The State of Health IT in Europe

Dr. John D. HalamkaI’ve been on the road for the past few days, describing the importance of patient and family engagement using mobile applications to healthcare leaders in Europe. The dialog has been bidirectional. I learned a great deal about the technology and policy challenges in each country. Patients, payers, and providers are struggling with issues such as usability, security, and supportability. 

My schedule has required several time zone changes - a keynote in Seattle on Saturday, a flight to London on Sunday for meetings with NHS leaders on Monday and a keynote in Birmingham on Tuesday.  In my discussion with UK leaders, they invoked the Chatham House Rule, something I had not heard about previously. To encourage open dialog, anyone who attended the meeting was welcome to use information from the discussion, but not allowed to reveal who made any comment.

In the UK, I heard a great deal about misalignment between IT departments and clinicians. IT departments are reluctant to embrace social, mobile, analytics, and cloud, instead insisting on centralized command and control of Windows desktop devices, often running Citrix/Virtual Desktop. Clinicians want mobile devices, universal access to applications anytime from anywhere on any device, and big data visualizations. There is innovation, with forward thinking firms creating novel mobile apps and piloting them in several NHS sites.

In Berlin, I met with a diverse array of stakeholders from the entire EU and Russia.  All are facing the challenges of an aging society, chronic disease, and rising costs. Several expressed frustration with the pace of healthcare IT innovation in Europe. Regulators and IT departments are reluctant to be early adopters. Windows and client/server platforms predominate. Despite extraordinary engineering in Germany, there is still a fear of technology change.

Today marks the end of my travel for 2014. I’ve cancelled planned speaking in Copenhagen and Amsterdam to support my father-in-law’s care.  As in previous years, my international collaborations have demonstrated to me that all our societies are making healthcare IT progress, but there is still a sense of urgency to do more.   Technologies move faster than politics and culture.  The work of John Kotter remains true in every location I visit - there must be a leader with vision, a guiding coalition, a reason for change, and an incremental step-wise approach to an idealized future state.    No technology, no matter how magic, can succeed without change management.