German hospital group to roll-out EMR

A major German hospital player has announced that it will begin to develop a national network of electronic medical records within the next few weeks.

The Sana-Kliniken – number four among the private hospital chains in Germany – have signed a contract with the Berlin-based GMD, a specialist provider for eHealth solutions.

The latest announcement reinforced a growing trend among German hospitals: The two biggest private hospital chains, Asklepios and Rhoen, are already working on similar EMR-projects. The aim of each programme is to make it possible for referring doctors to access hospital patient information and to communicate directly with the hospital via a secure internet connection.

What lies at the bottom of the trend to EMRs is the ever more fiercely fought competition among the 2000 German hospitals for patients and referring doctors. By opening up the possibility for resident doctors to access, say, chest-X-rays or laboratory reports directly and to copy the information into the doctors’s own IT-system, hospitals hope to become more attractive for doctors and, thus, to get more patients referred.

“The exchange of medical information between hospitals and resident doctors is a key factor for building bridges between inpatient and outpatient healthcare”, says Gerald Götz from the IT department of Sana.

What’s different about the Sana-project, compared to other hospital EMR programmes is that it will support an open German healthcare communication standard called D2D (“doctor-to-doctor”).

D2D has been developed by the Kassenaerztliche Vereinigungen, the political representative body of hospital resident doctors in Germany. This should mean that it will be far more comfortable for many resident doctors to access the hospital information, because the doctor’s own IT-system will usually be capable of handling D2D-data.

Other projects currently underway tend to use off-the-shelf web browsers without this standard, which can be quite a hassle for the doctor as it means using different software in parallel and downloading information manually.

Establishing a nation-wide system of shared electronic medical records has not been on the official agenda of the German national health-IT-project so far. There is a law which mentions these records briefly, but that’s all up to now.

The announcement of Sana shows once again, however, that Germany’s private hospital chains are not willing to wait any longer for a national EMR-strategy. A patchwork-style approach with major players of the German healthcare system all implementing their own shared EMR-solutions which will then later be made interoperable, sometime, somehow, looks increasingly likely.

GMD is owned by the Italian Health-IT-company NoemaLife. It has 350 customers in Central and Mediterranean Europe and Latin America. The company is listed at the Milan stock exchange.

For the Sana-EMR solution, GMD uses the so-called eFA-specification developed by the Fraunhofer Institute for Systems and Software Engineering in Berlin. The eFA-specification is also the technological basis for the Asklepios-project and for several smaller hospital-EMR-projects. It is freely available on the internet on www.fallakte.de.

To implement the eFA-specification, GMD combines the technology “Fusion Middleware” of Oracle with a product called ‘e-health solutions’, which received Frost & Sullivan’s Healthcare Information Technology of the Year Award in 2004.