Since the 4th millennium BC humans have been accessing and processing information about innovation and considering how to use what is in front of them! We call it reading! How many of you read at night? How many of you as children would get the torch under the covers and read just a little bit longer? For me it was Doctor Who books!
So, if reading is the route to innovative thinking and most of us love to do this at night, why oh why has the concept of reading in the dark been an obstacle for so many years that clever innovation hasn’t enabled it exponentially.
In 1800 if you wanted to read for one hour at night you would need to work an average 6 hours to earn enough money to buy the required amount of candle to do just that, and I wouldn’t have recommended anyone doing it under the covers either! However innovation was clearly hampered by the ability to read at night as the candle remained the main source of light to read by until the 1880s, when the oil lamp became the next innovation.
Horizontal innovation in action; 80 years to move from six hours hard labor to fund one hours learning to a new situation where you ‘only’ have to work for 15 minutes to fund enough oil for one hours reading. You would then assume that this vertical step would radically change the thinking for funding reading. Unfortunately not!
In 1950 the ability to read for one hour moved to a cost of eight seconds of work. The modern filament light bulb became the way in which we could gather knowledge to be able to innovate – another step change, but one that took just a little less than a century to reach. Again, more horizontal achievement rather than vertical change.
Today on average it costs less than a second to earn the funds to allow you to read for one hour in the dark. Now that’s an achievement. In over 200 years we go from spending all day working to be able to spend one hour learning and now it’s half second for the same! But, really if we were truly innovative in a vertical way, in a way that wasn’t an evolution of the same story, before the bright thinker makes a giant leap of faith, then perhaps we would already be in a position where technology allowed us to access energy for free, to create light that allows us to learn.
Innovation to deliver eHealth in Ireland requires different thinking. The concept of Research and Development needs to change, we can no longer ‘rip-off and duplicate’ what has been done elsewhere, for many reasons. Lessons learnt in eHealth globally show us that the transferal of technology from healthcare system to healthcare system has often caused so much upheaval that benefits are not released and clinical and patient engagement is made exponentially harder.
The Director General of the Health Service Executive in Ireland made a call to arms in the last week in February 2015. He suggested that health delivery in Ireland is now arriving in the information age. Two examples of that spring to mind, examples that have been delivered in different ways and ahead of any grand delivery model that my office will produce, showing me the will, the capability and the desire is absolutely there.
An electronic patient record (EPR) for Epilepsy has been in place throughout Ireland for more than a year. Delivering an integrated care pathway for patients suffering from a chronic illness that is cared for on a national basis to ensure that the best clinical minds are able to care for patients, offer them assistance in staying well and finding mechanisms to live a normal life with the illness.
What is innovative is the approach taken to the delivery of what has been described by one of the leading clinical advocates as a ‘postmodern’ digital solution. A solution that makes the best of what has gone before so effectively it goes so far as to celebrate it within the delivery and specifciation of the new system.
The epilepsy EPR has been defined by clinicians against the care pathway requirements. It is a digital and mobile solution, and it enables access to the longitudinal record in the settings where care is provided. There is an inherent information governance capability within the system that protects the information within the system for clinical use.
This has been delivered against a local standardised solution set rather than a national governance model and shows the delivery team of eHeath Ireland how innovation can be adopted into clinical settings when it is clear what the benefit will be to patients first and the clinical outcomes and process second without the technology featuring on the list of priority considerations.
The other startling piece of disruptive innovation is an extremely successful eReferral pilot in Cork and Kerry. There isn’t anything that vertically innovative about digitizing the referral process itself, this has been done before in many countries and care settings. The innovation here is the way in which the project team has gone about the delivery, a model we will try to make re-use of throughout the eHealth Ireland implementations.
The team has built the technology in an unobtrusive way, delivering an integrated system into the GP solution through messaging capability. Then the team was able to work with individual clinicians to understand the personal benefit they could achieve from having a digital referral solution in their care setting. Visiting the Mercy hospital in Cork it is very clear to see the data benefits to them and the process change that the delivery of a digital solution has enabled them to undertake, creating an information age referral process throughout the hospital.
The change in attitude to innovation, to allow eHealth Ireland to be built is underway already in this country. We will support this as it develops more and find more and ways to inspire this behaviour change, after all we all want to read at night!