Health policy Digital innovation in the HSE

Health policy
Additionally I'd have bloods taken in Tallaght, go to James only to be stabbed for blood again 2 hours later, why couldn't the results be simply be shared by email, ( was suffering from collapsing veins and arms were black from puncture holes)
I had bloods taken in Mater Private and reported on. Later that day, I was admitted to Mater Public through A&E. They were unable to access my bloods and refused offer from relative to nip around and get a copy stating “different hospital“. Yet doctor in A&E said patients are being transferred from public to private for procedures all the time.
On discharge, several days later, I asked for a copy of the bloods taken that morning but be told they couldn’t give me a copy due to GDPR!
 
Clinicians refer patients to where they believe the patient will get the appropriate treatment quickly and safely, not because a hospital's name appears in a box on a printed organization chart. The difference between an admin's view of health care and a clinician's or patient's perhaps?



I can understand that for many reasons and also for lots of people in Clare, Galway is a shorter journey time. I wonder was that taken into account when closing services in Clare and transferring care to Limerick on the organization chart? Travel distances, time and costs for patients don't feature on the little boxes admins look at.
The hospital groups were set up (given a new name) to try and streamline services. That was a government decision during Reilly time but it had been talked about before that.

A doctor can refer to a specialist AFAIK but for example shouldn't refer, let's say refer an ENT patient to Galway if they are living in Wicklow, they should be referred within the hospital group. I'm talking here about 'routine' stuff, not cutting edge stuff.

Clare was always part of the Mid West but there is a long history in Clare ever since maternity services were taken from Ennis, sometime in the 80s where patients from Ennis saying they would never attend Limerick.

UL hospital is the smallest group population and geographically, so in theory should be the easiest to manage! But I believe they are less beds per person.
 
As in from the patients' angle, which is the only angle that counts if he's to use his box of tricks to improve service levels and outcomes, reduce queues and misery?
I didn't get that from the article tbh. If I was trying to transform an organisation and was encountering friction across the board I might select one or two lighthouse sites where friction is lower, transform them initially and hold them up as bastions of excellence in the hope of leveraging the laggards into line.
 
I didn't get that from the article tbh. If I was trying to transform an organisation and was encountering friction across the board I might select one or two lighthouse sites where friction is lower, transform them initially and hold them up as bastions of excellence in the hope of leveraging the laggards into line.
That's what disappointed me. We can all ooh! and ahh! at the tech, but the only things that matter are measured from a patient's (customer's ) perspective. Administrators focus on efficiency, increasing throughput, or getting more of the same for less cost, patients and clinicians tend to want improved outcomes, or effectiveness.
 
You're correct, tech won't solve any problem (new or existing) unless it is coupled with robust processes that are complied with by People that have the approporate expertise. You need all three at the same time.

I would argue that the speed or efficency of reaching the improved outcome is a critical component of the quality of the outcome itself, particularly in healthcare. A complete & accurate diagnosis after 24 hours is better than after 72 hours.
 
I didn't get that from the article tbh. If I was trying to transform an organisation and was encountering friction across the board I might select one or two lighthouse sites where friction is lower, transform them initially and hold them up as bastions of excellence in the hope of leveraging the laggards into line.

Have to say I fully identified with it. I've never met so much systemic resistance to change as I have working with the public sector. Its a mindset. You get a bit n the private sector, but public sector is on another level.

I've no experience with the HSE. But where I have worked, when you succeed in changing process to automate it, or streamline it. They'll then change the process to break the improvements, or create 3 new process's that are even more long winded and convoluted. Have an approval process that has no purpose other than a check box. But delays everything for no reason. A new one a recently was having to submit a form, to apply for a 2nd form, that was required to submit a request for something.

As a patient, or parent of patients. So many delays due to jobs worth in admin. Once had to wait 6 months to get something faxed between two offices. Didn't happen until I threatened to turn up and deliver it by hand. I've sat in offices and rang the office I'm waiting in, just to see do they pick up. They don't.
 
The missus got a letter from the HSE yesterday advising her that some of her personal info was "illegally accessed and shared" as a consequence of the recent hacking. Hard to see how this could have happened if all of her personal info. had been paper based! ;)

More seriously, I wonder how many thousands of these letters have been issued by the HSE in recent weeks/months.
 
