Health Intelligence Priorities & Developments for Health

Dr Davida De La HarpeAssistant National Director of Population Health HSE

University of Limerick meeting

Introduction

• Transformation and Change in HSE

• What is population health?

• What is health intelligence?

• Where does research fit?

• The future?

HSE STRUCTURE Administrative Areas

Executive Structure

CorporateServices

Office ofthe CEO

Health Services

Corp. Plng.& Ctrl.

Processes

CEO

Board

Audit

Reform & Innovation

ICTSharedSrvs.

Procure Estates

Support Services

NHOPCCCPopulation

Health

HR Finance

SPRI Steering Group& Unit

Expert Advisory Groups *

Children *

Ageing *

Disability *

Cancer *

Surgery *

A & E *

* Examples

RHO

Consumer

Quality & Risk

C / PAD

Board / Sec

Comms.

Medicine *

Mental Health *

Our Mission = OurFundamental Purpose

To enable people

live healthier and

more fulfilled lives

Research

• A systematic and rigorous process of enquiry that aims to increase knowledge-

• When applied to health : it aims to improve health, health outcomes and health services

The Population Health Directorate

• Population Health's mission is to promote and protect the health of the population

• Emphasis on reducing health inequalities. • Takes account of all determinants of health and

recognises that good health is the responsibility of everyone

• Acts as a unifying influence for the entire health service, tries to ensure that a Population Health approach supports and informs the planning and delivery of health services in Ireland.

Population Health StructurePopulation

Health

HealthIntelligence

HealthPromotion

Health Protection

Emergency Planning

Strategic Planning

HREnvironmentalHealth

Population Health Function

A Population Health Approach includes theFollowing Using the best health intelligence for planning, evaluation and

performance management Planning for health and not just health services Promoting equity as a strong value in the health system Applying research evidence to improve health outcomes Adopting a formal approach to needs assessment to identify gaps

in the service Re-orientating service delivery from hospitals to primary care and

health promotion Providing services which are integrated within the health sector

and with those of other sectors Working with other sectors to improve health – to include public

involvement Demonstrating a better return for society from investment in

health

From: Change Area: To:

Acute/Episodic Chronic Acute/Episodic

Illness Cure Wellness & Prevention

Hospital/Surgery Healthcare System

Paper-based Computer-based

Expert Opinions Evidence Base

Individual Individual & Population

Care Requirement

Health Focus

Care Delivery

Health Records

Healthcare Knowledge

Approach to Care

Professional Discretion AccountabilityAccountabilityGovernance

Major Changes

Health Intelligence

• Health Intelligence is part of Population Health service within the Health Service Executive (HSE) and is responsible for capturing and utilising knowledge to improve health outcomes for the population

• Cross directorate supports and linkages• External linkages and collaborations

Health Intelligence components

• Small team in Dublin• Others locally based

throughout the country

Admin support

Specialised services

Research And

Development

EBHC

Strategic information

systems

Health Information

unit

A/NDHI

Health intelligence provides

• HIPE analysis and commentary• Demographic data• Mapping services• Evidence based supports and teaching• Advice on research projects and

applications• Internal HTA supports

What does Health Intelligence do?

• Health Information and Surveillance• Evidence Based Health Care, Research, and

Development • Support for Health Technology Assessment and Health

Impact Assessment: providing all those who make decisions in the HSE with high-quality information or tools to determine potential impacts of decisions on provision of new technologies or other developments on health and health inequalities

• Knowledge management: Capturing, collating, storing and sharing knowledge

• Linkages between health care professionals and relevant health care information.

Building Capacity

• Ability to seek evidence based information, synthesize and utilise it to improve patient care

• E-resources– key tool for knowledge management

• Networking increasingly important –learning from each other’s perspective (e.g.CHAIN)

Transformation Programme2007-2110

• Transformation of health and social services calls for a change in – What we do– How we do things– How we work together – How we all commit to each other

to enable people live healthier and more fulfilled lives

• Health intelligence underpins and facilitates this

Transformation priorities

• Transformation priorities - 6 in total – focus on 3• “Integrated patient journey”• “Ensure all staff engage in transforming health

and social care in Ireland”• “Implement a model for population health and

the prevention and management of chronic illness” - Pop Health

Health intelligence

• Intelligence is experience integrated and realised. Our journey involves unlearning what we know, seeing things in new ways and engaging dynamically in evolving how we perceive everything. It starts by knowing where we are and where we want to go. Knowledge is having information. Intellect is the ability to use it.

• Intelligence is the gift of seeing beyond it, seeing new relationships and thinking laterally, outside the box, it is the power of applying and abstracting dynamically. (M. E. Meegan)

• Applying this to our services and a population health approach

HSE research supportoverriding priority

• to ensure that investment ensures optimal delivery of services at a systems and individual level in the context of our population health approach

Health intelligence role

• enhance information, knowledge and resource exchange among researchers, care providers and policy makers and the public

• Feed in directly to reviews, service planning, horizon scanning, research

Things we need to do now

• Enhance capacity• work across boundaries within and outside the

HSE• use the information we have in a better way• Develop more innovative approaches to

information and knowledge management • Addresses -coding • Health identifier? • ? Legislation to allow better linking of patient

information

Key areas(1)

• Health service research-

• Getting research into practice-translational – scientific discoveries must be translated into

practical applications – The knowledge required to deal with a

majority of questions that arise exists- but accessing it is an issue

Key areas(2)

• Participatory research- researchers actively engaging with the organisation or setting they seek to study

• evidence-based information on healthcare outcomes, quality, and on cost, use, and access.

• Our priority research should prevent cancer, heart disease, stroke, and lung disease by developing and evaluating policies, programs, communications, and other tools to change the social, behavioural, economic and biological determinants of these diseases

Knowledge needs

• How to increase physical activity, improve diets, as well as reduce tobacco use, obesity, high blood pressure, stress, diabetes, drug and alcohol abuse, income inequality, poverty, illiteracy, etc……

• Not all in the domain of HSE- but we should be influencing

Research strategy

• Research – consultation process• Current work programme:• METR• Therapies research strategy• Childrens research startegy• Ethics- survey etc• Data protection and governance• Transformation -enabler

HI -• www.healthintelligence.ie• www.factfile.ie• Developing more web-based resources inc intranet-• Evidence based health care:• Programme developed- teaching sessions- working with EAGs etc• Inputting evidence base and interpretation in to the various

documents and working groups

• Information – Health Atlas Ireland: • Innovation awards• Core health intelligence staff acting as a resource for research and

networking and knowledge ( e.g CHAIN)

System changes?

• Enhanced third level linkages

• Funding stream??

• Recognition of research as a core function

• National support structures for research

• Balance between various kinds of research

Summary

• Brief outline of HSE• Over view of transformation • Thoughts on place of research • Update on current processes

• Thanks