Successful Health-IT – Just the use of information and communication technology (ICT) in healthcare?
Recently the Austrian government has agreed on the nationwide implementation of an Electronic Health Record (ELGA) in Austria. Although the Electronic Health Record is the second great leap after the introduction of the e-card system in Austria, to provide healthcare with means for a trans-institutional infrastructure to securely share a patient's health data, it raised the awareness for eHealth respectively the use of ICT in healthcare to a new peak in public.
Compared with other sectors such as the service domain, healthcare is still far behind regarding the widespread use of information and communication technology, but is rapidly catching up. Considering the developments in medicine such as the increasing specialization and intense use of medical technology in diagnostics and therapy the future direction seems obvious. Apparently information and communication technology has the potential to support a high quality, high-tech medicine respectively allows extending the scope beyond current possibilities, and so does eHealth.
On the other hand new options always go together with new challenges, threads and indeed fears. The widespread use of ICT in healthcare allows for whole new processes, a whole new way of thinking. Eysenbach has already payed tribute to this in the year 2001 by defining eHealth in a holistic way not only as a “…technical development, but also a state-of-mind, a way of thinking, an attitude, and a commitment for networked, global thinking, to improve health care…”. Existing dogmas such as the relation between the doctor and patient are no longer axiomatic and can be questioned in either way. eHealth may in future empower a patient to question a doctor's opinion, provide medical data, supervise medical data usage or even partially substitute a doctor by technology. Contrary it is also possible that technology supersedes frequent or direct contact with a doctor, automatically monitors a patient or gives advice.
Looking back on the history of health informatics or even broader on informatics as a whole we know that the list of failures is at least the same size as the list of accomplishments when technology found its way out of the laboratories into practice. So there is the central question what makes the difference? Long before the concept of eHealth was published we have already learned that a sound technical implementation is necessary but not sufficient, does not guarantee success. Multiple projects in the domain of eHealth have also demonstrated this simple rule.
In order to successfully transfer scientific results/concepts to practice it is necessary to step back from an exclusive scientific claim of perfection to a more practical, holistic approach to quality, which also considers the needs, fears and context of potential users and parties concerned. This does not imply a mutual exclusion or any contradiction per se or that a scientific approach can't consider these dimensions right from the start but when moving out of the laboratory priorities may need to be rethought or certain dimensions added.
It is beyond all doubt that without the use of ICT the current direction set in healthcare can't be effectively persuaded. The ideas and concepts from the domain of eHealth are an integral part of current and future healthcare, acting as enabling technologies. But it is necessary to carefully consider the effect of such technologies on the healthcare system as a whole but more important on the individuals concerned. True success can only be achieved when the final product or service is technically and organizationally sound and creates a noticeable benefit for the individual user that exceeds its cost.
The 8th scientific eHealth conference (http://www.ehealth2014.at), which takes place in the context of the eHealth Summit Austria (http://www.ehealthsummit.at) from the 22nd to the 23rd of April 2014 in Vienna, picks up on the strained connection of a constant extension of the use of ICT in healthcare and the need to achieve benefits from it in order to make it a success. In consequence this year's theme is set to “Outcomes Research: The Benefit of Health-IT”.
Univ.-Doz. Dr. Alexander Hörbst
Dr. Dieter Hayn
Univ.-Doz. Dr. Günter Schreier
Univ.-Prof. Dr. Elske Ammenwerth
Hall in Tyrol and Graz, 9th of April 2014