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Charting a digital revolution

The year 2016 was a quick one, that’s for sure! That phrase ‘where has the year gone’ never held so true. The turn of a year is always a good time to evaluate what has gone before and prepare for the 12 months ahead.

The eHealth Ireland programme within the HSE has been able to keep the promises it made from January 2016. As we moved from 2015 to 2016 we often spoke about the foundations that had been built and the change in culture that the team had gone through. This continues into 2017 with the ability to recruit 50 new members of staff into the team through the first part of this year. As we begin the New Year there is a feeling of renewed energy and capacity.  

Over 15,000 new devices were deployed over the year and a plan is in place to add a further 10,000 devices to this estate in the first quarter of this year 

The team is now at 282 whole time equivalents (WTEs), located throughout the healthcare system, augmented by approximately 35 external suppliers and partners. It is a single functioning digital team, no longer constructed on health board organisational boundaries and with a renewed focus on building a better health service. In 2016, some 87 new digital applications were deployed into the health system by this team and over 350 service improvement projects completed on time and budget.

Live services

We often consider key achievements being related to new change-based projects. Before we begin to describe these projects, though, it is worth reflecting on the running of live services. In 2016 we implemented a national helpdesk and the staff on this desk took over 177,785 support calls. All calls are now answered in 15 seconds or less, with only 11.8 per cent of calls breaching the service level agreement in place for a fix to be implemented.

We committed to the implementation of new ‘kit’ into the health system in 2016; we wanted to remove the reliance on the spiral notepad and biro wherever possible. Over 15,000 new devices were deployed over the year and a plan is in place to add a further 10,000 devices to this estate in the first quarter of this year.

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Mr Richard Corbridge, HSE CIO

A new process and procurement framework means that the devices deployed are new technology, smart devices. All devices have cloud capability and enable safe, secure, and timely access to information.

There are two personal highlights of 2016. First, the Future Health Summit, which hosted the eHealth Festival. The theme was a music festival, with every speaker coming on stage to their favourite song and relating it back to their wealth of experience in healthcare technology. The comments on social media were great; people had fun and were able to learn so much from global experts in healthcare technology. 

The second highlight was on an even bigger stage at the Microsoft Tech Gathering in Dublin, with one of the world’s biggest names in technology. I was invited to present the journey we have been on to Satya Nadella, the CEO of Microsoft.

Creating a digital identity for all staff was another priority for 2016. The procurement of this capability has been completed on time, the process to deliver digital identity to all staff is in place and around 20,000 staff now have a digital identity for the first time. The remaining 27,000 staff will be connected in the first weeks of 2017, ensuring all staff who work in health in Ireland have the ability to use technology as part of their role. Additionally, the ability to digitally communicate to all staff is now in place through the use of previously disparate email services and distribution lists.

Individual Health Identifier (IHI)

The large transformational projects have been able to progress with an agility not seen before in digital health in Ireland. In late summer the Individual Health Identifier (IHI) infrastructure was made live and work to create a public-facing privacy impact assessment was completed.

This solution is now ready to be commissioned and from this being completed we will be able to have the IHI in GP systems, on eReferral and in a number of pilot systems ready for evaluation very early this year. Work underway with colleagues in Northern Ireland will allow us to have a unique identity for patients transitioning the border for their care, further enhancing the patient safety capability that information systems can bring to the delivery of care.

All of the Lighthouse projects progressed with the agility that they were designed to, but perhaps none more so than the Epilepsy Lighthouse project. The success factors for this area and the way of working adopted are quite astounding. In one year the team has achieved ethics approval for the research element of the project; built the technology not only to sequence the genome here in Ireland, but also to display the sequenced genome and the geneticist’s analysis within the Electronic Healthcare Record (EHR).

