Digital Transformation @HSE

@hse_da

HSE Digital Transformation

@ehealthireland

Agenda• Introductions

• COVID-19 Digital Response from

Office of Chief Information Officer and

Office of the Nursing & Midwifery Services Director

Ross Cullen, Digital Innovation Manager HSE Loretto Grogan, National Clinical Information Officer – Nursing & Midwifery

About HSE Digital Transformation

• Established Q3 2019

• Division of the Office of the Chief Information Officer (OoCIO)

• Establishment of Digital Solutions Review Board Q1 2020 to ensure a robust process in place to trial, demonstrate and adoption of innovative digital healthcare solution

4th Sep. 2019 - Pictured at the Digital Academy forum are• Ross Cullen, Digital Innovation Manager HSE• Paul Reid, CEO HSE• Lorraine Smyth, Communications and Innovation Lead HSE• Martin Curley, Director of Digital Transformation HSE

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Our Five Pillars of Digital TransformationImproving digital capability, competence, coherence and capacity

• Digital Transformation Strategy developed

• New Masters in Digital Health Transformation designed and commenced

- 44 HSE multi-disciplinary staff as students- 12 Digital Change Projects to be initiated

• Digital Innovation Portfolio/Pipeline of >40 digital innovations being managed

- Prioritizing several innovations for broad demonstration and adoption- Digital Innovation Governance process developed

• ‘Stay Left, Shift Left’ Innovation Strategy aligning the digital health ecosystem

•Two Digital Academy Fora held in 2019 -sharing and shaping Digital Health solutions and strategy

AssessmentGate

Proof of Concept (pilot)Gate

Demonstrator Broad Adoption

Ideas

Ideas

Ideas

Ideas

Ideas

Digital Transformation - COVID-19 funnel

• Remote Patient Monitoring (patientMpower)

• Video Consultation (RedZinc Blue Eye)

• GP Video conferencing (Wellola)

• GP Video conferencing (NuaSolutions)

• Electronic prescription transfer• (via Healthmail)

• non contactless Thermometer(Trimedika)

• Respiratory care tool App (ACORRD)

• Vital Signs Automation (NEWS)

• Non Contact Voice Assistant intercoms(Amazon)

• Integrated Mobile Vital Signs for National Ambulance Service (NAS)

• Robotic Process Automation (Mater Hospital)

• Respiration wireless monitoring (Beaumont)

• Thermal Kiosk (multiple hospitals & CNU’s)

• COVID-19 disinfection Robot (Tullamore)

• Medication Adherence (HealthBeacon/PCRS)

• eSMART Voice Assistant (Sligo Mental Health)

• Robotic Process Automation (Tallaght)

• Drone Medication delivery (Moneygall)

• Physiotherapy consultation Telemedicine platform (RCSI Hospital Group & various)

• Secure Messaging (Connolly Hospital)

• ICU to nurse station video headset (TUH)

• TempTraq (TUH)

How it works1. Patient registered by clinical team & receives email or SMS to set-up account2. Patient completes registration & consents to sharing data with clinical team3. Patient supplied devices to monitor oxygen saturation & temperature which are ‘paired’ to their account via Bluetooth. Alternatively patients can enter measurements from existing device they have (e.g. thermometer)4. Patient receives reminders to record objective measures (e.g. SPO2, temp) & subjective measures (dyspnea, & cough severity)5. Data sent to secure portal automatically for clinical review

patientMpower - Overview• Deploy home monitoring for those likely to be mild / moderate or

recovering from COVID-19• Gather robust objective (oxygen saturation, temp.) & subjective (cough,

dyspnea) that will track disease progression• Escalate where patient trending towards severe disease

patientMpower has an ongoing clinical trial (NCT03744598) in respiratory disease

Remote Monitoring of COVID-19 Patients

AKARA has developed a robotic disinfection solution that

uses an off-the-shelf UV-C germicidal lamp, a technology

that has been proven in many studies to be effective against

pathogens on surfaces and in air, including SARS-CoV-2.

Trials in Tullamore and Mater hospital. Results show faster

and better results compared to conventional cleaning

How it Works

• Robot comprises an off-the-shelf UV-C germicidal lamp and a

robot base.

• Robot navigates room irradiating the air and nearby surfaces.

