Seamus Butler is the Delivery Director for ICT Services to Acute Hospitals for the Office of the CIO (OoCIO), HSE Ireland. Seamus has worked in healthcare for more than 30 years and has extensive experience in the delivery and management of ICT services and information systems. He has worked at various levels and in different roles in ICT services in the Irish public healthcare system including managing the IT function in a large healthcare organisation. In more recent times he has been responsible at national level for a broad portfolio of information systems projects, principally in the acute hospital areas.
In his current role of Delivery Director for Acute Hospitals he is responsible for the relationship between the OoCIO and the Acute Hospitals Division.
Major ICT Projects in Acute Hospitals
There are currently more than 60 ICT projects in train in the Acute Hospitals. Some of these are featured in Case Studies. A brief description of the more significant projects now follows:
Integrated Patient Management System (IPMS)
This project is deploying a new Patient Administration System (PAS) to hospitals. The PAS is the main information system supporting day-to-day operations and is used to record all activity including referrals, waiting lists, admissions, outpatient appointment/attendances, emergency department attendances, transfers/discharges, etc. 28 acute hospitals now run this new system and the rollout process is continuing. Current work is focussed on the University of Limerick (UL) Hospitals Group, where the first site - UL Hospital, Limerick - is scheduled for go-live on 26th June 2015.
National Integrated Medical Imaging System (NIMIS)
NIMIS is moving Ireland’s radiological services towards ‘filmless’ and "paperless" operations and enables secure and rapid movement of patient image data throughout the health service. This new imaging system allows doctors to electronically view their patient’s diagnostic images, such as X-Rays and CT Scans, quickly and easily. The rapid access and availability of patient’s records to health professionals is a significant step for service responsiveness and patient safety. 34 hospitals are currently operating the new system and the rollout continues.
The National Medical Laboratory Information System (MedLIS) project will deliver a single national standardised laboratory information system replacing the multiple systems currently in use across the 43 laboratories in the acute hospitals. The strategic goal of the project is to ensure that patients’ healthcare providers have rapid 24-hour access to complete and up-to-date accurate laboratory data across all sites. The implementation process for the new system commenced in the autumn of 2015 and full national rollout is likely to take approximately 4 years to complete. A programme brief is available here.
Maternal & Newborn
The Maternal and Newborn Clinical Management System (MN-CMS) is currently being configured and built for implementation in the 19 hospitals delivering obstetric and neonatal services. The system is a full Electronic Patient Record for these services and will support improved patient care and safety of services by ensuring all clinicians involved in each patient’s care has full access to the complete medical record when and where required. A programme brief is available here.
The Electronic Blood Tracking System is an automated system used to track all blood used in hospitals so that a full record is maintained from donor to recipient including the storage of blood in the intervening period. Strict environmental control of storage of blood is required and the duration of time that blood is outside of fridge temperature must be monitored for quality assurance purposes. The new automated system is now used across hospitals and its use within each site is being extended so as to achieve full use in the final stage of the blood journey – i.e. transfusion.
The Kidney Disease Clinical Patient Management System (KDCPMS) is an electronic patient record system designed to improve care for all patients who attend a Renal (kidney) Specialist Team in Ireland. The KDCPMS programme is jointly managed by the Office of the CIO and the National Renal Office. A KDCPMS case study is available here.
The Endoscopy Reporting System project is deploying ICT support systems in endoscopy services in order to streamline the production of diagnostic reports and ensure an efficient system for communication and storage of, and access to, reports and their associated endoscopy images. The system supports improved service quality and standardised records, while facilitating clinical audit, quality reviews and required accreditation standards. To-date these systems have been deployed in 22 hospitals and the rollout process is continuing.
Track & Trace
The Track and Trace System is used to track all Reusable Invasive Medical Devices (RIMDs) through their cleaning and decontamination processes and to trace their usage on patients. The devices comprise a variety of sterile instruments and endoscopes. The system being deployed helps lessen contamination risk, ensure compliance with required standards and assures quality. It maintains better quality decontamination records and enables ready access to the records. The system is highly automated using scanning technology and GS1/MS1 coding. It has been implemented in very many sites to-date and the rollout process is continuing.
Diagnostics Quality Improvement
Quality Improvement Programmes are an integral part of the histopathology, radiology and endoscopy services and are led by the respective Faculties in the Royal Colleges of Physicians/Surgeons in Ireland. ICT support systems are being rolled out to complement these programmes in each of these specialist areas. These systems collect key indicators for local and central reporting, for setting benchmarks and monitoring achievement of them. Additionally, in the case of radiology the ICT system provides operational workflow support for delivering peer review and communication of unexpected findings. The ICT systems are now extensively rolled out across hospitals delivering these services. The rollout process is continuing through 2015/16 in order to get all hospitals covered. Further information on the Specialty QI Programmes may be found on the RCPI website.
An increasing number of the intensive care facilities in hospitals have deployed full Electronic Patient Records within their departments. These systems integrate with physiological monitoring equipment and enable a central view of all relevant clinical information on patients in the ICU. They enhance record keeping, access to information and support clinical decision making. Most of the major teaching hospitals have deployed these systems over the last few years and other hospitals will be supported to do so.
An Electronic Patient Records System has been developed at Beaumont Hospital and is supported by the National Epilepsy Programme and the Office of the CIO for full national rollout. Considerable progress has now been made and the system is accessible from 9 acute hospitals, with the remaining 4 acute hospitals to follow shortly. Additionally, access to the system is being made available from other outreach centres and services as required. The system provides a full electronic record supporting prompt clinical decisions and continuity of acre across various settings. It also provides valuation knowledge and information about services for quality review and service planning.
The Irish National Orthopaedic Register (INOR) is being established which will define the epidemiology of joint replacement surgery in Ireland, provide timely information on the outcomes of joint replacements and identify risk factors for a poor outcome. A new central ICT system is under development to support INOR, which will collect a detailed dataset on each joint replacement procedure carried out in Irish hospitals, both public and private. The system will support local and central reporting and will facilitate easy identification of affected patients in the event of implant recall. INOR will increase patient safety, confidence and the overall patient experience. Its rollout will commence in 2015.
Ambulance Computer Aided Dispatch
The management of ambulance emergency calls is in the process of being centralised in two centres, Dublin and Ballyshannon. This arrangement is replacing larger number of “local” centres where calls were previously managed. A new National Computer Aided Dispatch (CAD) system is in the course of implementation into these two centres, which will be integrated communications systems and will process all calls received. The project includes the provision of Mobile Data Terminals (MDTs) in the emergency vehicles for communication with the CAD. The system encompasses integration with digital mapping to provide real-time vehicle location and determination of nearest available vehicle to respond to each call received. The new system will go live from September 2015.