Ireland’s digital health strategy talks about empowering patients but, in practice, we are still designing systems around clinics, not people. Unless that changes, and quickly, we risk missing the point of digital care entirely.
It has been a year since the Government launched its Digital for Care framework. The vision was right: “patient as an empowered partner”, “digitally enabled and connected care”, and a suite of projects from shared records to virtual wards.
But one year on, we are in the same place, with big ambitions, slow delivery and a model that still bends around the clinic.
Care doesn’t just happen in hospitals. The vast majority happens between appointments, at home, at work and in the craziness of daily life. This is where people manage chronic conditions, take their medications, monitor symptoms and decide whether or not to ask for help. And that’s where our current digital infrastructure often fails.
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Unfortunately, tools are still being designed with the provider in mind. The focus is in the completely wrong place, digitising records or streamlining clinical workflows, never addressing the challenges patients face on a daily basis.
In practical terms, what use is a hard-to-navigate app, a one-size-fits-all reminder system or a portal that doesn’t reflect diverse language or ability barriers? This isn’t patient-centred, it’s a digitised bureaucracy.
We need to flip the model: start with the patient, then build out. And we need the Government to lead on this. That means making patient-first design a condition of funding, roll-out and evaluation. New services should be judged on whether they enable self-management, reduce clinic dependency and improve outcomes that matter to people’s lives.
Other countries are already doing this. The NHS’s virtual wards have supported nearly 500,000 people in recovering at home, reducing pressure on hospitals. In the US, remote heart failure monitoring has cut emergency visits by 93 per cent and hospitalisations by 83 per cent.
These services work not because they’re digital, but because they’re designed to fit into life outside the hospital.
It’s not just a better experience, it delivers better results.
Remote cardiac monitoring has been shown to increase life expectancy by up to nine months while reducing hospital costs per patient. One study placed the cost per QALY (quality-adjusted life year) gained at just $10,700 (€9,150), far below the threshold for cost-effective care.
And satisfaction among patients is consistently high, with more than 90 per cent of users of remote monitoring reporting convenience, peace of mind and greater confidence in managing their condition.
The UK’s Fit for the Future strategy offers a useful contrast, not because it’s perfect, but because it’s moving.
It shifts the conversation from technology as a tool for hospitals to technology as an enabler of neighbourhood care, workforce support and daily patient empowerment. That kind of shift is cultural as much as it is operational, and it’s what Ireland’s framework is still missing.
We’ve outlined the right goals. What we now need is the courage to reorganise care around them.
Mindset shift
To its credit, Ireland is moving somewhat. E-prescriptions are becoming more common. Sláintecare pilots are exploring new models. The Health Service Executive (HSE) is investing in digital infrastructure. But the mindset still feels institutional. We are layering technology on to a system that was designed for a different era, rather than rethinking how care should work in people’s lives today.
The Digital for Care framework is a unique opportunity to change that. But it can’t just describe the shift, it has to drive it.
That means funding pilot programmes that start from the patient experience. It means measuring success by health outcomes, not login rates. It means embedding co-design with patients into how we procure, test and scale new tools. And it means setting timelines that match the urgency of the challenge. We can’t spend the next six years admiring the strategy.
Ireland has the talent and the companies to lead. Our medtech and healthtech sectors are already exporting solutions worldwide. But we can only be credible global players if we show that our own health system knows how to use them.
This is about more than modernisation, it’s about building a healthcare system that reflects how people actually live. If the Digital for Care framework succeeds in that, it won’t just digitise Irish healthcare. It will help humanise it.
And if it doesn’t? Then we’ll have built a digital system with the same flaws as the analogue one, just shinier.
Kieran Daly is cofounder of HealthBeacon
