The Health Information and Quality Authority will undertake or commission research to support its work in quality assurance, accreditation, health technology assessment and health information.
Research is currently being undertaken on behalf of the Authority in the following areas -
A User Configurable National Electronic Health Record: Technological Assessment of the EHRcom Standard for Ireland.
Project Researcher: Damon Berry MSc. BSc. DipEE
Project Synopsis: The Electronic Health Record (EHR) is the term used to describe the amalgamation of all the useful clinical information that has been collected and stored by different people in different locations about a patient from birth to death. The key features of the EHR are that it is patient centred and all information can be accessed from one place, no matter where the information is physically held.
Such a system has yet to be implemented fully in Ireland since as yet there is no agreement between IT providers on ways of sharing information. The inability to share patient records across enterprises is one of the key problems in health informatics.
There are several standardisation 'projects' addressing this need to digitally represent and share clinical data. The central thrust of the health informatics standardisation has been towards a European standard for health record communication called EHRcom.
A technological assessment of the five part EHRcom standard in line with iHIQA roles forms the central tenet of the research project. This research contributes to iHIQA's role by providing a framework to introduce quality health information that meets nationally agreed standards for decision-making, planning and delivery of services. The impact of the research findings will in the medium term, provide a set of detailed recommendations for the development of electronic communication that will support a national EHR programme for Ireland, leading to a longer term impact of realising a National EHR infrastructure. The benefits of such a framework to patients will be to safeguard privacy and confidentiality whilst promoting the optimal use of high quality efficient and effective health information systems.
Developing the optimal strategy and tools for creating and implementing a colorectal cancer screening program: a program to assess and to develop capacity and capability in a national treatment centre
Project Researcher: Professor Colm O'Morain, MSc Biochemistry
Project Synopsis: A recent editorial in Am J Gastroenterology examined the role of Faecal Occult Blood testing (FOBT) in three countries, all three countries advocated the use of FOBT as a first line screening tool for colorectal cancer for their populations based on cost, uptake and reliability/sensitivity. Ireland has yet to develop a colon cancer screening service and a number of issues need to be addressed prior to this service plan being implemented.
The aim of this 3 year study; the results of which will be published and submitted to relevant policy makers as part of developing a quality assured national cancer screening service, is to ascertain the optimal tools and framework to be used in an Irish screening service based on -
(i) patient acceptability
(ii) sensitivity and costs associated with the two types of FOBT and the associated long term costs of repeat tests/colonoscopies and
(iii) the attitudes and awareness ofthe Irish public around colorectal cancer screening.
A randomized trial of two types of FOB test will be conducted on 20,000 male and female GP patients between the ages of 50 - 70 years. The process of the study will contribute to the accreditation process of the hospital laboratory and increase in the skill set involved in managing and processing large numbers of FOBT in a quality assured environment.
Developing quality indicators for use in general practice in Ireland
Project Researcher: Dr Ailís Ni Riain, MB BCh BAO, MICGP.
Project Synopsis: Despite the Irish College of General Practitioners (ICGP) producing guidelines supporting continuing medical education and promoting audit, there is little in the way of formal quality improvement initiatives or tools in quality improvement in general practice.
The aim of this study is to develop quality indicators for general practice in Ireland using the RAND/UCLA methodology that reflects the administration of general practice which broadly includes clinical conditions, the patient's experience and practice management issues.
The ICGP will actively promote and support their use through their small group continuing medical education network (95% of general practitioners are members of the ICGP). It is hoped that this will embed a culture of quality improvement in Irish general practice.
Morbidity and epidemiology in general practice in Ireland
Project Researcher: Dr Claire Collins, PhD, MsocSc, BsocSc, Dip Stats (ICGP)
Project Synopsis: While there is data available on hospitals attendances in Ireland, little is known regarding general practice attendances. General practice is an untapped source of information about the health of our population, their behaviour and their utilisation of health services.
A sample of general practitioners will be recruited into a longitudinal data collection and analysis study.
The overall objective of this research is to provide a mechanism to collect data regarding morbidity among patients attending general practice and to describe general practice epidemiology, including health seeking behaviour, the consultation process, diagnostic and therapeutic outcomes and natural history of primary care illness.
The study will provide data on general practice morbidity and epidemiology. The data provided will indicate how better to promote healthy lifestyles and the enhanced management of disease.
Development and evaluation of a consumer driven standards and monitoring system for use within the disability sector
Project Researcher: Dr. Patricia O'Brien
Project Synopsis: The aim of this project is to research and develop a means whereby consumers can be involved, in a very practical and central way, in the process of standards development and evaluation for services.
The service user will be central to the work, ethos and culture of the Health Information and Quality Authority and this project aligns closely with this.
The National Institute for Intellectual Disability, Trinity College will lead this project but will work alongside key stakeholders including the National Disability Authority, Inclusion Ireland, the Interim Authority, service agencies, such as, Moore Abbey, Cheshire Ireland, people with disability, family members and advocates and the members of the Social Services Inspectorate.
One of the key objectives of the projects is the training of service users in the evaluation process for services and incorporating the research learning into the standards as they evolve.
The Cost of Implementing Hospital Accreditation - What are the benefits?
Project Synopsis: This study, commissioned by IHSAB, commenced in October 2006. The work is being undertaken in conjunction with the School of Business in University College Dublin and is expected to take three and a half years to complete.
The aims of the project are -
- To determine how much it costs acute care hospitals in terms of human, financial and physical resources, to run the IHSAB Acute Care Accreditation Scheme (ACAS).
- To undertake a cost benefit analysis for operating the ACAS.