Foundations in place for digital adoption in health service

Richard Corbridge, HSE



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9 March 2017 | 0

Along with these large projects, there are a number of smaller initiatives that are targeting certain specific areas. Three such ‘lighthouse’ projects were around bipolar disorder, haemophilia and epilepsy.

“For bipolar, we held a hackathon at the same time as Innovation Week, which created an amazing number of ideas to take forward as solutions for patients and clinicians in that field.”

“There was a chatbot solution to allow a patient to have a bi-polar friend on their phone that can learnt hem, and with permission, alert friends, family or clinicians to enable them to avoid an episode.”

The app can detect when a person has not gone outside all day and can prompt a conversation to see if the person is OK. The team is working with organisations such as SeeChange, as well as patients, focus groups and clinicians to bring together those who can drive development, which Corbridge says is “relatively unique to Ireland”.

Lighthouse solution
In haemophilia, that lighthouse solution was like a supply chain management solution that means treatments can be better tracked for storage and usage, dramatically reducing wastage of scarce resources. However, in the event of an issue, Corbridge says the system now allows for recalls in as little as 25 minutes.

Corbridge said the epilepsy lighthouse project was the one of which they were most proud.

“In 2016, we had begun the sequencing of genome of people over 30, with learning difficulties and epilepsy, and kids under 5 with suspected epilepsy. It is a consent-in programme, so absolutely no mandate to do anything other than taking part in this piece of research. But what has been done different is the sequenced genome and the geneticist’s opinion are placed into the EHR, so when the multi-disciplinary team are meeting, an epilepsy nurse, a social worker, community staff and the geneticists, to discuss the care for the patient, they can use the sequenced genome to try to alter the care pathway.”

There were patients that would have had epileptic seizures their whole life, and they were over 30 years old, he said. Armed with this new level of information, the patients’ diets were changed and many they saw their first day without an epileptic seizure.

“Diet can be a major part of treatment when you know the part of the genome that is causing the seizures. It can be too much calcium, or not enough.”

Epilepsy supports
Calcium is also a key part of most epileptic drugs, he reports.

“In many cases, you can make it worse, not better in the first application of drugs. In 2015, 90 people died in Ireland, of events related to epilepsy. Through sequencing the genome, we think we can take that out of the system. We also spent €5 million in 2016 just testing different drugs on people to try to find the right one for them, but if you have the genome sequenced, which is now $328, then we can tell what sort of drug is needed, almost immediately.”

“For a child under 5, we can capture and stop the impact of epilepsy at a much earlier age, which is very exciting,” he said.

“The fact that it is in the EHR, is the big thing. We can now make that information available out to clinicians, securely and appropriately, and it makes a massive difference for the possibilities to deliver care.”

Digital hospitals
Another key achievement was the first hospital going completely digital. In December, Cork University Maternity Hospital went paperless and digital.

“On a Friday at midnight, it moved to electronic records and by 07:00 Saturday, the whole hospital was working on digital records. 9,800 hours of training delivered.”

This achievement includes mother and baby records, with IoT monitors for vital functions on incubators. Vital signs can now be recorded automatically and incorporated in the EHR, without the need for the labour-intensive processes of the past.

In terms of future developments, there are plans for expansion of many of these programmes, from the EHR, to eReferrals and ePrescribing, as well as fully digital hospitals.

O’Loughlin said that there are also plans for further hackathon-style events where, with the help of the likes of NDRC and related events such as IoT World, the community of patients, developers and clinicians can come together to solve problems, as well as provide facilities to match technologies to ideas by clinicians.

Technology multiplier
Corbridge is adamant that technology can be a multiplier of resources through careful development and application. He highlights the fact that Ireland is low in terms of IT health spend at just 1%, when the EU average is 3%.

Of the more than 100,000 people working in health service in Ireland, less than 300 are in IT.

In terms of service delivery, says Corbridge, “that is about as agile as you can get.”

“With additional investment, we could do more. We have done so much in two years, but we can do so much more,” he said.


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