Swiss hospitals have done their homework: 95 percent are now connected to the electronic patient dossier (EPD). In recent years, they have made significant financial, technical, and personnel investments for this purpose.
However, the cost study now published by the Federal Office of Public Health (BAG) also shows that the benefits in everyday care remain limited. Only about a fifth of the hospitals actively use the EPD. At the same time, too few citizens open and use an EPD. The fundamental problem is that while hospitals are obligated to connect, this requirement does not apply to outpatient service providers. As a result, many treatment-relevant information remains outside the EPD, and its utility in daily care is inevitably limited.
Deep integration into hospitals' systems is only worthwhile if relevant and up-to-date information is available along the entire treatment chain. As long as this is not the case and citizens make little use of the EPD, it cannot create a noticeable added value in daily care.
High effort - now there needs to be an impact
According to the study, the connection to the EPD caused median costs of CHF 1,177 per bed with a portal solution and CHF 2,318 per bed with a deep integration. For a central hospital like the LUKS Group with around 840 beds, this equates to one-time costs of around CHF 1.0 million or CHF 1.95 million. For a regional hospital with around 170 beds, costs of around CHF 0.2 million or CHF 0.4 million arise. In addition, there are annual operating costs with a portal solution: In large hospitals, these are in the median at CHF 505 per bed; for 840 beds, this amounts to around CHF 0.42 million per year, for 170 beds around CHF 86,000.
"The hospitals have done their part and invested in the digital infrastructure. Now these investments must also have an impact in everyday care," says Anne- Geneviève Bütikofer, Director of H+ Ihre Spitäler. "We need applications that quickly and securely make treatment-relevant information available, avoid duplications, and specifically relieve the personnel."
Drive national standards and concrete applications forward now
The new electronic health dossier alone does not yet create added value for care. It is crucial that national standards are now introduced step by step and in a coordinated manner along the entire care chain. The focus is on concrete use cases such as e-medication and e-prescription. They must be directly integrated into the service providers' systems, simplify the exchange of information, and function in everyday treatment.
Further investments should therefore not simply flow into structures whose replacement is already foreseeable. The available resources should be specifically directed into interoperable applications and standards that improve quality, patient safety, and efficiency. To exchange information between service providers, practical solutions are needed outside of the EPD or E-GD.
Only if such applications are already widely and bindingly implemented before the start of the E-GD will relevant and up-to-date health information be available to citizens there. National standards, clear funding, and the binding involvement of all service providers are essential for this.