It is essential to have a health system that is transparent and accountable. Information needs to be collected, analysed and intelligently interpreted in order to allow the health system and population it serves to monitor what it is doing, recognise where improvements are occurring and identify potential problems, so that actions can be taken to rectify them.
It makes sense to use available data and information to support important issues such as patient safety and quality of the care. The Hospital Inpatient Enquiry Scheme (HIPE) system is the largest system providing information on hospital care in this country.
With this in mind, the Chief Medical Officer of my Department has been working on a report entitled ‘Health Care Quality Indicators in the Irish Health System: Examining the Potential of Hospital Discharge Data’ . This includes the measure of recorded 30 day in-hospital mortality rates following heart attack.
The work to date demonstrates the value of using HIPE as a tool to derive knowledge and understanding of health care quality. However, this work has also uncovered variation in the accuracy of data as reported through the HIPE system. Some individual hospitals have looked into the origin of this variation and attributed it to inaccuracies in both the medical chart and the subsequent coding of information that is then inputted by individual hospitals in the HIPE system.
I am concerned about this finding in relation to data quality given its potential patient safety implications. I believe that, arising from this, there is a duty on all hospitals to address measures that can ensure that the information which they record and report is accurate.
Concerns have been raised by certain hospitals and clinicians that the report, which seeks only to examine quality of data, could be either inadvertently or deliberately misinterpreted as making inferences on quality of care. I understand this concern. However, I do not accept that the solution is to disregard these data. Where that source of information is found to be flawed the solution is to improve it. These data have been collected by hospitals and the hospitals themselves must be accountable for the quality of them.
Therefore, the CMO in conjunction with the HSE and the Economic and Social Research Institute (ESRI), wrote to every public hospital in the country in 2012 requesting that they ensure that the information they recorded and reported for 2011 and 2012 was accurate.
It is expected that the report will be finalised and published in the near future.