HealthManagement, Volume 13, Issue 3/2011

Digital Health

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Over 90 percent of Europe's hospitals are connected to broadband and 80 percent have electronic patient record systems, but only 4 percent grant patients online access to those records. The findings emerge from an extensive investigation for the European Commission's Information Society and Media Directorate-General into the use acute hospitals make of e-health services.

The report, eHealth Benchmarking III, prepared by Deloitte & Ipsos in Belgium offers empirical evidence of the experiences of 906 public, private and university hospitals with the new technology on their own premises and in their dealings with external users and service providers. As part of the research, the survey also sought the views of hospital medical directors on electronic patient record systems and telemonitoring in all 27 EU countries plus Croatia, Iceland and Norway.

The former remain a top priority for investment in hospitals where there is still no common central information sharing system. The principle gain is considered to be efficiency. With the introduction of such systems, patient admissions are considered to have increased (55 percent of medical directors agree) and waiting lists reduced (49 percent agree). However, this does not appear to have been translated into higher quality treatment. Only 25 percent believe that the quality of the diagnosis has improved, 24 percent that treatment is better and 13 percent that medical errors have been reduced with the introduction of the electronic patient records.

One major reason given for the relatively low levels is interoperability between different departmental records – 46 percent of medical directors identified it as the largest barrier. Another is the absence of financial incentives for staff to use the new systems. The problem appears to be more acute in bigger hospitals, where 76 percent cited it as an obstacle compared to 46 percent for smaller ones.

Despite the low deployment of telemonitoring for outpatients (only 8 percent are covered), only 17 percent of medical directors consider it to be an investment priority over the next three years. According to the report, 78 percent of those surveyed believe that telemonitoring will have little or no impact on improving the quality of patients' lives.

Practically all (92 percent) of European hospitals are connected to broadband, but half of them have a bandwith below 50Mbps, while a higher one of up to 100Mbps would prove useful in advancing digital imaging and telemonitoring, the survey notes. Overall, the results show the best e-health practices are to be found in Denmark and Belgium. Across the 30 countries, there are differences in areas such as infrastructure, level of medical electronic external data exchanges with healthcare actors outside the hospital system and levels of access of ehealth services directly to patients.

More specifically, videoconferencing facilities are relatively common, especially for contact between internal medical staff and external healthcare providers (almost 40 percent of hospitals have them). A majority (65 percent) have a common electronic patient record system and electronic exchange of radiology reports occurs in two hospitals out of five. Four out of five hospitals have electronic patient record systems in place, but the report notes, they "do not yet seem to have reached a level of sophistication that will translate into clinical transformation".

However, only four percent of hospitals give patients access to their electronic records. The European Commission is looking to increase this percentage. In its digital agenda for Europe it announced that it would table a recommendation next year to define a minimum common data set for the interoperability of patient records to be accessed or exchanged across member states, while respecting data protection requirements. The aim is that patients should have online access to their medical details by 2015.

E-Prescription is another area where use of the new technology could be increased. It is currently available in 30 percent of the hospitals surveyed. But it is used mainly (87 percent) to connect to pharmacies on the premises and far less to external ones (29 percent).

The report notes that the differences in e-health use between member states "is of concern to patients who might be travelling around Europe and to policy makers concerned to maintain equity and balance throughout the geographic areas of the Union". The European Commission is already addressing the many issues involved. It has established an EU e-health Task Force to assess how information and communication technology can help accelerate innovation in healthcare for the benefit of patients, carers and the sector itself. Under the chairmanship of the Estonian President, Toomas Hendrik Ilves, it held its first meeting in Budapest on 10 May and is due to present its recommendations to the informal meeting of e-health ministers in Copenhagen in May 2012. 

Over 90 percent of Europe's hospitals are connected to broadband and 80 percent have electronic patient record systems, but only 4 percent grant patients

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