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HSE Digital Academy Forum Q4 Summary (11th December 2019)

The HSE Digital Academy Forum was held in the Main Boardroom in Dr Steevens Hospital on 11th December 2019. A Declaration of Public Service Innovation was signed by HSE CEO Paul Reid in the presence of Dr. Lucy Fallon Byrne, Assistant Secretary of Reform for DPER. The event was opened by the Director of Digital Transformation Professor Martin Curley. Prof. Curley welcomed us all to the event which he explained was organized as one of the key events in our public service 2020 innovation activity.  He outlined the agenda for the day which included speakers from the HSE, industry, academia, patient advocacy and politics. He also promised us demonstrations of new emerging technology and he then proceeded to showcase one such innovation. Prof. Curley showed us a small wearable Quasar device from Think Biosolution which he was wearing on his chest. Ross Cullen read out live data from the device from the other side of the room. This data included Heart Rate, Respiratory Rate and Blood Oxygen Saturation levels. Ross confirmed all vital signs were good and with that reassurance given, Prof. Curley welcomed our first speaker of the day Minister Jim Daly.


Minister for Mental Health and Older People Jim Daly

The Minister for Mental Health and Older People Jim Daly introduced himself and told us he was delighted to be invited to speak on the subject of Mental Health and Older Persons Health.

He warmly welcomed us all to the Forum and praised the driving force behind the Digital Academy Forum. He accepted that healthcare is a complex problem but he told us he believes that solutions are there. Concerning innovation and the concept of new thinking being espoused in the Forum, he stressed the concepts' importance by telling us “If you continue to do what you always do, you will always get what you always got.”

Minister Daly spoke of how he often makes the point that "it is not criticism but collaboration that will fix our problems" and the collaboration and innovation were in evidence in the forum with the range of people attending and working together. About his remit which is mental health, he spoke of how mental health is a peculiar area in that it can be done quite effectively in a digital space. This is evidenced by the number of pilots throughout the length and breadth of the country which are delivering psychology and psychiatry online. He cited international studies which have shown that children with autism are much more comfortable talking to a screen. People are also welcoming the anonymity of accessing therapeutical services through a screen. Services can be available where and when they are needed 24/7 through a screen in your own home. He gave the example of a specialist consultant in the Southwest of Ireland that could either spend 6 hours a day travelling to different patients to provide services or through the online pilot access patients instantly and help a much larger number than was previously possible.

After working for two and a half years in the department, the Minister told us he had had many good days, many tough days and many challenges but the most energising and hope-giving days were the ones where he was introduced to innovations that were being rolled out in healthcare.

Minister Daly concluded by telling the audience that the Academy is a vital piece of infrastructure within the HSE. It is exciting and innovative and he looks forward to seeing the results of the Academy in the coming months and years.

Prof. Martin Curley - Director of Digital Transformation

Professor Martin Curley gave us what he described as a "drive-by shooting of Digital Transformation Strategy" in which he outlined how we are looking to share solutions, spread solutions and come up with new solutions to challenges in Healthcare. He advocated taking inspiration from singer John Cage who said "I'm not scared of new ideas I'm scared of the old ones". Prof. Curley then Introduced the team working on Digital technology and welcomed Fran Thompson, CEO of OoCIO to the event.

Prof. Curley explained how Ireland could be the European Digital Leader in 5-7 years if we work in collaboration with our partners in the quadruple helix and Ireland could go further and be a Worldwide Digital Leader in 10 years.

Moving to the educational component of the Digital Academy Forum we were told that OECD research shows that 30% of Health Service professionals do not feel sufficiently skilled in ICT. The Digital Academy and it's training programs aim to combat this and to help develop a more highly educated ICT literate workforce.

The key thing Prof. Curley is trying to do involves the Stay Left Shift Left. This involves finding technology which enables people to stay well at home longer and in the event of having to be admitted to hospital, we will find technologies which will move people from acute setting to a community setting and on to a home setting.

Prof. Curley introduced us to the concept of living labs which are user-centred, open-innovation ecosystems and these are being pushed out nationwide in Ireland during the next few months. Ross Cullen showcased the HealthBeacon Smart Sharp Bin and gave an insight into its adoption by more than 3000 patients in Ireland.

