The Health Information and Quality Authority (HIQA) has today published a set of recommendations on the electronic sharing of health information along the older person’s patient journey. The Recommendations on the ICT Enablement of Older Persons Services support safe and effective electronic sharing of health information for older persons (and for other populations) across the full sector, public and private, and are aligned to national eHealth goals under Sláintecare.  

An older person typically receives care from a wide range of health and social care professionals in both community and acute settings. The health information of an older person is usually held across a number of IT systems or in paper records. It is often difficult for health and social care professionals to easily access and share this information across all settings and this can result in the older person being asked to repeat the same information multiple times. The high number of transitions across settings, and the increasingly complex nature of older persons care, are challenges to the safe and effective sharing of health information in older persons services.

Following the impact that the COVID-19 pandemic had on older persons services in Ireland, the COVID-19 Nursing Homes Expert Panel recommended the introduction of an integrated IT system to support the effective sharing of health information, the management of services, and the provision of alternate capacity. The Department of Health engaged HIQA to explore how the capabilities recommended by the Expert Panel could be progressed and implemented.

The Health Service Executive (HSE) is progressing a significant programme of work to deliver many of these capabilities. For example, informed by learnings following the cyber-attack on its information systems last year, the HSE is currently developing a basic electronic record for community care services to support the enhanced provision of health and social care services under the Enhanced Community Care programme.

While the HSE is developing systems with the capabilities that the Expert Panel requires, in practice these systems will need to be made available to, and adopted by, staff in a broad range of settings, services, and roles across the full sector – both public and private. The systems will also need to be interoperable with national eHealth solutions in the long term. Therefore, HIQA has worked with stakeholders across health and social care, and ICT, to develop strategic recommendations in these areas.

These recommendations are:

• The development of an overall, long-term strategy for ICT enablement of older persons’ services. This strategy will benefit not only older persons but all populations across the sector. Given that a high proportion of health and social care services are provided privately, to be effective such a strategy also needs to address both the public and private sectors. Therefore, a more complete stakeholder mapping is required, with older persons as a core stakeholder group to ensure their voices are heard.
• Internationally, best practice shows the need for more complete engagement with stakeholders over the lifetime of the strategic programme and to fully consider the time and resourcing needed to ensure full adoption of systems with cessation of paper use. Some countries have developed national initiatives for the broader upskilling of the sector more broadly.
• Finally, the recommendations show the need for measures to move away from point-to-point exchange of information, ensuring the (safe and appropriate) sharing of information in line with national standards. This is a core work programme for HIQA and therefore the recommendations highlight the need for the development of a suite of relevant national standards, informed by the actual information needs of stakeholders, including older persons themselves.

To progress these strategic recommendations, HIQA will develop a comprehensive suite of national standards to help facilitate the digital enablement of older persons services and the health information system in general for all populations.

Rachel Flynn, HIQA’s Director of Health Information and Standards, said: “Infrastructure to enable the sharing of information is underdeveloped in Ireland but is very much necessary to support integrated care, as set out in Sláintecare. HIQA looked at the wide mix of services that are delivered to older people to understand how information can be shared safely and effectively among the professionals providing that care. Some of these services are provided by the Health Service Executive (HSE) and others are outside the HSE, such as private nursing homes, GPs, and others.

“As with many countries, the emphasis has been placed on implementing national infrastructure to enable the sharing of health information not just for older people but for all people using health and social care.”

“Specific to the area of older persons’ care, there is a need to have clear governance that incorporates all service providers in that journey, a clear strategy, as well as the other measures outlined in the recommendations.”

These recommendations have been submitted to the Minister for Health.

Ends.

For further information please contact:
Marty Whelan, Head of Communications & Stakeholder Engagement
085 8055202, mwhelan@hiqa.ie

Notes to the editor:

• Through its statutory function for health information, HIQA develops recommendations, standards, guidance and reviews governance arrangements in the area of health information.
• The need for a national health information strategy, as outlined in The Need to Reform Ireland’s National Health Information System paper, is a key requirement called out in these recommendations. That paper made six key recommendations in relation to:
  • Strategy
  • Strategic Leadership and Governance
  • Legislation
  • Workforce
  • Standards and Interoperability
  • Health Information Infrastructure and Security.
• Recommendations were developed following engagement with stakeholders from key organisations and programmes across the areas of health and social care and of ICT enablement.
• A six-week public consultation was undertaken between March and April 2022 where interested parties had the opportunity to submit feedback on a set draft recommendations. All feedback received was analysed and this analysis has been published along with this report as the Stakeholder Involvement Report.
• Eight countries that have made considerable progress in ICT enablement were studied as part of this review. These were:
  • Australia
  • Canada
  • Denmark
  • Estonia
  • Finland
  • Northern Ireland
  • Scotland
  • New Zealand.
• The Enhanced Community Care programme is run by the HSE. Its aim is to enhance and increase community health services and reduce pressure on hospital services by providing more services closer to where people live, especially for older people and people with chronic disease.