Up to €1 Billion in extra payments to State Employees

St James's isn't a HSE hospital, and it does have one of the more advanced electronic health records in the Irish public system, but it is still being rolled out, so you will still find fragmented records there across different department.

Just a very quick question - are records in one hospital accessible in another hospital? If someone has a procedure in hospital A and then attends hospital B, will hospital B be aware of the patient's history in hospital A?
 
Just a very quick question - are records in one hospital accessible in another hospital? If someone has a procedure in hospital A and then attends hospital B, will hospital B be aware of the patient's history in hospital A?
In the case of my son he had two different sets of records in the same hospital. The second time he was admitted they were unaware of the first admission. That said I was in Naas hospital a few months back and that's like an episode of Fr. Ted.
 
Worth

Worth reading up on Section 38 organisations to understand how the large Dublin hospitals and Dublin maternity hospitals and some others are publicly funded but not part of HSE. I don’t know anyone who thinks that bringing them under HSE management would improve them!
The notion that it is a good idea for each hospital to have different systems for recording patient information is mind boggling.
The duplication of process and resource has to run into the tens of millions.
Reading your post, if you don’t mind me saying you have a certain amateur naivety about healthcare organisation.
Yes, I am probably grossly underestimating how wasteful and inefficient they are in this country.
Electronic health records are fundamentally different from ‘electronic reporting systems’.
I'm well aware of the difference.
Also, it’s unclear whether the problem with the HSE and broader public system is principally structural. There’s a strong argument to be made that it is cultural.
In my experience as a QA engineer, manager and LEAN practitioner one feeds into the other.
The cost I was putting forward for electronic health records is not an inflated cost due to Irish structures, but pretty well benchmarked internationally. The main reason, I suggest that no progress has been made here is the DPER reluctance to fund, probably as a fallout of the PPARS debacle.
We have one of the best funded healthcare systems in the world. There is absolutely no shortage of resources. The people who work in the Publicly funded healthcare sector choose to waste them, with the resultant suffering and deaths. If it was me I'd be uncomfortable with having that blood on my hands but then again I'm a bit naive.
 
Just a very quick question - are records in one hospital accessible in another hospital? If someone has a procedure in hospital A and then attends hospital B, will hospital B be aware of the patient's history in hospital A?
Typically no, with the exception of radiology reports and images. It’s a real problem for continuity of care.
 
The notion that it is a good idea for each hospital to have different systems for recording patient information is mind boggling.
The duplication of process and resource has to run into the tens of millions.

Yes, I am probably grossly underestimating how wasteful and inefficient they are in this country.

I'm well aware of the difference.

In my experience as a QA engineer, manager and LEAN practitioner one feeds into the other.

We have one of the best funded healthcare systems in the world. There is absolutely no shortage of resources. The people who work in the Publicly funded healthcare sector choose to waste them, with the resultant suffering and deaths. If it was me I'd be uncomfortable with having that blood on my hands but then again I'm a bit naive.
Indeed you are. But no offence intended. LEAN has applications in healthcare. Bolton hospitals was a good example last time I looked. But it is rather more complex overall than that.
 
When someone said that St James's wasn't a HSE hospital I was very surprised. Is it a fact, or someone just saying that it isn't?
 
When someone said that St James's wasn't a HSE hospital I was very surprised. Is it a fact, or someone just saying that it isn't?
SJH is a voluntary hospital like the Mater, St Vincent's, Rotunda, etc. They are usually "owned" by trusts/charities/religious orders and the HSE pays them to provide services. They retain a lot of control over their operations, e.g. they may have their own IT dept. It is effectively outsourcing. Similar to the way most schools run. Here's a list of the voluntaries: https://foi.gov.ie/voluntary-hospitals/

Hospitals like Connolly, Cavan, Sligo, Tullamore, etc. are statutory hospitals, i.e. owned and run by the HSE. They tend to be more centralised in their operations, e.g. IT is run centrally/regionally.

This difference is the reason that HSE hospitals were worse hit by the cyber attack than many voluntaries.
 
Indeed you are.
Indeed, that's how it can look when obvious problems are pointed out to the institutionalised.
But no offence intended.
None taken. This is an internet discussion forum where strangers talk. If people get offended here they need to take a hard look at themselves.
LEAN has applications in healthcare.
It certainly does, as do management practices and structures from the latter part of the 20th century (let's not be too ambitious).
But it is rather more complex overall than that.
The excuse used the world over by the inept and intransigent to justify their ineptitude and intransigence.
Nearly all organisational problems are really a collection of small simple problems. The 'more complex' problems are nearly always just a larger collection of small problems.
The problems does indeed start with culture and the culture of victimhood amongst healthcare employees is both tiresome and unjustified. The reason their job is hard, in the minority of cases when their job is actually hard, is their own fault. They are the HSE. It's up to them collectively to fix things.
 