Another device Prof. Curley showcased was Mobile Medical Diagnostics' mobile X-Ray machine. This example of a living lab was a vivid example of technology which is delivering care to the patient in their home environment rather than forcing patients to travel to Hospitals. The average age of the patient using the service is 86 years old. Bringing the service to the patient takes some of the demand out of the acute system. Prof. Curley then invited Lorraine Smith to introduce the next demonstration.

National Ambulance Service and RedZinc

Lorraine Smith introduced a demonstration from the National Ambulance Service of the implementation of RedZincs BlueEye technology. To demonstrate the practical use of BlueEye, a simulation of an accident scent was set up in a different room in Dr Steevens Hospital. Ambulance staff attended the scene of the accident and the lead paramedic was wearing the blue eye wearable video headband. The hospital control room was set up on stage in the Boardroom and we could see a Doctor interact with the paramedic staff through the video link, live at the scene of the accident.

It was fascinating to see the seamless way that the ambulance staff were able to get guidance from a consultant with regards to the patient with a severe head injury. Despite being in a different physical location the doctor was able to visually inspect the patient and talk the ambulance staff through assessing the condition of the patient. The communications were two way and both verbal and visual. The Doctor and ambulance staff were able to work as if they were in the same room. Once the decision had been made to transfer the patient to the hospital where the doctor was located, the doctor organised to have a trauma team ready for when the ambulance staff would arrive in hospital in 45 minutes.

Speaking at the end of the simulation, the lead paramedic explained the benefits for staff and patients from using this system. He welcomed the reassurance it provided that staff at the scene of the accident will have made the right decision and that the hospital staff will be expecting the ambulance when it arrives. The demonstration was incredibly realistic and vividly demonstrated how technology can be used to save people's lives and bring the expertise of hospital-bound doctors to work alongside first responders to deliver quick and accurate medical care.

Dr. Conor McGinn & Stevie the Robot

Dr Conor McGinn came to the podium next accompanied by his Robot Stevie. Dr McGinn is the lead engineer who designed Stevie the robot and he is an assistant professor in Trinity College, Dublin. Stevie recently made the front page of Time magazine with the tagline "The Robot will see you now".

Dr McGinn spoke about how he has worked with robotics since his time as an undergraduate student. He always saw the unbelievable potential of Artificial Intelligence combined with a physical form, the essential components of a robot. This engineering journey he undertook was influenced with by more personal journey concerning his Grandmother. Dr McGinn's grandmother was a former midwife who lost her self-esteem when having to go to a nursing home following an illness. The nursing home itself was very good but for his grandmother, her quality of life deteriorated and she lost her self-esteem and self-confidence.

This started a journey for Dr McGinn and he began by researching what was stopping robotics being built. He looked with his team to see how robotics could be used to enhance the quality of life for old people and staff.

They are now at the point where they have an end product ready to leave the lab and go out into the real world.

McGinn introduced us all to Stevie who was able to interact with the audience and inform us he was a social robot who wanted to help people stay independent as they get older.

Stevie was also able to help care staff facilitate social activities which are hugely important for older people in residential settings. DMG detailed some of the apps they have designed for Stevie including ones which allowed Stevie to run cognitively stimulating quiz type activities and musical based therapies. The next cohort of apps being designed currently will allow Stevie to facilitate physical activities for older people.

Dr McGinn demonstrated how Stevie can answer simple questions from older people who may have forgotten such as who will be visiting them. Stevie has a Skype aspect with the screen on his face and this bypasses the need for older people having to have their own devices for making Skype calls. A voice-activated request can launch a Skype call for people.

The design team is currently exploring how Stevie can help care staff with transferring important information when staff shift changes happen especially when staff finishing one shift do not have much time to meet with people starting the next shift.

This was a fascinating talk and a wonderfully entertaining demonstration of technology which is designed to look after the social, emotional and physical needs of elderly people in a friendly respectable way.

Prof. Curley then stepped up to the podium thanking both Dr McGinn and Stevie for joining us in Dr Steevens Hospital. Ross Cullen brought the new Digital Academy website online from maintenance mode to production mode and Prof. Martin Curley invited people to access it on He also announced an upcoming workshop to be held in conjunction with DEPR on January 31st on Garda Vetting and International refunds on medical insurance (details will be posted shortly on the new website ). Prof. Curley reiterated his ambition to move the Health Service in Ireland from digital laggard to European digital leader in five years and world leader in 10 years and then invited the assistant secretary-general of the Department of Public Expenditure and Reform Lucy Fallon Byrne to take to the stage.

