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'Anyone who worked the weekend has aged hugely': Emergency staff under intense pressure amid HSE hack

The shutdown of the system has impacted on scans, laboratory work and access to patient files.

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THERE ARE SIGNIFICANT delays at Emergency Departments in hospitals impacted by the HSE ransomware attack, as staff work to provide care without easy access to patient records and routine tests. 

On Friday the HSE revealed that a sophisticated ransomware attack had affected the entire HSE patient system and that all national and local IT systems involved in transferring or storing data had to be shut down.

Speaking to The Journal today, President of the Irish Association for Emergency Medicine (IAEM) Dr Fergal Hickey, said while Emergency Departments remained open over the weekend there has been “a very significant impact on their functioning”.

“What it means is that we’re forced to use completely manual systems – pen and paper,” he said.

We have to use a paper system to register people, we have to use a paper request to request x-rays, so a piece of paper goes with the patient. Then when the x-ray takes place, someone has to go look at the screen as it’s prepared by the radiographer, it doesn’t get sent back electronically. So that really does interfere with the processing of patients.

“Everything is slowed down bigtime. In some cases phone lines are down because they’re run over the network. Many departments have a chute system where bloods are sent [to the laboratory] in  the chute, so they are getting the results on paper back through the same chute system.”

Dr Hickey said all of this means there are significant delays, even for simple processes and testing. 

Blood work that would normally come back in one hour now takes seven or eight hours, he said, because hospital laboratories are also operating manually so they have to work in series rather than simultaneously. 

“The more complex the patient’s problem is, the greater the delay will be because we have no access to their previous information, previous scans, x-rays and so on,” he said.

“We’re completely dependant on what they tell us. If we can get their hospital chart that helps, but that doesn’t mean we’ll be able to see the images.”

He said staff over the weekend have come up with a number of solutions to work around the issue, but it is time consuming.

“Even to print labels to put on bloods and x-ray cards they had to have a clean laptop and a printer that’s not linked to the system,” he said. “Anyone who was on for the weekend, I think, has aged hugely.”

Dr Hickey said people should only attend an Emergency Department if they really need to. If they are attending, it would be helpful if they knew their hospital number from previous appointments or referral letters.

“There could be 100 Patrick Murphys on a system so we need some way of distinguishing between them,” he explained. “It’s really important that people bring as much information with them as they can.” 

He said patients who absolutely need to attend the ED are advised to contact their GPs who may be in a position to tell healthcare staff about their previous medical history, hospital attendances and their hospital number. 

Speaking to RTÉ’s News at One, Colette Cowan, CEO of the University of Limerick hospital group, said hospitals in the group were able to run clinics Friday and today, but “significant” cancellations will be made from today for the rest of the week.

She said people should expect substantial delays in the Emergency Department.

Cowan said staff over the weekend had worked hard to operate around the issue, but the hospitals “now need to move carefully” through the rest of the week to ensure patient safety. 

She said staff in some hospitals have to work as “runners” with blood results and access to CAT scans, MRIs and other types of scans has been impacted. 

Around 86,000 computers have been turned off, and a security team are going through 2,000 systems within the HSE to decide what level of access has been gained in the attack. The HSE has said publicly that it is still unclear what data hackers gained access to, whether that be administrative data, patient data, or staff data.

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A spokesperson for the Irish Nurses and Midwives Organisation (INMO) told The Journal that the ransomware attack has caused “substantial difficulty” for healthcare staff as they continued to provide care in recent days.

“As the health service restores systems, our concern is that staff and patient personal information may be compromised,” they said.

“Our members continue with care provision and are adapting as we have done in relation to Covid-19. Patients are understandably nervous that their care may be delayed. Obviously there will be delays, but our members are at work, are providing care, and will continue to do so.”

The INMO said it has asked that the HSE ensure staff are kept informed and it has sought clarity that payroll is not negatively impacted so that frontline staff get paid as planned. 

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