Professor David Keegan:

Unfortunately, it is not in the past. The question is how difficult it is at present. It is fair to start with examples of very good data and IT infrastructure and integration. The national integrated medical imaging system, a radiology system in operation throughout the country, is an example. A patient with a head injury in Galway can have the images looked at by the team in Beaumont on the same day that injury is sustained. We have examples of good integration but they are pockmarked and by direction largely.

We also noted through this, and the cyberattack highlighted it, that the infrastructure throughout the community health organisations is fragile and needs to be supported. The infrastructure in the HSE hospitals was exposed through the cyberattack. This was less so in the voluntary hospitals because they had put extra measures in place. We have multiple speeds of travel with respect to IT throughout the system. Our work has highlighted this. We were not fully aware of all this beforehand. We had a sense of it. It has really exposed that the different rates of travel on IT governance and infrastructure are a potential risk to its deployment.

The universal health identifier is crucial. The preference would be for a national decision on an IT platform for all health records. Then patients would not need to move. We have seen this effectively work in units and health organisations in the US and, more recently, the UK. We would like to see this system in place. In the interim we will keep working as much as we can. We have an issue at present in one of our sites. We have a service level agreement with Ashgrove House. We have to create a new cable link between there and the Mater. Ideally this should be all cloud-based with a web of integration. It is not just between spoke and hub as the spokes must also talk to each other.