Turning a citizen-built clinical app into a faster, audit-ready tool

The challenge

Between 2021 and 2023, East Metropolitan Health Service (EMHS) saw higher than expected rates of blood transfusion during hip and knee surgery. It introduced a Patient Blood Management pathway to monitor and support high-risk patients before and after surgery.

A Power App built internally by a citizen developer helped track these patients and coordinate their care. As its use grew, new requirements emerged and the app became hard to maintain. The EMHS Digital Design and Innovation team asked us to uplift it, make it more reliable and prepare it for future expansion.

Our approach

We focused on scalability, performance and the user experience.

We rebuilt the app's core components to remove failing logic and make data handling consistent. SQL stored procedures now manage create, update and delete operations in the database, which improves reliability, maintainability and performance. Every data query is fully delegable and targets SQL views, for faster, more accurate reporting and audit readiness.

We redesigned the interface for responsiveness, accessibility and readability, replacing a harsh red palette with a calmer clinical design that adapts to any screen size. Static screens became Power Apps components, so parts of the app can be updated without touching the whole.

We also added new clinical tools: follow-up tracking with colour-coded reminders, manual entry of blood results from sources that are not integrated, and snapshots of blood results to capture and audit each patient's progress over time.

The outcome

Clinical efficiency improved significantly. Follow-ups are faster and more accurate, there is less duplicated effort across systems, and the app supports better patient management decisions.

For one of its users, reviewing ten patients used to take nearly two minutes and now takes 13 seconds, and follow-ups that happened twice a week now happen daily.

Next, the EMHS team is using data from the app to build a Power BI dashboard that will identify transfusion trends and guide clinical decisions across more specialties.