New report highlights requirement for national health information plan

The need to improve Ireland’s healthcare information system has been known for some time. However, Covid-19 and the recent cyberattack have highlighted deficits in the current infrastructure, and the impact on patient care. On the back of these crises, HIQA has published a new position paper that has called for urgent reform in the area.

The paper states that the health service’s ICT infrastructure, as it stands, is “fragmented with major deficits”. Regarding Covid-19, the report says the “lack of maturity” of Ireland’s health information system made it even more challenging to respond to the pandemic. The past year-and-ahalf has underscored the importance of “high-quality, standards-based” health information, which can be communicated across acute and community settings.

“Covid-19 has particularly highlighted challenges of managing and delivering an effective public health service in Ireland in the absence of fit-for-purpose, integrated information systems in relation to infectious disease surveillance, public health case management and immunisation,” according to the report. Despite the efforts made by the HSE in rapidly delivering health information systems for the management of Covid-19, there are still serious deficits in our overall health information landscape.

For instance, the report points to the lack of a fully operational individual health identifier and the impact of this on roll-out of systems, such as the Covid-19 case tracker, test and assessment appointment scheduler, and Covid referrals. The report adds that the cyberattack “has had a severe and immediate impact on health services and has strongly emphasised the need for continuous investment and strengthening of our security infrastructure”.

HIQA says political commitment is required to deliver a new national health information strategy. This strategy should have achievable and timebound objectives that are aligned with Sláintecare. The report points out the strategy “needs to be assigned appropriate funding to ensure that its objectives can be fully achieved”.

“There is a need for a clear policy direction for health information, and a clear roadmap on how the different agencies within health and broader governmental organisations are coordinated, to deliver an integrated approach to health information and support the health and social care system in Ireland,” according to the Authority. To complement this work, the existing e-health strategy, which was published in 2013, is outdated and should be revised to reflect more
recent technological developments, according to the HIQA report.

E-Health Ireland has not been established as was originally intended, as a separate entity with responsibility for overall governance around e-health implementation. However, HIQA adds that an “operational function” for developing and
supporting systems required for the delivery of care should continue to exist in the Executive.

“The remit of this entity should be broader than e-health and include the centralised coordination and governance of national data collections and the secondary uses of health information at a national level.” Developing such strategies at a time when the health service is still tackling an unprecedented crisis will not be easy. But the cost of not doing so will be too high.