Every month, we meet with actors of the Valaisan health ecosystem. Today, we went to meet Cédric Michelet, eHealth manager at the Public Health Service (SSP) of the canton of Valais, to take stock of the availability of the electronic patient record (EPR) in Valais and of the health digitalization projects that are occupying the SSP.
The electronic patient record has been at the heart of the news in recent months. Indeed, many questions remain about its adoption in Switzerland. The data contained in this file is extremely sensitive, so how can we trust digital solutions? Cédric Michelet sheds light on the situation in Valais and reveals the different projects of digitalization of health that occupy the Public Health Service.
Discover below the second part of the interview.
In a position paper, the FMH considers the EPR – in its current format – too complex to manage for patients and believes that it generates more work than benefits for doctors. What is your view? Have you had any feedback from users yet?
The current EPR should be seen as a first brick on which the rest will be built. Indeed, we are aware that the EPR in its current form provides limited added value for professionals; this is why we are already planning to deploy other value-added services that will build on the foundation provided by the EPR. For example, we can mention the Shared Medication Plan (SMP), which will provide the most up-to-date view of the medication taken by a patient, or the Shared Care Plan (SCP), which will make it possible to coordinate interprofessional interventions. We also already have in production in Valais the Transfer service which allows direct exchanges of digitized documents between health professionals and institutions.
On the patient side, however, it should be noted that the EPR is already a major step forward. Patients have long had the right to access the contents of their medical records, but until now this has been a complicated process, as they had to personally request a copy of their records from each health professional and obtain them in the form of paper photocopies or, at best, files burned on a CD. The EPR provides a real-time view of part of one’s documents, without having to make a specific request each time one wants to consult them.
It is clear that the EPR brings changes in the relationship between the patient and the health actors. There is of course greater transparency, which allows patients to see the exchanges about him and perhaps better understand or accept the treatments that are proposed. But we must not neglect the fact that this can also generate difficulties for health actors, such as the questioning of diagnoses when a professional sends a patient to a colleague, or the influx of questions following the non-understanding of medical terms appearing in documents that can unnecessarily frighten the patient. This empowerment will have to be accompanied by measures to try to improve the health literacy* of the general population.
(*literacy = “skills of individuals to access, understand, evaluate and use health information to make decisions about their health, so as to maintain or improve quality of life”)
How do you approach the digital transformation of the health sector at the cantonal level? Could you present some of the projects that you have initiated or that you are following within the SSP?
E-health covers a wide range of activities. Moreover, the Valais is obviously a fertile ground in this field, whether it be the projects carried out by the research institutes of the HES of Sierre, the various startups of the canton and of course the Digital Health Connect.
There are a lot of themes to follow and to try to valorize. Unfortunately, our efforts at the level of the Health Department are limited by our resources: we only have two employees working on these themes. Consequently, we have to focus our efforts on a limited number of topics for the moment.
Obviously there is the EPR which takes up a lot of our time, as well as the implementation of MIEs for our fellow citizens. We are also actively participating in the development of future services that will be offered in addition to the EPR.
At the same time we continue to evolve and monitor the Transfer service, which has been in production since early 2014, and which ensures the exchange of digitized medical documents between the Hôpital du Valais and approximately 170 physicians in offices, for a volume of about 8,000 documents per month. This service, for which the canton of Valais has been the pilot, will be deployed by the end of October 2021 in the main institutions of the canton of Vaud and by the end of the year with the professionals in the field.
In addition, for some time we have also been dealing with issues related to COVID-19. For example, we have to manage access to the certificate generation applications for all the authorized professionals in the canton. This creates an additional workload.
In conclusion, there is a vast potential for digitization in the medical field at all levels. Nevertheless, we must always keep in mind that IT remains a tool at the service of people; we must not digitize processes and introduce new technologies for the sake of it, but on the contrary to simplify life and improve the comfort and security of the population and professionals. Pragmatism must remain one of the important values that guide us.
Read the first part here: The electronic patient record: where does Valais stand? – Swiss Digital Health