The Swiss healthcare system: entering a new digital era

Switzerland is one of the most innovative countries in the world, but when it comes to digitalisation of its healthcare system, the process of implementation is very slow. Nevertheless, the Federal Council is currently supporting the transformation with its Health2030 Strategy and its digital health promotion programme Digisanté. A central pillar of this digitalisation process is the electronic patient record (EPR) which has faced many hurdles to be implemented and adopted successfully due to the fragmented Swiss healthcare system. 

Switzerland has three main regions, which are home to digital health innovations: canton of Zurich, the Arc lémanique region and the Great Basel Area. These locations place Switzerland as a great digital health market where companies and startups choose to settle. 357 digital health startups were identified in Switzerland by the Swiss Healthcare Startup’s directory guide spanning through the entire patient journey (from prevention to diagnosis, treatment and monitoring). This correlates with the constant increase in investment in such ventures. However, these organisations face many hurdles, especially with reimbursement of their solutions, as the mechanism is complex and reimbursement for digital health solutions is not transparent.

According to our population survey, conducted in 2022, 68% of the population want to be owners of their personal health data. It is therefore key to empower patients more to better understand and use their health data through training, education and awareness-raising measures. Swiss Health Data Space, is a new initiative going in this direction, as it recruits pioneers who want to test and explore the digital healthcare infrastructure in Switzerland while keeping full control and ownership of their health data.

Digital health ecosystems are slowly emerging, for example networks of different organisations and solutions across the healthcare sector that share a digital infrastructure to ensure a seamless experience for patients. These networks increase transparency and efficiency in communication between the different actors. One such example is the Swiss Patient Journey Ecosystem Map.

Already now, numerous Swiss solutions support the overall patient empowerment, such as the four scaleups that were part of the Digital Health Academy’s 2023 cohort: Decentriq, heyPatient, Soignez-moi, and TOM Medications.

Eventually, the future of healthcare should be human-centric, fostering education and empowerment of the population to better understand their health data and navigate their digital health journey. Citizens should collaborate more with healthcare professionals, as this will strengthen their relationship and trust, as well as ensuring the continuum of care. Additionally, innovators and investors need to build symbiotic relationships as strategic investors provide valuable resources to innovators who are navigating the complex healthcare landscape; this will ensure long-term impact. Last but not least, public authorities need to set national standards and a clear framework for digital health in Switzerland, ensuring that solutions to our current problems are based on the same standards.

1.1 Background 

Switzerland is recognised as one of the most innovative countries in the world, highly ranked for many years in the IMD World Digital Competitiveness (WDC): it was ranked 5th in 2022 and in 2023 it can hold its position once again (IMD World Competitiveness Center, 2022). Similarly, Switzerland ranks 1st in the Global Innovation Index (Dutta et al., 2023), with the Index highlighting the significant R&D investment of Swiss global corporates, led by life science giants Roche and Novartis.

The Swiss healthcare system is one of the sectors in which Switzerland still lags behind in terms of digitalisation, as underlined by the “Bertelsmann Stiftung’s Digitalisation Index” (Bertelsmann Stiftung, 2019), where it was only ranked 14th. 

Digital health refers to the use of information and communications technologies in medicine and other health professions to manage illnesses and health risks and to promote wellness (Ronquillo et al., 2023). It has a broad scope, spanning through the entire patient journey (from prevention to diagnosis, treatment and monitoring) and includes mobile health apps, electronic health records, wearable devices with sensors, telemedicine and personalised medicine. Digital health has various benefits such as accessibility, accuracy, time saving and cost reduction.

The COVID-pandemic played a massive role in digital health’s growth worldwide, as new solutions were developed to support the healthcare of the population through the crisis, and a necessity to switch to at-home or minimal contact care models. Certain countries have been able to implement the necessary infrastructure and regulations required to digitalise their healthcare systems such as Estonia, Canada, Spain, Israel and Denmark. Their governments have made clear commitments to supporting the development of the sector. 

Switzerland is also trying to win back lost times by developing the digital health sector positively through various innovative solutions.

The Federal Council is currently supporting the digital transformation of healthcare in Switzerland through different ways. In the Health2030 Strategy, it defined the new health policy priorities, setting digital transformation as one of the main objectives (Federal Office of Public Health, 2019). In addition, the Federal Office of Public Health (FOPH) and the Federal Statistical Office (FSO) are jointly developing on behalf of the Federal Council, the digital health promotion programme Digisanté (Federal Office of Public Health – Digisanté, 2023).

