What is the crucial success factor for a national health network?
Prof. Rudi Van de Velde, Director of Information systems UZ Brussels
Technological innovation at local, regional or federal level is much more of a people challenge than an ICT challenge. If all of the players do not join forces around the patient instead of each acting separately the chances of technical projects like eHealth succeeding are low.
Every healthcare system battles three problems: keeping costs under control, improving quality and organising appropriate access. In the healthcare sector, these three challenges create genuine headaches for all governments across the world. Electronic patient files can offer a solution because they build on interoperability, which means that they also reduce costs.
The value of a network increases exponentially as more people use it. The efforts required to make an eHealth solution interoperable are really high and can barely be justified at present because there are so few users.
There are many eHealth programmes around the world, from clinical information systems to disease monitoring solutions, but they all risk getting bogged down through a lack of integration. Without coordination, they are information silos that will proliferate in isolation until they quickly reach a point where a lack of compatible standards, large legacy databases and user habits makes them inefficient.
A unique opportunity arises today to promote essential cooperation between all of the interested initiatives. Reed’s law, which in particular explains the success of Google or Ebay, asserts that as soon as people assign value to an (essentially social) network, whether this is through active participation or via evaluation, the value of this network increases exponentially. Even small peer-to-peer groups can therefore have a major non-linear effect on use of this network. Payment terminals and email are examples of particularly flourishing interoperable networks.
The creation of a national hub fed by data from different hospitals and regional health networks is subject to three essential conditions. Firstly, there can be no eHealth without the EPF (electronic patient file). Secondly, a high-performance infrastructure and network are absolutely essential. Thirdly, a certain number of basic services such as access management must be provided. But eHealth is much more of a human challenge than an IT challenge. Doctors, patients, ICT providers and policymakers, all of the stakeholders, must be convinced they should become involved. The project can only succeed if this is the case.
