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The potential for innovative collaboration
  between the HSE and ICT Suppliers




                          Potential for collaborative initiatives   1
The potential for innovative collaboration
  between the HSE and ICT Suppliers
   Our Objectives
   Current State
   Challenges
   New Environment
   New Ways of Business
   How do we engage
   Next Steps


                           Potential for collaborative initiatives   2
Our Objectives
To respond to government policy initiatives and in
the context of the current state of resourcing and
delivery of ICT within the health system, explore
the potentialities of establishing a process which
will:
     Engage with Industry to identify, assess and
      implement innovative collaborative opportunities to
      support the greater utilisation of ICT
     Underpin the importance of ICT in the successful
      delivery of a high performing health system


                                      Potential for collaborative initiatives   3
ICT Strategy Work Streams

   Implement strategic       •Major business development programmes, requiring oversight
                              at national management level.
    national business
        initiatives

                             •A range of initiatives.
 Support regional/ local     •100+ currently being processed
      initiatives

                             •Establish the framework that will specify the standards for
Develop the information       healthcare applications and provide facilities to enable these
                              applications to work together.
  framework for EHR

                             •Improve, extend and strengthen the communications network.
                              Consolidate the infrastructure. Provide quality services to
Improve ICT infrastructure    staff. Implement national information security standards.




                             •Enhance human resource capacity. Conduct skills audit.
                              Implement development programme and for ICT staff and for
 Strengthen ICT capacity      non-ICT staff.




                                                                 Potential for collaborative initiatives
Current Status - Overview
   ICT within the HSE accounts for 0.085% of
    total expenditure.
   2012 Total ICT expenditure is €116 million
       Revenue    €74.43m (excluding €19.7m phones)
       Salaries   €22.50m
       Capital    €25.00m (Current Spend Est.)
   Staffing 400 (280 HSE and 120 Voluntaries)
   Supporting 100,000 Staff, 50,000 devices,
    2500+ systems across a wide spectrum


                                  Potential for collaborative initiatives   5
Current Status Revenue

Revenue Expenditure
     Software Maintenance              €25.3 Million
     Hardware Maintenance              € 9.2 Million
     Telecoms Maintenance              € 2.7 Million
     Replacements Hardware             € 5.8 Million
     Replacements Software             € 2.2 Million
     External Services                 € 9.1 Million
          Hosting, Consultancy, Contractors, External Service
           providers




                                            Potential for collaborative initiatives   6
Current Status Capital Plan
Project Type                                     No. of Projects      Investment

Hospital Clinical                                      36             €11,213,675

ICT Technical Infrastructure                           22              €8,431,869

Core Hospital - iSoft (PAS)                             6              €8,138,013

Pre Hospital Emergency Care                             6              €4,570,624

Corporate Systems                                      12              €1,707,080

Community Clinical                                     11              1,259,130

New Building/ Refurbishment - Fit Out                   1               950,000

Core Hospital - iSoft (Order Comms)                     1              €550,000

Minor/ Miscellaneous Capital Projects                  97              €3,121,963

Totals                                                192            €39,942,355




                                                Potential for collaborative initiatives   7
Current Status Capital Projects April 2012

              Type              # Projects   Lifetime Capital      2012 Sanction
                                                                      Amount
Part 1 (non minor)                 26           €11.44m                €4.6m
Part 1 (minor)                     24            €1.42m                €1.42m
Part 2 (carryover projects)       148*          €99.88m               €20.34m
Total 2012 sanction to date                                           €26.36m

Part 1 (non minor) – Awaiting       6            €5.94m                €3.78m
Approval
Part 1 (minor) – Awaiting          14                                  €668k
Approval
Grand Total                       218#          €105.82m              €30.14m



* Within the (148) Part 2 sanctioned items, 88 are minors and 60 are NON minors.
# Within the total of 218 sanctioned items, 126 are minors and 92 are NON minors.




                                                        Potential for collaborative initiatives   8
Capital Projects 2012 Work Plan
   NIMIS
       Continue rollout – go-live at 11 further sites
   IPMS
       Continue PAS deployments in Dublin Mats & Paeds, South East (Midland, RVEEH,
        NRH)
       Order Comms commencement to support NIMIS
   Endoscopy
       Complete Phase 1, Contract for Phase 2 & commence deployments
   RIMD Track & Trace
       Complete Phase 1, Contract for Phase 2 & commence deployments
   MedLIS
       Procurement underway
   Kidney Disease Clinical Patient Mgt
       Implement 5 remaining Phase 1 sites
       Commence Dublin sites & contracted HD centres
   Maternal & Newborn Clinical Mgt
       Place contract and commence deployments
                                                         Potential for collaborative initiatives   9
Capital Projects 2012 Work Plan
   ICU CIS
       Complete the deployment in Sligo - Continue the deployment in CUH
   Emergency Dept CIS
       Undertake procurement and commence deployment
   National Environmental Health Information System
       Complete the rollout
   Civil Registration Online Appointment Bookings
       Complete deployment
   Counselling Service
       Complete the rollout
   National Child Care Information System
       Complete procurement and commence deployment
   National Dental System
       Complete the NW Upgrade - Continue rollout to other new sites
   Ambulance Service Computer-Aided Dispatch
       Complete procurement and commence deployment
                                                      Potential for collaborative initiatives 10
Capital Work Plan 2012

