SAS Institute: Standards improve efficiency in the health service
"New standards help to solve tomorrow's challenges in the health sector," claims SAS Institute Nordic's Inge Krogstad, who has a doctorate in operations analysis.
Mr. Krogstad is working on future IT challenges in the health sector at the world's largest private IT company. He has been a member of the Board of Standard Norge for many years and is familiar with standardisation from the supplier's perspective.
He believes that standardisation is decisive for achieving the targets set in the Cooperation Reform. This Reform was adopted by the Storting (the Norwegian Parliament) for gradual implementation with effect from 2012 and it basically means that patients shall be provided with health care as close as possible to home. The Municipal Health Service will take over a lot of the work of the Specialist Health Service, something which requires closer inter-municipal cooperation, and the Specialist Health Service will become even more specialised.
"In seven years time there could be a requirement for a further 100,000 employees in the health sector. Access to qualified personnel is the most important problem that needs to be solved. Everything else is simply a matter of details. However, we need to realise that employing so many people is not very realistic. This is why we need to think innovatively. The health service needs to be made more efficient by making use of standardising and automation, without such having a detrimental effect on quality," claims Inge Krogstad. He envisages standards being introduced on three different levels: semantic, technical and organisational.
Computers talking to each other
Semantic interoperability involves computers «talking to each other» in a secure manner. Their users share information and knowledge through electronic interactions, without being dependent on having to interpret the meaning of the data exchanged. This is the basic nature of automation.
"At the same time the «Internet of Things» is a technological quantum leap. Computers will collect big data about equipment, samples and patients. In this way hospital personnel can obtain full details about real requirements. For example, hospital beds and patients will be identified by using computer chips. Bed capacity could probably be reduced because hospital personnel will obtain details about available beds and where they are located, as well as what stage patients have reached in their treatment. This can help to improve patient flow. Hospitals are currently allocated resources on the basis of the maximum use pattern, while the real need for beds is probably not at great," says Mr. Krogstad.
He believes that the «Internet of Things» can help hospitals to make savings in terms of both working hours and jobs and that patient security will be improved. At the same time big data is paving the way for fundamental questions about data protection.
Mr. Krogstad also thinks that robots will take over practical functions to an increasing extent. Robots are currently already moving linen at Akershus University Hospital. Robots are able to free up resources in respect of packing and prescribing medicines, cleaning, lifting and moving things, so health care workers are getting more time for their patients.
New standards are the key to modernisation and they will contribute towards resolving the future lack of qualified personnel in the health sector.
"In the future patients will be able to participate more in their own treatment and receive tailored medication. They will obtain knowledge about their own conditions from the Internet and «health apps». This involves exciting standardisation challenges, not least in respect of maintaining patient security and the quality of treatment," says Mr. Krogstad. "Doctors will undoubtedly experience that they are gradually starting to act in a more advisory capacity as patients express a desire to sit in the driving seat themselves. The measurement of one's own symptoms will probably play a greater role in future diagnostics. This is a textbook example of the need for semantic, technical and organisational standardisation.
Organisational changes and the coordination of working processes between the municipalities and the Specialist Health Service are conditional on having common standards. The municipalities and health enterprises, etc. currently have different payment systems. Something which works well for one party is not necessary an optimum solution for another. For example, results-based funding can lead to over-treatment and hospitals placing priority on the most profitable patients.
"In our experience, IT support is based on standardisation and the analysis of medical coding will provide a positive contribution in such a context. The incentives for prevention and early treatment, i.e. good coordination between the municipalities and the Specialist Health Service, must be improved. It will be possible to avoid treatment injuries to a greater extent. The health sector of the future will not be an economic loss project," says Mr. Krogstad and adds: "The solution is common standards. We know that modernisation of the health sector will be a demanding task since placing focus on standardisation is almost regarded as being tantamount to dynamite.
- ISO/TC 215 Health Informatics consists of seven working groups. They are working on standards information structure and exchange, semantic content, security, etc.
- CEN/TC 251 Health Informatics: has four working groups on security, interoperability, information modelling and knowledge terminology.
Text: Siv Ellen Omland, Empower Communication
Photo: Nicolas Tourrenc