This document discusses building a sustainable health information infrastructure in Ireland. It outlines three key principles: being patient-centered by empowering patients with information; being integrated to eliminate duplication and fragmentation; and being standards-based to efficiently share information. The Health Information and Quality Authority aims to improve healthcare quality and safety by developing standards, identifying gaps, and publishing performance reports. Challenges include integrating the currently fragmented systems and ensuring benefits are realized. Leadership over the long term is critical to successfully implementing eHealth strategies based on these principles.

1. Building a sustainable health
information infrastructure
Jane Grimson
Director of Health Information and
Deputy Chief Executive
Health Information and Quality Authority

2. The perfect storm
G
a
p

3. Good quality information is critical

4. Role of the Health Information and
Quality Authority:
To drive continuous improvements in the
quality and safety of health and social
care in Ireland.

5. Health information function
Develop standards and guidance
for health information
Identify gaps in health information
Publish accurate information
about the performance of the
health and social care system

6. Work completed to date
Develop standards and guidance for health information
Guidance on Information governance for health and social care services
Guidance on Privacy Impact Assessment
What you should know about information governance
What you should know about data quality
Catalogue of national health information sources
Guiding principles for health and social care data collections
GP messaging standard (v2)
Referral data set, discharge data set, demographic data set
Guidance on messaging standards for Ireland
Guidance on classification and terminology standards for Ireland
Overview of healthcare interoperability standards
Identify gaps in health information
Provide advice in relation to identifiers for individuals, professionals and organisations
Publish accurate information about the performance of the health and social care
system
All inspection and investigation reports published

7. Key principles for a sustainable health
information infrastructure
1. Patient-centred
2. Integrated
3. Standards-based

8. Key principle 1:
Patient centered
Informed, knowledgeable
and empowered patient

9. E
N
C
O
U
R
A
G
E
D
D
I
S
C
O
U
R
A
G
E
D
$
Tertiary
Secondary
Professional
Care
Primary
Self-Care
(off the Map)
¢
INDUSTRIAL AGE MEDICINE
Source: Tom Ferguson, “Consumer Health Informatics,” Healthcare Forum Journal, Jan/Feb 1995, pp 28-33.
(doctom@doctom.com, wwwfergusonreport.com

10. E
N
C
O
U
R
A
G
E
D
¢
Individual self-care
Friends and family
Self-help networks
Professionals as
facilitators
D
I
S
C
O
U
R
A
G
E
D
Professionals
as partners
Professionals
as authorities
$
INFORMATION AGE HEALTHCARE
Source: Tom Ferguson, “Consumer Health Informatics,” Healthcare Forum Journal, Jan/Feb 1995, pp 28-33.
(doctom@doctom.com, wwwfergusonreport.com

11. Patient Pathway
Day Care Facilities
Local
Authority
Age Action
Social Services
Primary/
Community
Housing Services
Community Nursing
Secondary / Acute Care
General Practice
Physiotherapy
Ward Care
Operating Theatre
Diagnostics
Ambulance
Service
Emergency Dept.
Ambulance Journey
Information flows the wrong
way
Local Health System
Voluntary
Sector

12. Ambulance Journey
Ambulance
Service
Threatens patient safety
and
increases costs
Patient Pathway
Day Care Facilities
Local
Authority
Age Action
Social Services
Primary/
Community
Housing Services
Community Nursing
Secondary / Acute Care
General Practice
Physiotherapy
Ward Care
Operating Theatre
Diagnostics
Emergency Dept.
Local Health System
Voluntary
Sector

13. Source: eHealth Strategy for Ireland, Department of Health, 2013.

14. The ability of share information is at the heart of
patient-centred eHealth

15. Key principle: 2
Integrated
Eliminate duplication
and fragmentation

16. Current information
infrastructure in Ireland
very fragmented

17. Drivers for integrating health information
•
•
•
•
Connect multiple locations of care delivery
Support team-based care
Deliver evidence-based healthcare
Improve safety
– Reduce errors and inequalities
– Reduce duplication and delay
•
•
•
•
Improve cost-effectiveness of health services
Empower and involve citizens
Underpin population health and research
Protect patient privacy

18. Key principle: 3
Standards-based
Support efficient
information sharing

19. Benefits of standards
• Major role in ensuring safety e.g. Safe Surgery Saves Lives
(WHO)
• Support health service improvements
• Deliver economic benefits
• Benefits stakeholders including patients

20. “the lack of ICT systems interoperability and of widely accepted
standards directly implies compromised quality of healthcare
and unnecessarily high costs”
[Empirica 2008]

21. Standards in healthcare

22. Conclusions

23. Why has progress been so slow?
• What’s the best approach?
• How much will it cost?
• Will it deliver the benefits?
• How do we get there?
• What standards should we
use?
• ……

24. What can we learn?
• Don’t assume that solution which works well in one context will work
well in another
• Identify and implement the key building blocks for eHealth
• Build on local solutions based on standards to ensure that everything
fits together
• Benefits claimed should be evidence-based
• Strategic goal should be better healthcare, not cash
• Engage pro-actively with all stakeholders including patients
• Make sure all information flows are identified from direct patient care,
to clinical audit, quality improvement, reimbursement, population
health, service planning, and research
• Put in place robust governance to ensure privacy and confidentiality
• Leadership for the long term is critical
• Ensure that eHealth strategy enables and supports all policy objectives

25. Can we leapfrog?
• Go directly to Personal
Health Records at national
level?
• Adopt an integrated
approach to primary and
secondary information

26. Thank you