Regina Doherty (Meath East, Fine Gael)

I welcome to the opportunity to speak on this motion. We all recognise the importance of securing the Department of Health budget and the need for it to be ring-fenced for the areas of most need. This means that savings need to be achieved and changes need to be made.

I would like to focus this evening on the possible introduction of a patient database and prescription cloud database. Europe is heading down the e-health path, which means significant changes for patients and health professionals. One might ask how e-health care benefits patients and saves money. First, it allows for better data management and the collection of thorough information from patients, with attention to detail and delivery of same to clinicians in a coherent way. The more informed the doctor and patient, the better the delivery of care for all concerned. This would also result in fewer medication errors, fewer misdiagnoses and more optimised and coherent care plans.

As health care chains extend, the availability of shared patient information by way of a prescription cloud database, using unique medical records and PPS numbers, would result in the delivery of more coherent treatment. Spend per week by the HSE on pharmaceuticals, including payments to pharmacists, is estimated to be €3 million. As the prescription rate continues to increase, a central database, monitoring the dispensing of prescriptions, in particular, pain killers, is essential not alone from a financial perspective, but from a health promotion point of view.

The deadly problem of abuse of prescription drugs grew dramatically as they became increasingly available in our society. The introduction of databases would provide pharmacies with information on purchasers of prescription pain killers. A person who "doctor shops" and visits multiple pharmacies would easily be caught by a pharmacist checking the system. By requiring doctors to check the database before prescribing pain pills and pharmacists to monitor prescription usage, drug seekers can be caught and stopped more often. Use of this database in doctors' offices and pharmacies could help curb the excess buying of prescription pain killers.

A patient database system, such as the introduction of a patient medication card similar to that used in Denmark, would result in a more efficient health care service where mistakes are eliminated, data is transferred more efficiently and administration costs are reduced. Danish health care providers have been using an e-health system since 1996. Denmark's electronic patient medication card has helped eliminate errors and speeded up the flow of information.

The Danish national e-health portal was launched in 2003. It is a single access point to health care services for citizens and health professionals alike. Using a digital signature, Danish citizens can log on to their personal web space and use a variety of services, including reviewing their medication records and health data and communicating with

health care authorities. They can also register their final wishes in a living will and become organ donors. The introduction here of a patient medication card, similar to the one used in Denmark, would create a more efficient health care service where mistakes are eliminated, data is transferred more efficiently and administration costs are reduced. In the same way as a bank ATM card allows a person to access information relating to his or her bank account, a patient medication card allows him or her and medical care providers to access medical records and medication details. It provides direct access and up-to-date shared data about a patient's details and medical records.

Health care providers can upload information onto a secure and shared record system, accessible by way of the patient medication card, allowing, for example, a GP to upload details of a medical prescription, which pharmacists can then access and fill on demand. While the cost of implementing such a system in Denmark was initially expensive, it is estimated that by the end of 2008 the cumulative benefit was €1.4 billion in savings to the Exchequer. Messages and data transmitted by electronic communication have now reached more than 4.5 million items per month and health-care providers have benefitted from effective and efficient data transfer and greatly reduced administration costs. The patient has also benefited as there is faster, more reliable communication between health-care providers.

Similarly, a four-week UK study of 36,200 prescriptions found that 1.5% had a prescribing error, 25% of which were potentially serious. Aside from the human cost, medication errors represent a considerable avoidable expense for health-care providers. Now electronic medication records in Denmark and the Netherlands track all the medication that individuals have been given to identify who has taken what, how much and when. This information is available to providers and prescribers of medication - public pharmacies, hospital pharmacies, doctors' offices, locum posts, hospitals, mental health institutions and residential care and nursing homes. It is just one possible solution to address our ever-increasing health spend and I would like to present it to the Department with a view to having it reviewed.

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