Up to €1 Billion in extra payments to State Employees

[time to plan]

My wife works in one of the 'voluntary' hospitals. The stories of waste I hear would make your blood boil! I can't imagine the HSE could do much worse!

You have no idea.

 

[time to plan]

Does this mean when a hospital joins this system it records a procedure for patients prospectively - i.e. the hospital doesn't digitise its archives but simply records all new procedures from a given date?

They are different approaches taken. Galway University Hospitals is scanning and indexing historic paper records but it’s an expensive business to do on top of implementing Electronic Health Record solutions. However, there is no need to scan the entire archive as most patients with records will never be seen again. A scan on demand system means that you just scan the records of patients scheduled to be admitted or with an appointment. There is the. The challenge of dealing with ED attendances. But it’s still very expensive.

It is more common to start with a relatively clean slate, taking a view as to what electronic data can / should be migrated - appointments, attendances, diagnostic results and reports etc. It leads to a mixed process where existing patients have their paper records pulled for a time and if they are long term patients, a summary can be created on the new electronic system. - e.g allergies, active and historic diagnoses, historic procedures.

Eventually the need for historic paper records diminishes.

It’s painful but probably the only economically viable approach to getting off paper.

 

[time to plan]

IT systems have the annoying requirement that they need to be based in logic. In order for any system like this, or PPARS or anything else to work the underlying system needs to be reformed and standardised. The scope for saving, and the resultant freeing up of resources to improve services and working conditions, is colossal. Unfortunately the vested interests within the industry have too much power to frustrate change.

In order to merge IT systems HR systems and functions should be integrated first.
In order to integrate data entry a standard procedure for entering that data has to be introduced first.

Given the movement of Amazon, Apple, Google and Microsoft into the healthcare space I expect them to have offerings for healthcare systems in the medium term. I'm surprised that GE, Siemens or even smaller players like Draeger haven't developed an offering yet, given their relative dominance in the diagnostics and patient monitoring sector.

The last time I was in an A&E I did wonder why they couldn't give each patient a silicones bracelet with an RFID tag imbedded in it rather than a printed bracelet with a bar code. The RFID tag could hold their current records and track their location within the hospital. It's 30 year old technology and it's dirt cheap.

Cerner bought Siemens Healthcare.

RFID is interesting. You wouldn’t use it to hold patient records but their identity from which records can be accessed but you still need electronic records.

There is a startup in Limerick called Pinpoint Medical who do something similar with WiFi (triangulation? I don’t really remember)

Where RFID is used in healthcare is in tracking the location of paper notes, which can be a real problem.

 

[time to plan]

Indeed, that's how it can look when obvious problems are pointed out to the institutionalised.

None taken. This is an internet discussion forum where strangers talk. If people get offended here they need to take a hard look at themselves.

It certainly does, as do management practices and structures from the latter part of the 20th century (let's not be too ambitious).

The excuse used the world over by the inept and intransigent to justify their ineptitude and intransigence.
Nearly all organisational problems are really a collection of small simple problems. The 'more complex' problems are nearly always just a larger collection of small problems.
The problems does indeed start with culture and the culture of victimhood amongst healthcare employees is both tiresome and unjustified. The reason their job is hard, in the minority of cases when their job is actually hard, is their own fault. They are the HSE. It's up to them collectively to fix things.

You are still naive. The complexity of healthcare stems to a large extent from it being a low volume high variation sector. There’s always a stream of consultant types trying to apply fixes from manufacturing, airlines etc. They always screw it up in my experience.

Having said that, the Irish health system is a particularly poor specimen.

 

[time to plan]

SJH is a voluntary hospital like the Mater, St Vincent's, Rotunda, etc. They are usually "owned" by trusts/charities/religious orders and the HSE pays them to provide services. They retain a lot of control over their operations, e.g. they may have their own IT dept. It is effectively outsourcing. Similar to the way most schools run. Here's a list of the voluntaries: https://foi.gov.ie/voluntary-hospitals/

Hospitals like Connolly, Cavan, Sligo, Tullamore, etc. are statutory hospitals, i.e. owned and run by the HSE. They tend to be more centralised in their operations, e.g. IT is run centrally/regionally.

This difference is the reason that HSE hospitals were worse hit by the cyber attack than many voluntaries.

That is almost correct. While they are very commonly called voluntaries, I believe St James’s and Beaumont are statutory, but not HSE, and that their Boards are appointed by the Minister of Health. Section 38 agencies is the correct term but that is a bit picky.

I think they are funded by the Department of Health rather than the HSE but I could well have that wrong.

 

[time to plan]

I may have taken this thread off track enough. Will leave it now.

 

[time to plan]

I tell a lie. One last thing, to illustrate the cultural problems. And I’m not union bashing - as it happens I am pro unions, but this was really shocking and I can’t imagine it happening in a similarly unionised health system (e.g NHS) where the fundamental culture is one of public service.

HSE accuses union of undermining Covid-19 strategies

The HSE has accused the Fórsa trade union of undermining strategies to tackle the Covid-19 virus and potentially putting patients at risk by refusing to cooperate with certain technology in a row over staffing.

www.rte.ie

 

[Purple]

Cerner bought Siemens Healthcare.

