A year ago, the Health Service Executive (HSE) appointed its first chief information officer (CIO) to spearhead the digital transformation of Ireland’s ailing health system.
This week, a number of hospitals demonstrated how they are in the vanguard of that change.
If there is one word that comes to mind whenever I think of doctors or nurses in the Irish health system it is usually “beleaguered.” They are usually beleaguered by an overwhelming number of patients and stymied by a lack of resources, beds, outmoded processes, outdated IT systems and neverending industrial relations disputes.
This is despite the €15bn spent by Ireland every year on a health system you would be forgiven for considering is still the sick man of European health systems.
‘I want the new National Children’s Hospital to be born digital’
– LEO VARADKAR TD, MINISTER FOR HEALTH
However, at a special demo day at Temple Street Hospital organised by eHealth Ireland, new words like “passionate”, “ambitious” and “collegiate” entered the lexicon in which I imagine the health system’s professionals.
Yesterday (18 January), the HSE’s CIO, and the CEO of eHealth Ireland, Richard Corbridge explained how it is actually hospitals themselves that are driving change by creating platforms that could ultimately be replicated in every hospital in the land.
The lynchpin of these systems could be the forthcoming Electronic Healthcare Record (EHR) that Corbridge and his team are working to create for every citizen in Ireland.
Corbridge is seen as a rising star on the CIO landscape and is leading the digital transformation of the Health Service Executive (HSE). He is also the CEO of eHealth Ireland, which was established to accelerate innovation created in the process of transforming the HSE.
At Temple Street, Corbridge introduced Temple Street’s Children’s University Hospital’s clinical portal, Beaumont Hospital’s National Epilepsy Electronic Patient Record system and an ePharmacy Solution developed at Our Lady’s Children’s Hospital in Crumlin.
I put it to Corbridge that every presentation by leaders at these hospitals demonstrated passion and a conviction to solve problems and remove paper and bureaucracy from the picture.
What was most striking, however, is how many of these solutions could be made national and implemented in every hospital and clinic around Ireland.
“What we are trying to do is glue together the kind of building blocks that are being created,” he agreed.
“Ireland is unique in that it doesn’t have a national infrastructure. It has lots of local infrastructures and lots of local centres of excellence and our plan is to take all that learning and progression and make it available across the whole country. So, if you have the Crumlin pharmacy system, why wouldn’t you make that available in other hospitals?
“If you have the e-referral capability, let’s make that available, let’s use the learning in the Irish healthcare system and apply that in the whole system and allow us to really have an e-health enabled system.”
Joining the dots on Ireland’s healthcare ICT landscape
Norman Delanty, consultant neurologist and director of the Epilepsy Programme at Beaumont, explained how the epilepsy electronic record system came about. “This has evolved over a number of years now and we needed a database of our patients to enhance healthcare and facilitate research. We developed a bespoke electronic health record system specifically for epilepsy patients.
“It is now being used by other colleagues around the country, including St James’s Hospital, as well as in Galway and various neurology units around the country.
“Patients’ data would be available at different units around the country in the event of patients having a seizure and that data would be available to doctors and nurses.
“For 50pc of people with epilepsy we don’t understand the cause and so this will facilitate research into epilepsy.
“The things we have learned along our journey in creating this electronic health record will be applicable to other diseases, such as diabetes.”
Just like at Beaumont, various systems created at Our Lady’s Children’s Hospital in Crumlin could also be replicated to create a more unified healthcare system.
“At Crumlin, we have three initiatives,” explained Michael Fitzpatrick, chief pharmacist at the hospital.“We created a mobile app for the formulary (list of drugs), which is difficult to put in hard copy, so we created a mobile app and a multi-platform app with one CMS.
“We created an electronic drug file system for the intensive care unit that has been an outstanding success and we also created a smart pump system for reducing error in drug infusions. These are all error-reduction strategies that have not only a local reach but a national reach that can be easy to replicate in other hospitals.”
We also spoke to Dairín Hines, head of ICT and clinical informatics manager at Temple Street Children’s University Hospital, where a clinical portal has been created.
“We have rolled out a lot of technologies that have been department led and we had some local successes, like being paperless at the bedside and in intensive care. But we found that as we rolled out more technology patients didn’t attend just one department or speciality and clinicians were struggling with the fact that they didn’t have a single view of the patient. So from an ICT perspective not only did we want a strategy that was less paper-reliant but we wanted to roll out technology that addressed clinicians difficulties in logging into different systems.
“We created a clinical portal that involves one-stop login. This has resulted in a lot of spin-off benefits such as a graphing tool that we can also use as a motivational tool for children who have to take drugs over a long term.”
Ultimately, it is clear that Corbridge’s strategy is to take the excellence that is found at every level in the Irish healthcare system and amplify it. Each building block could have a national implication.
The showcase also launched The Lighthouse Projects, which will focus on using the EHR in three clinical areas: Epilepsy, Haemophilia and Bipolar, the latter of which will make Ireland the first country in Europe to do so.
Speaking at the showcase, the Minister for Health Leo Varadkar TD said: “During the recession, our health service fell behind when it comes to information technology. The economic recovery gives us the opportunity to catch up. As Minister, I have increased the ICT budget by 40pc to €55m. I want this to be sustained and increased further over the next few years. In particular, I want the new National Children’s Hospital to be born digital.
“I want ambulance paramedics to be able to access patient records electronically from the moment they get to the patient or even before. I want every GP enabled to refer patients to specialists online and I want every radiology and laboratory system able to talk to each other so that test results can be accessed easily and do not have to be repeated unnecessarily. We have plans to do all of this in the years ahead but we can only afford to do so if we keep the recovery going and the economy strong”.