Dr. Lucy Fallon Byrne - 

Dr. Falon Byrne began by saying how she was simply blown away with what she had heard and the demonstrations she had viewed at the DAF today. She was very impressed with what she described as real-life examples of genuine transformation in action. She told us how DEPR was leading out on efforts to promote a culture of innovation in the public sector with Innovation Week being held from 9-13 December as part of this.

Dr. Falon Byrne detailed how DEPR have been moving from 2011 to present from an initially reform-driven program to Innovation and Development being the driving forces today. DEPR are following a simple international model for reform and they aim to help the entire public service body to migrate into a high-performance organisation. Dr. Falon Byrne outlined the "Our Public Service 2020 framework" initiative which DEPR signed up to in 2017, a whole-of-government initiative with three focus areas: 1) Delivering for the public, 2) Innovating for the future and 3) Developing people and organisations.

The reasons for this concentration of effort are that if Ireland is to be truly successful, we must invest in innovation and transformation in the public sector. The plan is that In 10 years time, DEPR will be putting as must effort into the public sector as all the efforts and investments that are currently are going to SME's and multinationals.

Dr. Falon Byrne showed how that the HSE has been successful in the availing of innovation funds to date with an example of a small project which benefitted from this. St Colmcille's Hospital recently opened an Occupational Therapy department with support from the innovation fund. Dr. Falon Byrne invited submissions for the innovation fund which will be relaunched in January 2020. DEPR are providing help and training for innovation but Dr. Falon Byrne warned that we are still fairly low in innovation maturity across the public sector and unless we foster more innovation, we will not keep up with our customers. She congratulated all in the DAF and expressed her wish that we will work closely together in future on innovation into the future.

Prof. Curley thanked Dr. Falon Byrne for her talk and told us he was delighted to announce that on behalf of the HSE, Paul Reid had signed the Innovation Declaration earlier in the day which displayed the HSE's commitment to promoting and developing a culture of innovation into the future. Prof. Curley introduced the next section of the Forum which was the power hour incorporating submissions from four of the foremost women working in Digital Health in Ireland today. The first of these speakers invited to present was Eilish Hardiman, CEO of Children's Health Ireland.

Eilish Hardiman - CEO Children's Health Ireland (CHI)

Eilish introduced us to Children's Health Ireland (CHI) which is the newest organisation in the health system, being only one year old. CHI was set up when the three paediatric hospitals transferred into one single body. Our Lady's Children's Hospital Crumlin, Temple Street Children's University Hospital and the National Children's Hospital Tallaght all transferred their assets, liabilities, staff and services into this new entity which is the client for the new children's hospital.

The vision Eilish showed was one of an integrated network of paediatric healthcare in Ireland called Connected Health which has the new children's hospital at the centre.

This vision is all about transforming services and engaging citizens. All patients and their parents are digitally literate and staff must be educated and trained to match this digital literacy. To develop training for all the paediatric clinical staff to the highest standards, CHI is linked with seven universities in the south of Ireland and two in Northern Ireland to achieve this.

The digitising of Healthcare in relation to pediatric care is not just about Electronic Health Records (EHR) but it is more about how digital transformation can be made to work. Eilish outlined some of the challenges this posed. It is difficult not to think of existing processes and using paper but this has to be done if we are to be truly transformative. It is also extremely challenging in envisaging how the patient flows and data flows will operate in a digitally transformed environment.

From a numbers point of view, Eilish showed the CHI now Serve 320,000 children with 4000 staff across 4 locations.

The goal of the CHI is to move from an acute care model to one dealing with chronicity and complexity.

The question Eilish asks is how the child can be treated 1 in the Home, 2 in the local community, 3 in their regional hospital and only if needed to travel to the children's Hospital. The model strives to deliver services as locally as possible

She then gave us some stats for the new hospital to get a feel for its size and ambition. It will have 6150 rooms and is the equivalent size to the Dundrum Shopping Centre. It will have 380 Critical Care individual ensuite bedrooms which will all have a bed for a parent. There are also 93 Daycare beds There will be a 53 Unit family accommodation facility. There will be 1,000 parking spaces with 675 dedicated to families. 22 Operating Theatres and Procedure rooms and 4 acres of outdoor space with 14 gardens and courtyards are also to be included.

