Dáíl Contribution on e-health and access to services

Dáíl Contribution on e-health and access to services

Transcript: I wanted to put a question to the Minister on the promotion and enabling of e-health. Over the course of the Covid pandemic, we have seen a considerable move towards working from home. We have also seen the ill-effects of the cyberattack. I wanted to ask him what steps have been taken by the Office of the Government Chief Information Officer to promote and enable the development of e-health and if he will make a statement on the matter

Deputy Michael McGrath

I thank the Deputy for raising this issue. As the Deputy is aware, Harnessing Digital – The Digital Ireland Framework document was deliberately written to align Ireland with Europe’s Digital Decade: digital targets for 2030. While my Department is primarily responsible for co-ordinating the delivery of the digital Government element of the digital Ireland framework, we will, of course, work across all of government, including the Department of Health and the HSE, in the achievement of the specified targets.

We have seen a significant step forward in the provision of e-government services in Ireland over the last few years, with our passport, Revenue and driving licence services all proving extremely popular and an ever-growing uptake of MyGovID and use of gov.ie. I acknowledge the work of the Deputy’s colleague, the Minister of State, Deputy Smyth, who cannot be here as he is abroad on Government business, for driving a number of these reforms.

During the worst of the pandemic, we were able to stand up numerous services, including in e-health, with the vaccination portal and world-leading contact tracing app. The digital Covid certificate system was developed by the Department of Health and the Office of the Government Chief Information Officer, OGCIO, within my Department. There is considerable material here, which will be put on the record, but I want to specifically touch on the issue of e-health.

The Department of Health and the HSE have committed to revise and deliver a renewed e-health strategy by 2030. In doing so, they continue to work closely with my Department. We will also work with it as it delivers on Ireland’s national recovery and resilience plan, and the renewed national development plan’s digital commitments in respect of e-health and digital health services.

This will involve: continued phased deployment of electronic health record systems; use of health identifiers to create records that are unique to each patient; e-pharmacy and e-prescribing; summary and shared-care records; tele-medicine and remote care monitoring solutions. We have received specific funding under the national recovery and resilience plan with regard to a suite of e-health projects which, perhaps, I can come back on in a moment.

Additional information not given on the floor of the House

The digital Covid certificate not only enabled our people to travel with digital proofs of Covid-19 vaccination and recovery but we were also able to open up a portal to pharmacies and testing centres to provide proofs of negative tests for travel. Then we were able to create a privacy-enhanced version of our verifier to help open up hospitality and, finally, create the means whereby nearly 53,000 Irish people who were vaccinated in other countries have been able to avail of EU-compliant digital Covid certificates.

These successes provide a firm foundation for a more advanced and user-centric service model, with the evolution from e-government, where existing manual services and processes were computerised, to digital government, where services are re-imagined and developed based on a greater understanding of user journeys and choices.

The Government is committed, over the next several years, to build upon our strong foundations and to creating a trusted, user-driven, intuitive, inclusive and efficient world-leading digital government service, in which 90% of applicable services are consumed online. This is a very ambitious objective because it covers Government, local government, education and justice as well as healthcare. Moreover, we will develop priority plans and approaches through consultation with the most important users of the systems, our people and our businesses.

I am convinced that building our digital offerings around the needs of our people will further facilitate the already increasing uptake of digital government services, helping us drive towards the 90% of applicable services consumed online by 2030 target. This, in turn, will help facilitate the freeing up of resources to better support those who may struggle with technology, and-or may not be in a position to independently engage online.

This includes supporting such cohorts to engage, through providing them with digital skills and access to infrastructure, but also through focused supports such as assisted digital approaches, where individuals can get the necessary help to enable them over time to grow their confidence and capability in digital transactions. This will be further supplemented by non-digital complementary options, where more appropriate. Creating a better face-to-face experience for those who need it most and improving the times when and locations where these services will be available is an important part of an inclusive approach where everyone can benefit from digital transformation.

