ETENDERS

HSE7608 - Open Competition for Haemophilia Lighthouse Project

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Procurement Approach

Background

 

Haemophilia is an inherited bleeding disorder which is associated with recurrent spontaneous bleeding from early childhood. The National haemophilia service was the subject of a Tribunal of inquiry (2001) into the infection of patients with HIV and Hepatitis C as a result of state infected blood products. A key recommendation of the Tribunal was an improvement in management of medical records and the ability to track and trace medications.  Since this time the haemophilia service has undergone major improvements to the extent that it has been consistently recognised, by teams of international auditors (who inspect the service every 3 years), as a leading international haemophilia service. The improvement in quality and patient experience has also been associated with significant reduction in cost. The successful implementation of ICT solutions has been a key enabler in the improvement in haemophilia services. These ICT solutions included the following:

·         Unique national patient ID for all patients with bleeding disorders which is linked to existing hospitals numbers. Unique Global Standard GS1 codes have also been assigned to all locations (where haemophilia medicines can be stored), all haemophilia clinicians and all haemophilia medication packaging.

·         A shared national Electronic Patient Record (EPR) for approximately 20,000 patients in use by approximately  400 staff across 4 sites (SJH, OLCHC, CUH and GUH) with read only access in other sites. Clinicians also have access to the system from home.

·         A globally recognised best in class medication track and trace solution (using GS1 barcodes) from point of importation to point of administration both in the hospital and also the home (using a smart phone scanning App)

The above solutions have been associated with improvement across the key domains of healthcare: >80% reduction in medication errors, improvement in patient experience (>99% rating the experience as good or excellent) and significant cost savings.

 

Motivation for the Proposed Solution

 

The National Haemophilia service recently undertook a detailed review of the current service and identified opportunities for improvement. The review identified the following key themes for improvement which are outlined below.

Patient experience

The key themes identified the following gaps, needs and preferences of patients 

 

·         Real time electronic access to their clinical record including diagnosis, medication, clinical letters, pending appointments, treatment plans;

 

·         Improved access to electronic educational material in different formats

 

·         Ability to choose and book appointment on line including the ability to cancel, reschedule and book multiple appointments on same day;

 

·         Improved e- communication (email using clinical notes, Skype using clinical notes). 

 

·         Patient comments/complaints also identified the need for highly standardized care across all major patient pathways. A key component in addressing this issue is the need for electronic patient pathways with decision support.

 

Staff review of process

 

The key themes identified by staff, in addition to those already identified by patients include the following

 

·         Need to improve the ability to use the data that is already being captured including the need for improved data analytics and reporting tools

 

·         Need for integration between existing haemophilia EPR with enterprise systems (LIS and PAS systems) in OLCHC and CUH.

 

·         Need to implement standardised electronic pathways to cover all clinical and non-clinical processes with real time key performance indicators

 

·         Need to implement medication management solution to cover non haemophilia medications (in addition to the medication management solution which is already in place for the haemophilia medications)

 

·         Ensure that the excellent components of the current system are maintained

 

·         Upgrade or replace the current haemophilia EPR system so that it is on a more modern platform with sustainable support

 

Key components of the solution and Procurement Approach

The key components of the overall e-health solution for Haemophilia will be:

1.       A patient portal to radically improve self-management (on line choose and book, access to electronic record, advanced educational modules, ability for patients to report outcome measures);

2.       Deployment of full paperless EPR including diagnostic coding, medication management, clinical notes, order sets, integrated electronic care pathways, real time performance reports, provider approval and reminders;

3.       A summary care record to provide a dash board of key patient information from haemophilia solutions, enterprise solutions and patient selected health applications. This may be incorporated as part of the patient portal or the full EPR;

4.       Integration of the above systems with local patient administration / EPR systems where applicable;

5.       Data repository and analytics. A data repository to be designed, developed and deployed to collect data from all relevant sources and provide a base for data analytics;

6.       Deploy the IHI (Irish Health Identifier) as an integral part of any of any chosen solution;

7.       A Quality Improvement function incorporated as part of the new systems implementation;

 

This tender will comprise of 3 lots, namely

Lot 1:     Patient Portal

Lot 2:     Electronic Patient Record for Haemophilia patients

Lot 3:     Data repository with advanced analytic functionality

 

Vendors may opt to submit bids for any particular lot or part thereof, combination of lots, or all lots. It is recognised that multiple vendors may come together as a consortium to bid for some or all of the lots. In this case, a lead vendor shall be identified in the submission.

 

It is anticipated that the implementation of Lot 2 will require a substantial work effort in moving & migrating from the existing system to the new system. This being the case, implementation priority will be given to Lot 1: Patient Portal.

In each of the above three lots, the integration of the proposed solution with the local in-situ systems such as PAS, OCM, etc. should be inherent and fully costed to your submission.

The development of the existing Haemophilia solution formed part of a development cycle in order to meet the specific requirements of the clinical service. It was judged internationally as being both innovative and effective. Therefore, bids that are innovative in nature will be considered strongly alongside those of more developed solutions in order to ensure such functionality is retained and built upon. In all cases, the need to integrate and embed the solutions and implementation process with work in the Data Analytics and Quality Improvement functional space will be essential.