543 - Developing a Business Case for Advanced Patient Flow. Nick White, Alcidion

In a healthcare system where every dollar and decision counts, the difference between a good idea and a funded one often lies in the business case behind it. With patient flow challenges growing across Australia, the need for clear, strategic digital health proposals has never been more urgent.

In this episode of Talking HealthTech, Peter Birch speaks with Nick White from Alcidion about the challenges, strategies, and frameworks involved in developing business cases for digital technology initiatives in healthcare, with a particular focus on patient flow. Nick shares his experience on aligning technology adoption with organisational priorities, the complexity of healthcare funding and stakeholders, and ways to evaluate and communicate the impact of digital solutions, including real-time data platforms and AI capabilities.

Building a Stronger Business Case for Digital Health in Australia: Patient Flow, Priorities, and Practical Strategies

While digital technology is currently playing an increasingly vital role across the healthcare sector, securing funding and organisational backing for new solutions remains a challenge. In the absence of a solid business case, even the most promising ideas can struggle to gain traction. This episode of Talking HealthTech explores what makes a compelling business case for digital health, with a focus on patient flow solutions and lessons learned from real-world hospital implementations.

As technology continues to disrupt traditional models of care, the challenge shifts from “can this be built?” to “should we invest in this right now?”. Business cases serve as the bridge between vision and execution. In healthcare, however, this process is shaped by distinct challenges, including fragmented funding models, diverse stakeholder interests, and the fundamental duty to prioritise patient care.

Why Patient Flow Is Front and Centre in Australia

Patient flow, or the movement of patients through acute and post-acute care, has never been more urgent for the Australian healthcare system. Population ageing, increasing complexity of chronic conditions, staff shortages, and difficulties discharging patients to appropriate post-acute settings have led to system-wide blockages. Beds sit full, emergency departments overflow, and the pressure on resources only intensifies. As Nick White puts it: 

“Patient flow is a national priority for Australia. Stories from every health system across the country are the same. We’re all struggling with ageing populations, complex chronic conditions, and staff shortages.”

Improving patient flow isn’t just about efficiency. It touches clinical risk, the well-being of frontline teams, system costs, and the patient’s experience. Blockages mean more than longer waits; they can lead to adverse outcomes and a demoralised workforce.

Beyond Justification: A New Way to Present Digital Health Business Cases

A subtle but crucial distinction defines the strongest healthcare business cases: less about “justifying” spending, more about “explaining” the evidence, motivations and fit with strategic priorities. Explaining the reasoning behind proposed tech adoption, rather than selling it as the only logical choice, may produce stronger, more useful business cases. Nick notes:

“Justification is a bit of a negative word. It suggests it’s the wrong thing to do and I’m trying to convince you otherwise. It may well be that a business case is sound, but it’s not aligned with strategic priorities right now. It doesn’t fit with where the organisation is going.”

This is especially salient in times of rapid change. Major tech investments aren’t always rejected on merit; they may simply be out of step with the timing or direction of the health system. Good business cases consider not just evidence but also context.

The Nuts and Bolts of a Healthcare Business Case

Unlike consumer industries, where return on investment is often straightforward to calculate, business cases in healthcare must address more than just financial outcomes. Clinicians such as nurses and doctors often have a strong sense of what needs to change on the ground, but turning that insight into a persuasive business case for digital health can be difficult. Translating frontline experience into a proposal that leads to real change requires specific skills that many healthcare professionals have not been trained in. Nick White highlights this difficult terrain: 

“It’s not part of everybody’s day job to do a business case. So it’s not something that comes naturally to a clinician who has been a nurse for many years and is asked to do their first business case. It’s a hard thing to do, and in healthcare, it’s even more complex.”

The challenges come from several sources. Healthcare involves a wide range of stakeholders, including clinicians, administrators, IT professionals, patients, and technology vendors, each with different goals and expectations. Funding is often drawn from multiple sources, each with its own reporting requirements. In addition, decisions must be made within an ethical context where spending on technology could mean fewer resources for clinical staff or essential infrastructure.

Quantifying the Unquantifiable: Measuring Health Tech Impact

Many of the benefits of digital health are subtle, take time to appear, and are not always easy to measure. However, it is still possible to take a financially sound and structured approach, especially by using frameworks from health services research.

One widely used framework is the Quadruple Aim. This model encourages healthcare leaders to consider four key areas when evaluating an investment: patient experience, population health, financial impact, and clinician experience. Nick White points out:

“In healthcare, the four pillars are financial impact, operational impact, strategic alignment, and the clinical impact we’ll have. That framework gives you something concrete to focus on.”

