Ex-HSE digital lead urges swift roll-out of low-cost EHR

A low-cost electronic health record (EHR), based on open source non-commercial, well-established technology could be up and running throughout the Irish health system much faster than the current incremental approach, according to former HSE Head of Digital Transformation, Prof Martin Curley (PhD).

A pilot EHR scheme Prof Curley and two HSE managers, Ms Concepta de Brun and Ms Maxine Radcliffe, have worked on is currently being used for about 15,000 patients, some of whom have complex needs.

“This system enables information-informed, real-time care for people. It operates over seven fixed HSE sites and over 150 floating clinics, facilitating 50 HSE clinicians and social care workers in south Dublin, west Wicklow, and Kildare,” Prof Curley, who is Professor of Innovation at Maynooth University’s Innovation Value Institute, told the Medical Independent. Prof Curley left the HSE in 2023.

“Many of the patients have lots of vulnerabilities, and the system more than adequately meets their needs, which is promising for broader adoption across a less-challenged population,” he added. Among the patients are Ukrainian refugees, homeless people, and international protection applicants.

 The current EHR landscape in Ireland is fragmented with different hospitals procuring their own systems.

“There are so many digital change-motivated clinicians, but who are held back by a lack of HSE digital leadership, bureaucracy, and cohesion,” Prof Curley said.

“The ability for a clinician to see a detailed history of all the encounters a patient has had with the health system and an accurate current medication list would be game-changing here in Ireland, but is commonplace in many other developed countries.” In May of this year, Digital for Care: A Digital Health Framework for Ireland 2024-2030 was published. The document admits the implementation of a national EHR will be a “challenge”, “costly”, and is likely to represent the single largest area for investment in digital health across the health system. “A business case, aligned to investment guidance, will be developed, leveraging much of the work that has been done to date for other EHR programmes,” according to the framework. See interview.