What rule would you break to deliver healthcare value?
I joined the HSE in 2002 from a highly-technical background having worked as a software buyer for the DCC Group and Production Design Technician for General Motors. I had a real love for technology. I started as a Procurement Officer in a mostly paper-based supplies office, faxing and sending printed letters was standard. It was a real shock to me. I also found the management culture, from the open-door policy style I had been used to, to a more formal bureaucratic Max Weber type scalar chain system, a real change. If you had ideas you reported to your line manager and if they sought fit they would forward it up the line. I always felt this stifled innovation. I believe our people are our best asset.
If I was able to change something it would be to promote involvement in change from the ground up. I think nurses, NCHDs, HSCPs and clerical staff know their patients well and have innovative ideas. I would encourage participation. When we started the Digital Transformation Team we set up a dedicated email for innovation and digital ideas. Some of our best solutions came from this first contact. Culture change is a priority for me.
What is the biggest challenge to innovation?
How we introduced digital technology in the pandemic was often referred to as the big bang disruptor in healthcare. We leapfrogged about five years in the last two years. My fear is that medical professionals will return to old ways. I would instead like to harness the power of leadership and courage shown by our clinicians and senior management in that period. We have to progress, shifting left into the community avoiding acute settings using advanced clinical prioritisation and involving health and social care professionals.
I would like to see remote monitoring of patients in the community continuing. When we monitored and cared for Covid patients in the home we saved €20million on bed nights and kept people where they wanted to be. At present we have over 1,000 CF and COPD patients monitored at home. We have a pilot Heart Care at Home with 160 patients, I would like to see this scaled up. Video consultation is a life changer, especially for patients outside of Dublin. To have a consultation without the drive to Dublin and wait in clinics is something the patient expects and asks for now. The OECD 2019 report Health in the 21st Century, stated ‘healthcare is data rich and information poor’.
Another area we stepped up in during Covid was the use of data for forecasting, modelling and planning. We have tools now within the area of change and innovation that can monitor waiting lists by hospital group, individual hospital and individual speciality. We have a dashboard that can provide deep dive information. We also have new pathways using some of the e-enablers mentioned earlier. Yvonne Goff, National Director of Change and Innovation is the woman behind this progress. I am privileged to be involved in real change and innovation working with Yvonne and our team.