You better tell Siemens Healthcare that. They think they are now called Siemens Healthineers and employ 66,000 people with manufacturing plants in Ireland, the USA, Germany, the UK and many other countries.

RFID is interesting. You wouldn’t use it to hold patient records but their identity from which records can be accessed but you still need electronic records.

Yes, just like a bar code. The ability to track the patient location is the bonus, along with the contactless nature of an RFID tag.

 

[Purple]

You are still naive. The complexity of healthcare stems to a large extent from it being a low volume high variation sector. There’s always a stream of consultant types trying to apply fixes from manufacturing, airlines etc. They always screw it up in my experience.

Having said that, the Irish health system is a particularly poor specimen.

The level of variation at the structural side is far greater than necessary due to the structural and personal incompetence of the organisation and those running it.

 

[Purple]

I tell a lie. One last thing, to illustrate the cultural problems. And I’m not union bashing - as it happens I am pro unions, but this was really shocking and I can’t imagine it happening in a similarly unionised health system (e.g NHS) where the fundamental culture is one of public service.

HSE accuses union of undermining Covid-19 strategies

The HSE has accused the Fórsa trade union of undermining strategies to tackle the Covid-19 virus and potentially putting patients at risk by refusing to cooperate with certain technology in a row over staffing.

www.rte.ie

Yes, one of the many vested interests at play.

 

[Leo]

You have no idea.

Examples?

 

[Purple]

@Leo noted the stories of waste within one hospital to which @time to plan replied "You have no idea.".
@time to plan mentioned earlier that;

There’s always a stream of consultant types trying to apply fixes from manufacturing, airlines etc. They always screw it up in my experience.

Is it too much to ask that one of the best funded healthcare systems in the world, employing well over 100,000 people, or more than one in twenty people who works in this country, could manage to make some fist of fixing things themselves? If the people who work in the HSE (the people who actually are the HSE) spent 10% of the energy they currently spend whinging and moaning on actually making things better it would probably go a long way to improving things.

 

[RetirementPlan]

You are still naive. The complexity of healthcare stems to a large extent from it being a low volume high variation sector. There’s always a stream of consultant types trying to apply fixes from manufacturing, airlines etc. They always screw it up in my experience.

Having said that, the Irish health system is a particularly poor specimen.

I tell a lie. One last thing, to illustrate the cultural problems. And I’m not union bashing - as it happens I am pro unions, but this was really shocking and I can’t imagine it happening in a similarly unionised health system (e.g NHS) where the fundamental culture is one of public service.

HSE accuses union of undermining Covid-19 strategies

The HSE has accused the Fórsa trade union of undermining strategies to tackle the Covid-19 virus and potentially putting patients at risk by refusing to cooperate with certain technology in a row over staffing.

www.rte.ie

In fairness, the issue being raised by the union in this case is the over-reliance on the external consultants, the ones who always screw it up, as you noted yourself.

 

[PMU]

In fairness, the issue being raised by the union in this case is the over-reliance on the external consultants, the ones who always screw it up, as you noted yourself.

The RTE report https://www.rte.ie/news/2020/0518/1139188-hse-union-row/ makes it clear that "The dispute centres on union concerns about the HSE's use of agency personnel and contractors in the HSE,.....to deliver ICT services, rather than using direct staff employees already on recruitment panels". So it's not about external consultants, (i.e. those who provide intellectual and other services not normally available in-house), but hiring contractors (i.e. those who implement systems) when in-house promotion panels already exist. Any trade union worth its salt would defend its members interests in this case.

 

[becky]

That is almost correct. While they are very commonly called voluntaries, I believe St James’s and Beaumont are statutory, but not HSE, and that their Boards are appointed by the Minister of Health. Section 38 agencies is the correct term but that is a bit picky.

I think they are funded by the Department of Health rather than the HSE but I could well have that wrong.

All the voluntary hospitals (the vols as they are known) get their funding (and they don't like it one bit) from HSE but retain their own boards.

 

[Purple]

All the voluntary hospitals (the vols as they are known) get their funding (and they don't like it one bit) from HSE but retain their own boards.

He who pays the piper calls the tune. The problem seems to be the ability of the musician to read music.

 

[Marsupial]

I was hoping that the poster who claimed that GDPR helped criminals and fraudsters might explain the basis for that claim.

Sorry old boy, I've been away in the Algarve for the past few days so completely missed your plaintive cry for assistance. (Incidentally, I appreciate your strict observance of the GDPR protocols in not quoting my moniker in the above response; very correct and appropriate of you! )

I find it difficult to believe that someone would genuinely be unaware of the role of GDPR in preventing criminal investigations and in facilitating the carrying out of fraudulent actions. But then perhaps you were trying to wind me up? But if you genuinely want to see how GDPR can assist fraudsters then I refer you to the Flynn/Clarke case in Cork Circuit Court earlier this year.

 

[RetirementPlan]

Flynn/Clarke case in Cork

I'm vaguely aware of the case. From what I can see, the entire fraud and the vast majority of the investigation predates GDPR. The Garda raided them in June 2018, having been investigating since 2016. GDPR came into law in May 2018.
https://www.irishexaminer.com/news/courtandcrime/arid-40231541.html

Police entered the Altus apartment, with a warrant, on June 26, 2018, and

So what specifically is the GDPR issue here?