Committee Reports > List of Committees > Dáil > 1990 > Committee of Public Accounts > Final Report - Appropriation Accounts 1988

APPENDIX 18

COMPUTERISATION IN THE HEALTH SERVICE

The new policies for information technology (IT) developments in the health services are now fully in operation.

IT-related expenditure has been drawn together within a single subhead of the Health Vote and updated procedures for approving and monitoring IT investments are in place which complement the increased discretion delegated to agencies in relation to the acquisition of systems.

Detailed guidelines for systems planning, specification of requirements, selection of hardware and software, and systems implementation have been issued by the Department to agencies. The requirement for agency personnel at various levels to be involved in planning for the introduction of IT systems is underlined. System development initiatives are being explicitly related to service objectives and requirements, with value for money a key consideration.

Competitive procedures for the acquisition of IT products and services are being followed.

Strategic IT plans have been developed for a number of major agencies, including St. James’s Hospital, Mater Hospital, Portiuncula Hospital (Ballinasloe), and the Western Health Board. These projects have, among other things:

(i)brought senior personnel within the agencies concerned more directly into the IT planning process;

(ii)given an increasingly sharper focus to benefits expected to accrue from IT investments;

(iii)agreed priorities for individual IT applications within an agency-wide framework; and

(iv)laid down a technology platform capable of meeting future as well as present requirements.

A small number of major IT implementations have been initiated including Beaumont Hospital, the Mater Hospital and in the North Western Health Board. These are initially covering patient administration, order communications and some supporting modules. As well as providing definite potential to improve the utilisation of resources and to streamline paper handling generally (and in particular the ordering of procedures and the reporting of results) they will provide the core systems infrastructure for hospital and community wide information management and communications.

Beaumont Hospital, following a competitive tendering exercise, selected Hewlett-Packard hardware and software supplied by Gerber Alley. The North Western Health Board, also following competitive tendering, selected Digital hardware and software supplied by Ferranti. In the case of the Mater Hospital it was decided, in conformance with the strategic IT plan drawn up for the hospital by Price Waterhouse, to develop further with hardware (Digital) and software (SMS) already installed.

There have also been a number of important new individual computer implementations in support of specific service areas including stores and laboratories, and the same commercial hardware/software has been installed in a number of different agencies.

In addition the Department has commissioned the development of its own software to meet, in a very cost-effective manner, the basic patient administration and billing requirements of smaller hospitals (and as an interim system where required for larger hospitals). This software is now in operation in a number of hospitals in the Eastern, Midland and Mid-Western Health Boards and it is planned to expand this initiative to other relevant hospitals.

Within the Department itself a major IT planning exercise has been completed with a view to making greater use of IT within the Department in the future. A set of core management information/decision support systems have been identified covering, for instance, profiles and planning for hospitals, continuing care, and primary care, cost/activity analysis, health service personnel planning etc. The Department’s own developments are being geared to facilitate the acceptance of information in electronic form from health agencies for planning and policy purposes as relevant agency systems come on stream.