   All projects supported by:
   Infrastructure programme
          IAAS Programme
          SAN’s Programme
          NHN1 and NHN 2 Programme (Networks and IP)
          AD project
   Applications Support
          Vendor Management
          Applications Self Registration Database

   Planning
          ICT and Business Systems Planning


                                                     Potential for collaborative initiatives 11
New Environment
   Programme for Government 2011
        Reorganisation - Health System governance, administration
          and delivery
        Innovation and Commercialisation
        Research & Innovation
   Report of the Research Prioritisation Steering Group
    November 2011
        Priority Area A - Future Networks & Communications
        Priority Area B - Data Analytics, Management, Security & Privacy
        Priority Area C - Digital Platforms, Content & Applications
        Priority Area D - Connected Health and Independent Living
        Priority Area N - Innovation in Services and Business Processes
   Action Plan for Jobs 2012
        Relevant principal areas:
             1. Building competitive advantage – Innovation, Costs, Skills & Infrastructure
             3. Assisting indigenous business to grow
             7. Exploiting sect oral opportunities, including:
                  •   Health/Life sciences
                  •   ICT Hardware and Software
                  •   Business Process Outsourcing/Shared Services
                  •   Cloud computing
                                                               Potential for collaborative initiatives 12
Implications of new Environment
   Target key technology areas and sectors where innovation can
    be applied
   Reform public procurement to become a tool to support
    innovative Irish firms
   Reduce the cost of Government imposed red-tape on business
   Focus on enabling both the manufacturing and service
    sectors to innovate their service offering, service
    delivery and business processes
   Need for innovation around new business models
   Restructuring/re-organisation of the entire health system


                                         Potential for collaborative initiatives 13
Collaboration
“Collaborate, collaborate, collaborate: In the
case of an electronic health records system, no
single group (buyers, providers, users) alone
can carry through a successful implementation.
Concerted effort is the only way to ensure a
successful scenario where all parties gain
something”

- European Commission, DG Information Society



                                 Potential for collaborative initiatives 14
Realities of Current Environment
   ICT Staffing – 400 Staff
       Range and quantity of skill sets within HSE
       Change focus to project delivery
   Financial Resources – less than 1% of expenditure
   Idea to Project Start Timeframe
       Small projects with Frameworks 2 Months
       Small Projects without Frameworks 8 – 10 Months
       Large Projects > €5M 2 Years
   Government Policies & Procedures
       As a public body we must procure services and goods via the
        public procurement process



                                             Potential for collaborative initiatives 15
Challenges – Health System
   Health system re-organisation
   Business/Service engagement/ownership given
    the pressures
   Releasing of Business Resources for projects
   Expectations of Service Users
   Scale and Complexity of projects
   Project Fatigue
   Continuously emerging “non Project” initiatives
    (OPD, SDU etc.)

                                 Potential for collaborative initiatives 16
Challenges – Industry
   Health system re-organisation
   Engagement with the System
   Availability of Funding
   Lack of investment
   Procurement Process
   Maintaining a Competitive advantage
   Co-operative working arrangements



                               Potential for collaborative initiatives 17
New Models for Business Engagement
   Vendor Financing             Software as a Service

   Innovation – strategies      Open Source Software

   Supplier partnerships        Cloud Computing

   Smart procurement            Interoperability

   Research projects            Agile methods



                                        Potential for collaborative initiatives 18
Examples of new ways of Engagement
   Streamlined and standardised internal procedures &
    processes
   Professional and Technical Services framework
   Outsource a Service (including the ICT element)
       Home Help service
       Audiology
   Shared Service
       Renal
   Software as a service
       SAT
       Clinic booking/scheduling for bird flu vaccination
   Development through research and innovation
       Health Intelligence
       Framework for ICT services
                                                   Potential for collaborative initiatives 19
How do we Engage
   Engagement needs to be at industry level
   Establish an organisational/relationship (governance?)
    framework for collaborative initiatives
   Initiate a process of wider consultation with all
    stakeholders to:
      Identify new and/or innovative business models
      Assess their potential and viability
      Identify the opportunities for their utilisation
   Agree the procedures and processes to assess and
    manage proposed initiatives


