HSE Chief Information Officer presents on eHealth in Ireland, and how that will help people with rare diseases.

1. Richard.corbridge@hse.ie
Chief Information Officer – Health Service Executive - Ireland
Chief Executive Officer – eHealth Ireland
eHealthIreland.ie| @eHealthIreland @R1chardatron
eHealth in Ireland – What Next…

2. Delivering eHealth Ireland | Office of the Chief Information Officer
Evolution of Time
 Ireland and France didn’t
adopt Greenwich time.
 Dublin 25 minutes ahead
of London until October ’16.
 Railway stations adopted
the national time.
 Ulster and Bangor stations
maintain local time and Dublin
time.

3. Delivering eHealth Ireland | Office of the Chief Information Officer
Evolution of Time
 Before 1840 local time was
Standard (UK).
 Remove confusion and
create a standard.
 Eradicate near accidents.
 Local resistance (Leeds 7
minute ‘local time’ ‘70s)
 Benefits balance.

4. Delivering eHealth Ireland | Office of the Chief Information Officer
eHealth Ireland

6. 287
417
2013 2050
Healthcare Spend for age 60+ (€M)

9. 0 10 20 30 40 50 60 70 80 90
Ireland
Sweden
Cyprus
Netherlands
Belgium
Greece
UK
Malta
Luxembourg
Denmark
Spain
Romania
Austria
EU28
France
Bulgaria
Italy
Slovakia
Germany
Slovenia
Finland
Czech Republic
Poland
Hungary
Estonia
Croatia
Portugal
Lithuania
Latvia

10. 8440
9367
10162
11676
12709
14321
15186
15520
14818
14078
13317
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
€(Millions)
Public Expenditure on Health 2002 –2012
Source: Department of Health Key Trends
• Health expenditure in Ireland accounts for approximately 20% of
total current public expenditure.
• In 2015, approximately 17% of healthcare expenditure was spent on
pharmaceuticals.
• Cumulative budget impact since 2009 is a 15% reduction in health
spending

12. Delivering eHealth Ireland | Office of the Chief Information Officer
The IT strategy question?
Cross
Setting
Information
Integration
Electronic
Health
Records
National
Support
Systems
Care
Delivery
Enablement
Integrated, Patient Centric,
Efficient Care Delivery
Health
Service
Insights
Knowledge & Information Delivery Transformation
Clinical & Information Governance
Knowledge & Information Plan

13. Office of the CIO | Delivering eHealth Ireland
Personal / Data
Security
Resources / Funding
Instrument Panel /
Business Intelligence
Guidance/Insight/
Communication/Safety
Access to information
Healthcare Airways

14. Delivering eHealth Ireland | Office of the Chief Information Officer
AGILITY
Benefits yesterday,
today and tomorrow
needed
TRANSPARENCY
Investment in tech is
investment in health
.
Balancing Act

15. 8 years
56 days
10 hours
& 26 minutes
Can we have 5 years to “do” eHealth?

16. Delivering eHealth Ireland | Office of the Chief Information Officer
A Year in Numbers - 2015

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18. Delivering eHealth Ireland | Office of the Chief Information Officer
Current…

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Security.
Data Quality.
Information Governance.
Data Dictionary.

20. Delivering eHealth Ireland | Office of the Chief Information Officer
•
•
•
•
•
— Robert Wachter
Technology has transformed hotel,
transport, retail, banking, communications
………healthcare?
The goals of Reform cannot be delivered
without a National EHR
The 4th Utility

21. Delivering eHealth Ireland | Office of the Chief Information Officer
Overall Blueprint defined as the long term vision for eHealth in Ireland and
endorsed by industry – Solutions for Hospital Groups identified as a core area
eHealth Blueprint - EHR

