Missing in Action: Why Ireland’s Lack of a National Digital Patient Identifier Is Slowing Down Healthcare — and Lending

What Is a National Patient Identifier, and Why Does It Matter?

A national digital patient identifier (DPI) is a unique reference number assigned to every patient that links their medical records across providers, services, and time. Most developed countries have one. In Ireland, the Health Identifiers Act 2014 provided the legislative basis for the creation of the Individual Health Identifier (IHI). Ten years later, the system is still not operational.

According to the Health Information and Quality Authority (HIQA), the absence of full IHI implementation is contributing to “fragmented health information, increased risk of errors, and inefficiencies in care delivery¹”.

What It Means for Doctors

For hospital consultants operating in both public and private settings, the absence of a DPI causes daily friction:

1. Administrative Burden
Without a universal patient ID, consultants often duplicate data entry, chase down incomplete histories, and deal with mismatched lab or imaging results — all of which reduces
clinical productivity.

2. Inefficient Billing and Reimbursement
In private practice, insurers and the National Treatment Purchase Fund (NTPF) rely on accurate patient attribution. Without a DPI, delays and disputes are more common, cash flow is less predictable, and consultants bear the brunt of the inefficiency.

3. Harder Access to Finance
At GHC, we assess medical professionals’ cash flow based on expected reimbursement cycles and historical income. When billing is inconsistent — not due to poor practice, but due to systemic record gaps — it becomes harder for doctors to demonstrate financial reliability. The result? Delayed access to much-needed funds.

The Systemic Cost of Delay

In 2019, HIQA estimated that the failure to fully implement the IHI cost the Irish health system over €40 million² annually in duplicate testing, data reconciliation, and administrative overheads. This is not a theoretical problem. It’s real money lost, real time wasted, and real risk introduced — every day.

Global Comparisons Show the Gap

Countries with national identifiers are already taking the next leap: combining patient IDs with AI diagnostic tools, integrated prescribing platforms, and seamless e-referrals. Estonia, widely regarded as the most advanced digital health system in Europe, uses its national ID to power a fully interoperable³ health records system — enabling near real-time clinical data sharing across the country. In Ireland, meanwhile, the lack of even a baseline ID continues to stall progress — despite the technological capability and legislative framework being in place.

The Link to Medical Lending

This might sound like a health IT rant, but it’s directly relevant to how doctors are treated by lenders. Traditional banks look for stability: regular income, minimal risk, clear data trails. When reimbursement is slow or inconsistent — and that inconsistency stems from recordkeeping issues rather than doctor performance — it creates false negatives in credit assessment. GHC’s MediFlow product addresses this by evaluating doctors on their medical specialisation and tenure, not just bank statements. But the bigger fix must be systemic. We should not need to create workarounds for a problem that shouldn’t exist.

A Call to Action

Doctors should not have to fight an uphill battle to prove their financial fitness — especially when the root cause is outside their control. We call on the Department of Health and the HSE to:

• Accelerate IHI implementation across all care settings
• Publish a national roadmap with defined milestones and funding
• Engage with medical professionals and insurers to align systems

The Irish healthcare system cannot be truly modern — and consultants cannot be properly empowered — until this basic digital infrastructure is in place. The lack of a national digital patient identifier is a bottleneck — for care, for innovation, and for funding. It limits how efficiently consultants can practise and how confidently they can invest in their future.

Let’s fix it. Because the longer we delay, the more we all pay.

¹HIQA Report on Health Identifiers – https://www.hiqa.ie/reports-and-publications/health-information

²HIQA Business Case for IHI – https://www.hiqa.ie/sites/default/files/2019-10/Business-Case-for-Individual-Health-Identifiers.pdf

³e-Estonia – https://e-estonia.com/solutions/healthcare/e-health-record/