Pivoting, at Pace, to Virtual Patient Management, Communication and Education

Recent weeks have seen massive disruption to healthcare services as we grapple to meet service need in the context of the COVID-19 pandemic.

Over the past six weeks, the SCOPe Directorate* in St. James’s Hospital has pivoted from primarily in person assessment and review to a teleHealth model. This Blog will set out the key enablers that made it possible to achieve this change at pace.

* The SCOPe Directorate is the HSCP clinical structure in St James’s Hospital consisting of the five departments of Medical Social Work, Speech & Language Therapy, Dietetics, Occupational Therapy and Physiotherapy.

Our SCOPe team is no stranger to digital developments having led the digital transition from paper to electronic patient records (EPR) with all documentation transitioned by end of 2016. This improvement project was highly structured and a SCOPe EPR QI team managed implementation and governance.

The vision has always been to progress patient engagement, teleHealth solutions, shared records, patient portal etc. in structured phases.

Looking back, our experience and vision laid the foundation for digital readiness in the HSCP workforce, giving us a big head start when news of COVID-19 emerged.  

Our Journey to a teleHealth Model

In early March, the SCOPe eHealth QI team had a brainstorming session to explore the potential of teleHealth to support patient care as the situation evolved.

Services identified as potentially suitable for transition varied as HSCP staff work across all episodes of care including ED, in-patients and outpatient clinics.

Over the course of the following week, the SCOPe directorate moved to provide urgent assessment and review to all OPD services using a generic teleHealth platform.

Electronic appointments and an EPR are already in situ in St. James’s Hospital so the immediate need was to provide a safe, secure substitute for the face-to-face component of the therapy assessment.

Colleagues in the IMS department provided invaluable support including:

  • organising app demonstration
  • enabling of infrastructure
  • provision of licences for staff

Concurrently, the SCOPe team worked to develop:

  • the processes
  • clinical guidance
  • flow around implementing the teleHealth application
  • mechanisms for measuring activity while supporting staff in the introduction of the teleHealth app

Our Learnings So Far …

Feedback has been positive as the teleHealth model allows ongoing contact with patients who require HSCP input.

There is an acknowledgement that it is not ideal for all patients. However, staff report that they are getting better at identifying those patients for whom a virtual teleHealth clinic will work best and at adjusting their communication style to aid rapport development.

In some cases, the teleHealth clinic exists alongside a telephone clinic depending on the patient’s technological abilities.

There have been teething problems with Wifi /4G availability on the patient side and clear instructions are required on how patients can best manage their device for camera visibility.

This use of digital solutions to facilitate ongoing patient management is happening in parallel to the use of virtual tools to facilitate department communication and training.

Where social distancing cannot be observed, significant value is added by the inclusion of virtual video conferencing for education sessions on clinical preparations for the COVID-19 emergency, in-services, journal clubs and meetings.

There is a learning curve with using this technology … a need for collective understanding that technology may fail, cameras may freeze and small visitors may make an appearance in the feed of those working from home!

While it is not always as successful as a group face-to-face meeting, it is a very acceptable alternative when staff can’t all be present in the same room, at this time.  

As well as this, a campus-wide staff communication tool has been implemented in the last two weeks. This has also proven very beneficial for urgent communication from the hospital leadership team and this secure confidential messaging service can also be used to support communication in relation to clinical information.

Most of all, it is clear that the well-plotted transition to EPR created the conditions for readiness amongst the HSCP workforce in the following crucial areas:

Final Thoughts

While teleHealth developments in St. James’s Hospital were already under development, COVID-19 greatly accelerated implementation! By far the greatest asset has been the staff who were required to be ‘early adopters’ of change, learning as part of the doing rather than ahead of implementation.

It has been a huge undertaking and SCOPe HSCP have adapted admirably, motivated by the fact that these changes would lead to effective alternatives to direct patient care for service users.

This Blog was written by Joanne Dowds on behalf of the eHealth HSCP Advisory Group. Joanne is a clinical specialist physiotherapist working in the ICU of St James’s Hospital.

COVID-19 Profession-Specific Online Resources and Education

Over the last few weeks, I have seen first-hand the vital role HSCP are playing in response to the COVID-19 pandemic. 

