The Covid-19 pandemic has taught us all a lot and changed our everyday lives profoundly. We had to keep our distance, wear a face mask and had to provide 3-G evidence before entering a restaurant (fully vaccinated or recovered or PCR tested). In order to avoid unnecessary visits to the authorities and thus contacts, governments desperately needed to digitize the healthcare system. In the case of Europe and Austria, the flagship of digital coronavirus management is the Green Pass.
As a result of this crisis, the governments have significantly brought forward digitization in the healthcare sector. Nevertheless, there is vast room for further improvement - apps and wearables, for example, offer many opportunities. In this blog post you can find out what steps we need to take, why Estonia is a pioneer in e-health and what the EU can do.
What is the situation in Austria?
At least since the start of the Covid-19 pandemic, many Austrians are familiar with the electronic health record (ELGA). It represents the national basis of the e-health infrastructure and allows patients to access discharge letters, laboratory results and medication data. The data is stored in the electronic health record by healthcare providers, with the database focusing on documents from the inpatient sector and mobile and inpatient care facilities. To access ELGA, you need either a citizen card or a mobile phone signature.
In 2021, ELGA was expanded by adding the function of the e-vaccination certificate for recording coronavirus vaccinations. As a result, vaccinations against Covid-19 are recorded centrally. Vaccination certificates can then be easily downloaded from the portal using a QR code.
Another central point of contact for Austrians in regard to Covid-19 is the telephone health advice line “1450”. This hotline provides advice, answers to health-related questions and ensures that you are forwarded to the right service provider in the healthcare sector. You can even arrange a vaccination appointment simply and easily using this phone number.
Where do we have to catch up?
After clarifying the status quo in the digital healthcare landscape, an important question that needs to be answered is “where is still room for improvement?” According to an analysis by the Bertelsmann foundation, the greatest potential for Austria lies in the increased use of health data. In addition, efforts should be aimed towards the following areas:
- Clear strategic orientation
Here, the Ministry of Social Affairs, Health, Care and Consumer Protection must be obliged to publish a standardized and superior e-health strategy, so that a clear structure is created. - Usability of existing data for provisioning and research
A disadvantage of ELGA is that the uploaded information cannot be structured and processed automatically - especially for secondary use in research, only e-medication is currently included. - Integration of other data sources in a comprehensive platform
In an ideal platform, the patient’s path through the entire healthcare system is mapped and it is constantly further developed by integrating new potential and technologies. However, this case doesn’t exist yet. Outdated structures, such as handwritten documentation and different system solutions, are obstacles in the long run and make comprehensive use more difficult. There is also support for integrating non-medical areas such as dietology or physiotherapy into the e-health systems.
Estonia as a pioneer: What’s happening there?
Before we focus more closely on Austria, let’s take a look at Estonia. The Baltic state is the number 1 according to the Digital Health Index (status of the digitization of the healthcare system). In comparison: Austria ranks 11th in these statistics. The Estonian Central Health Information System and Patient Portal, EHIS, offers users three key advantages:
- In Estonia, all patients have access to personal information about treatments.
- Electronic prescriptions connect general practitioners, insurance companies, patients and pharmacists.
- Patients have protected access to diagnostic images.
It’s important that EHIS doesn’t represent a centralized database, but rather integrates independent software systems. All information is uploaded directly to the platform by healthcare institutions and digitally signed for verification. System security and data protection are very important.
All EHIS functions are based on central processes of the healthcare system, such as health records, prescriptions, referrals, or laboratory diagnoses. As a result, this also makes everyday life easier for health professionals, because data regarding examinations or medications can be accessed quickly.
Conclusion
Digitization is progressing steadily in all areas. So why stop at our healthcare system? Countries like Estonia have already demonstrated the benefits of a modern approach in the healthcare sector. Although Austria has been able to improve its infrastructure, we are far from having reached our potential in this respect.
For example, there is no standardized system for the whole country. Many measures are taken by the federal states on their own, which can result in parallel structures. In order for us to achieve this goal, however, there are still many steps to be taken, from data protection issues to the provision of a legal framework. The key to success is that we create an infrastructure that integrates stakeholders from federal government, states, science, social security, doctors, industry and patients and involves them equally in the creation process.
The EU may soon provide a ray of hope. The foundation for the future is to be laid in a European health data space.1)
Autorin:
Ayleen Cis
ayleen.cis@bdo.at
+43 5 70 375 - 1685
1) See De Keersmaecker, European Health Union: A European Health Data Space for people and science https://ec.europa.eu/commission/presscorner/detail/en/ip_22_2711 (accessed on May 6, 2022).
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