attack forced GHA to detach several systems for quarantining purposes but the resilience of GHA's cloud-based system meant that there was no net loss.
• GHA benefits from firewalls built into Azure that offer advanced risk resilience due to the EMR being hosted on a secure network, enabling preventative threat detection to reduce downtime and prevent extensive damage. Data sovereignty is also achieved with backup and disaster recovery sites being situated in Australia, enhancing business continuity benefits.
• GHA's EMR has a built-in service that constantly monitors system performance. When issues are detected, for example, if CPU utilisation exceeds the threshold, an alert is generated and action can be taken by the Altera Digital Health/Azure support team.
• System downtime is also reduced to a minimum so that if the primary system is offline, for whatever reason, a backup system can go live in a matter of hours.

"It's really exciting to see the speed, flexibility, resiliency and security that the Microsoft Azure cloud can offer in supporting the implementation of these critical clinical systems across the Gippsland Health Alliance. Many health services are moving to these types of deployment models so they can focus on getting more value out of the solution rather than having to worry about all aspects of security that are baked into cloud services."

Dr. Nic Woods
Health Industry Executive, Chief Medical Officer, Microsoft Australia

Leveraging the value of Sunrise solutions with the partnership of Microsoft, GHA has transformed from using an EMR to optimising its efficiencies with a true platform of health that enables usability, connectivity to devices/IoT and other advanced technology.

According to Jon Millar, Chief Information Officer, "Partnering with a world-class technology and solution provider supports less disruption during the workday, which can decrease time interacting with our EMR and maximise time spent with patients and improving patient outcomes."

"We expected some objections to using a cloud-based service because it's a new and different way of doing things and a big part of that concern is security. But we found that the system is a very secure environment that we have full control over with disaster recovery sites situated in Australia, and not overseas."

Matthew Pinches
Electronic Medical Record and Community Health Project Manager