Digitisation & Integration of Healthcare Records, why do we lag so far behind?

Indeed. A lot of "techie" answers that are very low level "install software, ???, Success".

The challenge we have here is a massive transformation programme where the bulk of the transformation (Costs/Effort) is in the way people work and the elimination of certain roles and creation of new roles with radically different skillsets (i.e. not a transfer or reallocation of people) all while keeping a struggling health system going. It's 10% technology problem 90% people.

This is really hard and the biggest challenge is a highly unionised workforce along with the exceptional power of the consultants along with a mandarin class of administrators all conspiring to resist change because it's not in the personal interests of a significant enough minority of healthcare workers to accept change. Unfortunately the solution will require significant industrial unrest to "break apart" the HSE so it can be reassembled as an effective organisation.

Here is an example from the LA:

Banking is orders of magnitude a simpler space to work in than healthcare.

Post 31 on the money, especially the US problem where whole cohorts of folk are now being denied insurance due to access to medical records.

as for the union issue

see this

A Fórsa representative told the WRC hearing that the employer "showed no duty of care to the worker" and highlighted that "she should have been referred to occupational health as a result of the stress caused to her by these proposed changes".

I was in a public service location lately and there were 3 staff knitting. They refused to take on alternative work at the same desk unless they got extra pay: on full pay and are running a website where the output is being sold.

"information science was at the core of our operations."

I'm taking it from this statement that you were part of the efforts to integrate library authorities so well done with the advances you have made there. Your first post mentions being penciled in for surgery due to the appearance of a lesion on a scan and that going to get your records from a private hospital that had additional information saved you from undergoing this surgery to remove a lung. I am sorry you had this stressful experience but it is very common particularly in the case of time sensitive interventions for procedures to be booked well in advance due to waiting lists even if there was only a chance that this intervention was to go ahead. I'm not working in respiratory health but I would be very surprised to see someone getting a lung removed based on one image and in most similar circumstances I have seen recorded a biopsy is taken initially to confirm with a histopathologist that the consultant's suspicion based on the image was correct. There are also patient paper records showing public hospital administration contacting other hospitals to get patient treatment details sent onto them in case they were relevant to future treatment but I don't know why this was left to you to do yourself in your own medical experience that you have highlighted.

Just to help me compare your success with what is required to be done with the health service, how many active library users are there in the country and how many library book listings needed to be integrated?

What extra difficulty does a shared database of patient records pose for healthcare workers?

They already keep patient records, in many cases they even have their own digitised record systems. The change is to have a centralised repository of patient records where medical practitioners can quickly & securely request or edit said records.

And the idea that banking is simpler than healthcare? Nonsense. In banking IT systems, there are far more actors in play, far more data by volume & frequency of updates, and a far greater consequences if something is cocked up.

With increased numbers there will be increased incidence of more difficult to integrate cases with some patients having multiple volumes of printed chart medical records and these are often the ones with the more difficult to deal with conditions. There are already IT systems accessible remotely for different classes of function but only some of them are cross linked between hospitals. With one that I am familiar with that gives lab results to a hospital group you have numbers of cases that are more complex with some results not showing up on a simple search by patient ID number and surname as they have more than one ID number assigned to them from tests done at different sites or even the same site after their number was changed for hospital administrative changes that I have never got fully explained to me. It is possible to see this in some patient printed charts where they will have one number in their older records but a different one in more recent records. Its my view that if you are dealing with a bigger number of records then the task does get more complex simply because there are more of the irregular cases that take extra work to figure out how to integrate correctly.

They won't bring it in because all the old dinosaurs who want to control everyone would immediately become outclassed by new graduates.

Ever been to either of those countries ?

Comparing Ireland and the Irish to either of them is like comparing apples to spuds.

It is a cop out to imply that unions are responsible for this mess, the problem lies with management. Employees in general will benefit from this and there is plenty of other work for anyone who duties are no longer required. First of all clarity of purpose from management is required and there is no sign of that.