Switzerland is facing complexities in the introduction of digital solutions such as the electronic patient record (EPR) (Patientrecord.ch). Due to its fragmented healthcare system and cantonal policies, its law has recently been placed in consultation to identify the optimal changes required for it to finally be adopted successfully by the population. As the governmental solution is taking a lot of time to be installed, healthcare players identified opportunities to launch joint consortiums to provide a digital health platform. The two biggest consortiums are Compassanna (Bluespace Ventures AG, 2023) and Well (Well Gesundheit AG, 2023). 

In recent population studies, it was clearly identified that the Swiss population is willing to share their health data digitally (Pletscher & Lerch, 2022) and onboard a digital health journey (Sternberg, 2022) given it has clear added value.

1.2 State of the digital health landscape

Switzerland’s digital health landscape has expanded in various areas over the years: telemedicine, wearables, patient records, healthy ageing, mental health, femtech, value-based healthcare and personalised medicine. 

Three principal regions are home to digital health innovations: Canton of Zurich, the Arc lémanique region and the Great Basel Area.

Zurich is the home to major technology companies, key universities in Switzerland (ETH, UZH, ZHAW) as well as many hospitals. In recent years, Zurich has grown its digital health footprint through the development of digital health hubs and incubators such as Digital Health centre in Bülach, Bluelion, and HealthTechPark in Schlieren.

L’Arc lémanique has also expanded massively, especially around Lausanne and Geneva due to the presence of  EPFL, university hospitals (CHUV and HUG) and campus of Biotech Innovation Park and Biopôle. 

Last but not least, the Great Basel area is a flourishing region, where pharmaceutical companies and medtech are closely located to the university hospital. DayOne from Basel Area has also recently grown massively and is leading a four-year Innosuisse Innobooster around digital health, the Digital Health Nation Innobooster.

These ideal locations position Switzerland as a great digital health market where companies choose to settle, and startups choose to be founded.

The digital health startup scene is also growing massively in Switzerland with 357 digital health related startups and scaleups identified in Swiss Healthcare Startups’ digital directory in October 2023 (Cortex – Swiss Healthcare Startup, 2023). Many incubators and acceleration programmes support the emergence of startups such as the Digital Health Nation Innobooster (Basel Area Business & Innovation, 2023). 

Investment into Swiss digital health startups has been steadily increasing until this year, reaching 30 investment rounds in 2022 (8% of all rounds) totalling close to 200M CHF (5% of all capital invested to Swiss startups in 2023). Just over 50% of these funds were invested into digital health startups in canton Vaud (Swiss Venture Capital Report, 2023).

One major hurdle which the startups in digital health are continuously facing is their business model, as reimbursement of digital health solutions in Switzerland is still not a transparent process. In comparison, Germany’s DiGa legislation is in place since the end of 2019 (BfArM, 2023), Belgium’s mHealth app reimbursement since 2021 (Agoria and beMedTech, 2023), and France’s PECAN legislation was approved earlier this year (2023) (Farah et al., 2023). Health applications in Switzerland that follow specific rules can be reimbursed by the basic insurance as stated in the Information Sheet provided by the Federal Office of Public Health (Federal Office of Public Health, 2022).

1.3 Citizen’s empowerment to own and understand their health data and health journey

According to digitalswitzerland’s 2022 study, which is based on the results of a population survey on the needs and fears towards the digitalisation of the Swiss healthcare system, citizens are willing to share their data digitally, given it has clear added value such as better usability (Sternberg, 2022).

It must also offer enhanced prevention, improved diagnosis and treatments and lower healthcare costs. One major finding from the study is the correlation between the level of education and the level of digital literacy and health literacy in Switzerland. 

Careum Foundation, combined both terms into a new term, digital health literacy, which is defined as the degree to which individuals are able to obtain, understand and judge health information from digital sources and use it to make decisions about their health. Careum Foundation worked on a two-year study project on health literacy (2019-2021) where they found that 72% of the Swiss population has difficulties in dealing with digital information and services and accordingly has very low levels of digital health literacy (De Gani et al., 2021).

Giving equal access to digital health competences in Switzerland should be a key focus to enable the population to feel empowered over their health data. More awareness-raising measures should be developed to support this. 

