eHealth Ireland:

eHealth – a Critical Enabler

Richard.corbridge@hse.ie

Chief Information Officer – Health Service Executive - Ireland

Chief Executive Officer – eHealth Ireland

eHealthIreland.ie| @eHealthIreland @R1chardatron

Office of the CIO | Delivering eHealth Ireland

Connected Health

Delivering eHealth Ireland | Office of the Chief Information Officer

Evolution of Time

Ireland and France didn’t

adopt Greenwich time.

Dublin 25 minutes ahead

of London until October ’16.

Railway stations adopted

the national time.

Ulster and Bangor stations

maintain local time and Dublin

time.

Delivering eHealth Ireland | Office of the Chief Information Officer

Evolution of Time

Before 1840 local time was

standard (UK).

Remove confusion and

create a standard.

Eradicate near accidents.

Local resistance (Leeds 7

minute ‘local time’ ‘70s)

Benefits balance.

Delivering eHealth Ireland | Office of the Chief Information Officer

The IT strategy question?

Cross

Setting

Information

Integration

Electronic

Health

Records

National

Support

Systems

Care

Delivery

Enablement

Integrated, Patient Centric,

Efficient Care Delivery

Health

Service

Insights

Knowledge & Information Delivery Transformation

Clinical & Information Governance

Knowledge & Information Plan

Delivering eHealth Ireland | Office of the Chief Information Officer

Business Change

Partner

6 Office of the CIO | Delivering eHealth Ireland

Business Enabler

Commodity

Time

Imp

act

Transition to Transformation

Delivering eHealth Ireland | Office of the Chief Information Officer

The IT engagement question?

Office of the CIO | Delivering eHealth Ireland

Delivering eHealth Ireland | Office of the Chief Information Officer

AGILITY

Benefits yesterday,

today and tomorrow

needed

TRANSPARENCY

Investment in tech is

investment in health .

Balancing Act

Delivering eHealth Ireland | Office of the Chief Information Officer

Office of the CIO | Delivering eHealth Ireland 13

Epilepsy: All patients on the EHR, Patient mobile application,

Population health analysis, GP access and image reviews, IHI,

Genomic sequencing for under 5s.

Office of the CIO | Delivering eHealth Ireland 14

Epilepsy: All patients on the EHR, Patient mobile application,

Population health analysis, GP access and image reviews, IHI,

Genomic sequencing for under 5s.

Haemophilia: National Integration to hospital PAS, Open

source platform, Open Data pilot, Patient mobile application,

IHI, Secure clinical communicator, Next generation solution.

Office of the CIO | Delivering eHealth Ireland 15

Epilepsy: All patients on the EHR, Patient mobile application,

Population health analysis, GP access and image reviews, IHI,

Genomic sequencing for under 5s.

Haemophilia: National Integration to hospital PAS, Open

source platform, Open Data pilot, Patient mobile application,

IHI, Secure clinical communicator, Next generation solution.

Bipolar Disorder: Secure clinical communicator, Information

integration regardless of setting, Open Source solution,

Innovation led approach, Clinical support tool.

Delivering eHealth Ireland | Office of the Chief Information Officer 16

Delivering eHealth Ireland | Office of the Chief Information Officer

Current…

Delivering eHealth Ireland | Office of the Chief Information Officer 18

Security.

Data Quality.

Information Governance.

Data Dictionary.

Delivering eHealth Ireland | Office of the Chief Information Officer

The ‘fourth utility’ in healthcare

International eHealth investment Estimates

• €15.8Bn England – NPfIT over 10yrs

• €1.6Bn Canada, Southwest Ontario – 2013-2017

• €25Bn – USA – HITECH Act / Meaningful Use

• €1.6Bn – Australia – predicted over 10yrs

• €5.4Bn – NHS – predicted in next 5 yrs

The history of technology as it enters industries is

that people say ‘this is going to transform

everything in 2 years’ And then you put it in and

nothing happens and people say ‘why didn’t it work

the way we expected it to?... . And then lo and

behold after a period of 10 years, it begins

working.

— Robert Wachter

UCSF

Technology has transformed hotel,

transport, retail, banking, communications

………healthcare?

More than 80% of US providers

use an EHR

Ireland lags most developed countries but

can learn from the investments and

initiatives elsewhere The goals of Reform cannot be delivered

without a National EHR

Globally, there are

more than 400

EHR vendors on

the market

DENMARK

99% discharge

letters,

orders/results,

prescriptions are

electronic

FINLAND

100% health centres

with EHRs

NETHERLANDS

All prescriptions

electronic

US – VHA

$3.09Bn in

cumulative net

benefits

US – VHA

100% primary

care /

hospitals EHR

Delivering eHealth Ireland | Office of the Chief Information Officer

What is the National Electronic Health Record?

