Written answers

Tuesday, 12 July 2016

Department of Health

Electronic Health Records

Photo of Carol NolanCarol Nolan (Offaly, Sinn Fein)
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32. To ask the Minister for Health the consultation that has taken place with the Department of Health in Northern Ireland with respect to working towards interoperability of cross-Border e-health services; and if he will make a statement on the matter. [20919/16]

Photo of David CullinaneDavid Cullinane (Waterford, Sinn Fein)
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45. To ask the Minister for Health the action being taken to address the differing legal frameworks, lack of legal clarity and lack of interoperability to facilitate health data exchange to ensure co-ordinated care across borders in respect of barriers to the deployment of e-health; and if he will make a statement on the matter. [20934/16]

Photo of Gerry AdamsGerry Adams (Louth, Sinn Fein)
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50. To ask the Minister for Health the progress made to date in the development of e-prescribing, online referrals and scheduling, telehealth and the development of summary patient records; and if he will make a statement on the matter. [20924/16]

Photo of Eoin Ó BroinEoin Ó Broin (Dublin Mid West, Sinn Fein)
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81. To ask the Minister for Health the progress made to date on the e-health strategy for Ireland; the actions that have been taken to date to bring this strategy in line with the European Union e-health action plan 2012-2020; and if he will make a statement on the matter. [20920/16]

Photo of Carol NolanCarol Nolan (Offaly, Sinn Fein)
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90. To ask the Minister for Health following approval to proceed in 2016 with an initial phase that will facilitate the electronic transfer of prescriptions, utilising Health Information and Quality Authority standards developed to date, and the national message broker health link, the current progress with this initiative; the progress being made with phased implementation towards a national e-prescribing solution; and if he will make a statement on the matter. [20918/16]

Photo of Donnchadh Ó LaoghaireDonnchadh Ó Laoghaire (Cork South Central, Sinn Fein)
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110. To ask the Minister for Health the level of implementation of electronic health records, EHR, system allowing the access and update of EHRs by different health professionals in an interoperable structure; the policy initiatives underway to move towards a shared EHR system; and if he will make a statement on the matter. [20928/16]

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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I propose to take Questions Nos. 32, 45, 50, 81, 90 and 110 together.

The importance of and the opportunity for eHealth or digital health to support health care reform and the delivery of a modern health care system has been recognised for quite some time. In 2013, the Government approved and published a strategy for developing eHealth capability in the Irish health system called the eHealth strategy for Ireland, 2013.

This strategy sets out a number of objectives and a road map for the delivery and implementation of eHealth to the benefit of both the citizen and the economy. The Government eHealth strategy draws heavily on and incorporates many aspects of the work done by the EU Task Force set up in 2011 to look at the potential for eHealth and its context in cross border health care resulting in the EU eHealth Action Plan 2012-2020, Innovative Health Care for the 21st Century.

Amongst the key objectives of the eHealth strategy was the setting up within the HSE, of an entity called eHealth Ireland to implement the strategy, the recruitment of a Chief Information Officer and the setting up of an Office of the Chief Information Officer, reporting to the Director General of the HSE. The CIO has been in place since late 2014 and eHealth Ireland is operating under his leadership. A Knowledge and Information Plan setting out the implementation objectives for eHealth was published in spring 2015.

The eHealth strategy also highlights the potential of cross border collaboration on eHealth and in particular the considerable experience of eHealth deployment in Northern Ireland. It highlighted an all-island opportunity for eHealth. Northern Ireland was a focus of attention amongst a number of case studies on eHealth implementation in the strategy. My Department has been engaged since 2013 in sharing and learning from Northern Ireland’s experience in this area. There is also engagement by HSE in eHealth initiatives in the context of the INTERREG Programmes and other opportunities such as Horizon 2020. The HSE and the Northern Health and Social Care Trust are progressing the implementation of cross border Radiotherapy services. This will be facilitated by the deployment of technology to ensure that the relevant patient data is available where the patient is being treated on either side of the border. I understand that officials from HSE will be partaking in a workshop with their counterparts from Northern Ireland shortly on the eHealth agenda in both parts of the island.

