Patients lose out due to dormancy of potential digitization-driven organisational transformation
While the business and care benefits of digital healthcare are obvious to doctors, patients and even business leaders, there are structural issues in European public healthcare systems that prevent them from using healthcare IT effectively. Healthcare is not exploiting the benefits of technology the way industries like financial services and retail have. If it is to remain sustainable and provide quality care at a rate governments can continue to afford, these structural challenges will need to be addressed.
Despite a compelling case in favour of digitisation, structural challenges prevent European public healthcare systems from using healthcare IT effectively. Right now, the industry is not following other industries’ lead in using healthcare IT’s potential to improve financial sustainability, patient experiences and, most important of all, health outcomes.
At current rates, some European health systems could lose their financial solvency in 10 to 20 years. On average, 5-10 percent of public healthcare expenditure is administrative cost, while the remaining 90-95 percent is the direct cost of medical services. Of the latter, three-fourths or more is spent on chronic patients…all this, while standards of care are eroded.
European hospitals are often dis-incentivised to implement efficiency improvements. First, systems are payer-based, so hospitals prefer to increase rather than decrease the number of patients they have to serve—since this results in more funding. In-home care, which is more cost-effective than hospital care, is also not reimbursed by payers, discouraging hospitals from applying it where possible. Then, different medical institutions create their own patient data warehouses to comply with reporting requirements. Lastly, healthcare IT is considered merely as a cost centre rather than an investment. This is a mistake on the part of managers—technology can be a source of important decision support information at both clinical and organisational levels…so the vicious circle continues. The policies and processes on which these actions are based need to be re-addressed from the ground up. There is much benefit to the effective application of IT-enabled healthcare transformation.
Three key benefits
Data gathering makes it possible to foresee threats to health and have patients consult a doctor earlier. Preventing foreseeable chronic episodes, in particular has been shown to create massive cost reductions in regions like the Basque Country in Spain, where managed chronicity has made a significant contribution to sustainability of public health.
Mobile technologies increase the involvement of the patient in—and cooperation with—a given therapy, by ensuring compliance with prophylactic principles, or that the patient regularly takes the prescribed medicines.
Full access to patient medical history could help ensure far more consistent and uninterrupted healthcare. Services based on such principles are already rendered in some regions of Spain, where telemedicine devices monitor health-related parameters, e-surveys make it possible to track the progress of therapy and patients can contact doctors or nurses to talk with them about concerns. This may seem minor, but results in vast time savings for the healthcare system and in direct benefits for patients.
It’s not about IT
Healthcare IT itself is not the answer—it is the enabler that should form the foundation of a fundamentally transformed healthcare system. For now, digitization thrives only in isolated spots. Merged information repositories, as demonstrated in Finland, provide a unified patient record where every doctor, nurse and hospital employee has access to the same data, which results in a seamless, co-ordinated care pathway—rather than having patients answer the same questions over and over again, with no shared record of procedures, prescriptions and other care. Resources are wasted on redundant effort and the risk of error is increased. Let’s not forget the benefits of telemedicine for people in rural areas with limited access to doctors. Equitable access to healthcare should be a prime objective for every public health system. eHealth is not about IT, tools, systems or new applications. What matters is the purpose: improving quality, increasing patient involvement, increasing patient satisfaction and making services more broadly available.