Cancer patients at risk if services don’t return to normal soon
THE risk of serious and negative outcomes for patients will increase if the HSE can’t return its services to normal within two weeks, a leading cancer specialist has warned.
The Clinical Director of Cancer Services at University Hospital Limerick (UHL), Dr Denis O’Keeffe, said staff feel like they’ll be ‘hit with a swarm of locusts next’ after the cyberattack on the HSE forced hospitals to return to using paper records on patients, slowing down every aspect of the care system.
Dr O’Keeffe told the Irish Mail on Sunday: ‘We’ve been hit with challenges continuously in a system that’s already working very hard to keep up. It’s almost unbelievable. At this stage, all you want is a normal day of work, the challenges that already come with treating someone with cancer. On top of that, you’re thinking, “Am I going to have the results? Where will I get them? Will I be able to get a scan? What’s their full review? How safe is it to go ahead with treatment? Do you have all the information that you would normally have on your electronic systems?”
‘These are challenges we never thought we would have to face but that has been what we’ve gone through over the last week.’
Dr O’Keeffe said he is ‘hopeful’ that there is an understanding within the HSE that the radiology systems will need to be restored first as they are crucial for continuing cancer treatments.
‘Right now the ability to look at a patient’s scans and compare them to previous scans is not possible, so this is only sustainable for a short amount of time because that person needs to be treated, but you need the up-to-date pathology and the up-to-date review scans to do that and now that just isn’t possible.’
Dr O’Keeffe said bowel, breast and lung cancers are particularly affected right now.
The UHL director said pushing decision-making off by a week or two is ‘manageable’ in these cases, but he warned: ‘Longer than that and the risk does increase.’
He said new patients who come in for treatment for the first time who do not have a history of cancer will be more straightforward to treat at the moment than patients returning for continued treatment, as their histories cannot be accessed.
He said it was very difficult to assess how long the current system could continue before there were patient fatalities directly connected to the closed IT service. Speaking on RTÉ’s Morning Ireland on Friday, Health Minister Stephen Donnelly said progress has been made in getting some systems back in a number of voluntary hospitals.
These include the National Integrated Medical Imaging System (NIMIS) radiology system, lab systems and patient administration systems.
Minister Donnelly admitted radiation oncology ‘remains a problem’ as disruption continues across many hospitals in the wake of the biggest cyberattack in the history of the State.
While some machines are running, the minister admitted that it was ‘not at the level’ the HSE wants.
In terms of how hospitals are operating at the moment, HSE Chief Operations Officer Anne O’Connor said outpatient services have decreased from 14,000 patients a day by 70% to 80%, elective inpatient services have decreased from 323 a day by 50%, day-patient services are normally 3,500 and are down 60%.
Chemotherapy was also down 50% on Thursday, but this may have improved in recent days.
Renal services are currently operating as normal at around 700 patients, while scoping procedures are down by between 70% to 80%.
There has been a significant number of hospital appointment cancellations and the health service is continuing to update its website with details for patients. Those who are attending appointments are urged to bring any documentation that contains their patient record number as there may be paper records that can be used to link prior histories.
HSE staff have been redeployed to hospitals to act as runners, they are hand-writing and handdelivering results.
Dr O’Keeffe said there are also significant delays relating to lab results, but that the turnover has improved since last week.
He told the MoS: ‘At the beginning, on Friday and Monday, we were looking at an increase of five to six times the normal turnaround in terms of our laboratory blood tests.
‘Now, that’s beginning to improve because we’re having some limited IT access to those results but you’re still talking about an increase of three to four times the normal turnaround for routine blood tests. And so you can imagine the impact that has in terms of assessing people, getting them planned for their chemotherapy.’
He said results that would usually turn around within an hour are being returned within three to five hours.
In terms of cancellations in the cancer services in UHL, Dr O’Keeffe said the hospital has been rescheduling patients coming back in for routine three-month or sixmonth follow-ups post-cancer and pushing them back by two weeks, or once ‘things get back to normality’. He added: ‘You’ve got to be hopeful that the powers-thatbe can get the wherewithal to begin to solve it piece by piece pretty quickly. So we remain hopeful, but we’ll see.’
‘Challenges we never thought we’d have to face’
‘Three or four times the normal turnaround time’