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Congress improves the delivery of health services to Aboriginal Australians with the assistance of AWS and Red Cirrus Services

2020

Central Australian Aboriginal Congress (Congress) is a comprehensive primary healthcare provider based in Northern Territory, Australia. Formed in 1973, its vision is to improve the health of Aboriginal and Torres Strait Islander people. Today, Congress operates from 22 locations, backed by a staff of clinicians that conducts around 13,000 episodes of care per month.

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Since migrating to the AWS Cloud, our infrastructure and capabilities have improved to the point where we have much more efficient access to patient data, are able to scale as and when there are spikes in usage of clinical information systems, enabling us to better care for patients in need of primary healthcare services.”

Trevor Osborne
Chief Information Officer
Central Australian Aboriginal Congress

Challenges

From 2015 to 2020, Congress has opened four new clinics and various client contact sites. Given that the health records of any patient could require secure distribution across a wide range of locations, including general practices, specialist clinics and hospitals, Congress clinicians rely on a centralized clinical information system to provide efficient and safe health services.

“Our clinical information system plays an essential role in allowing our doctors and other health practitioners to provide high quality care to patients. It is important that we have timely, reliable and smooth access to it so our consultations are efficient, continuity of care is maintained and appropriate follow up occurs,” says John Boffa, chief medical officer, Congress.

As the number of clinics and the volume of electronic health data grew, staff started reporting technology outages that impacted the delivery of quality care. The existing systems used to support the staff and doctors were unable to scale to meet increased demands.

“Our data centers were aging and in need of an upgrade. Combined with the dated servers that the our systems was running on, it could take our doctors up to five minutes—25 percent of the allotted consultation time for each patient—just to open a patient record. Having to spend such a large amount of their time on administrative tasks without actually treating patients resulted in a frustrating experience for our doctors. Feedback indicates that this contributed to increased clinician and doctor turnover,” says Trevor Osborne, chief information officer at Congress.

“Additionally, weekly hour-long server downtimes did not bode well for long-term infrastructure resilience. If there was ever a power outage or physical damage to the data centers, it could result in a halt to all operations, so we needed to find a way to mitigate that risk.”

The Solution

In 2017, Congress turned to Amazon Web Services (AWS) and AWS Partner Network consulting partner Red Cirrus Services to assist it in addressing the challenges it was facing.

Matthew McDougall, information and communication technology infrastructure lead at Congress, says, “For many organisations, cloud adoption is still a fairly new concept. Our decision, in 2017, to transition to AWS was unprecedented. We had to determine if the cloud was the right choice for us and whether or not we could manage AWS services comfortably and efficiently.” McDougall continues, “Fortunately, we had a leadership team that was open to exploring cloud, who provided us with the organizational buy-in required to create an action plan with AWS that could alleviate our overburdened servers and help clinical information systems run smoothly.”

Red Cirrus Services played a crucial role in identifying technological gaps―such as speeding up employee access to clinical information systems―and identifying how best to integrate AWS applications with Congress’ existing infrastructure.

“Implementations of cloud solutions can differ significantly based on individual use cases, and it could take years to understand how they can improve an organization’s processes. At times, unforeseen challenges can surface, too. For instance, cost management or governance issues,” says Lloyd Peacock, principle consultant at Red Cirrus Services. “It was vital that we had the support of Congress’ Executive Team, and that they were eager to learn and explore what the cloud could offer. This growth mindset was key in achieving a successful implementation of AWS services.”

At their locations in Northern Territory, Congress’ on-premises data centers were highly susceptible to environmental threats, such as flooding, which could lead to equipment failure and data center downtime. Congress has migrated completely out of its on-premises data centers by going all-in with AWS Cloud, greatly reducing the risk of physical damage on its IT infrastructure.

AWS Auto Scaling working in tandem with Amazon Elastic Compute Cloud (Amazon EC2) allows for Congress to create on-demand compute capacity, with the ability to scale at any given time for all employees, even during unexpected spikes in usage.

Clinical information systems are one of the most important workloads for Congress―they are responsible for facilitating all patient data storage, and the day-to-day administrative tasks of Congress employees. By optimizing them, Congress has been able to lay the foundation for providing its services to more patients in the community.

Further, Congress’ security posture has significantly improved. With 22 locations spread across Alice Springs and surrounding areas, Congress handles the processing of private and sensitive patient medical data. With AWS, Congress can now centrally monitor, control access to, and audit access to patient data.

Future Plans

Congress has helped clinicians to continue providing care to their patients efficiently and safely. It is now able to continue its expansion without concern that the addition of new clinics, doctors, and patients would cause a deterioration in the systems it uses to support healthcare delivery.

Moving forward, Congress is exploring opportunities to integrate machine learning (ML) and artificial intelligence (AI) into its IT stack. By using these technologies, Congress hopes to improve its research capabilities and provide more comprehensive solutions to health problems impacting Aboriginal communities across Central Australia.

“We have put so much effort into centralizing our data; we are now ready to find better ways to analyze it and derive insights that could lead to a deeper understanding of the health issues of Congress clients,” McDougall says. “AI and ML would be able to assist us in making connections that we have not already made, and it is our hope that this could help us to direct our efforts to where they are needed most.”

Congress hopes to leverage the wealth of information it has accrued since the start of its cloud journey, to continue improving health outcomes for Aboriginal people and promote the development of skills and job creation, with regards to digital transformation in Central Australia. “We do not see ourselves to be in competition with anyone, and are open to sharing with others in the industry how they can embark on similar journeys. At the end of the day, we are all working towards the same goal, which is to improve the standard of healthcare for Aboriginal people,” says Osborne.


About Central Australian Aboriginal Congress

Congress is a leading Aboriginal community-controlled health service with over 430 staff and 22 locations, providing comprehensive primary health care services in Alice Springs, Northern Territory, and six remote Central Australian communities.

Benefits of AWS

• Improved access to patient data and reduced clinical risks
• Scaling on demand
• Running Microsoft workloads on AWS

 


AWS Services Used

Amazon EC2

Amazon EC2 is a web service that provides secure, resizable compute capacity in the cloud. It is designed to make web-scale cloud computing easier for developers. Amazon EC2’s simple web service interface allows you to obtain and configure capacity with minimal friction. It provides you with complete control of your computing resources and lets you run on Amazon’s proven computing environment.

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Amazon S3

Amazon S3 is an object storage service that offers industry-leading scalability, data availability, security, and performance. Amazon S3 provides easy-to-use management features so you can organize your data and configure finely-tuned access controls to meet your specific business, organizational, and compliance requirements. Amazon S3 is designed for 99.999999999% (11 9's) of durability, and stores data for millions of applications for companies all around the world.

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AWS Auto Scaling

AWS Auto Scaling monitors your applications and automatically adjusts capacity to maintain steady, predictable performance at the lowest possible cost. Using AWS Auto Scaling, it’s easy to setup application scaling for multiple resources across multiple services in minutes. The service provides a simple, powerful user interface that lets you build scaling plans for resources including Amazon EC2 instances and Spot Fleets, Amazon ECS tasks, Amazon DynamoDB tables and indexes, and Amazon Aurora Replicas. With AWS Auto Scaling, your applications always have the right resources at the right time.

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Elastic Load Balancing

Elastic Load Balancing automatically distributes incoming application traffic across multiple targets, such as Amazon EC2 instances, containers, IP addresses, and Lambda functions. It can handle the varying load of your application traffic in a single Availability Zone or across multiple Availability Zones. Elastic Load Balancing offers three types of load balancers that all feature the high availability, automatic scaling, and robust security necessary to make your applications fault tolerant.

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