eHealth publifocus and the electronic patient file
An electronic health card to identify patients, an electronic file compiling all past and present data related to our health, an online service to give citizens a sense of responsibility: how will citizens greet this new “eHealth” strategy that has been adopted by the Swiss Federal Council?
To answer this question, TA-SWISS is carrying out an eHealth publifocus. A public debate is opened on this issue in order to find out what the citizens’ views are. The publifocus will enable us to identify the opportunities and risks of this new strategy, and to issue recommendations to the politicians.
Why hold a publifocus on «eHealth»?
The eHealth strategy was adopted by the Federal Council in June 2007. Distribution of the electronic health card will begin in 2008, and the electronic health file from 2010. The project is in its early stages, so there is still time to pass on information on this subject, and to issue recommendations for its application to political groups.
In addition, the eHealth strategy adopted by the Federal Council has left a great many questions unanswered. The publifocus is the ideal opportunity to try to answer some of these.
Aims of the publifocus
The principal aim of the publifocus is to review, the opportunities and risks of the electronic patient file with the citizens, to find out what their views and needs are and whether they will accept it, because up to now there has been too little consultation with the population on this subject. This publifocus is also a good opportunity to clarify certain aspects of the strategy that are still somewhat unclear.
The main questions for public debate are:
- Has this eHealth strategy been well received by the citizens?
- Do citizens want information about their health to be recorded on an electronic file?
- Do citizens feel that the government is spending its money wisely?
- What is the use of this project?
What is the «eHealth» strategy that has been adopted by the Confederation?
The term «eHealth» or «cyberhealth», is used to refer to the use of information and communication technologies (ICT) to organise, support and network all processes and partners involved in the public health system (based on the definition by the Swiss Federal Office of Public Health FOPH).
The eHealth strategy focuses on three spheres of activity:
- The insurance card and electronic patient file: from 2009, the strategy is expecting to record administrative data (e.g. name of insured person, social insurance number) on a card which will enable patients to be identified electronically. Patients will then be at liberty to add medical data, or to request that such data be removed (e.g. blood group, chronic illnesses, allergies, medical history). This card will be the first step towards the electronic patient file that every Swiss citizen will possess by 2015.
- Creation of a coordinating committee: as part of the application and development of the strategy, the government is planning to create a coordinating committee in parallel with introducing the above elements, and to set up a framework agreement from 2007 to clarify the legal issues.
- Online information and services: the basic objective is to use these to improve the skills of the population in the health area: protection of health, prevention of diseases, patients' rights , management of health crises, etc. To this end, the government wants to use the Internet portal to distribute information that can be understood by non-specialists. This information must be balanced, correct and reliable, and meet quality assurance criteria.
Opportunities and risks of the electronic patient file
At the moment, medical information relating to patients is fragmentary. Once the strategy is in place, doctors, hospitals and pharmacies will be able to record data electronically when they issue their invoices, and to consult patients’ medical data in the electronic file.
The aims of this new system are to raise the level of administrative efficiency by reducing administrative tasks for medical service accounting, to improve the medical quality and safety of treatments, and to give the insured a sense of responsibility (they will decide on the extent and use of personal data). The card should also make it easier to exchange information, irrespective of place and time. From a practical point of view, this card should prove especially useful in emergencies, because it should enable treatment to be given quickly and effectively.
The introduction of this new system does, however, give rise to a certain number of questions, the answers to which are still rather hazy:
- Will the confidentiality and protection of the data be respected?
- What will this new strategy cost? How will it affect citizens?
- Will the electronic file be reliable to use? Could it pose risks to health (incomplete or inaccurate data)?
- Who will have access to these data?
- Who will manage the data?
The idea of the publifocus is to initiate a debate on a controversial subject between groups of twelve or so citizens in different regions of Switzerland, and between the different groups.
- To prepare citizens for this debate, TA-SWISS will send them in advance a fully detailed booklet describing the strengths and weaknesses of the eHealth strategy, and of the electronic patient file in particular.
- TA-SWISS is responsible for selecting the citizens from different parts of Switzerland to take part in one of the publifocus events.
- The publifocus events are held in different towns in Switzerland under the direction of a moderator.
- The discussions are recorded in writing and will be published in a final report.
Project start: summer 2007 | completion: spring 2008
Results and Downloads
Final report (in German and French only)
Für ein effizienteres Gesundheitswesen. Bericht zum Dialogverfahren "ehealth publifocus und elektronisches Patientendossier. pdf publifocus repoort
Pour un système de santé plus efficace. Rapport du prossesus de dialogue publifocus ehealth et le dossier électronique du patient. Berne 2008. pdf - publifocus report
Four publifoci were held in spring 2008:
- Dr Sergio Bellucci, Managing director, TA-SWISS
- Ka Schuppisser, Information Society Coordinator, Federal Office of Communications OFCOM
- Dr Hermann Amstad, Secretary general, Swiss Academy of Medical Sciences SAMW
- Dr Michel Roulet, Project manager eHealth, Swiss Academy of Engineering Sciences SATW
TA-SWISS Project Supervisors
- Dr Sergio Bellucci, TA-SWISS, e-mail
- Nadia Ben Zbir, TA-SWISS
Experts from the e-Health or the public health sector
- Prof. Olivier Guillod, Director, Institute for health law, University of Neuchâtel
Human and social scientists
- Prof. Dr Alberto Bondolfi, Interfaculty ethics department, University of Lausanne
- Prof. Dr Luca Crivelli, Director Net-MEGS, University of Lugano
- Dr. Iva Bolgiani, Employee of the Health department, canton of Ticino, University of Geneva
- Markus Nufer, Manager of Governmental Programs, IBM Switzerland
- Pia Ernst, Director, Swiss patient organisation
- Walter Stüdeli, Director eCH, Association for eGovernment standards
- Fritz Britt, Director, Santé Suisse
- Dr Max Giger, Member of Managing Board, Swiss Medical Association FMH
- Edith Graf-Litscher, National councillor, Thurgau agency, ÖKK
- Hanspeter Thür, Swiss Federal Data Protection Commissioner, Bern
- Andrea Nagel, Project Manager eHealth, Federal Office of Public Health FOPH
- Ann Schwarz, Editor, Tages-Anzeiger Zurich
- Dr Rosmarie Waldner, Scientific editor, Zurich (chairman of the support group)
- Dr iur. Bruno Baeriswyl, Data protection commissioner, canton of Zurich
http://www.bakom.admin.ch/themen/infosociety/01689/index.html?lang=en eHealth strategy Switzerland
TA-SWISS reports and studies
- Study Computerbasierte Patientendossiers, 2000 (TA 36/2000)
- Study Der gläserne Kunde, 2000 (TA 38/2000)
- Study A basis for IT Assessment, 2002 (TA 43/2002)
- Study Der Vorsorgeprinzip in der Informationsgesellschaft : Auswirkungen des Pervasive Computing auf Gesundheit und Umwelt , 2003 (TA 46/2003)
- Study Telemedizin, 2004 (TA 49/2004)
- Report ICT and Privacy in Europe, 2006 (EPTA Report 2006)
CH-3011 Bern T + 41 31 310 99 60
F + 41 31 310 99 61
The project in brief
In 2015, every insured person should be equipped with an electronic patient file that is accessible anywhere and at any time. What do the main stakeholders think about this innovation? The publifocus on eHealth and the electronic patient file has enabled them to express their hopes, but also their fears.
Timetable: autumn 2007 - summer 2008
Project mandataries: Dr Sergio Bellucci, Nadia Ben Zbir, TA-SWISS