Time to catch up! The recent Future Health Summit 2017 was awash with international Health IT experts, and we were delighted to hear from them at the Council’s session. However before we go abroad, I’d like to highlight two local projects which were presented to us, showing that Ireland is already innovating and developing. So take a couple of minutes to read through this resumé of the event, and make a note of what might excite you!
Pharmacists, through our professional organisation, the Irish Pharmacy Union, became the fathers of two major standards
While we are all familiar with the maxim that “success has many fathers, but failure is an orphan”, there is a corollary. The perfect success story can be almost invisible, where a seamless solution just works. In Irish community pharmacy, there is an unsung story of standards in medicines information, with associated EDI messaging. These have helped to drive developments in both efficiency and safety for pharmacy and the wider public that it serves. In the 1980s, computerisation was in its infancy. BBC computers jostled with IBM PCs, Amstrads and Apple IIs. A 40Mb hard drive cost a king’s ransom and large lists were distributed on EEPROMs. Information standards were non-existent. Suppliers and software vendors jostled for dominance, all seeking a competitive edge through proprietary solutions. Emerging from this flux, a few issues were abundantly clear. The most obvious was the concept of lock-in. If pharmacists didn’t provide a solution, there was a real risk of getting tied to other people’s impositions. Pharmacists, through our professional organisation, the IPU, became the fathers of two major standards. One was a product file that was both commercially and technically agnostic. Distributed as simple text file, it provided current and reliable medicine information. The second standard followed from the first, a reliable electronic messaging system. While both these standards have evolved with the profession, they both illustrate the wisdom of a simple clear standard.
Understanding eHealth & Healthcare Informatics
Having only known a predominantly paper based healthcare system, I have slowly began the journey to untangle the complex world of Healthcare Information Technology, in particular technology enablers to capture and guide the patients journey across their lifespan through the continuum of care. Working as a Nursing Documentation Project lead in Connolly Hospital, I remain on a journey to understand how nursing practice can be reflected in an electronic format.
Putting stories at the heart of healthcare
Cecil Helman was a South African-born GP who died in 2009 of motor neurone disease. He was also an anthropologist whose textbook, Culture, Health and Illness remains a key reference and teaching text for medical anthropology. His approach to medicine, and life, is summed up in the words of one of his obituaries:
A Time for Everything
“There is a time for everything”. It’s not the norm to start a tech blog with a quote from the bible, and I promise not to make a habit of it, but there is a time for everything, and we are certainly in a time of change. I’ve joined the CCIO team to try to help that change; not for the CCIO or the eHealth Ireland team, but for those who work in the Irish Health Service and those who use it. We’re often told that the most dangerous phrase is “That’s the way we’ve always done it”, however waving that at our natural fear of change can be quite unhelpful. So let’s talk about change.
The HSE’s Chief Information Officer and the Clinical Strategy and Programmes Directorate are currently developing ‘Personas’ and ‘Scenarios’ to support the introduction of Electronic Health Records (EHR). As part of this project, a series of workshops for those working in the health services and also patients/service users was held on January 31st and February 1st.
One of the challenges of developing an EHR is capturing the diversity of needs it must address. Even a seemingly straightforward clinical setting will involve multiple interactions with multiple information sources. Contemporary mental health practice is focused on the community, but at the same time acute psychiatric units now co-located in acute general hospitals, and mental health issues very commonly arise simultaneously with general health needs, there is considerable overlap with the hospital system. Mental health services increasingly integrate multiple models of mental health, not only a purely medical one; while simultaneously safe psychiatric practice requires access to laboratory and imaging systems to the same degree as other medical disciplines.
When I think of wearables, I initially think of counting steps, but then I think of all the potential wearables have to improve the information clinicians receive about patients.
The Garden Shed
Our Chief Information Officer (CIO), Richard Corbridge, recently wrote a blog about being locked in the garden shed and I wondered if part of a Chief Clinical Information Officer’s (CCIO) role is spending time in the garden also – but not locked in the shed, instead down among the weeds.