                                      Potential for collaborative initiatives 20
Questions & Discussion




               Potential for collaborative initiatives 21

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Gerard Hurl - Industry Presentation 26-04-12

  • 1. The potential for innovative collaboration between the HSE and ICT Suppliers Potential for collaborative initiatives 1
  • 2. The potential for innovative collaboration between the HSE and ICT Suppliers  Our Objectives  Current State  Challenges  New Environment  New Ways of Business  How do we engage  Next Steps Potential for collaborative initiatives 2
  • 3. Our Objectives To respond to government policy initiatives and in the context of the current state of resourcing and delivery of ICT within the health system, explore the potentialities of establishing a process which will:  Engage with Industry to identify, assess and implement innovative collaborative opportunities to support the greater utilisation of ICT  Underpin the importance of ICT in the successful delivery of a high performing health system Potential for collaborative initiatives 3
  • 4. ICT Strategy Work Streams Implement strategic •Major business development programmes, requiring oversight at national management level. national business initiatives •A range of initiatives. Support regional/ local •100+ currently being processed initiatives •Establish the framework that will specify the standards for Develop the information healthcare applications and provide facilities to enable these applications to work together. framework for EHR •Improve, extend and strengthen the communications network. Consolidate the infrastructure. Provide quality services to Improve ICT infrastructure staff. Implement national information security standards. •Enhance human resource capacity. Conduct skills audit. Implement development programme and for ICT staff and for Strengthen ICT capacity non-ICT staff. Potential for collaborative initiatives
  • 5. Current Status - Overview  ICT within the HSE accounts for 0.085% of total expenditure.  2012 Total ICT expenditure is €116 million  Revenue €74.43m (excluding €19.7m phones)  Salaries €22.50m  Capital €25.00m (Current Spend Est.)  Staffing 400 (280 HSE and 120 Voluntaries)  Supporting 100,000 Staff, 50,000 devices, 2500+ systems across a wide spectrum Potential for collaborative initiatives 5
  • 6. Current Status Revenue Revenue Expenditure  Software Maintenance €25.3 Million  Hardware Maintenance € 9.2 Million  Telecoms Maintenance € 2.7 Million  Replacements Hardware € 5.8 Million  Replacements Software € 2.2 Million  External Services € 9.1 Million  Hosting, Consultancy, Contractors, External Service providers Potential for collaborative initiatives 6
  • 7. Current Status Capital Plan Project Type No. of Projects Investment Hospital Clinical 36 €11,213,675 ICT Technical Infrastructure 22 €8,431,869 Core Hospital - iSoft (PAS) 6 €8,138,013 Pre Hospital Emergency Care 6 €4,570,624 Corporate Systems 12 €1,707,080 Community Clinical 11 1,259,130 New Building/ Refurbishment - Fit Out 1 950,000 Core Hospital - iSoft (Order Comms) 1 €550,000 Minor/ Miscellaneous Capital Projects 97 €3,121,963 Totals 192 €39,942,355 Potential for collaborative initiatives 7
  • 8. Current Status Capital Projects April 2012 Type # Projects Lifetime Capital 2012 Sanction Amount Part 1 (non minor) 26 €11.44m €4.6m Part 1 (minor) 24 €1.42m €1.42m Part 2 (carryover projects) 148* €99.88m €20.34m Total 2012 sanction to date €26.36m Part 1 (non minor) – Awaiting 6 €5.94m €3.78m Approval Part 1 (minor) – Awaiting 14 €668k Approval Grand Total 218# €105.82m €30.14m * Within the (148) Part 2 sanctioned items, 88 are minors and 60 are NON minors. # Within the total of 218 sanctioned items, 126 are minors and 92 are NON minors. Potential for collaborative initiatives 8
  • 9. Capital Projects 2012 Work Plan  NIMIS  Continue rollout – go-live at 11 further sites  IPMS  Continue PAS deployments in Dublin Mats & Paeds, South East (Midland, RVEEH, NRH)  Order Comms commencement to support NIMIS  Endoscopy  Complete Phase 1, Contract for Phase 2 & commence deployments  RIMD Track & Trace  Complete Phase 1, Contract for Phase 2 & commence deployments  MedLIS  Procurement underway  Kidney Disease Clinical Patient Mgt  Implement 5 remaining Phase 1 sites  Commence Dublin sites & contracted HD centres  Maternal & Newborn Clinical Mgt  Place contract and commence deployments Potential for collaborative initiatives 9
  • 10. Capital Projects 2012 Work Plan  ICU CIS  Complete the deployment in Sligo - Continue the deployment in CUH  Emergency Dept CIS  Undertake procurement and commence deployment  National Environmental Health Information System  Complete the rollout  Civil Registration Online Appointment Bookings  Complete deployment  Counselling Service  Complete the rollout  National Child Care Information System  Complete procurement and commence deployment  National Dental System  Complete the NW Upgrade - Continue rollout to other new sites  Ambulance Service Computer-Aided Dispatch  Complete procurement and commence deployment Potential for collaborative initiatives 10
