Health Intelligence Priorities & Developments for Health Dr Davida De La Harpe Assistant 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 CEO Health Services Support Services Board Audit RHO Consumer Quality & Risk C / PAD Board / Sec Comms. CEO Office of the CEO SPRI Steering Group & Unit Expert Advisory Groups * Corporate Services HR Finance PCCC Population Health NHO Corp. Plng. & Ctrl. Processes Children * Ageing * ICT Shared Srvs. Disability * Cancer * Procure Estates Surgery * Health Services A & E * Support Services Medicine * Mental Health * Reform & Innovation * Examples

Our Mission = Our Fundamental 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 Structure Environmental Health Health Protection Health Promotion Emergency Planning Strategic Planning Health Intelligence HR

Population Health Function A Population Health Approach includes the Following 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

Major Changes From: Change Area: To: Acute/Episodic Care Requirement Health Focus Care Delivery Health Records Healthcare Knowledge Approach to Care Chronic Acute/Episodic Illness Cure Wellness & Prevention Hospital/Surgery Healthcare System Paper-based Computer-based Expert Opinions Evidence Base Individual Individual & Population Professional Discretion Accountability Governance 39

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

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 Programme 2007-2110 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 support overriding 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