Pictured above is Eileen Byrne, managing director, Clanwilliam Health presenting on Pippo. Photos: Maura Hickey
Ireland’s digital health ambitions have lagged far behind many countries, but progress has been made and the room for improvement is creating an optimistic future, writes Quinton O’Reilly
This year’s Smart Health Summit 2022 covered many topics and discussion points in the field. With full attendance, those present heard from experts covering many areas including value-based care, security, and patient experience management.
As Jonathan Healy, the summit chair, mentioned at the beginning of what was a filled-to-the-brim agenda: “One thing that is very obvious is this is a topic we talk about a lot, but when that change happens, that change happens very quickly.”
The day’s first talk was a video presentation by Andy Bleaden, community director of ECHAlliance, who spoke about the organisation’s work, joining up healthcare organisations from Europe and the rest of the world and its progress in creating a collective effort.
“Our understanding is quite basic and simple,” he said. “We bring all of the stakeholders together, including patients, citizens, carers, and families, as well as companies, researchers, and policymakers, to match both needs and solutions, to break down silos and transform healthcare delivery and create economic opportunities, which is the largest area of spend for a country.”
This led to the day’s first panel discussion on getting the basics in place and discovering the key enablers to drive improvements.
The panel featured Linda Vernon, acting digital culture and transformation clinical lead for Lancashire & South Cumbria Integrated Care Board in the UK, Raphael Jaffrezic, CIO of Galway Clinic, Dr Barbara Foley, health information manager of the Health Information & Quality Authority (Hiqa), and Neil O’Hare, Professor of health informatics at UCD and group CIO at Children’s Health Ireland.
While change can sound incredibly easy when said aloud, the reality can be quite complex as numerous stakeholders and governance issues have to be addressed.
The consensus was that it is more than possible to convince people to avail of a new system or way of working, but it needs governance and time to achieve that.
Dr Foley finished the panel by saying this means setting standards in operability, technical, and quality and developing a natural infrastructure underpinned by quality and interoperability.
“We recommended a national strategic entity for health information in Ireland that would cover the whole system and be responsible for leading on that,” she said. “Other countries have it, and if we had strategic leadership and governance, then we would be able to advance these changes across the whole system.”
The Swedish system
Following this were two talks on patient experience. The first was an international case study on NORDeHEALTH, the Nordic eHealth portal for patents, presented via video by Bridget Kane Docent, associate professor in information systems at Karlstad University Business School in Sweden.
In a detailed analysis of Sweden’s healthcare system and the wider Scandinavian region, the system allows patients to access their data in a collaborative health project that standardised patient records, a standard that other European countries can follow.
“In summary, patients expect to have access to their data and records in Scandinavia, and they’re interested in further developments,” she said. “There are concerns to be addressed, but we can envision it being a European-wide record. Maybe not today or tomorrow, but certainly it’s coming soon.”
Following up before the first coffee break Eileen Byrne, managing director of Clanwilliam Health, presented on the integrated patient portal Pippo (Patient Information Portal Online). Having 20,000 users on its main applications daily in Ireland and the UK, Byrne went through the process of the system, highlighting the level of control GPs have in pushing out information to patients and configuring the system to suit their needs.
“Start off with simple things like medication and appointments, things that are really important to patients,” she said. “They start to trust the app, there’s data coming from themselves and the GP surgeries, and then they start to trust more and more information going into the app about them.”
After the break, the concept of trust continued with Liz Ashall-Payne, the founder and chief executive of ORCHA (Organisation for the Review of Care and Health Applications), discussing the deployment of digital tools within large complex health systems. Ashall-Payne brought up a point that since technology moves quickly, the criteria for testing and assessing must change alongside it, a pace that can feel abrupt to an industry that moves quite deliberately.
“What we’re doing is looking to build trust by evaluating and testing technologies,” she said. “The big difference between a drug and technology is that the technology changes and some of these technologies change very quickly.”