It is also important to foster public trust in the safety, transparency and the value of digital solutions. To that end, my Department has driven forward the implementation of the Data Sharing and Governance Act 2019, which will provide full transparency around the sharing of data across the public sector. We have also worked with the National Cyber Security Centre and the public service, including the HSE, in the development of baseline security standards to raise the protection of citizen data. Both of these initiatives will help underpin e-health development.

These initiatives, coupled with investment in foundational infrastructure and national systems to enable transformation and reform of the health service in Ireland, will help to reduce our reliance on acute hospitals. It will also empower citizens to monitor their health status, adapt their lifestyles and support independent living and enable people to be cared for closer to home. Finally, the Government is digitally enabling the healthcare workforce in order that it has access to modern, fit-for-purpose technology, which allows them to save time, record better data and provide better care to their patients. For support staff, the provision of tools such as the integrated financial management system will increase efficiencies.

Deputy Marc Ó Cathasaigh

I acknowledge the role of NearForm in my home town of Tramore which was instrumental in the production of that Covid tracker app. It did a great job of work in a short space of time and for relatively good value. I worry, when I hear the new e-health strategy will be delivered by 2030, which seems an inordinate amount of time. While the cyberattack, which was a calamity within a catastrophe in that it happened during the worst of the Covid outbreak, presented an enormous challenge, it also presented an opportunity in that a great deal of new equipment was brought in and maybe the opportunity for a new approach. The Minister mentioned the digitisation of records. That needs to be moved forward, as quickly as humanly possible. This is something we have set out in Sláintecare and maybe there is an opportunity to grasp this, rather than set a timeline that leads us so far into the decade.

Deputy Michael McGrath

We all acknowledge that the pandemic accelerated many reforms throughout the system, including in the area of digitisation, especially in health. These reforms have been worked towards over a period of time, but the barriers were cut through and they were made to happen over the past couple of years. We now need to embrace them and build on them as a foundation for further reforms into the future.

If one looks at the €75 million suite of projects for which we have secured funding from the European Union under our national recovery and resilience plan, e-pharmacy is key. The deployment of new pharmacy systems within hospitals will not only provide better visibility of medications, usage and cost, it will enable the possible extension of these systems for use as e-prescribing tools throughout many of our hospitals.

In addition, community e-health solutions will include delivery of ICT communications and technical infrastructure and a key project in health, which is badly needed, is an integrated financial management system. I look forward to seeing the HSE and the Department of Health advance that project as a priority over the year ahead.

Deputy Marc Ó Cathasaigh

I have so many points I would like to address but I do not think I will have time. There are huge opportunities here with e-health and that is why I would like to see it accelerate as much as possible. There are huge opportunities in supporting ageing in place. Ongoing health monitoring, which would lead us to earlier and better interventions in people’s health, could be so important. There is a huge opportunity in providing healthcare in hard-to-reach areas such as the islands, where it is very difficult to access healthcare, when put together with e-prescribing.

However, we need a strategy in place, because there are also issues around the safeguarding of privacy, if we move the more integrated model in order that people have more rights and control over their records. I have worries about the erosion of working conditions. We see a movement towards a platform working model beginning to grow up in the caring economy. That worries me, from a workers’ rights perspective. However, we should move forward with this, as quickly as we possibly can, grasp those opportunities and face up to the challenges.

Deputy Michael McGrath

I agree with the Deputy’s sentiments. There is a fantastic opportunity here that we need to embrace. The Minister of State, Deputy Smyth, and I will, in the coming days, launch Connecting Government 2030, a digital and ICT strategy for Ireland’s public service. That will lay out, in much more detail, many of the key reforms on which we are working towards which will involve building towards 90% online uptake of key public services, in line with the targets set by the EU’s digital decade.

However, the Deputy made a critical point on access. Access to healthcare is not just about accessing a physical building or hospital. It is about accessing services online. The roll-out of the national broadband plan to remote areas of our country is absolutely imperative to that. All the measures we are progressing in the e-health area will, ultimately, help to reduce our reliance on acute hospitals. We also have to ensure that our workers in the healthcare sector are equipped with the technology, equipment and resources that they need to fulfil their functions. The Government will continue to work towards that.