Status of the health information system in Ireland and its fitness to support health system performance assessment: A multimethod assessment based on stakeholder involvement

Abstract Background A major 10-year health reform, called Sláintecare, was launched in Ireland in 2017 with aims of improving health system performance, governance and accountability, while achieving universal health coverage. To support the implementation of the reform, the Irish Department of Health requested technical support from the European Union in developing a health system performance assessment (HSPA) framework. An external team of researchers was contracted to work in close collaboration with the Irish health authorities on the “Performance accountability for the Irish health system” project. Between September 2019 and March 2021, a pilot HSPA framework for Ireland was developed and officially launched in September 2021. Routinely collected health data are needed to populate indicators in the HSPA framework. Considering the pivotal role of data, in this scope, an assessment of the health information system (HIS) in Ireland and its fitness to support the implementation of an HSPA framework was conducted, involving a broad range of stakeholders. Methods Between May and November 2020, over 50 informants were engaged in key informant interviews and multi-stakeholder consultation workshops as part of the HIS assessment and the broader HSPA project. Descriptive themes and data availability heatmaps were derived from interview data using thematic analysis. Indicator “passports” for the HSPA framework were populated during stakeholder consultation workshops. 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 and so were data linkage possibilities. The COVID-19 pandemic emphasised the national HIS’s shortcomings but also capacity for rapid development and improvement. Conclusions Assessment of the HIS in Ireland contributed to the development of a national HSPA framework but also created a momentum to further strengthen data infrastructure and governance and work towards a more data-driven and person-centred health care system.