The new hospital will be fully digitized – The plan is to build a paper light hospital without a medical records department. Self Service Kiosks will be present onsite and Smartphone apps and wayfinding will guide people from their homes to the outpatient's department. A cohort of robots will be used to deliver items around the hospital enabling porters to work more closely on patient support. There will also be links setup into schools to enable children who are resident in the hospital to listen to their classes from their home schools.

Stay left shift left is the model of care underpinning the CHI. There is a need for a digitally literate workforce and hence the CHI are supporters of the DAF and its objectives. Paediatrics staff working in Connolly do not have paper charts, they now use iPads. This is the vision for the new hospital.

Eilish spoke of the volume of work being done in advance of the physical move to the new hospital with all non-standard systems being standardised and integrated to ensure the move to the Children's Hospital runs smoothly. She concluded saying they intend to build the best hospital which will deliver the best service and this is what the children of Ireland deserve.

Lucy Nugent - CEO Tallaght University Hospital

The second speaker in the Power Hour was the CEO of Tallaght University Hospital (TUH) Lucy Nugent. Lucy informed us that TUH had just last week launched their 5-year strategy. This strategy has five main pillars which are Research and Innovation, People, Access, Infrastructure, Integrated care and Digital Enablement. They are looking to see how they can transform digital enablement and this supports all the other pillars. Their ambition is to move their supports beyond the confines of the four walls and move out to the community. TUH is part of the Dublin Hospital group and has a lot of shared services with Naas and St James Hospital. To offer the highest level of care, Lucy spoke of the importance of ensuring the patient experience is standardised and that workers experience is also standardised.

Lucy detailed the challenges which they were facing when they realised several core Information Technology systems were approaching the end of life. The decision they made involved implementing a digital Electronic Health Record System and building a system that looked to the future rather than than taking ashort term view and replacing systems as needed. They have taken a phased approach and their implementation solution allows them to control the pace of change. The benefits of this are the hospital is a busy environment and they can minimise the disruption which comes with taking on extra work.

Lucy listed some of the work they have undertaken to improve patient experience. Examples of this are there will soon be a patient portal available and patients will be able to get letters electronically.

GP's will have a portal into the patient portal enabling them to access data such as information on the patients stay in a hospital if the GP has not received a discharge summary. eReferrals will be improved. Single user sign-on has been piloted where staff can access the right information from any location and the most appropriate device.

From an operational point of view, TUH is moving towards having access to real-time information. They have implemented dashboards which are refreshing information every minute and these have information on critical metrics such as how the Emergency Department is doing, how many people are on trolleys and other key statistics.

The benefit of was this was put quite simply by Lucy saying "if you have real-time information you can make real-time decisions". The other benefit of having this data she showed was how they can look at using data for predictive proactive actions. TUH has a long history of innovations, it was one of the first to trial stroke telemedicine and it has a patient app. Ipad on a Sedgeway is a robot they use and it can be controlled from a mobile phone. They also lead the way in the use of pill cam technology where a patient can swallow a pill rather than having a colonoscopy. This year they partnered with Technology College Dublin for a 24-hour hackathon session and several innovative solutions were found to real problems. One of the projects which were founded in the hackathon is currently being taken to production with a final year student. The staff app was launched a few weeks ago and is useful especially for NCHD's who move around and can now access services from outside the four walls of the hospital.

Lucy gave a glimpse into the future with innovations such as robotics which are starting to be incorporated to move blood around the hospital and innovations such as partnering with a start-up company for gait analysis which will be tested in the live environment of the Hospital. Lucy closed telling by informing us Digital transformation and the digital journey were not just an occasional event but were becoming part of their DNA in TUH and part of what they do

Grainne Courtney – CCIO St James Hospital

Grainne gave us an overview of "Project Oak" one of the biggest digital transformations projects in Ireland. The project was dubbed project oak as its ambition was to get rid of paper records in St James Hospital and move to a digital platform.

This was done by transforming all nursing records such as admission notes and end of bed notes to electronic records. All Physicians notes which they write on a day to day basis were transformed. For medicines, electronic prescribing and allergy tracking was introduced. In the year since going live, there have been 4.5 million medications administered electronically.

