Health policy Martin Curley: Digitialisation of health service is being impeded

Health policy
While in theory I agree that's the idea, history has shown in practice the model of having the Govt of the day hold the HSE to account doesn't work. That's before we even touch on the other side of the coin, which is the political interference exerted on the HSE's decision making process too. The current model isn't fit for purpose, and we'll still be talking about the same problems with our healthcare system in another 20 years unless we change tack.
I hear you and would say that most people would agree.

However, for the very reasons you have mentioned, it is unlikely that a different health entity would perform any better.

We have to discuss tangible facts.

We can all see that in this case and I am trying to stick to eHealth, it is a fact that administrators did not follow the eHealth Strategy.

They have instead added considerably to the cost of the national rollout in terms of delays and overspend of public money by developing standalone systems.

In terms of accountability - as a first step - I am trying to get to who sanctioned these processes, if indeed they were sanctioned.

As mentioned previously, they are not taking place in an underground bunker.
 
This claim was supported by the union. Employee claimed scanning documents for a few minutes a day would lead to stress and exhaustion. How could you ever expect to implement large changes in the public sector if this is going on.

 
Dr Kennan who spoke at the recent Oireachtas committee on eHealth was interviewed on Radio 1 yesterday. https://www.rte.ie/radio/radio1/clips/22204552/
FF to minute 13 for the Minister Ossian Smyth, Dept PE&R.

So the reason the Minister cites for not signing off on the plan was that it was a large project that projected to deliver everything at once in 5 years time. His ministry wants incremental delivery across the 5 years with the systems enriching over time.

In development terminology the HSE were going down the road of "Waterfall" project mgmt & his ministry wanted "Agile" delivery methodology.
To my mind they shouldn't be developing anything, instead they should be buying everything. HSE is NOT in the Software Development Business.
 
This claim was supported by the union. Employee claimed scanning documents for a few minutes a day would lead to stress and exhaustion. How could you ever expect to implement large changes in the public sector if this is going on.

We got a new record management system in HR about 4 years ago. No issues with staff using it except the scanning took much longer than the old 'filing' system.

Every now and then we pay a company to deal with a backlog. The company was already approved by HSE through a procurement process.

Other than that, we all like the new system. We're not too crazy about the scanning bit.
 
No issues with staff using it except the scanning took much longer than the old 'filing' system.
I don't understand how it could take longer.

Besides, once scanned a document can be quickly retrieved electronically rather than having to file and refile or photocopy paper documents.
 
I don't understand how it could take longer.

Besides, once scanned a document can be quickly retrieved electronically rather than having to file and refile or photocopy paper documents.
We had to use a special scanner or scan to ourselves in a pdf. The first scanner only allowed 10 pages at a time. We did upgrade but the scanner was expensive. After it was scanned, you had to put it into the correct section and name it. Emails were fine, you didn't scan those, you just dropped them in and named them.

After that it had to be verified by a different user. It took longer, I'm not lying.

Once it was scanned everything was great, it's right there on your desktop.
 
In development terminology the HSE were going down the road of "Waterfall" project mgmt & his ministry wanted "Agile" delivery methodology.
But do you agree with him.

For instance he said:

"So, what we would like to see instead, is a stepwise delivery of services - one at a time. And what I’d like to see specifically this year is that you can see your prescription online, you can see the drugs that you’ve been prescribed online and that you’ve got a button you can press to renew your prescription."
 
“And what I’d like to see specifically this year is that you can see your prescription online, you can see the drugs that you’ve been prescribed online and that you’ve got a button you can press to renew your prescription online”.

wonder whats so important about the above that it will have the honour of being the first stage of digitalisation?
many GPs have already set up a system to allow you to request a prescription renewal online and have it emailed to your chosen pharmacy.
 
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“And what I’d like to see specifically this year is that you can see your prescription online, you can see the drugs that you’ve been prescribed online and that you’ve got a button you can press to renew your prescription online”.

wonder whats so important about the above that it will have the honour of being the first stage of digitalisation?
many GPs have already set up a system to allow you to request a prescription renewal online and have it emailed to your chosen pharmacy.
You don't get to see your script though. If you need to shop around you need your signed hard copy.
 
Well, having listened to that interesting little spit out from Ossian Smyth, Minister of State at the Department of Public Expenditure and Reform (DPER), provided by @nest egg above, it appears that for all intents and purposes the eHealthcare Strategy and the pace of its rollout is not determined by the Health Minister, The Health Department or the HSE, but rather by DPER.
 
Well, having listened to that interesting little spit out from Ossian Smyth, Minister of State at the Department of Public Expenditure and Reform (DPER), provided by @nest egg above, it appears that for all intents and purposes the eHealthcare Strategy and the pace of its rollout is not determined by the Health Minister, The Health Department or the HSE, but rather by DPER.
A senior manager in my hospital said to me 5 or 6 years ago that the only show in town was DPER, the DOH and HSE were only puppets. When it was set up Robert Watt was the Secretary until he got 'promoted' to DOH.
 
@valery I've closed the digital loop with my local pharmacy by emailing them monthly call-offs from the 3-monthly GP-to-pharmacy renewals. I started this at the beginning of COVID, reducing queues and visits to the pharmacy. Not every little success needs to come from the HSE, Dept of Health, medics or other public servants, although I'm sure if they hear about it they'll claim credit.
 
I see there's an effort to quantify the impact of the delays and inefficiency of our health service.

"Almost 1,300 patients died over the winter as a result of delays in hospital admission from emergency departments, according to an analysis of Health Service Executive data.

The death toll is 174 higher than the 1,104 excess deaths linked to healthcare delays that were estimated to have occurred last winter, the Irish Patients’ Association said. This exceeds the 155 people who died in road traffic incidents last year.

The association based its estimate on HSE data on patient experience times, which shows 104,818 patients have waited more than six hours to be admitted this winter.

There is one death within 30 days for every 82 patients forced to wait more than six to eight hours for a bed, British researchers estimated in a study published in the Emergency Medicine Journal last year."


 
What goes on the death certificate as the cause of death in these "excess deaths" cases?

  1. General delays & inefficiency in the health service?
  2. Incompetence in the overall health system?
  3. Finger-pointing by Finance & Health Departments?
  4. "Other"?
 
I notice that the Irish Patients’ Association based its estimate of "Patient Experience Times", which is also an estimate.

The HSE cannot provide reliable data on anything.
 
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