what was delivered
Web and Native Mobile Apps (Web, Android, iOS)
Back end platform with integral Clinical Decision Support system
Design, recruitment and onboarding of xWave Product and Technology teams
Implementation of robust and efficient product management processes
Agile development methodology with Continuous Integration / Deployment capability
Support during investment and enterprise sales processes
Client: xWave Technologies
When: Started 2020
Services: Platform & App development / CTO-As-A-Service
In 2020, xWave and the world's leading radiology group, the European Society of Radiology, agreed a partnership. Their goal was to digitise, improve and automate the referral, protocoling and scheduling of patients for radiology procedures. This would be done by applying AI and machine learning technologies to clinical data resources.
Threadable were chosen to build the new health platform xRefer. This was based on our track record of building innovative disruptive healthcare platforms.
The high costs of a broken workflow
Radiology scans are a common feature in healthcare. In Europe, approximately 350 million radiology scans are carried out in both public and private sectors annually, at a cost of €40 billion.
But approximately 30% of scan requests are inappropriate and unnecessary. This results in high costs for patients, who may experience adverse outcomes, and healthcare funders and insurers, from a financial point of view.
A smarter solution
xWave and the European Society of Radiology were seeking smarter solutions for the radiology workflow, that would:
- drive better patient outcomes through more effective identification of appropriate procedures at the point of referral
- generate savings for health providers by reducing inappropriate referrals
- identify and exploit the excess capacity available but hidden across health and clinical facilities
Stakeholder and user engagement
Our partnership with XWave began with a series of discovery workshops with all stakeholders involved in the existing manual process. We also sought feedback from hospital management and clinical governance specialists. Then, using this information, we moved into prototyping UX journeys, which we validated with user communities.
HL7 FHIR Interoperable by design
The founding team, led by leaders in healthcare and Radiology knew interoperability with other healthcare systems was a key requirement.
Providing the broadest context into a longitudinal patient record is crucial for doctors, consultants and radiographers to form a complete picture of a patient to support scan ordering through to protocoling and reporting.
HL7 standards act as a bridge between modern healthcare services and advancing information technology. With support for HL7 R2 through to HL7 FHIR, the xRefer product is simple to deploy standalone or fully integrated across hospital trusts, doctors and imaging centres.
A flexible, smart solution
The resulting xRefer solution is a multi-tenancy platform. Each clinical institution can use it to configure how they manage outbound referrals and inbound scan requests from other clinical institutions.
It brings all stakeholders into the journey including consultants, referring doctors, finance and billing teams, protocoling teams, patients, radiographers, and radiologists.
The xRefer platform supports:
- the definition of different roles and actors within each organisation
- flexible approval workflows
- a dashboard to ensure adherence to internal referral protocolling processes
- seamless integration with existing in-place referral methods
- hospitals to enable xRefer users to create and dispatch referrals destined for hospitals that are not using the xRefer platform.
Improved workflow and efficiency
xRefer simplifies the creation of radiology referrals for clinicians, doctors and GPs. It gives them a cloud-based digital referral platform for dispatching and tracking referrals to any institution that provides radiology services.
Security and auditing
Through out partnership with Deloitte we designed secure automated pipelines to support a robust release management process. The solution is hosted in a fully managed environment with secure and audited access controls appropriate to the processing of Protected Health Information (PHI), including HIPPA and ISO Compliance.
Identification of appropriate procedures
A core component, the clinical decision support (CDS) system supports the referrer to identify the best imaging solution to meet the clinical indications of their patients. This reduces overall scan volumes by 15% and provides multi-million-euro savings for healthcare funders and insurers.
Transparency for referrers
The flexible workflow within the solution provides full visibility and accountability to both receiver and referrer. For the first time, referrers will know the exact stage their patient is at in the process at any one time.
Patient engagement in the process is achieved by allowing them to select their preferred hospital and schedule appointments to suit their availability. This reduces costly DNA's (Did Not Attend) for hospitals and clinical institutions.
99.4% reduction in time to order referrals
15% reduction in overall scan volumes
30% of scans were improved though the use of the CDS
One of the most enjoyable and educational experiences I have had in my career to date has been working alongside Threadable. They provided us with "as-required" access to a broad team of skilled specialists with commercial, strategy, technical and operational capabilities to create a highly secure digital platform that has resulted in us gaining traction quickly with hospitals and clinical institutions across the world. As our business grows we continue to leverage their strategic, technical and healthcare domain experience.
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