Written answers

Thursday, 15 December 2005

Department of Health and Children

Computerisation Programme

5:00 pm

Photo of John GormleyJohn Gormley (Dublin South East, Green Party)
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Question 167: To ask the Tánaiste and Minister for Health and Children if, in respect of the iSOFT-Lorenzo computer system; if a person has been appointed with overall responsibility for the architecture of the system; if this person is a public sector employee or a consultant; if an overall architecture for the system has been drawn up; when an IT director will be appointed; and if she will make a statement on the matter. [39992/05]

Photo of Mary HarneyMary Harney (Dublin Mid West, Progressive Democrats)
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I have been advised by the Health Service Executive, HSE, as follows. Overall responsibility for the iSOFT project rests at present with the HSE's national director of ICT. Responsibility for various aspects of current project work has been delegated to some senior staff within the ICT directorate, reporting to the national director. This arrangement is sufficient for the current phase of the project but as the project grows and develops further, involving more extensive roll out across the country, the governance arrangements will be revised accordingly. Senior staff within the national hospitals office and the ICT directorate will be assigned to take responsibility for the service and ICT elements of the project respectively, working to a project board.

In addition, a subcommittee of the HSE's senior management team will form an ICT steering committee to oversee all major ICT developments. Within the iSOFT project a person has not been appointed with overall responsibility for the architecture of the system. There are several different aspects to architecture and the detailed design of each will be the responsibility of the HSE's ICT directorate, working in close collaboration with the national hospitals office. Staff within these units of the HSE will carry out the work involved and it is not foreseen at this stage that any consultancy will be required.

To date the architecture and design work has concentrated on the immediate requirements of getting the iSOFT system into live use in a number of former health board regions which have an urgent need to replace their existing IT systems. The architecture and design work to date will be developed further during 2006 for the full national roll out of the system.

Photo of John GormleyJohn Gormley (Dublin South East, Green Party)
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Question 168: To ask the Tánaiste and Minister for Health and Children if, regarding the electronic health record proposed for the iSOFT-Lorenzo computer system, the design for the electronic health record has been completed and implemented in any jurisdiction; if a copy of the concepts and design document, or its equivalent, can be made available; the person or body who will be legally responsible for the accuracy of patient data under the proposed system; the person or body who will be responsible for reconciling discrepancies in the information; the way in which security of access to information will be implemented in the system; and if she will make a statement on the matter. [39993/05]

Photo of Mary HarneyMary Harney (Dublin Mid West, Progressive Democrats)
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I have been advised by the Health Service Executive as follows.

Live deployments of full electronic health records on a wide scale jurisdiction are extremely rare. Many health systems have electronic records in parts of their services. Within hospitals these are typically referred to as electronic patient record systems. The concept of electronic health records brings together the various electronic records in different services-settings referring to each client-patient, for example, the amalgamation of records held by GPs with those held by other professionals in both community and hospital settings.

The iSOFT system was selected primarily for hospitals with the intention of initially deploying it to support core administrative processes and then to evolve its use over time into clinical support areas. As such it was seen as a means of achieving electronic patient records within hospitals and between hospitals. It was also seen as a key facilitator to achievement of electronic health records as it has potential for deployment in community care services also, which the Health Service Executive plans to do over time.

The achievement of full electronic health records in the Irish health service is a long-term goal. The concepts and design of such a system have not yet been developed and there is considerable work required over the next number of years to put the necessary foundations in place. The iSOFT system is an important element of this but there are many others.

The iSOFT system is being used extensively as a key element of building electronic health records in a number of other countries, for example, the UK and New Zealand. These are also long-term projects that are not yet completed and there are multiple suppliers involved.

Regarding responsibility for accuracy of patient data under the new system, the legal entity will be the Health Service Executive, or voluntary hospital or agency, as appropriate, which is accountable in law for compliance with data protection and other related legislation. Internal quality control procedures will be deployed to ensure a high level of accuracy of patient information.

Regarding reconciling discrepancies in the information, this will be a normal part of the operation of the new system and will be the responsibility of various staff involved in data recording and updating.

Regarding the way in which security of access to information will be implemented in the system, a security policy will be defined and implemented as part of the roll out of the system. The general principle will be that access to patient information will be on a need-to-know basis, consistent with job function and appropriate patient consent. It is recognised that there are huge patient-care benefits to ensuring that the right information is made available to the right person in a timely manner but this must be balanced against the need to ensure that inappropriate access does not occur either. All staff will log onto the new system on a personal name basis, thereby identifiable, and with their unique private access keys. All activity will be automatically recorded in an audit trail, thereby ensuring staff are accountable for whatever use or access they make.

Photo of John GormleyJohn Gormley (Dublin South East, Green Party)
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Question 169: To ask the Tánaiste and Minister for Health and Children if the €56 million cost quoted for the iSOFT-Lorenzo computer system includes the license costs of operating systems, office suites and databases required for inter-operating with the iSOFT software; if general practitioners will be required to run software by a particular supplier in order to interoperate with the Lorenzo system; if this software has been included by the Health Service Executive in its design for the system; and if she will make a statement on the matter. [39994/05]

Photo of Mary HarneyMary Harney (Dublin Mid West, Progressive Democrats)
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I have been advised by the Health Service Executive as follows.

The figure of €56 million covers the ten year cost of licences for iSOFT software, support services and implementation services. It does not cover the cost of licences for third-party software such as operating systems, office suites and databases. In 2005 the cost of licences for operating systems and databases related to the deployment of the iSOFT software was €558,928.16. This covers three of the former health board regions and further licences will need to be purchased for remaining regions as the iSOFT system is rolled out across the country.

In 2005 there were no additional licences required for office suites related to the deployment of the iSOFT software. This is because PCs typically have such software for other purposes in any case. In the future there is unlikely to be any additional requirement for office suites arising from deployment of the iSOFT software.

General practitioners will not be required to run software from any particular supplier in order to interoperate with current iSOFT software or future software emerging from the Lorenzo development programme. General practitioners typically run software supplied by a number of other companies. Inter-operation between this software and the various other software packages used elsewhere in the health service, for example, in hospitals and community care facilities, and is achieved by means of electronic messaging between the different systems based on national standard message formats. This approach enables disparate IT systems to interoperate with each other and there are many examples of its use in live contexts across the Irish health service, for example, for transfer of electronic laboratory reports and radiology reports between hospitals and GPs.

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