In the case of patient flow technology, measurable outcomes might include shorter hospital stays, faster bed assignments, fewer patients placed in the wrong ward, or better discharge planning. These changes can produce broader system improvements, which, when supported by careful data collection, can become strong evidence in a business case.

Nick also advises healthcare professionals to clearly document every assumption they make during the planning process. Whether it is in a spreadsheet or a simple text document, recording these assumptions and backing them up with independent studies or real-world case data helps make the business case more credible and transparent:

“Have a tab in your spreadsheet, or a Word document, for every time you make an assumption. Then capture it in the business case, because people will be looking for them.”

The Human Side of Business Cases in Healthcare

In industries outside healthcare, business cases often focus on financial return on investment (ROI). Spend a dollar, make back four; simple on paper. But healthcare defies this simplicity, because outcomes are often people-centred, not just profit-driven. As Nick puts it:

“Every dollar spent on software is a dollar not spent somewhere else, maybe on more nursing staff or new beds. In healthcare, the logic to invest isn’t always just about money. It’s about better outcomes for patients, less frustration for clinicians, and, importantly, whether the proposed solution aligns with our strategic direction.”

Health service providers must weigh complex factors that go beyond the bottom line: life-and-death decisions, ethics, regulatory compliance, and a diverse range of stakeholders from clinicians to administrators and investors.

Exploring the Full Value of Patient Flow

Some benefits from digital health investments are expected; others emerge later, “like ripple effects that can be even more valuable,” says Nick. Fixing patient flow often sets off a chain reaction of system-wide improvements.

Consider the issue of hospital outliers, where patients are admitted to a ward that is not suited to their condition because the appropriate one is full. Research shows that these patients often stay in the hospital twice as long and face a greater risk of negative health outcomes. Addressing this problem can lead to more available beds, less overcrowding, and more efficient use of staff time, all of which contribute to better patient care.

However, measuring the value of this freed-up time, often referred to as "released time to care," is not simple. Unlike in industries such as manufacturing, where efficiency gains can be directly linked to cost savings, the benefits in healthcare are less tangible. They may appear in ways such as staff being able to finish their shifts on time, having opportunities for professional development, or spending more meaningful time with patients. In a system already under strain from ongoing workforce shortages, these less visible outcomes can be just as important as measurable financial returns.

Navigating Change: Winning Over the Clinical Workforce

Healthcare is a complex, highly regulated space. Clinicians are ultimately focused on delivering the best outcomes for their patients, and introducing new technology into established workflows can be seen as a threat, not out of a reluctance to change, but out of a duty to maintain safe, proven processes.

“It’s not that staff are resistant to change. Typically, they’re cautious — they’re making sure patients come first and care isn’t compromised,” says White. When change is introduced, it’s vital to ensure the new solution makes “the right thing to do the easy thing to do.”

Showing that digital health doesn’t compromise safety or quality helps bring clinicians on board. For instance, the emerging body of research on remote patient monitoring and hospital-in-the-home programmes is starting to show not just safety, but improved outcomes for many patients.

The Challenge of Health Technology Architecture

A thorough discussion of digital health investment must include the challenge of technology integration. The technology infrastructure in healthcare, often referred to as the tech stack, typically combines older legacy systems with newer digital solutions. Determining when to enhance existing platforms such as the Electronic Medical Record (EMR) and when to introduce specialised applications requires careful consideration and is rarely a straightforward decision.

“What is the strategic direction of your health system?” asks Nick. “If you’re introducing new software, does it align with that direction, or add extra complexity? Sometimes clinical needs will justify doing both, but alignment makes for a stronger business case.”

In practice, this means mapping new solutions to existing data standards, especially Fast Healthcare Interoperability Resources (FHIR), and ensuring that information can be accessed in real-time across the organisation. 

Digital Patient Flow: From Luxury to Necessity

For many years, patient flow technology was viewed as a desirable addition rather than a necessary investment. However, in the context of Australia's resource-limited and high-demand healthcare environment, digital solutions for patient flow have become essential. The objective is not to adopt technology for its own sake, but to support frontline staff, enhance the patient experience, and ensure that every dollar is used effectively.

In this setting, well-developed business cases are critical. They often determine whether a solution is implemented or set aside. By concentrating on pressing issues such as patient flow, healthcare leaders can drive meaningful improvements in the system through thoughtful and evidence-based investment.

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Alcidion