Ireland’s digital-health roadmap

The Irish health system is undergoing a profound digital transformation. In May 2024, the Department of Health launched Digital for Care: A Digital Health Framework for Ireland 2024 2030, setting out a national vision for modernising health and social care, writes Emily O’Sullivan, Partner and EY EHR Lead.

ithin this framework, the Health Service Executive (HSE) published a companion strategic plan, the Digital Health Strategic Implementation Roadmap, outlining how digital tools, including nationwide electronic health records (EHR), shared care records, and patient-facing services will enable better, safer, more integrated care.

This plan is built around six guiding principles: making the patient an empowered partner, enabling connected care, fostering a digital-health ecosystem, promoting data-driven services, ensuring secure, foundational infrastructure, and supporting a digitally capable workforce.
The vision is to provide Irish patients and care-givers seamless, digital health records, whether they are in hospital, community care, or primary care, with care coordinated more smoothly, and data flowing securely across the system.

Despite great progress, Ireland is still on the lower scale of digital maturity in healthcare. It remains the only EU country without universal patient access to digital health records. Fragmentation persists, with multiple systems operating in silos, and rural areas face significant connectivity gaps. The 2021 cyberattack on the HSE exposed vulnerabilities in cybersecurity and accelerated calls for reform.

Why EHR success matters

An EHR is not just a digital version of a paper chart. It is a backbone for clinical transformation: a fundamental reworking of how healthcare is delivered, coordinated, and managed. Used well, there is evidence that EHR’s enable improved quality of care, patient safety, timeliness of information, efficiency, and cost-effectiveness of care.

Implementation of an EHR in support of clinical transformation of this scale and complexity is not easy. EHR projects involve the integration of a complex web of organisational, human, and technological factors underlying success, including appropriate governance and leadership, clinician engagement and training, adequate infrastructure, usability, interoperability, and alignment with local workflows. While technology is the enabler of these transformations, the wrap-around services like standardisation, change management, communications, and governance are key to achieve the results of usability, adoption, and sustainability.

If these factors are missing, the risk is a system that is designed without clinical workflow in mind which can therefore introduce risk to the patient.

Lessons from international experience

Looking beyond Ireland’s shores can offer a glimpse into who did it right. Ireland can leverage lessons learned from others in support of success.

What works:

• Strong governance, clinician engagement, change-management, and training are essential success factors: Success depends on organisational culture, leadership, end-user involvement, adequate resourcing, well-designed workflows, and workflow-based training. When all is said and done, usability comes down to process redesign and optimised clinical workflow. Policymakers must follow through with stable funding and clear governance for these concepts which are often short-changed if the design and build phases extend, which they often do. Without stable funding and clear governance, ambitions risk falling short.
• Interoperability and standardisation matter: Bringing key pieces of information together as opposed to forcing clinicians to go find the data they need to deliver patient care is a key concept of usability. Where fragmentation exists (which is a persistent problem in many jurisdictions who have rolled out EHRs), such as multiple systems and incompatible data standards, will undermine the promise of seamless cross-provider care. To fulfil the promise of integrated care, data must be consistent, shareable, secure, and flow smoothly across organisations, hospitals, clinics, community care, and social care.
• Ensure the underpinning technology works: Think wireless networks, user access, and safeguards for protecting patients’ data in the form of cybersecurity strategies and technology.
• Ongoing adaptation and continuous improvement cannot be neglected: EHR implementations are not a one-off project but a process over many years. The ongoing refinement of workflows, user feedback loops, continuous training, and responsiveness to changing clinical practices and technology advances are critical concepts in support of usability.
• Make sure benefits can be measured/monitored: Even with a predominantly paper-based ecosystem as a starting point, there are ways to ensure you are measuring a baseline in support of demonstrating benefits post go-live. This is important for funders and taxpayers to understand the benefit in the large investment that is required for the scale of a national clinical transformation.

International examples:

The above themes ring true when we look at international examples of who did it right. Across Denmark, Finland, Estonia, Israel, Singapore, and Canada/Alberta, the same core themes repeat:

1. central or coordinated governance with clear accountability;
2. interoperability built early, not added later;
3. clinician leadership and structured change management embedded throughout;
4. phased rollout strategies that emphasise adaptation, not perfection, at launch; and
5. transparent measurement and benefits realisation to sustain political and public confidence.
6. Clinical transformation is more than a technology rollout. It is about remaking how care is delivered: shifting from siloed, paper-heavy, fragmented services to integrated, data-driven, patient-centred care. This is clinical transformation in its truest sense. Ireland’s digital health transformation roadmap signals a pivotal moment. With the 2024-2030 framework, the HSE and the Department of Health are laying the foundation for a transformed health service: digital, connected, patient-centred, and ready for the challenges of the 21st century.

Ireland’s late start may prove advantageous. Free from legacy constraints, the country can leapfrog to modern, cloud-enabled, interoperable systems. The Health Information Bill 2024 provides a strong legal foundation, while the Digital for Care roadmap offers clarity on priorities.

But success will not be granted by technology alone. It will require strong leadership, deep clinician engagement, ongoing investment, and, above all, a willingness across the health system to change how care is delivered. If Ireland can get those pieces right, the result could be nothing short of a revolution in how health and social care delivery works for people.

E: Emily.OSullivan@ie.ey.com
W: www.ey.com/en_ie