I don’t know anyone who thinks that bringing them under HSE management would improve them!
My wife works in one of the 'voluntary' hospitals. The stories of waste I hear would make your blood boil! I can't imagine the HSE could do much worse!
 
Let's see how Graham O'Dwyer's appeal goes...
The legal concerns about the broad data collection and retention of telecom data arising in that case pre-date GDPR, and were red flags under existing Data Protection legislation.

I was hoping that the poster who claimed that GDPR helped criminals and fraudsters might explain the basis for that claim.
 
Okay, back on topic. When State employees have chosen to waste a billion less by accepting reforms that should have happened 30 years ago I'd be happy to give them a cut of it.
 
Just a very quick question - are records in one hospital accessible in another hospital? If someone has a procedure in hospital A and then attends hospital B, will hospital B be aware of the patient's history in hospital A?
It depends. The HSE have been rolling out very substantial eHealth initiatives over the past five years or so - see https://www.ehealthireland.ie/ for more details - but given the size, breadth of functions and organisational complexity of the health sector, we're still a long way of integrated systems for all functions for all hospitals. They also did some excellent work over the past 18 months, such as the Covid tracker, the vaccine booking portal and the Covid certificates.
 
Does this mean when a hospital joins this system it records a procedure for patients prospectively - i.e. the hospital doesn't digitise its archives but simply records all new procedures from a given date?
 
They also did some excellent work over the past 18 months, such as the Covid tracker, the vaccine booking portal and the Covid certificates.
Yes, when they can start from scratch and don't have to build on the foundation of 40 years of ineptitude they can do excellent things.

The problem is that they are hidebound by history.
 
St James's isn't a HSE hospital, and it does have one of the more advanced electronic health records in the Irish public system, but it is still being rolled out, so you will still find fragmented records there across different department..

But generally the Irish publicly funded health system is 20 years behind other health systems in terms of electronic health records - paper records are still predominant. It's a necessary investment to make, and will cost well over a billion over 10 to 15 years.

I wouldn't hold your breath. 20 years ago the UK launched the National Programme for Information Technology's NHS Care Records Service to provide a national standards-based interoperable electronic health records system. Unfortunatley, it wasn't a success and incurred significant losses, with the programme being terminated in 2011. Now, if the UK can't deliver an EHRS, I really don't see it happening here.
 
Does this mean when a hospital joins this system it records a procedure for patients prospectively - i.e. the hospital doesn't digitise its archives but simply records all new procedures from a given date?
Don't think there is any single yes/no answer to this. It depends on the function being digitised and the hospital and probably a whole lot of other factors too. There may be cases where it makes sense to digitise recent records, or cases where it is better just to start from day one and work ahead from there. It's hard to see the merit in going back and digitising EVERY patient record of EVERY issue, given the work that would be involved and the likely age of the archives.
 
I wouldn't hold your breath. 20 years ago the UK launched the National Programme for Information Technology's NHS Care Records Service to provide a national standards-based interoperable electronic health records system. Unfortunatley, it wasn't a success and incurred significant losses, with the programme being terminated in 2011. Now, if the UK can't deliver an EHRS, I really don't see it happening here.
IT systems have the annoying requirement that they need to be based in logic. In order for any system like this, or PPARS or anything else to work the underlying system needs to be reformed and standardised. The scope for saving, and the resultant freeing up of resources to improve services and working conditions, is colossal. Unfortunately the vested interests within the industry have too much power to frustrate change.

In order to merge IT systems HR systems and functions should be integrated first.
In order to integrate data entry a standard procedure for entering that data has to be introduced first.

Given the movement of Amazon, Apple, Google and Microsoft into the healthcare space I expect them to have offerings for healthcare systems in the medium term. I'm surprised that GE, Siemens or even smaller players like Draeger haven't developed an offering yet, given their relative dominance in the diagnostics and patient monitoring sector.

The last time I was in an A&E I did wonder why they couldn't give each patient a silicones bracelet with an RFID tag imbedded in it rather than a printed bracelet with a bar code. The RFID tag could hold their current records and track their location within the hospital. It's 30 year old technology and it's dirt cheap.
 
I wouldn't hold your breath. 20 years ago the UK launched the National Programme for Information Technology's NHS Care Records Service to provide a national standards-based interoperable electronic health records system. Unfortunatley, it wasn't a success and incurred significant losses, with the programme being terminated in 2011. Now, if the UK can't deliver an EHRS, I really don't see it happening here.
I lived through it (minor point - it was England not the UK). NPfIT is a great example of how not to do it - centralised command and control, run by ex management consultants, thinking that healthcare isn’t much different from an airline, manufacturing or the London Confestion Charge. Instead healthcare is a high variation sector so the challenges to digitise are significant.

NHS acute and community trusts have subsequently (to NPfIT) done a pretty good job of implementing Electronic Patient Record systems and integrating them. Ultimately, the investment has to be made in Ireland. It can’t continue forever as the only advanced economy largely reliant on paper records.
 
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