Many eHealth initiatives are pretty much known in the German healthcare system as well as in further European countries. The different scopes range from video-consultation for seriously ill COPD patients, tele-radiology to the electronic health card or certain regional health-supply systems (e.g. “UGOM” in Bavaria, Germany) – some of them already proven in daily practice.
Although recent initiatives from German health legislation and the Gematik aim at leveraging the utilization of the electronic health card and further expansion of secured HIT-infrastructures, recent studies say that major expectations across stakeholders and shareholders in the healthcare market have not been met so far. Reasons for this are controversially discussed and include lack of commitment, coordination and respective stakeholder acceptance.
Despite the ongoing public dialogue regarding data security, it is interesting to see that organizational or legal aspects play only a minor role during the realization of eHealth projects. However, we experienced even in this area numerous major challenges in our international projects.
In almost any project it is consented that the introduction of eHealth technologies leverages the interoperability across providers aiming not just at a more patient-centered approach but to integrate the patient himself pro-actively as well. Thus the question is not about the costs for acute or post-acute care but even more about how costs will transform along with the “human lifecycle” and the patient’s disease career. The answer can be given by investigating incidence probabilities, predictive modeling, risk stratification and simulation of preventative programs.
So what does this finally mean? A much broader, cross-sectoral, integrating approach will be required which includes micro- and macroscopic health-economic and health-management aspects while optimizing the utilization of existing and next gen technologies.
Proven examples from the U.S. (Accountable Care Organization, ACO) and the UK (Clinical Commissioning Groups, CCG) address various requirements from prevention, acute care, rehabilitation, well-being and lifestyle. These ventures clearly indicate the high evidence of integrating eHealth technologies in the operational and tactical space as well as population health analytic – recently also based on cognitive analytic principles – as strategic planning tools.
From my perspective it is very clear that healthcare systems – in particular mature healthcare markets – will be increasingly interested to learn from each other as from a high level view major economic challenges in Europe are comparable. This will finally enhance also the conversion of healthcare systems. As an example we observe this in Scandinavia where proven concepts in the Danish healthcare are currently migrated to Norway and Sweden.
Leveraging the utilization of eHealth technologies in Germany as part of population health management is linked to the ongoing transformation of existing reimbursement (fee-for-service, DRG) to a more value-based reimbursement. National and state administration expects to improve further the quality of medical outcome but finally the necessary consolidation in the provider market. The challenge for partners in the healthcare will be to design population health projects jointly with providers and payers and give at least raw indications about the improvement of medical, economic and further benefits. Thus only those companies with a broad international expertise in the population health arena, the knowledge in healthcare consulting and management, system integration and implementation of next generation health-IT (including cloud, big data and cyber security) will be appropriate partners in the healthcare.