Health and IT: Showing the way forward


That the health of citizens in OECD countries is improving is not in question. How sustainable healthcare systems are, however, is more of an issue. How can information technology help?

European prosperity is dependent on the health of its citizens, and there is a strong case for policymakers to stimulate investment in healthcare as a means of achieving long-term public health, social and economic objectives.

Evidence is growing that, if left unchanged, Europe’s current healthcare systems will become unsustainable over the next 15 years. The pressures we see today are set to rise as a result of ageing populations, evolving lifestyles and the changing patterns of disease. Chronic diseases are the biggest obstacle to the sustainability of many public healthcare systems. Not only are our healthcare systems ill-equipped to deal with the shift in demographics and diseases, they also face increased public scrutiny, and demand for more and better quality services.

If we continue with today’s treatment-based healthcare model, we will generate an unprecedented and formidable escalation in costs and demand. All healthcare stakeholders must act together now to develop new strategies which can drive efficiencies, improve the quality of care and address patient safety issues.

Clearly, innovation will be a fundamental requirement to address the many challenges our healthcare systems are facing. Encouraging innovation will also be key for making real progress towards more efficient systems, and we support the OECD’s work in this area.

Innovation is needed in a wide range of areas, including in the provision of health services, funding schemes, solutions and devices, as well as in the organisation and management of medical facilities. Information technology can play an important role in improving patient safety through the reduction of medical errors and in empowering the patient by giving them the ability to receive medical care remotely and to stay in their homes for longer. It can make patient records more easily accessible to professionals with the right credentials, as well as resulting in improved efficiency, for example by avoiding the duplication of examinations and in better use of healthcare professionals, considering the shortage in some specialised disciplines.

Given that clinical care needs to be disease and patient specific, we need to build an IT infrastructure in every European country for patient records, clinical decision support and disease management programmes. Such systems, when in place, must be capable of exchanging data with each other, at the very least at country level. So-called e-health applications and infrastructures have been developed and tested throughout Europe for at least a decade, although this has been done in isolation, leading to today’s interoperability challenges. In some countries, notably the Nordic countries and the UK, applications such as Picture Archiving and Communication Systems (PACS), e-prescribing, electronic patient record systems and IT-supported screening and disease management programmes, are already up and running, and achieving good results.

The OECD report “Improving health sector efficiency: the role of information and communication technologies”, recognises the incontestable benefits derived from PACS, leading to increased capacity, more effective healthcare and more satisfied consumers.

However, while the potential benefits of e-health are enormous, a number of barriers continue to hinder the introduction and proper application of IT and e-health solutions for healthcare. These barriers include a lack of political vision, fragmented governance and unsustained investment. They must be addressed to encourage a more rapid translation of innovation into patient benefits and healthcare efficiency.

In some quarters, there may be concern about the sometimes high cost of IT in the health sector; IT is seen as an investment with rather intangible benefits, and this makes it diffi cult for the corridors of power to be fully convinced. It is true that proper investment is required from the start, and that, in these tight economic times, it can be hard to make the case.

But if policymakers take a closer look, we are convinced they will agree that investment in health IT actually saves money. Good governance and internationally-recognised standards, such as DICOM (Digital Imaging and COmmunications in Medicine), are key to the success of IT investment projects, as well as to better, more effective healthcare. Users must see IT as a tool for progress, rather than an obstacle. It takes time to promote change and build trust, and to help us in this endeavour, we have developed 10 recommendations for a successful implementation of IT in healthcare :

1. Define a vision; 2. Overcome fragmentation in governance; 3. Develop innovative economic models; 4. Build trust; 5. Support citizen-patient empowerment; 6. Foster standards and interoperability; 7. Achieve legal certainty; 8. Enable market development; 9. Strengthen international position; 10. Stimulate innovation.

At the end of the day, patients and the wider public will demand more and more IT in healthcare, and policymakers must be in a position to respond to this need.

*Nicole Denjoy chairs the BIAC Task Force on Health Care Policy. BIAC is the Business and Industry Advisory Committee to the OECD. Visit

The Task Force actively supported the OECD Innovation Strategy, which was submitted to the OECD Ministerial Council Meeting in May 2010 and encourages further cross-cutting OECD work on fostering an innovationfriendly environment to address global challenges, including in the area of health.

COCIR is the European Coordination Committee of the Radiological, Electromedical and Healthcare IT Industry

©OECD Observer No 281, October 2010

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