‘You have a vision, but no plan’: health officials face scrutiny over electronic records

TDs are to quiz senior Department of Health officials over delays in introducing an electronic record for all patients, after hearing the long-planned project is “only at the starting line”.

The Oireachtas health committee will seek explanation for the delay from Department secretary general Robert Wall and incoming HSE director general Bernard Gloster, its chairman Sean Crowe said on Wednesday.

He was speaking at the end of a hearing on the HSE’s plans for digitisation during which TDs expressed their frustration at the lack of progress on big IT projects in health.

In 2018, the HSE sought approval from the Department, and the Department of Public Expenditure for procurement of an electronic health system, HSE officials told the committee, but their business case was rejected.

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The HSE then deferred its plans pending a review of the introduction of electronic health records in Children’s Health Ireland, chief information officer Fran Thompson said.

However, this review has not yet taken place because of delays in completing the new national children’s hospital in Dublin, the committee heard. It is unlikely to open until 2025.

In the interim, Mr Thompson said the HSE has had to implement “multiple tactical solutions” to deliver on the eHealth agenda.

While acknowledging the HSE has not been able to deliver on the “core” of its electronic health records plan and had not got “to the starting-line” he said many of the tactical solutions implemented “have made a difference”.

It will take five to seven years to introduce a national electronic patient record, he estimated.

[ Digitisation of health service is being impeded by ‘bad actors’, former department head says ]

Senator Martin Conway said he was “taken aback” at the lack of progress. “I accept you have a vision, but there’s no plan to back it up,” he said.

Mr Thompson acknowledged the health service was being held back with inefficient and often paper-based patient interactions. “Our current system lacks access to timely, accurate and robust data that is essential to informing decision-making and assessing resource utilisation across operational, clinical and strategic departments.”

Part of the original national electronic health record proposal, which was not approved, was to deploy a patient/clinical portal. He said the HSE is in the process developing an updated business case for this and has been in discussions with the Department of Health on it.

Only St James’s Hospital in Dublin and the four maternity hospitals operate an electronic health record for all patients. The new children’s hospital will be a paperless facility when it opens.

While investment in eHealth in the past was very low, it has increased considerably since 2020, Mr Thompson said. “Rectifying the historic underspend will take a number of years, even with the additional resources. However real progress has and is being made.”

HSE electronic systems have fully recovered from the May 2021 cyberattack, he added.

Last year there were 48,000 cyber-alerts, some of which could be an attack, but all threats were stopped.

He said 1,200 cases were investigated and 200 were found to be significant potential attacks.