An account of the proceedings
Written by Elaine Naughton
With registration topping over 200 people the scene was very much set for the exciting collaboration platform that is the eHealth Ecosystem.
Opening the day, Kevin Conlon, Dept of Health gave us the definition of the Ecosystem as being the convergence of Government, Academia, Industry and Health with the patient placed firmly at the centre in terms of the realization of benefits from improved safety, efficient pathways of care and access to treatments. The level of expertise at the event, incidentally, crossed Department of Health, HSE, innovative health technology suppliers, hospital chief pharmacists, dermatologists, nurses, academics, GPs, and software engineers, all facilitated admirably by HISI and ICS personnel - albeit in a room whose temperature continued to rise throughout what was the hottest day of the year thus far. Nevertheless, the attendees’ passion for the subject matter declined to succumb to the heat!
The focus of the day’s gathering was around ePharmacy, and in identifying the potential for an eHealth programme for Pharmacy “Are there opportunities to improve/develop ePharmacy in order to improve patient care?”
HSE CIO, Richard Corbridge, clearly thinks so. Having been introduced to the audience by Mr. Conlon as a gift that arrived in the HSE shortly before Christmas, Richard responded in his opening speech by saying that he had very quickly realized that he needed to be wrapped and ready to deliver from Donegal to Dingle, and everywhere in between, and all in one day…! Santa Claus indeed…!!
He elaborated on the concept of the Ecosystem as being everyone in attendance, each of whom he predicted would have a different concept of what an Ecosystem actually is by the end of the day. Since the Ecosystem has to be different things to different people, this would actually be a good thing as each would bring their version of events back to their own area of expertise.
He proffered: “How does technology and digital health affect pharmacists? Why ePharmacy?” Challenges that exist today include inadequate management of clinical information, deployed systems with unrealized potential and the realization that answering the inherent “What do we need?” could include giving the patient access to their own pharmacy/health record
The eHealth equation pits an aging population alongside technology advancement, health reform and clinical engagement. Clinical engagement in Ireland, says Richard Corbridge, is better than he has seen it anywhere in the world, giving the example of the 64 volunteers who have joined the first Council of Clinical Information Officers to further the eHealth strategy. He also spoke to a very appreciative audience about the fact that this generation will probably be the last without some form of clinical implants. Project UnderSkin by TickerFit is researching the possibility of an implant under the thumb that is programmed to monitor certain health indicators, blood sugars, temp, heart rate etc. and displays a hieroglyph on the skin based on its findings… alerting people automatically for example when blood sugars are dropping below safe levels.
He went on to outline the various deliverables of the Knowledge and Information strategy, prompting some attendees to tweet about the busy summer he had ahead!
Peter Connolly, HSE’s Head of Enterprise Architecture, then spoke about realizing the Ecosystem via Enterprise Architecture. What he is designing via the newly established design authority for the HSE is a robust and resilient architecture that will be able to support the eHealth strategy.
A very impassioned and candid narrative followed from Peter Kidd Deputy Chief pharmacist at UHG: Opening with a frank representation of a patient’s care pathway, including how a medical history can be taken multiple times he said “A patients journey is a waste of time if they don’t get the right treatment” and that treatment was down to the medicines they are administered. Highlighting the challenges faced he said that it was no secret that in giving the several accounts of their own medical history during their time from admission to treatment, 75% of patients have a complete and accurate history taken… which means 1 in every 4 people do not. 65% have a complete and accurate discharge prescription… 1 in 3 therefore… do not. There are currently 20-30 steps required from prescribing to delivery… he counters that only six steps are needed. And a “lean-ing out” of processes is overdue. There have been documented errors and he showed an example of 2 different drugs listed on the same label of a medicine container. He said a lot of the pharmacists time is spent (wasted) on history reconciliation efforts… including ringing GPs to make sure patient history is accurate. He went on to say that nurses don’t have time to care as their time is taken up with non-value-added administrative tasks - which often excludes ensuring that drugs are stored correctly. In conclusion he said that “We need to move away from Command & Control approach. A modern health service should not be subscribing to the idea of working hours being 9-5 Mon- Fri. IT & Finance needs to better understand the challenges faced and the role played by pharmacists - Pharmacists do not just distribute medicine – we are also the most qualified people to distribute information ABOUT medicine, drug safety & appropriate uses”
Dr. Aine Carroll - HSE, Presented a hard hitting set of statistics, admitting that she was there to bring everyone back to earth with a bang! “The healthcare system is hazardous... more hazardous than flying, driving & bungee jumping! We need to fix that… and technology is the way to do it. She also re-emphasised the key message from the day: A common language, ie establishing standards between organisations and systems is imperative.