68% of the population want to be the owners of their personal health data (Sternberg, 2022). Citizens want to be in control of their health data, know who has access to it and give consent to how it can be used for research (swissethics, 2021). The electronic patient record (EPR) is going in this direction as each individual has control over who can access their health information. The Federal Act on the electronic patient record, which states the framework conditions for the EPR has recently been put in revision to be adapted and ensure a successful adoption and use within Switzerland (Federal Office of Public Health – EPRA, 2023). 

Furthermore, a new initiative was launched at the end of 2022 with Swiss Health Data Space, which recruits pioneers who want to test and explore the health data landscape in Switzerland while keeping full control and ownership of their health data (Verein Gesundheitsdatenraum Schweiz, 2022).

The future of healthcare should be human-centric with a key focus set on educating and empowering the citizens to better understand their health data and navigate their digital health journey. This enables the patient to stay in better control of his health, their wellbeing, and therefore stay healthier longer.

2.1 Ecosystem approach

Digital ecosystems have disrupted many industries such as mobility, retail or media over the last years. In recent years, they have also started to appear in the digital health sector as networks of diverse organisations and solutions across the healthcare sector. They are connected by a shared digital infrastructure which ensures a seamless patient journey combining in medical data and patient generated data. These ecosystems enable disparate siloed solutions to be connected to ensure the patient has access to the best prevention, diagnostic, treatment and monitoring possible.

A digital health ecosystem ensures clear added value for the different actors (Deetjen et al., 2020):

• Patients benefit more through digital offerings.
• Providers will gain access to novel insights and combine digital and acute care through digital sources.
• Startups are able to rapidly tailor their solutions and reach a wider population as they scale.
• Pharmaceutical companies are able to reach more easily participants for clinical trials.
• Insurances have better service delivery and enable cost savings.

Crucial for such digital ecosystems is the need to identify and articulate positive network effects across different user platform view, and to grow the critical mass that each one has an immediate benefit from participating in such platforms (Zhu & Iansiti, 2019).

Additionally, digital ecosystems increase transparency and efficiency in communicating between the different players to improve the overall value for the system. 

digitalswitzerland has therefore created a Swiss Patient Journey Ecosystem Map to illustrate the different digital solutions focussing on enhancing the digital patient journey and digitalisation of the healthcare system in Switzerland. This representation enables the different players to remove the gaps, identify synergies between themselves and enhance collaboration. 

The Q4 2023 map illustrates more than 80 different players distributed along the five different categories: data interoperability, health monitoring, healthcare interactions, medical data history, prevention/ awareness.

Figure 1 – The Swiss Patient Journey Ecosystem Map – Q4 2023

2.2 Deep dives on best-practices

Switzerland has a great number of digital health solutions which support the overall empowerment of patients to better understand their health data and navigate their health journey. We will introduce the four key scaleups of the year: Decentriq, heyPatient, Soignez-moi and TOM Medications.

Decentriq

The challenge
To address the most pressing challenges in healthcare today, organisations require access to data beyond their borders. Between clinical notes, lab tests, medical images, sensor readings, genomics, electronic health records and the Internet of Medical Things (IoMT), copious amounts of real-world data (RWD) are generated daily, hiding a wealth of potential insights that could lead to better treatment and diagnosis — if they would be connected. Switzerland is at the forefront of healthcare innovation, possessing a wide ecosystem composed of pharmaceutical companies, leading hospitals and startups. However, the data is often siloed due to privacy concerns and poor data interoperability, making it hard for organisations to access and utilise it. This poses a dilemma for data custodians, like hospitals, who must balance patient privacy with the potential life-saving benefits of collaborative data use.

Solution
Decentriq combines confidential computing technology with a data clean room (DCR) framework to create a comprehensive platform for secure data collaborations at scale. This platform addresses the healthcare industry’s challenges by assuring both data privacy and data usability. It allows for rapid setup of data clean rooms that merge data from various sources without ever exposing any raw data and without any special equipment needed on-site.

Confidential computing technology provides hard proof that data is always under the data custodian’s control and never accessible by anyone else — not by other organisations participating in the collaboration, nor Decentriq, nor the cloud provider. Finally, advanced privacy filters ensure that retrieved results won’t unintentionally reveal private information.

