There are ongoing questions about the implementation of the HSE’s national medical laboratory information system. John Reynolds reports
The HSE has informed the Medical Independent (MI) it currently does not have an estimated budget for the national roll-out of the medical laboratory IT system, MedLIS.
The MedLIS project aims to establish a fully integrated, nationwide laboratory information system, enabling access to a patient’s complete diagnostic data. It is intended that clinicians and other healthcare providers will have 24/7 access to comprehensive laboratory information for each patient.
Work on MedLIS began in 2015; however, to date, the system has only been implemented at a single site – Beaumont Hospital in Dublin, where it launched in August 2024. Despite this limited deployment, €24.3 million has been spent on the project over the past decade.
In response to queries from MI, a HSE spokesperson said implementation will be governed through the health regions. The system will be deployed across multiple sites “through a series of waves”.
“An estimated budget is unavailable at this time,” according to the spokesperson.
The current focus is on the north-east region. Ultimately, the HSE intends for MedLIS to be implemented in every HSE-funded laboratory, with a target of full deployment across 43 hospitals by 2029. However, the roll-out has faced significant delays and strong opposition. Many consultants and medical scientists argue that the system is deeply flawed and not fit-for-purpose.
Letters
Two letters seen by MI – one signed by more than 50 medical scientists and consultants and another from a single consultant – have been sent to HSE CEO Mr Bernard Gloster and Chief Clinical Officer Dr Colm Henry.
The letter from the 50 medical scientists and consultants, sent earlier this year, warned that the system’s issues could lead to “avoidable clinical risks of error” and “a significant impact on productivity”.
It referred to the “financial and reputational risk related to the time delays on this project”.
The letter also expressed concern about inadequate support for medical scientists using the system, stating this was “resulting in implications for mandatory reporting and accreditation”.
Among the 16 separate flaws identified in the letter were fundamental issues with spellchecking, editing, search, and email functions. It also highlighted that only American medical specimen category options were available, as the system’s provider Oracle Health is a US-based company. The system’s inflexibility and slowness were further cited as major concerns. Oracle Health did not respond to MI on questions regarding these issues.
The letter from the single consultant, which was sent on 16 May 2025, warned that implementing the system “could have serious implications for cancer diagnosis and patient treatment”.
“The HSE is not allowing sufficient time for these issues to be satisfactorily resolved,” the letter continued.
“Adding to this time pressure is the commitment required by consultant histopathologists, who have to also perform their clinical duties [which are] being compounded by significant staff vacancies.”
The understaffing of medical laboratories is a significant issue. In March, around 2,000 medical scientists engaged in a work-to-rule as part of industrial action led by the Medical Laboratory Scientists’ Association, highlighting what it described as a recruitment and retention crisis, along with a significant increase in workload since 2019.
Meanwhile, sources told MI that some staff previously felt under pressure not to raise concerns about the use of MedLIS. The HSE did not respond to requests for comment on the matter.
Northern Ireland
A notable point of comparison to the troubled MedLIS roll-out is Northern Ireland’s recent deployment of its new CoreLIMS (Laboratory Information Management System) across its five NHS Trusts and blood transfusion service.
According to tender documents, the contract – awarded in late 2021 to UK-based firm Clinisys – was valued at £43.9 million. The first phase, involving roll-out to two Trusts, began in November 2023, with full deployment completed in just three and a half years.
North-east
Cavan-Monaghan General Hospital and Our Lady of Lourdes Hospital, Drogheda, are next in line for MedLIS deployment, with implementation due to occur before the end of the year. However, some view this target as unrealistic given previous delays and issues with the system.
Staff in Drogheda had previously considered industrial action in response to plans for the MedLIS roll-out. However, MI understands the medical scientists’ union has since advised staff to engage with the HSE and the MedLIS project team.
Separately, sources familiar with the project raised concerns about costs associated with the deployment being displaced from the provider to the HSE.
In addition, it is understood that a separate provider has been engaged to supply an archive system for MedLIS, with hospitals reportedly required to cover costs of around €250,000 each, along with ongoing annual maintenance fees.
Sources also indicated that limitations on the number of analyser connections supported by MedLIS may require the use of specific laboratory equipment and middleware software – adding further to the estimated costs. Neither the HSE nor Oracle Health responded to queries on these issues.
A senior health insider said the challenges with MedLIS do little to inspire confidence in the multi-billion euro plans for electronic health records within the health service.
“The approach with MedLIS reflects a broader pattern in how the HSE approaches digital transformation: An overreliance on large-scale, centralised legacy systems that are difficult to implement, slow to adapt, and often disconnected from the real needs of clinicians and patients,” they said.
“Too often, system design fails to reflect the realities of how clinicians work, document, and make decisions at the bedside. There’s a cultural disconnect.”
Procurement
The €17.9 million extension to the contract with Oracle Health in 2022 has been another source of controversy.
Oracle Health had previously been awarded a €33 million contract for the national roll-out of the system in 2015.
The Chairperson of the Oireachtas health committee, Social Democrat Deputy Padraig Rice, raised the issue of the contract extension at a meeting of the committee in June.
It is understood concerns relate to a change in the contract timeline, a new remote hosting arrangement in Sweden and technical architecture, and an altered payment structure.
Deputy Rice questioned whether the extension was in line with public procurement rules.
In response, Head of Health Infrastructure and Digital Health at the Department of Health, Mr Derek Tierney, said the extension was compliant.
The HSE’s spokesperson told MI: “The cyberattack [in May 2021] resulted in a requirement to undertake an urgent transition to the remote hosting solution referred to [within the published EU procurement notice]. The HSE is satisfied it acted in a manner that is consistent with its obligations under public procurement legislation whilst ensuring the successful delivery of the project.”
Meanwhile, in comments previously supplied to this reporter, Oracle Health General Manager Ms Seema Verma said: “We and the HSE are delivering a modern laboratory information system that will increase operational efficiency, reduce the administrative burden on healthcare providers, and improve the experience of patients nationwide.
“We are proud of the benefits [the] HSE has already gained from the system and confident they will be multiplied as it is deployed at additional facilities. Regular free updates to the system enable customers to modernise and optimise their systems and improve patient care.”
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