01.09.2012 eHealth improves quality of care: dream or reality?
eHealth. The Swiss eHealth Strategy is designed to improve the safety and quality of the Swiss healthcare system by linking up all the relevant players and their IT systems with each other and enabling them to access patient data whenever it is needed. For patients this means: "My healthcare data. Available whenever and wherever it is required."
People are becoming increasingly mobile, moving their homes, switching to another health insurer and/or family doctor, or travelling abroad. As a result, when they require medical treatment, essential medical data on their health status may often be entirely missing or have to be time-consumingly collected. The electronic interlinking can do a great deal to improve the availability of the right data just when it is needed. The term "eHealth" covers a wide range of electronic applications and services used in the healthcare system. They support procedures and communication and link up the different players – patients, doctors, therapists, insurers, laboratories, pharmacies, hospitals, nurses, etc.
The aim of eHealth is to interconnect the many different players and their IT systems and enable the vast amount of data on the treatment process which are currently available on paper or already in electronic form to be used. The cross-organisational electronic patient record (see article on page 2) will enable this in the near future. A further cornerstone of eHealth is the digital workflow support of care processes to improve the safety and quality of care and also stabilise costs in the long term. For patients all this means: "My healthcare data. Available whenever and wherever it is required."
Potential for quality improvements
Some practical examples will illustrate the system's potential for improving quality, bearing in mind that, for the diverse players involved, different aspects of data sharing offer different benefits in terms of quality.
For patients, for instance, better information quality and data security means more self-determination and self-responsibility. They can help manage their treatment by using digital resources such as internet searches or exchanges of information with comparable patients in online forums. The access to the data stored in the electronic patient record enables healthcare professionals whom they trust to access all relevant medical data. With all the essential data at hand, the healthcare professionals can make optimum decisions on diagnosis and treatment.
For the work of the healthcare professionals, on the other hand, facilitated data sharing with colleagues is a significant improvement.
Benefits of telehealth
eHealth can be used to overcome barriers of time and location. This aspect of eHealth is also called "telehealth". Teleradiology, for instance, allows radiological patient images to be assessed without the expert having to be at the patient's location. Telemedicine, on the other hand, enables patient vitals to be measured at home and transmitted directly to the healthcare professional. Therefore patients can, for instance, be discharged earlier from hospital without sacrificing the high standard of care by the healthcare professional.
In integrated healthcare models, eHealth enables the treatment of chronically ill long-term patients to be coordinated more effectively: electronic applications support interdisciplinary communication on the one hand and integration of patients and their families on the other. Individually adapted treatment plans can be managed and assessed digitally, also in palliative medicine for instance.
Digital documentation and availability of medical data can be used on a cross-organisational and cross-patient basis in order to compile large bodies of data, for instance for research purposes. With regard to general healthcare provision, these collections of anonymised data can enable significant conclusions to be drawn regarding the identification and course of infections such as measles, influenza, etc. Data of relevance to the investigation and assessment of widespread diseases such as diabetes or cardiovascular conditions can be evaluated more effectively if available in electronic form. Evidence-based medicine can also benefit from such databases.
Who owns the health records?
Among the risks associated with eHealth, data protection and data security require particular attention. The patient should own their own health data at all times and they should be fully informed on when, how and which data is used. This means that adequate organisational and technical measures have to be in place. In addition, all the players involved must bear in mind that technical resources also have their limitations and may, for instance, break down. In other words, they must also ensure a minimum level of care without eHealth.
Better quality of treatment, more data for research and prevention
Concrete improvements to care through optimised data processing and data sharing is unquestioned. In particular, when the treatment process involves several players, the current reality of telehealth and integrated care already demonstrates considerable potential for the improvements in quality that eHealth can achieve.
Sang-Il Kim, eHealth Suisse, firstname.lastname@example.org