  • HSCP are carrying out diagnostics and disease monitoring
  • HSCP are delivering specialist treatment and rehabilitation
  • HSCP are providing psychosocial and practical supports to patients and their families

HSCP services are needed at each stage throughout the patient journey and as such, it is incumbent on us to ensure we have the necessary information and resources to undertake our roles. 

In my last Blog (on April 5th), I focused on general resources available to HSCP in the context of the  COVID-19 pandemic.  Today, I am sharing more resources, relevant to specific professions* within the HSCP group.  

Unfortunately, it is not possible to represent all 26 HSCP disciplines in one blog post. Therefore, I have included a sample of professions from the therapy, diagnostics and social care domains of the HSCP group.  If your profession isn’t included and you would like to share resources, please do so in the comment box below. We would be delighted to hear from you.

Clinical Measurement Physiology

The IICMS has created a COVID 19 information hub to support members.  It contains links to resources and webinars such as Preparedness for Echo Labs: Insights from the Frontlines, Guidance for Neurophysiologists performing EEGs and Guidelines for GI Physiology investigations during Covid19

The Association for Respiratory Technology and Physiology also has a collection of guidelines and resources while the American Academy of Sleep Medicine has guidance for sleep labs and clinics.

The European Heart Journal recently published recommendations for cardiac imaging during the COVID-19 pandemic which may also be of interest.


INDI has provided learning resources on COVID-19 to assist dietitians being redeployed to hospital wards and ICU clinical roles.  These resources are accessible to members and non-members of INDI (via the guest login).  The INDI website also has a range of resources on healthy eating for all ages, from older adults cocooning at home to young children and families. These are for the public, carers and health professionals.

Abbott Nutrition has shared a webinar, recorded in 2018 with Irish ICU dietitians entitled ICU Nutrition Made Simple.  A range of pertinent questions are addressed including: the nutritional requirements through the different phases of critical illness, the requirements of the obese critically ill, refeeding syndrome in ICU, indications for parenteral versus enteral nutrition and how best to monitor to monitor patients with complex needs.  

Clinical Dietetics online provides a course on Mastering the Nutrition Care Process which can be accessed via the free 1-month trial (membership is $5.99 per month thereafter).  Registration with this site also includes updates, blogs and discussion fora, accessible via the dedicated app.

Medical Science

The ACSLM  provides links to information and guidelines for their members as well as highlighting relevant podcasts and other resources. See https://acslm.ie/?p=3756 for details.

The Royal College of Pathologists also has a COVID-19 resource hub, while the HSPC and HSE have issued guidance for specimen handling for laboratories.

Occupational Therapy

The AOTI has collated a number of resources to assist OTs.  These include links to online talks and resources for managing stress and wellbeing as well as general lectures on COVID-19. 

For OTs considering telehealth, there are links to relevant guidelines and a webinar.  OTs in the acute sector may find the webinar on skin integrity and pressure care useful.  Both webinars are free to AOTI members (€10 for non-members).

WFOT has developed a repository of COVID-19 resources from member organisations and have made the online module on Disaster Management for OTs free for a limited time.  WFOT’s online forum also allows OTs around the world to discuss practice and share resources.

Lorrae Mynard and OT Australia have a guide for managing disruption to daily life caused by COVID-19.


The ISCP and WCPT provide general information and resources on COVID-19.

For physios in acute care, I recommend the ACPRC as a go-to website.  Another good resource is the UCC Covid-19 Resource centre, which includes a 3-hour video lecture (a Modified Basic ICU Course).  The Australian Physiotherapy Association has provided a free online course: Virtual Cardiorespiratory ICU Update while the ISCP has an e-learning module on Pressure Care which is free to members.

The Intensive Care Society (ICS) and British Thoracic Society have valuable guidance documents, in particular, the ICS document on prone positioning.  Guidelines on ‘Physiotherapy management for COVID-19 in the acute hospital setting’ (pre-press) are available from the Journal of Physiotherapy.

For physios in other specialities who wish to refresh their respiratory skills, the CSP have free e-learning modules for respiratory oncall.  Physio Matters has a podcast on COVID-19 for musculoskeletal physiotherapists, while the Breathe Easy Podcast on ‘The Physiotherapy management for COVID-19 in the acute hospital setting’ is a worthwhile listen.

The newly released Oncall Buddy app, developed by Consultant Respiratory Physiotherapist Stephanie Marshall and Physiotherapist Iain Loughran is another great free resource for those working in respiratory.

