Health board extends its influence

18 Dec 2003

The Southern Health Board (SHB) has a well deserved reputation for leveraging communications technology to improve the quality of healthcare it delivers to citizens within its catchment area. So much so that the lessons it has learned and the practices it has pioneered are being applied in other parts of the country.

A case in point is the VPN (virtual private network) the board developed in Cork several years ago. “The Department of Finance’s Centre for Management and Organisation Development has taken our VPN and telecommunications manager on loan and it is now rolling out a similar system nationally,” says Ursula O’Sullivan, IT/EU manager at the SHB.

According to O’Sullivan, the SHB has also been made responsible for the co-ordination, development and deployment of a national health portal based on the expertise it gathered developing its own portal. “The national portal will replace the plethora of websites that currently exist,” she says. “It is very important in the context of the restructuring and reform programme. Boundaries aren’t important to people. They don’t care who’s administering care as long as they get it.”

O’Sullivan says that the national health portal will give people as good a service moving around Ireland as moving around Europe. “In fact better,” she corrects herself. “If you move 50 miles you could be in a different authority region but that doesn’t mean you shouldn’t have access to medical records. The portal will make it seamless. In addition, our financial controller, Raymonde O’Sullivan, is responsible for looking after finance systems nationally and our CEO, Sean Hurley, is lead CEO in national e-procurement reform.”

At a regional level, the board continues its Health eSHB strategy. A mobile component has now been added to its VPN. “This has allowed us to do more with our electronic patient record,” says O’Sullivan. The public health nurse out in the field now has the same level of access to patient records as someone sitting in an office.

In addition, there is now a single system for the public laboratories in the region. “Before, we had eight or nine separate laboratory systems at different hospitals. Everybody is now working to the same coding structure. Users don’t see that but in terms of what we can do with the information it’s a step forward,” she continues.

According to O’Sullivan, the lab results can now be delivered to GPs using a system integrated directly into their practice management software. “We have seven practice management vendors in the region and we have worked with all of them so that the results go across the VPN on the close health network and the GP gets them integrated into the patient record,” she explains.

The lab reports are formatted in HL7 (a healthcare IT communications standard) wrapped in XML, which, she says, is the best arrangement for delivering them. Doctors can still look up the results over the health board’s extranet but most prefer the integrated approach. According to O’Sullivan, the health board has saved €1m per year on postage costs alone. “That does not include efficiencies made. Now we are working on including radiology, bookings, appointment letters, discharge letters in the system and sending them out on an integrated basis,” she says.

The electronic patient record is also playing a key role in the board’s primary care strategy. “We have done a lot of work in places like Dingle in making primary case a base point for interaction with the health services,” she goes on. “We are looking at with whom we can share things such as registration. For instance, when someone in Dingle registers with a GP, that same data goes to a central registration database. That information set can be accessed, with proper controls by the public health nurse or the pharmacist who needs access to some information for drugs repayments, refunds and so on.”

By David Stewart