A Tale of Two Cities: E-Health in Germany and Australia

Over the last forty years, the average percent of Gross Domestic Product (GDP) spent on healthcare by members of the Organization for Economic Cooperation and Development (OECD) countries has risen considerably. Challenges including longer life expectancy, ageing population and technological changes have and continue to exponentially impact rising health expenditures. Reducing these expenditures as well as offering effective and efficient quality healthcare treatment has become a priority globally to healthcare. Technology and automation in general have the potential to reduce these costs; hence many countries are now looking at how to use information and communication technologies (ICT) in general and e-health solutions in particular to address these challenges. Hence, this paper focuses on such attempts by two countries. Specifically, it focuses on the German and Australian e-health solutions. The paper provides an assessment of these two solutions, the possibility for any lessons learnt with regard to designing and implementing successful and appropriate e-health solutions as well as understanding the major barriers and facilitators that must be addressed. Finally, Actor Network Theory (ANT) will be used to provide a rich lens to investigate the key issues in these respective e-health solutions. DOI: 10.4018/jantti.2012010103 International Journal of Actor-Network Theory and Technological Innovation, 4(1), 24-38, January-March 2012 25 Copyright © 2012, IGI Global. Copying or distributing in print or electronic forms without written permission of IGI Global is prohibited. Moreover, the use of information and communication technologies (ICT) in e-health solutions in particular appears to be the key to respond to these challenges (Wickramasinghe & Schaffer, 2010). In addition, several countries are changing their thinking about healthcare, because they know that the current situation is no longer feasible. Therefore, we are witnessing new healthcare reforms. Based on this fact, countries like Australia, Finland, Germany, UK and U.S., to name but a few countries, have started to change their healthcare system because they have recognized that with the use of information and communication technologies (ICT) in general and specifically e-health, healthcare costs can be reduced, while the quality of healthcare delivery can be improved (Wickramasinghe & Schaffer, 2010). This means that e-health is becoming an essential part of modern healthcare delivery, which in turn means it is now an essential one to fully understand. In their enthusiasm to develop e-health solutions, it appears to us that countries are focusing efforts to only address the internal issues. However, healthcare delivery is a global phenomenon and in an age where global business operations are prevalent, it is essential for e-health to also have a global, network centric perspective, including being able to support healthcare information exchange between different countries. This is the central thesis behind the doctrine of network centric healthcare (Wickramasinghe et al., 2007). Thus, a current problem is that in an attempt to address escalating healthcare costs countries are turning to developing e-health solutions, but because these solutions are not being designed with a global perspective rather than provide effective and efficient quality healthcare solutions they are likely to exacerbate the current situation and create more costly, poor quality healthcare solutions. One way to develop an ehealth solution, which has a global perspective, is to investigate the possibility of transferring an e-health solution across countries. In this way, it will be possible to support healthcare information exchange between countries. This is essentially the strategy that the banking industry adopted. Hence, this paper serves to explore the research question “How can we transfer e-health solutions?” In looking at the possibility of transferring different e-health solutions it is also necessary to have a rich theoretical lens to facilitate in depth analysis of all critical issues as well as their interactions. We therefore adopt ANT (Actor Network Theory) as such a lens.