PRIMA SANA – The Swiss Case Management App set to revolutionize the Swiss healthcare system for good

The rising costs of the current healthcare system in Switzerland add up to an alarming CHF 100 billion per year. At the individual level, the cost of mandatory medical insurance already represents an enormous burden for the majority of the population and their household budget.

The Swiss Case Management App

At the same time – according to the Institute of Health Economics in Winterthur – there is an obvious trend to invest in a healthy lifestyle, especially in times of a global pandemic. Companies in the healthcare sector and physicians are beginning to realize that they must rethink the importance of involving their customers/patients as active partners in order to raise general awareness of this healthcare challenge.

A recent study by the FOPH has shown that almost 50% of the population is completely overwhelmed in terms of their own health literacy. In addition, found that at least CHF 1.5 billion in medical treatments per year are spent unnecessarily or even dangerously.

The electronic patient record (EPR) is a tool that could contribute to some extent towards regaining a certain amount of control and transparency. But for patients and doctors to be able to establish a truly new partnership on an equal footing, all those involved will have to radically change the way they see themselves and others.

This is where the Swiss Case Management App – Prima Sana (as working title) comes in. It is intended not only to save at least CHF 1 billion in healthcare costs per year, but also to revolutionize the relationship and data transfer between patients, doctors and the health insurance company, thereby strengthening so-called “health literacy”. 

This is to be achieved with a Swiss case management app respectively with the digitalisation of the case management process (DCM – Digital Case Management). With this new app, the population/patients will be interactively educated and empowered to take more individual responsibility. Using personalized case management (general and individual health information, guidelines, facts & figures, rights and duties of patients and physicians), they are coached and supported in cooperation with all relevant actors within a medical case in order to achieve the best possible outcome in each individual case. This is done digitally (e.g. live face-time participation and recording during a visit to the doctor or to the disability insurance company – possibly using the already existing “Emergency Eye”) and of course physically if required.

After more than 10 years of experience as a case manager and some very unique medical ups and downs, it has made a huge and decisive difference in each individual case if a mediating actor was present during important health discussions with the doctor, employer or the accident, health and social insurance.

Case Managers play a unique and extremely important role within the healthcare system that is either completely underestimated or simply unknown to this day. The main objective of professional case management is to advocate an interdisciplinary consensus in order to achieve the best possible results in a “reintegration process” of clients at risk. Case management is basically a coordination management of a reintegration process, which should always be completely safe and solution-oriented and with a 360-degree perspective. Case Management is guided by the principles of autonomy, confidentiality and neutrality. It always looks at a patient holistically, i.e. not only physically and mentally, but also as a social individual in a systemic context. We call it the bio-psycho-social overview.

The 4 process steps of a professional case management

1. Assessment

2. Goal setting and / or action plan

3. Repeated Monitoring / Adjustments

4. Evaluation / Completion

Using a case management app, we digitally and interactively run through the 4 essential process steps of case management with all the necessary information for the customer and the case manager at your fingertips, using the coming electronic patient record (EPR) and other technologies. The data sovereignty lies to 100% with the patients. Within the app, we will work with a digital case management profile that contains, among other things, the current and regularly updated medical status with regard to the reintegration process and the timeline (physical, psychological and social).

As case managers, we will not only guide and coach you through the reintegration process and in regards of how to use the EPR or the “Emergency Eye” technology but in all other relevant aspects of an improved health literacy.

The Swiss Case Management App will thus include all existing and upcoming digital technologies for the benefit of the patient.

The biggest challenge is to build trust for both sides – patients and doctors and all other relevant stakeholders. We firmly believe that it is essential to find the right balance between digital and personalized advice throughout a case. The patient must always be the focus of attention. The app is merely a support tool to make the case management process more efficient, transparent and comprehensible for all parties involved.

There are several advantages for the patients, as they are accompanied by an independent and completely impartial person and technology. Every single case we run through this process will serve as a multiplier in terms of a newly acquired health competence. We know from our own experience that the majority of doctors also find the mediating support of an independent case manager very helpful.

A substantial reduction of the individual health insurance premium as a result is very feasible for future benefit. As we can easily prove to be cost efficient, completely impartial and therefore very trustworthy with this app. 

The latest development is that, as captain of this project and with a view to further professionalization and networking, I have enrolled in a master’s degree in MAS Health Care & Marketing at the ZHAW School of Management and Law in Winterthur as of September 2020. In addition, further discussions are currently taking place with one of Switzerland’s largest employer brands, a potentially interested private foundation, and a university as a partner.

The next major milestone is the launch of a pilot project together with potential partners to address all these exciting challenges with a unique and digital Swiss joint venture pioneering project across organisations and generations. Because in each individual case accompanied, we will be able to demonstrate the saved (material and immaterial) costs or the exciting benefits of behavioural changes and if you feel completely safe and supported despite a temporary vulnerability.

It is my firm conviction that this project could and should be accompanied by a media format in order to achieve the best and fastest possible results. I therefore call on the Swiss media landscape to become a partner of this project.

Author: Remo Heinrich

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