Community mental health case managers had become data archaeologists — spending most of the day assembling fragments instead of acting on clinical judgment. We moved the sensing work to the system, and gave the clinical day back.
A time-motion study across South Australian public community mental health services found case managers spending the majority of their day reconstructing clinical pictures from disconnected systems — not interacting with the people on their caseload.
Community mental health case managers spent 60 to 90 minutes each day searching three to four separate systems to figure out who among their caseload needed attention. That hour and a half came out of clinical time.
A formal time-motion study of 53 professionals across nearly 400 observed hours showed how the day was actually being spent: 43% on EMR interaction, 39% on professional coordination, and only 18% on actual consumer interaction.
The configuration produced a predictable outcome. Clinicians spent the majority of their time assembling fragments of information rather than acting on clinical judgment. They had become data archaeologists — and the work that mattered most happened in the narrow window left over.
The program integrates feeds from across the state's clinical systems, assembles a complete picture for each person on the caseload, and presents the case manager with a prioritised list each morning. The clinician arrives ready to act — not ready to search.
Clinicians scanned three to four disconnected systems each morning to work out who on the caseload might need attention. Patterns visible only by integrating across sources were typically missed.
The system continuously integrates EMR, dispensing, presentations and contact-record feeds. Risk signals — missed medications, emergency presentations, disengagement sequences — are flagged automatically before review.
Clinicians reconstructed clinical pictures from fragments in their heads. Each person on the caseload required assembly time before any clinical reasoning could begin.
Each person arrives with a structured clinical picture: medication history, recent presentations, contact patterns, missed appointments — assembled across sources and presented as a single view.
Triage rested on the clinician's memory of recent events and the time available before the next contact. The person who most needed attention was not always the one who got it first.
The caseload arrives risk-stratified each morning. Attention follows where the cross-system signal indicates it is most needed. Clinical judgment retains the final call on what to do.
The clinician searched, assembled, then acted — usually under time pressure, sometimes after a crisis had already started.
The clinician acts on intelligence that didn't exist before the system assembled it — frequently within intervention windows the previous configuration could not see.
The sensing work — gathering, structuring, retrieving — moved entirely from the clinician to the digital system. This was not simply a faster way to do what the clinician was doing before.
The system assembles a picture the case manager could never have assembled manually. It integrates across sources simultaneously. It detects patterns invisible to a human scanning records one by one — sequences of missed medication, contact disengagement against historical baselines, emergency presentations cross-referenced with care-plan goals.
The case manager's role qualitatively changed. They stopped being information assemblers and became clinical responders, acting on intelligence that didn't exist in the previous configuration.
Outcomes are framed qualitatively here. The verified detail lives in the published evidence base summarised in the next section.
Tested across South Australian public community mental health services and currently deployed across four SA Local Health Networks, supporting case managers responsible for 354 consumers in active care.
The program has received approval to roll out statewide through the Health Chief Executives Officers (HCEO) Council. Rollout is paused on funding decisions downstream of the program — the work from the Sandpit's end is complete.
The configuration supports — and does not replace — clinical authority. The system surfaces signals; the clinician decides what to do. All operations sit under formal information governance, clinical safety and HREC approval.
Six peer-reviewed papers across implementation, co-design, clinician decision-making and outcomes. A 2023 SA/NT iAward in the Public Sector category. A citation in the Productivity Commission's 2024 research paper on leveraging digital technology in healthcare.
Public Sector category. Australian Information Industry Association — the peak national industry body's annual recognition of innovation that delivers measurable benefit to government and the public.
aiia.com.au/iaward/2023-sa-nt-winners-and-merit-recipients →Cited in Leveraging digital technology in healthcare, Research paper, Productivity Commission, 2024, Canberra — the Australian Government's principal advisory body on microeconomic policy and regulation.
pc.gov.au/research/completed/digital-healthcare →Each Sandpit configuration applies the same four-operation decomposition to a different capacity problem. What stays constant is the method.
Bring it to the Sandpit. We'll diagnose where capacity is lost, configure what should change, and test it in a governed live setting before you commit at scale.