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Bridging the gap in eHealth

Ms Yvonne Goff took up post in the newly-created role of eHealth Ireland Chief Clinical Information Officer in January. 

A radiographer by background, she has over 18 years of experience in the health service with five of these directly involved in informatics. Having completed an MSc in Health Informatics in 2010, she joined the national implementation team of the National Integrated Medical Imaging System (NIMIS) project as both a manager and subject matter expert.

Explaining the background behind her appointment as Chief Clinical Information Officer, she said there is now a realisation that ICT has to be clinician-led.

“I am passionate that health technology will only succeed with clinical engagement and patient-leading projects. There is now a realisation that healthcare ICT needs to be clinically-led for it to be successful. I am a bridge between IT and clinicians and we are making the change process a more collaborative approach,” she told the Medical Independent (MI).

Continuing, she said there had been a lot of valuable learning from the HSE’s PPARs debacle. “The key from that is we learned every lesson, everything that had been done wrong and that is why we have clinical people now leading [eHealth projects in the HSE] and are now working collaboratively.”

‘There is now a realisation that healthcare ICT needs to be clinically-led for it to be successful’

Clinicians are very involved with piloting the electronic health record (EHR), individual health identifiers (IHIs) and ePrescribing projects, she pointed out.

For example, the three Lighthouse Projects have a specific focus to build an understanding of the benefits of an EHR in the Irish healthcare system.

The projects cover three clinical areas: Epilepsy, haemophilia and bipolar disorder, which were specifically chosen due to the variances in ICT usage across the three disease areas. Delivery through to realised patient benefits in 2016 is a core element of these projects.

“These pilots are always to ensure that these processes fit the workflow, that the technology fits, otherwise they fail,” Ms Goff told MI.


Continuing, she envisaged telemedicine and mobile health solutions becoming an integrated part of Irish health services. She likened their evolution to online banking, where people now do most of their banking online and over the phone and only go into a bank when they really need to. “With NIMIS, we do remote reporting and that has massively reduced waiting lists.”

Ms Goff explained that it was during the roll-out of NIMIS, and the initial teething issues, when it became apparent to her how important full clinical engagement was in the successful implementation of large health technology projects.

She noted that Healthlink, the long-running online system for GPs to receive clinical lab and radiology results, has been very successful in connecting the NIMIS system to primary care.

“The latest development is a receipt function to show they [GPs] have received the report. NIMIS have turned off all printing [since June 2015] so in six months we have saved between €100,000 to €150,000 in printing alone. Before, you’d have a radiology report and although Healthlink was there and the level of security [was in place] there was a worry still with receiving electronically and most GPs wanted to receive a paper printout as well. But we have closed the loop now and there is a secure receipt and all GPs on Healthlink are satisfied it is a safe, secure means of transferring data so now we’ve turned off the printing for about 70 per cent of Healthlink GPs.”

This means when printing is turned off for all GPs, the HSE could save between €350,000 and €400,000 a year in printing costs.

The next step for NIMIS will be linking with healthcare facilities with non-NIMIS systems, linking to GPs and the NHS for cross-border patients. Ms Goff explained that this will be done through the XDSi system.

“XDSi is a cross-enterprise document sharing of images, diagnostic reports and related information. It provides a solution for publishing, finding and retrieving imaging documents across a group of affiliated enterprises. In the Irish healthcare setting, it will facilitate communication between NIMIS and non-NIMIS sites, which includes Northern Ireland. This will be of particular benefit for the border counties, allowing records to follow the patient care pathway,” she said.

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