HSE imaging system fixed at ‘no cost’ to health service

Expert questions why coding error in software recording patient scans not spotted

The HSE’s National Integrated Medical Imaging System is used to store radiology, cardiology and other diagnostic images electronically. When images are archived, the  “<”, used in a report, was omitted and was not visible.

The HSE’s National Integrated Medical Imaging System is used to store radiology, cardiology and other diagnostic images electronically. When images are archived, the “<”, used in a report, was omitted and was not visible.

 

The Health Service Executive has said a flaw in its national imaging system for storing scans, which may result in thousands of patients requiring to have medical tests redone, has been fixed at no cost.

The problem has arisen with images of patients’ tests held at the HSE’s National Integrated Medical Imaging System (Nimis), which is used to store radiology, cardiology and other diagnostic images electronically.

It has been discovered that when images are archived, the “less than” symbol, “<”, when used in a report, was omitted and is not visible.

The HSE said on Thursday the error arose when data was moved within the Change Health systems (the provider of Nimis ) from one system to another.

“It is a coding error in what is known as the ‘integration engine’ rather than a database error,” the HSE said.

“The core system where the information is stored is correct. It is when other systems are used to view the information that the error occurs. However, in most GP systems this is not affected due to the use of the HSE’s own integration engine, HealthLink.”

The system had been fixed for “all reporting going forward” at no cost to the HSE.

Installation error

It has initiated a review which is expected to be completed by the end of October. Investigations so far indicate the error goes back to the installation of Nimis which in some cases was six years ago.

There is an agreed contract to upgrade Nimis to the next version of software but there is no plan to replace the system itself. Separately, a hardware replacement programme is already under way across the health system.

Meanwhile a data expert has questioned why the error was not spotted during testing.

Daragh O’Brien, managing director of consultancy firm Castlebridge, which advises on data governance issues, said this was a “data quality problem” that had a potentially significant impact on individuals.

“The HSE is correct to do a clinical review. But this is yet another example of the door being closed after the horse has bolted,” Mr O’Brien said.

“ I would have to question the quality of the testing that was done on the implementation of the system if something like this was missed.”

Mr O’Brien said the radiologist in the regional hospital who spotted the problem “should be applauded for raising a hand”.

Cause for concern

“But the question is did other people raise a hand on this in terms of it being an issue?”

“If something as trivial as this is missed, it gives cause for concern for any more complex or challenging information systems change.”

At least 25,000 X-rays, MRIs, CTs and ultrasounds taken since 2011 are affected. Thousands of patients across the State may need to have their medical tests redone after the problem was flagged by a radiologist in a provincial hospital last week.

Others may have received unnecessary treatment as a result of faulty information on the HSE’s system for storing scans electronically.

This would mean that, for example, where a patient had stenosis (narrowing) of the arteries of <50 per cent, this would be recorded wrongly as 50 per cent. The radiologist who wrote the original report would remain unaware of the error.