EHE interview: Harald Deutsch

Harald Deutsch

Harald Deutsch started his career as a physicist and trained as a doctor before going into business. He joined CSC after a long stint as managing director for healthcare at Accenture.

In his current role he is responsible for CSC’s activities in Europe, the Middle East and Africa relating to the public sector, healthcare providers and insurance healthcare. He also has global responsibility for e-health records and industry alliances.

E-Health Europe was given the chance to interview him at CSC’s offices at the Gherkin in London, when he visited the UK on a flying visit ahead of trip to the HIMSS conference in Atlanta. Unsurprisingly, he was in the mood to reflect on state of healthcare and healthcare IT in both Europe and the US.

Prospering from the downturn

HIMSS was electrified by the billions of pounds promised for healthcare IT by President Barack Obama’s American Recovery and Reinvestment Act. Nothing similar has been promised for Europe or the UK; where the NHS is being warned to prepare for £20 billion savings over five years.

Yet Deutsch is upbeat about the impact of the economic crisis on healthcare IT. “As long as the economy is still requesting governmental help, there is a good chance that it will help healthcare technology more than the years of prosperity behind us,” he says.

“A lot of e-health in Europe has been delayed over the past years, certainly not because of missing funds but because people are running in different directions and there hasn’t been enough feeling of an emergency to do something, which is now changing.”

Deutsch argues that the economic crisis has led some countries to conclude that healthcare technology is a piece national infrastructure; which is fundamentally new.

Government matters

Deutsh has strong views on the importance of strong, centralised government when it comes to healthcare IT projects. He believes that the countries that are lagging behind on e-health are those that have decentralised government and healthcare systems facing little pressure to innovate.

“We are observing an era of govermentalisation in healthcare,” he claims. “The main value that technology can provide comes from generating scale to bring down the cost.

“This does not work so well when things are scattered. Information cannot be provided because some parties maintain that information. You don’t have overarching projects because central issues are missing.”

Deutsch includes France and Germany in his examples of countries that have sufficient resources to have a good e-health infrastructure, but which are too fragmented to bring it to reality.

Bad news is good news

In the UK, CSC is widely seen to be struggling with its contract to provide joined-up electronic patient records to the North, Midlands and East of England through the highly centralised National Programme for IT in the NHS.

Critics, including the Conservative Party, argue that it is struggling precisely because its ‘one size fits all’ approach does not work for NHS organisations; or a public worried about government databases. They point to smaller, more decentralised healthcare systems as making more progress.

Deutsch does not agree: “In all regions and all countries large scale tech problems are disputed and part of public discussion. The further you are from the UK, the more admired the technology programme is as a reference,” he says.

“The matter of fact is that nowhere on the globe has a company made that many changes in a handful of years.” For this reason, Deutsh is not worried about the impact of the national programme on CSC’s reputation across other EMEA markets.

“From a press point of view you may think that we could have a reputation issue. That is in no way the fact,” he says. “All countries and bids greatly appreciate what we are doing. Look at what the French and German presidents have announced – delay is clearly a constant thing in healthcare technology.”

Top three trends

Against this background, Deutsch identifies three big trends for healthcare IT in coming years. E-prescribing is one of the key ones, particularly for smaller countries that are deploying the technology on a national scale.

He also feels the time is right for routine business intelligence, particularly in hospitals. “Business intelligence is required, possible and is growing. The more penetration electronic patient records have, the more value we can pull out of the layers of business intelligence.”

But he warns that business intelligence is a small segment in crowded market place, and that it could take years before companies earn money from investing in it. He also feels that it will “take many more years before EPRs are transparent and widely distributed.”

Cloud based records “won’t fly”

An issue that is receiving a lot of attention at the moment, particularly in the US and the UK, is personal health records of the kind being offered by Microsoft with HealthVault and Google with Google Health.

Deutsch is interested but mildly sceptical about these. “This is a private patient record, so the interface directly to the patient will be very interesting. Will there be enough benefit for the patient when the providers are only partly motivated?” he wonders.

He also raises questions about the kind of content these records will hold. “There will be a better informed patient, someone who can find information from ten years earlier, but will there be [vital treatment] details or just industry required information?

“All the industry players play different games depending on their business models, so it will take years to decide on these questions.”

Deutsch is even more sceptical about another much hyped idea: cloud computing in healthcare. “Cloud computing will happen, but will it happen in healthcare soon? No.

“There are clear reasons for this. It’s a technology that is efficient where large scale, highly competitive organisations can generate massive advancements from getting their back-ends organised. This is just not the case in healthcare.

Before jetting off to Atlanta, Deutsch adds that healthcare is a market that IT finds hard to penetrate in any form.

“Innovation speed within healthcare is not dependent on the availability of the technology; it’s more about how quickly the migration or change can happen,” he says. “Technology is rarely a matter in and of itself.”