Health Service Executive of Ireland

“This strategy gives us a framework for delivering a modern patient experience, regardless of ordinary days or extraordinary times.”

- Fran Thompson, CIO of the Health Service Executive in Ireland

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80,000 FTEs + 40,000 WTEs

7M+

Vaccination Doses Administered

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Health Service Executive helps combat the pandemic and advance public health with cloud-based vaccine management system

“In February 2020, we had our first case of COVID-19 in Ireland,” said Fran Thompson, CIO for Ireland’s Health Service Executive (HSE). “Schools and shops had closed their doors, arts and sports were stopped, no one could travel, and those still employed were working from home. Like the rest of the world, it was a situation myself and my team could not believe the sight of, let alone the way in which it unfolded overnight. There was no time to plan, no time to evaluate, just a call to action.”

Learn more about the HSE

The HSE provides public health and social services for everyone living in Ireland. It is the largest employer and organisation in the state, employing over 80,000 people directly and an additional 40,000 people through contracts. Its annual budget is over €20 billion, giving them an exceptional amount of fortitude and expertise.

HSE had a number of regional vaccine systems and programs that managed things like the flu, HepC, and childhood vaccines -- outbreaks that tend to be more concentrated compared to COVID-19. In this case, HSE needed a national program that could enable its teams to move quickly as they work to keep people safe, “and we found that solution in IBM and Salesforce,” Thompson continued.

Combating A Pandemic

Prior to COVID-19, Thompson and his team had begun discussing early reform plans in an effort to bring more modern, digital tools and processes to the services HSE provides. These plans included things like: how HSE might be able to inform and engage the public on topics of interest more frequently, community-based care delivery, maintaining data compliance requirements, and so on.

“But again, we suddenly found ourselves being called into action overnight. Our reform plans jumped off of PowerPoints and Excel sheets, and were put into action immediately, turning what easily could have been a traditional, reactive response into a transformative, strategic approach,” said Paul Reid, CEO for HSE.

It was very important to the HSE that citizens were kept informed of both their individual vaccine journey and the overall progress of the vaccine rollout programme. “We needed a way for people to get vaccinated in non-HSE sites, and remove the kind of superfluous barriers that didn’t align to the ‘all hands on deck’ situation we were in. We also wanted all staff -- both our own teams and frontline healthcare workers, which included the many dedicated retired healthcare workers who rejoined the HSE to contribute to this effort -- to be vaccinated within the same 2-week timeframe as our own employees so that they were safer while working the frontline,” Reid continued. “At the end of the day this was about people; their lives, their families, and their communities.”

“This is where IBM came into the picture. We became the tactical partners that helped Fran and team bring these strategies to life,” said Paul Murphy, Country Leader, IBM GBS Ireland.

Saving Lives Through Teamwork

Reid, Thompson, and team launched COVAX (COVID-19 Vaccination Information System), a nationwide vaccine management platform on the Salesforce Customer 360 Platform for Government. It gives HSE the tools to manage the communications, intake, and personalise case management work at the scale demanded by COVID-19, freeing up time and energy for frontline workers to focus on getting jabs in arms, faster. Here’s how it works:

Step 1: Intake and Outreach
The public start by visiting COVAX’s public portal, built on Experience Cloud, or by calling the HSE Live call center, built on Service Cloud. They are then guided through a series of questions that capture basic demographic information, Personal Public Service number, address, etc., all of which is stored in a personalised patient record in Health Cloud. “The automated, self-service nature of this intake process not only minimises the amount of time frontline staff would otherwise be spending taking down information, but also mitigates the risk of error -- especially important when dealing with a crisis of speed,” said Murphy.

Step 2: Service Delivery
Once a citizen has registered and is eligible to receive a vaccine, a scheduling algorithm determines the optimal vaccine clinic and appointment time based on demographics, vaccination capacity, vaccine availability, and geo-proximity to the closest vaccination centre. The resultant vaccination appointment is sent to the citizen via Marketing Cloud, which automates 2-way communications via SMS, maximising attendance and building ongoing Citizen engagement.At the vaccination clinic, frontline staff check in and validate the identity of the hundreds of Citizens in the queue with a secure and rapid search on the Salesforce platform. As the person enters the vaccination booth, the vaccinator reviews the information housed in their Health Cloud profile record, confirms consent and eligibility, records the vaccination details (e.g. vial number, type of vaccine etc.), and administers the vaccine. The event is recorded in the patient’s profile and a second appointment is scheduled, further consolidating workflows into the one operational system.

Step 3: Relationship Management
HSE also launched a contact center as a part of the system, HSE Live. Built by IBM in only 3 weeks, it now supports over 2,000 service agents as they work through an average of 20,000 questions per day via email, phone, chat, and so on. “The result is a digital front door that gives patients the kind of modern, omni-channel experience they have come to expect of enterprise-level services, and frees up phone lines for the more complicated scenarios that are best resolved via a live conversation,” said Murphy.

Step 4: Employee Engagement and Training
With the addition of myTrailhead, HSE staff were provided with relevant and timely training to help them rapidly learn how to best use the new platform. myTrailhead provided HSE with a learning platform used to train frontline staff on anything from new health directives and updates to safety protocols to how to use new features made available on the system. IBM included Shield, bringing an additional layer of security to the system.

Step 5: Reporting and Employee Enablement
TableauCRM was added to provide HSE with a set of advanced business analytics tools to monitor and report on all aspects of vaccination data quality and individual Citizen vaccination completeness status.

Step 6: Integration and Connectivity
Throughout each of these steps, MuleSoft was critical in helping HSE to adopt an API-led approach to connectivity. “We did this by creating reusable API building blocks that could securely link core data domains such as patient data (Individual Health Identifier / EIRcode), GP systems (Healthlink), pharmacy, appointments (OptaPlanner), and vaccination events,” said Murphy. “The result is a seamless, real-time, connected experience with the patient at the center, not operations.”

And, thanks to an agile delivery process, the initial MVP went live in just 9 working days. The team started the rollout with four acute hospitals, and from there “we’ve been pushing new features, functionality, and/or locations ‘live’ every three weeks since,” said Thompson. “As vaccine availability changed and government policy shifted, the rollout plan was constantly adapted. None of us have worked through a pandemic before, so this level of agility has been that much more critical in helping us act on new information in real-time.”

Broadening the Scope

To date, over 250,000 of Ireland's healthcare workers are registered on the system, along with over 500 care homes, 50+ hospitals, 4,000+ vaccinators and 2,000 support staff. Approximately 3.7 M people have been registered via Salesforce, an additional 2.2 M people have self-registered via the public portal, and over 7M vaccines have been administered. “In other words, we have vaccinated three in five of Ireland’s population,” said Thompson.

And this number only continues to grow; watch these numbers increase daily since time of publication, here.

As HSE continues to take a risk-based approach, the team prioritised especially vulnerable groups first, such as the elderly and those with pre-existing conditions, followed by 50 acute hospital sites and about 500 care homes. They also set up ‘pop-up clinics’ to give the general population access to the vaccine as more people become eligible. At peak time, the HSE had 43 mass-vaccination centres and 4 satellite clinics, which together used Salesforce to administer up to 50,000 vaccinations per day.

“The work we have done here has solved today’s COVID-19 vaccination challenges, and will pave the way for years to come,” said Thompson. “This strategy gives us a model, a framework, for linking doctor systems to hospitals, portals, and patients. This strategy gives us a framework for delivering a modern patient experience, regardless of ordinary days or extraordinary times.”