Kainos and Tallaght University Hospital

Tallaght University Hospital (TUH) is one of Ireland’s largest acute teaching hospitals with adult, psychiatric, pediatric, and age-related healthcare on one site. The Hospital is a provider of local, regional, and national specialities. It is also a national urology centre, the second-largest provider of dialysis services in the country and a designated trauma unit.

Kainos were engaged in mid 2021 to provide a managed service to support the new Electronic Patient Record (EPR) system dubbed 'Synergy'. Tallaght University Hospital (TUH) set out a clear strategic goal to create a 'Hospital Without Walls' to ensure that all staff have access to the latest patient information across the hospital and its multiple locations in the community.

Kainos collaborated with Tallaght throughout the full-service delivery lifecycle and led the planning, technical and service design, build and migration from the legacy solution.

Kainos managed service and support are focussed across the following vital areas:

• Create a seamless experience for 3,000+ clinical staff to access data and workflows
• Replace paper through the redesign of digital care pathways to future-proof TUH’s digital vision in line with the Hospital’s five-year Strategy (2019-2024)
• Support the integration of Synergy with TUH ICT and external systems using HL7 and FHIR standards to allow data sharing with PAS, Radiology and GP systems
• Prioritise programme change and the management of Synergy to go live with no operational disruption at the pace determined by TUH
• Provide a multi-disciplinary capability to ensure that healthcare staff continue to have quick and easy access to a single view of a patient's health and more
• Enable TUH to release continuous delivery and integration enhancements at pace by proactively managing requests through development to testing and ultimately release
• Improve patient care with a new Clinical Portal, with a goal of improving clinician end-user experience

Problems faced by challenges not being addressed

• Continued operational risk presented by the end-of-life legacy systems
• Impact on patient waiting lists and a missed opportunity to create efficiencies that increase patient capacity
• Continued reliance on stand-alone, discreet paper-based systems which preclude wider internal and external system integration
• Additional rolling cost to host and support the legacy systems
• Failure to consolidate the Hospital’s position as a leader in integrated care

• Replaced end-of-life systems with a modern secure, extensible, and maintainable solution
  
• Reduced operational overhead and risk by providing the ability through an everything-as-code approach to develop and deliver application enhancements within hours instead of weeks and months.
• Provided health information at-a-glance, through comprehensive Amazon CloudWatch real-time dashboard visualisations and analysis.
• Delivered integrated support services and increased service robustness and availability using our 24/7/365 dedicated support and AWS continuity services
• The optimised AWS platform and application minimised cost overheads by continuously evaluating and optimising costs leveraging AWS Auto Scaling Groups, Spot instances and Reserved Instance procurement recommendations reducing Tallaght’s carbon footprint
• By building intelligence into our Application / Integration / Cloud / Cyber monitoring and alerting services we:
• Enabled early issue identification and proactive automated fixes before TUH services are impacted
• Ensured continued compliance with NCSC Cloud / CIS Benchmarks Security Principles and industry standard frameworks to support a zero-trust approach.

Outcomes

• Within a month of launch in November 2021, the solution was supporting:
  • Over 2,000 active end-users
  • Carrying out 6,000+ business actions per day.
• Provided TUH with the ability to develop and deliver application enhancements into production within hours instead of weeks and months.
• Increased service robustness and availability, via modern cloud-native AWS services and the implementation of automated zero-downtime release processes where possible have resulted in services availability of > 99.9%