Finally, Physiopedia offer a free Coronavirus Disease Programme on their trial account. However, caution must be exercised due to variances in terminology and policies between the UK, US and Ireland.


The Psychological Society of Ireland (PSI) has created a Covid-19 resource page for Psychologists, healthcare workers and members of the general public.  They also have guidance on the use of online therapy and telephone therapy for practitioners transitioning to telehealth.

The American Psychological Association (APA) has a COVID-19 resource centre with general resources, student resources and resources for practitioners and healthcare professionals.  The APA’s podcast, ‘Speaking of Psychology’, also has a special episode on Coronavirus Anxiety.  

The British Psychological Society publication, The Psychologist, has developed a dedicated page for collecting and linking psychological perspectives on the Coronavirus.

Radiography and Radiation Therapy

The IIRRT has provided information and direction to members regarding COVID-19.  Similarly, the Society of Radiographers in the UK has collated resources for radiographers. They have flagged e-learning resources provided by Health Education England, including the free to access Coronavirus Disease Programme.  

The Royal College of Radiologists has resources for managing both clinical radiology and radiotherapy services during the coronavirus pandemic.

The American College of Radiology has published guidance for radiology departments to support adaption of work flow practices, particularly in relation to infection control.

Other educational opportunities are available on Radiopeadia and on MRI Online, the latter providing a free course on COVID-19.   This course demonstrates the typical CT scan findings of COVID-19 pneumonia and how the findings progress over the course of the disease.

Social Work

The IASW has developed a COVID-19 Resources section on https://iasw.ie/covid-19 which is regularly updated with new and emerging information and supports for social workers. A guidance document for the medical social work profession response to COVID-19 has also been developed to support social work which plays a pivotal role in bereavement work with patient, family and staff support.

Supports available on www.iasw.ie include links to resources for working with adults with learning disabilities, working online and home visits. Further resources can be found on the BASW site and at the UCC School of Applied Social Studies padlet.

Further resources can be found on the BASW site and at the UCC School of Applied Social Studies padlet.

Speech and Language Therapy

IASLT has produced a guidance document on COVID-19, as has the Royal College of Speech and Language Therapists, London. The latter also provides links to relevant resources for SLTs navigating the changing working environment brought about by the pandemic. 

The Irish Head and Neck Society has put forward Considerations for clinicians dealing with head and neck cancer during the COVID19 outbreak.

* Please be aware that information and guidelines in this area are changing rapidly.  Although these resources are up to date at the time of writing this blog, they may be superseded by new guidance in the coming days and weeks.

This Blog was written by Éadaoin O’Hanlon on behalf of the eHealth HSCP Advisory Group.

Covid-19 Online Resources and Education

“The best part of learning is sharing what you know”

Vaughn K. Lauer, Author


What does COVID-19 mean for me?

How will COVID-19 affect my clinical practice?

How can I best support my patients?

And protect my own health?

Since the outbreak of COVID-19, my head has been filled with many questions.  As a physiotherapist working in an acute hospital, I am used to caring for patients with respiratory conditions and am accustomed to working in a critical care setting. 

However, that does not mean that I am any less daunted by this novel disease.  From speaking to HSCP working in other settings across Ireland, I know I am not alone.  The outbreak of COVID-19 is without a doubt a massive challenge for all HSCP, especially for our many colleagues who have been redeployed to unfamiliar roles in unfamiliar settings.  

Thankfully, there is help out there!  HSCP can and should harness the potential of online education and resource sharing to enable rapid upskilling.   

General Resources

The first stop for all HSCP on COVID-19 should be the HSE’s Health Protection and Surveillance Centre.  As well as general guidance for health professionals, this site provides links to the current case count in Ireland, advice for the general public, and posters and resources for use in healthcare settings. 

A video on the correct donning and doffing PPE is presented and is essential viewing for all frontline staff.  This video can be found on hseland.ie along with further guidance on hand hygiene and infection control.

The WHO and the European Centre for Disease Prevention and Control also provide excellent general guidance and updates at an international and European level, while the Cochrane library and research journals listed below have COVID-19 resource centres with up-to-date and emerging research evidence. 

For those HSCP deployed to manage patients in critical care and ICU, the Society of Critical Care Medicine provides a free online education programme: ‘Critical Care for Non-ICU Clinicians’.  

