It's easy to forget that our current healthcare system is, historically speaking, still in its infancy. But some ideas are easier to let go of than others. For example, the concept that the hospital is the key element of supplying these services may be one common misconception to overcome. Once that's in progress, we should see the healthcare system expand beyond hospital borders.
An ageing population, on the one hand, and the increase of prolonged and costly chronic illnesses on the other, means that there will be a greater demand for a level of continuous care that hospitals cannot deliver in a cost effective manner. Care will become more distributed, with the burden shared by a large variety of health providers – GPs, physiotherapists, pharmacists, home-carers, family members, private health clinics, gyms, food nutritionists … the list goes on.
However, this creates a considerable technology challenge. It's a non-trivial task to securely and efficiently share patient data when working between so many stakeholders – one that has long been worked around or avoided. However, according to the latest report from IDC and EMC, it's one that will need to be confronted sooner rather than later. The report, which is based on interviews with 188 hospital IT and non-IT executives from EMEA as well as 12 national and regional government executives in charge of eHealth programmes, revealed that budget constraints and high costs of maintaining legacy systems in hospitals are holding advancements back. Only around 19% of budget in western Europe (WE) is set aside for enhancements or upgrades and with the same proportion spent on innovation. But organisations do realise that IT is crucial to enforce change, with integrated and secure access to data and applications (4.2 in WE) ranked as the most important hospital IT priority, well above lowering the cost of IT (3.9 in WE). (Respondents were asked to respond using a scale ranging from 1 to 5, where 1 stands for 'Not at all important' and 5 stands for 'Most important'.)
The healthcare system needs to be better suited to dealing with the increase in long-term non communicable diseases (NCDs) which require prolonged treatment rather than acute episodes that require hospitalisation. A patient-centric system based on the sharing of patient data within hospital systems, while also going beyond hospital borders and a wider spectrum of relevant stakeholders – including doctors, GPs, specialists and other healthcare practitioners – seems the best model for the future. This integrated care model provides benefits both economically and in terms of improvements to patient outcomes.
The steps to achieving this model could be positioned in three stages. Firstly, in the short term, hospital executives should assess their assets (technologies, standards and patient data), processes (clinical, administrative, governance, risk and compliance related) and skills to unearth opportunities in patient data integration and analysis. For instance, document management tools applied only to automate patient data compliance could be used to improve safety of medical orders. Hospitals should start to experiment with document life-cycle management, big data and cloud computing to build collaborative pilots that involve other stakeholders along the health value chain.
In the medium term, a road map designed to integrate both care service delivery and patient record initiatives, which identify gaps relative to existing assets, processes and skills could be created. This should combine the gap assessments with early evaluation of pilot projects in terms of business model sustainability to attract further budget support.
Finally, in the long term, clinical and administrative workflow should be optimised by leveraging an integrated patient record system to improve the appropriateness of care, with benefits clearly communicated.
Ultimately the future of healthcare will require that the right people see the right patient's data, with their consent, enabling health providers to deliver the appropriate care based on a full understanding of the patient's history. Technology will play a key role in making this happen.
Stuart Nyemecz is district manager of regional public sector, EMC
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