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The Swiss healthcare system on the fast track to digitalisation

Interview with Beat Haldemann, Responsable du Système d’Information de la Direction Générale de la Santé (DGS) Vaud

Interview with Beat Haldemann, Responsable du Système d’Information de la Direction Générale de la Santé (DGS) Vaud

How do you explain the delay in healthcare digitalisation in such an innovative country like Switzerland?

Countries who are presumably ten years ahead of Switzerland in this field often have a more centralized government that imposes how digitalisation is rolled out in the country. Swiss federalism does not allow to go as fast and as coordinated as those countries. In the last few years, Swiss public health authorities mainly invested into health institutions in order to digitise the whole internal information system in the different institutions (hospitals, clinics, EMS, CMS) to prepare for healthcare digitalisation. We now move to the second step: the deployment of an e-health information exchange and sharing platform, the CARA eHealth platform. The next step will be the fluidification of information to allow better coordination and continuity of patient care, integrated in the daily practice of healthcare professionals.

Several efforts towards the healthcare digitalisation are currently being made, as the Electronic Patient Record (‘dossier électronique du patient - DEP’) shows. What is the plan?

Two first solutions will be deployed on the eHealth platform CARA at the end of the year: the DEP, the electronic patient record, and the secured transfer of medical data between professionals, based on highest levels of data security and data encryption.

Beyond file and data sharing on a common platform, the much greater ambition we have, where we think the real added value for professionals in the health sector relies, is the development of collaborative services like the shared medication plan (PMP) and the shared care plan (PSP) to start with. Through their implementation, we address some of the real constraints and issues that our health system will face in the next years which are related to the complete changing citizen demographics, with older people and many patients requiring heavy poli-medications because of chronical diseases, and the on-going trend of specialisation of health professionals. In fact, this is the real challenge: securing a clear care plan and good continuous medication plans for these patients.

How do you see the integration process of the latest eHealth technologies in the Swiss healthcare system?

All services deployed on the eHealth platform CARA induce a significant change in the posture and the daily practice of the professionals of the healthcare system. The patient and his/her pathway through the healthcare system must be in the centre of all professionals’ attention and the exchange and sharing of medical information is a prerequisite of good coordinated and continuous inter-professional care. This change is significant.

In addition, within the healthcare system, increasing complex and heavy diagnostic equipment generate huge amounts of data, which remain unreadable without artificial intelligence. Here is a privileged ground where AI and big data have a huge potential in the healthcare system.

The collection of medical data and information is extending from the healthcare system to the citizen & patient at home. Devices developed for patients at home (medical apps on smartphones, connected devices, wearables, etc.) generate huge amounts of valuable data and embarked algorithms on smartphones offer health prevention functions; here artificial intelligence has another capital role to play.

And finally, between the healthcare system and the patient at home there is a link that we have to urgently modernize using the latest available eHealth communication technologies.

The DGS maintains an on-going technology & innovation watch on many areas of the eHealth domain; as soon as services or solutions are mature enough, they become natural candidates for the deployment on the eHealth platform CARA with integration in the medical practices, for the benefit of improved patient care.

You recently joined the Digital Pulse. Which do you think are the strengths of this project?

Two main elements that come to my mind: I) the personal network, a fantastic variety of exceptional people with very distinct profiles around the Geneva Lake and (II) the health projects we assess, qualify and mentor. I hope that I can contribute with my systematic view of the public cantonal healthcare system, the knowledge of the articulation amongst its key players and my information system expertise. I am very proud to help the positioning and to nourish the potential of these new solutions in this field.

Why believe in digital healthcare?

Digital health is just the most natural evolution of the healthcare system. We catch the train of digitalization that other market segments have already successfully taken years ago to be more efficient and effective. Healthcare digitalisation is not a big risk, we know it works in other market segments and we have to go through it now to catch up our delay; let’s take benefit of the potential that comes with digitalisation.

How do you see healthcare in Switzerland in a 5-year span?

Regarding eHealth I think the delay we have in comparison with some northern countries can be caught up in 5 years from now thanks to the know-how and the experience we learnt from them. I believe in 5 years’ time we could be at the right level of integration into clinical practice and proximity with the population with much better integrated and shared medical care and continuous & secure medication like it is in countries like Denmark or Estonia, for example. We know it works, let’s do it!

Direction générale de la santé VAUD

Interview conducted by Beatrice Volpe, Vivactis Suisse (July 2019)