This has resulted in the ability for 10 patients to consent and 10 more to begin going through the process. DNA on eight of the 10 consented has now been collected and provided for sequencing. The multi-disciplinary team (MDT) has reviewed the first sequenced genomes of four patients and discovered the specific pathogenic mutation relating to the epilepsy type; then, as a MDT, they have been able to work together to apply this information to the clinical approach with the patient and carer and therefore change the treatment course.

One of the four is over 30 years old and has seizures every day of their life. The team have identified a genetic mutation that if an element of diet is altered then daily seizures will likely cease for this patient. This activity, once proven, can be applied to all consenting epilepsy patients, particularly those of a young age where action could have a huge impact upon the life they lead.   

I have spent this year being very proud of each and every deliverable; each and every member of the team. On a hot evening in July I was asked if I would be interviewed ‘live on stage’ at an event called A Journey of Disruption. The emotion leaked out as I told the story of ‘Hello My Name is…’ just a week after the amazing Kate Granger had passed away and indeed the emotion did come out with my story of the work that our very own Epilepsy Lighthouse project had achieved.

Meanwhile, the amazing success we had with the Innovation Showcase in Ireland showed me just how much I want to keep moving forward, but also alerted me to the fact that the public want us to keep striving to meet head-on the agenda of building a better health service.

eHealth Ireland is not only successful because of a national team – it has been successful in 2016 through supporting the wider HSE infrastructure to deliver. Two examples of this come to mind. University of Limerick Hospitals Group has been perhaps the most forward thinking of our acute hospital groups in the work it has done to unify its information capability. It now has a single, integrated Patient Administration System across the whole Group. It is able to share information about patients being cared for across the Group, while patients and clinical staff are uniquely identified within the systems and information is now collected as part of the delivery of care that can be used for the management of the Group.

In addition, the Group has been able to go live with a new emergency department system, a solution that takes it a step closer to a single solution for emergency information.   

The South/South West Hospital Group led the way in not just developing but adopting a Group-wide digital strategy for acute and indeed community health. It has put in place what is needed to build integration throughout the Group, creating a ‘good governance’ model and excellent links to academia that will bring significant reward and development opportunities in 2017. 

Willpower

The impact on my own feelings of the maternity system go-live in Cork University Maternity Hospital (CUMH) in December surprised me. In 20 years in health technology, there have been some ups and downs, as there is with any job I guess, but the go-live in this amazing hospital and the commitment, engagement, willpower, and care of the staff involved made that weekend and the impact of that system the most important thing I have been involved in over those 20 years. CUMH is now a hospital that provides care supported completely by up-to-date information, accessible at the right time and right place and by the right people.

The hospital is now able to truly provide an integrated service throughout the entire maternity pathway. The implementation is being quoted by Cerner, the eHealth Ireland partner here, as one of the best ever worldwide. The information now available to healthcare professionals about the maternity service they are delivering is phenomenal – they can trace and monitor almost every aspect of care, they know the number of orders, medications and activities taking place on a patient-by-patient basis and can track the delivery of care and link it to real-time patient data through Internet of Things-enabled devices on the wards.

Seven hours after go-live, a nurse said to me she had no idea how she did her job before the system was implemented. This filled me with confidence that what we are doing is the right thing and most importantly the right way to go about it. The digital early warning services available to clinicians in Cork will save lives.   

Anyone of a certain age has felt a bit more mortal over the past year; the loss of Bowie, Prince, George Martin, Leonard Cohen, George Michael, Carrie Fisher, and so many more talents, has made us all look at where we are and consider what mark we want to leave.

Talking about psychology recently with two friends, they commented separately that child psychology asks us to celebrate the ‘art of trying’ rather than success.

I agree, but if we want to truly achieve the goals we set ourselves, then 2017 will be the year of trying even harder, celebrating every single success along the way, making friends from colleagues and truly achieving as a team that understands why we do what we do.

  1. john purdy on January 13, 2017 at 10:50 am

    Richard,

    great commentary, portrayed in one of my all time favorite movies,Any given Sunday, progress occurs in inches which are hard won,

    John

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