• Robot stops at several strategically chosen locations for defined

periods of time (typically 2-3mins).

• Navigation route planning informed by lab and clinical testing

data – from published papers and testing undertaken by Akara.

COVID-19 disinfection Robot

Mobile X-Ray for Nursing Homes and Private Homes • Mobile X-Ray – avoid patient transfer to hospitals• Licensed by EPA• Digital technology, remote connectivity and reporting• Timely patient-centred care & diagnosis in familiar surroundings • Proven hospital avoidance mechanism• Consultant Radiologists IMC registered (Dublin based)• Radiographers highly experienced and CORU registered • Reports available within 1-4 hours of image capture

Since lockdown (end of March 2020)• 9 new nursing homes services request (35 nursing homes overall to date)• 57 X-rays including:

- 18 chest X-rays - 03 post-op check X-rays- 06 acute fractures (required hospital treatment)- 04 minor fractures (conservatively treated)- 26 other

• 51 older persons avoided a transfer to ED. Oldest patient seen was 101.Nursing homes are reluctant to transfer residents to hospital unless it is absolutely necessary. Families/residents do not wish to leave nursing home.

RedZinc provided a Virtualised Clinic called BlueEye Direct Video for

Virtual Clinics, using real-time web based video communications

technology, so healthcare professionals can see their patients

remotely.

The service allows healthcare professionals to set up an

instantaneous video consultation with a patient on their smartphone,

using an encrypted and secure data session. It is very easy for the

patient to use, with no set up or app installation required.

Data protection is a key component of successful video consultation

services for patients and clinicians, to ensure utmost privacy and

security.St. James and Tallaght using platform on 16/03/2020

Mental Health Staff in various CHO’s using platform from 20/03/2020

Two Week Activity (as of 14/05/2020)

• 563 active users (~70%) conducted a video consultation in the last fortnight

• 1,420 video consultations conducted in the last fortnight

• Average call duration of 23 minutes

Secure, user-friendly Videoconferencing

Other Video solutions available in HSE include:• Attend Anywhere (One to one with patients)

• WebEx (Groups)

• Microsoft Teams & Skype for Business (staff &

Groups)

• WhatsApp (temporary exemption for COVID)

More information at:https://healthservice.hse.ie/staff/coronavirus/working-from-home/virtual-health/virtual-health.html

Non Contact Infrared Thermometer Kiosk

• Includes Face Recognition, Thermometer Body Temperature Scanner

• Evaluation underway as Temperature checking kiosks for Nursing homes & Acute Hospitals

Currently running in 6 hospitals, further proliferation underway (pending COVID-19 increase)

COVID-19 Acute Triage & Patient Management System

• Defines a novel measure of patient status called the COVID Critical Care Index (CCCI)

• CCCI has been designed collaboratively by a team led by Prof. Richard Costello including respiratory specialist clinicians and researchers from Beaumont, St. Vincent's, St. James, the Mater and clinicians from S3 Connected Health.

• Clinical tool for respiratory care of COVID-19 patients• Is a response to the need for tools that enable hospitals to optimise and

scale acute respiratory care delivery• Is a web application accessible via mobile phone

The Connected Health Ecosystem

Head & Neck Cancer

(Rabbit)

Pre-Injection 5 min 4 days

• Increased Adherence

• Real world insights

• Reduce waste / unused medication

• “In an unstable complex system, small islands of coherence have the potential to

change the whole system.”

Ilya PrigogineRussian/Belgian physical chemist and

The Nobel Prize winner in Chemistry 1977

Telehealth – National perspective

https://www.ehealthireland.ie/National-Virtual-Health-Team/National-Virtual-Health-Team/

https://healthservice.hse.ie/staff/coronavirus/working-from-home/virtual-health/virtual-health.html

Telehealth – National perspective

POC in collaboration with OPS Lead

We want to hear from you

What would help you now and in

the future

National Digital Response Team

What's happening

Devices Current systems – Care Notes and Epic Care SAT – new vendor Additional functionality to meet long stay requirements Improved linkage with other services St Mary’s Digital Improvement Project Ongoing OoCIO collaboration with Michael Fitzgerald’s

office

@loretto_grogan

www.hsedigitaltransfrormation.ie |www.ehealthireland.ie

@hse_da@cullenrossi

@ehealthireland

Better together and thank you for your time