The University Hospital of Zurich (UHZ) isn’t waiting for digitisation, it is driving it. This isn’t only for economic reasons, says Martin Matter, ICT director and member of hospital management.
Text: Roger Welti, Images: © Giorgia Müller, 21. August 2017
The «Digitisation of the health sector» is currently a hot topic. What’s it like being at the forefront of this transformation?
In comparison to other sectors, such as banking and industry, this transformation is only occurring with a few years’ delay in the health sector. This means it is currently proceeding with the corresponding dynamism. However, using IT to optimise hospital processes is nothing new. We’ve been doing this since we’ve had IT at the hospital.
Why do hospitals have more experience with this than other players in the health sector?
For a start, the potential we have is greater than average. At the hospital, we maintain round-the-clock operations for 365 days a year and with maximum availability. This means that there are an enormous number of processes that are also being performed without interruption. The potential to keep questioning these procedures and continue improving them is correspondingly large.
«In the hospital, there are an enormous number of processes that are also being performed without interruption. The potential to continue improving them is correspondingly large.» (Martin Matter)
In order to save costs?
That is the second aspect. As a hospital, we need to operate between our obligation to provide services, and the list of tariffs defined for these services. We have correspondingly little room to influence the profits we make. Increasing the efficiency of our processes is just about the only leverage we have. And we exploit it too.
Has the federal law on electronic patient records (EPDG), which has been in force since last spring, been a catalyst for these efforts?
Yes, it certainly has. In the past, we concentrated on optimising our processes within the hospital. We're now dealing with a whole different dimension, and that’s why we’ve built up better networks between service providers and have now standardised, and thereby simplified, work processes.
The UHZ is one of the hospitals leading the way in shaping the establishment of the largest eHealth platform in Switzerland. Under the umbrella of the Axsana trustees and together with Swisscom Health, the cantons of Zurich and Bern are setting up a networking platform to allow use of electronic patient records and to structure data communication between service providers efficiently. The UHZ has been involved in this ground-breaking national eHealth project since the very beginning.
«Increasing the efficiency of our processes is just about the only leverage we have. And we exploit it too.»
Are you confident that this effect will bear fruit?
We are pursuing this vision with all our energy. However, no-one can currently say how quickly the desired effects will materialise. What is clear: Increases in efficiency must result in additional costs. The start-up funds totalling CHF 30 million provided by the federal government are unlikely to be sufficient. How further financing will proceed is currently being examined in different projects.
«In order for EPD to be successful, it is essential that patients’ experiences convince them of the benefits of eHealth in their everyday lives.» (Martin Matter)
The UHZ is actively working on the implementation of the EPDG despite this uncertainty. Why is it taking on this role?
With 44 clinics and institutes, we are the largest hospital in the Zurich canton. In 2016, we treated approximately 41,000 inpatients and counted more than 570,000 outpatient visits. If we exploit the potential for optimising administrative processes, this will have corresponding large effects. We intend to benefit from this as quickly as possible. That’s why it was immediately clear to hospital management that we shouldn’t wait until the EPDG has been implemented, and instead should lead the way.
What, specifically, are you promising?
We want to work together with other service providers to break down administrative barriers, which will allows us to make better use of UHZ capacity. Today we have bilateral agreements with all partners, for example. In the future, we will be able to structure administrative cooperation in an association comprised of all Swiss service providers. This will make us faster and will increase efficiency.
Could you provide an example?
Let’s take the discharge of a patient to a rehabilitation clinic. In future, we’ll be able to see at a glance the clinics in which an appropriate placement is available for this patient; we’ll be able to transfer him or her there quickly and in a straightforward manner. This helps us, the rehabilitation clinic and, of course, the patient as well.
Which other ways will the optimisations achieved by eHealth be tangible for patients at the hospital on an everyday basis?
In order for EPD to be successful, it is essential that patients’ experiences convince them of the benefits of eHealth in their everyday lives. This goes beyond the EPD, and is relevant for the hospital’s administrative processes in particular. The patient won’t have to provide basic data every time they go to a hospital, won’t have to wait as long, and will be better informed and better entertained when doing so. We are even considering showing how to get to where they will be treated on our premises by means of their smartphone.
«I think that a 10-year timeline is realistic. At the UHZ we’re likely to have introduced many compelling applications a lot earlier.»
So smart applications should convince patients of the benefits of eHealth?
Exactly. If we don’t succeed in doing so, then we will simply have two systems instead of one. We will tend to find that younger people will be inspired by eHealth, and others who will continue communicating with their doctor and hospital using analogue channels, as they did in the past. That would be very inefficient, and expensive.
Martin Matter, CIO University Hospital of Zurich
And how have the efforts to convince the hospital staff gone?
We are also working on this at the UHZ. We have a special process team that we’re sending around the entire hospital. The group analyses the current processes with teams and individual employees, and suggests optimisations that are now possible thanks to the innovative use of IT. Sometimes employees are a bit sceptical to begin with. However, once they experience how much easier it makes things, they are soon enthusiastic about it. We have, for example, standardised the schedule used to allocate patients to doctors and treatment rooms across all of our 44 clinics for the first time. This makes our daily work noticeably easier in one go.
When will patients and employees be able to experience the full potential of eHealth at the hospital, and be able to use it?
I think that a 10-year timeline is realistic. At the UHZ we’re likely to have introduced many compelling applications a lot earlier. However, it will take some time and persuasion before eHealth prevails throughout the health sector and before patients fully get on the bandwagon. Personally, I find it extremely exciting to experience and help shape this process. And I am fully convinced that the effort will pay off.
Martin Matter has been the Director of ICT and a member of the UHZ hospital management board since 2014. Matter, who holds a degree in business economics, was responsible for ICT-related topics at Oerlikon Contraves and Sulzer Metco. He then worked for the canton of Aargau, most recently spending five years as the head of IT for Aargau. AT the UHZ, Matter and his team are continuing to develop the hospital’s information technology to ensure that it contributes to the safety and quality of diagnosis and treatment of patients.
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