The roots of a digital transformation journey

First Nations Health Authority (FNHA) is the result of 10 years of negotiation to create a health care governance structure for First Nations populations in British Columbia, Canada. Taking time and care to build the right foundation for the future is core to FNHA’s values. According to Jeff Gingera, Director of Project Management Office (PMO) and Business Analysis at FNHA, the organization’s directives and values—such as consensus, agreement, and trust—inform everything it does. “We focus on what we can do proactively to support the health of the population,” he says. “That’s where our IT solutions play a key role, brokering data between programs and services so that we can coordinate patient data and providers with various program services.”

The FNHA offers coverage across BC, including remote communities that are accessible only by boat or plane. Mobile phone coverage and broadband access can be challenging in these remote areas, where infrastructure is susceptible to weather events and natural disasters. Within the organization, these geographies are divided into five regions: Vancouver Coastal, Interior, Fraser Salish, Northern, and Vancouver Island. Each region has developed their own regional health and wellness plans in collaboration with the communities they serve. The FNHA works with nations and communities to bring programs and services closer to home to improve their health and wellness outcomes.

In 2019, FNHA began deploying Microsoft 365, including SharePoint and Microsoft Teams. Employees used Microsoft Access databases, SharePoint sites, and Excel spreadsheets for daily workflows, non-Microsoft systems, and pen and paper. The organization wanted to transform delivery of its community-based health and wellness services while standardizing processes, but choosing technology that could integrate with disparate enterprise solutions to support both patients and internal users was a challenge. “We were leading the digital transformation conversation in health care as a young organization while creating a service delivery strategy for improvements within information management and IT, which includes our enterprise applications, productivity tools, core technology, architecture and security,” says Stuart Bourhill, Chief Information Officer and Vice President of Information Management and Information Technology at FNHA. “There was a significant set of considerations and stakeholders across a complex environment.”

Raising ‘Voices’ to serve the community

FNHA based its new solution on Microsoft Dynamics 365 Customer Service and Microsoft Power Platform. A survey of its stakeholders yielded the name “Voices of Our Relations” (“Voices,” for short). The organization identified nine use cases to focus on first: complaints and compliments, nurse daily logs, health care navigation, crisis management, safety hazard management, community health plan request management, health benefits operations, oral health tracking, and health emergency development, resiliency, and response.

As of January 2023, FNHA is using its Voices solution for these functions to better capture and use data and streamline services. The organization worked with new IT partner, ITK Consulting, to store system data in a main repository. Each of the use cases has an associated Microsoft Power Platform application, which in some cases replaced a previous solution. “We took a risk making such a sweeping change,” says Bourhill. “However, this project has propelled us to stage a true digital transformation.”

The Quality Care and Safety Office (QCSO) has been using Voices since December 2021. “The Voices system has transformed our work process, allowing us to spend more time on client interactions rather than documenting in multiple different systems that didn’t work together,” says Laurie Edmundson, Manager, Quality Care and Safety at FNHA. ”Now we have a streamlined way to include regional positions into the QCSO workflow and its intuitive system made training new positions a breeze! I have recommended Voices/Microsoft Dynamics and Jeff’s team to many other departments in the last eight months, and will continue to do so any chance I get.”

A community-based view of patients

To track client interactions, complaints, and compliments, FNHA uses Voices to capture nurses’ daily chart and activity logs and to aggregate the data from various systems. Employees uses Voices to help clients navigate the health system and to ensure their needs are met—often, through interactions with multiple agencies to manage patients’ health journeys. For example, this process could include recording contact with separate external agencies to book an eye exam, request a wheelchair, get a ramp installed in a home, or order blood glucose test strips to help a patient manage diabetes.

“The Nurses Daily Log – Voices system has allowed us much greater insight into our nursing operations, with benefits such as easy entry, real-time data, and aggregate reports that make it much simpler to plan programs and services in support of patient care,” says Suzanna Ho, Manager, Quality and Client Experience, Nursing at FNHA.

“The solution is cloud-based, so it’s always accessible, even from remote areas,” says Gingera. “We use it to automate crisis-support requests. For example, a mental health crisis can be associated with current events, like the recent discovery of grave sites at residential schools. This atrocity has affected First Nations communities both in the immediate area and across the province. The Voices solution will help us coordinate and navigate our response to crises and provide the right support.”

The FNHA provides hundreds of millions of dollars in health benefit coverage through partnerships with Pacific Blue Cross (PBC), BC PharmaCare, Indigenous Services Canada (ISC), and First Nations organizations. To support this critical function, FNHA uses the Voices system to coordinate its support of client enquiries around vision, dental, medical supplies and equipment, and prescription benefits. The data from these interactions is available in trend reports that FNHA uses to identify opportunities and gaps, and to make strategic decisions about current and future services.

Data transparency balanced with information security

When it comes to controlling data access, Gingera says, “We’re grateful to Microsoft and ITK for helping us design the data security. Only those who are authorized have access to information, which can be aggregated and anonymized so management can make decisions based on patterns without seeing patients’ personal data.” He notes that ITK took the time to understand FNHA’s business and set the right security parameters. ITK’s project team also completed the San’yas Indigenous Cultural Safety Training Program to bolster its awareness of Indigenous communities and treatment in Canada. “We’ve seen hundreds of projects in our careers, and this is one of the best vendor experiences ever,” notes Gingera.

Data captured in the system is available immediately. This aggregation of real-time data into reporting for long-term decision making, trend analysis, and efficiency evaluations will be valuable going forward.

A foundation for growth

Although it was a high-stakes project—new software deployed in a Hybrid-Agile approach with a new vendor, ITK, as a first foray into the cloud—feedback has been overwhelmingly positive. The Nurse Quality team leader likens it to accelerating her team’s processes from five to ten times.

The FNHA has many more use cases in line for Voices. “Microsoft Dynamics 365 is an excellent solution for automating workflows, simplifying data capture, and presenting information back to clients, both in real time, heads-up displays, and with reporting,” says Gingera. “It’s a case management and workflow automation tool that when combined with Microsoft Power Apps and Microsoft Power BI is a true enterprise solution. Very few systems are so flexible, which helps us solve many business problems.”

When FNHA completes its full Microsoft 365 adoption, it anticipates even more Dynamics 365 benefits. The organization is looking forward to taking advantage of the fact that Exchange Online is in the cloud and its OneDrive deployment is fully activated. “We’ll be able to incorporate Power BI features like Power Automate more often in the future,” says Gingera. “Microsoft Dynamics 365 and Microsoft Power Platform are an amazing foundation to build on for patient experience and case management, empowering our employees to bring their creativity forward and increase productivity.”