The HSE Critical Care Programme has resources available online for staff being redeployed to Critical Care.  These include an orientation manual and free online education modules.  While these are designed for nursing staff, some sections are applicable and valuable to HSCP. 

The Health Education England (HEE) e-Learning for Healthcare site also has a Coronavirus Disease Programme, which is now free to access without registration.   

If you are looking for further clinical guidelines, the National Institute for Health and Care Excellence (NICE) has released a number of rapid guidelines and evidence reviews to support healthcare staff. 

Of particular interest is their rapid guideline for managing adults requiring critical care during the COVID-19 pandemic

In addition, the HSE has launched a Clinical Guidance and Evidence repository for COVID-19.  This provides a repository of the latest research evidence to equip clinicians in Ireland to respond to the coronavirus pandemic. It includes clinical guidance, evidence summaries and an online facility to request a rapid evidence review in relation to specific clinical questions regarding COVID-19. 

Another central repository to be launched this week is from the National HSCP Office. This will enable a sharing of COVID and non-COVID resources with the intention of reducing duplication of effort for HSCP at this time.

Learning from the Italian COVID-19 Experience

As COVID-19 is a novel disease, there is huge value in connecting with countries like Italy, in the peak of the pandemic, to gain from the emerging learning there. 

The Pediatrica Intensiva podcast gives a great insight into the Italian experience.  It includes interviews with intensivists about the realities of managing the COVID-19 outbreak and caring for critically ill patients. 

The International Society for Quality in Healthcare also has a webinar and podcast which shares the experience of Dr Francesco Venneri, a clinical risk manager and emergency front line worker in Tuscany.

These recommendations are not exhaustive and we welcome any suggestions you have on general resources that could assist HSCP at this time. Please share using the comment box below.

Stay tuned for our next Blog on profession-specific on-line resources.

– this blog was written by Éadaoin O’Hanlon on behalf of the eHealth HSCP Advisory Group.

Brave the Wilderness 1

Just as Penicillin was the wonder drug to emerge from WWII, perhaps we’ll look back on the COVID-19 Pandemic as the inflection point for teleHealth.”

Dr Mark Lewis, MD @marklewismd


eHealth is a broad term which refers to the use of information and communication technologies in healthcare. In late 2018, digital leaders, representing the HSCP group and the National HSCP Office, came together to lead eHealth developments for the health and social care professions.

In the context of the COVID-19 pandemic, health systems are looking to rapidly expand the use of digital solutions across a number of different care areas and settings.

In this, the first in a series of eHealth-related blogs, we will set out the starting point for those of you currently grappling with deploying this complex service change at speed and, in particular, we will explore teleHealth considerations.

These unprecedented times  require disruptive thinking and innovation.

* * * * * * * *

Digital Solutions – the Starting Point

Digitally enabled services offer huge opportunities to continue to provide high quality care, reaching patients in the community. In addition, for those HSCPs in isolation, digital tools can enable them to continue to work effectively.  

Digital solutions always begin as well thought-through quality improvements, underpinned by sound Quality Improvement (QI) principles including a) being clear on the intended change and b) establishing how it will be determined that a change is indeed an improvement.

Technology serves as an Enabler, not the disruptor. It is important, too, to consider measures which will demonstrate improvement.

From our experience, keeping the service users at the centre of the plans is vital to ensure any change ultimately improves experience and outcomes for them.

HSCP are well versed in QI methodology with large numbers now trained and routinely leading QI projects in their work environments.

* * * * * * * *

Our Top Five Considerations for teleHealth Solutions

Prior to COVID-19, the need for teleHealth was outlined in Sláintecare action 10.3.3. To provide teleHealth solutions to support delivery of care in the community closer to patients and their families’. 

Aligning with this action, the HSE Service Plan 2020 has prioritised the adoption of a  telehealth strategy.  

Many HSCPs have already begun to design and implement teleHealth solutions and there has been a definite acceleration in the past fortnight.

So, what are the top five considerations for teleHealth solutions?

  1. Telephone vs Video consultation. Consider what is actually needed. Not all clinical interactions will need or can be delivered via video consultation, while a combination of both might be needed in some areas.

What use-cases are appropriate for Video consultations?

