What is a eHealth ecosystem anyway and do hospitals need one?

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Prof. Neil O’HareDirector of Informatics, St. James’s Hospital

Images of Ecosystems.

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The definition of an Ecosystem!

•An ecosystem is a community of living organisms (plants, animals and microbes) in conjunction with the non-living components of their environment (things like air, water and mineral soil), interacting as a system.

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So what bothers me in my daily chores!(Do I need one of these ecosystems?)

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Nagging thought Number 1

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The CEO (previous!) story…

•Asked to take up position of Director of Informatics.

•Given two minor tasks• Get rid of the paper chart• Provide him with a dashboard on his phone on

the status of the hospital.

Data Warehouse in SJH

Average Length of Stay (1)

Average Length of Stay (2)

Average Length of Stay (3)

This is lovely, but still no real benefit.So what about something else…

Start Times in Theatre (2)

Start-Times in Theatre (1)

Questions & more questions…

•Why are all operating theatres, with the exception of Cardiac surgery, starting late and running over?

•This is inefficient and costly.

•Why is Cardiac Surgery not a problem?

•Can’t find the patient!

•Need to walk a different route to theatre!

Is the CEO happy?

•Still don’t have the app for his phone!

•Getting real-time data.

•Being used actively by the new clinical directorates to drive change – patient pathways!

•Built the DW to cater for the hospital group.

•Work in progress….

Nagging thought Number 2

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The National Integrated Medical Imaging System (NIMIS)

Prof. Neil O’Hare

neil.ohare@hse.ie

The National Integrated Medical Imaging

System (NIMIS)

Non-NIMIS Hospital

NIMIS Hospital – Not yet live

PACS Status in Ireland

NIMIS Hospital - Live

Status as of Mar 2015

•52 sites live

•22,000 users.

•10m+ studies (not images!) on archive with about 180,000 per month being added (approx8,000 per day).

•>200TB of storage. (Over a PB in total storage)

•12m reports.

•5m+ orders on system with approx 200,000 added per month.

Questions a DG / CFO might ask…

• Have I got good productivity from the staff?

• How quickly does an exam take to do and then to report?

• Is the equipment being used efficiently?

• What do I need to do to improve productivity and reduce waiting times, etc?

Nagging thought Number 3

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So, where are we going?

Europe HIMSS Model

e-Hospital Aims

• To implement a full electronic patient record;

• To implement full electronic prescribing across the hospital;

• To provide the clinical user with the data they need; where, and when it is needed;

• To provide the patient with greater and more rapid access to their medical information;

Aims contd…

• To provide the community health care system with greater and more rapid access to the required patient data electronically;

• To provide a comprehensive business / data analytics function;

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Sounds great, but there is a BIG BUT!

• All the HSE’s ICT and Capital budget is gone for this year.

• Difficult to engage with companies due to fear of procurement challenges / litigation

• For ICT related elements, need OGCIO approval.

• Even for quick turnaround projects, this can be slow.

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Need an understanding that a large % of IT / technology projects can fail.

But in the Irish Health system “Failure is not an option”

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Herald in a new era – the HSE CIO…

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First Health CIO – that’s good.

Head of eHealth Ireland – that’s good I think!

But will Richard be given the power and the responsibility to move things forward – hopefully.

As Peter Parker’s dad said:“Peter, with great power comes great responsibility.”

Nagging thought Number 4

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But this is not the whole story……

Ventures into Social Media

Prescriber’s App

So, what I need to do is…..

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Hospital

Patients

IT Systems (Vendors)

Devices & Apps

Community

Clinical Personnel

Public

HSE / DOH

So, is that an “Ecosystem”?

Or just a fancy term for what we are doing anyway!

What is a eHealth ecosystem anyway and do hospitals need one?

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Neil O’Harenohare@stjames.ie