Impact on the patient
The use of RWD greatly accelerates research and development, as well as legislative decision-making processes, resulting in quicker access to more effective treatments in the market. When treatments become more targeted and administered more promptly, patients experience improved outcomes. Hospitalisations are minimised, and care providers can potentially intervene even before they become necessary thanks to improved diagnostics models. This means patients benefit from more efficient and proactive healthcare solutions.

Testimonies

“Decentriq’s unique solution gives us the ability to bring diverse datasets together for research while strictly preserving patient privacy. By facilitating secure analysis, their innovative approach holds the promise of improved patient outcomes and a more collaborative healthcare ecosystem.”

— Prof. Dr. med. Dirk Müller-Wieland, Director of Center for Cardiological Studies, University Clinic RWTH Aachen

Team
Decentriq was founded by Maximilian Groth and Stefan Deml in 2019 in Zurich. They lead a team of 35 people from the company’s headquarters in Zurich and are distributed across more than 10 European countries. The company’s mission is to foster data collaboration, even with the world’s most sensitive data.

Collaboration & Partnerships
Data clean rooms powered by confidential computing have enabled the following use cases:

Development of tools to enable earlier treatment of rare diseases
Using Decentriq, data custodians from hospitals make rare disease datasets available — offering a comprehensive perspective of the patient journey without revealing patient row-level information or risking patient reidentification.

Linking clinical trial data with RWD 
With Decentriq’s DCR technology, pharmaceutical companies can combine patient data, match it to clinical trial data, and analyse the data to create more targeted treatments — all while preserving patient privacy.

Enabling transformative healthcare networks
Decentriq is providing core infrastructure enabling iCARE4CVD consortium partners to bring together data on over one million cardiovascular disease patients while ensuring patient privacy.

Research of this magnitude has the potential to transform care for the 60 million Europeans, and many more around the world, impacted by cardiovascular diseases.

Future vision of healthcare
Decentriq’s vision for the future of healthcare is one where more organisations can collaborate on health data while resting assured that this data will remain private. We look forward to seeing how these collaborations can result in pioneering research and advances in diagnostics, treatment, and patient care.

heyPatient

The challenge
Doctors use 80% of their time for administration, while patient-faced processes are mostly still paper-based. Healthcare costs explode and puts healthcare  service provision at stake. A joint study from McKinsey and ETH concluded that Switzerland can reach annual savings of CHF 8.2 billion per year through the use of patient-centred digital health solutions (Hämmerli et al., 2021). The potential health impact and medical utility are substantial.

Solution
heyPatient streamlines processes, relieves staff members, thus improves healthcare outcomes and reduces costs.

• heyPatient offers a transformative platform that simplifies and enhances healthcare delivery for providers, patients and regions.
• Their solution-integrated app is available in 17 languages and serves as a digital companion who organises appointments, enables paperless interaction with healthcare partners, keeps everything at hand and integrates the personal care network.
• Hospitals and clinics subscribe to their modular SaaS-functionality to easily digitise and automate processes (e.g. e-admission, e-appointments etc), reducing costs and improving outcomes.
• Data is securely stored in Microsoft Azure Swiss cloud, prioritising data security and compliance.

Impact on the patient
heyPatient’s impact on patients is significant, as it digitally accompanies patients along their journey across various healthcare providers, simplifies interaction, thus improves healthcare outcomes.

Patients’ Testimonies
Here are two quotes that capture this impact:

“With heyPatient, I no longer have to spend hours managing my healthcare appointments and paperwork. It has made my healthcare experience much more convenient.”

“heyPatient is like having a personal healthcare assistant in my pocket, it helps me manage my health by making everything from appointments to communication with healthcare staff much easier.”

Team
heyPatient’s dedicated team consists of 12 individuals with a diverse range of expertise, who have achieved remarkable success in building a strong offering and establishing an awarded, market-proven healthcare SaaS-solution (Swiss made software) with highest customer value.

The co-founders Matthias and Regula Spuehler, both serial founders, lead in the role of CEO and COO with a strong commitment, owning over 75% of heyPatient AG.

Every team member is an expert in their field, allowing heyPatient to quickly develop and deploy value-focused services and solutions for their customers.

Collaboration & Partnerships
heyPatient is dedicated to collaboration and has achieved significant success:

• Co-development of new features with the heyCommunity where they quarterly exchange on their roadmap with their customers.
• Partnering with Microsoft, Swiss Post and Siemens, they aim to revolutionise healthcare, increase interoperability and simplify service delivery.
• Attracted a diverse customer base of 6 hospitals and clinics, as well as a gynaecology practice group and pharma.
• Actively contributing to research, such as the Innosuisse Flagship project SHIFT, to advance healthcare through strategic partnerships.