  • Routine chronic disease check-ups
  • Counselling and psychological support
  • Any condition where trade-off between attending in person and staying at home favours the latter

When should Video generally not be used?

  • Potentially serious, high-risk conditions needing extensive physical examination
  • If internal examination (e.g. gynae) cannot be deferred
  • Co-morbidities affecting ability to use the technology (e.g. confusion)
  • Serious anxieties about the technology (unless relatives are on hand to help)
  • Some hard-of-hearing patients may find audio difficult but, if they can lip-read or use chat, video may be better

Credit to Professor Trisha Greenhalgh on behalf of the IRIHS research team, University of Oxford https://q.health.org.uk/event/video-consultations-how-to-set-them-up-well-fast/

  1. Choose a solution that meets privacy and security requirements, and ensure that you have a secure network/wifi connection. The quality of the connection is also important – better connections mean better consultations! 
  1. Liaise with your ICT department about requirements for set up – do you have a laptop or PC with speakers, microphone and webcam? Will you need a headset to keep hands free for writing or interacting with patient resources? 
  1. Ensure that you design and plan the QI process for your teleHealth clinics before you start. Don’t jump in to making calls. Consider: 
  • Where will clinics take place? Is the environment set up appropriately? 
  • How will teleHealth clinics be scheduled? 
  • What information will the patient need in advance to prepare them for the appointment? 
  • How will consent be obtained and recorded?  Measures taken in response to Coronavirus involving the use of personal data, including health data, should be necessary and proportionate. Decisions in this regard should be informed by the guidance and/or directions of public health authorities or other relevant authorities. See https://www.dataprotection.ie/en/news-media/blogs/data-protection-and-covid-19 for further information.
  • How will you document the consultation? 
  • How will follow up be arranged? 
  • Consider what the patient will have to do to take part, you should aim to minimise the set up requirements on their part as much as possible as digital literacy can vary. 
  1. Ensure that HSCPs delivering clinics have appropriate training on use of any new technologies. 

* * * * * * * *

The National HSCP Office is compiling an online repository to collate and share eHealth and clinical HSCP resources to reduce duplication of effort at this time. Watch out for updates, it will be live on 3rd April, 2020.

This post was written by the eHealth HSCP Advisory Group.* Stay tuned – our next blog will address eLearning opportunities.

(*Members include Marie Byrne, Heather Cronin, Meabh Smith, Deirdre Gilchriest, Claire Browne, Joanne Dowds, Julie O’Connell, Fiona Maye, Orla Maguire, Ruth Reidy, Kate Murphy, Sarah Moore, Eileen Heffernan, Paul Ryan, Éadaoin O’Hanlon, Siobhan Keohane, Alison Enright).

“Move fast - Speed trumps perfection”  

Michael Ryan, WHO

Do you need information and advice on COVID-19? Go to www.hse.ie/coronavirus

Welcome to HSCP Share

“There is no power for change greater than a community discovering what it cares about.”

Margaret J Wheatley, Author & Speaker

A very warm welcome to HSCPshare.com, a new format for connecting Health and Social Care Professionals (HSCP) with one another, all 16,000 of us throughout the Health Services!

Set up by the HSE’s National HSCP Office, we hope this new format will add to our existing communications, helping to share information and learning from within and outside the HSCP community.

The HSCP Share Blog has been in the planning process for a little while and special thanks to the HSCP Communications Advisory Group and the eHealth HSCP Advisory Group for their invaluable assistance.

The process was somewhat accelerated in the past fortnight, though, as we found ourselves in extraordinary times, dealing with the new reality of the COVID-19 pandemic.

Very quickly, it became clear that now is the time for sharing and inspiration, while we deal with unprecedented challenges which require new thinking and approaches.

Our five main aims for this blog are to:

  • Share knowledge and promote organisational learning
  • Hear points of view from HSCP and other HCPs in practice, academia and management
  • Assist in developing networks of practice
  • Raise visibility of HSCP service impacts and consider opportunities for further impact
  • Enable collective dialogue

You can follow the blog by going to www.HSCPshare.com and adding your email address to the ‘Follow’ box.

We’re also on twitter – @WeHSCPs. Please do follow, share and contribute – this is your opportunity to showcase your work, its impact and to learn from others.

– Jackie Reed, National HSCP Lead

Do you need information and advice on COVID-19? Go to www.hse.ie/coronavirus