Resourcing health IT is an investment, not a cost

The provision of an indicative timeline for the roll-out of digital health reforms by the Minister for Health is to be welcomed, according to IHCA Senior Policy and Research Executive, Mr Dara Gantly

Every consultant will share the view that every effort needs to be made to digitise healthcare records across Ireland. It is a long time coming. As such, the recent indication of a timeline for the roll-out of digital health reforms by the Minister for Health Stephen Donnelly is to be welcomed.

The current deficits in our digital infrastructure are significant, with inefficient and outdated information technology (IT) systems and hardware. The continued absence of electronic health records (EHRs) also negatively impacts patient care, staff morale, and productivity. With the majority of Irish hospital records still paper-based, there is an urgent need to fund a national EHR hospital-wide system without delay.

EHR

A business case for a national EHR was submitted to the Department of Public Expenditure, NDP Delivery and Reform in 2016. However, this was not approved as the Department wanted this to be validated first in the National Children’s Hospital before rolling it out across the health service. At one level, one could argue there is some merit in this position. But the strength of that argument has diminished over time as the completion date for the new hospital has been pushed out further and further.

The Minister for Health Stephen Donnelly estimates that the regional deployment of EHRs is likely to cost between €200 and €300 million for each of the six new health regions – or up to €1.8 billion nationally. The final amount could, in fact, be more and end up similar to the cost of the new National Children’s Hospital, such is the scale of the task ahead.

Timeline

The Association welcomed the provision of an indicative timeline for the roll-out of digital health reforms by Minister Donnelly during the second stage of the Health Information Bill 2024 last month. Crucial e-health platforms are due to come on stream this year and next, paving the way for phase three which will see the roll-out of full digitalisation across the health service.

Additionally, it is positive that the proposed legislation appears to enjoy broad cross-party support in the Oireachtas. The Association will continue to engage with all relevant political stakeholders in order to ensure that the legislation leads to a positive outcome for both our patients and membership.

Funding

It is worth noting that digitally mature health systems typically spend between 4 and 6 per cent of their overall health budget on digital health. This would equate to between €1 billion and €1.5 billion in Ireland based on a €25.7 billion health budget in 2025. The HSE recognises the need for significant and sustained investment to achieve a number of transformational goals, including the implementation of EHRs and a national shared care record. It is seeking the above level of funding from Government to deliver the various initiatives outlined in its recently published digital roadmap.

IT funding in health would have to more than double from the current level of 2 per cent to between 4 and 6 per cent of the overall health budget to meet the above target. This would help ensure Ireland obtains a fit-for-purpose national health information system that enhances patient care and treatment and supports better planning and delivery of health services. Ideally, this funding should also be front-loaded in order to meet Ireland’s commitment under the EU Digital Decade policy that 100 per cent of EU citizens will have access to their own electronic health records by 2030. This target will be extremely challenging for Ireland to achieve.

A fit-for-purpose digital health system for Ireland is essential to provide health staff with the necessary digital tools to optimise efficiency, collaboration, and productivity in a more modern health service. With these tools, consultants will be able to deliver improved accessibility, more efficient workflows, and most importantly enhanced patient care and safety.

Given that every €1 spent on technology could potentially generate up to €4 in savings from the resulting time and other efficiencies, this funding allocation needs to be viewed as an investment, not a cost.