Future vision of healthcare
heyPatient’s future vision for healthcare centres on the simplification of interactions with increased patient-centricity, efficiency, and digitalisation. This encompasses:

• AI integration: Incorporating AI-based services for personalised healthcare solutions.
• Enhanced interoperability: Collaborate with strong partners to facilitate seamless multi-stakeholder healthcare delivery based on industry standard HL7 FHIR.
• Holistic transformation: Simplifying and supporting transformation from sick- to healthcare not only for providers but entire regions.
• In summary, heyPatient aims to create an efficient, patient-centred, and digitally integrated healthcare ecosystem through innovation, technology and collaboration, benefiting patients, providers, and healthcare regions.

Soignez-moi

The challenge
It happens often that one is sick and cannot reach their General Practitioner (GP) or they do not have an available appointment for treatment. What can be even worse, is to wait countless hours in an emergency department (ED). Soignez-moi.ch has a solution to help patients in such situations.

Solution
Reaching out to a doctor has never been that easy. Soignez-moi provides a simple solution to treat everyday symptoms that drag patients down. Soignez-moi’s medical questionnaire is free of charge and its triage indicates if someone can be treated remotely or a physical consultation is required. By design, Soignez-moi is a patient-centric and fully digital company where the patient decides his journey and is in charge of their data. They are the only provider in Switzerland that can send prescriptions directly to patients, thus allowing them to choose freely where they want to get their medicine. Their triage module is also extremely customisable and allows hospitals to improve patients’ flow in the emergency department. By better defining the level of emergency ahead and thanks to their modular approach, a hospital can better plan certain cases (pre-defined symptom or group of symptoms), or refer patients to various care centres, depending on infrastructure and available personnel.

How it works
Soignez-moi provides a simple and intuitive solution:

1. Patients simply go to soignez-moi.ch and answer a medical questionnaire to find out if they can be treated remotely.
2. A doctor then calls the patient within the hour, and if needed, they receive an electronic prescription to go to the pharmacy of their choice.
3. The patient might even perform some exam/test in one of 180 partner pharmacies to identify the best treatment.
4. A consultation report is sent to the patient’s GP and Soignez-moi follow up on the case 48h later to check on the progress of the treatment.

Business Model
For a flat fee of CHF 59 reimbursed by the mandatory health insurance (if any, the exam/test are also covered by mandatory health insurance).

Impact on the patient
The impact on patients is huge since they have direct access to a doctor within a couple of minutes and thus can be treated and relieved. The best way to ensure that a solution has a real impact on people is to perform a survey. Soignez-moi therefore send a satisfaction survey one week after the consultation of a patient ended. 40% of their patients filled in this questionnaire and more than 95% rate their experience with 4 stars . 

Patients’ Testimonies

“Fast, proactive and efficient. I would use the service again without hesitation given the difficulty of obtaining a physical appointment with a general practitioner.”

“It was really fast and I really appreciated the doctor I had on the phone, very understanding and attentive!”

Team
Soignez-moi has a very seasoned team that supports their vision. Just within the founders, they have more than 50 years of healthcare experience. The team includes a dedicated team of developers all coming from Lausanne. Their medical protocols have been validated scientifically by the Notfall Zentrum of Inselspital, thus giving credibility to the work performed by their doctors.

Collaboration & Partnerships
Soignez-moi have treated more than 23,000 patients over the last three years and have been able to conclude renowned partnerships in the Swiss French part. They are the telemedicine provider for Réseau Delta (>950 registered GPs), Medbase Romandie, Hôpital la Tour, Hôpital de Réseau Neuchâtelois, Hôpital Jules Gonin, etc.

Future vision of healthcare
The future of healthcare for Soignez-moi.ch is a dynamic landscape where advanced technologies, personalised medicine and patient engagement converge to redefine the delivery of services. From AI-driven diagnostics to genomics-based treatments, this future promises a holistic and interconnected approach focused on prevention and individual well-being.

TOM Medications

The challenge
Only 10% of patient’s disease therapy is monitored today by doctors, hospitals or insurances. 90% lies in the darkness of the patient’s privacy. Uncontrolled. Unobserved. What is seen as a crucial problem in advancing the future of medicine is not access to accurate real-life data. All patient information is captured in specific time-boxes, and we have no idea how patients behave and what happens in their everyday lives outside of the surveillance of doctors and pharmacists. Currently, there is a black box of information about patients, which is needed in order to truly deliver personalised medicine.