The goal for the project was to benefit the patient and Grainne outlined several ways this was achieved. The first was in freeing up Nursing Staff from the time spent on administrative tasks allowing them to spend more time with patients. The time taken on medication rounds was reduced allowing more time to care for patients. Safety embedded with medication was introduced. After a year there had avoided 384,000 opportunities for transcription errors in rewriting files. Safer drug administration was the objective and now if a drug is not given to a patient it is documented as not given and reasons noted. Prebuilt Order sentences are embedded in the system so the order, dose and intervals are all included and are easily readable.

Allergy documentation moving to electronic has moved allergy compliance from 80% up to 99% +. The system will warn doctors if they attempt to prescribe medication which contains an ingredient which the patient is allergic to.

Select audited benefits to doctors are improved quality of prescribing Vancomycin in particular, adopting electronic operation notes and an increased focus on inclusion care.

Grainne showed us the structured nursing notes and the business intelligence metrics which the system allows nurses to view. The system showed not only patients who had pressure ulcers and falls but also helps safeguard patients who were at risk of developing ulcers and failing. This information is invaluable in providing targetted proactive care for patients.

The information makes St James Hospital a great place to work as it allows Doctors and Nurses to get information and deliver great care. The fact that the whole hospital was involved in the project was a unifying experience for the hospital.

Grainne showed how they had used every opportunity to show the users what was coming and the benefits it would bring They got the users to assist with testing to build ownership. Face to face training was given for prescribers, e-learning modules were developed and a blended record environment used. The plans for the future include voice recognition and integrating with other systems.

Grainne spoke of how proud they were of the success of Project Oak and how it had unified the hospital staff making it a wonderful place to work.

Diane Nevin - Digital Entrepreneur – SDN Innovation Solutions

Diane kicked off by outlining her background in entrepreneurship and female leadership. She described herself as a proud member and supporter of eHealth Ireland and its objectives for over 10 years.

Diane believes that Digital Transformation is the number one priority in most organisations. It's an on-going process to identify the needs and wants of customers. She told us that the vision is critically important in digital transformation. People are hugely important in the process but if the vision is not clear, this will slow down the process. The change will not happen merely because the technology is available.

Her advice for digital transformation in Health is to start with the patient. It is important to have an understanding of the touchpoints within the patients' journey through the system .Be aware that digital transformation can create difficulties as healthcare teams are working multidisciplinary. It is very important to create measurable targets for these teams.

Minimising new risks and being aware that transformation and change are always challenging is key. Change management needs to be thought through and must be embedded in every project. Change management in digital transformation is a journey. Staff must be central to change management and it is very important to foster staff and ensure they are managed correctly. Entrepreneurial thinking from staff should be fostered and supported. People don't leave jobs, they leave managers.

She asked us to embrace design thinking to the way we work, to change from a "can we do this" mentality to "should we do this". Customer engagement and customer discovery are vitally important and if we are building a system, we should involve patients in its design.

Diane is a great believer in the embrace thinking strategy which says "Tell me and I will forget, Show me and I may remember, Involve me and I will understand.” To foster this thinking, we must create a sustained culture of innovation and not just workshops and talks.

Innovation can be unpredictable but it can be managed. If we are to measure and manage, we must use action metrics as opposed to vanity metrics. We want to make ourselves look good and show the best side but we have to be willing to show real-time data and to be able to show when things don't go well in addition to when things worked. Diane finished by discussing female leadership and she was impressed with the HSE and how female leadership was being fostered. She stressed the importance of female leadership to identify and support the next generation of female leaders, giving them the confidence to enter the boardrooms. As well as being important for the next generation of female leaders the companies themselves benefit. In the market of complexity, most successful organisations have diverse leadership.

Conor Kennedy - Service Improvement Lead, HSE Mental Health  

Conor spoke next on developing digital mental health supports in Ireland.

The main challenges they detailed were difficulties in how they delivered Community Health care, getting better challenges and Budget. A lack of upstream support can lead to downstream pressures. There is a growing expectation from the public so it is important to be mindful of the gaps between people's expectations and how services can be delivered.

Solutions provision came from a theoretical framework around three concepts. The first being the Stay Left Shift Left approach to embracing digital support, the second being the quadruple helix approach to innovation which involves collaboration with Health Services, Industry, Academia and Citizens. The final approach is to implement structured project management based on Prince II methodology.

