Physicians working in doctors’ practices and hospitals are having an increasingly difficult time. First, they are having to deal with patients who are more informed than ever and who come to appointments with all the answers before the doctor has even had a chance to study the test results. And now, these same patients not only want all of their diagnostic data, x-rays, and lab analyses stored in an electronic medical record (EMR), but they want to be able to access that record whenever they need it. In fact, almost half (43%) of the roughly 9,000 patients who took part in a recent worldwide survey conducted by management consultants Accenture said that they would consider switching to a different physician if it meant that they could access their personal electronic medical record. In Germany, at least, doctors are reluctant on this point: only 12% are in favor of giving patients full access to their medical records. “Most health centers and clinics already have state-of-the-art IT in place,” says Accenture’s Sebastian Krolop, “they just don’t exchange information with other health care institutions.”
Worldwide, at least three-quarters of doctors report that they have the capability to work with electronic medical records. In Spain, that figure is as high as 95%, while in Germany and the United States, it’s 93%. In practice, however, just under half of all doctors actually use electronic medical records on a regular basis. There are two reasons for this: either the processes are new and need to become established, or there are unresolved technical issues. In Germany, for example, one of the main obstacles is the lack of binding standards for data transmission. “Every physician and hospital does it differently,” says Krolop, who, despite the existence of a number of pilot projects, has yet to identify an approach that could potentially be adopted as a shared industry standard. Currently, patients who are admitted to a hospital in a different federal state from the one they live in will not benefit much from having an electronic medical record. That’s because it is highly unlikely that the “source” health center or hospital will be using the same data transmission standards as the “target” one.
Singapore set to be first country with full EMR system
Elsewhere in the world, there are a number of examples of how “connected health care” can be implemented:
– US managed care consortium Kaiser Permanente has built up its own health network for insured members; its nine million customers are obliged to use the 650 clinics and health institutions that belong to the network. This approach has the advantage of enabling medical experts to make new findings based on the treatment data collected, to set up individual care programs, and – ultimately –to create added value that would not be possible without the network.
– Singapore is currently introducing a nationwide scheme known as the National Electronic Health Records (NEHR) system. The idea behind NEHR is that each citizen has a single, centralized medical record for the entire health system (though it will only be accessible to members of the medical profession). As soon as a patient attends a health center or hospital, the on-site team will be able to call up the relevant data for that patient directly from his or her medical record. The latest survey by Accenture shows that the use of electronic health information by doctors in Singapore rose from 32% to 49% between 2011 and 2012. Thanks to NEHR, Singapore, with its five million inhabitants, will soon be the first country to adopt the use of electronic medical records in full. “As a small country with a highly centralized decision-making set-up, Singapore offers the ideal conditions for implementing a nationwide EMR system,” says Krolop.
Vendors in Germany have been providing the technology for establishing the use of electronic medical records in hospitals for some time. Berlin’s Charité, with more than 3,000 beds and over 13,000 employees, is one of Europe’s largest university hospitals. It began a pilot scheme – based on SAP Electronic Medical Record – back in 2011. You can watch a video about the project here:
So, despite their reputation for shunning IT, there is clearly no lack of willingness among Germany’s physicians to adopt the use of electronic medical records. More than two-thirds of the medics surveyed believe that IT creates added value – not just from the financial perspective, but, more importantly, in terms of making it possible to reduce medical errors, improve diagnosis, and shorten waiting times.
Enormous potential for SAP HANA in-memory technology
Nevertheless, as far as IT in health care is concerned, the evolutionary process still has some way to go. On a scale of 1 to 3, most health care institutions are lodged somewhere between stages 1 and 2. Stage 1 is where IT is in use and is driving efficiency; lab results, x-rays, and MRI images are available in electronic form. Stage 2 – where data is exchanged between service providers and health care institutions – becomes more complicated because of incompatible transmission standards and security concerns. Sebastian Krolop describes stage 3 as the point at which it is possible “to gain insight from the data collected”. For example, if certain medications or implants are causing complications on a regular basis, then it makes sense to look at and compare the data of a large number of patients who have taken that medication or had that kind of implant fitted. “Are there anomalies that need to be addressed during treatment?” asks Krolop, who is a trained doctor and sees enormous potential for deploying SAP HANA in-memory technology in this area.
On the threshold between stages 1 and 2, it is currently the patient who is determining the speed of progress toward connected health.
Over 200,000 health apps currently available
The Aktionsforum Gesundheitsinformationssystem e.V. (Afgis), a federation of bodies and individuals devoted to promoting the quality of health care information in Germany, and the Zentrum für Telematik und Telemedizin (ZTG), Germany’s competence center for health care telematics, estimate that there are over 200,000 health apps currently available, but warn that offerings for smartphones and tablets may not meet the standards of quality that medical experts require of such applications. But that won’t be of much interest to patients: For at the moment, they really don’t have that many options.