High-level stakeholders outline the way forward for eHealth in the EU at Incisive Health's roundtable in the European Parliament.
“For 15 years we have been talking about eHealth, but very little has changed”.
Those were the stark words of one participant at Incisive Health’s eHealth roundtable, held in the European Parliament on 29 January.
And, to some extent, those words are absolutely true. As communication, then retail, then music, then finance have all been transformed by digital technology over recent decades, it seems that healthcare services have stood still – a relic of another time.
But this does not do justice to some of the ways in which eHealth has evolved. Many of us now wear watches which can tell us how healthy our lifestyles are. People with long-term conditions are increasingly making use of apps to help manage their own healthcare. Online medical services are increasing in number and reach.
What is still lacking – and where our participant was absolutely correct – is work to address the manifest failure to integrate these new technologies into mainstream healthcare services across Europe. And this failure gives rise to concerns that, in failing to ensure the benefits of the latest technologies are made available to all, health inequalities will only increase as a result.
This failure is no reflection, at least nowadays, of a lack of appetite. Participation in our roundtable stood as testament to that – and the MEPs, Commission officials, member state health attachés, pharmaceutical companies and patient groups who attended were all eager to understand where the blockages lie, and how, collectively, they might be overcome.
And increasingly, there is the will to act. The Estonian Presidency’s efforts on eHealth led to the Digital Health Society Declaration and subsequent Council conclusions on eHealth in the Digital Society. At our roundtable, Austria revealed that eHealth will be a topic high on the agenda for their forthcoming Presidency, too.
Furthermore, EU and national level policy initiatives are increasingly being informed by an emerging body of evidence on what needs to be done. Incisive Health’s own report on eHealth – which underpinned discussion at the roundtable – was clear about the challenges we face. Firstly, a lack of trust in the results of eHealth services. Second, concerns over how companies make use of an individual’s healthcare data. And third, a lack of healthcare system endorsement. These findings echo the findings of the European Commission’s own public consultation on digital health.
The time now, then, is ripe for action. And at our roundtable there was much agreement both on the challenges that need to be addressed – and on what needs to be done.
Firstly, there needs to be a much greater degree of interoperability between the IT used by healthcare systems and eHealth services. And this requires – secondly – a much greater degree of investment in the digital infrastructure of healthcare systems.
Thirdly, there needs to be some method of assessing and approving certain, effective eHealth technologies which bring added-value to people. And fourth, these approved healthcare technologies need to be reimbursed by healthcare systems.
Finally, to unleash the opportunity of Big Data to drive real improvements in population health, there needs to be common standards governing data flows.
In some of these areas, action has already been taken – the General Data Protection Regulation will enter into force from May 2018 (and we all wait to see what impact it will have). In other areas, initiatives have yet to commence. And in other areas still, there are immediate opportunities to forge ahead, and quickly: insurers at our event, for example, remarked that the new HTA proposal is an opportunity to deliver the eHealth approval mechanisms – and resultant reimbursement – that will lead to a step-increase in demand for eHealth and a “paradigm shift”, as one MEP put it, in how people see and use health apps as tools for managing chronic diseases and not just monitoring lifestyle factors.
In all of these areas, there is of course the potential for controversy. Finding the right balance between Member State and EU competency was a thread running through our discussion. Where the balance lies between public and private spending will be a thorny issue too.
But progress is now, finally, being made – and the European Commission’s Communication on eHealth scheduled for March/April demonstrates the importance of the agenda to the EU over the year ahead.
What is clear, then, is that although eHealth may not have transformed healthcare over the last 15 years, the next 15 years – and even 15 months – will be a different story.