Head of IT for Northern Ireland’s Health Department meets the COVID-19 challenge

Although lockdown measures are starting to ease down across the UK, the battle against COVID-19 is far from being won yet. Spearheading the fight is the NHS and a relentless army of key workers who are keeping the country ticking. Supporting this endeavour are CIOs delivering digital solutions at a critical time.

In Northern Ireland, Dan West, Chief Digital Information Officer (CDIO) at the Department of Health Northern Ireland, is going beyond his remit of IT leadership and digital solutions in healthcare to focus on the COVID-19 challenge.

Before joining the Department of Health in Northern Ireland, West was Director at NHS Digital, the national provider of information, data and IT systems for commissioners, analysts, and clinicians in health and social care in England, and prior to that he was a Managing Director in the Healthcare part of Accenture, the global professional and technology services company.

In this interview, West spoke to CIO UK about how he and his team are overcoming the obstacles brought about by the pandemic within the Department of Health Northern Ireland.

Below is an edited transcript of that conversation, for clarity and brevity.

[More lessons from the NHS: Find here how NHS Digital is meeting COVID-19 cybersecurity challenges and how NHS CIOs are confronting confronting the pandemic.]

CIO UK: As Chief Digital Information Officer for Health and Care in Northern Ireland, how are you and your team supporting medical staff during the COVID-19 pandemic?

Dan West (DW): The Health and Social Care digital response to the pandemic in Northern Ireland has included five main strategic goals, including mobilising the workforce; enabling locations and capacity; informing and supporting the public; developing data and insights; and supporting vulnerable people.

CIO UK: Can you explain each of the five main strategic goals in more detail?

DW: We are mobilising the workforce though the delivery of more devices and upgrading central infrastructure and systems to allow staff members to work remotely, including things like VPN firewalls and increased usage of tele and video conferencing services.

This has been challenging due to our starting point – around 80 percent of our roughly 45,000 machines are workstations – and the rapidly increasing demands of the system (which include Business Continuity for critical resources prior to the Prime Minister’s announcement of the ‘stay at home’ policy, along with orders of magnitude more requirements for laptops and tablets subsequently). We are now looking at how cloud technologies might accelerate how we meet the wider mobilisation requirements and prepare ourselves for the next wave of the pandemic.

By enabling locations and capacity, I mean that we are supporting Health and Social Care organisations to equip existing locations handling COVID-19 patients – and new locations and facilities to increase capacity and support staff. This includes the use of ‘Nightingale’ locations for increased acute beds, supporting the fit-out of MOT test centres and drive-in locations for virology testing. We are also enabling increased access to relevant patient information for elective work being carried out by independent sector hospitals.

We are informing and supporting the public by providing a more modern user experience for information about the pandemic and triage support – and reducing the burden on front line staff through telephone and digital channels where possible.

Through developing data and insights, we are gaining understanding the flow of information within and across the Health and Social Care sector, providing consistent access and tool sets for analysts and supporting operations and planning for the pandemic response.

Last but not least, we are supporting vulnerable people by building datasets and digital solutions to help vulnerable patients receive the best care, while reducing burden on acute facilities. We’re working with partners across government to look after the shielded population.

CIO UK: Can you share any specific examples of what you have been doing so far?

DW: We haven’t historically had a single helpline number for citizens to call to interact with Health and Care services. England, Scotland and Wales all have variations on the 111 theme, but this hadn’t been adopted in Northern Ireland.

As part of the pandemic response we’ve set up the 111 COVID-19 helpline for the Northern Irish public to use for questions and to reduce some of the traffic that would have resulted in a telephone call with GP or GP Out of Hours. We’ve also created a region-wide mobile app [COVID-19 NI], a first for the Health and Social Care system here.

The helpline receives thousands of calls each day from worried citizens, and the mobile app has been downloaded around 48,000 times. It has strong approval ratings from users and is used several thousand times per day with hundreds of specific questions posed to the COVID-19 NI advice and guidance ‘chat bot’.

As demand for frontline services increases throughout the peak of the pandemic, we are striving to improve the helpline and the mobile app so that more members of the public in Northern Ireland can find the vital information they need, without having to reach-out to front line Health and Care workers for help.

In Northern Ireland, we have a number of existing, region-wide data resources, including regional data warehouses and information analysis for statutory reporting. While paying appropriate attention to data privacy regulations, we have been able to enhance the centralised information and provide a cloud-based reporting service that will provide a wider array of organisations with improved access to COVID-19 data for dashboard, analysis, and modelling purposes. Another first in the region.

