The discovery of a fault affecting at least 25,000 patient records in the HSE’s computer system is extremely worrying. Even more so is the fact that an astonishing six years elapsed before the flaw was noticed in the way X-rays, ultrasounds and scans were stored.
Data protection advocates frequently express concern about the security of personal information when stored online, and often with good reason. Within this category of information, it is hard to think of data more important than a person’s health records. This latest revelation shows there is cause for concern about the accuracy, and not just the security, of this digitally-stored information.
The HSE has suffered its share of misdiagnosis controversies in the past but in this case the software was at fault, and not the clinicians who carried out and interpreted the scans. Doctors would have remained in the dark about the problem had it not been picked up by an observant member of the profession in a provincial hospital last week.
Ever since, and perhaps because of, the Ppars fiasco of over a decade ago, the HSE has suffered from a lack of IT investment. The result has been a large number of fragmentary computer systems that barely communicate with each other and the slow roll-out of digital records as part of an e-health strategy for the 21st century.
The problem affecting the National Integrated Medical Imaging System (Nimis), which is at the centre of the current controversy, appears to spring from the same issue of internal miscommunication. When images were sent for archiving from one part of the system to another, the “less than” or “<” symbol was omitted. The incorrectly stored data may have misled doctors making diagnoses, possibly leading to over-treatment.
At this stage, it is not clear what the effect was on patients, if any. The HSE has acted promptly in addressing the issue since it emerged last week by having the bug fixed and setting up an internal investigation. It has said the problem is confined solely to the “less than” character. Patient safety issues are being prioritised, officials say.
This investigation must answer key questions: Why did this error occur? Why was it not spotted earlier? What was the impact on patients? Are there any other glitches in the system?
It is hard to see how the fault was not identified during the running in of the Nimis system. And although the move to electronic records has many advantages, why were records not printed for patients’ files, as a back-up? It is to be hoped cost-saving was not a factor.
With the HSE hoping to spend €1 billion upgrading its IT systems over the next decade, it is vital that answers are found to these questions, and confidence restored in the organisation’s ability to properly mind and use patients’ personal medical information.