Solution
TOM Medications wants to advance personalised medicine, by building a real-world evidence platform, the «TOM insights» platform. At the core of their technology lies high-quality real-world data, sourced from the TOM app. These patient-generated data undergo rigorous analysis to yield intuitive insights into various aspects of healthcare, including disease progression, patient experiences, medication adherence, disease burden, treatment pathways, treatment effectiveness, and the cost of care.

Recognising the need to capture previously untapped information, they designed the TOM app with a focus on engagement, drawing from feedback from over 20,000 patients. This approach has resulted in a highly engaged patient community, with an app stickiness of up to 71% surpassing even social media giants like Twitter (41%), and comparable to Facebook (66%), and WhatsApp (84%).  Patients use TOM as their companion throughout their disease management, resulting in an enormous pool of patient health data over a long period of time.

Through this commitment to gathering and analysing authentic patient experiences, TOM Medications drive healthcare advancements firmly rooted in real patient journeys. This approach paves the way for a personalised approach to healthcare, ultimately reshaping the way care is delivered and experienced.

Impact on the patient
Patients are already benefiting from being able to use the TOM app 100% free of charge and 100% anonymously to manage their disease, leading to more positive treatment outcomes for patients and a higher quality of life. The insights generated from the TOM Insights platform will add to the benefits since it aims to advance developments of more personalised medicine for patients. Thus, patients will get treatment tailored to their needs and improve their health.

Patients’ Testimonies

“Since I’ve been using TOM, I’ve been taking my medication more consciously and consistently! The fact that the app informs me when the medication is almost used up is awesome! I would definitely recommend it!”

“I had recently lost track of when I needed to take which medication and whether I had already taken it. Before I tried TOM, I had tried other medication apps, but I find that TOM has been much more thoughtfully created. It really has thought of everything and it helps me a lot in my everyday life.”

Team
The team of TOM Medications currently counts 12 people, composed of pharmacists, data engineers, software developers, UX designers and business developments. Having such an interdisciplinary team is necessary to bring their vision to life. Apart from their team, they are excited to have their advisory and management board consisting of experts from the healthcare industry and science, successful entrepreneurs, as well important stakeholders, such as Galenica and Sanitas, which are their go-to partners in building a product that really fulfils a current need in the market.

Collaboration & Partnerships
TOM Medications collaborate with a two-digit number of partners from the healthcare sector, be it pharma, insurance, or research institutions. And all these collaborations have the patients’ health improvement in its centre. For instance, they collaborated with Sanitas to create an adherence programme, worked with Galenica and Mediservice to digitalise pharmacy services in the TOM app, and with the Diabetes Center Berne they collaborated in Real-World-Data.

Future vision of healthcare
Their company’s vision is clear: personalised medicine is the future of healthcare, enabling healthcare providers to shift the emphasis in medicine from reaction to prevention. But personalised medicine needs data to do so. And especially (hard to get) patient-generated data to create unique real-world insights. These insights can lead to breakthroughs in treatment strategies, the identification of previously undetected adverse effects, and the development of novel therapies tailored to individual patients’ needs. With more than 200 million patient-generated data already at the heart of the TOM evidence model, they are at the forefront of the transformation of the Swiss healthcare system.

3.1 Society: How can the Swiss population engage with digital health initiatives?

Human-centred and patient-centric design principles strive to put people at the centre of their solutions, particularly with respect to being aligned with their needs in the context of the local healthcare system(s). A majority of the population will not have been involved in the initial design phases of new digital health solutions, yet have an important role to play in refining these solutions – either through direct feedback or simply by letting the companies behind them leverage their user data to improve.

To engage with new solutions, there are often some fundamental prerequisites that enable an integrated user experience. One such enabler is the electronic patient record (EPR), which will become the gateway to many future digital health solutions. The sooner people begin to use their EPR, the sooner we reach a critical mass of people able to access digital services.

Fostering digital health literacy is therefore pivotal. Ensuring the Swiss population, especially the elderly, feels safe, and comfortable navigating these digital technologies is essential. Widespread education in the form of workshops, training programmes, and user-friendly interfaces are imperative to bridge the digital divide, as well as encouraging dialogue between those who have had initial experiences with these solutions and those who are still learning about the benefits and convenience of digital healthcare delivery.

