Health and social care services in Ireland are undergoing a system-wide reform and transformation following the ten-year vision set out in Sláintecare, published in August 2018.
The reforms include a plan to put in place modern ‘e-health’ infrastructure and improve data, research and evaluation capabilities.
This could transform how healthcare is delivered and, therefore, outcomes, said Brian Jordan, head of innovation and industry solutions at Cisco Ireland.
“In order to fully comprehend the potential impact of ICT in healthcare, it’s necessary to first understand how services are structured currently to contextualise how they will go on to change by digital transformation,” he said.
“While digitisation of acute care services gets the most focus, the community healthcare budget accounts for almost 40 per cent of the HSE spend.”
As a result, the delivery of healthcare services outside of acute care including community care, social care services, specialised mental health services and primary care services are going through a process of transformation.
Jordan said that improved digitisation is required not just with acute hospital services but also with the nine Community Health Organisations (CHO) as they are best positioned to alleviate direct citizen reliance on acute services during the Covid-19 pandemic.
Data sharing is a key issue. “The HSE recognises significant IT weaknesses have been identified at organisational levels to support the aggregation, feeding, formatting, sharing and reporting of data required for patient-level costing and activity-based funding,” he said.
Funding allocation for health services now targets not only capacity issues like hospital beds, but also the need to provide care closer to the patient’s home rather than overloading hospital services.
“A €58 million investment is targeted at eHealth and ICT infrastructure: a key driver of integrated care, connecting clinicians and patients across healthcare settings and enabling the effective and efficient flow of health information,” said Jordan.
Key deliverables for 2021 include progressing initiatives such as the Home Support Management System, ePharmacy and ePrescribing, the Community Hub Management System, and the National Waiting List Management System, as well as key Covid-19 solutions including the Covid tracker app, Covid Care Tracker (CCT), and Swiftqueue Appointment Scheduling for Covid-19.
Other deliverables include infrastructure upgrades and further deployment of national systems such as the National Medical Laboratory Information System, Medical Oncology Clinical Management System and the National Integrated Medical Imaging System.
“Enhancement of ICT infrastructure will also provide better connectivity in primary and community care. These developments are critical to sustaining existing services, enhancing healthcare delivery and improved patient outcomes,” said Jordan.
The data challenge will have to be met in providing integrated care, though: lack of interoperability within existing systems, lack of data or incomplete data, lack of data feeder systems, poor data definitions and lack of collaboration tools.
“The HSE can only succeed in delivering patient- centred care by focusing on developing patient- centric integrated care pathways. Doing this requires connected devices, shared data, resilient connectivity, application interoperability and the digitisation of paper records,” he said
Meanwhile, as the list of connected devices in healthcare settings continues to grow, network and device security becomes extremely important.
“Fortunately any devices connected to the network, including blood fridges, glucometers, [and] other lab devices, can be tracked and managed, and careful consideration in how to order optimise traffic and policies for these connected devices will be required,” said Jordan.
The IT sector can respond to the challenges, Jordan said, because it has been dealing with these issues in different contexts for years. Resilient IT networks can be built and cyber security solutions implemented.
“Collaboration tools like Cisco Webex and workflow integrations will enable telemedicine with appointment scheduling, remote consultations with full audit capabilities. These ICT capabilities are critical during the pandemic when physical meetings are being avoided.
“Clinical workflows can also be made more efficient with collaboration tools, for example, patient care generally relies on multiple specialists discussing and analysing patient data. Given the critical nature of these discussions, the use of a unified collaboration platform to share clinical information in a timely fashion is essential,” he said.
In the early phases of this pandemic, Cisco, working in conjunction with IBM, deployed Cisco Webex in University Hospital Galway so that patients could have safe video communications with family members and clinical teams.
“This solution recently won a Sustainable Business Impact award from Chambers Ireland. Much of the software development for the Webex collaboration platform is done by our software engineering centre in Galway,” he said.
“Other key innovations during the pandemic involve Cisco Meraki camera solutions to assist in social distance monitoring and PPE mask identification which are critical needs for many organisations at present,” he said.