Brian O’Connor – ECH Alliance in finding himself introducing people in attendance who should already know each other, re-emphasizes the fact to him that we need an Ecosystem.
He outlined the key ecosystem priority areas and gave some excellent and authoritative insight into the experiences he has had with ecosystems across Europe, China and Canada, inviting speakers from the floor to underline their own experiences.
In the afternoon we had a number of presentations around emerging opportunities. Amanda Green from Cerner spoke about how the emergence of viable markets will require open standards. Smartplatforms.org is a site hosted by Cerner which promotes collaboration across borders.
Nicola Mountford, Director of UCD Connected Health, explained the range of activities undertaken in the academic community, including ARCH and Insight, in support of eHealth in general and ePharmacy as a case in point, in collaboration with the Ireland East Hospital Group.
Keith McLernon spoke about the ePharmacy and digital pharmacy solutions that they have available and in Mallow they are piloting an ePharmacy solution using HL7 standards, which will reduce transcription errors, improving patient safety.
Helen McBreen NDRC highlighted the innovative companies present like TickerFit, Medxnote etc., who have come through the NDRC innovation centre and have achieved real success with their technologies and solutions. As investors the NDRC are looking for Global opportunity in innovation (“not tech for tech sake, not solutions to local problems”) they are looking for technology projects that are not easy to replicate… and they are looking for teams who can work together to share the challenges that need to be overcome when you are setting up a company.
Volunteers attended a Future Health workshop, 10 -15 ideas that could be turned into businesses. MDTs worked together over 7-8 weeks to validate the problems they proclaimed existed, and build business cases around those. It is difficult to get people to articulate and believe in their ideas. Describing what the problem is first before attempting the technology that will solve it, is often what the NDRC is more concerned with.
#1 Ecosystem- Kevin Conlon.pdf (size 1.1 MB)
#2 Ecosystem Launch - Richard Corbridge.pdf (size 1.8 MB)
#3 Peter Connolly - HSE Enterprise Architecture.pdf (size 1.3 MB)
#4 ePharmacy - Peter Kidd.pdf (size 1.4 MB)
#5 Aine Carroll E-pharmacy.pdf (size 324.5 KB)
#6 ECHAlliance - Irish Ecosystem Brian O'Connor.pdf (size 836.8 KB)
#7 Ecosystem- Nicola Mountford UCD slides.pdf (size 190 KB)
#8 eHealthIreland NDRC HelenMcBreen2906.pdf (size 440.5 KB)
Recording of Table Discussion Feedback
29-06-15 ePharmacy discussion feedback.m4a (size 34.6 MB)
Next Meeting: Sept 18th location TBC
Mary Cleary, ICS: The reaction to the day has been extremely encouraging. The wide range of topics and concerns and questions raised by attendees can clearly be resolved in the collaborative environment of an ecosystem.
Michael Tighe, HISI, I’m extremely proud to have gotten to today. It is something we’ve been working towards for 3 years.
Paul McCarthy, Full Health Medical Ltd. www.fullhealthmedical.com : A great day. We work in the area of preventative health and enabling people to understand their test results. eHealth has the ability to improve this. If the Ecosystem succeeds and brings all of the innovations that are out there together, patients will be the real winners and tax payers will benefit from the savings.
Mike O’Keeffe: Insight Centre UCC: Very informative and a very attractive opportunity for all involved.