Following the path of digitalization in Slovenia and Europe: What role does digitalization play in the healthcare system?

Today, we can confidently say that technology has changed our lives to such an extent that the world can never go to how it was before. Regardless of field – business, transportation, food production or personal life – we cannot ignore the impact of technology and digitalization.

In the future, however, this trend of change is expected to continue exponentially. In principle, we can claim that introducing new technologies has made it easier and faster to perform specific tasks, increased efficiency and productivity, and generally improved our standard of living. Of course, we must not overlook the disadvantages of technology’s increased impact, such as a less human approach in certain areas.

Digitisation of healthcare in Slovenia

According to the Republic of Slovenia’s Ministry of Health, they are aware of the importance of Slovenian healthcare digitalisation. In the second half of 2022, the Ministry of Health will present a strategy for digitising healthcare, which is being prepared in cooperation with technical assistance from the European Commission and a group of health stakeholders, the statement said.

In 2021, the European Commission approved Slovenia’s Recovery and Resilience Plan (RRP), which provides 83 million euros for investments in the digital transformation of healthcare. In addition to the RRP, funds for investments will also be provided within the framework of the Act on Provision of Funds for Investments in Slovenian Healthcare in the Years 2021 to 2031 (ZZSISZ).

The digital transformation includes the introduction of new digital services and the digitisation of existing ones, faster access and exchange of patient data, use of modern information technology to communicate with patients and healthcare professionals, the development of analytical systems for ongoing adoption and adjustments of healthcare measures, and, last but not least, better planning of patient care.

Implementation of the Recovery and Resilience Plan aims to raise the level of digitalisation in the entire Slovenian healthcare system. The contractors and areas to be funded within the plan will be identified and approved by the European Commission.

This covers remote health monitoring, certification of eHealthcare information systems, single digital patient record and data administrative model, Central Registry of Patient Data, a transition of providers to paperless business, robotic preparation and storage of medicines, speech recognition, and information support for dispatching.

The Slovenian zVEM portal already represents a certain level of digitalisation in healthcare. Photo: zVEM.
The Slovenian zVEM portal already represents a certain level of digitalisation in healthcare. Photo: zVEM.

The ministry said that information support for patients’ appointments to the primary level will also be available by mid-2023. Through the zVEM portal, safe communication between patients and healthcare professionals will be enabled (sending notices, referrals, appointments, etc.). Patients will receive information about examinations appointments and appointments at the primary and other levels.

The Slovenian zVEM portal already represents a certain level of digitalisation in healthcare. Namely, patients can access medical referrals, prescriptions, and other documents via telephone or the internet. Finally, they can also check the current vaccination certificates against COVID-19, recovery, or test results (RVT) via the zVEM portal.

Digital transformation of healthcare on the European Union level

In 2018, the European Commission identified three sectors around which activities to enhance the digitisation of healthcare are taking place.

The first pillar concerns secure access to and sharing of health data. To facilitate greater access to cross-border healthcare, the Commission is building the eHealth Digital Service Infrastructure (eHDSI) to allow e-prescriptions and patient summaries to move between healthcare providers.

The first cross-border exchanges started in 2019, intending to have all the other EU countries on board by 2025. In the longer term, the Commission is working towards establishing a European electronic health record exchange format accessible to all EU citizens.

Digitization can bring more accurate diagnoses and better decisions in healthcare.
Digitization can bring more accurate diagnoses and better decisions in healthcare.

The second pillar covers integrating and exchanging health data to support research, faster diagnosis, and improved health. Here, the Commission intends to tap into the vast potential of health data to support medical research to improve prevention, diagnosis, treatments, drugs, and medical devices.

Digital services can empower citizens, making it easier for them to take a more significant role in the management of their health, from following prevention guidelines and being motivated to lead healthier lifestyles to managing chronic conditions and providing feedback to their healthcare provider; written under the third point representing the third pillar.

Technological trends in healthcare

In different fields, the technological trends are more or less similar. One of the advantages of the technology is that the same technology can be implemented in several various fields, having a different contribution in each field. For example, we can talk about robotics, which is found both in healthcare and car factories. But let’s take it slowly and first look at all the technological trends in healthcare as defined by the McKinsey consulting firm.

People want to be more up to date with their state of health. One way to do this is to use connected and cognitive devices, including portable, wearable, and ingestible devices. This allows patients to monitor their health anytime and anywhere and be constantly involved in improving their health.

Robotic based technologies are already well established in healthcare. They have become so sophisticated that they can collaborate with medical staff in hospitals, automate routine tasks such as processing applications, measuring patient vital signs, etc. Medical robotics can also be found in the operating room, where robots are used to ease the physical burden of surgeries and enable minimally invasive approaches.

Data analysis presents one of the most significant changes in healthcare. Insights gained from a vast amount of data which is the basis for physicians to make decisions lead to better outcomes for patients. For example, platforms and applications that store, transmit, and analyse medical data can be used to identify patients who are candidates for highly targeted therapy.

In addition, data and analytics are becoming so advanced that robots will be able to record physiological data during medical procedures, which improves both surgical planning and medical education.

