Patients will have a central role

Government are recognising that healthcare is one of the last paper-based sectors of the economy. It has been estimated that, quite apart from the costs involved, this leads to then of thousands of deaths each year.

There is no doubt that a fully integrated computerised e-health system will bring with it its own challenges, and will undoubtedly on occasions also deliver its share of problems. But, as has been the case with all other sectors of society and the economy, integrated computerisation in this sector will improve the situation. While many healthcare sectors have their own computerised systems they are mostly not integrated with other systems operating in the sector. This leads to a mainly paper-based system operating between these incompatible structures. Furthermore, the real power of the existing computerised systems is not maximised as they are unable to provide a whole-of-patient service.

Inefficiencies and errors occur due to the lack of information, lack of sharing, lack of standard processes and lack of decision support—elements that other knowledge-based industries thrive on.

New national broadband networks not only supplies the infrastructure for national e-health systems—it can also be a catalyst for the standardisation and integration of the various widely dispersed computerised systems that are currently used within the sector.

However, an equally important element of e-health is that it will give the patient/client a central role in the health system. At present the patient is simply a subject, with little or no power in the process. The government has already indicated that the control of e-health information ultimately rests with the patient.

This will completely transform the industry, with patients taking far greater control of their own healthcare. Many healthcare issues will no longer be an abstract concept; linking them with patient data will personalise healthcare and enable personal healthcare management. Caregivers can be integrated into the healthcare system to assist the patients in the process.

Once the broad e-health policy is in place a modular implementation will be required. It will be impossible to apply all these different e-health applications at the same time. When the ground rules are in place the implementation should be paced and prioritised.

Intelligent personalised e-health

Internet-based services such as those from US-based PKC show what can be done once all the information is seamlessly linked and patients and their care professionals are allowed to work with that information. Their ‘couplers’ service connects (couples) a range of healthcare-related information and uses the knowledge available in the industry to assist in providing solutions, directions and choices.

The current healthcare system is extremely inefficient and, mainly due to a lack of intelligent personalised information, does not provide the patients with any opportunity to take a leading role in their own healthcare process. This is perhaps one of the reasons that as much as 25% of Internet-related information is directly or indirectly connected with healthcare. People want to be more in control and in desperation they go the Internet. While there is plenty of good information available there it is also well-known that it is easy to sell desperate people solutions that most likely don’t work.

This is why it is so important that the national healthcare system and not the Internet becomes the place where people find direction and interaction with their healthcare providers.

Accountability and transparency

Furthermore, very few people argue about the enormous cost-saving elements of e-health. Per country, these can amount to tens of billions of dollars, and in the larger countries to hundreds of billions.

The main impediment to the introduction of e-health has been the powerful vested interests within the industry. For whatever reasons, they have persistently rejected any development in integrated patient-related e-health services.

In the USA medical accountability is becoming more and more of an issue, and only an e-health system can provide the level of transparency required of the healthcare process. The current largely manual and paper-based but also the computerised processes have no standards and it is simply impossible to use all the information in any coherent way.

Imagine if other sectors—finance or transport, for example—were managed in this way. We would have financial collapse and transport chaos.

With e-health now becoming a serious government policy issue there will be no turning back; over the next decade the system will be changed beyond recognition—and for the better.

National broadband key to national e-health

Some people have argued against the need for an FttH-based NBN, saying the capacity provided might not immediately be needed. But a very important additional element of an FttH NBN is its security and reliability. If countries are moving in the direction of e-health they will need an infrastructure that is more reliable than the current Internet, and an FttH-based NBN can deliver this better than copper-based technologies.

If we look at the trans-sector and systems integration opportunities that national broadband networks have to offer it makes sense to have it as the key infrastructure for the delivery of e-health. And this would also strengthen the business case for the building of such a national infrastructure—if something like 25% of a national broadband is going to be used for healthcare that would indeed also put that broader infrastructure investment on a sound economic footing.

With more people in healthcare and telecoms beginning to understand the importance of the other’s sector it is no wonder that they are looking at each other more closely. Both sectors can profit enormously from the introduction of e-health.

Telcos in particular are becoming seriously interested in understanding and in working with the healthcare sector to start building a better business case for future telecoms investments. As a matter of fact, companies such as Telstra in Australia and KPN in the Netherlands are seeing this as a critical development.