«Our EPR works. I have no concerns.»

Samuel Eglin finds this fun fact only moderately amusing: Switzerland is probably the only European country where several different ‘tribal communities’ offer their own EPR. In order for these to communicate with each other, a metasystem is needed. “This exclusivity increases the technical complexity and the costs considerably. To put it bluntly, we had to adapt international standards to the Swiss way of doing things,” explains Samuel Eglin. “What’s more, during the development of our system, we needed to implement new regulatory requirements again and again, because the federal government’s implementing regulations kept changing.” And it didn’t help that axsana had to change certification bodies in the middle of the ‘race’.

Samuel Eglin is glad that he could count on Swisscom’s health specialists during the development marathon. “They pushed through valiantly when faced with numerous sticking points. The ongoing alignment between our teams was a key success factor, and their approach of developing aspects together with the users was impressive.” It’s not surprising that the high level of complexity, the changing regulations and the time pressure occasionally triggered conflicts between the partners. On this subject, Samuel Eglin added: “But we always found each other on a constructive level. The Swisscom specialists showed a lot of flexibility, even during difficult periods.”

Today – around six months after certification – axsana’s EPR is working reliably from a technical perspective. Swisscom ensures the secure and compliant operation of the EPR platform in the Enterprise Service Cloud. It provides all the necessary components such as the patient index, document repository/registry with authorisation system and the portals for patient and provider access. Swisscom has thoroughly shored up the platform to meet the highest ICT security requirements for the management of highly sensitive health data, including the use of bug bounty programmes. Samuel Eglin is satisfied with how the system is running: “The platform is stable in operation, the performance is easily scalable. Our EPR works. I have no concerns. It proved advantageous that Swisscom was able to draw on its extensive portfolio when setting up the platform and optimally combined existing private cloud, security and other solution components. We also benefit from the fact that Swisscom has a unique pool of specialists, thanks to its size.
Even for solving very specific problems, we can always find someone.” With its Managed Services such as F5 perimeter protection, firewall, managed OS etc., Swisscom keeps axsana’s private cloud in top form.

Within just six months, around 120 hospitals and 700 care homes from 14 cantons have connected to axsana’s EPR. The Swisscom Health specialists support the institutions both during operation in a test environment and in the subsequent technical connection to the productive environment. What about the onboarding of patients?
“We run our own certified patient record opening offices,” explains Samuel Eglin. “In addition, together with Swisscom and other partners, we have developed a mobile onboarding system – for use in care homes, for example. However, the EPR will only be suitable for use by the masses once we can offer the population the option of opening records online. That’s something we’re working on.” Yet the most important building block for the success of the EPR lies at the political level, emphasises Samuel Eglin: “Only after the changeover from the current opt-in principle to an opt-out approach has been completed, will the EPR fulfil its role as defined by the legislator. We are involved in political initiatives to achieve this.
After all, it wouldn’t do for such a costly system as the EPR to only be used by a minority.”

At the end of April 2022, the Federal Council decided to change course in order to promote the widespread implementation of the EPR. The opt-out model will now apply to patients, and all medical service providers, from Spitex (home care) and physio practices to existing GP practices will be obliged to connect to the EPR. The corresponding draft is being prepared and submitted for consultation.