SA Health’s Sunrise is ready to make us the envy of the world
By Dr James Malycha
James Malycha is a senior intensive care doctor at The Queen Elizabeth Hospital. In November, he’ll be demonstrating a new system to the world’s largest healthcare informatics symposium. The system is called CCCIS and it integrates SA Health’s Electronic Medical Records (EMR) with a state-of-the-art AI solution. Within just a year, it could not only relieve pressure on overworked hospital staff, it could give them a clinical tool that will be the envy of the world. And the crazy thing? This new system perfectly mirrors the old bedside chart…
In November, I’m flying to Atlanta to the American Medical Informatics Association, a symposium of 3000 delegates. I’ve been invited to demonstrate how South Australia could – somewhat inadvertently – be on the forefront of digital healthcare.
Let me explain…
South Australia is in the unique position of having all its clinical data – your, my, our health records – gathered in a single system called ‘Sunrise’.
Anybody who’s followed along since 2017 will know that implementing this Electronic Medical Records (EMR) system into our public hospitals hasn’t always been easy. But here’s the good news: Sunrise is on the threshold of revolutionising clinical care and making South Australia the envy of the world.
Sunrise links all the state’s public hospitals together. Every day, patients’ data – vital signs, medications, clinical notes – are entered by doctors and nurses via computer ‘workstations on wheels’ (or WOWs).
Underpinning Sunrise is a vast database. Interrogating the data has proved difficult, but at least it exists, and better still, it has matured. So, eight years after the EMR was installed we’re in the perfect place to realise its power and potential. And perhaps you won’t be surprised that the key to this is Artificial Intelligence.
I’m working with a new AI system called the CALHN Critical Care Informatics System (CCCIS for short, though we call it ‘Kiss’).
It’s the result of four key partners: Digital Health SA, part of SA Health which enabled CCCIS to work with Sunrise; Central Adelaide Local Health Network (CALHN), the hospital network that runs The RAH and TQEH, and has supported the project for two years; HeartAI (the AI developer I’m part of); and AusHealth, the Adelaide-based medical research charity and health tech incubator.
Over the last six weeks, I’ve asked a number of doctors and nurses to test CCCIS in their busy wards. At present, it works on the WOWs, but the interface mimics the old ICU paper charts that used to sit at the end of the bed. In the next 12 months, we’ll begin testing the system on touchscreens which quite literally mimic the ICU chart and allow doctors and nurses to once again be at the bedside.
It’s no exaggeration to say they’ve loved going ‘back to the future’ – the digital chart is fast, easy and familiar. But they’ve been blown away by the new level of empowerment afforded by AI.
Working directly with Sunrise, CCCIS can answer questions like ‘what is the trajectory of this patient’s vital signs?’ or ‘has this patient’s IV drip been in for too long?’. This year, we anticipate CCCIS using AI to answer even more sophisticated questions like, ‘Assess the risk of this patient developing an acute kidney injury – and recommend a correct drug to avoid it.’
And no, the AI is not taking over! It’s built to ensure the human is always in the loop. As we say in AI, ‘it’s working under the bonnet not behind the wheel’.
This is ground-breaking stuff. It didn’t happen easily, but neither did it happen by accident.
The culture in South Australia has allowed for powerful and capable forces to come together: Digital Health SA has proved a rare example of a public workforce working successfully with a private vendor to enable this single-model EMR; the government has been brave enough to stick with the program through thick and thin; and the former and current CEOs of CALHN saw the potential of liberating the full potential of Sunrise through a safe implementation of AI.
Now, to be clear, our project is at the research stage. Our next challenge is to transition CCCIS into an operational-grade platform – and that’s when we’ll see if it can really hold up in the fierce heat of a working Intensive Care Unit, a frantic emergency department or a bustling surgery ward. And if it works in the QEH? Well, we can scale it up to the entire state at the push of a button.
So, believe me when I say, even though it’s taken a long time, the extraordinary power of Sunrise is dawning. We’re starting to see the light.