A paradigm shift: the potential of predictive care in Ireland

In recent years, a significant shift has been witnessed in healthcare approaches worldwide; a growing interest in predictive care which aims to proactively identify and prevent potential health issues before they arise.

This innovative healthcare model offers immense potential, creating a paradigm shift to revolutionise healthcare in Ireland and improve patient outcomes by focusing on prevention rather than reactive treatment.

Traditionally, healthcare in Ireland, like in most other countries, has largely been centred around treating acute episodes of illnesses and diseases. For historic and cultural reasons from the 1950s onwards, Ireland’s healthcare funding has, by international comparison, been particularly skewed toward acute hospital care and has lagged behind other countries in the development of community-based services. However, with the implementation of Sláintecare, we are now seeing a historic reform of Irish health services to align resources and services to the population needs of the future.

Diagnostics and chronic disease management programs are now being developed in the community. The aim is to shift care toward anticipatory prevention rather than crisis, minimising the level of medical intervention required and keeping people healthy in the community. The timing of this development in community health services coincides with scientific breakthroughs using data to predict health crisis risk.

There is an opportunity to embed predictive technologies into the design and allocation of these new community services from the start. Doing so would make Ireland a global leader in predictive public healthcare.

Growing evidence shows that health inequalities can be reduced by using data to find those in need rather than awaiting crisis, particularly for those with the most unequal outcomes.

New solutions to age-old challenges

Ireland’s increasingly ageing population (see figure 1), a good thing in itself, is also putting tremendous pressure on the healthcare system. The successes in extending life expectancy comes at the cost of rapidly increasing unhealthy years for the system to support. The current model is economically unsustainable even in the short-term, providing sub-optimal quality care to patients.

Graph showing Ireland's ageing population
(Figure 1: Irelands ageing population- Health Service Capacity Review 2018, Ireland)

So how can predictive care create a paradigm shift in Ireland?

What is predictive care?

Predictive care leverages modern technology and machine learning to identify individuals at risk of developing specific health needs. By analysing medical histories, physical activity and context, models can detect patterns and make predictions about future health risks. This revolutionary approach utilises existing data and makes earlier intervention possible, transforming the healthcare system and leading to better patient outcomes while reducing costs.

A proven method that empowers patients

The successful impact of predictive care can be seen in HN’s work with Staffordshire and Stoke-on-Trent, in England. HN, a healthtech company specialising in predictive care approaches, conducted a randomised controlled trial in South West Staffordshire, looking at how existing patient data could be used to predict those most likely to attend A&E or need hospital care in the near future. This method was supplemented with targeted clinical coaching to reduce patients’ dependence on A&E and GP services.

Using this unique approach, Staffordshire ICS was able to identify and prioritise people at risk of worsening health conditions in real-time by analysing their patient records. The algorithm targeted individuals who were likely to consume three or more acute hospital bed days in the next six months.

HN’s analysis showed that in Staffordshire the 5% highest consumers of hospital services were using 71% of all non-elective (NEL) hospital bed days. 88% of these patients had more than one long-term condition.

HN case study
(Figure 2: HN Case Study, 2022)

Potential benefits of predictive care in Ireland

According to the Irish Nurses and Midwives Organisation (INMO) over 7,832 patients, including 138 children, went without a bed in Irish hospitals this July. The INMO's TrolleyWatch figures show 72,391 patients have gone without a bed in 2023, a 10% increase in the same time period in 2022. The INMO has warned that the HSE must view this as a indication of what is now inevitable this winter and must act accordingly.

Preventative care can reduce these figures by intervening early, reducing unplanned bed days and improving overall health. As demonstrated by the evidence above (figure 2), the implementation of technologies such as HN Predict can reduce A&E attendances and costs.

According to the European Commission, three in ten Irish adults and more than half of the Irish population over the age of 65 have at least one long term health condition, but the majority of these people are able to live healthy lives requiring little medical intervention. The Slaintecare mantra of ‘right people, right care, right time’ is apt here, and rightly highlights the importance of finding people with whom to have an impact.

Several complex factors lead people into health crisis. These factors do have data tags, and modern data science and machine learning allow us to process this data and produce astonishingly accurate predictions. The randomised controlled trial cited earlier showed that over 80% of emergency health events could be predicted 4 to 6 months in advance.

Crucially, predictive care can empower individuals to take charge of their own health. By providing personalised risk assessments and recommendations for lifestyle modifications, individuals are equipped to make informed decisions about their health and engage in proactive measures to prevent diseases.

In contrast, a reactive approach often leads to delayed diagnoses, costly treatments, and poor health outcomes. Predictive care empowers individuals to take control of their health through personalised risk assessments and lifestyle recommendations, leading to informed decisions and proactive measures to prevent diseases.

Predictive care approaches have the potential to greatly support chronic disease management and healthy ageing in Ireland, where chronic diseases such as diabetes, COPD and cardiovascular disease are major health concerns. By leveraging predictive analytics, we can shift the focus from crisis management of these diseases to prevention and ultimately better self-care. This not only improves patient wellbeing but also reduces the burden on the healthcare system, increasing capacity for elective procedures and reduce waiting times.

Existing data is the key to unlocking the power of prevention

One of the key factors driving this paradigm shift is the vast amount of available data. With the digitisation of healthcare records, providers have access to sufficient patient data to allow accurate prediction. This data, when analysed using modern data science and machine learning enable accurate predictions by considering numerous factors leading to health crises.

The implementation of AI-powered predictive care represents a transformative step in Ireland's healthcare landscape. By shifting the focus from reactive to proactive healthcare, Ireland can significantly improve population health, enhance patient outcomes, and create a more sustainable and equitable healthcare system. This exciting paradigm shift holds immense promise for the future of healthcare in Ireland.

Neil Pope

Chief Commercial Officer, HN