Investment in e-health proposed under development plan

Investment in electronic health records and new IT systems will directly improve patient services and allow chronic disease to be managed at home and in the community, the new National Development Plan says.

The plan confirms proposals already announced by the Health Service Executive in recent years, which were also a feature of the Sláintecare report on reforming the health system.

It says ICT systems such as electronic prescribing and tele-health will “directly improve patient services allowing chronic disease to be managed in a more patient centred environment at community level including in patient’s homes”.

Investment in ICT infrastructure will enable the integration of services and flow of information across and within various care settings.

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This will include the National Electronic Health Record (EHR) programme, which the national plan says is “vital to make patient information available through technology to support improved patient care, safety and efficiency”.

While the total cost of the electronic health records plan is not set out, the former chief information officer of the HSE said two years ago it would cost up to €875 million to fully implement.

Richard Corbridge said the capital costs would be between €345 million and €467 million over five years, with revenue costs of between €302 million and €408 million.

A nine-year plan, however, estimated capital expenditure of between €354 million and €479 million, with revenue costs of €235m to €345m.

The Government’s National Development Plan envisages a 10-year implementation timescale for digital health services.

“Digital health services will enable the right information about the right patients to be available securely in the right health care setting at the right time. This will allow doctors and nurses to enhance patient safety and will also support, in time, patients being able to securely access their own health data,” the plan says.

“Digital health implementations envisage a range of systems to underpin patient safety, efficiency and the critical building blocks required to support integrated care across our health system.

“The National Development Plan will also fund the ongoing investment in healthcare ICT to support a range of functions including electronic patient record systems, radiology, laboratory and diagnostic facilities.”

The plan will build on the recent introduction of a maternal and newborn health record in Cork, and will support the implementation of similar systems in other healthcare settings, including the acute, primary and community care areas.

A business case prepared by the HSE's digital division eHealth Ireland for the EHR in 2016 said electronic health records can be used to "provide a rich source of intervention, outcomes and cost for retrospective data and trend analysis, which can identify areas where further research is required and likely cost effectiveness of treatments".

It says EHRs also “readily support the identification of candidates for prospective studies and enforce the collection of data”.

The document also says such records can “be readily searched to find suitable case studies to support bedside or lecture based clinical teaching”.

eHealth Ireland has acknowledged that challenges with the introduction of electronic health records are likely to include concerns about privacy and the sharing of information, which will involve “ongoing engagement” with the Data Protection Commissioner.