The eHealth strategy also called for the setting up of an eHealth ecosystem to develop eHealth linkages and stakeholder engagement including patient engagement similar to one already working in Northern Ireland and several other jurisdictions. The eHealth Ireland Ecosystem has been operating for over a year and is very useful platform to provide stakeholder engagement on a range of issues as well as economic connectivity for the SME community in Ireland. In addition, in the context of the implementation of the eHealth strategy, the HSE has set up an eHealth Ireland Advisory Committee comprised of a number of academic, technology and healthcare experts whose role is to support and guide implementation of the eHealth Strategy through the implementation of the Knowledge and Information Plan.

Interoperability of computer systems is a major challenge facing the implementation of eHealth whether within health care services or in the context of cross border health services. A key component needed for delivery of successful eHealth solutions is the adoption of a standards based approach to the implementation of ICT systems. The Health Information and Quality Authority have developed a range of standards to support eHealth. My Department is also actively engaged with the EU eHealth Network which was established in 2011 to pursue solutions to interoperability and standardisation between Member States. Under the auspices of the eHealth Network, the Joint Action to Support the eHealth Network (JASEHN) has been established. My Department is actively involved in a number of related work streams of the Joint Action, whose overall aim is to provide the optimum environment, both technical and legal, to allow for interoperability of health care systems in the context of cross border services. As part of the HSE eHealth work, the Office of the CIO has established an Enterprise Architecture Unit dealing with interoperability and standards based in many instances on EU related work on summary care records and ePrescribing. The eHealth Ireland team have created a clinically focused function that is known as a Chief Clinical Information Officers Council. This function takes lessons learnt from other jurisdictions globally and ensures that technology is deployed with clinical engagement and leadership.

With regard to Electronic Health Records, the Office of the Chief Information Officer has recently submitted a detailed business case for a national electronic health record programme for Ireland. My Department is currently evaluating how this might be progressed particularly in delivering an EHR in the context of the work being planned for the New Children’s Hospital which aspires to be the first digital hospital facility in the country. In developing a national electronic health record programme we must build on the progress to date in ICT deployment but also the lessons learnt from other jurisdictions in developing an optimum solution for Ireland. This programme, if progressed, will require a substantial investment in ICT. It also offers the opportunity for re-configuration of services with the potential of a safer, patient centred and more integrated approach along with significant efficiencies.

I am glad to say that since 2013 and the publication of the eHealth strategy for Ireland substantial progress is being made in furthering the eHealth agenda and I look forward to further progress, particularly in regard to electronic health records. The capital programme for health care ICT has been increased from €40m in 2014 to €55.0m in 2015 and 2016. The new eHealth structures are progressing well with the planned rollout of new health care ICT infrastructure and solutions across the health services including key clinical systems such as a new national laboratory information system (LIMS), maternal and new born information system (MN-CMS) the Medical Oncology Clinical Information System (MOCIS) due to go live in the next 12 months. MOCIS will provide digital support for prescribing and administration of chemotherapy treatments.

In addition, the eReferrals Programme has delivered a solution to provide electronic referrals between primary and acute hospitals using the Health Link facility. To date 48 hospitals have been connected and the programme is working well. Other work that is being progressed is in the area of ePrescribing. The HSE are currently evaluating work done across various regions on ePrescribing and a National ePharmacy programme has been established to develop the components for a business case for a national ePrescribing solution. Further work is required to develop and define a national drugs file as a key building block for a national ePrescribing solution. The progress achieved to date on eHealth and specifically ePrescribing can be followed up on the eHealth Ireland website www.eHealthIreland.ie.

The delivery of digital health care services and the rollout of an electronic health record (EHR) will require a further robust legal framework to ensure confidentiality and security of patient data consistent with the new EU data protection regulation, Regulation (EU) 2016/679. Two current legislative initiatives by my Department are intended to support eHealth amongst other issues. The Health Identifiers Act, 2014 is providing a legal basis for a robust system of identifiers in the health sector and the Health Information and Patient Safety Bill, currently being drafted, includes provisions to support interoperability. My Department is currently examining the appropriate information framework that will provide the optimum environment to support eHealth and the deployment of electronic health records in the future. The health care delivery system straddles both the public and private domains and requires a robust information governance environment to ensure the right information about the right patient is available securely, in the right place and at the right time.

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