HUS – operations management reporting provides a real-time snapshot to support daily management

Hospital District of Helsinki and Uusimaa, or HUS, Finland’s largest healthcare operator, uses a visual tool for its operations management to monitor the ratio of patients to staff resources in different hospital units, updated every 15 minutes. The daily management snapshot developed jointly by HUS and Pinja automates the manual work previously associated with operations management, now making workload situations transparent and supporting daily decision-making. Encouraged by the positive feedback, the solution will be extended from inpatient wards to outpatient clinics in the next phase.

The cooperation in brief

The aim was to automate daily management snapshots

The data on patients and staff members needed for daily management previously required manual data collection in HUS units. The data was manually extracted from various sources into a large Excel spreadsheet, which was updated twice a day. In the spring of 2021, the HUS Abdominal Center and, as a result, HUS more broadly set the goal of creating a snapshot automatically and in real time.

New solution that updates the snapshot every 15 minutes

The system solution, built together with Pinja, replaced the previous Excel spreadsheet, and now provides a snapshot of the situation in real time. The transmission chain from source systems to reports is automated, and information on patient numbers and staffing trends is updated in the summary view every 15 minutes to support daily decision-making.

The next step is to extend its use to outpatient clinics and surgical units

The snapshot solution was developed to be easily scalable. The pilot phase demonstrated the benefits of the system solution in supporting operational management, and the use of the system was gradually extended to more than 120 inpatient wards in HUS. With good experiences and positive user feedback, the next step is to move on to outpatient clinics and surgical units. Artificial intelligence-based forecasting models are also being developed to support the snapshot.

The daily healthcare management project is a model example of successful cooperation between a public operator and a business partner to develop the daily management of healthcare

Markku Mäkijärvi, Director General at HUS

The snapshot supports decision-making, facilitates resourcing, and increases security

HUS wanted to modernize its snapshot monitoring, above all to support decision-making related to daily management, optimize human resources, and increase patient safety. It was also considered important that real-time indicators help to increase transparency, job satisfaction and commitment of carers, and provide opportunities to influence the design of their work.

For monitoring purposes, it was necessary to know how many patients were on the ward at a given time, how many more were expected to arrive during the day, and how many were being discharged. Another important piece of information was the human resource, i.e. the planned and the actual number of staff – for the latter, acute absences had to be considered.

A modern snapshot solution was a strategic goal for HUS

In spring 2022, HUS and Pinja launched a joint development project to further design, define, and implement a snapshot solution. The implementation phase started in fall 2022. The information officer for the reporting solution was Tommi Juntunen, Special Planner from HUS.

– We needed an automated snapshot of the changing landscape of healthcare that would allow us to monitor patient flow in real time and with confidence. This was also one of our strategic goals for 2023, says Tommi.

Patient and resource status data was previously collected manually from several different data sources into a large Excel file. Patient numbers were manually extracted from the Apotti patient information system, staff resources from the shift planning system, and acute staff absences from various communication channels.

– Excel was no longer a solution for the 2020s – we wanted to move to the modern age in this respect as well. We already used Microsoft Power BI reports for many other purposes, Tommi says.

The snapshot update interval was reduced from 12 hours to 15 minutes

A key challenge in building the snapshot was time. The aim was to collect information from different sources to support daily management in a reliable and secure way, but as quickly as possible. The aim was specifically to provide an up-to-date snapshot of the situation so that decisions could be taken with confidence.

– In practice, the updating of data was carried out in as real time as is possible in such a multi-dimensional environment. The previous Excel spreadsheet was updated twice a day, and now the goal was to update reports every 15 minutes. This goal was also achieved, says Jaakko Niskanen, Project Manager at Pinja.

Getting data through all the necessary steps in a large environment is challenging with traditional reporting tools when the goal is to report in real time. 

– For real-time and reliability, we decided to separate the operations management solution into its own environment that also serves other snapshot products, says Niskanen.

PowerApps provided a convenient solution

The development project automated the extraction of data from Apotti, the data pool, and the data warehouse, and also developed a new solution for acute absence management, which aggregates the data into a common operations management report view. The technology solution for managing acute absences and beds, for example, was Microsoft’s Power Apps platform, which has since been extended to other purposes at HUS.

According to Jaakko Niskanen, who consulted on the technology choices, Power Apps has proven to be a very convenient solution for situations where there is a need to enter and store data in a format suitable for reporting.

– In the case of HUS, we were able to use Power Apps to streamline workflows, and collect snapshot data that was not directly available in the source systems. The threshold for implementing Power Apps is low, and it is cost-effective to build solutions on top of it, especially when the client owns Microsoft licenses, Jaakko says.

The snapshot solution was made scalable

From the very beginning, the snapshot solution was built to be scalable, as the aim was to extend its use comprehensively to the different units of HUS. The pilot was started in the inpatient wards of the HUS Abdominal Center, and thanks to the positive feedback, the solution has since been widely adopted in other units. It is currently used in more than 120 inpatient wards in HUS.

The new solution is now used by around a thousand employees at HUS, and covers almost all clinical wards. Next, outpatient clinics and surgical units will be included. There are also plans to build predictive models based on artificial intelligence to support snapshots.

– Now that we’ve had time to gain experience across HUS, it’s clear that the need was real, and the snapshot solution has provided much-needed support for decision-making. User feedback has praised the ease of use of the service and the fact that real-time information is available at all times, says Tommi.

A broad partnership makes cooperation straightforward

HUS and Pinja have worked together since 2020. Joint implementations can already be found in many areas, including the HUS data warehouse solution, integration services, and reporting of operating room activities.

In the case of the snapshot solution for daily management, the project was promoted by a core team of experts from HUS and Pinja, which was expanded at different stages of the work with additional experts. In particular, during the validation and scaling-up phases, the development work has also involved a wider range of users.

– Above all, this has been a good collaborative project. Having been involved from the very beginning, I can say that this would not have been possible without good and seamless cooperation – from the data warehouse developers to the reporting experts. I can openly praise Pinja, and I have praised them on many occasions during the project. It has been a pleasure to work together with Pinja’s experts, and my own skills have also developed in many ways, Tommi says.

– The daily healthcare management project is a model example of successful cooperation between a public operator and a business partner to develop the daily management of healthcare, says Markku Mäkijärvi, Director General at HUS.

Jaakko agrees.

– Overall, the cooperation has gone well. HUS has a dedicated and competent project team that enabled the project to progress smoothly, and we have also gained a good deal of substantive knowledge over time. Another reason why it is nice to work with HUS is that the work is done without unnecessarily rigid practices. We simply formulate, define, and implement what is needed together.

HUS in a nutshell

1. Finland’s largest healthcare operator

27,500 employees

2.2 million inhabitants in its cooperation area

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