Dáil Éireann Debate, Tuesday - 18 April 2023
1754. Deputy Richard Bruton asked the Minister for Health if he will provide a progress report on investment in a proper system of electronic health records; if he will indicate the barriers, if any, to more rapid progress; the estimated penetration to date; and the initiatives planned to accelerate and complete the project. [18165/23]
View answerThe phased roll out of Electronic Health records (EHRs) is continuing with provision of an Electronic Health Records (EHR) System at the New Children’s Hospital underway with a contract now in place and staff being recruited to support its roll-out. When complete, this will be the most extensive EHR deployment in Ireland to date. The New Children’s Hospital has been designed as a digital hospital and requires a functional electronic health record (EHR) as a core element of its operations.
The deployment of electronic health records at the New Children's Hospital builds on the success of other major eHealth programmes such as the EHR deployment at St James Hospital, which has a hospital wide electronic health record system in place since 2018. The use of electronic health records is now embedded in the process of delivering care to patients at St James, the largest acute hospital in Ireland.
With the aim of reducing risk to newborn babies and their mothers, we now have an EHR system deployed across three of our major maternity hospitals (plus the maternity unit at University Hospital Kerry), with plans to cover the two remaining large maternity hospital by 2024. This means that today 40% of babies born in Ireland. By 2024, 70% of babies will have an electronic health record assigned at birth. Completion of the two remaining large sites at the Coombe and Limerick Maternity was delayed as plans were adjusted because of the cyberattack in 2021, and the need to migrate the system to the cloud and take other mitigating actions to increase cyber resilience prior to further expansion.
It’s important to note, that Electronic Health Record (EHR) deployment is only but one of over 700 funded ehealth project and initiatives currently underway under the government’s eHealth programme to deliver a range of eHealth/Digital services to meet the needs of all patients and healthcare professionals working in the acute, community and primary care settings, in line with Sláintecare objectives.
The Department of Health is currently accelerating progress on a digital patient healthcare record deployment programme with the HSE which will deliver access for patients to their digital health record, starting with a summary care record. The roll-out of digital health record solutions will complement the existing work being undertaken to progress more extensive EHR deployments such as those at St. James Hospital, our maternity hospitals, the new children's hospital, the national rehabilitation hospital and the national forensics hospital. A business case is also being developed to deploy an EHR across community healthcare settings.
As part of this, the development of a Health Information Bill is well advanced and will underpin the future roll-out of patient records digitally to the population; it is expected that a Memo for Government approving the General Scheme will be brought forward shortly. As part of the health information policy landscape, the Bill will ensure Ireland has a fit for purpose national health information system to enhance patient care and treatment and support better planning and delivery of health services.
It was necessary in the last 2/3 years to focus on development and deployment of national health systems to respond to the pandemic (e.g. national vaccination system linked to GPs & pharmacy systems, national test & trace surveillance systems etc ). The health service also had to deal with the devastating impact of the cyber attack in May 21 and the significant effort required to restore health systems and services.
We are now investing a significant amount of resource in Digital Health to support the implementation of Sláintecare. Capital funding for ICT has increased from €85 million in 2018 to €140 million in 2023. Additional revenue funding since 2019 also means that there are more ICT professionals now working in our health service than ever before. Staffing has increased from 365 in 2019 to 867 in March 2023, with teams made up of ICT professionals, technical project managers, healthcare professionals and support staff. Revenue funding allocated to the Office of the CIO at the HSE for eHealth has increased from €50m in 2019 to €165m in 2023. This is in addition to recurring funding spent across the rest of the health service for routine, operational ICT expenditure such as network and telephony charges, application support etc that is paid for directly by hospitals and local healthcare sites. In addition to this, Budget 2023 also allocated once off funding of €40m to strengthen cyber-resilience.
Given the priorities of the last few years, the Department of Health is now working closely with the HSE, given the emergence of the Regional Health Areas, to develop a procurement approach, a phased deployment plan and a hosting model, suitable for the deployment of EHRs on a much broader basis, to enable reform of the health service, and to meet the needs and expectations of patients and healthcare professionals. This approach is also taking cognisance of the significant investment and the time required need to deploy these systems and will need the necessary support of Government and stakeholders.
Our engagement with other countries who have deployed EHRs, indicate this is a complex task that requires a clinical leadership, a strong focus, robust governance, sustained commitment, significant resources and expertise in technology and data privacy. Of particular note is that countries that are well advanced in terms of eHealth have reported significant challenges implementing enterprise EHR systems in particular.
The Department is also progressing a new Digital Healthcare Strategic Framework 2023-2030, which will succeed the eHealth Strategy published in 2013, and associated implementation plan, will provide a roadmap for how EHRs systems will be approved, procured, and deployed in the future, how interoperability standards will enable the provision of national electronic health records, shared care records, summary care records and the ability for patients to access their own health data in the future. It will also guide the programme of work required to deliver electronic health records for all.
Our engagements with health systems in other parts of the world, that are considered leaders in digital health, all indicate that patient access to digital health records is a long term project with very few, if any, examples where this has been achieved simply by deploying a single, national enterprise EHR solution. These programmes must be clinically led, informed by patients, and address the needs of healthcare professionals, patients and the health system itself that is responsible for managing the service.