Moreover, collaboration with healthcare professionals is also key. Building trust between patients and digital health providers can be achieved by involving local doctors and nurses in telehealth initiatives. This collaborative approach ensures that patients receive a continuum of care (including all providers from pharmacy to at home nursing by the intermediary of the hospitals) combining the advantages of both digital and traditional healthcare services.

Such collaboration can be initiated by the patients themselves too; this will encourage providers to start or continue their digital transformation initiatives. By engaging with digital health tools, the Swiss population can open the dialogue as to the pros and cons of these technologies, and together address the key questions of data privacy, data ownership and usability.

Adopting new digital health tools when in good health is a good way to become familiar with solutions before they are needed in a care setting. Once onboarded, patients can comfortably benefit from the services they offer such as online information resources, telemedical consultations or opportunities to plan and track diagnostic and therapeutic information in support of care pathways.

3.2 Business: What is needed from innovators and investors to increase impact in Swiss digital health innovation?

Digital health innovation is rarely a short-term journey. While initial (angel) investors and grant funding can help initiatives to get started, the road ahead to patient impact and profitability will be long and complicated due to decisions on which market segments and solutions to prioritise. 

Therefore, dilutive and non-dilutive investors must seek long-term impact rather than short-term gains.  Correspondingly, innovators must be prepared and equipped to articulate this impact in terms of savings and improvements to different healthcare stakeholders. 

The Swiss economy is investing heavily in hardware and software, especially in digital technologies as stated in ETH’s survey (Wörter, 2022). This is particularly the case in the digital health area with an important growth in funding of digital health companies and therefore an increasing number of venture funds entering the sector.  In startupticker VC report’s survey, it was identified that more than half of the investors invest in digitalisation topics in the healthcare sector (Swiss Venture Capital Report, 2023). 

While this year, 2023, has clearly been challenging in the Venture Capital sector, particularly for those seeking first-time investment, an increasing number of active Corporate Venture Capital (CVC) funds have begun seeking earlier stage investments. CVCs are often in the strategic position of aligning their portfolio companies with their respective corporate strategies, and therefore have an opportunity to seek close integration of innovative solutions through collaboration; both in terms of teams, customers, and data interoperability. 

To increase the impact of digital health innovation in Switzerland, a symbiotic relationship between innovators and investors of any kind is crucial. Investors can provide mentorship and resources beyond monetary support, aiding innovators in navigating the complex healthcare stakeholder landscape.

Open interfaces enable other solutions to connect and securely share data via international standards such as HL7 FHIR. Such solutions enable greater scalability as new collaborations can be integrated via these standards. This also results in an imperative for established companies to explore how to enable such data interoperability and move away from siloed data models. Cuore from Swiss Post is just one example of a platform that enables data interoperability (Swiss Post Ltd, 2023).  

In this way, innovators have the opportunity to leverage the ecosystem mindset and encourage regional and national initiatives that increase skills and enable technology which is required in key areas such as connectivity of devices within care settings. Identifying solutions that deliver mutual benefits in the realm of digital transformation can provide industry-wide benefits as a positive externality from the implementation of one specific innovation. 

In this spirit, there is an imperative to be inquisitive about what is holding back the integration of digital health solutions and ensure even with limited resources that innovators are addressing environmental, social, and governance topics in addition to their technical solutions.

3.3 (Non-)Political: How should/will the Swiss regulatory framework around digital health evolve in the next few years?

In the coming years, the Swiss regulatory framework around digital health is poised for significant evolution. Public authorities need to set national standards and a clear framework for digital health in Switzerland together with international regulatory bodies and industry stakeholders. 

Moreover, beyond setting standards, public authorities also have a role to ensure that different players collaborate within the ecosystem to avoid Swiss citizens being obliged to use multiple disconnected applications and services. The human-centred design principles of the innovators should be considered by policymakers.

Data security and data privacy should be at the forefront of the discussions as it is important to ensure that all solutions follow strict regulations and ensure that the citizens’ data are handled appropriately. The FOPH has launched a group of experts focusing on Data management and standardisation in Switzerland (Federal Office of Public Health – Digisanté, 2023). It is key that all the different digital health solutions, which are developed, are based on the same standards and follow the international FAIR norms. The Swiss Personalised Healthcare Network has made considerable progress on making health data FAIR for secondary usage (SPHN, 2023). 

