By Ruth Whittington (

The World Healthcare Congress, held March 10 – 13 in Berlin, always provides interesting insights on the ways governments, clinicians, and healthcare providers perceive healthcare delivery. In the same congress last year, held in Barcelona, two themes dominated the presentations and networking discussions.

The first was the concept of an electronic patient healthcare record – whether it was ethical, how it might be perceived by patients and clinicians, and how such a record might impinge upon such issues as cross-border healthcare provision within Europe. The second theme was chronic disease and how poorly healthcare providers deal with the handful of chronic diseases that account for more than 70% of all healthcare resources.

This year’s congress showed how far healthcare or at least the attitudes of the upper echelons of healthcare decision-makers progressed in a single year. Last year focussed on the concept and ethics of an electronic record; this year, the need for such a record was a given and instead, emphasis was on how best to implement such records and the integration of primary and secondary healthcare by using records to coordinate provision. Many countries are attempting to implement these records and the main issue they face is how to integrate all the existing data sources without undue changes in healthcare practice. The exhibition area of the congress abounded with systems aimed at capturing information, electronic diagnostic maps for patient care, and monitoring healthcare provision by use of guidelines and electronic record keeping. Ethics, apparently, have gone by the board.

Chronic disease management has undergone a similar transformation. Last year we were being alerted to the impact this had on healthcare; this year we were treated to advice and experiences in long term disease management systems, virtual wards for patients at risk, and systems to prevent chronic disease development. The shock of it all has evidently worn off; it seems now governments are knuckling down to deal with chronic diseases by as many new and innovative programs as they can devise. This year systems for prevention are in their infancy – what’s the bet that next year we will be assessing the impact of preventative programmes?