Overhaul needed on ‘paper-based’ health sector records

The State’s health service regulator has called for an urgent overhaul of how health information is managed, saying that it is central to the success of the Sláintecare reform plan.

The Health Information and Quality Authority (Hiqa) has said there are “major deficiencies” in the collection, use and sharing of information with data on patient health usually being managed on different electronic systems or on paper-based systems, which can affect people’s safety.

The watchdog has called for the establishment of the long-recommended eHealth Ireland digital systems to manage patient information, not just across the Health Service Executive but across the wider health and social-care sector.

It also wants new legislation to allow patient information to be shared more easily and new guidance and codes of practice for healthcare professionals.

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Hiqa said that changes to how patient information is managed and shared and the legislation underpinning it was critical to the rollout of Sláintecare, the Government’s 10-year plan to overhaul the health service and integrate health and social care across State services.

Laura Magahy, the executive director of Sláintecare, cited the slow progress in rolling out of the ehealth system as one of the reasons for her resignation from the role last month.

Rachel Flynn, Hiqa's director of health information and standards, said the urgent reform of the management of health information had to be made "a political priority" and that Hiqa's concerns should be "a wake-up call" for everyone involved in health and social care.

“Sláintecare is about integrated care. You cannot have integrated care relying on paper to communicate,” said Ms Flynn.

“I have spoken to community health teams where they are delivering care in the community using a paper-based folder to share information. There are huge inefficiencies in that.”

Cyberattack

Ms Flynn said the experiences of the Covid-19 pandemic and the cyberattack on the HSE earlier this year showed the impact on people’s safety from having to rely on paper records and led to an increase in waiting lists and rescheduled appointments.

“Covid highlighted the fact that a lot of our information systems are very, very basic,” she said.

The pandemic showed that the State did not have a digital system covering vaccination programmes, while gaps in information systems highlighted how the State was unable to vaccinate particular groups, such as people with diabetes, because there was no national register.

Health information systems in other countries allows them to prescribe medicines online but the Government had to pass emergency legislation for digital prescriptions during the pandemic.

Ms Flynn said that Denmark has operated an online portal for patients where they could book appointments for Covid-19 test and look up test results and download their vaccination certs.

“Denmark already had that infrastructure in place for all healthcare so they didn’t have to reinvent it for Covid-19, making their management of Covid-19 somewhat easier,” she said.