InterSystems’ John Kelly says interoperability will be ‘a cornerstone’ in the delivery of a digital innovation strategy in healthcare.
Nearly one in four Irish citizens, about 1.3m people, currently languish on one healthcare waiting list or another.
In the 16 years since the then Minister for Health Mary Harney, TD, declared the situation in accident and emergency units to be a “national emergency”, there have been multiple strategies and task forces put in place to tackle the problem of access to health services.
Yet, the number of patients on our public waiting lists continues its inexorable rise. The July figures from the National Treatment Purchase Fund showed that there are 627,856 people awaiting a first outpatient appointment. This represents an increase of 4,000 increase on June’s figures.
The unfortunate reality is there is no panacea or silver bullet for the problems afflicting access to health services because there are multiple contributory factors.
Our growing and ageing population means that demand for health services will continue to increase for the foreseeable future.
According to the latest census data from the Central Statistics Office, our population grew by 7.6pc between 2016 and 2022. At 5.1m, the population is at its highest since the 1841 census. The simple fact is that we are living longer. Life expectancy has increased by two and a half years over the last 15 years, which is due in no small part to the quality of care delivered by our world-class healthcare professionals.
Clearly there is compelling argument to increase the use of digital health to improve patient experiences, increase system capacity and boost cost-efficiency. With more than 90pc of Irish people owning smartphones, there is plenty of scope for collaborations to improve access to healthcare through mobile applications.
Prof Martin Curley, director of digital transformation at the HSE, advocates a ‘stay left, shift left’ digital innovation strategy. This involves shifting care left from acute care to caring for people preventatively in community and home settings. This shift allows for the highest quality of life to be provided at the lowest possible cost.
This would certainly tie in with the broader thrust of EU policy. Last year, in response to Covid, the EU announced it would be investing €5.1bn to boost healthcare innovation and increase systemic resilience under the banner of EU4Health.
The EU4Health programme aims to advance healthcare digitisation, which extends to health records, the provision of telehealth and tools supporting citizen empowerment. The EU Commission says it wants to see health data used to increase access to services.
Medical data needs to be rendered useable
Of course, healthcare data is challenging to work with and inherently complex. The data is fragmented and often stored in different source systems and silos. Some of it is structured and some unstructured. It can be in different formats – text notes, numeric, spreadsheets, paper records, digital records, images, videos and multi-media.
In Ireland, paper records are still widely used and much of the most valuable information remains in clinicians’ notes. The problems become more acute as science understands more about the human body and clinicians collect ever more information.
The challenge is best summed up in the quote: “There are oceans of data, but only puddles of clinical meaning.” Is it surprising then that research by InterSystems found medical data scientists only spend a fifth of their time analysing data, the rest being spent on locating it, merging it and putting it into shape so it is useable.
This has become so onerous that the term ‘data wrangling’ was coined to describe the variety of processes designed to transform raw data into more readily used formats.
To build e-health applications that promote access to healthcare and open the door to remote monitoring and management, medtech innovators need clean and healthy data that is consistent and useable, whatever its source.
To facilitate care coordination, drive efficiency and reduce duplication, the data must be shareable with other applications with the IT systems of hospitals, GPs and other care providers. The ability of systems, applications and devices to exchange and make use of information is referred to as interoperability.
Interoperability will be a cornerstone in the delivery of a ‘stay left, shift left’ strategy as all data – irrespective of whether it is captured in the home, in a community clinic or in a hospital – must flow seamlessly across the continuum of care, be combined with other data on that patient and accessed by authorised parties whenever and wherever it is needed.
A solution to the data challenge
Given the need for interoperability capabilities, e-health applications built on a unified data platform tend to have several advantages.
Healthcare data in multiple formats can be ingested, transformed and normalised at high speeds. Taking care of the data wrangling frees up developers to concentrate on what they are best at and what makes their applications effective.
By eliminating the need to integrate multiple technologies and toolsets, a unified platform reduces the amount of code than needs to be developed and tested. This can significantly reduce the time-to-market for a new application.
To reduce waiting lists and provide modern care to ageing populations that generate increased demand amid high medical inflation, medtech innovators must be able to concentrate on innovation. We need new delivery models and new technology to provide access, taking advantage of the explosion of smart consumer devices.
Disease prevention and home care for example, reduce hospital admissions and costs, which is why we need to treat more patients at home using remote techniques.
But for medtech innovators to meet these needs, they first require clean and useable data. Once we clean up healthcare data and make it interoperable between different systems and devices, a transformation in access and provision will take place.
By John Kelly
John Kelly is a sales manager at healthcare data management company InterSystems Ireland.
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