By April 2020 all Swiss hospitals ought to be a part of a “stammgemeinschaft”, a regional neighborhood to supply a nationwide EHR, the so-called EPR (digital affected person file) all through Switzerland, in keeping with the Federal Digital Affected person File Act (EPDG).
A yr on, Healthcare IT Information asks Stefan Hunziker (pictured beneath), CIO on the Lucerne Cantonal Hospital (LUKS), how the EPR has developed in Switzerland and the way the hospital plans to implement it.
HITN: The LUKS is taken into account a pioneer within the Swiss healthcare system – and the EPR is a part of the Swiss digitisation technique. How is the nationwide implementation of the EPR going?
Hunziker: To chop an extended story quick: The EPR is just not but up and operating in Switzerland and we subsequently haven’t any expertise with it at LUKS. The partly controversial dialogue and the pandemic have clearly proven deficits and are giving the digital transformation within the healthcare system a powerful push. As issues stand, we assume that we’ll actually be capable to use the EPR from autumn 2021.
Nonetheless, through our hospital info system (HIS), which we have now been utilizing on the Lucerne Cantonal Hospital for 1.5 years, we have now already been exchanging knowledge with the outpatient sector for a while and have additionally been serving the affected person aspect since June 2020.
HITN: What does this HIS-based knowledge trade with the outpatient sector seem like on this twin technique?
Hunziker: On the one hand, we’re at present utilizing the referral portal from our HIS to speak with GPs and referring physicians, and thus embody the GP within the therapy workforce. With the affected person’s consent, the co-treating outpatient physician receives a complete perception into the affected person’s medical historical past and the chance to work together with the inpatient colleagues.
Alternatively, for point-to-point communication, we have now been utilizing an encrypted mail communication platform for well being professionals referred to as HIN (Well being Data Web) for many years. The diploma of use varies tremendously right here, relying on the choice of the outpatient suppliers.
HITN: How does the HIS-based knowledge trade with sufferers work?
Hunziker: We talk with sufferers through the built-in affected person portal, which is offered as a separate smartphone app or internet resolution. With the pandemic, demand has elevated massively. Each choices present the affected person with lab knowledge, discharge studies and coronavirus take a look at outcomes. That is a gigantic aid for us within the present state of affairs.
HITN: What challenges nonetheless have to be overcome with a view to make the EPR usable for Swiss hospitals in apply?
Hunziker: The regional neighborhood, which LUKS has joined, has not but been licensed. Accordingly, the EPDG is just not but in operation. The beginning has been postponed a number of instances by the legislator and has not but been decided for our area. Our connection work has been accomplished so far as doable. The discharge of the LUKS connector to the EPR remains to be pending as a part of the certification course of.
HITN: Healthcare IT Information not too long ago reported on the establishment of the ePA in Germany. There, too, the nationwide affected person file is just not but absolutely operational. What would your recommendation be primarily based in your experiences?
Hunziker: The intention needs to be to give attention to use instances that carry advantages. The processes ought to actually be digitised and never transferred 1:1 from the analogue world. Digital transformation is a serious funding and won’t work with out monetary incentives from the general public sector.
HITN: What benefits does Epic’s HIS nonetheless provide inpatient care after the roll-out has now been accomplished?
Hunziker: The platform is steady and particularly in the course of the pandemic some benefits have turned obvious. Because of the standardisation within the nursing service, we have been in a position to shortly deploy nursing workers throughout departments. We’ve an in depth overview of COVID-19 instances always and pandemic-related software program developments have been out there to us from Epic in a well timed method.
We use the affected person portal for the transmission of outcomes of the coronavirus assessments and for vaccination planning for sufferers and workers. We at present have over 50,000 lively portal customers. We additionally use the platform for residence monitoring, e.g. for monitoring oxygen saturation in coronavirus-positive aged sufferers or for dietary management of overweight sufferers. After all, there’s nonetheless loads of optimisation work to be accomplished within the aftermath of the launch. We additionally attempt for additional standardisation and in addition structured knowledge trade.
HITN: Are there some other experiences with the Epic HIS resolution that you just’d prefer to share?
Hunziker: We use an built-in platform centred on the affected person. We give attention to interdisciplinary and interprofessional cooperation in particular person affected person care. As well as, we have now real-time info at system stage for planning, monitoring and useful resource administration in addition to knowledge to assist high quality administration.
At LUKS, we feature out two upgrades a yr with improvements and now have interoperability instruments at hand within the Epic toolset. For instance, we’re independently in a position to present the COVID-19 vaccination knowledge required by the regulator to nationwide registries.
HITN: What do you hope for from the EPR sooner or later?
Hunziker: For the time being, we do ship the info to the EPR. Nonetheless, the end-user solely notices this to a restricted extent. The important thing query is: What’s related to therapy? What ought to we ship and what from the EPR is related for us as a hospital? This can be a huge debate in Switzerland, particularly because the knowledge is at present nonetheless delivered unstructured in paperwork. At LUKS, we’re striving for a structured knowledge trade and can focus totally on the vaccination file and drugs as the primary use instances.
Healthcare IT Information is a HIMSS Media publication.