We’ve recently introduced a modernised patient database system to our BreastCheck programme - AIRE (Assessment, Information, Record & Evaluation). This new system aims to simplify and streamline workflows, allowing our BreastCheck team to focus more on direct patient care. With AIRE, we can access real-time data to track each screening participant’s journey and address any gaps in service delivery.
The development of AIRE is in line with the HSE's Digital Health Strategy, which aims to improve health services for both patients and staff, making them more modern and easier to access. The strategy outlines that the first key step to providing fully integrated care is to create digital systems that support it.
Why we needed AIRE
The previous system, NBSP (National Breast Screening Programme), served us for over 20 years but couldn’t keep pace with recent technological advancements or the growing development of services, such as expanding the age range for BreastCheck and introducing procedures like vacuum assisted excision (VAE), which can allow some women to avoid surgery.
Designing and planning
The design phase of AIRE involved input from many of our team members to ensure the new system met the needs of each discipline. Gaining consensus across teams was challenging, especially where procedures differed. Workshops identified potential improvements and allowed for cohesive planning across various workflows.
Pre-launch training was extensive, giving staff confidence in using the system.
Roll out
AIRE officially went live on 20 May 2024, a few weeks after our initial planned move, which we rescheduled to ensure the safe and secure transfer of data from NBSP. We used this additional time to provide more staff training and improve data transfer quality.
To prepare for our go live date we slowed down the number of screening invitations issued and booked assessment appointments early. This meant that heading into implementation we were as up to date as possible and importantly, screened women would not have to wait longer than necessary for assessment. We closed down the system for 2 days to allow for the transfer of data. The development team were onsite to manage the switch over and worked with us over the following weeks to address snags.
Challenges
AIRE has been the biggest system change in 25 years of BreastCheck and affected every single member of staff working across the entire patient pathway. We knew that adapting to AIRE would pose some challenges, including early-stage system adjustments. Our priority at all times is patient safety. We reduced screening numbers over the implementation period to minimise the impact of this system change to our screening participants and ensure their continued safety.
As we continue to face and resolve the challenges of the system change, we are focusing our work in areas which will most benefit women attending our screening, assessment and results clinics.
The huge benefit that new technologies will bring for our participants now, and in the future, makes the necessity of reduced screening numbers this year worthwhile, and we are now safely increasing our invitation rates.
Benefits
We are already beginning to see the benefits of AIRE emerging. It is a user-friendly system based on up-to-date technology and means we will be able to follow every woman’s journey throughout the whole screening pathway. It is beginning to reduce our administrative tasks with less reliance on pen and paper.
AIRE's ability to integrate with other systems brings additional benefits. It has streamlined communication with stakeholders, such as GPs through Healthlink, saving time, reducing manual tasks, and cutting costs. Integration with Auto Address API has improved data quality and the accuracy of address data. It provides our addresses with coded identifiers which will help us to identify areas where increased efforts around equitable access and support for screening participants are needed. AIRE also integrates with our mammography imaging system (PACS) and we continue to work with our radiology and radiography teams to enhance systems with more dynamic reading and assessment workflows.
Next steps
Our next step in the implementation of AIRE is to complete the validation of data so that we can generate activity and performance reports. We are aiming to use our real-time reporting capability to monitor trends and track service capacity. This is an additional benefit of AIRE that wasn’t previously available to us. This data will help us to refine and improve our operational responses, and plan and prioritise actions to address challenges such as the pauses to screening invitations during 2020 and 2021; reduced screening invitations during the implementation of AIRE; and the ongoing challenges of recruitment of clinical staff. With the ability to analyse data on clinic activity, we can develop targeted strategies to optimise services.
Continuous improvement
We remain focused on refining AIRE, offering ongoing training, and prioritising updates based on feedback. Weekly meetings help ensure consistent progress, with an overarching goal of enhancing service quality and standardisation for all patients.
With the new AIRE system, we will be better equipped in the future to offer more efficient care, improving the entire screening journey for women who choose screening.