Switzerland is Moving Towards Interoperable mHealth

By: Michael Strübin, European Programme Director, Personal Connected Health Alliance

More than 80 percent of respondents to a recent consultation by the European Commission on the transformation of health and care said they would be happy to share their health data if privacy and security are ensured.  And health authorities are hearing the same message from their citizens.  All over Europe they have announced plans to build national electronic health record systems or patient portals that allow citizens and patients to upload health data (i.e., blood sugar levels) and share it with their physicians and informal caregivers.  Good.

But there are technical challenges: how to get the data into the systems so they can be read and processed?  As public entities, the health systems cannot favor specific vendors or products: they must require data in a standardized format. They also need to proceed with caution, ask experts, and involve stakeholders before they pick the most suitable standard: nobody wants to bet on the wrong horse.  Nowhere in the health system is this bet more risky than where the health systems interface with the personal and medical device market:  the mobile phones, devices and gadgets used by citizens and patients.

This is why interoperability is taking so long.  Some countries are moving faster:  Denmark, Finland, Norway and Sweden in the Nordics are frontrunners, with strong public health systems and high levels of IT literacy and trust in the quality of public institutions.  Close runner-ups are regions in Spain (Catalonia, Galicia, Andalusia) which, with their single payer systems, may find it easier to install complex IT systems.  And this spring, the Ministry of Health in Austria finalized its technical framework directive for the deployment of chronic condition management programs, also mandating standards for data from personal health devices.  (Some paths towards public adoption of personal connected health standards are discussed in PCHAlliance’s Continua Adoption Playbook.)

Now, along comes Switzerland: as a federal state, with a weak national executive and a strong tradition of local rule, it falls to eHealth Suisse, a small office in Bern, to coordinate the eHealth policies and actions of the national and regional (Kanton) governments.  eHealth Suisse just published the evaluation report for mHealth standards prepared by three leading Swiss experts on eHealth interoperability.  PCHAlliance's Continua Design Guidelines were appraised and recommended, along with IEEE, IHE, HL7 FHIR and others, and were given high marks for their robustness and maturity (read it in German or in French).  A consultation is open until September 3; final results are expected in the fall.

What do all these countries and regions have in common?  They are small countries, and by themselves may not be able to prompt the big device makers to adapt their strategies.  But the momentum for standards and interoperability is growing, and the big vendors ignore it at their peril.