Data systems currently used across the healthcare system will have until 2025 to fully integrate individual health identifiers (IHI).

The HSE’s Digital Health Strategic Implementation Roadmap, a draft of which has been seen by Pulse+IT, states: “Any new digital systems and capabilities deployed going forward must be fully integrated with IHI to link patient data with existing systems.”

“Existing legacy systems that are currently not fully integrated must put a roadmap in place to close this gap as soon as possible – but no later than a 2025 completion.”

The document specifies that “fully integrated means implementing not just from a technical perspective but also must include the operational processes to clean, merge, and maintain usable linked patient records”.

The roadmap follows the release of the Digital Health Framework for Ireland (2024-2030) strategy, which focuses 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; and secure foundations and digital enablers.

IHI integration is just one of several major changes ahead for the digital health industry. The roadmap details 48 individual initiatives that will be rolled out over the next seven years with the aim of delivering a patient-centred, digitally enabled health and social care system. Among these are new regulations and requirements for digital health software and devices.

There will also be regional electronic health records (EHRs) that will run on the same standards and minimum data set as the National Shared Care Record.

The roadmap says national standards for data sharing and use will be adopted, and a national procurement framework for future EHRs will be established. A shortlist of enterprise-level EHR vendors will be created that the regions can draw upon.

The roadmap plans a standardised approach to medical device evaluation, including assessment of conformance with relevant international standards and compliance with HSE data standards for interoperability and integration.

Interoperability between medical devices and health information systems will use standardised data formats and communication protocols, including HL7, FHIR, and DICOM.

There will be a new requirement for a software bill of materials (SBOM) for medical devices, which will detail the supply chain for all the software components used in building the overall software application.

There will be a specific quality assessment tool for software as a medical device, in particular for health apps. The HSE plans to develop a library of health apps which have undergone a base-line quality assessment. There will also be a distinct quality assessment process for AI tools which meet the definition of ‘medical device software’.

There will also be a standardised processes for the management of adverse events including investigations of incidents involving digital health software.

The roadmap does promise increased collaboration between the HSE and industry, with active engagement with SMEs, start-ups and “other innovation agencies within the care technology sector”.

Healthcare innovation clusters are to be established to “foster collaboration between start-ups, other agencies e.g., GEC (Guinness Enterprise Centre, HIHI), medical practitioners, patients, and problem-solvers, and enable greater innovation within the health sector”.

An “innovation procurement programme” is also planned. The roadmap says this will support the early evaluation, assessment and integration of emerging technologies, enabled by clear interoperability standards, and data privacy safeguards.

Initiatives outlined in the roadmap that are currently being rolled out include:

• HSE patient app
• HSE-Live contact centre
• Remote care/digital therapeutics
• Telehealth
• Reliable secure connectivity
• Modern workspace and productivity tools
• Shared care record
• Population health management
• Medication management
• Diagnostics
• EHR procurement and delivery
• Patient journey analytics
• Healthcare data analytics
• Patient identify management
• Integration and interoperability

The next steps include:

• Integrated referral management
• Orders comms and care delivery
• Patient safety and quality of care
• Digitisation of health care records
• Medical device integration
• Healthcare worker identity and access
• A mobile ecosystem for the frontline

Future initiatives include:

• Patient feedback platform
• Open Health API framework
• Employee feedback platform
• Precision medicine support
• AI in healthcare
• Open innovation and ecosystem