HIQA recommends improvements to information management practices at the HSE Primary Care Reimbursement Service (PCRS)
HIQA has today published a review of information management practices at the Primary Care Reimbursement Service (PCRS). The PCRS, which is part of the Health Service Executive (HSE), is responsible for making payments to healthcare professionals for the free or reduced cost services they provide to the public under various national health schemes, including the General Medical Services (GMS) Scheme. Additionally, the PCRS is responsible for processing all medical and GP visit card applications.
This review was undertaken in order to assess compliance with the Information management standards for national health and social care data collections within the PCRS. Comprehensive and high-quality information management is particularly important for the PCRS given the complexity of steps involved in generating PCRS data, the vast quantity of sensitive financial and clinical data that is produced and stored, and the number of stakeholders involved in the process.
The review makes eight recommendations which, if implemented effectively, will drive improvements in information management at the PCRS.
Rachel Flynn, HIQA’s Director of Health Information and Standards, said: “The review identified a number of areas of good practice in relation to information management within the PCRS. However, key areas for improvement were also identified, particularly in relation to the need for a more strategic focus on information management across the entire organisation, and in particular, better use and dissemination of the rich data and information that the PCRS holds. To ensure that the PCRS can fulfill its essential role, it is important that the HSE implements the eight recommendations made by HIQA today.”
This review found that while there are clear governance arrangements in place at an operational level in relation to information management within the PCRS, there is a less structured approach in place in terms of how information management is strategically discussed, planned and managed across the organisation. Specific roles and responsibilities around aspects of information management lacked clarity, including the implementation of audit recommendations or how data generated by the PCRS is used effectively to improve the service.
Ms Flynn continued “The need for high-quality data within PCRS cannot be overemphasised given the nature and volume of data generated and processed and held by the organisation.”
This review found an overall awareness of the significance and importance of information governance and data quality within the PCRS. However, the current approach to the management and use of information would benefit from a more strategic and consolidated approach through, for example, the development of an organisation-wide strategy for information management.
Ms Flynn concluded “Complying with the Information Management Standards will improve the quality of national health information and data, which will ultimately contribute to the delivery of safe and reliable health and social care in Ireland. This will help to instil confidence in patients, clinicians and all other stakeholders that healthcare decisions are based on high-quality information, the availability of which will ultimately improve patient safety.”
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Notes to editor:
- The full report can be found at the link below.
- A summary of the eight recommendations for improving information management practices at the PCRS can be found on page 12 of the report.
- The PCRS is an extremely valuable national health data collection and holds a rich source of data in relation to eligibility and reimbursement of public health services provided under the national health schemes in Ireland. Currently, in the absence of e-prescribing, the PCRS is the richest source of national prescription data and is the largest data source for measuring drug exposure in specific populations in Ireland. As a result, the data collected, processed and held within the PCRS is used for many important purposes, such as guiding clinical decision-making, monitoring diseases, organising services, informing policy making, conducting research and planning for future health and social care needs, both at a national and local level.
- In 2017, 3.6 million people were eligible for the national health schemes, and the PCRS made payments of €2.75 billion in relation to services provided under these schemes.
- The findings from this review identified that these data are not currently maximised or used to their full potential. Dissemination and use of the PCRS data could be improved and enhanced further through, for example, the publication of more granular level prescription data. The potential of routine data sources, such as the PCRS, to be optimised to provide key information relating to pharmaceutical policies or prescribing patterns was highlighted in a recent OECD report (Feb 2019).
- This review is part of an overall review programme being undertaken by HIQA to assess compliance with the Information Management Standards in all major national health and social care data collections within the HSE. A considerable amount of data is collected on a regular basis about health and social care services in Ireland. This data is used for many important purposes, such as to guide clinical decision-making, monitor diseases, organise services, inform policy making, conduct high-quality research and plan for future health and social care needs, both at national and local levels. Ultimately, the review programme aims to drive quality improvements by identifying areas of good practice and areas where improvements are necessary across national data collections.
- Information management is defined as the process of collecting, storing, managing, using and sharing health and social care information. It is a broad definition that includes the aspects of governance and management arrangements, data quality, information governance and use of information.
- The General Data Protection Regulation (GDPR) was enacted across all EU Member States on 25 May 2018.
- A catalogue of all national health and social care data collections in Ireland was first published in 2010 and was most recently updated in 2017 — Catalogue of National Health and Social Care Data Collections in Ireland. The current catalogue features 120 data collections. National health and social care data collections vary in size from large data repositories, such as the National Perinatal Reporting System (NPRS), to smaller patient registries, such as the Alpha-1 Research Registry.