The different health solutions need to use structured interoperable data for the different systems to be able to communicate with one another efficiently. This is the only way possible to ensure that we move away from siloed solutions into ecosystems and networks of solutions that interlink with one another. Like this, each actor will be able to focus on its key added value and bring their own expertise to the healthcare ecosystem.  

Furthermore, there should be a concerted collaborative effort to establish clear guidelines and standards for digital health solutions such as telemedicine practices, home monitoring devices, and digital therapeutics. This clarity is essential for both, providers and patients, ensuring that services are safe, reliable, and accessible across the country.

The Swiss healthcare system is ready for digital transformation. Due to its great location and presence of diverse key healthcare partners, Switzerland has all the required tools to grow steadily in the digital health sector. However, this will only be possible if all the different healthcare players – patients, providers and public authorities – collaborate. 

Startups and scaleups are a very important part of the innovation process of healthcare in Switzerland, and they will continue to play an even greater role in the upcoming future as thought leaders of our evolving digital health ecosystem. 

Empowering Swiss citizens to better understand and own their health data as well as better navigate their health journey are critical to ensure equal access to digital health knowledge and positive patient outcomes for the population. Digital health solutions, such as the ones who took part in digitalswitzerland and Swiss Healthcare Startups’ Digital Health Academy 2023, are the innovators of today and tomorrow; they are the new digital health players who will enable us to achieve the next steps of digitalising the healthcare system in Switzerland by working together with the patients and other healthcare actors.

In the future, citizens should become an even stronger partner in designing and testing digital health solutions to ensure their needs are met. Innovators and investors will need to partner up to ensure that long-term impactful and interoperable solutions thrive in the healthcare ecosystem.

This is a collaborative publication between the different scaleups from the Digital Health academy and digitalswitzerland’s team.

Authors:

Romain Boichat, Co-founder and COO, Soignez-moi
Redona Hafizi, Co-founder and Head of Pharma, TOM Medications
Maria Scoz, Healthcare and Life Sciences Business Developer, Decentriq
Phil Norris, Senior Manager Scaleup Enablement, digitalswitzerland
Regula Spuehler, Co-founder and COO, heyPatient
Jade Sternberg, Senior Project Lead Digital Health, digitalswitzerland

Supported by:

Diana Hardie, CEO of Swiss Healthcare Startups
Susanne Gedamke, Managing Director, Swiss Patient Organisation
Milan Vopalka, Head Healthcare, Public Sector Switzerland , Amazon Web Services (AWS)
Theodor Wilhelm, Head of Strategy and Business Development and Member of the Executive Board, Post Sanela Health AG

About the Digital Health Academy:

In collaboration with Swiss Healthcare Startups, digitalswitzerland launched the first edition of the Digital Health Academy, a 6-month cohort based programme for scaleups working to empower the patients to own and understand their health data better. Decentriq, heyPatient, Soignez-moi and TOM Medications were part of the 2023 cohort and, through this academy, were positioned as thought leaders in the digital health space. As part of the programme, they were mentored by experts, benefited from in-depth workshops, a matchmaking bootcamp with corporates and the chance to join ecosystem events such as Digital Health Day (Zurich) and AI for Life (Geneva).

About digitalswitzerland:

digitalswitzerland is a nationwide, cross-sector initiative that aims to transform Switzerland into a leading digital nation. Under the umbrella of digitalswitzerland more than 200 organisations, consisting of association members and politically neutral foundation partners, are working together to achieve this goal. digitalswitzerland is the point of contact for all questions relating to digitalisation and is committed to solving a wide range of challenges. Learn more about digitalswitzerland. 

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The Swiss healthcare system: entering a new digital era. 

A visualisation of the pioneering solutions that inspire a digital health ecosystem” is published! 

Zurich, 13 December 2023

Although great care has been taken in the preparation of this publication, the author and contributors involved are not responsible for the accuracy of the data, information and advice provided, nor for any printing errors.

All rights reserved, including translation into other languages. No part of this publication may be reproduced, transcribed and/or translated into any computer language, including any information processing language, in any form without the prior written permission of the authors.

The rights to the trademarks mentioned remain with their respective owners.

Coordination of the publication: Melanie Holenweger and Jade Sternberg (digitalswitzerland)

Graphic design: Nina Holenstein (www.niniparati.com)