The Strategy & Reform Chair welcomed Board and Committee members to the meeting and introduced Professor Richard Greene (Chief Clinical Information Officer), Ms Emer Moran (Interim A/CFO Community Finance) and officials from Deloitte, Strategic Partners Ms Rebecca Ring and Ms Fran Cousins and Director Mr Ger Butler to the meeting.
The Chair advised that as part of the Digital for Care: A Digital Health Framework (2024 – 2030), the digital health strategic implementation roadmap was developed which advances key Sláintecare Initiatives including the National Shared Care Record programme (NSCR) and the development of a roadmap and investment case for Electronic Health Record (HER) deployment. The NSCR and the EHR are complementary and part of a health ecosystem which also includes the HSE patient app and the national diagnostic systems which will be connected to the National EHR.
It was noted that the delivery of a unified, lifetime EHR for citizens is also government policy as set out in the Programme for Government 2025 and the National Service Plan 2025 underscores the necessity for an EHR under the 'Strong Foundations' commitment.
The Board and Committee members were advised that although Ireland is currently ranked as the 5th most advanced digital economy in the EU, it lags significantly behind in digital health maturity, and ranked last in digital health readiness among developed nations according to the OECD, which highlights a critical area for improvement. In response to this, the delivery of a single EHR with comprehensive functionality across all of the services was being proposed.
The CTTO presented to the Board and Committee members, the National EHR Preliminary Business Case (PBC), which was circulated in advance of the meeting.
A presentation was provided setting out the case for change, the proposed solution including the scope of the EHR and the governance, procurement, implementation approach, risk management processes, and full financial and economic appraisal as required under the infrastructure guidelines.
It was noted that a comprehensive assessment of potential solutions to meet objectives was held which led to the shortlisting of three options for further financial and economic assessment. Board and Committee members were advised that a national EHR from a single vendor, delivering a single-instance EHR with comprehensive functionality emerged as the preferred option, yielding the best benefit-cost ratio and having the lowest risk profile. The CTTO advised that from an economic perspective, this option emerged as the most favourable choice, yielding the highest Economic Internal Rate of Return (EIRR) and highest Benefit-Cost Ratio (BCR), driven by its superior economic benefits, and had the lowest risk profile compared to the other shortlisted options.
Board and Committee members discussed the detailed risk management strategy which was developed outlining the framework for identifying, assessing, and managing risks associated with the programme and the mitigating actions required to manage the risks.
Board and Committee members welcomed that the EHR sets out to deliver a unified, lifetime electronic health record that empowers patients and care providers to achieve better health outcomes, enhances quality and safety across all health and social care services, and improves their efficiency and agility.
Committee members considered the Preliminary EHR Business Case, and if members had any further queries that they be forwarded to the Board office.
Committee members recommended for approval to the Board the adoption of the Preliminary EHR Business Case to progress to tendering and initiate procurement, and for onward circulation to EAP and MPAG and the recommendation within the Business Case, based on the cost-benefit analysis conducted, to progress with the National EHR programme, implementing a single EHR.