22. Delivering eHealth Ireland | Office of the Chief Information Officer
National EHR Registries and Domains
Stakeholders
Clinical Management / Point of Care Environment
National EHR Integration and Access Layer
Communication
Layer
Core
Capabilities
I.A.A.A.
Layer
ProviderHealthPortal
National EHR Registries
Client Registry Provider Registry Location Registry
National EHR Domains
Medical Imaging Laboratory Results Pharmaceutical
History
Clinical Document
Repository
Encounter History
Message
Queuing
Message Data &
Transformation
Message
Encoding
Service
Management
Identity
Management
Authentication Access Secure Audit
Single Sign On Exception Handling Context Management Terminology Services
Record Locator
Services
Orchestration ETL Privacy
Certification and
Integration Toolkit
Secure
Messaging
Logging
Immunization
History
Infectious Disease
History
National Analytics
Performance
Management
Population Based
Analytics
Business Intelligence
Registration
National eHealth Blueprint
Healthcare Providers Patients Corporate Administrators and Managers
Legitimate Relationship
Services (LRS)
Corporate Setting
FinanceManagement
Procurement
HumanResourcesand
PayrollManagement
AssetManagement
Health&Safety
ContractManagement
FacilitiesManagement
RosteringTimeRecording
ProgramManagement
CustomerRelationship
Management
Consumer Health & Wellbeing
PatienttoProvider
SecureMessaging
Self-Health
Management
Schedulingand
Administration
NationalPatient
Portal
VirtualCare
Education&
Awareness
Community Healthcare Organisations
PatientAdministration
CaseManagement
ElectronicDocument
Management
ClinicalNotesandRecords
PatientTestResults
CarePathwaysandDecision
Support
ReferralManagement
MobileClinicalManagement
PopulationHealth
Management
ComputerizedPhysicianOrder
Entry
ePrescribing
Hospital Groups
HospitalPatient
Administration
HospitalMedicalImaging
HospitalLaboratory
HospitalPharmaceuticals
CaseManagement
DiseaseManagement
CarePathwaysandDecision
Support
ComputerizedPhysicianOrder
Entry
ReferralManagement
PopulationHealth
Management
ElectronicDocument
Management
ePrescribing
ElectronicClinicalNotesand
Records
Community
Operational
Systems
Acute
Operational
Systems
National
Shared
Record
Integration
Moving from paper records
locked in organisations to a
digital patient record shared
across care settings
4 Components
Examples:
• Order Communications /
Results Reporting
• Medicines Management
• Clinical Notesstems
The “glue” that binds all this together
and maintains integrity and security
across the system
Systems
Examples:
• Single MPI
• Scheduling
• Clinical Notes / Records
• Screening & Surveillance
eHealth Blueprint
eHealth Blueprint - EHR

23. Delivering eHealth Ireland | Office of the Chief Information Officer
5 Years 10 Years
CriticalTactical
Solutions
InnovativeSpecialist
Solutions
National Solutions
PAS
Replacement
Initial National Shared
Record
Haemophilia
Lighthouse Project
Epilepsy
Lighthouse Project
BiPolar Lighthouse
Project
Portal
(Organisation)
Other Future
Projects
Order/Comms
Other Future
Projects
NCH Implementation Other
Single
Solution Set
Evolving to a single
solution set will require
agility and a governance
approach that supports a
dynamic environment
Other Future
Projects
National Shared Record Development
MEDLis
MN-CMS
NICIS
Acute Operational Components – Phased Implementation in HG’s
Community Operational Components – Phased Implementation in CHO’s
NIMIS
National Solutions
Other
Other
eHealth Blueprint - EHR

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Epilepsy: All patients on the EHR, Patient mobile application,
Population health analysis, GP access and image reviews, IHI,
Genomic sequencing for under 5s.

27. Delivering eHealth Ireland | Office of the Chief Information Officer 27
Epilepsy: All patients on the EHR, Patient mobile application,
Population health analysis, GP access and image reviews, IHI,
Genomic sequencing for under 5s.
Haemophilia: National Integration to hospital PAS, Open
source platform, Open Data pilot, Patient mobile application,
IHI, Secure clinical communicator, Next generation solution.

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Epilepsy: All patients on the EHR, Patient mobile application,
Population health analysis, GP access and image reviews, IHI,
Genomic sequencing for under 5s.
Haemophilia: National Integration to hospital PAS, Open
source platform, Open Data pilot, Patient mobile application,
IHI, Secure clinical communicator, Next generation solution.
Bipolar Disorder: Secure clinical communicator, Information
integration regardless of setting, Open Source solution,
Innovation led approach, Clinical support tool.

31. Year 1800
6 Hours
31
One hour of reading light!
Year 1880
15 Mins
Year 1950
8 Secs
Year 2014
0.5 Secs

32. Delivering eHealth Ireland | Office of the Chief Information Officer
Horizontal Innovation!

33. Delivering eHealth Ireland | Office of the Chief Information Officer