e-Health: The Challange of the Czech Healthcare System
The European Liberal Forum in cooperation with the Institute for Politics and Society held on 9th November 2017 a morning seminar on the topic of eHealth, the last follow-up event of the international conference Digital Czech Republic 2017. We had the honor to welcome in discussion Dieter Feierabend, a project leader of sustainable social systems & healthcare, NEOS Lab from Austria, and Pavel Vepřek, a leader of the initiative Healthcare 2.0 from the Czech Republic. The debate was moderated by Adam Vojtěch, Member of Parliament of the Czech Republic.
Firstly, the speakers were asked what does eHealth stands for and they expressed very similar views. Pavel Vepřek thinks that eHealth is about communication, since the lack of efficient communication between patients and doctors may result in unwanted impacts. For Dieter Feierabend eHealth is about generating and sharing information between various shareholders and the purpose is to do it better than in the past years.
The debate continued by discussing obstacles of implemention of eHealth. Mr. Feierabend emphasised 3 main points: unflexible framework of sharing data, incomprehension of medical statistic by doctors and a need for European standards. According to Mr. Vepřek, better understanding of ICT projects is needed, since physicians are resistant to eHealth. Another problem is that ministers´ work led to merely formal and inefficient steps.
Both speakers agreed that there is a need for setting up common standards for keeping and communicating patient´s records, which, consequently, will save money and time to people moving/migrating between member states. At the end, it should be also obligatory system after some transitional period. Furthermore, if the system is good, any opt-outs won´t be needed.
Dr. Šmatlák, Vice-President of General Practitioners in the Czech Republic, contributed to the discussion and expressed the belief of GPs that even if they are not against eHealth as such, they are warning the government that the system of e-prescription is prepared badly, wasn´t tested and it will probably fail. In the end, it can lead to leave of many doctors who are not willing to undergo such pressure on the part of government.
Dr. Blahuta, Director of State Institute for Drug Control, disagrees with unreadiness of this system and points out to high number of doctors expecting the e-prescription.
Participants did not agree on the costs of e-Prescription in the Czech Republic. While according to the report of highest control institute, e-prescription will cost 380 millions CZK, academics´ calculations amounted to 1 billion CZK and say that the government is ommiting the costs of stakeholders.
Concerning decentralisation of eHealth system, according to Mr. Feierabendthe general standards should be at the EU level, the basic framework at the national level, and the implementation at the regional level. Mr. Vepřek points out on the action plan of government which set up eHealth priorities. Using currently working communication system, they want to manage identity of healthcare records, define data standards and create information infrastructure.
Dr. Pavel Hroboň from Advance Healthcare Management Institute added that apart from Estonia, there is no other example of well managed top-down project in other countries. However, the standards have to be defined on the national level, because no one else can do it.
In order to motivate people to participate, the system has to be user-friendly and without obtacles. Moreover, since the technology changes the distribution of power of different stakeholders and, consequently, the relationship between physicians and health fund will change, which will also leed to difficulties of keeping the motivation. The doctors are trying to persuade government that the system should be mandatory in order to keep them on the government´s side.
Rút Bízková emphasised a lack of professionals in the regions and by pushing people to do something it will even worse and bring up the case of telemedicine and its potential to solve this problem. Mr. Feierabend firstly said that the there would be enough tasks for humans even in digitalised era and secondly, lack of people won´t be resolved by technology, since it is more question of tasks. According to Mr. Vepřek, high competition in labour market resulted in preference for easier jobs and jobs with higher wage standards than health care. To change this trend, the change of framework is needed including defining roles of various stakeholders and increasing attention of health insurances. Nowdays, many companies obtain CE marks for medical devices. However, if they want to sell their softwers within EU, they still need to fulfill different standards. That is why the single digital market has to be created. So, the question of standards is just at the beginning now.
Adam Vojtěch summarized the main point which is a need for new legislation so as to set up the eHealth and he hopes that the new minister of health will do that. It is also necessary to support all various tools mentioned before. In the end, these tools themselves are much more effective than the work of state.