CIO UK: What are the greatest challenges for the NHS in Northern Ireland, as opposed to the rest of the UK, and how are you overcoming them?

DW: Operationally, the ability to mobilise the workforce has been one of the biggest challenges in the beginning. The government’s decision for non-essential workers to stay at home meant that a large number of non-frontline workers needed to access systems, and our infrastructure needed to be extended. This is not isolated to Northern Ireland, but progress made in other jurisdictions around the shift to cloud technologies, like Microsoft Office 365 and Teams, meant other regions found it slightly easier to scale their systems for the sharp increase.

Also, historically, the approach taken to primary care in and out-of-hours services in Northern Ireland meant the idea of a region-wide helpline and digital ‘self-triage’ facility was new for us. The national approaches – managed by colleagues in Westminster to establish national COVID-19 virological testing capacity – is resulting in some rapid activity around data matching and communication.

In the secondary care space, prior to the pandemic, we were on the brink of commencing a very large electronic medical records (EMRs) transformation programme that would replace an array of legacy systems with an integrated platform. The main challenge here is that we wish that the pandemic had come after we’d delivered that programme. Other non-digital factors, like staffing and vacancy levels, meant that we had to work quickly to bring on board new resources.

CIO UK: Are you collaborating with the health services in the Republic of Ireland (RoI) to overcome these challenges and fight the pandemic more effectively?

DW: Yes, we have had sharing of information with colleagues in the Department of Health in Dublin. The triage app was something that we collaborated on from the outset and the excellent work that has been done to establish on the RoI contact tracing service will become particularly relevant and interesting as we shift from the current lock-down phase into the later stages where rapid detection and reaction to outbreaks will be a big factor in saving lives.

As we go forwards, the plans around digital proximity for democratising contact tracing will need particular alignment between Northern Ireland and the Republic of Ireland, partly given that Flybe is no longer operating into and out of Belfast. The North-South movement of the virus may be more of a concern than the East-West movement.

CIO UK: Are you partnering with any vendors or tech providers in relation to any of these COVID-19 related projects?

DW: Yes, the response from the technology industry has been absolutely fantastic. Vendors big and small have offered products and services, sometimes temporarily free of charge, during the pandemic. In the vast majority of cases this is with a genuine goal to helping in difficult times, rather than just a sales opportunity.

We have partnered with Civica for development of the COVID-19 NI smartphone app and a design agency in Belfast called BigMotive to do the user research, engagement and testing, and app design. We’ve been working with one of the Trusts that had already established a Microsoft Azure tenancy. The Trust along with partners from EY and Microsoft have been absolutely critical in getting the PowerBI based analytics platform established.

CIO UK: Are you working with other NHS CIOs to offer a co-ordinated response during the pandemic? 

DW: Yes, we are staying connected across the other devolved administrations, sharing learnings and challenges directly with Scotland and Wales and via colleagues at NHSx who are facilitating across the UK. We are connected to NHSx, NHS Digital, Public Health England and NHS England in relation to product and service development. We have been supported by Gartner in getting connected to the IT leadership of the worst hit areas in Northern Italy to build a view on what lies ahead for Northern Ireland.

CIO UK: Would you like to offer any other insights that you think might be useful to CIO UK readers in relation to the work you are doing at the moment?

DW: Things are now starting to stabilise in the current phase of the pandemic, so we are turning our attention to enabling the recovery strategy, accelerating the safe return to ‘normal’ for people in Northern Ireland. This means building operational and digital services to rapidly identify and react to individual infections and regional outbreaks, reducing the rate of infections to slow or stop the spread of the virus and reducing and delaying the next epidemic wave.

Our focus is on the various digital interventions to support easement of social distancing measures, including things like the data architecture for multiple sources of testing capacity and use of digital tools in proximity and contact tracing to support the transition to containment phase. We need members of the public to continue to observe current social distancing measures and really engage with the digital tools that we will make available to help citizens to get back to work and normal life.

Awareness of contact tracing is increasing, with the public and media discussion focusing on the importance of contact and proximity history for COVID-19. Contact tracing is a permanent and ongoing fixture within public health, with a number of infectious diseases subject to tracing every day, for example meningitis. The idea of a contact tracing app, which is receiving media and political focus, is a technique to accelerate the identification of contacts. The government’s ability to step-down current lockdown arrangements and society’s ability to keep the infection rate low and our people safe, will be greatly supported by wide engagement and adoption of the digital tools.

It will be critical to get the current information governance, privacy and human rights concerns handled quickly, given the potential positive impact that the digital tools could have on the speed with which we can ramp-down restrictions.