Healthcare services tend to provoke fairly energetic debate. As patients, carers, employees and taxpayers many of us feel we have a right to voice opinions on a wide range of issues – often not particularly positive.
Among the most trenchant of these opinions tends to be the use of technology, or lack of it, in the health service. While other sectors are using game-changing technology to simplify and make many daily or mundane tasks more efficient, the health system lags behind. Indeed, in a world with more than 45,000 heath apps available on app stores it seems the healthcare sector is at least a decade or more behind.
Frank O'Donnell, KPMG's head of health and public sector in Ireland, says that health service providers in Ireland understand the nature of this technological challenge but also believes there is a need for realistic aspirations about what can be achieved.
“The examples of where change has made a difference didn’t come about simply by replacing analogue systems with digital ones”, he says. “There was a wholesale rethinking of the purpose of the services and a lot of thought was put into making the most of the opportunity that technology provides to enable change.”
O'Donnell points out that the Health Service Executive's chief information officer, Richard Corbridge, has been promoting the mantra "no more IT projects" for the last 18 months. This represents a marked change in the HSE's approach to the healthcare technology challenge. It is now a case that technology is seen as a catalyst for change rather than a reason for it.
Corbridge told a recent session of the Oireachtas Committee on the Future of Healthcare that building on change that has already met with some success elsewhere provides Ireland with a unique opportunity to apply lessons learned in other countries. "Now is not just a safer time to invest in digital solutions for health but an essential time", he added.
A recent KPMG-supported report by the UK based Nuffield Trust highlighted where some of the opportunities lie for technology to make a difference that patients actually notice. These include better-co-ordinated care where IT systems support improved collaboration across different settings such as the GP surgery, hospital or home-based care.
The Nuffield study referenced a solution introduced by the Imperial College Healthcare Trust which sees community midwifes enter all data directly into an iPad which automatically syncs with the hospital database. Instead of having to travel to the hospital at the start of each day, a case list can be downloaded from home and the app suggests an order of cases based on geographical location.
According to O’Donnell, this delivers obvious and measurable benefit at the front line: “Improved patient care as a result of more time spent on patient contact can make all the difference.”
Benefits from improved resource management are scalable nationally, according to O’Donnell. “Combine the thinking behind better resource management with the delivery of a national shared patient record and you see how patients will start to see a measurable difference,” he says.
But is the health system unfairly singled out as a laggard when it comes to technology? O’Donnell says he is a realist and maintains that success is achievable if hard won. “There is no doubting the ambition for effective change in organisations such as the HSE.”
He says that there is also widespread recognition that technology alone won’t move the dial. “Delivery in any complex sector is challenging – healthcare particularly so, given the wide range of stakeholders. However, there is a clear recognition that without the right attitude, technology in itself will have limited impact. Organisations need to invest at least as much in programmes of organisational change and transformation as they do in the technology itself.”
The good news is that he believes patients will start to see the benefits of the new technologies sooner rather than later. “Ireland is working towards a system whereby patient records are standardised and shared nationally. Ultimately this is about attacking costs and inefficiencies arising from poor information and communication by developing systems to help co-ordinate care and support healthcare professionals in collaborating more effectively.”