TY - JOUR
T1 - Status of the health information system in Ireland and its fitness to support health system performance assessment
T2 - a multimethod assessment based on stakeholder involvement
AU - Ivanković, Damir
AU - Jansen, Tessa
AU - Barbazza, Erica
AU - Fernandes, Óscar Brito
AU - Klazinga, Niek
AU - Kringos, Dionne
N1 - Funding Information: In 2017, a major 10-year health reform called Sláintecare was launched in Ireland []. To measure progress in achieving reform objectives and their alignment with the broader policy cycle, the Irish Department of Health (DoH) and the Health Service Executive (HSE) initiated and supported the development of an actionable [] national HSPA framework for assessing health system governance and performance. The development of the framework was supported through the European Union’s (EU) structural support reform programme [], and led by an external team of researchers through the “Performance accountability for the Irish health system” project. At the end of the project, an HSPA framework for Ireland was proposed [], consisting of five clusters, 16 domains and 36 subdomains, 49 features and 266 indicators (Fig. ), and was officially launched by the Irish Minister of Health. Publisher Copyright: © 2022, The Author(s).
PY - 2023/12/1
Y1 - 2023/12/1
N2 - Background: Between 2019 and 2021, the first Irish health system performance assessment (HSPA) framework was developed. As routinely collected health data are necessary to continuously populate indicators of an HSPA framework, a purpose-driven assessment of the health information system (HIS) in Ireland and its fitness to support the implementation of an HSPA framework was conducted. This study reports on the status of the Irish HIS through a multimethod assessment based on continuous broad stakeholder involvement. Methods: Between May and November 2020, over 50 informants were engaged in individual and group interviews and stakeholder consultation workshops as part of the HIS assessment process. Descriptive themes and high-level data availability heatmaps were derived from interview and workshop data using thematic analysis. Indicator “passports” for the HSPA framework were populated during stakeholder consultation workshops and analysed using univariate descriptive statistics. Results: The HIS in Ireland was able to provide administrative, survey and registry-based data for public sector acute care services, focusing on structure, process and output metrics. Significant data availability gaps, most notably from primary care, private hospitals and community care, were reported, with little availability of electronic health record and people-reported data. Data on outcome metrics were mostly missing, as were linkage possibilities across datasets for care pathway monitoring. The COVID-19 pandemic highlighted the national HIS’s shortcomings but also the capacity for rapid development and improvement. Conclusions: A tailor-made assessment of the HIS in Ireland, involving a broad set of relevant stakeholders, revealed strengths, weaknesses and areas for improvement in the Irish health data landscape. It also contributed to the development of a national HSPA framework and momentum to further strengthen data infrastructure and governance, while working towards a more data-driven and person-centred healthcare system. This work demonstrates the utility of an inclusive HIS assessment process and is applicable beyond Ireland, where this case study was conducted.
AB - Background: Between 2019 and 2021, the first Irish health system performance assessment (HSPA) framework was developed. As routinely collected health data are necessary to continuously populate indicators of an HSPA framework, a purpose-driven assessment of the health information system (HIS) in Ireland and its fitness to support the implementation of an HSPA framework was conducted. This study reports on the status of the Irish HIS through a multimethod assessment based on continuous broad stakeholder involvement. Methods: Between May and November 2020, over 50 informants were engaged in individual and group interviews and stakeholder consultation workshops as part of the HIS assessment process. Descriptive themes and high-level data availability heatmaps were derived from interview and workshop data using thematic analysis. Indicator “passports” for the HSPA framework were populated during stakeholder consultation workshops and analysed using univariate descriptive statistics. Results: The HIS in Ireland was able to provide administrative, survey and registry-based data for public sector acute care services, focusing on structure, process and output metrics. Significant data availability gaps, most notably from primary care, private hospitals and community care, were reported, with little availability of electronic health record and people-reported data. Data on outcome metrics were mostly missing, as were linkage possibilities across datasets for care pathway monitoring. The COVID-19 pandemic highlighted the national HIS’s shortcomings but also the capacity for rapid development and improvement. Conclusions: A tailor-made assessment of the HIS in Ireland, involving a broad set of relevant stakeholders, revealed strengths, weaknesses and areas for improvement in the Irish health data landscape. It also contributed to the development of a national HSPA framework and momentum to further strengthen data infrastructure and governance, while working towards a more data-driven and person-centred healthcare system. This work demonstrates the utility of an inclusive HIS assessment process and is applicable beyond Ireland, where this case study was conducted.
KW - Assessment
KW - Health information system
KW - Health system performance assessment
KW - Ireland
KW - Stakeholder involvement
UR - http://www.scopus.com/inward/record.url?scp=85142209104&partnerID=8YFLogxK
U2 - https://doi.org/10.1186/s12961-022-00931-1
DO - https://doi.org/10.1186/s12961-022-00931-1
M3 - Article
C2 - 36397053
SN - 1478-4505
VL - 21
JO - Health research policy and systems
JF - Health research policy and systems
IS - 1
M1 - 1
ER -