Collaboration is essential with private sectors and other public entities such as the Samaritans, Crisis text Line, video doc and Spun Out.

The actions taken included providing counselling online.

There has been redevelopment of the website in addition to setting up call lines and text-based support systems. The development of is a central point of truth to combat the amount of fake information online. All information is fact-checked by clinical experts and the search function is validated.

The second strand is your mental health information line which is a single contact information and signposting service for mental health. All call takers are trained in safe talk protocols and the service is available 24 hours a day, 365 days a year. Services are now available in the right place at the right time. Young people are more inclined to text rather than talk, so a dedicated active listening text service was established originally in the US and here, 100 Milion messages have been processed. It has been rolled out to the UK and Canada and will arrive in Ireland next year. The service is manned entirely by volunteers. It also uses artificial intelligence support to interpret texts to identify and flag more serious messages, moving them to the top of the queue to be seen by volunteers.

These online Therapy services are focused on counselling online, Internet cognitive behavioural Therapy and telepsychiatry. A pilot study carried out in conjunction with the turn2me organisation and GP's. The GP's provided initial referral to the counselling office and the service was offered to patients.

The second pilot was looking at waiting lists in the CHO2 region, offering people on their waiting list access to the service. Turn2me has reported a 43% increase to their site. There is growing evidence of the effectiveness of internet-based Cogitative based Therapy and they work with Silverlight based in Dublin providing this service. They can access services remotely at a time of their choosing, all the time being supported by a psychiatrist. It is currently a pilot project so there is no data to date.

Healthy Ageing for a new Digital society (Hands) – Panel Discussion

Jamie Cudden – Jamie leads Dublin City Council's Smart City program and he spoke about how he believes in using technology to make a real difference for people and communities. He and the council do a scan across the city every year of the challenges they face and these range from perennial issues such as traffic congestion and pollution to the longer-term challenges such as the ageing population. Jamie informed us the number of people over 80 in Dublin in the next few years will quadruple. He told us he is very interested to offer the city of Dublin as a testbed to resolve problems of an ageing population with innovative solutions.

Ved San outlined his beliefs in how companies exist not to just serve their shareholders but to serve the communities that they work in. He spoke of how he loved the fact that we can use technology to make a real difference to real problems. We also have intuitive easy to use technology now, for the first time we have the technology you do not need to spend 6 days training to use. we have the capacity of helping the elderly live longer, to age with confidence in their own homes.

Lorraine Smyth spoke next on how the technology used in the project is so unobtrusive, this technology being a small sensor the size of a matchbox. She outlined the different warning signs the system could monitor and warn support staff about. Examples Lorraine gave were the ability to monitor if a door is left open at 3 in the morning, to tell if a person hasn't left the house in few days and also to measure gait deterioration over time. Staff monitoring the system can liaise with the public health nurse and intervene when required. The system can lighten the load of a public health nurse

Mary Galvin – Research plan. She told us the technology is ready and can be anchored in the person's home, making make a better future for someone. To older people, their home is their haven. HANDs are researching the differences in each person's home environment. The technology is there to do multiple tasks but it is vitally important to ensure it fits into the home environment.

Colm spoke next giving the perspective from the ESB. He is looking forward to participating and collaborating with HANDS. ESB has done considerable work with Smarter Home technology and they are looking to see what services they could offer to older customers. They are looking at what they could offer in collaboration with partners to deliver peace of mind. ESB are very interested in open collaboration and open innovation so they are very happy to be a partner with the project.

Dee Conroy / Owen O' Doherty – Integrated Care Program for Older People

Dee Conroy spoke first regarding the aims and structure of the Integrated Care Program for Older People (ICPOP). The primary aim is to develop services which will facilitate the shifting of care away from acute hospitals to community-based coordinated care. It involves working with Sláintecare, treating people at the lowest level of complexity as close to home as possible. The three core components are Healthy Living, Enhanced Community Care and Hospital Living. The main idea is using technology to keep people well at home. To will involve the use of ICT to allow people to remain in communication with the community. Underpinning this model is a new structure for care community health networks. This will consist of 96 networks each caring for 50,000 people and will involve proactive monitoring of elderly people to manage the care of older communities. There will also be specialist multidisciplinary teams out in the community working. If elderly people need to attend hospital, the ICPOC structure will try and reduce the length of stay and facilitate people moving back to the community and ultimately back to home. There are 15 pilot sites up and tunning and more teams coming on stream all the time.

