what is an ehealth ecosystem and do we need one - neil o'hare

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What is a eHealth ecosystem anyway and do hospitals need one? 1 Prof. Neil O’Hare Director of Informatics, St. James’s Hospital

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Page 1: What is an eHealth ecosystem and do we need one - Neil O'Hare

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

Page 2: What is an eHealth ecosystem and do we need one - Neil O'Hare

Images of Ecosystems.

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Page 4: What is an eHealth ecosystem and do we need one - Neil O'Hare

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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Page 5: What is an eHealth ecosystem and do we need one - Neil O'Hare

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

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Page 6: What is an eHealth ecosystem and do we need one - Neil O'Hare

Nagging thought Number 1

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Page 7: What is an eHealth ecosystem and do we need one - Neil O'Hare

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.

Page 8: What is an eHealth ecosystem and do we need one - Neil O'Hare

Data Warehouse in SJH

Page 9: What is an eHealth ecosystem and do we need one - Neil O'Hare

Average Length of Stay (1)

Page 10: What is an eHealth ecosystem and do we need one - Neil O'Hare

Average Length of Stay (2)

Page 11: What is an eHealth ecosystem and do we need one - Neil O'Hare

Average Length of Stay (3)

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

Page 13: What is an eHealth ecosystem and do we need one - Neil O'Hare

Start Times in Theatre (2)

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Start-Times in Theatre (1)

Page 15: What is an eHealth ecosystem and do we need one - Neil O'Hare

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!

Page 16: What is an eHealth ecosystem and do we need one - Neil O'Hare

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….

Page 17: What is an eHealth ecosystem and do we need one - Neil O'Hare

Nagging thought Number 2

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Page 18: What is an eHealth ecosystem and do we need one - Neil O'Hare

The National Integrated Medical Imaging System (NIMIS)

Prof. Neil O’Hare

[email protected]

The National Integrated Medical Imaging

System (NIMIS)

Page 19: What is an eHealth ecosystem and do we need one - Neil O'Hare

Non-NIMIS Hospital

NIMIS Hospital – Not yet live

PACS Status in Ireland

NIMIS Hospital - Live

Page 20: What is an eHealth ecosystem and do we need one - Neil O'Hare

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.

Page 21: What is an eHealth ecosystem and do we need one - Neil O'Hare

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?

Page 22: What is an eHealth ecosystem and do we need one - Neil O'Hare

Nagging thought Number 3

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Page 23: What is an eHealth ecosystem and do we need one - Neil O'Hare

So, where are we going?

Page 24: What is an eHealth ecosystem and do we need one - Neil O'Hare

Europe HIMSS Model

Page 25: What is an eHealth ecosystem and do we need one - Neil O'Hare
Page 26: What is an eHealth ecosystem and do we need one - Neil O'Hare

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;

Page 27: What is an eHealth ecosystem and do we need one - Neil O'Hare

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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Page 30: What is an eHealth ecosystem and do we need one - Neil O'Hare

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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Page 31: What is an eHealth ecosystem and do we need one - Neil O'Hare

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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Page 32: What is an eHealth ecosystem and do we need one - Neil O'Hare

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.”

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Nagging thought Number 4

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Page 34: What is an eHealth ecosystem and do we need one - Neil O'Hare

But this is not the whole story……

Page 35: What is an eHealth ecosystem and do we need one - Neil O'Hare

Ventures into Social Media

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Prescriber’s App

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So, what I need to do is…..

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Hospital

Patients

IT Systems (Vendors)

Devices & Apps

Community

Clinical Personnel

Public

HSE / DOH

Page 40: What is an eHealth ecosystem and do we need one - Neil O'Hare

So, is that an “Ecosystem”?

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

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

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Neil O’[email protected]