Irish hospital systems ‘are like those in 1890’ when it comes to patient records
THE IT SYSTEM in Irish hospitals is so out of date doctors feel they are working in the 19th century, according to a leading psychiatrist.
Elderly patients may have a paper file with 700 pages detailing their illnesses, with this information needing to be transferred between hospitals as treatment becomes more specialised.
Despite some progress in maternity records and specialised illnesses, the rollout appears painfully slow to medics in the system.
Matthew Sadlier, a consultant psychiatrist across a number of hospitals in Dublin, said he can’t understand the delays which have impacted on changes to electronic health.
He said: ‘You look at our IT infrastructure, which is a laughable entity. You can walk into an Irish hospital and you might as well be walking into it in 1890 as 2017. You have paper-based records, and we will see routinely difficulties with patients who will attend A&E and with communicating across the Dublin divide.
‘You are signing consent forms, you are sending letters. Notes have to be copied to be put in an envelope to be couriered across. So patients are in hospital for two or three days before a decision is made because you are waiting to find out who they are, what their issues are.’
The only Irish hospitals working fully with electronic health records are Cork University Maternity Hospital and Kerry General maternity at an estimated cost of €35m. The other 17 maternity hospitals are scheduled to join over the next two years. But already medics have complained the new computer system is not compatible with that used by GPs, in spite of warnings about this.
‘Our IT systems are laughable’
IT beggars belief that in 2017 medical records across the country are still kept in paper files, rather than being computerised. As psychiatrist Matthew Sadlier points out, our increased longevity means that files on some patients can run to as many as 700 pages, precariously grouped in ragged folders.
The result is that when a patient presents at a new hospital or with a new consultant, the pages must be explored manually, a process so laborious that it often delays treatment until a doctor can precisely establish the patient’s medical history.
Some maternity hospitals and hospices already have EHRs (electronic health records) for their patients, but the national rollout to other maternity hospitals has already been delayed because of a number of compatibility issues with different systems and with the referral systems that are used by GPs.
It is understandable that the Government might be wary of spending hundreds of millions on new computer systems.
The UK attempted it and saw cash fall into a €12bn black hole. Here, botched introduction of the PPARS system to control health payroll and personnel was a €220m disaster, as was the attempt to introduce electronic voting machines.
The wariness might therefore be understandable, but it still is not acceptable. Other smaller European countries, such as the Netherlands and Denmark, successfully computerised their records.
It is a savage indictment of the HSE when a psychiatrist says that walking into an Irish hospital is like returning to 1890, rather than living in 2017. Paper records lead to confusion, and patients have been known to receive the same tests twice because one hospital effectively cannot talk to another without the courier transfer of a stuffed paper folder. This is nonsensical and it is long overdue that our hospitals were brought into the 20th century, never mind the 21st.