After almost a year-long delay, the Healthy Islands project is finally underway, aiming to revolutionise the delivery of healthcare to three islands off the west coast of Ireland using telemedicine.

Led by the University of Galway, the project is a collaborative effort involving the HSE Digital Transformation team and local and regional authorities. It aims to integrate telemedicine for the people of Clare Island and Inishturk off the coast of Mayo, and Inishbofin in Galway.

None of the three islands have an on-site doctor, although a doctor visits Clare Island from the mainland once per week. For Inishbofin, it is three times per month and for Inishturk, it is once per month. Due to the impact of bad weather on travel to the mainland, some patients can go up to four months without having access to a GP.

The initiative was officially launched in June 2023. However, a delay in issuing contracts say work delayed the kick off until this summer.

Speaking to Pulse+IT from his home on Clare Island, research fellow at the University of Galway and project lead of the Healthy Islands initiative Ian McCabe said the project was now well underway.

“We are in the process of getting this done now,” Dr McCabe said. “I’m looking out the window at the moment, hoping the next ferry will deliver the ECG machine.”

The new piece of equipment will mean that if an individual on the island develops chest pain, the on-site nurse can administer an ECG and a doctor on the mainland can review the results in real time.

Much of the basic foundations of the project are now in place, Dr McCabe said.

“We’re doing it with basic equipment, with screens and Webex to connect patients to the doctor. There is a kit of devices that connect the patient to a tablet to measure vital signs, like weight, blood pressure, blood oxygen levels, and lung function.

“The doctor or nurse can help the patient take these measurements and they can have a face to face consultation on Webex where the doctor has all the information at hand.

“We’re also using a digital stethoscope so the nurse can take recordings of chest sounds or cavity sounds and transmit them through the app to the doctor on the mainland.”

He is also hoping to extend University College Hospital Galway’s virtual care pathways to the islands. The hospital currently has two virtual pathways in operation, with a third due before the end of this year.

The COPD virtual care pathway was launched in April 2024 and has already saved 358 bed nights. The initiative is being offered to inpatients to reduce hospital length of stay and to patients who present to the emergency department with stable COPD exacerbations as a way of avoiding hospital admission.

Recent data suggests the average length of stay in virtual care is 7.6 days, a 35.5 per cent improvement compared to the national average.

Under the COPD virtual care pathway, patients use the MyPatientSpace app to report daily symptoms, and are equipped with a pulse oximeter to monitor vital health metrics such as oxygen levels and heart rate on a daily basis.

Any deviations from target levels or problematic patterns activate immediate notifications, allowing for rapid action and personalised care to address concerns before they escalate.

The heart failure virtual care pathway has just recruited its first patient and a virtual pathway for atrial fibrillation is expected to be operational by the end of November. The latter will employ a smartphone app which uses the phones camera and flash to detect heart rhythm and identify life-threatening atrial fibrillation.

“I would like to have some element of this offered to the people on the islands, so that they could have engagements with their GP virtually or, enhanced with telemedicine, they could become part of the hospital-based care pathway but still remain on the island,” Dr McCabe said.

“They would, hopefully, overcome their episode and get discharged, all while remaining in place on the island. I think it would be a very real way to demonstrate just how these things can transform healthcare.

“We’re anxious to get this project up and running on the islands properly. I come from Clare Island so I have skin in the game. It’s my mother and father who are going to be impacted by this, so it’s very important to me personally that we get this done.”