Switzerland is widely praised for its excellent universal healthcare system and strong pharma sector. Seen as a bastion of efficiency and innovation, the country is nonetheless falling behind its European counterparts when it comes to healthcare digitalisation. Recent PharmaBoardroom interviewees weigh in on the country’s digital lag, its electronic patient records, and the soon-to-be-implemented DigiSanté initiative.
A System under Pressure
With its universal system backed up by required insurance from private non-profit insurers and a comprehensive network of doctors and outpatient centres, the nation boasts a high standard of healthcare. “In any international comparison, Switzerland has an excellent healthcare system. A system that enables our population to get the treatment they need, promptly and to the latest medical standards,” says Anne Lévy, director-general of the Federal Office of Public Health (FOPH). But despite these high standards, Lévy admits, “it’s also a system that is clearly under pressure. That’s true of both our need to contain our costs and our need for further rapid progress on the digitalisation front.”
Fragmentation across Swiss Cantons
“Digitalisation can be transformative for Switzerland’s healthcare system, yet it’s an area where the country has lagged behind other markets,” laments Max Pahlow, managing director of Johnson & Johnson Innovative Medicine Switzerland.
Despite the quality and universality of its system, Swiss healthcare does have inherent complexities. “One of the primary reasons for [the country being behind] is Switzerland’s federal structure, where 26 cantons operate independently. This fosters innovation in different ways but also leads to fragmentation, slowing down the widespread adoption of digital solutions,” he maintains.
“The current infrastructure in Switzerland is fragmented, lacking the necessary interoperability across different cantons and between the private and public sectors. These systems do not communicate effectively, creating significant barriers to utilizing healthcare data efficiently,” Katharina Gasser, general manager at Roche Pharma Switzerland concurs.
Like in other countries, the Swiss are also concerned about the safety of their data. “Another factor is the concern over data privacy and security. Understandably, people are cautious about how their medical data is handled, and this highlights the need for a robust legal and security framework,” says J&J’s Pahlow.
Electronic Patient Records
Some progress has been made in recent years. For the FOPH’s Lévy the electronic patient record (EPR), a personal collection of health-related documents patients can decide to share with healthcare professionals introduced in 2022, was a major milestone. “The EPR’s benefits are undisputed. By bringing together all the relevant information about a patient’s health, it can tangibly improve the quality of the medical care,” Lévy claims. “The EPR also improves the efficiency of the overall healthcare system – by preventing information from getting lost, or by avoiding unnecessary repetitions of medical procedures such as X-rays or laboratory examinations.”
Not without its faults, the EPR has not yet been fully adopted by patients or medical institutions and practitioners. “We’re working on this, partly by expanding its usability to areas such as electronic vaccination certificates or e-medication plans, and partly by undertaking a comprehensive revision of the relevant legislation which should facilitate its further development,” says Lévy.
Industry Efforts and DigiSanté
Pharma industry stakeholders are aware that the country cannot continue to straggle and have pushed to advance the digital agenda. “We’ve made significant progress, particularly on the legal front. In 2021, we implemented several projects that set the stage for a more digital healthcare system,” affirms René Buholzer, CEO of Interpharma, the association of Switzerland’s research-based pharmaceutical industry. Despite these foundations for digital transformation, practical implementation is still limited. “We need to see these changes translate into real-world improvements. The groundwork is there, but it will take time before the full impact is felt across the healthcare and pharmaceutical industries,” he says.
The Swiss government’s Federal Council has also recognised the need to push the digitalisation envelope and has adopted a programme to promote digital transformation in the healthcare system – DigiSanté. “Initiatives like DigiSanté are so crucial. This initiative not only sets common standards and legal frameworks but also aims to improve infrastructure and, equally important, engage the public to increase acceptance of digital solutions in healthcare,” Pahlow asserts. The Swiss Council of States approved the allocation of CHF 392 million over ten years for the DigiSanté programme, which is set to enter the implementation stage next year.
“Most Swiss doctors’ practices and all Swiss clinics have digital information systems. The problem is that these systems don’t all use the same data standards. We want to ensure that all the appropriate healthcare information can be sent with a single click from a clinic’s information system into the relevant EPR. To do that, though, we need shared and binding data standards which enable health data to flow seamlessly and securely from one system to another. And this is where Digisanté comes in,” Lévy confirms.
Leveraging Real-World Evidence
Pharma industry leaders also contend that as a result of its lack of digitalisation Switzerland is not leveraging the potential of real-world data to improve patient outcomes. “Switzerland faces challenges in fully capitalising on real-world evidence, largely due to the slow pace of digitalisation,” says Florian Saur, country president at AstraZeneca. “Without a robust digital infrastructure, it becomes difficult to effectively collect and utilize real-world data, which in turn delays the ability to translate those insights into improved patient care.”
Roche’s Gasser agrees. “We see immense value in real-world evidence. While clinical trials capture only 2 to 3 percent of the available data, the remaining 98 percent is an untapped resource that could greatly improve patient outcomes and healthcare efficiency.”
Clear Gains
The benefits of improving Switzerland’s digitalisation are apparent for most. “It will reduce healthcare costs, minimize waste, improve diagnostic accuracy, and prevent unnecessary treatments,” Pahlow reasons. “Digital tools can also help avoid harmful drug-drug interactions. Moreover, streamlining administrative tasks would allow more resources to be directed towards patient care rather than bureaucratic processes.”
“A more aggressive adoption of digital health solutions could potentially save up to 20 percent in healthcare costs if we achieve full digitalisation,” advances Ernst Niemack, managing director of vips, the association representing pharmaceutical companies operating in Switzerland.
With DigiSanté implementation on the horizon and a consensus that digitalization has clear benefits, stakeholders are mostly optimistic. “I’m convinced that, within the next ten years, we’ll be clearly benefiting from all the efficiency gains that derive from having systems better interlinked,” says Levy. “We’re optimistic that with stronger governmental leadership, we can accelerate progress,” Buholzer maintains.
Swiss healthcare is nevertheless facing a tough task. “Although digital health is now a high priority for stakeholders, with the government allocating substantial funds to develop standards over the next 10 years, there is still much work to be done,” Niemack cautions.
