Biomedical Engineering Reference
In-Depth Information
their own practice, status, and economic position. (Note that medical pro-
fessionals can also endorse negative propaganda to hamper the diffusion
process of new products, cf. as was attempted in the case of genetic self-test
in the Netherlands.) Further technical issues, such as reliability and interop-
erability, are issues that are important considerations for medical profession-
als and nonprofessional users. Moreover, the provision of good information
with regard to usage and benefits of applications together with user-friendly
design are factors that stimulate users to use certain technologies in spe-
cific situations, and thus require users (sometimes their representatives such
as professional patient organizations) to be involved in the development
process.
Finally, a factor that may seem commonplace at first sight is the availability
of infrastructure. For the applications of BAN, the existence of a database
system where data can be securely stored and viewed by different profes-
sionals is necessary. The EPR could provide such platform. However, until
now, the introduction of the EPR in the Netherlands has been faced with
great barriers. Our interview with the representatives of NICTIZ* (t he i insti- i-
tution that is responsible for the implementation of EPR in the Netherlands)
and all other major stakeholders active in this field has made it evident that
without a basic EPR, it becomes difficult to guarantee that relevant stake-
holders such as patients themselves and health-care providers will have ade-
quate access to all relevant information that is required at point of care. The
data that are generated through monitoring activities has to be coherently
stored and be available along with other medical information to be meaning-
ful for all relevant parties. The chairman of the Dutch tele-health workgroup
on cardiovascular diseases confirms this conclusion in a professional ICT
health care magazine, where he tersely stated, “Tele-health without EPD is
no Tele-health” (Flim 2008).
12.3.2 Changing Health-Care Sector and Position
of Different Stakeholders
Specific to the Netherlands, since January 2006, the health-care sector has
witnessed relatively radical reforms. This has caused the central role of the
state in the enduring operation of the health-care system has been replaced
by private health suppliers. Health-care insurances were privatized, and the
government's responsibility since then mainly concerns the accessibility and
quality issues of health care. These changes have opened new opportuni-
ties for actors in the field to organize their businesses in a more pragmatic
way. For instance, health-care insurers in the new system have received more
*
NICTIZ was founded in 2002 by organizations representing the Dutch health care and IT sec-
tors. NICTIZ is funded by the Ministry of Health, Welfare and Sports of the Netherlands. It
is principally focused on two initiatives: to develop an Electronic Health Record and to build
a national secure electronic communication infrastructure for the health-care sector.
