Modernising the HSE: Electronic health records, digital referrals and robots in Tallaght

"Currently a referral letter touches 16 pairs of hands, technology is changing that down to one"

We often hear tales of new technologies that may emerge and transform how we live our daily lives, but are you aware of the level of technology being implemented and used in our hospitals today? I wasn't, and so I visited Science Gallery here in Dublin, which is hosting a showcase as part of Health Innovation Week. 

"Health Innovation Week in Ireland has been an idea that came about three months ago to try and show the public what technology changes can do for the healthcare system," explains Richard Corbridge, Chief Information Officer at the HSE. "We've had all sorts of events running from Saturday through until Thursday. We've had everything from a hackathon to help people build a new solution for bipolar disorder to an exhibition at the Science Gallery, which is very much an opportunity for organisations to show what they can do for healthcare across the Irish system. And it's free!"

The atmosphere at the Science Gallery was electric. There was a mix of tech giants such as Microsoft and Samsung in attendance, along with smaller, Irish startups. Marie O'Loughlin, Engagement Specialist at e-Health Ireland explained the end goal for Health Innovation Week. 

"We want people to walk away and know what the healthcare system is like now. There's some really cool technologies that are already in the healthcare system at the moment. We have LUCY the robot from Tallaght who is here. She's part Segway and part iPad. She's existing right here in Ireland now, in Tallaght Hospital." 

The doctor can control the device remotely, around the hospital floor from an app on their smart phone, and when it is alongside the bedside the physician can then converse with the patient about their condition.

Aside from showcasing the technologies on offer, the organisers want to involve children in the process.

"We are doing a Minecraft hackathon at the moment. We have over 250 kids, from 15 schools building a virtual health ward of the future. This is what they see health looking like in 2030," says O'Loughlin. 

VR:

Virtual reality is a concept that has captured the imaginations of gamers, but the health system has worked with developers to devise a remarkable use for it in the medical field. 

"Samsung has worked with us to create a VR experience around anxiety and how one feels when they suffer from anxiety. We worked with SeeChange and developed a storyboard alongside Samsung so that people can experience it for themselves."

Samsung has also worked to develop VR experiences to illustrate what it is like to work in an emergency department. Users put the Gear VR on and suddenly they are pushing a patient into the hospital from an ambulance. The wearer is then asked to make calls to save the patient. It's a remarkable tool that needs to be seen to be believed!

Electronic Health Records:

While it is hard to predict how our health system will look in five, ten or fifteen years time, it's worth acknowledging the strides the HSE has made in recent years. Richard Corbridge, Chief Information Officer at the HSE, says 2016 has been an important year so far. 

"This year has been massively exciting. We've put a lot of what we call "building blocks" in place. For example, every hospital in Ireland can now receive an electronic referral. Last month 45% of GPs referred patients digitally rather than sending a paper letter and stamp. We now also have the individual health identifier. This means every person in Ireland can be uniquely identified within the health system digitally, which is a huge leap forward." 

"But then you look at smaller projects that have created for the first patients to have their genome sequenced in epilepsy. Sequencing the genome to allow a patient to know what sort of epilepsy they have and target the right drugs straight away is a life saving solution for Ireland. We talk a lot about putting the patient at the centre of the health system. By using digital solutions, we can do that. That's how they can interact and engage." 

Some may be nervous about the notion of an electronic health record, but Corbridge says the HSE is giving patients large elements of control in that regard. 

"One of the things Ireland has defined differently to any country in the world is that when we have an electronic health record, patients will be able to see their record and see who has looked at it. That is fundamentally different to the rest of the world and a huge leap forward in terms of ensuring the people of Ireland are happy about the information the healthcare system has about them and who's looking at it."

While privacy and security are of the utmost important to the HSE, if a patient is not comfortable with this system, they have made it very easy to 'opt out'.

"Ireland will allow a patient to "opt out" of having an electronic health record and the ability to do that will be straight forward. In the NHS you had to opt out 17 times to not have a digital record. In Ireland, you'll be able to do that once. This is being built as a big infrastructure piece. The privacy side, the ability to see who has looked at your health record is another part."

It's worth noting, however, that there are many benefit to the electronic health records, as Corbridge explains.

"If you look at the e-referrals we spoke about; currently a letter touches 16 pairs of hands - from the GP to the clinician that's going to refer you. Now with e-referrals, the patient can see the referral arriving into the hospital whilst still sitting with their GP. That's just one example." 

Maternity care:

In the coming weeks, Ireland's maternity care is set to receive a digital boost. 

"One other thing we'd like to talk about is the maternal / newborn electronic health record being delivered in December of this year. This is a huge thing for Ireland. This is the first maternal, newborn electronic record to ever be delivered and it's Ireland's first electronic record as well. It's going live in Cork in the first week of December. It's a massive thing for us. We're very proud of the team in Cork who have worked so hard and completed around 8,500 training hours, just to get everyone trained up on it," says Marie O'Loughlin, Engagement Specialist at e-Health Ireland.

This will replace the bundle of paper records during a pregnancy. When the child is born, they will have their electronic record straight away. The baby will be hooked up to different sensors to test bloods, temperature and identify early warning signs of anything that might be going wrong.

"This is a much safer and efficient way of looking after our patients," says O'Loughlin.  

Further information about Health Innovation Week is available here