With 82% of its population vaccinated, we find out how data is informing decision-making and reshaping healthcare in Ireland as part of its eHealth strategy
By JOANNE SWEENEY - THIS ARTICLE WAS ORIGINALLY PUBLISHED IN THE YUAN
In March 2020 Ireland reported its first official case of coronavirus. That date marked the disruption of Ireland’s health service but also its data strategy. 15 months later, still in the midst of a pandemic, the Health Service Executive (HSE) was struck by a catastrophic cyberattack infecting over 2,000 hospital, community, and specialist health systems. It was the worst thing that could have possibly happened and at the worst time. That day was Friday, May 14 2021. The ransomware using Conti disrupted entire systems and resulted in a significant data breach.
The technology systems which the health service rely on were essentially shut down. Care and the health service continued to function albeit at a slower pace given the lack of IT systems.
This event served to remind health leaders of the critical role data plays in planning, delivering and assessing health care. But it didn’t take the cyberattack to introduce a mindset shift, because for 10 months prior to this, the Office of the Chief Information Officer (OoCIO) within the HSE had been spearheading a new data strategy, sparked by the pandemic.
Mark Bagnell is a General Manager in the OoCIO. Having worked in Information Services across the private and public sector throughout his career, he describes the agility and pace of digital transformation in the HSE during the pandemic as “remarkable”.
“We had no choice but to be agile. We literally had to respond overnight, and in fact, we have been iterating and responding every day for the past 17 months - from testing and tracing cases of coronavirus, establishing mass testing centres, creating modelling of clusters, and the setting up of a nationwide vaccination programme to assisting with the issuing of digital COVID certs and now planning for a potential booster vaccine programme. It’s been relentless and we have had to move at speed, but our teams have been remarkable."
“It’s important to understand the complexities of health tech and the many numbers of factors at play simultaneously. In order to get the tech right, we have to work closely with clinical teams and be very clear on the intended outcome which is ultimately better patient care. It’s collaborative and patient-centric.”
AI as the antidote to the virus
Data has been a central cog in the vaccination wheel in Ireland. It has, and still is, providing senior leaders with the evidence they need to inform how to deal with community transmission, staffing levels in public hospitals, redirecting resources to communities for walk-in testing and vaccination centres and the re-opening of society. Every single facet of life in Ireland uses the data powered within the OoCIO to help inform their next strategic move.
Azure and Power BI have been used in conjunction with Java and Python programming languages to “collect, pipe and analyse big data.”
Mark Bagnell says the Azure platform powered by Microsoft was built very quickly at the start of the pandemic and this allowed them to combine data from a myriad of systems to solve day-to-day health challenges. “It was scaled up and used as a central source to pipe in data from a number of sources such as labs and private hospitals. This was then complemented by tools such as Power BI and Qlik to display the data in an easy-to-understand visual dashboard for decision-makers.”
From engagement to efficiency
Mark Bagnell says the HSE’s eHealth strategy has always played a key role in the transformation of the organisation. Technology is disrupting how healthcare is delivered in Ireland, an island nation with a population just shy of five million people.
Ireland has an ambitious seven-year eHealth strategy and with a dedicated team of skilled professionals leading it out, it has received not only the respect of the organisation but also the funding required to serve a staff of over 100,000 people with a budget of €21 billion.
“Our eHealth strategy is transforming healthcare delivery systems in Ireland into safer, higher quality, more efficient, easier to access systems that pay for themselves over time. The cost-benefit analysis of investing in technology systems combined with a culture of transformation and a willingness to redesign existing work practices is how we are driving change."
“We are getting engagement very early on in projects from our colleagues within the HSE as we try to plug as many information gaps as possible. Our mission is to aggregate and analyse the big data to empower health specialists and managers to make the best decisions possible.”
Mark Bagnell says the data strategy rolled out during COVID-19 has also helped the communications team deliver critical public health messaging to the public and build trust and buy-in.
What is eHealth?
eHealth (Electronic Health) involves the integration of all data sources involved in the delivery of healthcare using artificial intelligence and other technologies. Such data sources include patient details and their records, caregivers and their systems, monitoring devices and sensors, as well as management and administrative functions.
In essence, it is a fully integrated digital ‘supply chain’ involving high levels of automation and information sharing.
eHealth systems are patient-centric and involve the use of modern information systems and technologies to integrate and coordinate the delivery of healthcare to ensure improved patient outcomes, greater efficiencies of delivery, higher levels of transparency and improved ease of access.
eHealth places an increased emphasis on prevention and empowers consumers (patients) to proactively manage their own health often from remote settings such as the home while reducing costly hospitalisations.
From the providers perspective, it enables efficiencies through decreased hospitalisations and lengths of stay, avoidance of duplication of procedures and tests, reduced reliance on error-prone paper-based processes and up to date, accurate and timely patient record history
The role of AI in transforming healthcare delivery
There are a series of projects that are AI-driven at the centre of Ireland’s eHealth strategy, separate to COVID-19.
- > Electronic Health Records (EHRs)
- > Telehealthcare and telemedicine systems
- > ePrescribing
- > Automated pricing, performance, billing and claims management
Mark Bagnell says that healthcare systems globally are straining to meet current demand and will struggle to meet forecasted future service demand arising from ageing populations and chronic diseases in particular unless information-based innovation is introduced.
“This innovation while disruptive in nature is not entirely new and many other industry domains have been using similar systems for many years. eHealth technologies have been evolving steadily."
“We see eHealth as an infrastructural investment for Ireland that will bring benefits to the general wellness of the population, generate service efficiencies and also bring significant economic opportunity. eHealth is also a significant enabler to the current reorganisation of the Irish healthcare service.”