I've sat in offices and rang the office I'm waiting in, just to see do they pick up. They don't.

There was an infamous case a few years ago when a lady rang into the Joe Show complaining about not being able to get onto some phone-in competition without repeated calls to the premium-rate number. As I recall Joe remarked it must have been expensive for her to ring in so many times at premium rates. "Ah no bother", sez yer woman, "sure I'm at work in the Dept of whatever." Despite being roundly criticized for her behaviour, by the time the item ended she saw no problem with her behaviour, skiving off work and wasting her employer's money on phone calls. It seems to be rife.
 
There was an infamous case a few years ago when a lady rang into the Joe Show complaining about not being able to get onto some phone-in competition without repeated calls to the premium-rate number. As I recall Joe remarked it must have been expensive for her to ring in so many times at premium rates. "Ah no bother", sez yer woman, "sure I'm at work in the Dept of whatever." Despite being roundly criticized for her behaviour, by the time the item ended she saw no problem with her behaviour, skiving off work and wasting her employer's money on phone calls. It seems to be rife.

Wasn't there a similar incident involving a prominent, cap-wearing Kerry TD some years ago?

Update: There was indeed: https://www.irishexaminer.com/news/arid-30510879.html
 
Hoping we hear more on the Martin Curley resignation this weekend. As a (relatively recent) HSE admin worker, I joined 2015, I must say I have found an inherent dislike of employees joining from private sector entrenched in the HSE.
This is backed up by unions, they still operate with a 'senior most suitable' mantra in many cases where employees leave at short notice. This gives a situation where employees who have never tried to improve a process or lean towards being more efficient in their entire career given the reins, so to speak, until the leavers successor is in situ. Then that new person will be up against it for sure to turn an entire department around.
In my mind employees with 35 years + service should be 'encouraged' to go. There is still far too much resistance to change & employees biding their time to increase their pension.
 
Hoping we hear more on the Martin Curley resignation this weekend. As a (relatively recent) HSE admin worker, I joined 2015, I must say I have found an inherent dislike of employees joining from private sector entrenched in the HSE.

Well, there was some mention of him during RTE's "It says in the papers" earlier this morning. I was only half-listening, but it appears that he has spilled some more beans/made some interesting allegations about the HSE's incompetence.

In my mind employees with 35 years + service should be 'encouraged' to go. There is still far too much resistance to change & employees biding their time to increase their pension.

And would you include hospital consultants and senior nurses in that sweeping statement?
(Have you ever heard of ageism? - bear in mind that, some day soon, you too may be regarded as an old 'stick in the mud' by your younger, more dynamic, colleagues!)
 
I certainly have heard of ageism & I think this needs to be balanced with 20/30 somethings coming through with massive mortgages/expenses but all with new ideas, innovations etc.I think this is part of a broader societal conversation we need to have. Believe me you are kidding yourself if you think a nurse with 35 years service is working the wards! If still there at that stage, they are walking round with clipboards.
 
As a country, we strive for the best outcomes for patients, which is the reason and the only reason the HSE exists. Either it can do its job or it cannot.

With respect @Groucho, if certain people in the HSE or indeed in the Government, cannot get beyond something as fundamental as the inefficiency of paper systems, then they cannot understand anything of the 21st century - healthcare or otherwise. I say this as a 70-year-old.

If the set-up of electronic medical records is impeded, then so would the set up of necessary security systems.

Healthcare cannot afford to stand still. Emerging innovations, which considerably improve patient outcomes, reduce economic costs and bring services to patients rather than patients to services cannot be ignored or resisted by random individuals or coteries, regardless of who they are. They are not entitled to set what amounts to their own anarchic policies and procedures.

We need better vision from the politicians, the Health Department and the HSE.

It has already been said that this is a small country. Why make it smaller by creating autonomous hospital or regional hospital groups?

Where does primary care dovetail? Primary care is probably at its worst since the foundation of The State.

Payroll, procurement, recruitment and IT, should certainly be centralized.

Every healthcare service should feed into research and knowledge – hospitals don’t know or experience everything.

Reporting systems need to be timely, intelligible and comprehensive in order to set appropriate budgets and facilitate better forecasting.
 
