SCHWARTZ HEALTHCARE-IT BLOG

A European Perspective

Research and consulting firm Health Industry Insights (HII) released its 2008 Western European Top 10 Predictions. According to HII analysts Jan Duffy and Silvia Piai, European healthcare providers are facing an "inconvenient truth": the traditional healthcare service delivery model — based on big box hospitals set up to deal with acute episodes, doctors as the only owners of clinical information, and little attention dedicated to wellness and prevention — is no longer sustainable. New patterns of demand, resource constraints, and glitches in the quality of service have brought this model to the point of no return. Health Industry Insights foresees common patterns of transformation of both the service delivery model and information technology modernization in Western Europe.

For their predictions for 10 key changes taking place in 2008, please click the "Continue Reading" link.

 

Investment in EHR/EMR Will Continue to Grow in 2008

Investment in electronic health records, or electronic medical records (EHR/EMR), will continue to increase in 2008 and this area is expected to experience the highest growth when compared with other technologies. A recent Health Industry Insights survey study found that 38% of hospitals in EMEA are currently investing in EHRs. There is a natural progression from the implementation of EHR to the adoption of other related and integrated applications, such as
• Patient demographics, medical history, medication history, adverse drug events
• Lab and radiology orders/result reviews
• Pharmacy order entry and medication reconciliation
• Decision support — real time and back end drug alerts

Although the current focus of EHR investment in most EMEA countries lies in the hospital, the need to include primary care and other smaller provider practices will become increasingly apparent, driving the need for further investment. In the Balearic Islands, a summarized care record stored on a clinical data repository has been provided to clinicians (in GPs' offices, hospitals, ambulances) through a clinical portal strategy and EMPI (enterprise master patient index) system technology. Approximately 450 professionals from the hospitals of Inca, Menorca, and Son Llatzer use the summarized care record, and networks must reach robustness to handle the data traffic. High volumes of data will lead to further investment in infrastructure and storage devices. Moreover, further investment needs to be made in the security area, given the sensitivity of data, and major focus will be placed on role-based access systems.

Patient Safety Will Drive CIS Enhancement

Clinical risk is mainly composed of two variables: the human factor and the organizational factor. There are two ways of addressing clinical risk:
• Intervening in human behavior that leads to errors by making health professionals aware of risk conditions (e.g., improving health professionals' knowledge through continuous training).
• Focusing on organizational conditions where errors occur. From the analysis of adverse events, healthcare providers can recognize where, across the clinical pathway, processes are weak or misleading and re-address the whole care system.

Advances in best practices for clinical safety will drive new technology development in 2008 and beyond. Improved patient safety continues to be high on the list of priorities for healthcare executives. Clinical information systems that are designed to track and monitor patient activity, cross referencing interactions and identifying potentially hazardous situations, will be in great demand. Providers will increasingly look towards clinical information systems (CIS) and other information management tools to assist them in improving the decision process and patient pathway, as well as increasing the efficiency of health care staff.

Use of Wireless/Mobile Technologies Will Increase

Healthcare providers will increasingly depend on wireless technologies. The use of mobile technologies will drive expanded interest in identity management tools to ensure security and confidentiality. The Federal Service for Health in Belgium has launched a project pilot called "Vinca" to provide ambulatory nurses and therapists with mobile tools (PDA, smart phone, UMPC) that have card reader features. The project aims to provide health professionals with patient information at the point of care to reduce the administrative burden and minimize errors due to excessive paperwork. The mobile device reads the social security card or eID card to identify the patient and health professional. EMR software will use data captured at the point of care for various purposes, such as invoicing, automatic agenda management, and updating the nurse's record.

Sensors Will Start to Make Sense

Sensor-based devices such as RFID are increasingly being used in the healthcare environment. Large hospitals started to apply RFID tags in asset tracking; for example, tags on instruments and readers on sterilization chambers, portable carts, doorways, and storage cabinets can validate proper cleaning or disposal and help locate the required instruments. A much greater impact of RFID on clinical processes will come from the identification of patients, medication, and blood and laboratory samples. Sensor-based devices and applications will start to prove their value. Demonstration projects will expand in 2008 and begin to show cost and efficiency benefits. Over the next 12–18 months, RFID technology will move away from the introductory phase and grow into a more widely used solution to label, track, and trace drugs, equipment, blood, and patients. Passive RFID tags are expected to make headways in tracking drugs, blood, lab samples, and other disposable items. Active RFID transponders will instead be deployed in large hospitals, especially in emergency rooms, to track high-value equipment, such as mobile diagnostic machinery and, increasingly, patients.

