Over the years, governments have attempted to integrate technology into healthcare around the world. Some have been successful - some have been failure's.
Over the years, governments have attempted to integrate technology into healthcare around the world. Some have been successful - some have been failure's. One area of technology in healthcare which has always been a bit shady in terms of development is IT. But over the years have governments finally realised that IT can play an influential part in healthcare?
In various countries, governments have started to look to IT as a solution to their soaring healthcare costs and to improve the quality of care, but it hasn't always gone to plan.
Healthcare has always suffered from limited resources and conflicting demands and that is especially true for technology, with IT managers having to counter the view that money would be better spent on "front-line" medical technology such as CAT scanners - particularly if the latter generate new revenue.
According to Forrester Research, healthcare enterprises in North America spend just 22 percent of their IT budgets on new IT initiatives, compared to 28 percent for businesses in other sector, The Financial Times reports. If this is the case in North America, then it's going to be the case elsewhere.
But in spite of this statistic, the outlook for healthcare IT appears to be is looking brighter. "Across the OECD, there is a universal acceptance that we should be investing more to digitalises healthcare," says Andy Mullins, head of health at PA Consulting.
Attempts at data integration in Europe
In 2006, Germany began to field test a nationwide eHealth card scheme which would ultimately embrace 80 million users, 300 health insurance companies, 2200 hospitals and 188,000 physicians and dentists.
As well as containing patient data and insurance details, the smartcard can hold electronic prescriptions and be used to access a patient's health history online. The card would allow Germans access to state healthcare, and were supposed to be using the card whenever they saw a doctor, attended a clinic, or bought drugs.
The project was supposed to be running nationwide in 2009 but ran into opposition from many GPs who could not see any advantage in this new way of working. Security concerns were also raised.
After spending €1.7 billion on the initiative, the German government decided to put the project on hold due to the opposition the project was facing. The cards will only be used in a few pilot areas as a simple identification card. It had been hailed as the most extensive eHealth communication project in the world.
Health insurance companies were annoyed at the shelving of the scheme because they want a new card as a substitute for their present membership cards, which do not have a photograph and can be misused, Computer Weekly reported.
In the UK, the National Programme for IT (NPfIT) has run into a barrage of criticism not just for its huge cost - GBP£12.7 billion since 2002 - but for the delays and the lack of consultation with suppliers and medical professionals. Some IT suppliers have abandoned their involvement.
NPfIT is an initiative by the Department of Health in England to move the NHS in England towards a single, centrally-mandated electronic care record for patients and to connect 30,000 General practitioners to 300 hospitals, providing secure and audited access to these records by authorised health professionals. The Department of Health agency NHS Connecting for Health (NHS CFH ) is responsible for delivering this programme. In due course it is planned that patients will also have access to their records online through a service called HealthSpace. NPfIT is said by the NHS CFH agency to be "the world's biggest civil information technology programme."
One of the key planks of NPfIT is the summary care record, a simplified EHR, which is supposed to be running nationwide by early 2011. But as of December 2009, only 152 GP practices and two of the 168 hospital trusts were using summary care records.
"The summary care record is a good idea, but I am not sure that having all medical records online at all times is really necessary. A lot of physicians are not qualified to interpret specialist data and there is a risk that the GPs get information overload," says Robin Hughes, founder of Ascensus, a UK-based vendor of practice management software.
Attempts at data integration in America
In America, President Barack Obama has identified nationwide electronic healthcare records as one of the key technologies to help contain the staggering cost of healthcare in the US. This one initiative, if adopted by 90 percent of doctors and hospitals, could save US$77 billion per year, according to a study by Rand Corporation.
The target is for most Americans to have electronic health records by 2014. Yet in 2009 only five percent had an advanced EHR system capable of looking up medical histories and ordering tests electronically.
Fearing that many physicians will drag their feet on the EHR issue, there are federal funds to subsidise the cost of equipping practices with EHR systems. And those who still refuse to buy an EHR system will see their Medicare and Medicaid payments reduced from 2015.
Is healthcare IT worth it?
In the long-run, healthcare IT may save money, but look at the money which has been put into the projects - none of them are successfully up and running to be able to save the country in question money.
Germany, for example, spent €1.7 billion on getting its eHealth card scheme up and running, before abandoning the problem at the first signs of dissatisfaction from the country. What healthcare IT needs is for governments' to stick with their original ideas - keep them going and hopefully see them succeed, not give up at the first sign of trouble, further angering the public over the wasted money.
Information technology can substantially improve the safety of medical care by structuring actions, catching errors, and bringing evidence-based, patient-centred decision support to the point of care to allow necessary customisation.
Healthcare is an industry which needs to keep moving forward - adapting technology, specifically IT will help it to continue to move forward.