The Bern cantonal government's proposal to centralize patient data across all public hospitals using a single American software system has sparked significant debate. The plan, which aims to streamline information exchange, faces strong criticism from IT industry associations and some hospitals over concerns about potential monopolies, high costs, and data security.
Key Takeaways
- Bernese government proposes using Epic software for all public hospital IT systems.
- The plan aims to improve data exchange and patient safety across hospitals.
- IT industry and some hospitals warn of a potential monopoly by a single American provider.
- Concerns include price dictation, high costs for smaller hospitals, and potential US access to sensitive patient data.
- The Insel Group in Bern has used Epic since March 2024, with other major Swiss hospitals also adopting it.
Bern Seeks Unified Hospital IT System
Patient data is highly sensitive. Currently, hospitals in the Canton of Bern use various IT systems to manage this information. This diversity complicates communication, often requiring hospitals to share data through PDF files and email. The Bern cantonal government seeks to improve this situation.
The government proposes a new legal framework. This framework would ensure that public hospitals in Bern not only record data according to uniform standards but also use the same IT system. Private hospitals would have the option to adopt the new system voluntarily. The government has stated its readiness to offer financial support for the transition.
Fact
The Canton Bern government has specifically named the Epic clinical information system, an American provider, as the product hospitals should procure.
The Insel Group, a major hospital network in Bern, began using Epic in March 2024. The Lucerne Cantonal Hospital implemented Epic earlier. The University Hospital Zurich and the Children's Hospital Zurich are also planning to switch to Epic. This trend shows a wider move towards this specific system in Switzerland.
Industry and Hospital Concerns Emerge
The overall idea of standardizing data and simplifying information exchange between hospitals is well-received. Responses to the consultation on the proposed legal change confirm this positive sentiment. The Bern Hospital Association believes a unified data structure improves patient safety. It also helps avoid duplication of efforts and enhances collaboration among hospitals. They agree that advancing healthcare networking is the correct path.
However, significant criticism quickly follows these positive remarks. Many hospitals feel that requiring them all to use the same system goes too far. The Bern Hospital Association argues this approach could create a monopoly for one company. This would limit competition and choice.
"The plan to entrust all health data of the Canton of Bern to an American provider in the medium term needs to be questioned," stated GLP Grand Councillor Casimir von Arx. "This entails a great dependence on the USA."
Background
The Canton of Bern has many public hospitals. A significant number of these hospitals currently use the Kisim information system. Kisim is developed by the Swiss company Cistec. This existing infrastructure highlights the scale of the proposed change.
Price Dictation and Data Security Worries
The Commerce and Industry Association has expressed reservations about the American provider, Epic. They describe Epic as very expensive. They suggest it might be too large and costly for smaller hospitals. The association questioned why alternative systems were not more thoroughly evaluated during the planning phase.
The issue extends beyond cantonal borders. The IG E-Health, an industry association for IT systems in healthcare, warns against relying on a single provider. They argue this creates a risk of price dictation. This association includes major players like Ascom, Post, Swisscom, and Cistec. They believe the government's preliminary decision to favor Epic is "inadmissible."
IG E-Health states that Epic is unlikely to be the best solution for all hospitals. They point out that several significantly cheaper options are available. The association advocates for a two-track approach. Each hospital should retain the freedom to choose its own system. Alongside this, a central platform for data storage could be procured. The IG E-Health suggests that the canton could simply define standards for data formats and interfaces, which would also be sufficient.
Statistics
The Inselspital Bern has been using Epic software since March 2024. This provides a local case study for the system's implementation.
The Health Data Space Association also finds the choice of a closed American platform problematic. They advocate for open-source solutions. These are generally more transparent and more affordable. The association aims to accelerate digitalization from the perspective of citizens, prioritizing public benefit and control.
Political and Privacy Concerns
The plan has drawn political reactions. In a cross-party motion, GLP Grand Councillor Casimir von Arx called for the software choice to remain open. He emphasized the potential for significant dependence on the USA if all health data is entrusted to an American provider.
Reactions have also come from the Zurich cantonal parliament regarding the decision to implement Epic at the University Hospital Zurich (USZ). Several politicians referenced the Inselspital in Bern. They claimed that the original budget there was "far exceeded."
Direct Quote
Insel President Bernhard Pulver strongly disputes these claims. He wrote on LinkedIn that the budgeted costs were not exceeded. He also stated the system was implemented on time and without significant malfunctions. Pulver believes it is time for hospitals to find a common IT solution.
Zurich politicians also raised concerns about potential US government access to Epic data. They cited the Cloud Act, which provides a legal basis for US authorities to access data stored abroad by American companies. This highlights a key privacy worry for sensitive patient information.
Competitor Cistec has filed a complaint against the decision to introduce Epic at the USZ, as reported by the IT portal "Inside-IT." This legal challenge underscores the contentious nature of the decision. The outcome of this dispute could have broader implications for IT system choices in Swiss healthcare.
Looking Ahead
The debate surrounding the Bern cantonal government's IT plan for hospitals is complex. It balances the need for improved data exchange and patient safety with concerns over competition, cost, and data sovereignty. Stakeholders across the healthcare and IT sectors continue to voice their opinions. The final decision will shape the future of digital health infrastructure in the canton and potentially influence other regions.
The move towards standardized systems is a global trend. However, the specific choice of provider and the implications for data ownership and access remain critical points of discussion. The Bern government's proposal highlights the challenges involved in modernizing healthcare IT while protecting sensitive information and promoting fair competition.