Tiny Estonia is not above some boasting to the rest of Europe when it comes to e-health.
President Toomas Hendrik Ilves used a European summit on e-health in Riga this week to attack his neighbors over their failure to seize opportunities in information technology to improve health care.
Estonia has been a frontrunner in e-health: nearly all prescriptions are issued electronically, and two-thirds of hospitals use e-health technologies in some way.
Spending is on the increase: EU governments and health care providers will spend more than €12 billion a year on health IT by 2018, according to industry estimates. But the benefits outside a few countries are hard to find.
Ilves touted Estonia as a model of how IT in preventive and treatment services can “improve both the welfare of patients and the health care system in general.” But more widely across Europe, “health care is lagging ten years behind when compared to other industries,” he said.
The conference comes a week after the EU released its digital single market strategy, which stressed that “digital technologies for health and care offer opportunities for citizens, health and care providers and industry.”
Health commissioner Vytenis Andriukaitis told the meeting: “We must seize these market opportunities to fulfill a vision for healthcare in the 21st century.”
The Commission has been struggling for years to bring greater coherence to EU development of health IT — to potentially drive economic growth, as well as improve individual health and ease strained health care budgets.
Greater use of e-health services was pegged as central to the EU’s 2011 directive on cross-border care, helping free movement of patients, and improve access to quality care in remote or underserved areas. The conference is addressing many obstacles identified in recent Commission consultations — notably privacy and security, safety and transparency, interoperability of systems, and web entrepreneurs’ access to the market. It is also exploring how far large-scale deployments could be supported by EU funds from its Connecting Europe Facility that backs new cross-border infrastructure and services.
Pēteris Zilgalvis, a senior Commission official with direct responsibility for health IT, who is also in Riga, told POLITICO: “Digital solutions can increase the dynamism of the European economy and deliver benefits to EU citizens.” For him, the conference promises the chance to explore how mobile health and e-health can help EU citizens manage their own health by empowering them, as well “ensuring the sustainability of our health care systems.”
But the challenges also emerged clearly from other speakers at the meeting, particularly from health professionals, patient groups and companies.
Walter Azori of the European Patients Forum said he backed patient empowerment through IT, but questioned whether Europe was yet able to achieve that.
The concept “is still not clearly understood across Europe,” and is even perceived as a threat by some doctors, he said. He said the EU needs a strategy to promote greater commitment from health professionals, education and support for patients, and quality of data to help patients to make informed choices.
Paul De Raeve, secretary-general of the European Nurses’ Federation, warned against a simplistic top-down approach.
There is a role for IT in health, he said, and particularly in ensuring continuity of care. But he added: “The Commission and member states need to talk with stakeholders … and not about stakeholders.”
Discussions on clearing the way for more mobile health applications in Europe provoked concerns in some industry participants.
Martin Wrigley of the Application Developers Alliance said progress on agreeing on a data privacy code of conduct was too slow.
A Commission working group began last month, but the timeline set is too leisurely for an industry that moves so fast, and risks holding up innovation, he said.
Dee O’Sullivan, director of myhealthapps, may have been the most pessimistic. She said the meeting revealed “a disconnect between all stakeholders — patients, doctors, app developers, industry” on mobile health, with disagreements over how and where health apps should be certified or regulated, and “a lack of understanding of each group’s key needs and problems.