By Michael O’Farrell
THE decision to outsource the IT infrastructure for next year’s Covid vaccination programme raises serious concerns about its roll-out, campaigners have warned.
It has emerged that the HSE is concluding a contract with a private technology firm so that vaccines can be booked, monitored and tracked online.
This comes as representatives from the home care sector last night questioned the HSE’s ability to oversee an ordered roll-out among the tens of thousands of over-70s being cared for at home.
‘The Government do not have a good record when it comes to online systems,’ said Joseph Musgrave, the CEO of Home and Community Care Ireland (HCCI).
‘They don’t even have a national system for home care. They roughly know how many home care clients there are but there’s no national database or register,’ he said.
Mr Musgrave said he doubted the HSE’s ability to roll-out the necessity IT systems and said he would have more faith in the private sector’s ability.
The IT system deal – with an unknown private firm – could also involve the creation of an unprecedented national database containing personal information and health details of most of the population, raising serious privacy concerns.
Such a system would exceed in scope and scale every other patient database the HSE has ever set up, though unfulfilled plans for a system-wide patient identifier within the health service have been in place for years.
Last night, Irish Council for Civil Liberties executive director Liam Herrick called for an immediate data protection assessment of the vaccination plan. ‘Any proposal to engage private sector bodies in this area gives rise to serious concerns about privacy and data protection,’ he told the Irish Mail on Sunday.
‘The GDPR [General Data Protection Regulation] is clear that health data is among the most sensitive categories of personal data, and that special protections must be in place in relation to how it is collected, retained securely, used and shared, as well as how and when it might be destroyed,’ Mr Herrick said. ‘As a first step, there is a clear legal obligation on the State to carry out a Data Protection Impact Assessment of any such system before it can even be considered,’ he added.
Stephen McMahon, of the Irish Patients’ Association, also raised privacy concerns and queried what identity number the system would use.
‘The issue is what number are they going to use? Is it going to be your PPS number because not everybody has a PPS number,’ he told the MoS.
‘It will be interesting to see what consent issues there are and what consent process they develop for people being vaccinated,’ he said.
‘Will the data be shared with third parties and will it be shared with third parties outside the State? Will it be anonymised and how secure is it? We’ve got to look at GDPR, the ethics of what they’re going to be doing with the data. That’s an important aspect of it.’
Mr McMahon was also critical of the HSE’s ability to manage the IT requirements of rolling out a vaccine in light of its poor computer infrastructure.
‘We saw the other day that the HSE still haven’t upgraded from Windows 7,’ he said.
A spokesman for the Office of the Data Protection Commission confirmed that the Department of Health had met the commission about its plans in recent days.
‘The Department of Health has contacted us and we met with them Thursday,’ the spokesman said.
‘They outlined some of their plans and they have committed to engaging with us further as the plans develop. They will have to do a Data Protection Impact Assessment on the project and they’ll engage with us on that,’ the spokesman said.
Under the Government’s plan, those to be inoculated would be able to register online. The system would keep track of those who have been vaccinated and allow their reactions be monitored.
Full details of the plan have yet to be approved but informed sources have told the MoS that the use of PPS numbers is not envisaged.
Instead it is understood that the use of Individual Health Identifiers (IHI) is being considered.
Since 2009, when Mary Harney was the health minister, successive governments have been seeking to introduce IHIs to allow for the integration of health services across the system. Legislation to create an IHI database was passed in 2014 but the HSE system has struggled to roll one out properly despite millions of euro being spent.
For example, the HSE’s Office of the Chief Information Officer, with 350 staff and a budget of more than €50m annually, has so far failed to get the IHI system up and running and most people do not have an IHI yet.
One of the consequences of failing to roll-out IHIs meant the health system was unable to track the spread of Covid-19 brought into nursing homes from patients transferred out of the acute sector in the first wave of the coronavirus pandemic.
The legislation underpinning the use of the IHI register – the Health Identifiers Act in 2014 – does allow individuals and entities that are prescribed by the Minister for Health to access the IHI database in certain circumstances.
One such circumstance, includes the ‘identification or prevention of a threat to public health’.
Meanwhile, doctors and pharmacists are becoming more and more frustrated at lack of clarity about the part they will play in the vaccine roll-out and have raised concerns at the development of software to track the roll-out.
Irish Medical Organisation GP chairman Dr Denis McCauley told The Irish Times that GPs want to play a role but ‘the longer our keenness is held on tap, the more frustration will actually develop’.
‘If they are going to develop a brand new software, let’s hope there’s no “northside Luas/southside Luas” moment where they say the tracks aren’t the same,’ he said.
Yesterday, pharmacist and former Dublin Fine Gael TD Kate O’Connell questioned why the existing IT system used by GPs and pharmacists to record patient information could not be adapted for the Covid vaccine as it already uses a unique patient identifier number.
‘It seems like a strange time to implement such change,’ she told Brendan O’Connor on RTÉ Radio 1 yesterday. ‘The existing system could be made more robust to my mind, to facilitate it.’
