Implementing a National Cancer Information System in Ireland

Challenge

Ireland has nine designated cancer centres – eight adult and one paediatric – and 26 additional sites that can administer Systemic Anti-Cancer Therapy (SACT).² Cancer patients often receive initial diagnoses at cancer centres and then go on to receive SACT and follow-up care at smaller centres.⁵ This hub-and-spoke model of care provides access to cancer care, but service provision can be varied and delayed due to issues around sharing patient information.²

Healthcare professionals being able to access accurate and complete patient health information is a key factor in providing efficient cancer care. While Ireland has a national cancer registry, the information collected is used for overall epidemiological analysis, not individual care provision.⁶

Healthcare professionals have stated that a lack of access to comprehensive clinical patient information results in delays to care and an increase in errors in providing patients with SACT, which can result in serious complications.¹ Irish healthcare professionals have cited a lack of information-sharing between healthcare locations, limited/lack of centralised IT infrastructure and systems, and unavailability of patient records as risk factors for medication errors.¹

Solution

Irish healthcare professionals worked to engage policymakers to recognise the issues around clinical information-sharing in Ireland.^{1 3} This engagement led to the founding of the National Cancer Control Programme (NCCP) – a directorate responsible for converting research into action to improve the provision of cancer care in Ireland – including the implementation of a National Electronic Prescribing System in the National Cancer Strategy.^{3 7} Continued engagement from clinicians led the Health Service Executive – Ireland’s publicly funded healthcare system – to develop and implement the National Cancer Information System (NCIS).^{1 2} The NCIS is a computerised system that records and stores information relevant to a patient’s cancer care.²

The information stored includes:²

• Name and address
• Medical history
• Type of cancer diagnosis
• Treatment options
• Current cancer drug routine

As well as holding clinical patient information, the NCIS supports the prescribing and compounding of medication to reduce errors, and facilitates multidisciplinary meeting documentation and reporting.¹ The NCIS hopes to provide:⁴

• Safer and more equitable treatment
• Real-time, secure access to patient records and clinical notes
• Improved and faster access to treatment and diagnoses
• Cost effective use of staff and medicines
• Business intelligence to assist in future treatment scheduling, thus improving the patient journey.

The NCIS was launched in 2019, with St Luke’s Hospital Rathgar being the first location to implement the system.

Next steps

The NCIS will continue to be rolled out across all sites in Ireland. As the system is fully implemented, it will be continuously improved based on evaluations and learnings.³ Continued development and improvement of the NCIS system aims to improve the quality and safety of cancer care whilst improving patient journeys and streamlining clinician care administration.⁴