The subsequent panel discussion was on patent experience management. The discussion featured Declan Murphy, founder and chief executive of Isaac Care, Linda Vernon, acting digital culture and transformation clinical lead at Lancashire & South Cumbria Integrated Care Board, Ruth Bailey, founder and chief executive of Vigo Health and Maria João Jacinto, executive director of patient innovation and researcher at the Nova School of Business and Economics in Portugal.
For Murphy, it’s about emphasising care in the community and making it more accessible and prioritising it, especially in the years to come, while Bailey mentioned how human nature plays a role in it where healthcare professionals need to see and feel the benefit of these changes at the front line.
That means these systems must be structured and introduced so that those workers aren’t overwhelmed by the learning curve, on top of what is already a demanding profession. The following panel discussion was on treating the right patients in the right order and using technology to tackle backlogs.
The panel featured Dr John O’Shea, chief digital transformation officer at Dell Technologies, Shona D’arcy, founder of Kids Speech Labs, Sonia Neary chief executive and co-founder of Wellola, and Lorraine Smyth, change and innovation acute strategy at the HSE.
As D’arcy mentioned, their work is to give clinicians the power to develop new pathways to reduce waiting lists and help their lives.
This can be as simple as sending parents the information and resources they need for their children, which can greatly help them and alleviate pressure on medical staff.
The final panel discussion before lunch was on value-based care with featured Dr Seemit Dhage, head of healthcare EMEA of ServiceNow and Dr Fiona Kiernan, founder and chief executive of Zeumed.
When asked what could be recommended to improve service, Dr Dhage said that Ireland’s challenges aren’t unique and that data partnership and collaborations need to happen, with systems already in place that can be used as inspiration.
“You have examples of how that collaboration can work, whether it’s between a group of GPs with a local hospital and managing that patient and generating that value. I would say it’s one manageable project … that can be a blueprint for work across Ireland,” he said.
After lunchtime, the talk returned with Chris Carmody, CTO and senior vice-president of UPMC, discussing an important topic in healthcare – cybersecurity. Covering all the major bases of good security practices, such as knowing your data, who has it and where it’s going, Carmody stressed that security is everyone’s problem and not just the realm of IT.
Following was a showcase of major digital health companies in Ireland which featured Dr Ann Shortt, founder and medical director of Full Health Medical, Eoin O’Reilly, chief executive and co-founder of DermView Ltd, Liam Ryan, Ireland manager for Silvercloud Health, and Una Kearns, founder and chief executive of mypatientspace who each spoke about the challenges and opportunities they face.
Joining them was Martin Curley, director of digital transformation and open innovation at the HSE, who mentioned how Ireland has a lot of improvement to make in the field and how patient education and digital health literacy are really important.
“There are three major shifts happening from clinicians to patients or citizens, so it’s not doctors know best, it’s patients know best,” he explained.
“The other two shifts are illness to wellness, our entire system is constructed around the rule of rescue … and we could be the first country in Europe that everyone every year could get a proactive wellness check, and we could do that for the price of a PCR test.
The last shift is from hospital to home where McKinsey has found in research that by 2025, 40 per cent of care currently provided by US healthcare facilities could be provided at home.”
The final panel discussion looked at shaping digital reimbursement of digital health apps in Ireland and featured Fruzsina Mezei, health economist and digital health consultant for EIT Health France, Dr Sebastian Eckl, founder and chief executive of ProCarement as well as Neil O’Hare and Liz Ashall-Payne.
Referring to DiGA in Germany, Mezei mentioned that one of the first things to do is to establish a common framework that countries can agree upon that can be used for digital medical devices. Following that in priority is their healthcare effect and its pricing.
“The first thing we need to establish is whether countries can agree on a common framework to be used for these digital medical devices,” said Mezei. “Germany is a pioneer with reimbursement and while there are things that need improvement, this is definitely something that countries need to consider because this is how you improve access,” she added.
As Healy ended the summit with the optimism that appeared throughout all talks, he said: “What’s important is what we do now, to support the companies like the ones we had today, and become a world leader.”