SOA a Pragmatic Replacement for Standards

By early 2008, the European Commission, following extensive consultation with member states and experts in the field, will establish a set of guidelines on European ehealth interoperability. In the medium term, the commission plans to support large-scale pilot projects, in cooperation with member states, to demonstrate that interoperability is achievable. In the longer term, the union aims to agree on processes for the implementation of interoperable solutions throughout Europe. The guidelines will entail recommendations on technical standards and architectures and the establishment of common communication platforms. To address interoperability problems, healthcare organizations are progressively adopting service-oriented architecture (SOA) for their information systems, even though there is a lack of standards and fragmented environments. Given the pragmatic approach of SOA, Health Industry Insights expects that its application in the healthcare sector will increase in 2008 and beyond.

Business Intelligence Will Address Performance Management Data Requirements

The introduction of performance-related funding and incentives is creating a stronger demand for data capture and analysis tools. Business intelligence (BI) applications can supply information for pay-for-performance programs, performance management tools, evidence-based medicine, reporting, and data summarization. Health Industry Insights suggests that more sophisticated off-the-shelf BI and analytics will emerge as the requirements become clearer. Off-the-shelf business intelligence applications will mature to supply applications that are better suited to providers' needs. Business intelligence applications will be developed and used by providers to increase the transparency of data covering technology in use, outcomes, quality of care, the cost of care, and patient safety (adverse events prevention and recording, evidence-based medicine, etc.).

Health 2.0 Will Affect Consumer Interaction With Healthcare System

Health 2.0 will become increasingly mainstream, and healthcare stakeholders will invest in Web 2.0 technologies to create "stickier" and more competitive Web sites and interaction tools. Multimedia channels, such as Webcasts and podcasts, will increasingly be used to distribute health information. Uptake of healthcare Web sites exploiting Health 2.0 technologies will be challenged by consumer relevance, reliability and ease of use, and workflow and data integration with other healthcare processes. The European Union, recognizing that citizens are avid consumers of health-related information on the Internet, supported an initiative within the eEurope2002 agenda and developed a communication on the core set of "Quality Criteria for Health-Related Websites." These criteria should be commonly used by member states, as well as public and private bodies, and should be applied in addition to relevant community law. Criteria include guidelines for transparency, information sources, privacy and data protection, updating of information, accountability, and accessibility.

Health and Wellness Will Spur Investments

In the long term, prevention activities will be key in the cost-cutting strategy for the whole healthcare sector. Governments and providers are trying to shift the responsibility for health and wellness to the consumer. However, there is a huge need for new technologies, applications, to extend information and transaction management to consumers. In 2008 attention to the healthcare process will increase, as will the focus on wellness incentives and self-care management. The market will start to pay attention to the need for and provision of technology-supported initiatives that address the requirement for a consumer-driven health system.

Focus on Delivering Care Across the Healthcare Continuum Will Grow

Changing demographics means a big shift in demand for and type of care. The aging of the population and the stronger weight of chronic diseases on overall healthcare expenditure are transforming the way of delivering healthcare services. The use of integrated technologies to support capture and analysis of patient data will be vitally important to improve patient safety and quality of care across the healthcare continuum, particularly as treatment focus begins to shift to chronic disease management. The role of primary and ambulatory care will be fundamental and will be more integrated with social services. Health Industry Insights predicts that services will be progressively provided across the entire healthcare continuum. Nonetheless, fragmented systems will hamper integrated care delivery, leading to an increased focus on application integration. In the long term, SOA and the integration of wireless technology will be key enablers for a significant EMEA move toward a digital healthcare environment.

Clinical and Non-Clinical Solutions Will Continue to Blur

Intelligence is progressively embedded in everyday healthcare devices and tools, and the lines between clinical and non-clinical systems will blur, as will the lines between devices used only by medical practitioners and those used by consumers. As these technologies continue to converge, it will undoubtedly have an effect on the ICT budgeting and justification process and could also affect who has the responsibility for managing the technology. Convergence of clinical and non-clinical solutions will require a more holistic approach to the healthcare technology architecture and indeed to healthcare in general. In order to achieve successful implementations, all stakeholders should be involved in the decision process while developing new systems or solutions.

What Should You Do?

Healthcare executives need to set up business incentives, processes, and information technology — especially electronic health records — tools to encourage and enable the exchange of patient clinical data across secondary and primary care providers. The adoption of common standards, such as IHE, HL7, and DICOM and implementation of security best practices and technologies will be the building blocks of information exchange. Lean clinical and administrative processes must be designed and technologies (e.g., RFID, wireless, and CPOE) must be implemented to reduce the wastage of precious resources and time.

 

Tags: CPOE, EHR, EMR, EMR+PR, European+HCIT, Healthcare+Analysts, Healthcare+PR, HIT, Medical+PR, Online+PR

Posted by Shawn Whalen on March 18, 2008 at 9:05 AM
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