ehealth in support of safety, quality and continuity of care within and across borders

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Lesley Evans
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1 ehealth in support of safety, quality and continuity of care within and across borders Gerard Comyn Acting Director Information Society & Media DG European Commission

2 Overall ehealth Policy ehealth in support of: Improved productivity of healthcare systems higher quality care at the point of need better health information processing Continuous and more personalised care solutions respond to the needs of elderly people informed & responsible participation of patients and informal carers Prevention and prediction of diseases save lives and avoid costly treatments Higher patient safety optimise medical interventions and prevent errors Support to mobility of patient timely access to vital information at the point of need

3 EU ehealth Vision ICT Enabled Continuity of care Through all the stages Across all the points of care Prevention Diagnosis Care Rehabilitation HEALTH AUTHORITIES HOSPITAL PHYSICIAN HEALTH INSURANCES How: Sharing information (within or across borders) PHARMACY LABORATORIES Tools: Electronic health records, Regional health information networks

4 Interoperability within borders Linking all the point of care within a region/country Health Centre Hospital Emergency Pharmacy Secure Networks mobile PC Mobile, Wireless & Broadband Region 2 Region 3 Region 1 Home

5 Connectivity: to other GPs 100 Access to electronic systems of other health actors: GPs EU27 EU27+2 FI DK NL SE IS 35 ES 34 IT 32 SI BE UK 22 NO PT EE FR BG AT PL MT HU CZ IE LU DE EL SK LT CY RO LV Source: empirica: ICT and ehealth use among GPs in Europe 2007, Bonn April 2008

6 BE BG CZ DK DE EE EL ES FR IE IT CY LV LT LU HU MT NL AT PL PT RO SI SK FI SE UK IS NO % GPs connected to secondary healthcare (hospitals and/or specialist) EU27

7 SE UK IS NO Electronic exchange of data for at least one purpose CZ DK DE EE EL ES FR IE IT CY LV LT LU HU MT NL AT PL PT RO SI SK FI BG BE EU27 %

8 Interoperability across borders Linking basic information between patient summary systems or giving access to physicians to patient summary in your home country Direct access of physicians when legal Patient Summary 1 Patient Summary 2 Secure Networks Country or Region 1 Country or Region 2 Country or Region 3 Standardised exchange/access of minimum common data Mobility

9 Identification of Professionals

10 Networking: cross-border 100 Exchange medical patient data crossborder routinely EU27 EU NL MT CY DK EL FR SE BG BE ES AT CZ NO IE FI UK LT PT IT DE EE LV LU HU PL RO SI SK IS Source: empirica: ICT and ehealth use among GPs in Europe 2007, Bonn April 2008

11 Interoperability of Electronic Health Record (EHR) Systems ehealth Interoperability: means the ability of two or more EHR systems to exchange both computer interpretable data and information human interpretable meaning and knowledge. This definition recognises the need for connecting people and health service providers for the optimal delivery of health-related services to citizens (within or across borders).

12 Interoperability Concept with vast scope and many facets with no unique solution and no easy solution Many research groups working for decades Many international efforts with US, CA, and AUS Major technical aspects are common with other areas Semantic interoperability has to be done by the domain experts

13 Interoperability : why? Lack of interoperability is detrimental to the patients (leads to lack of information, medical errors, limited patient mobility) health professionals (difficult access to health records) health managers (lack of economic analysis) researchers (reduced availability of medical data) industry, in particular to small- and mediumsized enterprises (reduced market shares).

14 EC places emphasis on Interoperability EC Recommendation on (cross border) EHR Interoperability EC Mandate (M 403) to CEN, CENELEC, ETSI to provide standards on ( 1) patient and health practitioner identifiers; 2) the patient summary; 3) an emergency data set Large scale pilot: EC Launches (CIP) pilot to deploy the above 3 services across MS

15 Recommendation on cross-border interoperability of EHR systems JO L 190 du , p Aim: guidelines for national and cross-border interoperability of EHR systems Scope: incl. also patient summaries, emergency data sets, medication records / eprescription Actions at four levels: (1) political (2) organisational (3) technical (4) semantic Monitoring, evaluation & awareness rising Compliance with national & EU laws

16 IMPORTANT TO REMEMBER Interoperability of EHR systems cannot go at the expenses of the privacy, data security and confidentiality First priority guarantee the fundamental rights and freedoms then interoperability Requirement a close cooperation with the national supervisors for personal data protection (They must be involved in the process of development and deployment of EHR systems)

17 Political level of cross-border interoperability Point 5c) EHR systems should be an integral part of regional and national ehealth strategies Point 5d) ehealth strategies involved in national frameworks for territorial cohesion and development Point 5i) Planning 5 years Point 5j) Inclusion of users and stakeholders (mainly financing, procurement, training, education)

18 EC and Member States cooperation in ehealth deployment Large Scale Pilot on cross border interoperability (epsos = Smart Open Services for European patients) 12 EU member states, 22m, Cross-border services safe treatment for citizens when in another MS European Patient Summary (emergency treatment, unplanned care) eprescription across the EU (continuity of care) EU Interoperability Network CALLIOPE Community building, exchange of experience All member states

19 The current ehealth standards situation is for systems interoperability within a single health service provider supportive for intra-organisational: 73% very unsupportive for systems interoperability between several health service providers somewhat unsupportive somewhat supportive for systems interoperability in national health systems very supportive n = 94 respondents for systems interoperability in crossborder care provision unsupportive for cross-border: 70% for competitiveness of European ICT-for-health companies Source: ebusiness Watch ehealth Expert Survey, empirica, 2007

20 EU policy implications Promote EU-wide agreement on priority standards and their uptake, harmonisation and further development of necessary standards Strengthen collaboration initiative of ISO, CEN and HL7 Commitment of member states to global ehealth standardisation Stronger involvement of industry and user groups

21 ehealth in EU ehealth market is lacking the bottom line for every business: TRUST among the major players: Authorities Users Industry What can we do about that?

22 Ideas for Action Commission, National/Regional authorities, Health prof. associations, Industry Collect and promote the evidence of ehealth benefits Building trust among the stakeholders More investments (Private Public Partnership) Demonstrate Scalability of solutions focusing on the interoperability, certification and security (privacy enhancing technologies). Create conditions for global market development and innovation e.g. Business models, user incentives, skills development legal and regulatory framework (e.g. protection of intellectual property, legal certainty regarding privacy and liability) financing and procurement - towards innovation friendly ehealth market

23 Thank you very much for your attention Contacts: Gérard Comyn, ilias Iakovidis DG Information Society and Media Unit ICT for Health

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