Dr. Jennifer Doran:

I thank the committee for having us here today to address how to improve quality and duration of life for those living on Ireland's offshore islands. I am a medical doctor and a research physician in e-health and I also have a background in law, having worked for over five years in the European Commission and Parliament, focusing on the area of regional development. I am joined by my colleagues, Dr. Ian McCabe and Dr. Noreen Curtis. Dr. Curtis will speak about the day-to-day realities and challenges of life as an island GP, while Ian and I will speak about the pilot projects in e-health that the health innovation via engineering, HIVE, laboratory in the University of Galway is pioneering. We are a group of doctors, researchers, thinkers and engineers focused on finding innovative solutions to healthcare problems using technology and engineering. We do this in the hope of keeping the Irish population, particularly the rural population, living longer and better and reducing the need for admission to our hospitals and care homes. We have focused our work on some of the most isolated parts of Ireland, working at the frontier where isolation meets innovation. Where better to start, then, than the islands?

Our work began a year ago on Clare Island with the Home Health project and will soon expand to Inishturk and Inishbofin under the umbrella of the Healthy Islands pilot. With the committee's support, we hope to expand this and grow the suite of healthcare solutions and options on offer to Ireland's island and rural populations. We are also working on a pioneering "virtual ward" project aimed at delaying admission to and facilitating early discharge from hospital so as to keep people in their own homes for longer.

The Covid-19 pandemic showed us what can happen when patients are unable to visit their doctor or hospital for fear of infection. However, similar barriers to healthcare exist year-round for a large portion of the population, who find attendance at their healthcare provider difficult due to distance, disability, lack of transport, responsibility for loved ones, land and livestock, or inclement weather.

In all these situations, a telemedicine solution could provide options for alternative models of care. Nowhere is this more true than in the management of chronic conditions such as hypertension, heart failure, diabetes and other comorbidities, which together represent the biggest burden on the Irish health service. Here, telemonitoring and telemedicine have the potential to revolutionise a patient's experience of care, save time and money for both patient and provider alike and alleviate some of the strain on our already heaving health service.

Modern medicine has meant that people are living longer and, correspondingly, there has been a huge increase in chronic illness. This means new approaches are needed to deliver healthcare efficiently and effectively. This is especially important for those living many miles from their local tertiary care centre, whether distanced by land or sea. Telemedicine allows the secure, remote exchange of medical data between patients and healthcare professionals. It is used to increase patients' access to care and provide effective healthcare services at a distance. The overarching goals of our work are to explore the impact of remotely delivered healthcare on the well-being of isolated rural communities, particularly those on the island; to evaluate its impact on patients' experience of, engagement in and management of their own health and chronic conditions; and to investigate barriers to the adoption of digital health, well-being and monitoring among adult populations in rural communities, particularly those on the islands.

Clare Island, where we began our work a year ago, is home to a community of 160 people. They have carved out a living for themselves on this remote island 5 km off the west coast. Serviced by a single doctor who travels weekly to the island from the mainland, it is home not least to several newborn babies but also to an ageing population attempting to live with and manage a complex tapestry of chronic conditions and comorbidities. For many, a routine hospital appointment can mean days away from home and an arduous journey via boat, bus and car, together with a costly stay on the mainland, until weather permits a return home. That is before we mention slippery cement steps at both island and mainland piers, where you sometimes have to take your life in your hands getting on and off the boat. This is particularly challenging for those with physical disabilities or activity-limiting health conditions. In our work, we are conducting feasibility studies into how the remote delivery of healthcare and health promotion can improve the health of a rural community, and we are examining its impact on people's lives at both individual and community levels with a view to expanding this pilot model to other islands and across rural Ireland.

As my colleague, Dr. McCabe, will explain, through our work on the Healthy Islands project and the Home Health project, together with our partners in the HSE, Cisco and the Western Development Commission, we hope to bridge the gap and level up the access to healthcare for those living in rural and offshore areas of Ireland. I thank the committee.