The new chief information officer of Ireland’s Health Service Executive once had plans to become a teacher.
While he hasn’t realised this early ambition, Richard Corbridge believes health IT has given him another way to make a difference.
“It sounds corny to say, but I do feel that I’m giving back by being involved. IT can always help to change and innovate and make things easier to do – that’s why I’ve stayed involved, because I strongly believe we can make a difference to frontline healthcare.”
Corbridge will start his new role on 15 December, leading the way on the Irish government’s plans to transform health IT in the country from its current state.
It is undoubtedly a challenge, but one he says he is looking forward to and which his years of experience in the NHS will prove invaluable.
Systems support and frontline experience
Corbridge’s first role after leaving university was as a quality and systems analyst at Perot Systems Government Services, before moved into a position as a programme manager at the NHS Information Authority in 1998.
He took on a range of responsibilities during his five-year stint, including technical support for cancer screening and leading the data transfer service programme to transfer information between NHS organisations.
The establishment of the National Programme for IT led to a valuable change of scene, as Corbridge moved to the Solihull Care Trust on a one-year secondment as the primary care trust’s associate director of modernisation and redesign.
“I got frontline experience, which really helped me understand how to apply the national programme to a real-life situation,” Corbridge says.
In 2004, he was recruited to NHS Connecting for Health as a programme manager, where he took on responsibility for implementing the Summary Care Record and oversaw “the first few million records” going live.
A move to the NHS Information Centre in 2009 saw him manage a number of project roles and look at how information could support research – a perfect build-up for his appointment in 2011 as the CIO of the NHS National Institute for Health Research’s Clinical Research Network.
Leading the knowledge and information directorate, which provides information systems and business intelligence to a workforce of around 10,000 NHS staff, Corbridge procured and implemented a range of systems.
His work won recognition at a national level, with the network’s open data platform a finalist at the 2014 EHI Awards for ‘excellence in healthcare business analytics’, for bringing clinical research data sets together with multiple forms of data analysis and visualisation.
Getting in at the ground floor
When the Health Service Executive came looking for a CIO, Corbridge says the opportunity to build up the Irish health IT systems from the ground up was too compelling to ignore.
“I’m getting in at the ground floor, and it’s everyone’s dream to start from the beginning, add to a strategy and pull a team together.”
Ireland’s health service has never had a CIO before; the need for the role was established last year in a “roadmap” published by the Department of Health and the Health Service Executive on how technology can be used “to support healthcare from the very beginning”.
The Irish healthcare system differs significantly from those in the other areas of the UK. Corbridge says Ireland has a two-tier approach to health, with a voluntary sector which caters for more well-off citizens with health insurance and public hospitals for those who require greater assistance.
The Irish government is planning to reform the healthcare system to bring the two sectors closer together and make them easier to access. Improving the country’s use of healthcare IT will be a key part of that. “I want to make sure technology as a base for the provision of healthcare steps up in Ireland,” Corbridge explains.
He says the current state of clinical IT systems in Ireland is a mixed bag, with digital maturity varying from region to region. “There are pockets of excellence with systems such as PACS, but they tend to be local areas of excellence rather than national programmes.”
More than building blocks
Corbridge says the next five years are about putting together the foundations – “more than building blocks”– for a national approach to health systems.
“There are a number of programmes underway already, but we need to pull them together and make them joined up.”
One of the main projects is to establish an individual health identifier, an Irish version of the NHS Number, to ensure patients can be accurately and consistently identified across systems.
“There are an awful lot of things we can take from English programmes, like the Spine, and we can start to look at how we can create an individual health identifier.”
A number of other “basic things” that need to be accomplished include connecting the GP system to other parts of the health service, and work to start integrating systems across social and community care.
The need to push ahead with an IT transformation is acute: Corbridge mentions plans for a new Dublin’s children hospital in 2019, designed as a digital hospital with no space for paper records.
Despite this, Corbridge is determined not to set “unachievable deadlines” for suppliers. He says the health service will need to work with them to understand what they can deliver and how they can help each other.
“Rather than saying: ‘Here’s the things we have to deliver, let’s go deliver them’, we want to say: ‘Here’s a strategy, goals and principles, you say you’re the experts in technology, you tell us how you think that can happen’.”
Clinical buy-in is also critical: Corbridge says he is keen to ensure that clinicians are more tightly integrated into IT projects to assuage any concerns they may have and ensure they can become advocates for greater use of technology.
“We need to engage clinicians from the start, understand what their priorities are, and explain what the benefits can be, instead of being overly bureaucratic.”
As Corbridge steps into the role, he is keen to learn from and work with his nearby neighbours at the devolved administrations such as Wales and Scotland, collaborating on systems where appropriate to avoid unnecessary duplication of effort.
“I think there are similarities in all of the devolved administrations… are there economies of scale that can be got at? One of the things I’d hate to see is a system sold on to another country when it’s already been developed elsewhere – there must be ways we can work together.”
He believes lessons can also be learned from NPfIT, both in its unwieldy centralisation and lack of engagement with local areas as well as the good work it did to lift digital maturity and put some key systems in place.
“One of the lessons the national programme demonstrated is that you have to take people on a journey. You can’t just say, ‘Thou shalt do this’…but the technology gap also has to be plugged in terms of how mature some of the systems are.”
While Ireland has not led the way with health IT, Corbridge says he is heartened by the vision laid out in the government’s e-health strategy and confident that he can help the country’s health system to meet the challenges it faces.
“It’s clear there has been underinvestment, compared to most countries, in using technology to improve care…but now there’s an acceptance that more needs to be invested to support health technology in a better way.”