Imperatives

Improve Quality , Safety , and Efficiency of Healthcare
With advances in medical science, there are now many more conditions that can be diagnosed and treated, involving many more procedures that are increasingly complex, and so the potential for errors and adverse effects associated with healthcare is ever-increasing. Minimizing preventable errors and accuracy of diagnosis is a top priority for our healthcare systems. Demographic and societal changes are also increasing costs of healthcare, and these costs need to be contained through a focus on efficiency and value for money. Dealing with the global recession and its impact on public sector investment in health has to be a top priority in the next few years.

Health Information
The provision of comprehensive health information is a business imperative for all the public and private healthcare providers. The European Union has taken the political leadership with its Health Information Exchange scheme. Indeed, several projects and cross-border initiatives to exchange electronic health records and information concerning electronic prescriptions are being carried out between European states and among different healthcare providers and health organizations within each state. Electronic Health Records systems are critical to an accurate and usable exchange of health information and also to laying the foundations for reducing healthcare costs over the long term.

There is also an increasing emphasis on the delivery of integrated health and social care provision, expanding to incorporate education and other government services. Information exchanges between these services will be essential.

Transparency and Accountability
Healthcare providers must become more transparent and accountable, both to enable their customers to make more informed choices and to demonstrate the quality of the healthcare being provided. Equity and consistency of service provision is a constant challenge.

Choice
There is a drive to provide patients with greater choice and better information to help them choose. A revised funding system will ensure better rewards for healthcare providers who provide responsive, accessible, and high-quality services. Individuals will have more control over the choice of treatment and, therefore, how the healthcare budget is spent. The provision of information in a format that enables performance comparison of healthcare providers and of individual practitioners will help individuals to make better choices. Patients will take more responsibility for their own health and more control over their treatment.

Business trends

There is a strong focus on quality, safety, and efficiency of healthcare provision. Safe and effective care must be delivered to patients who are treated with compassion, dignity, and respect. In this setting, health services are pushing for the development of Key Performance Indicators and the roll-out of benchmarking to support the quality agenda.

Commissioning and the ongoing development of systems to support a competitive market for the procurement of health services will challenge established suppliers to adapt to operating in such an increasingly commercial trading environment.

There is an emphasis on providing individuals with the personalized healthcare that they need—in the right place, at the right time, and by the right person. There are changes in the number and variety of care settings in which healthcare is being delivered: in homes, GP surgeries, high-street retail premises, mobile devices. Technology is viewed as a key enabler for more services to be delivered outside traditional hospital settings, bringing care to the patient rather than the patient to the care.

Service reconfiguration within specialties, such as trauma and stroke care, is being proposed as a route to improving outcomes for patients and increasing productivity and efficiency. This involves the consolidation of provider facilities or the establishment of networks through which patients can be transferred as their specialist treatment needs increase. Although the clinical and business cases for such changes may be sound, public and political opposition to the perceived loss of services present significant obstacles.

In the context of care continuity with different care providers involved in a 24- hour world of healthcare delivery, the provision of information to facilitate the delivery of healthcare is increasingly important. The increase in information flow brings with it corresponding challenges relating to access, integrity, and interpretation of information as well as information overload. Accurate Business Continuity Management will be vital to ensure continuous patient care services that are highly dependent on Electronic Health Records.

In order to comply with Data Protection Regulations that administer the intense data exchanging between the different healthcare organizations, the implementation of multiple, innovative information channels can be seen as strategic allowing patients to keep track of the location of their own private data.

It is necessary to stress the importance of securing the wireless network of the organization from unauthorized users, especially as machines and applications with wireless connections from field terminals used by doctors and other care-givers are becoming more and more popular.

‘Single Sign-On’ (SSO) simplifies access to multiple software systems for doctors, nurses, and administrative officers and limits access to individual healthcare information to the minimum level needed. Nevertheless, SSO can also weaken security if strong authentication methods are not implemented.

Interoperability is a current concern at different levels: such as systems or data. At systems level, Service-Oriented Architecture (SOA) will play an important part. At data level, semantics and language processing are playing an important role.

So, as IT becomes a necessary tool in most healthcare activities, the dependence on technical infrastructure will increase. Ensuring reliability and availability will be key as they become the basis for delivering services. Healthcare providers should be focused on their real value—healing and caring for patients, not on IT systems.

The cost of healthcare needs to be contained and, as a result, there is a strong focus on efficiency and value-for-money. Controlling healthcare expenditure through payment systems is high on the healthcare agenda, together with controversial co-payment models of financing. An efficient billing system would also give transparency of both activity and cost information and reactivity to government policy.