Moving from paper records

locked in organisations to a

digital patient record shared

across care settings

4 Components

Examples:

• Order Communications /

Results Reporting

• Medicines Management

• Clinical Notesstems

Examples:

• Single MPI

• Scheduling

• Clinical Notes / Records

• Screening & Surveillance

National

Shared

Record

Community

Operational

Systems

Acute

Operational

Systems

Individual Health Identifier

The “glue” that binds all this together

and maintains integrity and security

across the system

eHealth Blueprint

National EHR Registries and Domains

Stakeholders

Clinical Management / Point of Care Environment

National EHR Integration and Access Layer

Communication Layer

Core Capabilities

I.A.A.A.Layer

Pro

vid

er H

ealt

h P

ort

al

National EHR RegistriesClient Registry Provider Registry Location Registry

National EHR DomainsMedical Imaging Laboratory Results Pharmaceutical

HistoryClinical Document

RepositoryEncounter History

Message Queuing

Message Data & Transformation

Message Encoding

Service Management

Identity Management

Authentication Access Secure Audit

Single Sign On Exception Handling Context Management Terminology ServicesRecord Locator Services

Orchestration ETL PrivacyCertification and Integration Toolkit

Secure Messaging

Logging

Immunization History

Infectious Disease History

National AnalyticsPerformance Management

Population Based Analytics

Business Intelligence

Registration

National eHealth Blueprint

Healthcare Providers Patients Corporate Administrators and Managers

Legitimate Relationship Services (LRS)

Corporate Setting

Fin

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Clin

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The Individual Health Identifier

Programme is a key enabler that

allows information to be shared about

a patient

Pharmacy GP Systems

Private

Hospitals

Other healthcare providers will

access and contribute to the National

Shared Record through the

Integration Capability

Delivering eHealth Ireland | Office of the Chief Information Officer

What is the National Electronic Health Record?

The National EHR

comprises:

What does the National EHR do?

• Transforms patient experience

• Delivers greater patient safety and more

effective care

• Drives efficient delivery of health services

• Makes the wider reform programme

possible:

- Underpins integrated care

- Provides the information for

proactive health and wellbeing

initiatives

- Provides the operational systems to

realise CHO’s and Hospital Groups

- Captures accurate information on

activities that show the true cost of

treating a patient

! The National EHR is a fundamental cornerstone for the delivery of high quality,

comprehensive and accurate information in a timely manner for the provision of

patient centred, effective and efficient care

Pharmacy

GP Systems Private Hospitals

Delivering eHealth Ireland | Office of the Chief Information Officer

Building engagement and direction

The eHealth

Strategy

identified the

EHR as a key

requirement

The Knowledge

and Information

Plan through

extensive

stakeholder

engagement

identified EHR

capabilities

The EHR

Vision and

Direction set

out the case for

change and

rationale for

introducing and

EHR received

ministerial

support

The HSE conducted

an intensive

engagement with the

global eHealth

industry. This

informed the HSE on

the feasibility of

creating a National

EHR and the

optimum approach for

Ireland

The publication of

the National EHR

Strategic Business

Case in Q2 2016

will set the direction

of travel and define

the overall delivery

programme

Dec 2013 Q4 2014 – Q1 2015 May 2015 August 2015 Q2 2016

Significant

ongoing public

engagement

Delivering eHealth Ireland | Office of the Chief Information Officer

Path to a Single Solution Set

23

Delivering eHealth Ireland | Office of the Chief Information Officer

The Irish Public Expect Digital Access and Services

eHealth Ireland conducted a 2 month public consultation on EHR

Source: Initial Findings from EHR Public Consultation

Delivering eHealth Ireland | Office of the Chief Information Officer

The Irish Public Expect Digital Access and Services

eHealth Ireland conducted a 2 month public consultation on EHR

Source: Initial Findings from EHR Public Consultation

Delivering eHealth Ireland | Office of the Chief Information Officer

The Irish Public Expect Digital Access and Services

eHealth Ireland conducted a 2 month public consultation on EHR

Source: Initial Findings from EHR Public Consultation

Delivering eHealth Ireland | Office of the Chief Information Officer

The Irish Public Expect Digital Access and Services

eHealth Ireland conducted a 2 month public consultation on EHR

Source: Initial Findings from EHR Public Consultation

Delivering eHealth Ireland | Office of the Chief Information Officer

Why be social?

Office of the CIO | Delivering eHealth Ireland

“Twitter is organic, instant far

reaching and raw”

@LeeSpokes1 #WGT16

Delivering eHealth Ireland | Office of the Chief Information Officer

Why be social?

Office of the CIO | Delivering eHealth Ireland

6th April – 22:00 - #IrishMed

14th April – 17:30 - #eHealth4All

Delivering eHealth Ireland | Office of the Chief Information Officer

Network = Reach

Connection not Network

Delivering eHealth Ireland | Office of the Chief Information Officer

Horizontal Innovation!