HSE initiative: The Health Service Executive (HSE) plans to introduce a national immunisation database to improve vaccination levels within the next two years.
The database will join the more than 50 separate electronic databases and a similar number of paper-based filing systems holding vaccination records into one archive. Patients will be identified on this archive by their PPS number.
Lesley Smith, project manager of the initiative, said while all vaccines were recorded against a patient's chart, "it could be a chart in a hospital, in a GP surgery, in a clinic, in a health board. And all these are not joined up."
The result is incomplete or duplicate vaccination records for many patients, particularly where people have moved to a different health board area.
"If there is an outbreak, such as with mumps in some third-level colleges earlier this year, it can be a massive task to find out who has had their MMR. So sometimes people receive a vaccine when they don't need it. And when third-level institutions vaccinate, some record that on an IT system, some only record this manually," Ms Smith said.
Multiple databases mean not all health boards can provide timely, accurate information to the National Disease Surveillance Centre (NDSC) to estimate vaccination uptake. This is compounded by the fact that many GP surgeries still use paper-based records and that the existing reporting system was designed as a payment system for GPs rather than as a method of tracking patients and vaccines.
For the project to succeed, the level of computerisation in many GP surgeries will have to improve.
Such a system would also allow the immediate tracking or recall of a batch of vaccine, said Ms Smith. "Compare that to the recent difficulties with the polio vaccine, there were literally people looking through paper files for days and days. With a central system, we could potentially run a report in minutes."
The project raises data protection issues, which Ms Smith said would have to be handled openly and transparently. "We want to make sure we keep patients' information confidential and secure but at the same time for a system like this to work you need to have the people who need to access it, able to access it."
The goal of a single, searchable database is based on the findings of the National Review of Immunisation/Vaccination Programmes reported from 2002.
