What is an eHealth "ecosystem" anyway, and do we really need one?

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

2. Images of Ecosystems.

3. 3

4. 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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5. So what bothers me in my daily chores!
(Do I need one of these ecosystems?)
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6. Nagging thought Number 1
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7. 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.

8. Data Warehouse in SJH

9. Average Length of Stay (1)

10. Average Length of Stay (2)

11. Average Length of Stay (3)

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

13. Start Times in Theatre (2)

14. Start-Times in Theatre (1)

15. 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!

16. 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….

17. Nagging thought Number 2
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18. The National Integrated Medical Imaging
System (NIMIS)
Prof. Neil O’Hare
neil.ohare@hse.ie
The National Integrated Medical Imaging
System (NIMIS)

19. Non-NIMIS Hospital
NIMIS Hospital – Not yet live
PACS Status in Ireland
NIMIS Hospital - Live

20. 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 (approx
8,000 per day).
•>200TB of storage. (Over a PB in total storage)
•12m reports.
•5m+ orders on system with approx 200,000
added per month.

21. 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?

22. Nagging thought Number 3
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23. So, where are we going?

24. Europe HIMSS Model

26. 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;

27. 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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30. 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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31. 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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32. 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.”

33. Nagging thought Number 4
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34. But this is not the whole story……

35. Ventures into Social Media

38. Prescriber’s App

39. So, what I need to do is…..
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Hospital
Patients
IT Systems
(Vendors)
Devices &
Apps
Community
Clinical
Personnel
Public
HSE / DOH

40. So, is that an “Ecosystem”?
Or just a fancy term for what we are doing anyway!

41. What is a eHealth ecosystem anyway
and do hospitals need one?
41
Neil O’Hare
nohare@stjames.ie