Electronic Health Record
Portal, Epilepsy Electronic Patient Record and ePharmacy in Acute Care
Minister for Health, Leo Varadkar today (Monday 18th January 2016) attended an eHealth Showcase in Temple Street Children’s University Hospital, organised by the HSE’s eHealth Ireland. eHealth Ireland was established one year ago to put in place a suite of technology-enabled solutions in order to improve and make more efficient the delivery of health care to the population.
The showcase highlighted some of these technology-enabled solutions which are currently operational within the Irish health service. The advantages of this technology are two-fold. Firstly, it enables the healthcare system to deliver safer and more efficient services for patients. Secondly, it provides clinicians who deliver patient care the technology needed to solve complex medical problems.
Both of these principles are clear reflections of the HSE vision and values for 2016 and onward which is underpinned by care, compassion, trust and learning.
The Chief Information Officer (CIO) for the HSE, Richard Corbridge, introduced a number of the technology-enabled solutions as part of the Showcase including Temple Streets Children’s University Hospital – Electronic Health Record Portal, the National Epilepsy Electronic Patient Record and Our Lady’s Children Hospital, Crumlin – ePharmacy solution set including hospital based ePrescribing.
Speaking at the event Minister Varadkar said, “During the recession, our health service fell behind when it comes to information technology. The economic recovery gives us the opportunity to catch up. As Minister, I have increased the ICT budget by 40% to €55m. I want this to be sustained and increased further over the next few years. In particular, I want the new National Children’s Hospital to be born digital.
“I want ambulance paramedics to be able to access patient records electronically from the moment they get to the patient or even before. I want every GP enabled to refer patients to specialists on-line and I want every radiology and laboratory system able to talk to each other so that test results can be accessed easily and do not have to be repeated unnecessarily. We have plans to do all of this in the years ahead but we can only afford to do so if we keep the recovery going and the economy strong”.
Richard Corbridge, CIO said, “For a number of reasons, primarily due to the lack of funding during the recession, the Irish health system has been late introducing technology to make healthcare more efficient and safer. We are now advancing at a new pace with a number of important projects, some of which we highlighted today. These projects will be able to deliver on the benefits promised due to the joint involvement and ownership of healthcare professionals and information technology specialists.
Following learning from other jurisdictions, Ireland is somewhat of a world-leader in joining both healthcare professionals and IT specialists in the process of developing our systems; a partnership not yet evident in other health systems. Despite its scale and complexity, such a joined-up approach gives eHealth Ireland a significantly better opportunity for success.”
Demonstrating how the partnership works in practice, a number of clinicians explained their involvement in the project and also how they benefit from the newly implemented technologies. In particular, the clinicians during the 90 minute Showcase described how the new technology provided:
- More efficient work processes, thereby providing them with increased time for patient care;
- Better access to more robust clinical information, and;
- Better access to decision support tools.
Yvonne Goff, the eHealth Ireland Chief Clinical Information Officer commented, “If you work in any other industry in Ireland, information systems will support how you deliver your service. Through the eHealth strategy, Ireland now has a detailed plan and a commitment to funding to adopt these principles more thoroughly in the healthcare setting. What is even more exciting though is that Ireland is doing this with a patient and clinical focus and not a technology lead. This will ensure that the primary focus for Ireland is the range of benefits brought to patients through this technology – and not just the technology itself.”
The National LightHouse Projects
In order to better describe the benefits that technology can offer to patients, the showcase described in detail the new National LightHouse Projects. These three new initiatives were launched as projects that have a specific focus to build an understanding of the benefits of an Electronic Health Record in the Irish healthcare system. Key to the success of the projects is the timeline they offer – delivery through to realised patient benefits in 2016 is a core element of these projects.
The projects will, where possible, add to elements already in place and will cover three clinical areas: epilepsy, haemophilia and bipolar disorder.
The Epilepsy Lighthouse Project: The Epilepsy area of care already has a technology programme underway that when complete will offer all patients with epilepsy and the clinicians who treat them a more efficient and truly personalised treatment pathway for managing their condition using technology-based solutions.
Working closely with 50 consenting children with epilepsy and 50 consenting adults with a diagnosis of both Intellectual Disability, and epilepsy, the project group aims to develop a new model of treatment and care. This model will be underpinned by technology, focused on the individual patient and will be rolled out in a consistent manner across the healthcare system.
Key elements of the Epilepsy LightHouse Project include:
- Genomic sequencing of an individual patient; this would allow scientists to read genetic codes so they can make comparisons between normal versions of a gene and disease-causing versions of a gene thereby assisting in developing a treatment and care pathway.
