Only about 20 to 25% of medical practices in Switzerland document electronically today. But thanks to user-friendly and cost-effective e-health cloud solutions, that could soon change.
Computerized medical practices have been around since the 1990s. For those that have switched to “electronic,” physicians and their teams have since been grappling with ever-expanding programs and constantly updating computer power. Because the older a system is, the less security it offers and the slower it works. No sooner has the upgrade been completed than the latest software demands another costly update…
In the Swiss healthcare system, millions of francs could be saved through improved data exchange. The federal government’s e-health strategy calls for an electronic patient record for every resident by 2015. To date, however, only one in four medical practices in Switzerland documents electronically, mainly because of the feared costs of introducing and maintaining practice-compliant information technology. That could now change soon. Thanks to cloud computing, e-health is becoming affordable for medical practices and even offers potential savings.
IT resources as needed
Cloud computing is a type of IT outsourcing. The idea of cloud computing is based, among other things, on the fact that not everyone has to build and maintain their own infrastructure. Instead of storing patient data with its own software on its own servers, the medical practice obtains applications, computing and storage capacity from the so-called “cloud” via the Internet. This outsourced IT infrastructure can be used at any time as needed.
The cloud is like a subscription that the user pays for. Analysts agree that the incipient paradigm shift from client/server to cloud computing is as significant as the shift from mainframe computers to client/server systems in the 1990s. According to an estimate by management consultants Roland Berger, global cloud computing revenue will triple to $73 billion by 2015.
In the healthcare market, cloud computing is attractive to players for several reasons. IT resources can be adapted to changing situations at short notice. In the healthcare sector in particular, needs and organizational structures are changing rapidly. Cloud computing promises cost advantages in adapting to these changes and thus meets the demands for cost reduction. Instead of having to purchase, operate, maintain and bear the costs of a specific hardware and software environment themselves, customers pay an amount based on their actual needs. Cloud service providers make their resources available to as many users as possible, thereby achieving optimal utilization. This in turn enables them to realize cost reductions, which in turn allows more cost-effective offers to customers.
Another advantage of cloud-based solutions: they are basically accessible from anywhere. This is an increasingly important consideration for physicians in particular. Data is increasingly being captured and processed on mobile devices such as smartphones, tablet computers, etc.
Public clouds are no-goes
In her exposé “Health Data in the Cloud,” however, attorney Ursula Widmer, of the law firm “Dr. Widmer & Partner” in Bern, urges caution with regard to secrecy and security: “Doctors are also bound by medical secrecy in matters of online activities and outsourcing of data: Swiss Penal Code (StGB) of December 21, 1937, SR 311, Art. 321. According to the Federal Law on Data Protection (DSG) of June 19, 1992, Art. 35, all persons are liable to prosecution who intentionally disclose without authorization secret personal data or personality profiles requiring special protection, of which they have obtained knowledge in the course of their work. Health data is particularly sensitive personal data that falls within the scope of the provision.”
Medical practices that work with a cloud provider must make sure that security risks are completely eliminated, explains Dr. Adrian Spalka, a private lecturer in information systems security at the University of Bonn, in the German newspaper Ärzte Zeitung. Spalka has been working on the subject for years and is considered an expert in his field. He, too, emphasizes, “Physicians who use cloud services and outsource data are not only bound by strict data protection rules, but also face criminal liability if patient data falls into the wrong hands.”
Public clouds, such as those offered by Google, Microsoft or IBM, are out of the question for medical practices for security reasons. With these services, the physician has no control over storage location and storage personnel or attacks by hackers. If the servers are located on U.S. soil, the data could even fall under the U.S. Patriot Act and thus be accessible.
Secure cloud solution for primary care physicians
“Security is one of the very most important issues,” Michael Ziegler, managing director of H-NET in Zurich, tells HAUSARZT PRAXIS. “From our point of view, this is also the reason why e-cloud solutions for physicians have not been introduced earlier. With our “E-Medicus” solution, we have a level of security that even exceeds that of Internet banking.”
The authorization is bi-directional. The Health Professional Card of the FMH with certificate is recorded by a card reader or installed once on the PC. Then the doctor, or the personnel authorized for certain specialist areas or roles, would still have to enter a personal PIN. The entire high-security hosting runs in a Swiss data center, which is also bank-certified. Access is via a hardened browser from H-Net. This “Secure” browser creates a security-optimized part on the Internet. Interest among physicians is high, and his company has gained 80 new customers in the past year, says Ziegler.
H-NET is working with E-Medicus GmbH in Basel, which was the first provider in Switzerland to develop a web-based solution for medical practices in cooperation with physicians and with the support of experts from the Swiss healthcare sector. Their Medical Director, Dr. med. Yves Nordmann, explains: “The products of E-Medicus – for example E-General for general practitioners – are characterized by their intuitive usability in addition to their unrivaled price-performance ratio. Neither for physicians, nor for MPAs are trainings necessary.”
The E-Medicus products are compatible with Windows, Mac and Linux and are also available as tablet versions. The offer is also particularly suitable for group practices and physician networks. Among other things, E-Medicus offers:
- Patient registration with daily updated master data
- Consultation documentation with automated medication interaction checks and electronic prescriptions
- a web-based agenda
- automated laboratory connection
- electronic data exchange
- automatic and free backups
- Updates and high-security hosting
Experts speak of 70% in savings that can be achieved with the cloud.
Cloud systems on the rise
“According to the eHealth strategy of the federal government and the cantons, practice systems should participate in the virtual IHE dossier. E-Medicus is ready for this with the connection to the Affinity Domain H-Net AG/Swiss Medical Suite and fully supports the federal strategy”, Dr. Nordmann sums up.
One of the first physicians who have been working with E-Medicus for two years is Adrian Merz, MD, from Riehen BS. He explains to HAUSARZT PRAXIS: “I was looking for a simple, flexible practice software adapted to my needs as a pediatrician. For this, E-Medicus does not require expensive hardware, it is maintenance-free and relatively inexpensive. The software is simply structured and you can access the whole practice from any computer with a secure internet connection. The support from the vendor is also sensationally good.”
Will doctors in the future no longer have their computers physically located in their practices, but share the computing power of a larger computer with others via the Internet without anyone noticing? Experts are certain of this, provided cloud systems are multi-tenant and it is ensured that multiple users can work on them without being able to view each other’s data.
Peter Leuenberger, Dipl. Computer scientist at XWare GmbH, Sursee LU, provides neutral IT consulting for physicians on behalf of the FMH: “That 70% of IT costs can be saved with cloud solutions seems a bit exaggerated to me. But IT costs can indeed be reduced, depending on the requirements of the physician. Certainly, cloud solutions or IT infrastructure outsourcing are also on the rise for the medical profession.”
Jörg Weber
