The Department of Health has published the long-awaited national digital health strategy, less than a fortnight after coming under pressure from the Oireachtas Committee on Health.
The Digital Health Framework for Ireland (2024-2030) promises a future that “harnesses the power of data, digital technology and innovation to widen access to health and social care services, provide improved affordable and equitable care, better patient safety and greater productivity”.
The priorities are to allow health service users to access their own digital health record, provide healthcare professionals with comprehensive information about their patients in digital form in real-time, deliver patient care close to home, and facilitate greater efficiency and reduced costs for the system.
The Framework sets out a step-by-step roadmap for accelerating the shift to a fully integrated national digital health ecosystem, with a focus on six principal issues:
- Patient as an empowered partner
- Workforce and workplace
- Digitally enabled and connected care
- Data driven services
- Digital health ecosystem and innovation
- Secure foundations and digital enablers.
The document promises that a new patient app will be launched later this year which will provide patients with direct access to their personal digital health record. Patients will have access to easy-to-use digital tools to help manage care, including scheduling and pre-registering for appointments, referral information, public and private waiting list information, online booking systems for ordering blood tests, and repeat prescriptions.
The app will afford patients greater choice in how they receive care and will be the access point for a broader range of digital services, including telehealth, virtual wards and remote monitoring. Importantly, patients will retain control of how their data is used and who has access to their health record.
The initial version of the app will include public hospital appointments for maternity services, signposting to services, vaccination records, self-care supports, and medication lists.
Healthcare staff will be provided with “a more modern fit-for-purpose workplace environment, with ICT infrastructure that includes high speed connectivity, Wi-Fi, and ready access to PCs and specialist workstations where needed”, according to the Framework.
There will also be a staff portal, which will allow staff members to manage timesheets, reimbursement, payslips, well-being, and occupational health resources. eRostering will be standard procedure.
Staff will have access to training initiatives that improve digital literacy, and there is an acknowledgement that they must be provided with appropriate connectivity, devices, and access.
Shared Care Record
Digitally enabled and connected care will be central to Ireland’s new digital health future. The first step is to develop a national shared care record (SCR), which is planned for roll-out next year. This platform will collate and store patient information from both acute and community services., and will allow clinical information to travel with the patient.
The procurement process for the platform is already underway. The SCR will ultimately provide the basis for the envisioned electronic health record (EHR) system.
According to the Framework, investing in a single nationwide roll-out of an EHR system for both acute hospitals and community services presents a significant challenge. It points out that achieving semantic interoperability between connected systems in health continues to be a significant and ongoing challenge for all healthcare organisations, globally.
The plan is to build on existing investments in EHR and related clinical information systems to date. However, the Framework states: “there is now a clear need to consolidate the number of solutions deployed across the health service, not just to manage complexity, data, standardisation, and interoperability, but also to build a critical mass of core capability in terms of the expertise needed to deploy and support these complex systems into the future”.
Work is to begin on defining national standards for data sharing, interoperability and clinical terminology, and a national procurement framework for future EHRs is being established. The aim to develop a shortlist of successful EHR vendors. The six new health regions being established under Sláintecare will then choose a preferred vendor from this list for implementation locally. Certain sanctions will apply.
There is to be a renewed focus on health data collection for research and service planning. The operational systems that are introduced will be required to capture structured data.
“By investing in new digital systems and our data analytics workforce, we can increase the quality and timeliness of the data collected in a range of areas, including clinical, financial, and resource data across both acute, community, and corporate settings,” the document states, adding that “this will, in turn, allow us to capitalise on the power of data to drive service transformation so we are ready to deploy new advanced technologies of the future such as artificial intelligence (AI)”.
Secure foundations and standardisation
In order to drive this transformation to a seamless, secure, connected digital health system, innovators will be given improved access to support and funding. There will be transparent and standardised pathways to apply for support, funding, and resources for innovation projects. Tailored procurement pathways will support smaller, indigenous companies, but there will also be increased opportunities for international engagement.
Procurement processes will also consider engagement with smaller, innovative companies and facilities like living labs, which provide a controlled environment for the health service to assess new solutions, whilst enabling companies to develop their solution for mass adoption.
Particular attention will be given to technologies that reorientate service delivery away from acute hospitals and towards general practice and community-based services. There will be continued support for robotic process automation (RPA) and precision medicine support (PMS) solutions.
Finally, the document states that the successful delivery of the strategy requires a secure foundation. Strong cybersecurity and resilience will be built into all IT infrastructure, processes, and practices.
Digital identities and audit logging will allow full traceability of who has accessed digital health records, when, where, and why. In relation to the adoption of cloud hosting, the Framework calls for a clear strategy that “strikes the correct balance between scalability, cost, and security”.
The necessary legislation and standards to facilitate this digital transformation are to be advanced. There will be a robust legislative basis for the creation and delivery of digital health records, and the legal basis and obligation for health service providers to share the data needed to build these records will be set out in the forthcoming Health Information Bill and will be guided by the European Health Data Space Regulations.
Implementation roadmap to come
At the launch of the strategy, Minister for Health Stephen Donnelly said: “Digitising services across health and social care is a priority for myself and my department. Through successive budgets, government has consistently increased both capital and revenue funding for digital health. The health service now has an ambitious forward-looking digital pipeline to deliver on the vision of this strategic framework.”
“Digital technology now extends throughout most aspects of our daily lives. We use it at work, at home, in our social lives, when we look for information, book flights or pay for goods or services. The public demand no less in healthcare,” he said.
In parallel to this Framework, the HSE has been working on a Digital Health Strategic Implementation Roadmap 2024-2030 which provides details on the various initiatives under each of the six principles, and the programmes, systems and services that need to be put in place in order to bring about the level of digital transformation required of the health service. The roadmap is due to be published shortly.