- Patient reported outcomes where the patient can report to their treating clinician, via a patient mobile portal, specific and personalised information on their seizures, quality of life, and medicine compliance.
- Clinical analysis where clinicians can use gathered aggregate data to analyse and gather insights for the wider patient community to inform future care and population health.
- Individual Health Identifier will be included to enable the patient’s clinical and other relevant data to be integrated with other healthcare systems with the patient’s consent. This allows greater efficiency and reduces the chance for error as the patient moves from one part of the healthcare system to the next.
eHealth Ireland and the HSE is delighted to have reached an agreement with the RCSI to deliver this LightHouse project as a collaborative research project. This will be the first time that the HSE has been able to deliver this kind of project with one of the academic centres of Ireland. In addition, the continued support of Beaumont Hospital and Epilepsy Ireland will continue to be significantly involved in the delivery this project.
The Haemophilia Lighthouse Project will work with the Haemophilia patient community to further develop and implement technology that will allow the sufferers of haemophilia access to mobile technology to facilitate them in receiving and providing important information regarding their medical condition and care while “on the move”.
This includes useful information such as details of care incidents, haemophilia product details which they have used, expiry date and recall status of products, as well as to aid in the secure communication directly with their individual medical teams.
This data will be recorded in the Haemophilia Electronic Health Record which can be viewed by clinicians to enhance their delivery of personalised patient care.
eHealth Ireland is delighted to have the agreement of St James Hosptial, Our Ladys Hospital, Crumlin and Cork University Hospital who will collaborate and work together on this important project.
The Bipolar Lighthouse Project: This is a new area of research and development for the vast majority of healthcare systems globally. The Bipolar Lighthouse Project will evaluate patient and clinical need in relation to building a secure technology-enabled clinical system which will support information integration and provide a clinical support tool for patients and their medical team. Clarity around the patient benefit and focus will be built through engagement with care focus groups and patient groups in this area from design through to delivery in 2016.
At the Showcase, the eHealth Ireland team also provided an overview of the successful achievements for eHealth during 2015. These included the successful piloting and rollout of eReferral, the implementation of the first stages of the Individual Health Identifier (IHI) and the development of the Knowledge and Information plan.
The #eHealth4All hash tag was used during the showcase to allow health professionals from throughout the system to reflect their thoughts and considerations to the team.
Notes to editor
Temple Street Children’s University Hospital Temple Street University Hospital Clinical Portal was rolled out to the entire hospital in Feb 2015, having previously been live in the two sponsor areas of Endocrinology and Neurosurgery since Nov 2014.
Clinician’s caring for patients can, with one login, access a collated view of patient information on site or remotely to support timely decision making. This patient information contains demographic details, past and future patient encounters (emergency, inpatient and outpatient as well as theatre, laboratory and radiology exams are all viewable), with electronic sign off protocols and governance.
It is supporting the Hospital’s ICT strategy with regard to becoming less ‘paper reliant’ and moving towards an EPR.
National Epilepsy EPR – Epilepsy is a chronic neurological disease affecting at least 37,000 people in Ireland. Its diagnosis and optimal management relies on input from a number of healthcare disciplines (e.g. medical, nursing, psychology, administration ) in a variety of healthcare settings (e.g. community, primary care, specialist hospital ) together with the active participation of the patient (and/or family/carer). However, traditional models of healthcare delivery lack integration and can result in uncoordinated patient care, conflicting advice, and delays in diagnosis and treatment. For more information visit http://www.ehealthireland.ie/Case-Studies/Epilepsy-EPR-/
Our Lady’s Children Hospital, Crumlin – Pharmacy in action – There are three innovative solutions developed by medical, nursing and pharmacy professionals. The three solutions are:
Medicine Formulary smart phone app, ePrescribing capability from within ICU, Standard Concentration Smart Pump Drug Library.
The medicine formulary is an up to date, mobile, multi-platform reference for drugs commonly prescribed and used in OLCHC along with associated clinical and prescribing guidelines for health care professionals.
The ePrescribing component of the PICU Clinical Information System allow for drugs to be prescribed for patients electronically, reducing the risk of error associated with traditional hard copy drug charts and further enhancing patient safety through the use of predictive clinical decision support.
The smart pump drug library enhances patient safety by eliminating the use of traditional ‘weight based’ dosing from routine paediatric practice and ensures that standard concentration infusions are prescribed promoting accuracy, efficiency and compatibility with future information technology developments.
eHealth Showcase Material (Infographic PDF)