digital transformation @hse
TRANSCRIPT
Digital Transformation @HSE
Ross CullenHSE Digital Innovation Manager
@hse_da
HSE Digital Transformation
@cullenrossi @ehealthireland
OPS 2020/DPER• Ann Broaders• Breda O'Brien • Catherine Madders• Dean Reid• Hilary Dolan• John O'Donoghue• Laura Mahoney• Vinny Langan• Philip Mcgrath and the wider OPS
2020/DPER team
Tallaght University Hospital• David Wall, CIO Tallaght University Hospital• Valerie Wallace• Catherine Wall• Wider TUH Project Team
Before we begin…
Public Service Innovation Fund
Public Service Applicants
(Thank you)
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• (Missing – Des O’Toole, Digital Clinical Innovation Lead HSE
Our Core Team
Lorraine SmythCommunications &
Innovation Lead
Lorraine has worked with the HSE for 19 years across Primary Care, Procurement, Communications
Lead (National HR) and Innovation Management. Lorraine is member of the
steering group for National Staff Engagement Forum and Action 6
OPS DPER Innovation Team.
Martin CurleyDirector of Digital
Transformation
Prior to joining the HSE Martin was Senior Vice President and group
head for Global Digital Practice at Mastercard. Previously Martin was vice president at Intel Corporation
and Director/GM of Intel Labs Europe, Intel’s network of more
than 50 research labs which he help grow across the European region.
Ross CullenDigital Innovation
Manager
Ross has worked across a number of senior eHealth, Communications
and Programme Management roles over his 20 year career at the HSE.
He joined the Digital Transformation team in 2019 and manages HSE
Digital Labs – an eHealth Innovation Portfolio and supports their MSc. in Digital Health Transformation with the network of Irish Universities.
Des O’TooleClinical Digital Innovation
Lead
Des have more than 35 years’ experience in the health service with senior roles across nursing,
acute management and HIPE. Des is passionate in creating opportunities to engage with
cross functional teams directly impacting service user experiences, safety and
outcomes.
Digital Health Maturity Roadmap
DigitalBudget
DigitalCapability
DigitalValue
Digital Business
Model
Digital Health Macro Capabilities
SustainableEconomic
Model
FundingAmplification
ManagedSpending
Low Spending
European Leader
Mediocre
Average
Managed Yield and Portfolio
ValueMeasurement
EstablishBenchmark
ServiceCentre
Cost Centre
InvestmentCentre
Beginning
OptimizedValue
World Class
Initial
Basic
Advanced
Intermediate
MaturityLevels
Optimizing
3.
2.
4.
5.
1.
Value Centre
2019
2026
2030
Timeline
2020
Min. Budget
Digital Transformation
Dig
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Aca
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Dig
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Lab
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Dig
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Aca
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Foru
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Nurture, support and grow a ‘Digital First’ culture
Dig
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Dis
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Te
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Our Five Pillars of Digital TransformationImproving digital capability, competence, coherence and capacity
Educating our workforce (including our Masters in Digital Health Transformation) to increase digital competence, capability and capacity.
Our integrated digital innovation strategy of “stay left, shift left” to orchestrate the ecosystem with more than 60 partners to again increase digital capability, capacity and coherence.
Real world clinical environments with the four types of partners involved in the Quadruple Helix (Government, Industry, Academia and Citizens/Patients). We have 20 living Labs nationally, building digital capacity and capability.
‘Ted Talks’ for digital healthcare; sharing, spreading and socialising eHealth and digital innovation ideas and solutions.
Testing emerging technologies and actively digitalizing processes.
Vital Signs Automation(Digital NEWS)
HSE Digital Transformation
Summary
• The project is piloting a digital National Early Warning Score System (INEWS) system on ward(s) in an acute hospital with an evaluation in collaboration with our University partners.
• A Digital National Early Warning Score System can improve patient safety significantly while maximising utilisation of existing bed capacity.
• Having robust INEWS supports the reduction of the deterioration of a patient, fundamentally saving lives and improving patient outcomes.
• Funding of €50,000 was awarded to HSE Digital Transformation. Tallaght University Hospital was selected as pilot site. Additional funding for pilot was provided by TUH.
• Procurement commenced in June 2020 and vendor selected in Oct 2020. Implementation commenced mid Nov 2020.
• Implementation of pilot currently paused due to increase of COVID-19 activity in hospitals.
What is INEWS
“The Irish National Early Warning Score (INEWS) facilitates early detection of deterioration by categorising a patient’s severity of illness and prompting nursing staff to request a medical review at specific trigger points utilising a structured communication tool while following a definitive escalation plan.
Adopting INEWS is beneficial for standardising the assessment of acute illness severity, enabling a more timely response using a common language across acute hospitals nationally.”
Source: www.gov.ie/en/collection/cc5faa-national-early-warning-score-news
Some of the INEWS physiological observations include: • Respiratory rate • Oxygen saturation (SpO2) • Room air or supplemental oxygen (a score of ‘3’ is added for ‘any O2’) • Heart rate • Blood pressure • Temperature.
INEWS scoring is currently manually calculated on paper using the INEWS standard in public hospitals throughout Ireland.
