Within two weeks of the Covid-19 pandemic hitting Ireland the HSE had developed a software tool to support patients, from initial contact with the health system right the way through to recovery. The Covid Care Tracker is one of several highly innovative and effective responses to the pandemic developed by the HSE in partnership with Microsoft, in addition to a number of partners including Sysco Software Solutions and Tekenable.
Other solutions included a chatbot to take some of the load off people working in the HSE’s Covid information call centre, and a data lake which is a key source for the statistics provided daily by NPHET and others.
“One of the most important things for us in Microsoft is the partnerships we build with customers,” says Frank O’Donnell, public sector lead with Microsoft Ireland.
“At the outset of the pandemic, and as people were looking at projections of where Covid-19 could go, we worked closely with the HSE to see how we might support their response, and provided tools to give the best insights to help inform decision making at senior levels – we wanted to ensure the solution would have the widest positive impact.”
The HSE wanted Microsoft’s assistance in building cloud-based solutions to help it meet the huge challenge facing the country at the time. “Our team worked with the HSE’s IT and clinical teams, along with other IT partners, to develop a solution in a timeframe never achieved before,” O’Donnell notes.
“We always start with a model of care of how the HSE is going to clinically manage and support people,” says HSE interim chief information officer, Fran Thompson. “It puts patients at the centre and provides clinical supports to deliver the best possible care for an individual. That’s always our goal.”
Model of care
That model of care incorporates everything from initial contact with a GP, testing, community assessments, hospital care, ICU care, and follow-up care in the community.
We wanted a robust, scalable platform, that was highly secure
“The model was developed by our Chief Clinical Officer and his team,” Thompson adds. “Our job was to put in place technology solutions to deliver and support it. While we had some solutions already in place, we recognised there was more to be done. We turned to partners for assistance and Microsoft is a key partner of ours.
“Time was of the essence, but there could be no compromise on quality. “We did not want to build from scratch, but we wanted a robust, scalable platform, that was highly secure,” he says. “It also needed to be extremely flexible.”
One of the first solutions developed was the health chat bot. “The HSE was receiving a significant number of enquiries from the public and the systems were highly challenged,” O’Donnell explains. “One of the measures we developed with the HSE was the health bot. This allowed some incoming queries to be handled using artificial intelligence (AI). The health bot was handling 30,000 enquiries a day within a few weeks of first getting up and running.”
That proved invaluable, according to Thompson. “When we set up the HSE Live call centre it was taking 120,000 calls in one day. That wasn’t sustainable. The nature and types of questions were covering all aspects of Covid, at this stage people had very little understanding of Covid-19. Using AI, the automated response system took a lot pressure off the call centre.”
The Covid Care Tracker
The Covid Care Tracker has been key to the overall response. “It is at the core of how we support the Covid tracking and tracing operations,” says Thompson. “We developed the software using the Microsoft Dynamics 365 tool. We worked with a Microsoft partner on that. It covers three big functions for us. It puts the patient at the centre throughout their journey and all of their interactions with the HSE; it interfaces with the existing and some of the new systems we have put in place; and it allows us to automate some of our interactions with the public. For example, the initial electronic referral from a GP system is automatically transferred to the HSE, that in turn is transferred to the contact tracing service, and all the contacts are then recorded on the system as well. Contacts are in turn referred for testing through the scheduling service.”
The system also manages the testing process. “If a person has had a positive test the system will prompt a call to inform them. It is also able to text a patient to let them know they have tested positive provided they have opted to be contacted in that way. The text will inform them that they should self-isolate and seek medical assistance if they feel ill. The system also prompts a follow-up call to elicit close contacts and relays the information to the contact tracing service. Recently we had 17,000 tests a day and the system can handle the weekly test numbers without any issues whatsoever.”
Reliability is a key feature. “One of the reasons we went with the cloud, and a tool as strong as Dynamics 365 and the Power Platform, is so that the solution would be accessible to citizens at all times,” says Thompson. “Our reputation depends on it. We need a partner with a robust toolset that is totally reliable. We are now on the 25th release of the tracker software. We started with a minimum viable product (MVP) and we keep rolling out updates with additional functionality all the time. We will shortly add a feature to allow close contacts to self-report before they receive a call or text message.”
When we started the journey, we didn't have this toolset and key to developing it was having partners like Microsoft
“It took just two weeks to roll out the initial solution,” O’Donnell remarks. “We had daily meetings with clinicians to tell us what they wanted. It was vitally important to have the clinical experts in the room all the time.”
The tracker collects data from a variety of sources and that is being used to provide information and insights to NPHET and others. “We built a data lake in the cloud, on Azure, to manage the data and provide insights on dashboards for managers and others,” says Thompson. “A lot of the information we provide both internally and externally is sourced from this data lake. It’s a really strong end-to-end data solution.”
It goes beyond mere information. “We can look at hospital beds and roll up the numbers nationally or drill down into hospital group level or individual hospital. We can tell how many beds in any hospital are being used for Covid patients at any time. It can also tell us how many available ICU beds we have and where they are.”
“With the flexibility of the solution, we can integrate the data to provide real insights. We can look at the different Community Health Organisation areas around the country and drill down to get data for each one. That allows us to ensure that we can support the workload across the various hospitals and utilise metrics to manage the process. This level of data can help us decide whether to assign extra resources in certain areas if required. If we know there are areas where there is significant additional demand for testing capacity, we can deploy pop-up centres where necessary.”
The HSE response has attracted international attention. “We have had a lot of calls with national and regional health agencies overseas,” says Thompson. “They have been fairly astounded by what we have managed to achieve. Others have copied what we have done. When we started the journey, we didn’t have this toolset and key to developing it was having partners like Microsoft.”
“Microsoft works with health systems globally to help them digitally transform. Over the last eight months, we have seen how the HSE has led the way by implementing both an innovative and comprehensive solution to address the challenges of Covid-19.”