Connecting Patients to Care: Building Public Health infrastructure

Healthcare professionals reviewing project data symbolizing healthcare project management software Implementing Healthcare Projects Health and Social Care Northern Ireland

We’ve looked at the journey the patient takes when visiting a hospital, and how a new drug gets from the lab to the patient. We’re now going to look at the infrastructure needed to connect those two processes.

In the US, that gets done through a combination of the federal government, the state, and insurance companies. But in Europe, it’s predominantly provided for by the government. And, taking Ireland as an example, that comes under the auspices of the Health Service Executive (HSE).

Building Public Health Infrastructure

According to its Statement of Strategy 2021-20231, the Department of Health’s 5 Strategic Priorities are:

  1. Manage COVID-19 and promote public health
  2. Expand and integrate care in the community
  3. Make access to healthcare fairer and faster
  4. Improve oversight and partnership in the sector
  5. Become an organization fit for the future

Organizational Structures and Capital Investment

The HSE’s remit then can be divided into two; to establish and run the organizations created to meet those five objectives. And to construct the physical buildings from which they can then operate.

In other words, its job is to put in place the most efficient organizational processes and to oversee the resulting construction projects in the most cost-effective way.

The National Children’s Hospital in Dublin

Unfortunately, a huge number of construction projects go wildly over budget, especially when it comes to public hospitals. Things got so bad with the building of the National Children’s Hospital (NCH) in Dublin, that the government commissioned PwC to investigate what on Earth had gone wrong. Their paper, published in April 20192, concludes that:

“Cost trend reporting was fragmented, difficult to interpret and at risk of error (and that) processes to manage risk, change and documentation were ineffective and project systems were insufficient.”

Inadequate and dis-functional communication processes

So one of the principal reasons for the apparently insane cost overruns at the NCH was a failure of communication. Senior executives and management weren’t being informed about changes to cost estimates, or any of the other changes. So managing risks, and understanding where potential problems might arise, or had already arisen, became impossible.

In short, as the saying goes, the right hand didn’t know what the left hand was doing.

Sharing information through technology

In other words, those two, core HSE objectives, around organizational structures and reining in construction costs, both come down to the same thing; the processes that channel information, i.e. data, throughout the organization.

And that goes for both the HSE as a whole and the individual organizations or bodies that service those five core objectives. And the key to frictionless communication is the software you use internally.

Once you start using the right software, everything gets uploaded to the one, central information hub. So everyone has access to each one of those plans, reviews, reports, and updates. Which means everyone is working off the same figures and reading from the same script. Furthermore, all of that gets done in real-time. So everyone is permanently up to date.

Getting access to centralized data

The result is a consistent level of reporting and a transparency to risk management. All of which produces a clear audit trail, so everyone can see how each of the individual decisions was made. Which strengthens the internal structures and processes, and hugely aids governance.

On one level, it’s remarkable that something as simple as using the right software can solve so many of the structural problems that all organizations are faced with. Which is why the HSE has been so careful about choosing the project management software it uses internally.

But the real question is, why isn’t everybody making better use of software? And what kind of savings might that produce?

Sources
  1. https://www.gov.ie/en/organisation-information/0fd9c-department-of-health-statement-of-strategy-2021-2023/
  2. https://merrionstreet.ie/merrionstreet/en/news-room/releases/20190409_nch_report.pdf

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