Ireland’s healthcare system is facing significant challenges. While the reasons are complex, one thing is clear – it’s not just down to money. Ireland is ranked 7th in healthcare spending per capita globally, just above the Netherlands and Sweden.
What follows below, and on our eHealth microsite, is not a story about an idealised future. This is a story about what a digital healthcare service could look like in Ireland using today’s technology – technology that has already been deployed by countries with fewer resources.
It starts with a unified health record.
If we’re serious about digitally enabling the healthcare system, a unified health record is the key. Health professionals will be able to access the patient’s complete medical history, regardless of where the treatment took place.
The Health Service Executive (HSE) has been running an Electronic Health Record (EHR) Programme since 2014. While some progress has been made, patient records remain siloed between locations and services.
We took a look at how a unified health record could have an impact, across six different areas:
- Access
- Transparency
- Empowerment
- Community Care
- Prevention
- Data Ownership
Everyone should end up with a single record or a series of records that are connected. That information should be available to healthcare professionals when they need it and importantly, available to patients also. Because it is the patient’s information and they are entitled to understand what is happening. — Lorcan Birthistle, CEO of St James’s Hospital
1. Access
Right care, right time
Same-day access to GPs is a problem in Ireland. One reason is that patients are tied to specific GP clinics that hold their records on file. By making health records accessible across healthcare services, we can enable greater flexibility for patients to receive the care they need, anywhere.
So if a patient’s GP is not available, they can instantly find a doctor – locally or online – who has all of the patient’s information available at their fingertips.
Chile (ranked 43rd in global healthcare spending) is integrating healthcare records into a single patient view, using a system that makes it easy to connect data across healthcare services. The aim is to provide a single point of access to patient data for all healthcare professionals.
2. Transparency
For consultants and patients
Ireland currently has one of the longest waiting times in Europe to see consultants. With a unified view of the patient, consultants from different hospitals can better share knowledge and collaborate on treatments, reducing duplicate tests and related delays.
And we can make transparency work both ways. What if our GP could view consultants’ availability in real time and book referral appointments straight away?
Northern Macedonia (ranked 88th in global healthcare spending) has a booking system in place where available consultant slots are shown to patients at referral. Streamlining their process has played a huge role in shortening Macedonia’s waiting list. Rather than start from scratch, Serbia (ranked 60th), has successfully licensed and deployed Northern Macedonia’s system.
3. Empowerment
Enabling better self care
According to the HSE’s National Patient Survey, patients want clearer information about self-treatment after a consultation or hospital discharge.
With test results, medication details and treatment plans readily accessible, we can empower patients to better manage their care from the comfort of home.
This translates to fewer avoidable appointments, taking pressure away from clinics and hospitals.
Today, three in four Irish adults over 50 have at least two or more chronic conditions. It’s more difficult for these patients to self-manage when treatment information is only provided verbally.
4. Community Care
Supporting our nurses
A key goal of Slaintecare is to increase the levels of care in the community – lessening the burden on A&E and hospital beds. So we should empower Primary Care Teams with the right tools and information.
A unified health record – with the ability to update in real time – can provide a live view of the patient’s situation to all members of the Primary Care Team. Not only would this allow for a more holistic approach, it would also cut down on paperwork.
According to an INMO survey, admin tasks for a Public Health Nurse can take 3 times as long to complete as the nursing needs of patients. More than 40% of respondents also stated that they did not have a written up-to-date care plan for each patient.
5. Prevention
Through richer insights
Ultimately, preventing illness from happening in the first place should be the goal. With all health records digitised, we will have a readily accessible database of anonymised health data, updated in real time.
We can use insights from this data to create better strategies for vaccinations, healthier eating programmes, and preventive check ups like cervical screening.
At least 14 countries in Latin America have adopted a nationwide electronic immunisation record, which is being used for forecasting and strategy development.
6. Ownership
Taking charge of our data
As data becomes ever more important, we need to be in control of our records. That includes control over who gets access to our medical data, and at what level.
We could restrict certain data to certain professions. Or we could choose to give loved ones full access to our records, enabling them to help us as we age.
We could even provide fitness data from our smartwatches to GPs and nurses, giving them a holistic view of our health.
In Germany, digital health record services like AOK and Vivy let you control how your data is shared, underpinned by progressive health regulations introduced in 2015 and 2019.
Where is Ireland on this journey?
The HSE has estimated that full implementation of its Electronic Health Record (EHR) Programme will take up to 15 years. By then, the Irish population will be larger and older, putting even more strain on the healthcare system. It could be argued that Ireland needs to aim for a shorter timeline.
The unified health record can play a critical role in making the entire system more efficient. Done well, it will improve treatment planning, alleviate the burden on professionals, and ultimately lead to better healthcare for all. Now it needs the right focus and commitment to become a reality.
Wipro Digital Dublin team members Narut Byrne, Conor Normile and Thiago Scolari contributed to this article. Say hello!