Victor Boyhan (Independent)
Link to this: Individually | In context

I welcome the Minister of State, Deputy Jennifer Murnane O’Connor.

Robbie Gallagher (Fianna Fail)
Link to this: Individually | In context

Cuirim fáilte mhór roimh an Aire Stáit chuig an Teach seo inniu. I extend a very warm welcome to all our visitors here this afternoon. As the Minister of State will be well aware, speed is crucial for accurate diagnosis. Timely and accurate diagnosis are essential for effective treatment planning, improved patient outcomes and reduced risks. Accuracy is, of course, paramount but the speed of diagnosis can significantly impact the efficiency and effectiveness of healthcare delivery in our hospitals. Anyone who has visited the Beamont Hospital seeking the results of a biopsy or has accompanied a relative there knows all about it. This is why, alarmingly, doctors have expressed concerns over the delayed national medical laboratory IT system and have called for a risk assessment of same. MedLIS, which is the medical laboratory IT system, has been in this country for the past ten years but so far has only been rolled out to one hospital, that being Beaumont Hospital. The Cavan-Monaghan hospital group, among others, are next in line for the MedLIS system, eventually going nationwide. MedLIS is used to log and track blood tests and medical samples. Doctors have serious concerns about this IT system and have written letters detailing 16 significant flaws with the system. They have great concerns about the basic functionality of the system and are calling for a review of same. There appears to be an issue with regard to its search and how that search is collated. They have serious concerns about the implications of this on diagnosis and treatment. Complaints that the HSE does not allow sufficient time for satisfactory resolution of issues is also a major concern for them.

In 2015, we signed a contract in this country for €33 million with Oracle Health, and in 2022, a €17.9 million extension on the basis of a national roll-out, but so far only €24.3 million of this has been spent.

More than 50 consultants and medical scientists wrote to the chief executive and the chief clinical officer with concerns. Some medical scientists have threatened strike action based on patient risk at a hospital where MedLIS has been proposed. Modern systems, we all know, are essential, but many have serious issues with doctors’ concerns not being addressed.

Oracle also supplies health records to maternity hospitals and St. James’s Hospital in Dublin. That poses the question of how efficient and accurate the system is working in these hospitals.

I have no doubt that the HSE is taking these issues seriously. Can the Minister of State elaborate on what actions have been taken to alleviate the general concerns of staff and senior management at Beaumont Hospital to ensure that the system they are operating is fit for purpose? Second, can she enlighten us on the likely roll-out of the medical laboratory IT system at other hospitals on the waiting list for such a development?

Jennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
Link to this: Individually | In context

I thank the Senator for raising this important issue. I welcome the opportunity to outline the current position. The Senator is referring to the ongoing implementation of the national medical laboratory IT system. As with all clinical ICT system deployments, patient safety is the most critical element, and I am informed by the Department that issues raised by the doctors are being addressed by the HSE. I will come back to the Senator on that, but as I have been informed today, the doctors' concerns have been raised and are being addressed by the HSE. All hospital labs in Ireland are independently accredited by the Irish National Accreditation Board. Investment in digital health technologies such as MedLIS supports the delivery of the Sláintecare objectives of integrated care, patient empowerment and improved safety, and sustainability in service delivery.

MedLIS is an important national programme that forms part of a wider investment to digitise the health system under the digital for care strategy. Recognising the need for reform, our programme for Government makes specific commitments with regard to the digitisation of the health service as a key enabler for modernisation and reform. As the Senator said in his opening statement, that is very important. It is our future and that is the way we have to go. Having a single lab record enhances patient safety, enables standardisation across all labs, and improves effectiveness and efficiency throughout the healthcare service. MedLIS is a national lab system intended to serve the needs of all lab sites well into the future. A report commissioned by the MedLIS project board to assess progress up to 2018 highlighted several findings and suggested a series of recommendations on how to improve delivery of the programme. Based on these findings, the HSE made a number of changes. Despite the impact of delays caused by the global pandemic and the cyberattack on the health service, MedLIS successfully went live at Beaumont Hospital in August 2024. One change that was needed following the cyberattack was the migration of MedLIS to a secure, cloud-based environment. Deployment of MedLIS at Beaumont Hospital had been prioritised due to existing risks associated with its legacy systems. The solution has played a significant role in advancing Beaumont’s ongoing digital transformation.

The MedLIS laboratory system deployed at Beaumont Hospital is from Oracle, a major international IT systems vendor. It is widely used throughout the world and the majority of users are happy with how it is working. The partnership and business relationship between the HSE and Oracle remains governed by the original contract signed with Cerner, now Oracle, in 2015. This contract underwent a review prior to its extension in 2022.

As with any large and complex technology implementation, there are elements that, post “go live”, will require improvement, optimisation and further change. The HSE is committed to following through on this optimisation work. Given the size, scale and complexity of the laboratory project, these issues have been very much as expected and are a testament to the close working of the project team and the laboratory teams across the hospital. The solution deployed at Beaumont is one of the most widely used hospital systems in the world and is used at over 1,500 sites. Because it operates differently from the system it replaces, it requires some changes in how people do their work.

As MedLIS is a national programme, this requires the alignment of processes across all sites. The team is actively engaged locally, working through system optimisation to streamline labour-intensive tasks and improve how the system works to benefit all staff on all sites.

Robbie Gallagher (Fianna Fail)
Link to this: Individually | In context

I thank the Minister of State for her detailed response. I fully appreciate that, as she outlined, it is a very big undertaking and a complex piece of work. We all understand and accept there will be teething problems. However, it is important that while doing so, we do not close our ears to what doctors and medics are saying to us and that, during the process, we listen to their concerns. We know that delayed diagnosis or misdiagnosis, which can result in delayed or perhaps no treatment thereafter, is something that causes medical practitioners grave concern. I am heartened by the response of the Minister of State and I trust that the HSE will take on board the grave and genuine concerns expressed by medics on behalf of us all.

Jennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
Link to this: Individually | In context

This is very important. As I said, I am informed by the Department that the issues raised by the doctors through the media are being addressed by the HSE. Significant efforts have been undertaken by the HSE to ensure that hospital teams are incorporated into the design and deployment of the MedLIS system at all hospital sites. MedLIS aims to modernise laboratory services, ensuring high-quality, efficient and patient-concentrated care across Ireland.

Officials in the Department are not aware of any other general issues regarding general diagnostics. It is important that the Senator would share the specifics with me today. He referred to the risk assessment and the suggestion that there are 16 flaws with the IT system. He might give that information to the HSE again. I know the HSE is committed to working with Beaumont on this system. It is important that all of us work together to solve whatever concerns there are. This is about patient safety and how we all work together. I again thank the Senator for highlighting this very important issue.