For three decades, the digital patient record has been broken. We have the technical means to improve the quality of medicine and reduce its cost, but we do not use them, because it would require a firm decision from a national government which does not exist. Indeed, it would not make sense to create such a file at the cantonal level since patients are naturally led to consult beyond the borders of their canton. Furthermore, the national software must be made compatible with the diversity of those used in the firms, which should be necessarily aligned. We can imagine the resistance these imperatives would encounter.
Currently in 99.2% of medical practices, the file is handwritten, a precarious stack of tens or hundreds of sheets which can only be consulted by a single practitioner. And again! Beyond a certain pile, in fact all of this is not consultable even for the person who wrote these notes. We no longer know how to check what all the analyzes or prescriptions of the past were. We can no longer detect previous symptoms which would have made it possible to predict the arrival of a pathology.
This leads to duplication of costly tests like MRIs and inconsistent medication prescriptions. This does not make sense in terms of care and it makes care more expensive than it should be. A digital file instantly allows data to be filtered.
The absence of such a file would therefore be incomprehensible if we did not remember the obstacles which arose in the 1990s. The fear raised was the violation of medical confidentiality. However, this has already been covered by the health insurance companies. When this electronic file is finally produced, it will naturally be necessary that access to it be reserved for the patient and their treating practitioners and that it be inaccessible to the employer and insurance companies. The file can commonly be protected with a password.
Interests, prejudices and ignorance do not make it easy to reach a consensus between the Confederation, the cantons, doctors and pharmaceutical companies.
Jacques Neirynck
An anonymized version of the file should be created to provide medical research with a gigantic source of observations that can be cross-referenced with other characteristics. What is the real impact of tobacco, alcohol, sugar, salt, meat, fats on the appearance of certain pathologies? How, based on this scientific data, can we prevent rather than cure? In this way, we could develop a real health policy rather than letting it drift with the increasing cost of health insurance.
This powerlessness is an indication of the weakness of political institutions. Interests, prejudices and ignorance do not make it easy to reach a consensus between the Confederation, the cantons, doctors and pharmaceutical companies. Health is not the main business of the federal government and it will not be until a minister is assigned exclusively to it. But tomorrow is certainly not the day before. Until then, we must explain to public opinion that the growth of health insurance contributions could be slowed down if this file became compulsory. There might be a chance that the matter would not be buried by a popular vote.