There is an increase in chronic disease brought on by lifestyle factors, specifically, and an aging population, generally. Strong emphasis on preventive services and promotion of healthy living habits is needed. Obesity, reducing alcoholism, treating drug addiction, reducing smoking rates, improving sexual health, and improving mental health are key priorities. It is widely agreed that people need to eat healthier food, to get more people more physically active, and to encourage companies to invest more in the health of their workforce.

The expectation on patients will be that they take more responsibility for their health as part of gaining more control over their treatment. More visibility of information will help them to make better choices that, for enlightened patients, could lead to containment of their conditions. In other words, the aim is to go from an episode-driven view of healthcare to a continuum view with equal attention to lifestyle, with the citizen at the center of the management cycle, as committed actor in the management of his or her health.

There is a trend to review European regulations in aspects such as certification of hardware and software for medical use, and national transpositions or implementations of the Data Protection Directive. The main objectives would be to identify and eliminate barriers towards flexible deployment of new healthcare services and paradigms at pan-European level, while maintaining European standards for security and privacy.

There is an increasing requirement for accurate and usable information in order to measure the quality of service provision. This information is required by managers, clinicians, and the public alike. Measures already include subjective measures such as feedback from patients on their views of the quality of services and outcomes. Again, this can be managed with IT solutions.

An increasing number of patients requiring expensive operations are traveling abroad. The EU is increasing its influence in health by increasing directives on free movement of citizens and services within the EU. This may lead to pan-European regulation and compliance.

The European Working Time Directive will have an impact on a number of aspects of the health profession. In particular, the number of hours worked by junior doctors will be limited, potentially increasing the number required by 30-40% and leading organizations to carefully consider their skill mix.

Translational medicine, connecting research directly to patient care, is of growing importance. The emphasis is on ‘bench to bedside’—removing the hurdles between research and clinical practice.

New genomic tools allow better targeting of medicines. Personal medicine accommodates individual differences in medical care, enabling evidence-based medicine and medicine that is tailored to the needs of the individual.

Climate change is not seen as a top priority for healthcare providers, but, with a greater risk of severe weather, care providers will need to ensure that this does not negatively impact the level of care they are able to provide by having clear management protocols for deployment in extreme conditions. On a shorter scale than climate change, there is a strong trend towards the integration and joint assessment of environmental and healthcare information (such as epidemics or the impact of pollution or water quality on the health status of citizens).

In the event of a pandemic, natural disaster, or terrorist atrocity, healthcare providers must be able to cope with the sudden peak of demand that is placed upon them.

Impact technologies

With an increasing focus on transparency, Business Process Management can help. It would also help to increase efficiency and reduce costs through exposing inefficient processes.

Outsourcing infrastructure, applications, and business processes can drive down costs. Healthcare providers would benefit from outsourcing and will need to evaluate where outsourcing offers the most benefit and how that benefit could be realized.

Healthcare trusts will arrange optimal medical care within restricted budgets by using Business Intelligence, predictive analytics to predict demand, and dashboards to raise awareness of potential problems before they arise.

Patient, staff, equipment and drug safety, in addition to data protection, all require Identity and Access Management with role management and information risk dashboards.

Sharing services and technology in a national system will enable a better level of technology and services whilst reducing costs. With a focus on reducing costs, Legacy Management can help the move from costly, monolithic systems to loosely coupled and, therefore, more agile systems. SOA will play its part here.

Enterprise Content Management will become increasingly important both in giving medical staff access to key patient data such as x-rays electronically and in giving patients access to more information. The key technology enabler for interaction with patients is portal technology.

Increasing amounts of data from different sources will require Master Data Management to maintain data consistency and integrity across systems. When exchanging data between providers and other parties, Metadata Management will ensure consistency of understanding. Better information can be provided in a shorter timeframe.

Medical staff will access up-to-date patient information as well as manage inventory levels for medical supplies more effectively through the use of mobile applications

Remote sensors and telemedicine will play a key part in improving remote patient care through monitoring vital signs and reacting appropriately.

Keeping track of patients and tracing drugs, the blood for transfusions, and other items will increasingly make use of RFID.

Enterprise Asset Management including remote sensors, GPS, and RFID, will play an important part in keeping track of expensive
equipment as well as extending its lifespan through pre-emptive maintenance. Innovation Management will help both healthcare organizations and healthcare technology providers maximize benefits from R&D investments and technological developments by bringing the best ideas swiftly to maturity.

Increasing the collaboration across the growing number and type of healthcare providers might benefit from new Web 2.0-type collaborative technologies, such as wikis.

All information dealing with tracking, tracing, and location (as well as Web 2.0 and Collective Intelligence) will make use of GIS systems or components.

In addition, social technologies such as social networks and blogs could be used to better inform patients wanting to take a greater role in their treatment choice. These types of technology can also facilitate increased participation, for example, through enabling patients to provide feedback on the service they receive.