“Hospital information systems are not indispensable”

Hubert Haag, head of the international healthcare business at T-Systems

Traditional telecommunication companies are heavily involved in European e-health- markets. In the UK BT is a key supplier behind the multi-billion English NHS IT programme, and T-Systems, Deutsche Telekom’s IT and business networking division, is equally committed.

Hubert Haag, head of the international healthcare business at T-Systems, told E-Health Europe that with 12,000 European healthcare customers T-Systems is a leading player when it comes to e-health solutions in Europe.

T-Systems and Germany’s e-health smartcard project

And in perhaps its most significant e-health project yet T-Systems recently won the contract for the national backbone network within the German smartcard project.

EHE: Can you go into more detail about the role T-Systems will play in the project’s future?

Hubert Haag: “It is clear that we were very happy about this success, and I have to say that this was a must win for us. It is a five year contract with the national health IT organisation Gematik, with an option for further five years afterwards.

“The backbone network will be one of the central components of the smartcard infrastructure as soon as it becomes an online system. Still, this was only one bid, and the success does not mean that we are in any better or worse position for other bids than we were before.

“As a telecommunication company, T-Systems does not only offer networking solutions, but also security and identification services for health IT applications. We have customised electronic patient record solutions in the portfolio. We have our own Trust Centre and, last but not least, we offer smartcard solutions of all kinds both for medical professionals (‘health professional cards‘) and for the insurants (‘elektronische Gesundheitskarte‘, electronic health card). All this runs separately.”

EHE: Things did not run entirely smoothly for T-Systems in the German smartcard project during 2007. The company was unsuccessful in a series of bids for the provision of smartcards to three major German health insurers.

Hubert Haag: “True. There were different reasons for that which I do not want to comment on in this context. But, it lies in the nature of bids that one company does not win all of them. We try to look at it positively: these contracts were for about 40 to 50% of the German market for electronic health cards. This means that another 50 per cent has not been allocated so far. We are prepared.”

T-Systems pan-European operations

EHE: What are the key markets for T-Systems regarding e-health solutions?

Hubert Haag: “Our home base lies in Germany, obviously. We are strong in Austria, Switzerland, Spain, and South Africa. And we have some customers in Eastern Europe. It is always difficult for us to provide numbers for market shares, because we have such a broad spectrum of solutions that we offer. All in all we have about 12,000 customers in healthcare in these countries.

“This includes health insurance companies that use our IP platforms, care facilities or hospitals that use RFID solutions, digital mail administration, digital archiving solutions and so on. When we are talking about health-IT in a stricter sense, we are the market leader in hospital networking solutions in Austria and one of the market leaders in Germany. We also have a series of interesting telemedicine installations in Spain, and we offer hospital information systems in Europe but also in the Middle East.”

EHE: Can you give some examples of regional networking solutions in the different countries?

Hubert Haag: “In Austria, our key project in this context is certainly the NÖMED WAN-project which we are providing for the ’Niederösterreichischer Gesundheits- und Sozialfonds‘ (NÖGUS) in the Austrian state of Lower Austria. T-Systems is connecting all public hospitals there via a Master Patient Index that uses the Austrian E-Card for patient identification.

“What is currently being developed is a decentralised patient record solution which enables doctors to access medical data from other institutions with the help of the patient’s E-Card. Hospitals do not have to change their information systems for that, so it is about integrating solutions rather than replacing them. NÖMED WAN is particularly interesting because it is considered a model for what might be realised nationwide in the Austrian smartcard project.

“In Germany, the most interesting project is certainly the prospeGKT project in Bottrop together with the Bundesknappschaft, a health insurance company. We are establishing a shared electronic patient record solution there for 20,000 patients of 70 doctors in private practice and two regional hospitals. Bottrop is not among the official test regions of the German smartcard project, but the solutions that are used there are compatible with what Gematik is demanding. We are actually among the first that use the electronic health card for accessing an electronic patient record, so this is a milestone project.”

"In Spain, we have a variety of telemedicine and e-health projects running. One is in the region Extremadura in central Spain, where we have installed a regional health network that uses an SAP based medication module, which enables a large number of primary care centres to do electronic prescriptions.

“In Switzerland we are engaged in St. Gallen where we are coordinating one of the pilot regions for the Swiss smartcard project now.

Why integration is T-Systems’ core e-health expertise

EHE: T-Systems sees it’s core expertise in e-health is as an integrator of existing solutions. You have just announced a cooperation agreement with the Austrian company Tiani Spiri, what are the details of this?

Hubert Haag: “Tiani is a small but very innovative Austrian company that is strong in making existing health-IT solutions compatible to the demands of the ’Integrating the Healthcare Enterprise‘-initiative (IHE). It has been a major player at all recent connectathon workshops run by the IHE.

“Tiani offers middleware for connecting different health-IT solutions according to IHE standards. For electronic health records, for example, there is a registry/repository solution that is able to cope with both structured data according to the CDA 2.0 standard and unstructured data like pdf files. This is very important for an integrator like T-Systems. We have cooperated with Tiani already in different projects. We have now signed a written agreement to extent our partnership, and we will announce further projects in due course.

T-Systems future as a hospital information systems provider

EHE: Apart from integrating solutions, T-Systems is also offering its own hospital information system (HIS), the SAP based ish-med. Your former partner on this HIS solution, GSD, was taken over by Siemens a year ago. How did this affect the ish-med-business?

Hubert Haag: “Since Siemens is a stronger partner in financial terms than GSD was before, I would say that, if anything, development of ish-med is accelerating in the new partnership. We have roundabout 200 ish-med customers at the moment, mainly in Germany and Austria. With Siemens and SAP together, we will probably get even better access to the market in the long run.

“We are also a distributing partner for the HIS iMedOne. This is the flagship product of TietoEnator, a Scandinavian-based health-IT provider with an explicitly international approach to the HIS market. This should also help in getting access to other European markets.”

Why T-Systems won’t develop a next generation HIS

EHE: Given that the HIS-market is heavily consolidating at the moment, could you comment on the future of T-Systems as an independent actor in this field? Will there be a T-Systems ish-med five years from now?

Hubert Haag: “The HIS solution ish-med came to T-Systems in 2000, when Deutsche Telekom took over Debis, a subsidiary of DaimlerChrysler at that time. So ish-med is not “our baby”. HIS certainly is a strategic topic for us. But when I look at what is happening at the moment in the HIS market, I am convinced that HIS solutions in the future will look different than they look today. There will probably be an IT layer on top of them which might include workflow, accounting and logistics. Our ish-med is highly compatible with this approach, but T-Systems will not develop its own next generation HIS like Siemens, TietoEnator or iSoft are doing at the moment. So yes, HIS is important for us, but it is certainly not indispensable to life. Our key expertise lies in system integration.

Philipp Grätzel