It is hard to believe that six months has passed since the infamous HSE Conti ransomware attack of May 14, 2021, thought to be the work of a Russian gang known as Wizard Spider. A HSE worker inadvertently clicked a computer link and received a message that some 700 gigabytes of patient data had been accessed and encrypted, with examples of the stolen data offered as proof.  Thus followed a demand of some €15 million for its release, and a threat to sell the data to the highest bidder on the dark web. Since then, IT specialists have been working day and night to preserve, repair and rebuild the HSE’s systems.  This all suggests that, if we are to use computer systems in our health service, we need to invest in them significantly.

It is against this backdrop that a report entitled Futureproofing Healthcare in Ireland: Personalised Health Index 2021 was launched recently, as part of an international initiative aimed at tracking and encouraging the evolution of health systems worldwide. Out of the 34 countries examined in the index, Ireland ranked 19th overall. The top three countries were, unsurprisingly, Finland, Germany and Sweden, followed by the Netherlands, the UK and Spain.

How did Ireland really do? Performance was based on four equally-weighted ‘vital signs’. The first, ‘policy context’, examined civic participation, environmental and social determinants, biobanks, access to data for research and scale-up funding. Ireland ranked joint 12th with the UK. ‘Health information’ included patients’ access to their data, cross-border data cancer registries, use of electronic health records and data infrastructure. Ireland ranked 19th in this area. ‘Personalised technologies’ covered wearables, treatment availability, decision support systems and access to CAR-T technologies. Here, Ireland ranked joint 19th with Poland and Lithuania. Finally, ‘health services’ examined the planning, organisation and delivery of healthcare, with measures such as equity, research and development, patient portals, telemedicine, integrated care initiatives and genomic testing. Ireland came 22nd, which was well below average. On a positive note, Ireland was among the top five countries in relation to access to data for research, but conversely the willingness of the population to share data for medical research and healthcare improvement in Ireland was low.

A panel of experts on Irish healthcare and policy was formed to examine the findings of the international index from an Irish perspective. They stressed that the electronic health record is the building block for much of the delivery of personalised healthcare. It will allow patients and healthcare professionals to access their data in a variety of settings, allowing the seamless transfer of care. A secure patient portal allowing ease of access would be the ideal, they found. They highlight that the unique health identifier/individual health identifier already exists and is underpinned by legislation, but its widespread rollout has been delayed and put on the long finger as the health service’s IT infrastructure remains inadequate. 

The expert panel ultimately concluded that the deficiencies are due to a lack of infrastructure and delays in implementing data sharing policies, which means that Ireland is losing out on opportunities in research, clinical trials and advancements in genomic testing – to the detriment of patients and the Irish healthcare system.

It will be interesting to see how the panel’s recommendations progress and whether they will indeed futureproof our healthcare system in Ireland.