Behind an X-ray or MRI scan is a national digital network. What does NIMIS do, who developed it, and how much has it cost?

When a patient is transferred between hospitals, the clinical team receiving them may need access to scans taken elsewhere. Ireland’s National Integrated Medical Imaging System, or NIMIS, is designed to make that possible.

The system allows authorised healthcare professionals to store, retrieve and share diagnostic images and reports electronically. It is intended to reduce delays, avoid unnecessary repeat examinations and support decisions across hospital boundaries.

The basic function: storing and sharing scans

NIMIS combines two types of healthcare software:

• A Picture Archiving and Communication System (PACS), which stores and displays medical images.
• A Radiology Information System (RIS), which manages examination details and radiology reporting.

Together, these systems support digital handling of X-rays, CT scans, MRI scans and ultrasound examinations. Participating hospitals can access images electronically rather than relying on physical films or copies transported between sites.

NIMIS is focused on medical imaging. It is not a complete electronic record containing every part of a patient’s healthcare history.

Why the system matters when patients move hospitals

The main benefit is continuity of information. If a patient is treated at one participating hospital and later attends another, the receiving team may be able to view existing images and reports.

According to the NIMIS patient-information leaflet, the intended benefits include:

• Fewer unnecessary repeat examinations, because previous images are available.
• Faster access for specialists, supporting consultation between hospitals.
• Shorter waits for results, through electronic reporting.
• Less reliance on physical films, which can be lost, damaged or delayed.
• Controlled access to personal information, through individual staff accounts.

Avoiding an unnecessary X-ray or CT scan can also reduce radiation exposure. However, repeat imaging may still be clinically appropriate, particularly if a patient’s condition has changed or a new examination is needed.

NIMIS improves the movement of information; it does not create additional scanners or staff, and it does not by itself eliminate waiting lists.

From national programme to hospital rollout

The HSE began the NIMIS programme in 2008. Following a European procurement process, McKesson was selected as the supplier in 2010. The HSE now identifies the supplier as Change Healthcare.

The first hospital to go live was Sligo University Hospital, on 21 June 2011.

The rollout involved more than installing software. McKesson’s imaging platform had to be connected to specialist applications and existing hospital systems. Hospitals also had to adapt local workflows, reporting processes and access arrangements.

NIMIS therefore developed through a combination of commercial technology, national HSE planning and implementation by individual hospitals.

How widely is NIMIS used?

The HSE’s published 2026 response reports that NIMIS covers:

• 88 hospital and community or primary-care locations
• Approximately 65,000 active user accounts
• More than 66 million stored imaging records

The response identifies St Vincent’s and St Michael’s hospitals, which joined in November 2025, as the most recent additions covered by those figures.

The scale of the system means that its performance depends not only on the software itself, but also on connectivity, storage capacity, user access and the ability of participating sites to maintain compatible systems.

The cost has grown beyond the original project

The HSE’s 2009 annual report described planned investment of more than €40 million in the original project.

In its response to parliamentary question 22812/26, the HSE reported total investment of €194,020,099, including VAT, over 16 years. That figure includes implementation, support, upgrades and equipment refreshes. The response also lists annual support and maintenance costs of €8,152,203, including VAT, for 2026–2027.

The €194 million figure should not be read as a direct increase from the original €40 million budget for exactly the same work. The later figure covers a much longer period and includes the ongoing costs of operating, upgrading and renewing the system.

A September 2026 procurement notice records a further €1,950,500 contract, excluding VAT, to refresh image-storage infrastructure. It shows that maintaining a national imaging service requires continuing investment. However, it should not be added to the cumulative total without confirming whether it is already included in the HSE’s reported figure.

Oversight and security remain important

The HSE manages NIMIS through its Technology and Transformation service, supported by a programme board and national, regional and local teams.

A separate parliamentary response states that the last national quality-assurance audit took place in 2017, followed by an IT audit in 2018 and a security audit in 2024.

These audits address different risks. A quality-assurance audit may examine clinical and operational performance; an IT audit may assess technical controls and reliability; and a security audit may focus on protecting confidential information. All are relevant to a system holding millions of medical records.

For patients, the value of NIMIS is ultimately practical: ensuring that clinicians can access the images they need when making decisions. Its success should therefore be judged by how consistently, safely and efficiently it supports that outcome.

Sources

• HSE, Annual Report and Financial Statements 2009, p. 55: the original investment exceeding €40 million and planned national rollout. (drugsandalcohol.ie)
• HSE, response to PQ 22812/26: programme origins, supplier, rollout, coverage, governance and cumulative and annual costs. The PDF’s printed date says April 2025, although it answers a 2026 question and includes November 2025 developments; this article identifies it by its parliamentary-question reference. (about.hse.ie)
• NIMIS patient-information leaflet, hosted by Children’s Health Ireland: how images are shared, intended patient benefits and access controls. (childrenshealthireland.ie)
• “Ireland’s National PACS Project”, HealthManagement, 2010: procurement, original technical design and hospital implementation arrangements. (healthmanagement.org)
• HSE, response to PQ 22804/26: dates of national quality-assurance, IT and security audits. (about.hse.ie)
• EU Publications Office, HSE 29516 procurement notice: September 2026 storage-refresh contract and supplier. (op.europa.eu)