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At the end of 2016, Boston Children’s Hospital, US, published a blog describing seven predictions for digital health for this year.
With this in mind, we wanted to consider the predictions of one of the world’s leading children’s hospitals and apply them to what we think can be achieved in Ireland in 2017.
A focus for eHealth in Ireland this year will be digital solutions to support the care of children, be it preparation for an Electronic Healthcare Record (EHR) for the new National Children’s Hospital, or the continued implementation of the Maternity and New-born Clinical Management System.
eHealth Ireland has set its sights on being able to apply these trends to what it delivers in 2017, fully supporting the ‘building a better health service’ agenda of the HSE with digital solutions.
1 — Telehealth adoption by patients
We have seen the adoption of telehealth in other jurisdictions begin to make a difference to how care can be delivered. Colleagues in Scotland have been making a success of telehealth in outreach regions for the last five years or more.
Whether it is driven by the health system, special interest vehicles or the patients themselves, it doesn’t matter. The creation and adoption of design principles relating to telehealth and the digital identification of patients and clinicians will aid adoption.
Three examples spring to mind of success in 2016 that can be built on. The wonderful work of the Heartbeat Trust in the connectivity of GPs for consultations prior to and after heart surgery has begun to change the model of care on offer, and all at a price that is affordable from a technology point of view.
The delivery of patient portals is something that will be at the forefront of care in 2017. The go-live of a patient portal for epilepsy and the initial go-live of a patient portal for the viewing of a person’s own elements of a summary care record will enable Ireland to understand better the impact of this information on the delivery of care away from the more traditional care centres.
The final example is an Irish company called Web Doctor, which has gone from start-up to truly delivering a platform for primary care that is centred around the patient and is built with the patient in mind.
2 — Increased engagement with patients for telehealth solutions
Boston Children’s Hospital describes the second trend for 2017 as ‘increased engagement’. In the UK, health policy analyst Roy Lilley wrote a blog at the turn of the year asking the NHS to ban the word ‘engagement’, suggesting that it should only be used to describe the meshing of gears or the sound you hear when a phone line is busy!
Taking his principles of having two-way conversations with our patients, partners and colleagues and listening to their wants and needs and then applying them to this trend, we will see increased interest from patients in accessing telehealth through digital solutions. The ‘dawn’ of the wearable and quantified self has happened already and yet only as we move into 2017 will patients really be able to start to use telehealth that they define themselves, that they are in control of, and where the benefit is targeted for them.
3 — Innovative visualisation devices hit the clinic
The adage that health in Ireland has a great deal of data, not so much information, and struggles to gain timely insights from what it collects, has been pointed out a great many times over the last two years. At the HSE/eHealth Ireland Innovation Showcase in November 2016, a number of amazing new solutions that enable visualisation were demonstrated, from holographic anatomy to virtual reality anxiety treatment; this type of technology can and will be adopted where appropriate in 2017. The idea of training clinicians through the use of virtual and augmented reality has become something that the RCSI is pushing ahead with. It is an exciting prospect. The eHealth Ireland team is now in the process of implementing Microsoft Surface Hubs into a number of maternity hospitals — a piece of hardware built to enable visualisation and interaction of data in a whole different way.
4 — Clinical experience software
The piece by Boston Children’s Hospital describes how the interoperability of information, a move away from data messaging, and a move to information integration will change the way in which clinical experience is delivered. Certainly, when Ireland considers the change in the experience now possible in Cork University Maternity Hospital, Ireland’s first digital hospital, I would have to agree. The ability to have information live with the clinical team regarding the care of the patient in front of them, the ability to collect critical information and apply it to the clinical record as it happens, clearly makes a difference to the care experience. When lab test results can also be automatically added to the record and algorithms can flag issues to clinical staff that can be linked to information collected in real time, then at last digital will be making a difference to the delivery of patient care.
5 — Maturing market for digital health start-ups
The IrishCentral.com site published a review of digital start-ups in Dublin in late December 2016. According to the site, there are 775 Irish digital start-ups that have decided to locate in Dublin. Funding in 2016 (to end of September) to these start-ups was in the region of €734 million, a massive jump from 2015. Over half of these were health start-ups, such as Carrick Therapies and Genomics Medicine Ireland, which gained €84.5 million and €40 million respectively in 2016. The eHealth Ireland ecosystem and the initiatives put in place by the team to support innovation being adopted into the healthcare system will, in 2017, continue to grow this market, concentrating first and foremost on the health of the nation but allowing eHealth Ireland to meet its secondary challenge — to be a catalyst for the wealth of the nation too.
6 — Expanded offerings from insurers and pharma
The difference in healthcare systems between Boston and Ireland is significant. The relationship between big pharma and public healthcare systems globally is not always a comfortable one. Yet at the same time as the issues of drug costs need to be resolved, we are now seeing the role of pharma in digital health changing. For example, the work that Pfizer has done with eHealth Ireland in 2016 to create a digital solution to support the medicines reconciliation process from acute to primary care has been extremely successful, so much so that eHealth Ireland will look to implement the solution countrywide in 2017. The insurance companies in Ireland have led the way in providing access to telehealth solutions, offering to customers solutions like Web Doctor and the ubiquitous Babylon Health, and changing the access model for customers to one that is less demanding on the healthcare system itself.
7 — Personalised care through voice-enabled devices
Homes are now asking Siri, Cortana and Alexa for help. Search YouTube to see the video of all three in a perpetual loop seeking assistance from each other for a feel for how the battle of virtual assistance is going to take off — one of the funniest things I have seen all year. We really can imagine these services coming to health quickly. Voice recognition and dictation are already a key part of any radiologist’s ways of working, for example. When an EHR for Ireland is specified, there will need to be an ability not just for the capture of text and images, but also voice recordings — a giant leap into uncharted territory that will need to be managed carefully from a security and governance point of view.
It’s great to consider the trends of the future. There is a whole career out there as a futurist for many commentators on eHealth.
The difference for eHealth Ireland in 2017 is that, because of the foundations created in 2016, each of these seven trends feels that bit more achievable.