Owen O'Doherty - Carefolk

Owen spoke about the changing demographics in Ireland which has meant planning for the care of the elderly is a necessity and not a luxury. At a time health service is stretched there is a need to deliver a platform which provides a basis for fully integrated care. Carefolk has invested time and resources into working on ensuring the technology that is deployed is easy to use and easy for users to adopt. They supply a toolbox which supports caregivers in organising the care plans of their care recipients. The Carefolk system fits seamlessly into the integrated care plan for older people and fully supports the Stay Left Shift Left ideology underpinning the plan.

Dee Dineen - KheironMed

Dee introduced the MIA system which is an Artificial Intelligence-based system that has been designed to support radiographers in the fight against breast cancer

MIA uses deep learning technology which is a form of Artificial Intelligence that had only been possible to use since 2015 with advances in computing power. The system learns from reading large volumes of slides both new and retrospective. It learns what is clear and what is suspicious, the aim being that it will ultimately make the same decisions as the best radiologists.

MIA Replaces one of the radiographers in the double-check workflow. It acts as an independent second initial reader of the scans. If both initial readers agree on the result the decision is accepted. If MIA and the initial scanner disagree, then the scan goes through an existing arbitration process where a third reader or group of readers step in to decide if the patient is recalled. Downstream in the process, a human radiographer still makes the final call. MIA assists with the difficult decision to recall a patient or not and frees up a radiographer from the initial screening.

Gary Boyle - Citizen / Patient

Gary Boyle gave the most moving and heartfelt talk of the day . Gary is suffering from Parkinson's Disease and he described in vivid detail the symptoms he had initially developed with difficulties doing mundane tasks like brushing his teeth and finding his writing becoming illegible. He then told how he could still remember vividly the 2nd September 2009, the day he was told he had Parkinson's Disease and the devastating effect it had initially on him and subsequently on his family.

He introduced  "Loud and Proud" Speech Therapy to the audience, which is something people with Parkinson's have to use as they lose their perception regarding the volume they are using when speaking to people. In his mind, he was shouting when speaking to us but in reality, he was speaking as a normal level.

Gary detailed some of the supports and therapies available for people with Parkinson's disease and he spoke of some of the absurdities where devices manufactured in Ireland are shipped out to the UK and available there but not available to the HSE in Ireland. He also spoke of how Irish Set Dancing is recognised as an extremely effective therapy for Parkinson's but this is not available unless it is organised privately.

Gary vowed to continue to advocate for a cure for Parkinson's and access to improved services and he told us that innovation and common sense will dramatically reduce the cost of care.

Gary was a reminder of why we were all at the forum and like everyone else attending, he is committed to delivering a healthcare system which continuously strives to find better solutions to health problems.

Professor Dianne Conrad – Grand Valley State University

Dianne Conrad is working in Ireland on a Fulbright Scholarship to Ireland from the USA. She spoke about the work she is doing, developing a model for all healthcare workers as they all need digital competencies

Dianne told us that at present the advanced practise nursing practitioner guidelines only say nurses must be able to record data. This is insufficient in an age where more and more systems are ICT based and information which is critical to delivering optimal care is contained in these systems.

Progress measurement should not be based on how many hours you spend working within a unit. The student should be able to display that they can understand and have mastered competencies. It is vitally important for nurses to continuously develop competencies.

As part of the scholarship, Diane reviewed international competency standards and this assisted her in developing a baseline level of core competencies which all health professionals should have.

The digital competencies required include knowing how to review digital records and recognise relevant data, the ability to review discharge summaries online and finally the ability to interact with patients and assist them with using patient portals to submit data.

Diane concluded by telling us that there needs to be standardization of evidence-based digital competencies guiding curriculum content in ICT in graduate and postgraduate nursing education. For this to succeed, input is required from key stakeholders in Ireland to develop nursing and midwifery competencies in Ireland.

Martin Curley came to the stage for the final time and closed off the forum. He thanked everyone for attending and announced that the next forum will be held on the 11th March 2020 with details to be published at a later date at or via Twitter



Images from the event can be seen here (via Flickr)

You can also see additional videos on our YouTube Channel here