Northern Ireland’s health minister Edwin Poots has grand plans for its health service and says they are underpinned by “getting the IT right.”
Two years ago, the country launched a “transforming your care” project, a six year scheme to develop a new model for health and social care.
Supporting this is a regional e-health strategy focussing on electronic care records, communication and information that encourages trusts to use technology to deliver more care in community settings.
Getting staff mobile
South Eastern Health and Social Care Trust runs four major hospitals and 120 facilities, employing 11,000 staff; and it wants to get them as mobile as possible.
Stephen Stewart, its assistant director for technology and telecommunications, says that by developing a bring-your-own-device strategy, underpinned by a virtual desktop infrastructure, it can give clinicians what they want.
“Our healthcare professionals outside hospitals work in clinics and community centres. We have tablets and laptops deployed with wi-fi dongles and other various other methods of connections,” he says.
However, he argues that giving all staff mobile devices would prove costly, which is why the trust is working on its BYOD plans. South Eastern has deployed a mobile device management platform from Airwatch and is currently trialling a BYOD scheme with 20 community clinicians.
“We’re pretty comfortable with the technology and our mobile device management platform Airwatch, but we still need to work out the impact,” Stewart says.
Implementing national systems
Earlier this month, South Eastern formally opened two performance optimised data centres from HP. The PODs are 20 foot containers that, according to the company “deliver the equivalent computing power of a 2,000 square foot brings and mortar data centre.”
Poots was invited to the opening, and applauded the trust’s decision to adopt the data centres, which host a HP private cloud system that will both handle all of its IT operations and underpin the mobile working and virtual desktop strategies.
South Eastern worked with HP and BT on the PODs, which have been installed as part of a hospital rebuild project that would have included a new server centre if the HP solution had not worked out faster and cheaper. But Poots anticipates that others will follow.
South Eastern has long been Northern Ireland’s leading beacon when it comes to IT. It was the first trust to trial the country’s electronic care record, or NIECR. The £9 million project launched in 2012 and aims to give 20,000 clinicians access to a range of health and social care systems through a portal.
These include Northern Ireland’s emergency care summary record, lab systems and patient administration systems, which Poots argues will make a huge difference to care.
“Clinicans will have quality data at their fingertips, something that will be hugely beneficial to them,” Poots said at the opening. “There will be immediate benefits for citizens, whether they will actually realise them or not. Clinicians will see the benefits as they provide the care for the patients because they will have better access to quality information.”
Benefits to come
The roll-out of the NIECR’s Orion portal began last spring, and will give clinicians a single, browser-based view of key patient information, customised for different types of user.
“We can see massive benefits and we think that the value for money we’re getting is excellent,” Poots said. “The ECR cost us £9 million for a population of 1.8 million people. I think that’s just good value for money for the information that gives us.
“We had people turning up for appointments and the consultant wouldn’t have the right information. That’s dispensable now because the consultant will have the right information.
“You no longer have people tracking down files for people. GPs are immediately getting info back to them about what’s happening with their patient.”
The NIECR is undoubtedly an interesting model. But the scenarios that Poots so enthusiastically describes have still to materialise. Stewart says: “It’s not really fully rolled out yet. Not every healthcare professional can access it, and not all systems are on it.”
Still, he is also very positive about the changes it will bring. “We have got a number of acute systems, but very few community systems, feeding in to it.
“Another issue is that not every GP practice contributes to it. From our perspective, that needs to happen for full advantage to be taken of it. Within the next six months we want to get community fully into it.”
He adds that his trust has 1,500 users accessing it every day, but that very few of those are nurses. “The emergency care summary record doesn’t offer much to them in terms of how they do their work,” he says.
Nursing tech the next step
Poots is ploughing on with his informatics agenda, and the next step, he says, is to deal with nursing technology.
“I would like to be looking at things like handheld technologies in hospitals; where nursing staff don’t use pens and paper any more for recording, where we get to the point where everything is only recorded once in the hospital and that goes straight to the database,” he told the launch meeting.
He adds that he thinks Northern Ireland may even be strides ahead of the rest of the UK when it comes to embracing technology.
“We think that in terms of UK and Ireland we are probably ahead quite a lot. We’re probably not ahead of everyone, but quite a lot, and there is energy to maintain momentum here to continue to embrace technology,” he added.
What’s next for Northern Ireland? In the future, Poots wants to follow in the footsteps of the American banking sector, which sends work to Northern Ireland overnight while the US sleeps.
“We have made considerable advances, but there are still considerable advances to be made,” he argued. “If we catch up on technology we could offer services to the US where overnight we could do work on their behalf like in the banking sector.
“The Chicago Mercantile and the New York Stock Exchange have their two largest offices outside of Chicago, New York and Belfast. We could potentially do that in healthcare, too.”
Still, Poots issues words of caution and advice to trusts in the country, saying they should think twice before buying new technology just because “it looks pretty.”
There will always be challenges because technology is always advancing at a very rapid pace. One of the challenges we have is quality control, where we make sure the technology is at an appropriate cost but also fit for purpose in the future,” he says.
“You don’t want technology that is quite good now but in a couple of years is completely outdated. There will always be advances. You always want to acquire technology that has advantages for a longer period. “
Hear more about this project on the latest EHI Podast.