A sample study from the Galway Clinic has shown that there is a 50.44% error rate (ranging from incorrect totals, total scores, wrong field) in calculating the INEWS manually on paper records, which is the practice with all public HSE hospitals throughout Ireland at present. This can contribute to a delay in clinical interventions and some patient developing Sepsis, cardiac arrest and many other conditions. For example, In 2017, 23% of sepsis patients in Ireland were admitted to a critical care bed and the average length of stay (aLOS) is twice as long in these patients and their mortality is also twice that of those managed on the ward.
A similar study was carried out by the Health Innovation Hub/HSE South and UCC which concluded that: “error rates in recording NEWS on the current paper based system are unacceptably high- with 59% of errors relating to outcomes that could significantly impact patients. If timing delays are removed from the assessment, paper based NEWS recordings demonstrate a type 2 error rate of 39% where the digital system shows a rate of 0%.”
The Introduction of a Vital Signs Automation (VSA) system using INEWS allows early indication of patient health deterioration and alerts nursing staff and doctors to respond quicker and as a result, improve patient outcomes, increase bed capacity due to improved efficiencies and a reduction in transfer to high dependency or intensive care units.
Problem
Ref: GOOD NEWS, BAD NEWS An Assessment of Error Rates in Recording NEWS (Noreen Lynch, Niamh Allen, Tanya Mulcahy)
Problem
SolutionFollowing procurement at Tallaght University Hospital, the Syncrophi KEWS 300 system was chosen (CE-marked Class IIb Software as a medical device)
Benefits
• Improvement in quality/recording of measurements • Improvement in calculation of INEWS • Reduction in time to record measurement and calculate INEWS • Improvement in escalation and management of deteriorating patients • Improvement in access to vital signs data through electronic system • Improvement in patient care • Reduction in charting error rate • Improvement in management process.
Next Steps and the Future
• Recommencement of project in Tallaght University Hospital following a reduction in COVID-19 cases• Further evaluation of solution in conjunction with a student team currently undertaking our MSc. in Digital Health
Transformation
• Our vision is to have a national deployment of system across our health service to support INEWS
• Independent evidence from Golden Jubilee National Hospital NHS Scotland (GJNH Clinical Effectiveness Manager) has shown that average patient length of stay has been reduced post implementation. This is something we wish to further evaluate. In addition we wish to investigate its effectiveness in supporting management of SEPSIS 6 protocol.
• Further integration other medical Vital Signs Devices. Currently under testing for integration is RespiraSense,a wireless respiratory monitoring system currently being deployed out across all HSE hospitals in response to COVID-19 by HSE Digital Transformation in partnership with multiple HSE Stakeholders (inc. CCIO, CNIO and PMD)
• RespiraSense is a Medical Device designed to measure Respiration Rate (RR) of alert patients through a piezo electric sensor and a Bluetooth wireless transmitter that attaches (sticks) to a patient.
• A nurse or doctor can attend to a patient from a safe distance to review Respiratory rate and trends. This allows for a more rapid intervention without delays associated with a change of Personal Protective Equipment (PPE).
OPS 2020/DPER• Ann Broaders• Breda O'Brien • Catherine Madders• Dean Reid• Hilary Dolan• John O'Donoghue• Laura Mahoney• Vinny Langan• Philip Mcgrath and the wider OPS
2020/DPER team
Tallaght University Hospital• David Wall, CIO Tallaght University Hospital• Valerie Wallace• Catherine Wall• Wider TUH Project Team• Clinical Team at Tallaght University Hospital
Special mentions to• Loretto Grogan, HSE CNIO• Richard Greene, HSE CCIO
• Ronnie McDermott, HSE National Medical Device Advisor, Acute Services
• Gerard Duignan, Clinical Engineering Dept. Head, Cavan Monaghan
• Ms Louise Henry, CNM, Cavan Monaghan
• Colleagues in the Office of the CIO (OoCIO)• Health Innovation Hub Ireland
• HSE Digital Transformation Team• Martin Curley• Lorraine Smyth• Des O’Toole
Special thanks…
Digital Academy Forum – Playback recommendations
Loretto Grogan CNIO,HSE The Practitioner Perspectivehttps://youtu.be/vkfZIOcbijA?list=PLrzDQd57O-_QTkqzYaqOotFKweByr84mh
Dr Michael Harty Chair Oireachtas SC The 1% Propositionhttps://youtu.be/jabOXfN3BP4?list=PLrzDQd57O-_QTkqzYaqOotFKweByr84mh
Prof Anthony Staines Prof, DCU The Logic of Openhttps://youtu.be/O30D9bsYkKw?list=PLrzDQd57O-_QTkqzYaqOotFKweByr84mh
Digital Academy Forum Q4 2020www.hsedigitaltransformation.ie/news/playback-digital-academy-forum-q4-9th-december-2020
Playback - Introduction to Robotic Process Automationwww.hsedigitaltransformation.ie/news/playback-introduction-robotic-process-automation
Playback - Digital Academy Forum 15th July 2020www.hsedigitaltransformation.ie/news/playback-digital-academy-forum-15th-july-2020
Links to be posted in the webinar comments box shortly…