Interview with Drs.Ellen Maat,Director of Healthcare ICT,Netherlands Health Ministry

HITM: Hospital IT departments are at the center of many changes such as e-Health and e-business. Will the new reforms have implications for hospital IT departments ?

Drs. Ellen Maat: In our view, e-Health describes the application of information and communication technologies across the whole range of functions that affect the healthcare sector. e- Health can therefore function as a lever to improve the access, affordability and quality of healthcare.

HITM: What are the key challenges and priorities for healthcare IT – for example, on new standards ? Do you believe it is too ambitious to harmonise IT systems at a European or international level, before things like big legacy mainframe systems have been modernised?

Drs. Ellen Maat: Due consideration needs to be given to the fact that EU Member States and other countries around the world have different approaches and priorities to IT implementations in healthcare and may be starting from different points in the development cycle.

Before any degree of harmonisation of IT systems can take place at an international level, consensus needs to be reached on a more abstract level. This would include topics such as identification, authentication and authorisation mechanisms and intermediation services to achieve semantic interoperability between diverse codification systems and languages.

HITM: What about skills and demographics? We hear there is a decline in IT student intakes by universities and technical schools in Europe. Is this true in the Netherlands ?

Drs. Ellen Maat: No, recent statistics are demonstrating an increase in new intakes for IT-related studies. The number of new registrations at universities throughout the country have gone up from 14.550 in 1995/96 to 16.310 in 2006/07. The same applies to technical schools: 9.680 students enrolled in 1995/96 against 21.510 in 2006/07.

HITM: Can you comment on finance and budgetary pressures ? IT has often to cope with competition from demands for new medical equipment like scanners, bedside monitors etc. Will this change because of the new environment ?

Drs. Ellen Maat: The use of ICT was, until a few years ago, more common in other market areas then in the health care sector. This is about to change due to the acknowledgement of the importance of medical data exchange for the quality of health care. Over the past few years, the mobility of patients has increased and this demands a focus on exchange of information between healthcare institutions. Due to a new focus on electronic exchange of information, we expect this to lead to an increase of investment on ICT-applications for medical data exchange.

HITM: Globalization is also becoming an issue. The EU identifies healthcare technologies as a priority for Europe. However, it is also opening up research cooperation with countries like India and China. Do you believe this is a Trojan Horse for large Asian IT companies? Especially given their close ties to the US technology industry and financial firms ?

Drs. Ellen Maat: One of the basic assumptions of our national program for health IT is that the healthcare professionals are themselves responsible for the implementation of IT applications. Apart from taking into account the governmental regulations regarding the connection to the national IT infrastructure, healthcare professionals are at liberty to choose their own IT supplier. This supports the Dutch freemarket approach and the recent healthcare reforms. Given the Netherlands’ ambitious healthcare financing reforms, some observers expect an impact on hospitals in terms of productivity and efficiency pressures.

HITM: Hospital IT departments are at the center of many changes such as e-Health and e-Business. Will the new reforms have implications for hospital IT departments ?

? Drs. Ellen Maat: In our view, e- Health describes the application of information and communication technologies across the whole range of functions that affect the healthcare sector. e-Health can therefore function as a lever to improve the access, affordability and quality of healthcare.

HITM:What are the key challenges and priorities for healthcare IT – for example, on new standards ? Do you believe it is too ambitious to harmonise IT systems at a European or international level, before things like big legacy mainframe systems have been modernised?

Drs. Ellen Maat: Due consideration needs to be given to the fact that EU Member States and other countries around the world have different approaches and priorities to IT implementations in healthcare and may be starting from different points in the development cycle.

Before any degree of harmonisation of IT systems can take place at an international level, consensus needs to be reached on a more abstract level. This would include topics such as identification, authentication and authorisation mechanisms and intermediation services to achieve semantic interoperability between diverse codification systems and languages.

HITM:What about skills and demographics ? We hear there is a decline in IT student intakes by universities and technical schools in Europe. Is this true in the Netherlands ?

Drs. Ellen Maat: No, recent statistics are demonstrating an increase in new intakes for IT related studies. The number of new registrations at universities throughout the country have gone up from 14.550 in 1995/96 to 16.310 in 2006/07. The same applies to technical schools: 9.680 students enrolled in 1995/96 against 21.510 in 2006/07.

HITM: Can you comment on finance and budgetary pressures ? IT has often to cope with competition from demands for new medical equipment like scanners, bedside monitors etc. Will this change because of the new environment ?

Drs. Ellen Maat: The use of ICT was, until a few years ago, more common in other market areas then in the healthcare sector. This is about to change due to the acknowledgement of the importance of medical data exchange for the quality of health care. Over the past few years, the mobility of patients has increased and this demands a focus on exchange of information between healthcare institutions. Due to a new focus on electronic exchange of information, we expect this to lead to an increase of investment on ICT applications for medical data exchange.

HITM: Globalisation is also becoming an issue. The EU identifies healthcare technologies as a priority for Europe. However, it is also opening up research cooperation with countries like India and China. Do you believe this is a Trojan Horse for large Asian IT companies? Especially given their close ties to the US technology industry and financial firms?

Drs. Ellen Maat: One of the basic assumptions of our national program for health IT is that the healthcare professionals are themselves responsible for the implementation of IT applications. Apart from taking into account the governmental regulations regarding the connection to the national IT infrastructure, healthcare professionals are at liberty to choose their own IT supplier. This supports the Dutch free market approach and the recent healthcare reforms. (CC and TS)