Health delivery and academia combine forces

Assistive technology and smart home technology are important subjects for healthcare delivery and academia in Northern Ireland.

They are just one area among the many current projects and initiatives described below by Paul McCullagh of the University of Ulster and Paul Comac of the HSC ICT Training Group.

As in other parts of the UK, the area of ICT in healthcare delivery is undergoing significant change in Northern Ireland.

On 9 March 2005, the Minister for Health, Social Services and Public Safety Angela Smith launched a 10-year development programme, backed by an additional investment of at least £95 million, with the intention of delivering new systems and technology across the Health & Social Care Service (HSC):

The programme's aims, which mirror other regions of the UK, include:

  • new computer systems to link GPs to hospitals;
  • electronic health care records, appointment details and up-to-date information to be available when and where it is needed and with more emphasis on quality healthcare;
  • patients to have more information about the care being planned for them and that patients should not have to wait as long for appointments, tests, diagnosis or other treatment.

Projects include GP ICT connecting all GP surgeries to the HSC network for secure internet access, email and the roll out of electronic transfer of pathology results from laboratory systems to all practices.

A second project is the Health and Care Number, replacing numerous hospital numbers with a new unique patient identifier. Electronic registration at GP surgeries, GP systems, PAS systems will all utilise this number.

Thirdly, the Person Centred Community Information System (PCIS) aims to establish a single integrated community health and social care record for all patients and clients in respect of community based services. In4tek's PARIS system is the preferred option based on experience gleaned by the South East Belfast Trust.

An Electronic Prescribing and Eligibility System (EPES) will also be developed, installed and supported. The contract, worth £6.8 million over five years (awarded to Hewlett-Packard) will involve all community pharmacists within 24 months.

A 2-d bar code on GP prescriptions containing all of the information on the prescription will then be read in to pharmacy systems, and information will then be transferred electronically to the Central Services Agency for checking and payment purposes.

The project will reduce error, provide greater efficiency, reduce fraud and provide accurate prescribing rate statistics.

A GP Payments Calculation and Analysis System (PCAS) was implemented in March 2005. Disease prevalence statistics were calculated by using data provided from each GP system and the PCAS system was used to calculate the number of quality points due to each GP practice under the new contract.

A cervical screening system (using the Exeter System) for the purposes of call and recall was introduced, with the aim of electronic transfer of cervical screening data to practices. Phase two will replace the Cellular pathology systems with a standard system already operating in the Belfast Link Laboratories and will deliver a complete, integrated, regional cellular pathology record.

An electronic Referral Management System (ERMS) aims to reform outpatient services and is designed to reduce waiting times for treatment.

In addition to the upgraded ICT infrastructure, there has been major organisational restructuring as a result of a Review of Public Administration Review of Public Administration resulting in one Regional Health and Social Services Authority to manage performance; seven primary care-led commissioning groups; five health trusts (instead of the previous 18) providing the services.

Health informatics interests are coordinated through BCS Health Informatics Forum. There are also strong links with Healthcare Informatics Society of Ireland Healthcare Informatics Society of Ireland, with many research papers presented at this forum.

A number of high-profile international research and knowledge transfer meetings with a health informatics theme have been organised in the last few years including: European Society for Engineering and Medicine (Belfast, May 2001), third European Workshop on Personalised Health, (Belfast Dec 04) third European Workshop on Personalised Health, (Belfast Dec 04),  International Conference on Smart Homes Technology (Belfast, June 06).

In December 2004, The Ulster Institute of eHealth (UIeH) was launched. This is a forum to promote collaboration between academics at the University of Ulster and professions allied to health at Ulster Community & Hospitals Trust (now South Eastern Trust).

The UIeH website provides information to the citizen to promote breastfeeding, manage stroke, to provide information on treatments associated with pain, and for the better control of type 2 diabetes.

The Queen's University Belfast hosts a healthcare informatics research group. Research topics include: digital microscopy and machine vision in cancer diagnosis and prognosis; signal processing and compression in medical imaging; surgical informatics; information and communications technology in primary care; decision support systems in clinical decision making; telemedicine.

The HSC ICT Training Group provides a seminar programme for dissemination of important health informatics advances to the local sector by local, national and international speakers.

Areas of interest include: telemedicine, and store and forward referrals; ICT in health and social care; hospital information systems; general practitioner systems; assistive technology, home monitoring and smart homes; chronic health management for conditions such as diabetes and coronary heart disease; data mining and decision support; eHealth and information to the patient; nursing informatics; health informatics education.

The seminar programme provides synchronous video-conferencing to outlying hospitals, and provides a link between academia and practice. Dr Victor Patterson, a consultant neurologist at the Royal Victoria Hospital and co-editor of 'Introduction to Telemedicine (second edition)' [Richard Wootton, John Craig, Victor Patterson (eds), Introduction to Telemedicine (second edition). RSM press, April 2006], routinely performs teleneurology as part of his clinical practice.

An area which is important to healthcare delivery and academia is the introduction of assistive technology and smart home technology. University of Ulster in collaboration with Dundalk’s Institute of Technology have contributed to the design of a 12-unit housing pilot in Dundalk, to be ready for occupation in 2007.

The 'Nestling' project was so-named to convey the concept of having technology unobtrusively 'nestled' into the homes and devices - even the fabrics that people wear.

The South Eastern Trust has commissioned smart home technology from Tunstall Ltd to provide support for chronic patients and has teamed up with Nestling to provide cross border collaboration in this area.
The University of Ulster has been awarded funding of over £250,000 to carry out multi-disciplinary research in a new European funded project called CogKnow. The project is focused on helping to address some of the problems faced by ageing people with early signs of mild dementia.

The three-year project involves 11 partners with a range of scientific and medical expertise from across Europe, including organisations from Estonia, Malta, Scandinavia, Spain, France and Netherlands. The project is aimed at helping people to remember, maintain social contact, perform daily life activities and enhance their feelings of safety.

The objective is to research and prototype a portable, easily configurable, device that is available to those people with memory lapses and other symptoms of dementia and associated disorders.

A further project, Di@l-log, allows doctors to monitor and track diabetes patients from home using intelligent spoken dialogue technologies which can relay patient data directly to the clinic through telephone conversations. This is about to proceed to a clinical trail.