HIQA has today published a review of information management practices at the Hospital In-Patient Enquiry Scheme (HIPE), which is the main health information system used in Ireland to inform healthcare planning, delivery and funding; health promotion; and research. This review was undertaken in order to assess compliance with the Information management standards for national health and social care data collections within HIPE, which is designed to collect demographic, clinical and administrative information on discharges and deaths from acute hospitals nationally.

Information management is particularly important for HIPE given the significance of its data for planning and funding, the significant quantity of data produced, the vast number of stakeholders involved in generating the data, the complexity of the data flow pathway and the significant cost associated with generating the data.

The review makes nine recommendations that, if implemented effectively, will drive improvements in information management at HIPE. Rachel Flynn, HIQA’s Director of Health Information and Standards, said: “The review found shortcomings in governance structures at HIPE that have the potential to impact on its crucial role in healthcare planning and funding. To ensure that HIPE can fulfil its essential role, it is important that the HSE implements the nine recommendations made by HIQA today.”

HIPE was transferred from the Economic and Social Research Institute (ESRI) to the HSE in 2014. Within the HSE, certain responsibilities for HIPE have been devolved to two separate divisions, namely, the National Finance Division (specifically the HPO function) and the Acute Hospitals Division. Ms Flynn continued: “Since its transfer from the ESRI to the HSE in 2014, there is little evidence from this review to demonstrate that HIPE has been effectively embedded into the National Finance Division and Acute Hospitals Divisions structures and also into the wider governance structure of the HSE. In the absence of clear governance arrangements, effective risk management and performance management have been limited, posing potential challenges to the overall functioning and use of HIPE. “In particular, this review found that there are no national oversight structures and arrangements in place for the governance, leadership and management of HIPE at a senior level within the HSE. Furthermore, the review found that there is no forum at the national level to regularly review and monitor the range of governance issues required to ensure the effective management of HIPE such as reviewing strategy, business plans, performance and risk for HIPE.

“Although the review identified that some improvements have been made in the area of data quality initiatives and HIPE clinical coding over the past number of years, the approaches to solving the overall information management issues of HIPE have not developed. From an information management perspective, the flow of HIPE data should be seen as one continuous process which starts at the clinical documentation stage to the point where the data is ready for use by key stakeholders to inform decision-making. This fact needs to be acknowledged and addressed by the HSE Senior Leadership team, and a coordinated approach to the governance and management of HIPE needs to be prioritised.

“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. Compliance with these standards 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.”

Ends.

For further information please contact:

Marty Whelan, Head of Communications and Stakeholder Engagement
(01) 8147480 / 086 2447623
mwhelan@hiqa.ie

Notes to editor:

• The full report can be found at the link at the bottom of the page
• HIPE is a health information system managed by the Healthcare Pricing Office (HPO) in the HSE. 
• HIPE is an extremely valuable national repository of health information. For example, HIPE data underpins the National Healthcare Quality Reporting System annual report published by the National Patient Safety Office in the Department of Health. HIPE data is also an important indicator of hospital activity as it identifies the demand for services in each hospital and the hospital’s capacity to treat patients. Additionally, HIPE data is essential for implementation of the HSE’s Activity-Based Funding (ABF) Programme. Over €5 billion was allocated as the budget for the Acute Hospitals Division in 2018. 
• 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. 
• The Information management standards for national health and social care data can be found here 
• A Guide to the Review Programme for national data collections can be found here
• 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.