I have been advised by the Health Service Executive as follows.
Live deployments of full electronic health records on a wide scale jurisdiction are extremely rare. Many health systems have electronic records in parts of their services. Within hospitals these are typically referred to as electronic patient record systems. The concept of electronic health records brings together the various electronic records in different services-settings referring to each client-patient, for example, the amalgamation of records held by GPs with those held by other professionals in both community and hospital settings.
The iSOFT system was selected primarily for hospitals with the intention of initially deploying it to support core administrative processes and then to evolve its use over time into clinical support areas. As such it was seen as a means of achieving electronic patient records within hospitals and between hospitals. It was also seen as a key facilitator to achievement of electronic health records as it has potential for deployment in community care services also, which the Health Service Executive plans to do over time.
The achievement of full electronic health records in the Irish health service is a long-term goal. The concepts and design of such a system have not yet been developed and there is considerable work required over the next number of years to put the necessary foundations in place. The iSOFT system is an important element of this but there are many others.
The iSOFT system is being used extensively as a key element of building electronic health records in a number of other countries, for example, the UK and New Zealand. These are also long-term projects that are not yet completed and there are multiple suppliers involved.
Regarding responsibility for accuracy of patient data under the new system, the legal entity will be the Health Service Executive, or voluntary hospital or agency, as appropriate, which is accountable in law for compliance with data protection and other related legislation. Internal quality control procedures will be deployed to ensure a high level of accuracy of patient information.
Regarding reconciling discrepancies in the information, this will be a normal part of the operation of the new system and will be the responsibility of various staff involved in data recording and updating.
Regarding the way in which security of access to information will be implemented in the system, a security policy will be defined and implemented as part of the roll out of the system. The general principle will be that access to patient information will be on a need-to-know basis, consistent with job function and appropriate patient consent. It is recognised that there are huge patient-care benefits to ensuring that the right information is made available to the right person in a timely manner but this must be balanced against the need to ensure that inappropriate access does not occur either. All staff will log onto the new system on a personal name basis, thereby identifiable, and with their unique private access keys. All activity will be automatically recorded in an audit trail, thereby ensuring staff are accountable for whatever use or access they make.