We are way behind. When it comes to embracing technology, health systems lag financial services by decades. Banks spend around one tenth of their money on ICT while health systems spend next to nothing.
Ireland trails behind most other OECD countries in terms of investing in healthcare ICT; 0.85 per cent of total healthcare spending compared to an EU range of two to three per cent.
But it need not always be thus. It may sound far-fetched but Ireland can lead the world in eHealth.
We just need to find the right formula to make it happen, as we did when we built a financial services industry from the ashes of Dublin’s desolate docklands. Or when Irish officials and politicians toured the world touting Ireland as a Mecca for pharmaceuticals, data centres and social networking giants.
Growth & jobs
The eHealth Strategy for Ireland published late last year set out the potential of eHealth to reform Ireland’s ailing health services. Technology can deliver efficiencies while making services more accessible, safer and better.
The barriers to progress are also well explained: We didn’t spend enough in the past, we don’t have much to spend now; we have far too few healthcare IT professionals employed in the sector and (thanks in part to recruitment limits and the need to shed or reskill administrative staff) rectifying this is an industrial relations minefield.
However, none of this will help to make eHealth work for Ireland.
Arguing that it will improve transparency or better integrate primary and tertiary care has yielded only slow progress to date. For politicians and the public, those arguments are yawn-inducing.
We have to think outside health and baldly borrow the political rhetoric of the day.
eHealth needs to be plugged into the coalition’s central narrative if it is to gain traction at Cabinet and win the kind of whole-of-government support required for action.
All policies must serve the “Growth & Jobs” mantra. That’s just the way it is at the moment. Patient empowerment and continuity of care do not cut it.
The Departments of Finance and Enterprise need to be reminded that the global telemedicine market was worth $9.8 billion in 2010 and $11.6 billion in 2011, and is forecast to grow by an annual average of 18.6 per cent, reaching $27.3 billion in 2016.
The only thing these departments care more about than finding expenditure efficiencies is generating economic growth. Know your audience.
Business case
The eHealth Strategy makes some excellent points about the potential for eHealth to create jobs for indigenous start-ups and to attract or retain the kinds of global companies that have continued to invest here.
But these arguments should be stronger and stressed from the start. Instead they are the 11th point in an 11-point list of eHealth benefits.
The document speaks of the potential for creating new systems, technologies and skills that are exportable. This is exactly what the Government wants to do and what Enterprise Ireland is working towards every day.
Our high-tech companies should be the ones thought of in Singapore, Dubai or Slovenia when eHealth is discussed. This requires branding to ensure that Ireland means health IT. And branding, we can do – as long as the product we’re selling (Ireland as an e-health hub) is ready for consumption.
eHealth ecosystem
It may sound contradictory but despite playing catch-up, we start with a series of advantages over competitors.
Companies like Google and Microsoft are already active in eHealth, and the big medicines and medtech companies have a major interest in making this work too. Cloud computing will be an important enabler of eHealth (here and abroad) and the cooperation of everyone from Pfizer to Cook Medical and IBM to Intel is required to make health IT work.
All of these companies are already here. If (ironically) teleconferencing is not good enough, the Government could get senior people from just about every company that matters into a hotel room off the M50 in two hours.
We need to ask them how they would design a smarter digital health service. And we need to let them try to do it. Perhaps a third day could be added to next year’s Web Summit to create a platform for developing Ireland as an eHealth hub. Implicate them in solving the problem and see if they have any more luck than those who have tried in the past.
Pitching Ireland
The Chief Information Officer, to be recruited by the HSE, should lead this group and be willing not just to oversee tenders for new IT systems or to launch training schemes for staff, but to bat for Ireland internationally. They should be an eHealth advocate rather than an operative – and a shameless salesperson for the country’s rebooted digitally-enabled health service.
Of course, the HSE and Enterprise Ireland have major roles to play in weaving together health and business policy. But if we want big hitters with a record of making things happen then we should turn to the Industrial Development Authority.
We need the IDA to pitch Ireland as an eHealth Hub. We have the IT companies, the blue-chip pharmaceutical companies, and leading medical devices firms big and small. We have the tech-savvy English-speaking graduates, the modern-but-cheap office space, and a critical mass of entrepreneurs and investors.
The weakest part of our eHealth pitch is the health system itself. Best not to dwell on the reform-resistant, resource-starved services and instead sell it as virgin territory.
Ireland can attract more health ICT firms here with same mix of incentives that appeal to multinationals in other related sectors. It can become a pilot site – an island of excellence, if you will – for the latest in eHealth.
Late-bloomer
True we are not as advanced as the likes of Denmark and Canada. But by becoming a testing site for new ideas we could leapfrog the early movers to become leaders instead of followers.
Being slow to the party has its advantages. At a national level there is no real legacy infrastructure to be dismantled or incorporated into a state-of-the-art system. Ireland can learn from the mistakes of the first movers and jump ahead to the leading edge of where technology is now – there’s no need to trudge down the same path taken by others.
It is similar to how some African countries have skipped several steps in the evolution of telecommunications. Not for them the expensive, exclusive and one-dimensional landline networks.
No, they see no need to install phone cables in every home when a decent GSM phone network allows wireless access to anyone with a cheap mobile handset. This serves not just to catch up with frontrunners, it opens the way for innovations that leading Europe countries have been slow to recognise.
Mobile phones are used to bring basic health services to people in remote areas who would otherwise not have access to professional advice.
And health is way behind banking. Today, 60 per cent of Kenyans make payments using their mobile, with the technology more popular in rural areas (where banks are fewer) than in cities. Irish banks are just beginning to promote mobile banking.
The point is that those who are behind today need not be behind forever.
The arguments for eHealth are good but unless they are framed in a way that mobilises the most efficient arms of government we will miss an opportunity to create a virtuous circle of growth and health reform.
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Autor(en)/Author(s): Gary Finnegan
Quelle/Source: Irish Medical News, 07.02.2014
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