08. October 2020

SHIP – the future of communication in Swiss health care


Communication // The use of information and communication technologies is not as widespread in the health care sector as it is in other services. For the most part, communication between service providers and cost bearers is not standardized, let along digitalized – the SHIP communication standard is about to change this.

Until now, communication processes in the health care sector have been unable to keep up with the increasingly fast-paced  environment, and are susceptible to errors. There is a clear trend towards digital solutions, which are capable of standard-izing communication processes and ultimately of automating them too. One such solution has been developed by SASIS AG  together with ti&m. SHIP has already been rolled out success-fully by the Solothurner Spitäler hospitals and by Helsana; other users will be going live shortly.
ti&m masterminded the technical implementation. In 2016, they were asked to provide their IT expertise and knowledge of digi­talization. A solution was developed for how the messaging  standard – the semantics – and the processes could be bundled in a connector. The current design is an entirely new and innova-tive concept.

Inefficient processes lead to asymmetric communication
Admission and discharge dates for inpatients and detailed infor-mation about their treatment are crucial pieces of information for cost bearers. Quick and transparent handling of requests for confirmation of coverage between the service providers and cost bearers is also required.

Currently the majority of these requests are handled manually and, depending on recipient, via a range of channels including letter, fax, telephone, or email. Data transfer takes a long time, and usually takes place only after treatment has been adminis-tered. It has now been recognized that this inevitably leads to inefficiency and high costs;  the insurance industry is aware of these issues, and SASIS AG has worked together with ti&m to  develop a solution that simplifies the unnecessarily time­consum ing work involved in processing. The solution developed provides for timely, secure, and efficient exchange of information and data, even when multiple cost bearers are involved. 

Data protection is guaranteed at all times
Using a “privacy by design” approach, data protection was incor-porated into the design of the process. The required security is provided using end-to-end encryption between the service provi-ders and cost bearers. 
In addition, a multi-stage, standardized process ensures that only the necessary data is exchanged directly at any stage. This means that data exchange and processing is kept to only that which is necessary. Compared to the status quo, this actually leads to significantly stronger data protection.

Using standards to create a common ground
In November 2019, the standardization association eCH approved a messaging standard (eCH­0235). This sets out the overarching messaging framework for harmonized and largely automated handling of administrative processes between health care stake-holders in relation to the processing of treatment costs. There is additionally a data standard (eCH­0234) which defines the overarching technical concepts and data types, a process stan-dard “Hospital inpatient” (eCH­0236) which defines the technical process logic and message content, and the process standard “Care” (eCH­0237) which performs the same function for the care aspect. These are beneficial to the central objective of a uni-form and secure exchange of data.

How does this communication standard work, and what does it do?
The “Hospital inpatient” communication standard corresponds to the patient care pathway: Planning the hospital stay, cost assurance via insurer and canton, admission, treatment and  discharge. The open SHIP standard guarantees flexibility for  further development, thereby ensuring the system is secure and future­proof. It is easiest to explain how it works with reference to the “Hospital inpatient” process standard.

In detail, it looks like this:
1. After registering for an inpatient stay, the hospital patient administration sets up a treatment case in their system. This automatically triggers a message to the relevant cost bearers relating to opening the treatment case.
2. The hospital sends the necessary data to the cost bearers, fully encrypted, to verify acceptance of the costs.
3. Verification of cost acceptance is largely automated; the hospital then receives a reply from the cost bearers, again electronically, in the form of either an assurance, a rejection, or a request for further information.
4. When the patient is admitted and discharged, the hospital again automatically sends a corresponding message to the cost bearers.
5. No need for letters, faxes, phone calls, or emails – the new standard provides for the necessary information and data to be exchanged entirely by digital means. As a result, processes are simplified, automation is worthwhile, and there are savings in terms of administration costs.

A direct connection is set up between two partners using point-to-point communication, which offers a high degree of securi-ty and control. The immediacy coupled with the fact that only  those involved have access to the communication is the best  argument for using this data exchange process.
In terms of practical application, cases that have been processed using SHIP are already 50 % less likely to generate report queries and rejections, according to service providers. In prac tice, cost bearers have been able to process 75 % of cases automatically. Stakeholders in the Swiss health care sector who have signed up for SHIP can therefore look forward to positive results. Digi­talization of communication is finally making progress in the health care sector, ensuring that administrative processes are digitalized, standardized, and automated using the most strin-gent security standards.

Domenico Fontana
Domenico Fontana

Domenico Fontana has been managing affairs at SASIS AG for 4 years. A business economist, he has many years of experience in running national and international companies.

Vinzenz Schläfli
Vinzenz Schläfli

Vinzenz Schläfli is responsible for marketing SHIP. His role involves planning, coordinating, and leading sales and marketing activities to establish SHIP throughout Switzerland.