With all the valuable insights derived from data analytics, we must have technologies that convert analytical insights into practical solutions to enhance diagnosis, improve predictive interventions, and optimise clinical productivity. Like robotics, artificial intelligence can increase productivity and cost-effectiveness and enhance the quality of care.

Artificial intelligence (AI) also provides patients with convenient and customised services. Virtual nurses can communicate with patients, gather information about their symptoms, diagnose diseases and even schedule appointments.

The development of blockchain technology is in its infancy, but companies from all industries are delving into this technology, including healthcare. Blockchain holds the potential to enable more secure transactions; patients feel less exposed when sharing data, as the process is more confidential. In addition, blockchains make data more accessible, allowing other technologies to better leverage data.

Digitisation in healthcare must always be human-centred

However, the digitalisation of healthcare has plenty of challenges, which arise on an ongoing basis, and it is, therefore, necessary to find solutions swiftly. Problems can even be located in one of the basic steps of digitisation: electronic health records. The so-called EHR (Electronic Health Record) system is a digital version of patient files that allows authorised physicians working in the ward or on-site to view medical records.

The so-called EHR (Electronic Health Record) system is a digital version of patient files that allows authorised physicians working in the ward or on-site to view medical records. Photo: AAMC.
The so-called EHR (Electronic Health Record) system is a digital version of patient files that allows authorised physicians working in the ward or on-site to view medical records.
Photo: AAMC.

“Despite successful digitisation, doctors face many problems,” said Josef Dvořák from the innovation agency Direct People during the EIT Health Morning Health Talks 2021 series, organised in Czechia by DEX Innovation Centre the local EIT Health Hub. There are many EHR systems, and they often cannot communicate with each other.

“Apart from the mutual incompatibility of systems, the problem is also an administrative burden. Doctors spend up to half of their time entering data into the system. Other problems apart from the bureaucracy include false alarms and potentially fatal system errors when ordering medicines. As a result of the EHR, there is a significant share of burnout syndrome in medical staff,” added Dvořák.

If digitisation focuses only on technology, the result may be unsatisfactory. EHR systems should serve people, address their needs and, above all, make the work of healthcare professionals easier.

All digital tools and systems should be created in cooperation with end-users. “Customer needs are at the heart of our strategy,” commented Tomáš Vavrečka from Phillips. “This way, a system can be created that is sufficiently simple and usable in medical practice.”

Sofia Couto da Rocha, head of the Transformation and Digital Innovation project in Lusiadas Saúde, Portugal, agrees. “Digital transformation is always about people. Unfortunately, this is sometimes forgotten.”

The decentralised digitisation of healthcare was accelerated, among other things, by the COVID-19 pandemic. “People were afraid to meet, and we registered increased demand for online medical services and consultations. We developed the #TodosPorUm application in just seven days, which evaluated the user’s symptoms during the pandemic based on a questionnaire and, if necessary, referred the client to medical staff,” explained da Rocha.

Almost 400,000 queries have been passed through the application, and 3,800 paramedics verified the functionality of the chat. But the COVID-19 pandemic will come to an end. “I hope that digitisation in diagnostic services will develop further beyond COVID, and that digitisation will go beyond telemedicine,” noted Teigu Schutte, Mobiguity.

Cybersecurity Risks in Healthcare

According to software company Galen Data, one of the biggest challenges that arise with the digitalisation of healthcare is cybersecurity.

Cloud connectivity powers much of the data capabilities in digital healthcare. It has also created the category of cloud-connected medical devices. The idea of devices with sensors that can communicate with other devices and systems is often referred to as the Internet of Things (or IoT).

All of the data generated, stored, and transferred between systems and parties over the internet may open up the potential risk for data to be accessed by unauthorised third parties. It is possible for somebody to discover the data accidentally or for malicious actors to breach the system. In any case, patients’ personal data makes its way into the wrong hands.

How is digitization affecting the personal patient-doctor interaction?
How is digitization affecting the personal patient-doctor interaction?

However, the cybersecurity risk doesn’t just pertain to the exposure of private data. Patients and healthcare professionals that rely on data to make treatment decisions depend on correct and accurate datasets. If data is deleted or altered, it can lead to a wrong diagnosis, treatment plan, or other adverse events. 

After all, we must not forget that the personal patient-doctor interaction is also essential in healthcare. Utilising technology can help keep healthcare professionals and patients connected, even when they are not physically present together, similarly to social networking. We can indeed stay in touch with more people this way, but we often notice that this contact is no longer so personal.

Keywords: digitization, health, technology, life

Author: Marko Želko

Disclaimer:

This article is part of joint project of the Wilfried Martens Centre for European Studies and the Anton Korošec Institute (INAK) Following the path of digitalization in Slovenia and Europe. This project receives funding from the European Parliament. 

The information and views set out in this article are those of the author and do not necessarily reflect the official opinion of the European Union institutions/Wilfried Martens Centre for European Studies/ Anton Korošec Institute. Organizations mentioned above assume no responsibility for facts or opinions expressed in this article or any subsequent use of the information contained therein.