The launch last week in Dublin of one of the latest software packages for medical practices is an indication of how information technology can benefit doctors and a reflection of big business interests in health care. It also raises questions of security and trust, because if hospitals or GPs are going to use software to manage patients, are patient records secure?
The product introduced last week is called "Health one" and has been developed by Health Data Management Partners (HDMP), of Brussels. In fact, it was just the Windows 95 version that was launched, since a DOS version of HEALTH one has been around since 1990.
HDMP is owned by SmithKline Beecham, one of the world's largest health-care companies, which made £1.65 billion sterling pre-tax profits last year.
Health one is one of a number of products which contain all the information relating to patients, built up on a per-visit basis. It supports multimedia records to store X-rays or other images, allows search, retrieval and analysis of records, can exchange healthcare records with other systems, provides facilities for writing reports or certificates and records prescription details.
In Ireland, this particular system is distributed by Health Ireland Partners, of Stillorgan, Co Dublin, which is a joint venture company formed by Diversified Health Systems Ireland and the Health Ireland User Group.
Diversified Health Systems is another SmithKline Beecham company, involved in disease management, while the Health Ireland User Group comprises the 300 or so medical practitioners who use the system in this State.
Anyone who has ever worried as a doctor scribbled symptoms and drug allergies on scraps of paper will no doubt see immediate benefits to an automated patient record system.
Electronic systems also facilitate population analyses. The managing director of Health Data Management Partners, Mr Ian Kennedy says that unlike the US, there are no large health databases in Europe, where many separate health organisations hold millions of files.
But do people want their health details on large databases? Public sentiment associates paper information with more integrity than electronic information, which is seen as more easily changed or deleted not to mention prone to eavesdropping by hackers.
This is likely to be of particular concern in an area as sensitive as health information. Mr Richard Greene, a technical consultant with Health Ireland, says all doctors using the system are trained to backup the records.
Security is built in by using encryption to prevent unauthorised access, and patient information is not sent over public data networks. There is also an audit trail of information entered, which even the doctor cannot alter in the event of a dispute with a patient.
One Dublin GP familiar with various electronic records systems is Dr Conor O'Toole. He first used computers in 1984 when practising in Australia, and has used electronic records at his Stillorgan practice since 1991. He says he could not practice without electronic records, and now uses a system called GP Clinical, which he describes as "an integral part of my practice".
However, he says, the two big costs associated with electronic records systems are "getting the data on board, and the maintenance".
The Health one system, for example, costs £1,500, which includes installation and training, and requires a Windows 95 PC with at least a Pentium P166 processor and 32 Mbytes of RAM, and a large backup device such as a 100Mbyte Zip drive. On top of this, there is an annual maintenance fee of £480, which includes membership of the Health Ireland User Group.
Another issue is the involvement of a major drugs company in providing such systems. Although the system introduced last week contains a drugs database, SmithKline Beecham was careful to point out it "will not be involved in the prescribing of pharmaceutical products through Health Ireland Partners", and at the launch Mr Greene stressed that SmithKline Beecham "will not be pushing its own drugs" through the database.
Eoin Licken can be reached at eoin@stilet.to
