What model of eHealth do we need in Ireland?

Health information technologies and eHealth systems are evolving and developing rapidly and before any decision is made on the specific model of eHealth that is appropriate for Ireland, it is essential to explore learnings from elsewhere and ensure that any future investment offers the best value possible and appropriately meets the needs of the Irish people, writes Professor Jane Grimson.

Delivering and improving healthcare services through the use of the internet and other online technologies – also called eHealth – is a key feature of safe, effective, modern healthcare. eHealth can include electronic prescribing, electronic health records and the online exchange of health information between different services providing care to patients.

Prof. Jane Grimson
Prof. Jane Grimson

Frontline professionals, in particular, have a keen appreciation of the importance of putting patients at the heart of our healthcare service, both in terms of healthcare delivery and future service planning. A person-centred approach to care means, among other things, that people should be able to move seamlessly between all the types of health and social care they use.

Safe, reliable, healthcare depends on access to, and the use of, information that is accurate, timely, relevant and complete. Frontline healthcare provision is information-intensive, generating huge volumes of data every day with lack of up-to-date information leading to the unnecessary duplication of tests – for example, if critical diagnostic results are missing or overlooked, tests have be repeated unnecessarily. At best this may mean that appropriate treatment is delayed, or, at worst, not given.

Importantly, systemic improvements in the use of health information, which support patient safety, often relate to doing things differently and improving current processes

A crucial part of this, and one which has increasingly come to the fore as services develop and modernise, is that health information should accompany patients along their pathway of care. eHealth can support the delivery of this person-centred approach, increasing safety and quality for patients and delivering efficiency gains and cost savings for service providers.

Importantly, systemic improvements in the use of health information, which support patient safety, often relate to doing things differently and improving current processes. It must be recognised that not every improvement requires additional resources or investment. Often, as in the case of good information governance, improvement can be about raising staff awareness about their responsibilities, joining-up the way information is collected and used across services and taking a strategic view on how services can be delivered more safety and effectively in the best interests of the public.

Some of the current health information deficits, which negatively impact on the provision of an efficient service, include the lack of a system of unique identifiers for individuals, health professionals and organisations and the absence of a national, standardised GP referral system. HIQA has previously published recommendations and guidance on these and other areas of health information under its mandate. It is anticipated that the upcoming Health Information Bill will address these points, mandating minimum requirements.

Health information has a central role to play in making evidence-based healthcare planning decisions – an area that is particularly important in the present climate. This can inform where to locate a service, whether or not to introduce a national screening programme and decisions on best value for money in health and social care provision.

In addition, services will benefit directly from eHealth in a number of ways: By ensuring that all relevant information about patient care is available at the crucial point of service delivery, the risk of adverse incidents is greatly reduced, quality is improved, and the unnecessary duplication of tests is eliminated.

In light of the importance of this area, HIQA has now published Developing National eHealth Interoperability Standards for Ireland: A Consultation Document which called for feedback from healthcare professionals, the public, those who use services, policy makers, healthcare planners, health software vendors, and service providers on the development of eHealth Standards for Ireland.

HIQA has reviewed a growing body of evidence on this topic which clearly indicates that eHealth applications lead to major cost savings, improved quality and increased efficiency. Whether eHealth tools are used behind the scenes by healthcare professionals, or directly by patients, they play a significant role in improving the quality and safety of care.

International research clearly shows that the area of eHealth is a critical priority and that overall, in terms of service development and improvement in the area of health information in Ireland, more should be done to effectively and securely link patient information across healthcare settings to support the delivery of better, more efficient care.

In addition, services will benefit directly from eHealth in a number of ways: By ensuring that all relevant information about patient care is available at the crucial point of service delivery, the risk of adverse incidents is greatly reduced, quality is improved, and the unnecessary duplication of tests is eliminated

Health information technologies and eHealth systems are evolving and developing rapidly. Before any decision is made on the specific model of eHealth that is appropriate for Ireland, it is essential to explore learnings from elsewhere and ensure that any future investment offers the best value possible and appropriately meets the needs of the Irish people. This is HIQA’s intention as the development of eHealth standards for Ireland progresses and immediate priorities are identified.

One of the most important learnings is the need for appropriate national standards to be in place to ensure that information can be exchanged electronically safely and efficiently. HIQA’s consultation document set out how the Authority proposes to proceed with the development of an appropriate set of internationally proven standards to underpin eHealth.

Among its key areas of work, HIQA is responsible for setting standards on all aspects of health information, and monitoring compliance against them. In addition, HIQA is charged with evaluating the quality of the information available on health and social care in Ireland and making recommendations in relation to improving the quality and filling in gaps where information is needed, but is not currently available.

The consultation concluded at the end of January 2012 and HIQA is now reviewing all feedback received. The consultation document on developing national eHealth interoperability standards for Ireland is available to download from http://www.hiqa.ie/publications/developing-national-ehealth-interoperability-standards-ireland-consultation-document.

Professor Jane Grimson is Director of Health Information, HIQA.