Abstract
Aim To describe and discuss the increased capacity of the small clinical team and workflow flexibility offered through using the Project Lyreen digital platform.
Introduction/ Background: The Response for Vulnerable People (RVP) team supports new migrants, homeless people and excluded groups across over 250+ distinct locations in the Dublin Midland region of Ireland.
Supporting thousands of distributed migrants that are new to the country with limited access to primary care required a change of approach. Through remote working a small clinical workforce is supported by a larger social care team who act as the eye’s ears and hands of the clinicians.
Methodology: Project Lyreen is layered secure suite of tools that is entirely device agnostic and comprises a cloud based EHR, cloud based threaded communications layer and cloud-based data aggregation. This empowers enhanced care and support delivery to migrants and other excluded groups both remotely and face to face in non-traditional healthcare settings in challenging circumstances.
Project Lyreen Platform digital stack layers
EHR: Provides distributed remote multi-viewer access to clinical records for clinicians AND patients which equates to safer more effective and efficient care. Care as usual in Ireland is provided via paper records which are single viewer face to face only.
Communications layer: Entire multi-disciplinary team in threaded secure channel for advice and care planning means safer more effective and efficient care.
Standard Care in Ireland is provided and co-ordinated via face to face telephone or email, rarely real time live dialogue including image/video. Our solution includes telehealth as standard for both consultations and conferencing between the team and this is supported by secure threaded messages.
Data Aggregation: Tools provide the ability to collect data using online/offline forms and aggregate into a secure shared filespace as well as the EHR. Files and forms can be securely shared and edited online/offline. Care as usual equates to paper based forms.
Cloud Computing: The entire service is device agnostic, access to layers is through web interface SAS (software as service ) rather than local installations. (care as usual = best comparator -local installed per machine licence no access outside of windows)
Main results and findings: Initial findings of an evaluation undertake by Professor Martin Curley (Maynooth IVI) suggest platform performs a full 10x shift left in multiplying the capability of a small group of clinicians in that it allows a small(er) than would otherwise needed team of clinicians (n=14) to support a larger than typical group of patients with complex needs (n=15000). Further detailed data on this will be presented at the conference This platform. enhances access to health services for groups that would otherwise be excluded from health care as they cannot access mainstream care services for a range of reasons.
Conclusions: Project Lyreen is undergoing full testing and evaluation at a larger scale and in different clinical contexts (200,000 patients and acute/community settings). It is proposed to be scaled as a complete digital health spine for Ireland.