Hospitals are preparing for weeks of disruption from the cyberattack that has left staff physically running paper charts to replace the compromised IT systems.
Thousands of hospital treatments have been put in jeopardy, with Tánaiste Leo Varadkar declaring it an attack on the State.
Chief operations officer with the University of Limerick Hospital Group, Noreen Spillane, said elective and outpatient treatments will be cancelled for this week as a safety precaution.
“We certainly have no indication that this will be fixed this week, that is a concern. It is having such an impact, and as time goes on, it will have more impact," Ms Spillane said.
There is a manual backup for all systems, but no one expected them to all go down together, she said, confirming the hospital group has closed down between 80 and 100 different IT systems.
X-rays can only be read in the radiology department, and a team of "runners" take other results around the hospital. Clerical staff must phone families as email updates cannot be sent.
Ms Spillane praised staff for adapting, including communicating with patients by telephone, and with each other on the StaffApp.
Scientists in all hospital laboratories rely on IT to receive and share tests within the hospitals and out to GPs.
Chair of the Medical Laboratory Scientists Association Kevin O’Boyle found himself doing sums on paper at 4.30am on Monday.
“It’s been back to basics,” he said.
A particular challenge is assessing the urgency of patient results which would normally be compared with previous results. This now requires phone calls to doctors for context.
Laboratories have doubled the staff on duty, but he said this is not sustainable.
Cancer care is heavily impacted by lack of access to previous reports, said Professor Seamus O’Reilly, oncologist at Cork University Hospital.
"The ICU is all gone to paper now, the old system of large sheets of draughtsman tables with sheets of vital signs and lab results.”
Any patients discharged yesterday were given a letter to deliver to their GP.
Cork GP Dr Nuala O’ Connor said patients cannot get blood results from laboratories but prescriptions are going to pharmacies.
“It would only be absolute urgent tests we can send. They can process the urgent laboratory tests but they have to phone back the results," she said.
A HSE spokeswoman said hospitals are working to get priority systems back online, including radiology and diagnostic systems, maternity and infant care, patient administration systems and radiation oncology.
Meanwhile, social workers are also bracing themselves for a temporary return to paper records.
It is understood the Child and Family Agency is increasingly concerned the attack has taken Tusla’s National Childcare Information System (NCCIS) offline.
A portal through which people can make referrals is also out of action.