Seamless chain of care

Medicine generally strives to be at the forefront of technology, always willing to try new procedures and spend time and money on research to the benefit of humankind. New pharmaceuticals and surgical advances have made it possible to prolong and improve the quality of life for almost everyone. Yet when it comes to information technology, healthcare professionals see it as an administrative burden rather than a strategic aid to improve the quality of care.

Healthcare agencies spend about $500 per employee per year on IT, compared to $700 in education, $1,430 in government as a whole and $6,000 in the financial sector. Hospital administrators and health ministry managers think they have bigger problems than worrying about IT, so the government industry manager of any given computer company can’t even get his foot in the door to see them. So instead the company rep trots down to the tax office or the defense ministry, deciding it’s not worth his bother to address the healthcare market. Says Ilias Iakovidis, an officer in the Information Society Directorate General at the European Commission: “If you think of a huge line of people queuing up for the healthcare budget, the telematics people are always the last in line. And when they get to the table there’s no money left.”

Healthcare providers do of course have big problems. Developed countries have ageing populations and developing countries have increasing populations; both face the twin challenge of improving the quality and accessibility of healthcare while keeping a tight rein on costs. Healthcare organizations talk about a chain of care where patients move from a doctor’s referral to a secondary care institution such as a specialized hospital, and back to primary or community care in the patient’s home.

It can take six months from the time a GP writes an admission note to when a patient actually meets a hospital specialist. In larger countries, more than one billion messages are exchanged each year by the different parts of the healthcare system – family doctors, nurses, dieticians, physiotherapists, other hospital staff and people working for ambulance services, insurance companies, pharmacies, laboratories, blood banks, government departments, etc. Most requests for appointments, orders for drugs, blood and other supplies, invoices for services, prescriptions and so on are handled on paper. Besides being slow, the process is inefficient and it ties up staff who could be better employed looking after patients. When inefficiencies lead to errors, in blood orders for example, patients can suffer directly. With over-crowded hospitals, long waiting lists and a shortage of trained medical staff, governments would like to see patients move along the chain of care more quickly.

Conducting medical transactions online would speed up the processes. A shared database of information about patients should be the nucleus of an electronic medical record, accessible everywhere it is needed and used as the basis for all clinical decisions. Healthcare systems should be integrated and web-enabled to provide seamless care, where doctors and hospital workers have access to all the information they need to provide effective advice and treatment, and where patients have trustworthy information sources to assist them in looking after their own health.

*Article extracted from ‘eGov: e-Business Strategies for Government’ by Douglas Holmes, published by Nicholas Brealey Publishing, ISBN: 1-85788-278-4. US $29.95. To order,