gms | German Medical Science

62. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V. (GMDS)

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie

17.09. - 21.09.2017, Oldenburg

A prospective longitudinal study of the implementation of the Swiss electronic patient dossier – experts’ assessment at baseline

Meeting Abstract

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  • Laura Naumann - Hochschule Osnabrück - University of Applied Sciences, Osnabrück, Deutschland
  • Ursula Hübner - Hochschule Osnabrück - University of Applied Sciences, Osnabrück, Deutschland
  • Birgit Babitsch - Universität Osnabrück - Human Sciences - New Public Health, Osnabrück, Deutschland

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie. 62. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e.V. (GMDS). Oldenburg, 17.-21.09.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocAbstr. 227

doi: 10.3205/17gmds100, urn:nbn:de:0183-17gmds1003

Veröffentlicht: 29. August 2017

© 2017 Naumann et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Background: In Switzerland, the national law about the electronic patient dossier (elektronisches Patientendossiergesetz, EPDG) is taking effect from April 2017 on [1]. The electronic patient dossier (EPD) is a nationwide virtual record that should store patient data in a decentralized manner to be used for patient care [2] . The intention of the law is to improve quality of care, clinical pathways, and patient safety to increase the systems´ efficiency and to promote patients´ competencies [2]. Due to the complex nature of building nationwide electronic health records, barriers and facilitators have to be investigated [3] and longitudinal measurements have to be implemented to reveal the actual changes over time [4]. Challenges due to the Swiss federal system and due to multilingualism make Switzerland an interesting case study.

Aim of the study: This study intends to track the short- and mid-term effects of the EPDG using a longitudinal and prospective research design and qualitative methods. The effects should be appraised by a series of Swiss stakeholders, who should report about their subjective views on (potential) barriers, facilitators and ongoing developments of the EPD. This part of the study is embedded in a more comprehensive project to study country specific forces on national eHealth developments in various nations and over time.

Proposed methods: The status prior to EPD implementation is covered in this part of the study. Thus, the collected data serves as a baseline for Switzerland. 52 potential experts were identified in a snow ball system, 19 agreed to participate. The expert sample covered a broad range of the field: healthcare providers from different settings (5), experts affiliated with healthcare policy (4) and privacy (1), interest groups (5), IT-vendors (3) as well as academia (1) were represented. They came from all major regions of Switzerland covering the German (15), the French (3) and the Italian (1) speaking parts of the country. The expert interviews were conducted via telephone and with the help of a standardized guideline, consisting of open-ended questions. On average, the interviews took 40 minutes.

Points for discussion: A comprehensive list of possible barriers and facilitators could be identified in an initial analysis: over 60 different topics emerged from the interviews. Federalism was regarded as the most obvious barrier. Additionally, the role of the physicians and unclear reimbursement rules were mentioned as potential obstacles. The interviewees expected a positive impact of patients on the EPD developments and stressed the role of IT industry. The experts’ views varied on certain topics, such as the influence of the hospitals and reactions from the citizens. The EPD act itself was viewed positively because it would bring about legal clarity and should be the starting point for building a nationwide interoperable system. Studies from other countries indicate that undertakings like the EPD can cause extremely diverse attitudes among key stakeholders and that these reactions might change over time [5]. Therefore, the interviews will be repeated within the next three years and contrasted to findings from Austria, Finland, Germany and the UK.

Acknowledgements:

This study is funded by Lower Saxony Germany (grant: ZN 3062).

Die Autoren geben an, dass kein Interessenkonflikt besteht.


References

1.
Eidgenössisches Departement des Innern, Hrsg. Verordnung des EDI über das elektronische Patientendossier (EPDV-EDI). 22.03.2017 [accessed 12. April 2017]. https://www.admin.ch/opc/de/classified-compilation/20163256/201704150000/816.11.pdf Externer Link
2.
Bundesversammlung der Schweizerischen Eidgenossenschaft, Hrsg. Bundesgesetz über das elektronische Patientendossier (EPDG). 19.06.2015. https://www.admin.ch/opc/de/classified-compilation/20111795/201704150000/816.1.pdf [accessed 12. April 2017]. Externer Link
3.
Cucciniello M, Lapsley I, Nasi G, Pagliari C. Understanding key factors affecting electronic medical record implementation: a sociotechnical approach. BMC Health Serv Res. 2015 Jul 17;15:268. DOI: 10.1186/s12913-015-0928-7 Externer Link
4.
Roberts MJ, Hsiao W, Berman P, Reich MR. Getting Health Reform Right. A Guide to Improving Performance and Equity. Oxford University Press; 2008. ISBN 978-0195371505.
5.
Akhlaq A, Sheikh A, Pagliari C. Health Information Exchange as a Complex and Adaptive Construct: Scoping Review. J Innov Health Inform. 2017 Jan 25;23(4):889. DOI: 10.14236/jhi.v23i4.889 Externer Link