Updated: Dec 6, 96
IRELAND

The Irish health service is administered through eight regional boards, in all of which there is significant information systems development, and several centrally-funded Independent Voluntary Hospitals. IT policy has moved from one of standardisation, which, though partly successful, did not meet the requirements of a multifaceted service using information as a major instrument of change. These groups compete for information systems funding, usually by commissioning a Strategic Plan, which if approved by the Ministry of Health is funded. Users are thus intimately involved in the developments.

In 1988 a new policy, moving from technology driven to service-led developments, with competition for products and services, was introduced. A number of functions were devolved to agencies under central direction. Close co-operation now exists between central government and the operational agencies and between the agencies, resulting in greater security of funding, encouraging participation in European programmes, and commissioning strategic systems. The Ministry of Health has published a National Health Strategy in 1994 and future IT developments will be aligned with this.

In a typical health board area there will be seven main information systems areas covering client services, planning and control, personnel, finance, registration, environmental services and general support services.

As an example, in the client services area, systems cover a wide range of operational areas, including laboratory and radiology systems, care planning as well as the general patient administrative systems. Key objectives are to recognise and support the multifaceted relationship between the board and the client, provide operational support to the clinical and administrative staff delivering the care while recognising special needs such as access, security and level of detail, and providing support to health care and service planning at all levels.

Government policy is to encourage network development with the mandatory use of OSI standards. Development of links between hospitals and community (including GPs) is particularly emphasised, and development is at varying levels but is hampered by the low level of GP computerisation. However, the Health Strategy published in 1994 sets out a number of objectives for the development of general practitioner services amongst which is a target to achieve 80% computerisation of general practice by 1998. Standards for hardware and software in general practice have been agreed and a general practice accreditation scheme is in place. Significant investment is being made in acquisition of systems by general practitioners which is aided by a special general practice development fund. Good progress is being made towards the Health Strategy target. In addition pilot projects are in place covering data links between GPs and hospitals, patients registration and use of the International Classification of Primary Care (ICPC) coding system in general practice.

The EC FEST, STAR and COCO projects are also assisting in the development of the links between hospitals and the community. Ireland is also very actively involved in the CEN TC 251 groups.

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