Health plans ‘not based on evidence’

Just read this in todays Indo. According to the National Director of Cancer Control Professor Tom Keane, planning for health services in Ireland is made difficult because some decisions could be based on “opinion” rather than evidence.  In case you haven’t heard of him he is the person who is in charge of reorganising cancer services into eight specialist centres. Does this mean he is implying that the IT systems in place in Ireland are insufficient?

He also brought up another interesting fact from his work in Canada. During the overhaul of cancer services all existing managers had to resign and reapply for their jobs.. They were either reappointed or deployed elsewhere. Nobody lost their jobs. Shades of lean thinking there.?

WISDOM in the HSE

WISDOM is a system being developed by the HSE (Health Service Executive)/HRB (Health Research Board), according to the HRB “WISDOM is a web-based mental health information system which will capture information on inpatient and community care services in Ireland”. At the moment it is being tested in Donegal.

This system has been in development for some time, as far as I know internally within the HSE and HSB.

According to a HSB newsletter in December 2007 “The HRB is working in collaboration with the HSE and stakeholders to develop an information system to expand the data currently collected from in-patient and community settings. The name of this mental health information system is WISDOM (previously know as NPIRS/COMCAR)”.

 OK, this is all well and good but where is the mention of Evidence Based Healthcare, Outcomes all of which are supposed to be applied across the board to all Health Services Delivery projects.

It also mentions a rather long development lifecycle “..the Board is comprised of clinical personnel, service users, carers, ICT personnel, data protection experts, consumer affairs experts, and HSE management. It will meet each month over the next two years, overseeing the proof-of-concept stage”.

 Two years!! Has nothing been learned from PPARS, etc? And how can a proof of concept take two years? Is nobody following Agile processes? By their nature Public Service IT projects will have considerable refining of the system and it is almost impossible to get everything correct with one major release.

 The main press release detailing the system is located here. I’m not into bashing organisations but if they talk of using best practices across the board then that is what they should do.

 It really does worry me that not once does it mention Evidence/Outcomes in any of the material I have seen related to the WISDOM system. Is this just another case of focusing on process rather than outcomes?

 Also where is HIQA (Health Information and Quality Authority)in all this seeing that two of their core functions are Health Technology Assessment and Health Information.