  • 11. Capital Work Plan 2012  All projects supported by:  Infrastructure programme  IAAS Programme  SAN’s Programme  NHN1 and NHN 2 Programme (Networks and IP)  AD project  Applications Support  Vendor Management  Applications Self Registration Database  Planning  ICT and Business Systems Planning Potential for collaborative initiatives 11
  • 12. New Environment  Programme for Government 2011  Reorganisation - Health System governance, administration and delivery  Innovation and Commercialisation  Research & Innovation  Report of the Research Prioritisation Steering Group November 2011  Priority Area A - Future Networks & Communications  Priority Area B - Data Analytics, Management, Security & Privacy  Priority Area C - Digital Platforms, Content & Applications  Priority Area D - Connected Health and Independent Living  Priority Area N - Innovation in Services and Business Processes  Action Plan for Jobs 2012  Relevant principal areas: 1. Building competitive advantage – Innovation, Costs, Skills & Infrastructure 3. Assisting indigenous business to grow 7. Exploiting sect oral opportunities, including: • Health/Life sciences • ICT Hardware and Software • Business Process Outsourcing/Shared Services • Cloud computing Potential for collaborative initiatives 12
  • 13. Implications of new Environment  Target key technology areas and sectors where innovation can be applied  Reform public procurement to become a tool to support innovative Irish firms  Reduce the cost of Government imposed red-tape on business  Focus on enabling both the manufacturing and service sectors to innovate their service offering, service delivery and business processes  Need for innovation around new business models  Restructuring/re-organisation of the entire health system Potential for collaborative initiatives 13
  • 14. Collaboration “Collaborate, collaborate, collaborate: In the case of an electronic health records system, no single group (buyers, providers, users) alone can carry through a successful implementation. Concerted effort is the only way to ensure a successful scenario where all parties gain something” - European Commission, DG Information Society Potential for collaborative initiatives 14
  • 15. Realities of Current Environment  ICT Staffing – 400 Staff  Range and quantity of skill sets within HSE  Change focus to project delivery  Financial Resources – less than 1% of expenditure  Idea to Project Start Timeframe  Small projects with Frameworks 2 Months  Small Projects without Frameworks 8 – 10 Months  Large Projects > €5M 2 Years  Government Policies & Procedures  As a public body we must procure services and goods via the public procurement process Potential for collaborative initiatives 15
  • 16. Challenges – Health System  Health system re-organisation  Business/Service engagement/ownership given the pressures  Releasing of Business Resources for projects  Expectations of Service Users  Scale and Complexity of projects  Project Fatigue  Continuously emerging “non Project” initiatives (OPD, SDU etc.) Potential for collaborative initiatives 16
  • 17. Challenges – Industry  Health system re-organisation  Engagement with the System  Availability of Funding  Lack of investment  Procurement Process  Maintaining a Competitive advantage  Co-operative working arrangements Potential for collaborative initiatives 17
  • 18. New Models for Business Engagement  Vendor Financing  Software as a Service  Innovation – strategies  Open Source Software  Supplier partnerships  Cloud Computing  Smart procurement  Interoperability  Research projects  Agile methods Potential for collaborative initiatives 18
  • 19. Examples of new ways of Engagement  Streamlined and standardised internal procedures & processes  Professional and Technical Services framework  Outsource a Service (including the ICT element)  Home Help service  Audiology  Shared Service  Renal  Software as a service  SAT  Clinic booking/scheduling for bird flu vaccination  Development through research and innovation  Health Intelligence  Framework for ICT services Potential for collaborative initiatives 19
  • 20. How do we Engage  Engagement needs to be at industry level  Establish an organisational/relationship (governance?) framework for collaborative initiatives  Initiate a process of wider consultation with all stakeholders to:  Identify new and/or innovative business models  Assess their potential and viability  Identify the opportunities for their utilisation  Agree the procedures and processes to assess and manage proposed initiatives Potential for collaborative initiatives 20
  • 21. Questions & Discussion Potential for collaborative initiatives 21