A long-promised investigation into an abortion carried out at the National Maternity Hospital this year is being delayed by the hospital's inability to print a hard copy of electronic records.
The hospital has been forced to call in the HSE and Cerner, the US company that designed the system, in an effort to provide the woman with an “entire hard copy” of her records.*
The issue has wider implications, as the health service moves from traditional printed records to electronic ones. Holles Street is one of relatively few Irish hospitals to have made the switch to e-health records.
The difficulties that have arisen in printing the records apply “on a national level”, the hospital has told the woman.
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Its contention that the electronic chart contains “all relevant clinical information” is not accepted by the woman and her partner, who are unhappy that key documents were not included among the files previously sent to them by the hospital. They want the NMH to swear an affidavit explaining the omissions.
A hospital spokesman said: “We have offered that either the couple involved or their representatives come into the hospital to review the full medical record, or alternatively we are open to a means of ensuring they can review it electronically elsewhere”.
Rejecting this proposal, the couple's solicitor, Caoimhe Haughey, said the electronic charts were not secure for patients and were not properly maintained.
Review team
Despite the objections of the couple, Holles Street has indicated its intention to proceed with the investigation promised last May. This has also been delayed by disagreements over the composition of the review team.
The hospital has told the couple it “must” proceed with the review “as a matter of utmost urgency so that the outcome and any learnings can be shared on a national level”.
In a letter to the couple, it has asked them to agree to release of their medical records to the chair of the review, UK based foetal medicine consultant Pran Pandya, so that the inquiry can begin "without delay".
In the case, the couple received two test results indicating their baby had a fatal foetal anomaly, but a later test result, received after the termination had been carried out, showed he had no genetic condition.
Objecting to the proposed composition of the review panel, the couple say it should comprise experts, such as consultants from continental Europe with no previous professional links to NMH.
The hospital has rejected this proposal, though it has agreed to allow the couple nominate additional experts to the review panel.
Patient safety
Minister for Health Simon Harris, who has met the couple, strongly wishes to see the review completed "as expeditiously as possible", according to an official.
A review is "increasingly urgent" to address the couple's concerns and from a wider public interest perspective, according to Marita Kinsella, head of the Department's national patient safety office, in a letter to the couple.
Ms Kinsella says once the hospital provides the couple with the medical notes, it will move to begin the review process.
But Ms Haughey has complained to the Data Protection Commissioner over alleged breaches of the couple’s data protection rights because of the difficulties accessing their medical records. She accused the hospital of trying to “railroad” the couple into a process of its own choosing.
The couple are expected to meet the Minister and the clinical director of the HSE’s women and infant health programme, Dr Peter McKenna, soon in an attempt to break the stalemate.
*Article amended on January 9th, 2020, at 5.48pm