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I certainly have heard of ageism & I think this needs to be balanced with 20/30 somethings coming through with massive mortgages/expenses but all with new ideas, innovations etc.I think this is part of a broader societal conversation we need to have. Believe me you are kidding yourself if you think a nurse with 35 years service is working the wards! If still there at that stage, they are walking round with clipboards.

In my experience nurses of all types are far less on the wards since it became a degree. They are IMO less hands on than in the past.

I don't think it's only 20-30s that have ideas. That's just ageism.

I don't know what personal financial situation has to do with it. Should there be a means assessment for promotions? Cost of living and housing crisis is a different issue. You need to lobby the govt for action. Not saw the branch you're standing on by destroying any promotions opportunity past 40.
 
Hoping we hear more on the Martin Curley resignation this weekend. As a (relatively recent) HSE admin worker, I joined 2015, I must say I have found an inherent dislike of employees joining from private sector entrenched in the HSE.
This is backed up by unions, they still operate with a 'senior most suitable' mantra in many cases where employees leave at short notice. This gives a situation where employees who have never tried to improve a process or lean towards being more efficient in their entire career given the reins, so to speak, until the leavers successor is in situ. Then that new person will be up against it for sure to turn an entire department around.
In my mind employees with 35 years + service should be 'encouraged' to go. There is still far too much resistance to change & employees biding their time to increase their pension.

There is an element of time served in public sector. If only the new people got promoted then there would be no long term progression.

What they don't seem to do is measure how long things take and why. Especially when it comes to admin.

These things can be counterintuitive. Someone might need slow unless overseen by a manager. But perhaps they are always waiting on the manager to approve things. When the manager is overseeing the employee they get instant approvals done. It's the manager who's is the roadblock.
 
What they don't seem to do is measure how long things take and why.
Like Vincent's taking 4 full days from the time an appointment letter is printed to getting it postmarked and to the post office. Or like last week I made 16 calls to Vincent's switchboard number, 2 of them were answered, the other 14 calls just rang off. Based on my little sample 87.5% of calls to Vincent's switchboard fail. I asked to be transferred to the General Manager's office on one of those calls, and was transferred to a Nurse Manager instead. What digital innovations could rectify problems like those?
 
Neither can this

“The hospital (Our Lady of Lourdes Hospital, Drogheda) has been dealing with an ambulance bypass protocol which has seen critically ill and unstable patients from Meath bypassing Navan Hospital and being brought to Drogheda.

Meath TD Peadar Tóibín claimed that some patients from Meath were being brought by ambulance to Drogheda to be triaged and then sent back to Navan A&E for treatment by ambulance or by taxi.

“If they are being brought by taxi a medical professional has to accompany them and then that medical professional is travelling back to Drogheda by taxi.

“What should be a single patient journey to A&E now takes three individual journeys.”

"If you were to design the most inefficient and wasteful pathways for a patient to get to an A&E this would be it.”

HSE takes decisions to close ED departments before building capacity in the other EDs. That’s irresponsible and disrespectful and dangerous for patients on trollies, chairs and sometimes on floors for unacceptable periods.

No one is suggesting that digitising services will mask atrocious decision making. But this thread is about digital innovation.
 
Like Vincent's taking 4 full days from the time an appointment letter is printed to getting it postmarked and to the post office. Or like last week I made 16 calls to Vincent's switchboard number, 2 of them were answered, the other 14 calls just rang off. Based on my little sample 87.5% of calls to Vincent's switchboard fail. I asked to be transferred to the General Manager's office on one of those calls, and was transferred to a Nurse Manager instead. What digital innovations could rectify problems like those?

There are automatic call answering systems that capture calls without human intervention.

They should also be logging missed calls.
 
They should also be logging missed calls.
There's a heap of stuff they should be doing, would be doing or could be doing if they'd organize themselves and "someone" in there showed some initiative and leadership.

38 years ago next summer I started work for a company that had all the facilities you'd expect from a modern company with integrated telephony and data systems. We were a manufacturing/assembly site, but customers using our products, like British Telecom, our own Deepartmint of Gateposts and Telegraph-poles and many other similar organisations Europe wide visited us to see our tightly integrated hardware, software, and service products in action.
 
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