In July of this year in the National Digital Research Centre (NDRC), Richard Corbridge, CIO HSE and eHealth Ireland spoke about the digital transformation happening in Ireland’s national healthcare system. He shared his experiences about this journey of disruption and his thoughts on eHealth developments in the future. I recently had to opportunity to meet him and to gain more insights.
There are several case studies on the eHealth Ireland website, can you tell me a little more about them?
The different case studies on the eHealth Ireland website are there to promote and show the work that’s been done already. They highlight the benefits being realised by patients and clinicians through the use of eHealth technology.
Over the last 10 years, Ireland hasn’t particularly invested in healthcare technology. About 1% of the health budget goes on technology; the average across the rest of the world is 3.5%.
This has meant that many local organisations have invested in making things happen. These case studies promote the local initiatives that have been successfully implemented and reviewed. They have been proven clinically and are patient focused. We can now start looking at how to turn these into national solutions.
A prime example is e-Referrals which was originally a pilot project in Cork and Kerry Hospitals. These regional hospitals piloted e-Referrals because they wanted to make it work in their local areas. They came up with a solution which has now been implemented throughout the whole country. Every hospital in Ireland now has access to the e-Referral system and in August over 40% of GPs used the service.
The local initiatives point the way to what can be done on a national scale. They’ve involved many stakeholders, how did that collaboration work?
The engagement across health in Ireland is much better than it was in the NHS when they tried to do this. Here in Ireland clinicians are coming up with bright ideas daily and asking:
“Can we have a go at this?”
“Can I try and work with a new company to try to do that.”
There’s phenomenal engagement in Ireland around health technology. I’m constantly blown away by how big and how good a journey that is. It makes a big difference if the stakeholder group is engaged in making decisions at the earliest of points.
Ireland has won awards and has been recognised globally as having one of the best clinically engaged workforces in a digital reform of any other country in the world. Even the NHS, who we legitimately stole the idea of having a Chief Clinical Information Officer (CCIO) from, is now coming to Ireland to have a look at how we are doing things here.
Our CCIO lead, Yvonne Goff has in 12 months completely changed the way that healthcare business is being done in Ireland. She now has 210 volunteers working for her from the whole width of the HSE. Yvonne recently won the Tech Professional of the Year 2016 in the Tech Excellence Awards for her excellent work.
— Richard Corbridge (@R1chardatron) September 3, 2016
The case studies are split into different regions and hospitals. Integrating them is a big task, how will this be done?
The whole thing is a big task. Ireland now has the first ‘Cloud First for Health Policy’ in the EU. That gives us a unique opportunity to put the solutions gained from these case studies onto the Health Cloud from where they can then be deployed quickly.
A ‘Health Cloud’ can you explain what that is and why it’s being used?
Microsoft is supporting the EU Council in delivering policies to enable a Health Cloud for different member states of the EU. This Council works through what policy changes and initiatives are required for the Health Cloud to be put in place. Between January of this year and now we have worked through what policy statements need to be agreed, how to protect Irish citizens’ data and how to provide a degree of security and assurance beyond what local data centres could ever do.
Let’s take a look at health records today and the data centres and infrastructure in place. There are 17 data centres for health in Ireland. We call them data centres, however, they’re often wooden cupboards in corridors, that can’t be easily secured compared to AWS or Microsoft Azure or whatever partner cloud solutions that are considered. We strongly believe a cloud first policy is a good thing to do.
What were and are some of the challenges encountered along the way?
Before we had the ‘Cloud First Policy’ the challenges were about how to get the infrastructure up and running and how to get people access to the system. A good example is that there are 47,000 people in health today that don’t have a digital identity, they can’t log onto technology to support them in the delivery of care. Therefore how do we get everybody a digital identity, how do we give them access to a solution?
One of the reasons I think that we’ve been good at local initiatives but not been able to leapfrog to national initiatives is the need to invest in national solutions. To do this requires more money. It also requires a bit more bravery. Trying to deal with the whole country brings up issues of cultural and business change that we need to get right from the very beginning.
What’s next for eHealth Ireland and how are you getting the word out to the public about the work you’ve been doing so far?
At the moment we are working with the NDRC on the HealthTech Programme which is enabling clinicians to develop their ideas to create more eHealth solutions.
From the 22nd to 23rd November we will be taking over the Science Gallery in Trinity, it’s a free event and it’s open to the public. We will be showcasing our current case studies and people will be able to experience and interact with them. They will also be able to see the work that Irish start-ups are doing in eHealth. Other major health related conferences will be taking place in Dublin during November which we will also be participating in. We believe strongly that by opening up what eHealth Ireland is doing to a multitude of experiences, digital and healthcare based we can learn and learn and learn how to get this right first time.
The digital transformation that’s happening in Ireland at the moment is a big task. It involves many shifts in infrastructures, cultural attitudes, resources, financial investments and much more. Richard Corbridge is driving this digital transformation forward and with his knowledge, passion and expertise, it’s in very safe and steady hands.
To keep up-to-date and know more about eHealth Ireland you can follow them on Twitter @eHealthIreland