Fighting disruption in the Health sector

Posted by  Ton Dobbe

An interview with Sarndrah Horsfall – Executive Director, Business Services at AHPRA, Australia

Recently I interviewed a number of customers around the question “How do you fight disruption in your sector”. One of the people I talked to was Sarndrah Horsfall who leads the business services division within the Australian Health Practitioner Regulation Agency (AHPRA).

AHPRA is the national organisation responsible for implementing the National Registration and Accreditation Scheme across Australia. They were founded in 2010, are self funded, operate on a budget of AUD$ 170 million and employ +800 people and work with over 1400 board, committee and panel members.

Can you explain the major challenge faced in your industry today i.e. What’s happened/happening and why is doing nothing not an option?

“In 2010 AHPRA, our organiation, was formed out of 38 organisations across 8 States and Territory jurisdictions. Besides this restructuring it encompassed the transition of 97 health professions board down to 14 Professional National Boards with 650,000 registered practitioners, and on top of that a complete new National Scheme governed by 1 National Law which was developed from 78 separate Acts of Parliament and 1.5 million data items from 85 different sources.

As you can imagine mastering such a transition meant a lot of changes and concessions along the way for us to be up and operating from 1 July 2010. However, 6 years on we now realise we have a very complex regulatory environment which will need modernisation. Here’s why:

The mutlifaceted nature of our National Scheme has meant we have developed very complex processes that restrict us from being as efficient as we could be. We are too resource intensive. 

Let me give you an example: We manage not only registration and accreditation of +650.000 health practitioners but also complaints about practitioners. Complaints (we call them notifications) are when a member of the public, a patient, colleague or an employer is concerned about the health, conduct or performance of a registered practitioner.  

We have seen a rise of 24% since last year with over 6,000 complaints received nationally. And this is a trend that is likely to continue. To keep up we have two options: change or simply add more staff to manage the process. The latter is not an option for an organisation that’s managed under a tight budget.

And we all know that  the future of regulation means that businesses cannot stay the same, we have to change. Not being disrupted is not an option.

Facing the challenge – what were the top initiatives you introduced to prevent being disrupted / to disrupt your industry and with what objective specifically?

“Unfortunately I don’t do preventing disruption well – I do disruption very well! I came in about 18 months ago and have a track record in managing strategic change in complex environments, organisational development, team development, financial and performance management. In that period we have developed our ‘disruptive’ transformation program which encompasses four key initiatives to deliver AHPRA’s transformational change that will provide better service, better value and a more responsive and adaptable organisation. These pilars are: policy and process, people and culture, enablers (technology) and last but not least a collaborative workplace.

The main objective was to understand the complexity of the business, including the lack of workflow support and an over-reliance on manual processes.  This led us to commence a lean review of all of our business and regulatory processes.  The outcome was a very cumbersome process with a high degree of “noise” (non-value adding activities) in our system.  For our back office systems the 57% of Finance and Procurement activity and 51 % of Human Resources activity was identified as noise.  Manual processing, manipulation and a lack of system supported processes was the main cause of the noise.  You can imagine how we could revolutionise our systems and processes if similar “noise”  levels were applied in other areas.

What were the top 3 things that really worked well for you in making these intiatives successful? And how do the results look so far?

We are still in the early stages of our program but we cannot over emphasis the need to communicate to your staff and external stakeholders enough. Our role is to bring them on our journey with us as we look to make small but gradual changes. The 2nd one is around cultivating a positive environment to support our people to be the best and we have invested in providing learning experiences to facilitate change resilience. The last thing is change management. This is crucial and the one area we invested in before we kicked off our transformational program. And technology is crucial in relation to this. So to support these initiatives we are implementing new systems across the entire business.

How does the Unit4 product contribute to success? How critical is the product in relation to this?

“That’s clear: being able to make decisions in real time especially in turbulent times. It’s crucial that key staekholders have full confidence in us. Information is the foundation for all our decisions and as such it needs to be 100% accurate, timely and relevant at all levels of the business. We selected Unit4 Business World On! as our ERP backbone. In particular it’s architectural design allows us to deliver upon the sophisticated information needs of our organisation. We can model the business any way we want in the system so that it reflects the complexity of our business and changes with it as we evolve.

Business World On! will be the platform that consolidates over 12 finance systems nationally. It will be the foundation to get everybody on board to create an organisation that operates effectively and efficiently. Every part of the business will be touched over a period of 12-18 months. So it’s really transformational. But its for the right cause; it’s about empowering all our people to become self-sufficient, more productive and deliver value through great service delivery.

What did you learn along the way i.e. what would be your advice to others in a similar situation?

“It is critical to bring your staff, decision makers and stakeholders along on the journey. You need to create the change wrap around keeping everyone on board during the journey. Inevitably some will question whether this is working – change can be hard for people and there will be times when transition is less smooth - but it’s imperative to keep them on course recognising that you need to adjust your plan to take into account changes to your enviornment.”

Ton Dobbe

Ton joined Unit4 in 1991 as a partner manager before moving to the product team and subsequently taking the position of product manager. He became global head of product marketing in 2015 and has since been responsible for some of Unit4’s most successful product launches. He took on the role of chief evangelist in 2016.