Less paperwork and better care – the role of InterSystems TrakCare at Ireland’s National Rehabilitation Hospital

Based in a new world-class, purpose-built facility in Co. Dublin, the National Rehabilitation Hospital (NRH) provides a complex and specialist rehabilitation service for the Republic of Ireland.

At this facility, adult and paediatric patients who have a physical or cognitive disability as a result of an accident, illness or injury, receive a comprehensive range of interdisciplinary rehabilitation services.

It provides care for both in-patients and out-patients and has an on-site Rehabilitation Training Unit (RTU) as well as satellite facilities.

The hospital is committed to best clinical practice and a patient-centred approach to ensure each person achieves the best possible outcome. It does this through consultant-led interdisciplinary teams (IDTs) that work across stroke, brain injury, spinal cord injury, limb absence, and paediatric programmes.

Ireland’s National Policy and Strategy for the Provision of Neurorehabilitation Services highlights the vital need for individuals to receive the right care, at the right time, from the appropriate specialists in a comprehensive, patientcentred rehabilitation journey.

A key priority is to facilitate seamless transitions between services through enhanced communication and information-sharing. With an integrated, flexible, and coordinated approach to care, any individuals with neurological conditions will access the essential support their condition requires.

NRH, however, had an outdated patient administration system (PAS) in place prior to TrakCare, supported by paper charts and each discipline keeping its own notes or logging into stand-alone applications.

The resultant gaps in data hindered efforts to fully optimise rehabilitation. Addressing these data gaps was fundamental to improving care quality and strategic service planning.

Consequently, the procurement and implementation of a robust, data-driven Clinical Management System (CMS) was identified as a critical enabler, allowing for the systematic collection of data on referrals, therapies, clinical outcomes, and patient experiences.

After a rigorous procurement process, NRH selected InterSystems TrakCare to help deliver its vision. The decision hinged upon TrakCare’s ability to improve care coordination through an integrated data model, ensuring up-todate accuracy and real-time access across teams.

Data integration specifically designed for healthcare environments and standards means the solution provides a longitudinal patient record. This offers a clinically-focused interface suited to users’ workflows, with ease of access from multiple devices.

Prior to implementation InterSystems worked closely with all stakeholders to establish data governance structures that support patient safety and fast, accountable decision-making. John Maher, Head of Information Management and Technology at NRH said:

“From the outset, we were clear that the clinical management system would not just be about technology, it was also about aligning clinical, operational, and technical priorities to ensure the system supported safe, efficient, and patient-centred care. This led to the establishment of cross-functional governance structures with clear decision-making authority and strong clinical leadership to guide every stage of the project.”

TrakCare’s modular architecture and native interoperability enabled NRH to pursue phased implementation. InterSystems uses a repeatable, scalable implementation methodology (known as ARIES) which reduces project risk and provides predictability in deployment timelines.

TrakCare is a pre-configured system that incorporates global best practices, ensuring easier deployment and ongoing support. The Irish Regional Edition includes built-in interfaces with national systems such as the Individual Health Identifier (IHI) and Healthlink, along with pre-configured clinical documentation (e.g., the Irish Early Warning Scores), decision support tools, and other components tailored to the Irish healthcare environment.

After the new PAS was successfully launched hospital-wide, the hospital followed up by deploying core clinical functionality, ensuring a smooth transition for frontline teams. A month later, this was followed by electronic prescribing and medicines administration (ePMA). The overall implementation project was delivered on-time and in-budget despite such external challenges as the global pandemic and the Conti cyberattack.

NRH embraced a proactive approach to change management and communication, engaging stakeholders across all disciplines through a variety of methods including a network of “change champions”.

A comprehensive, role-specific training programme was rolled out, which included a train-the-trainer model in which key staff were upskilled to deliver over 150 tailored learning sessions across departments. Training was designed to reflect real-world clinical and operational workflows, making it more useful for those who would be using the technology.

In light of EU Network and Information Systems Directive (NIS2) and data sovereignty requirements, TrakCare is hosted in two new private-cloud datacentres in Dublin, so data remains under Irish jurisdiction at all times.

“TrakCare has become the living memory of the hospital. Every new feature added builds on that foundation, giving us confidence to innovate quickly while keeping our focus on the patient,” said Maher...