Swiss healthcare costs have almost doubled since the mid-1990s. According to figures from KPMG Switzerland, systematic digitalization would lead to more effective, more efficient medical treatment and potential savings of almost CHF 300 million.
Data from the Federal Statistical Office (FSO) shows that healthcare costs in Switzerland have doubled since 1995: In 2014, direct healthcare costs totaled CHF 74.6 billion (CHF 759 per resident per month) – equal to 11.6% of Switzerland’s gross domestic product. Almost 80% of these costs are incurred by 2.2 million chronically ill patients. “Direct costs” here mean expenses incurred as a direct result of treatment, such as physicians’ fees or surgery costs.
With the onward march of digitalization, the number of smartphone users in Switzerland is increasing by around 10 percentage points each year. KPMG Switzerland’s Sector Head Healthcare Michael Herzog argues that, «With one eye on the associated technological opportunities, if smartphones were to be linked up to electronic patient records in the future, this would present an effective starting point for cost savings.» In this context, KPMG Switzerland has calculated what impact digitalization could have on honing and streamlining medical treatment and, in particular, on stabilizing costs in the healthcare industry.
The Federal Act on the Electronic Patient Record (EPRA) was approved by Parliament in June 2015 and came into force in April 2017. As a framework act, it sets out the conditions for the centralized electronic processing of sensitive patient information. In the future, it will allow healthcare specialists to access existing data on their patients’ treatment that has already been collected and recorded by third parties at an earlier stage.
Since the benefits of electronic patient records do not begin to materialize until a patient has consulted care providers multiple times, this innovation is especially relevant to the chronically ill. For instance, a joint regulatory impact analysis conducted by the Federal Office of Public Health (FOPH) and State Secretariat for Economic Affairs (SECO) indicated that introducing electronic patient records could potentially save more than CHF 1.6 billion. If coupled with the technological opportunities brought by smartphones (health apps, wearables, etc.) along a digital patient pathway, electronic patient records would harbor significant potential for considerable cost savings in the Swiss healthcare industry.
The patient pathway traditionally involves face-to-face interaction between patients and their care provider, making appointments over the phone and exchanging medical histories by email, fax or mail. By contrast, the digital patient pathway could see gadgets such as wearables and health apps continuously monitor a patient’s vital functions, for example, and transmit them directly to the physician if need be. Telemedical service providers would thus become the first port of call in the event of medical complaints or queries. The digital patient pathway would let patients book a doctor’s appointment at any time, using their smartphone for example, regardless of office hours. This would put an end to what was previously a time-consuming way of booking. What is more, it would no longer be necessary to exchange hard copies of a patient’s medical information since this could be stored, downloaded and viewed centrally as an electronic patient record.
By KPMG Switzerland’s reckoning, one full cycle of this digital patient pathway via five stages (family physician, specialist, acute care hospital, rehabilitation clinic and family physician) could save up to 87 minutes or CHF 59 per patient.
* Assumption: If a chronically ill patient visits the same care provider multiple times, their data is no longer recorded in full as a hard copy. A shortened medical history is also taken. A 25% reduction is therefore applied based on KPMG’s empirical data.
** As a basic principle, the only time patients would be required to register in person in the digital patient pathway would be to open their electronic patient record. This would also mean there was no need to exchange their medical histories.
*** This calculation is based on the median gross monthly salary in Switzerland in 2014 (CHF 6,427) and the actual annual hours worked in 2015 (1,893 hours) according to FSO figures.
Although this focuses on chronic diseases, all patients were taken into account when calculating the potential savings since they are all affected by digitalization in equal measure. The calculation was based on FSO data and thus assumed 1.4 million cases of hospitalization and 16.8 million outpatient consultations. The results show that potential savings increase exponentially in comparison to the number of stages, i.e. digitalization really pays off when multiple stages are involved. That is why economies of scale like this are of particular relevance to the chronically ill, as they are often treated in several stages.
Even KPMG’s conservative estimates for outpatient consultations indicate potential cost savings of CHF 296 million depending on the number of stages patients go through on their digital pathway. Looking at the results of the study, Marc-André Giger – a specialist in the healthcare industry at KPMG – concludes: «With the vast economies of scale offered by digitalization, this potential could be substantially enhanced. Exploiting the full benefits of electronic patient records and the opportunities presented by smartphones would ensure that we could standardize and compare patient data, which would markedly increase the quality of medical care and put an end to the unbridled rise in costs facing the Swiss healthcare industry.»
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