By Charles V Scatchard
The healthcare sector currently spends increasingly vast amounts of financial resources on data generation and processing. In addition, the need for efficient information systems is becoming increasingly critical to societies in which citizens live longer and travel more frequently, placing increasing demands on healthcare systems.
In terms of the accessibility and transferability of information, the healthcare sector lags noticeably behind many other sectors. At best, information is fully transferred from one fixed point to another and then must be reprocessed, reclassified or reproduced at its new destination. Potentially harmful errors sometimes result. Harmonization or coordination of processes and “back office” operations could result in substantial efficiencies, cost savings and more responsive healthcare delivery. Without a standards-based framework that enables the various healthcare information systems to communicate unambiguously with one another – the healthcare sector is prohibited from achieving the true potential that viable eHealth initiatives can offer.
In this context, the European Commission’s initiative to develop a European Electronic Patient Summary is a clear signal that Brussels intends to move forward with interoperability and secure information exchange. The proposed Summary will be a first step toward secure and reliable exchange of clinical health information between institutions, organizations and nations. A recommendation on this is expected to be presented in 2007 and will definitely be useful as Member-States in Europe move forward with national eHealth programs.
It is clear that the number of countries that take on a national approach to eHealth is growing – even encompassing federal initiatives in countries in which healthcare is a regional concern. So, it is not only Connecting-for-Health in England and plans for the Nationwide Health Information Network in the U.S. – but also the DMP-project in France, the Gesundheitskarte in Germany and the National Archives in Finland that demonstrate the increased political and financial focus on national health infrastructure-investments in IT.
In the future, eHealth initiatives like those above will play an important but still relatively undefined role in the improved management of chronic disease and in disease prevention. As important, eHealth initiatives also have the potential to reduce national healthcare costs – a critical factor when one considers that the primary barrier to reforming health services is financial, and that future prosperity and wealth continues to be inextricably linked with health.
The challenges facing societies on both sides of the Atlantic are not identical, but they are similar in many respects. There may, therefore, emerge possibilities for industry to create strategies around operating with a joint U.S.-EU focus. The ways in which companies that operate on both sides of the Atlantic resolve these issues could constitute important input for policy makers in areas such as standards for interoperability, privacy protection and data security.
A more active role for the patient in decision-making with regard to sharing information should also be envisaged and encouraged. An increased understanding of healthcare systems among citizens may, however, be a precondition for a more active role for patients and citizens in the process. In addition, the sharing of patient information amongst healthcare professionals could also play a vital role in the future management of prevention of illness and the spread of pandemics.
Shared standards for interoperability are critical for future international collaboration. Given that international standards are not in place in all countries, harmonization of standards might be most feasible in situations in which existing regional roadmaps are being replaced by national roadmaps. If focus in this process is placed on the exchange of vital clinical information – tangible results will be possible in the short term, Motivating decision makers to allocate more resources to eHealth initiatives and standards is fundamental to producing real healthcare improvements for citizens in both the EU and U.S.
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