It is still too early to say if confidential patient information, either recent or historical, has been compromised as a result of the cyber attack on the Health Service Executive's IT systems, according to Tony Canavan, chief executive of the Saolta University Health Care Group, which runs the seven public hospitals in the west and north-west of the country.
Mr Canavan said that the health authority is examining if patients' medical records may be among the data affected by the attack, which has caused major disruption to the health service and is having 'a very significant impact' on patient care.
He added: "Unfortunately, what we cannot do right now is give people an assurance that all is fine. We don't know how our systems have been compromised. It will be a number of days before that assessment will be completed. We are doing our best to protect sensitive patient data if we can."
Mr Canavan said the health service never experienced anything like such a cyber attack before, saying: "It has been our biggest challenge without a doubt. Even if the damage caused to the HSE's IT systems is repaired this week, the incident will still have had a major effect on patient services.
"This cyber attack is not just an administrative inconvenience, it goes to the heart of patient care and the implications are huge for patients' health. It's not that we had one big system attacked, lots of systems we have were attacked. We still don't have any clinical IT system of any shape back in place operating [in the public hospitals] in the west and north-west.
"Our IT people took the correct decision to shut all our IT systems down. When the time is right, they will bring all the systems back, one at a time. Hopefully, we will be able to prioritise the important ones. The three most important are radiology, laboratory, and radiotherapy. But that's not to say that the others are not important.
"It is incredibly difficult regarding chemotherapy, for example. We wanted to prioritise some patient groups. We could do that earlier in the week but it is getting progressively difficult. Doctors do not have access to any historical patient information. Radiotherapy is one of our services which is highly dependent on a computerised system. If someone is going for radiotherapy, they meet their consultant and a treatment programme is all worked out and planned on the system. For these patients, that plan cannot be implemented now. People who were expecting to receive radiotherapy last Monday, for example, have not received it.
"The best example [of the current situation] is, you have a patient in a hospital bed who is waiting for a radiology result. It goes on to the computer system; that means that clinicians can see these results on any of the computers in the hospital. That's how normal patient care takes place. In the case of an MRI scan, for instance, subsequently the image and the report are on the computer system for the doctor. Now, none of this can happen. Tests can be requested and results can be delivered manually. We literally have 'runners' - staff bringing test results to various parts of the hospitals.
"One of the difficulties is nobody knows how long we will be in this position. If we get out of it this week, it will have had a very significant impact on patient care. The real risk is if it goes on for another week. The length of time it goes on for is the real risk to patients. Most people understand if you have a serious illness like cancer, time is important in terms of getting a diagnosis and being treated quickly."
Saolta is constantly monitoring the current situation and revising its plans accordingly, he said. "We set up a planning horizon or timeline of one week and looked at what arrangements we could put in place to keep the show on the road for one week. By this Friday (today ) we need to look at these plans to see if we need to change them."
The health chief is concerned that the cancellations of hospital appointments is adding to an already significant backlog of cases due to the pandemic.
"My concern is for patients who perhaps have been waiting significant periods of time for operations or diagnoses due to these being delayed because of Covid-19 - and now this. That's the main thing that is concerning," he said.
