Bad Hofgastein, 2 October 2014 – “There is an urgent need now to implement available solutions in the field of eHealth and telemedicine. It’s time to stop hesitating,” was the clear message of Pēteris Zilgalvis who heads the “Health and Wellbeing” unit at the European Commission’s DG CONNECT. Speaking at the European Health Forum Gastein (EHFG), Zilgalvis explained how eHealth can be a contributing agent for improving quality, cost, productivity and growth in the field of health care. “Telemedicine is a key element in forward-looking health care systems faced with an increased prevalence of chronic diseases and cost-intensity of health services from growing demand and resource scarcity. eHealth can be the driving force in implementing innovative models and products that enhance equality of opportunity in accessing health facilities as well as their management.” He is calling for reform commitment that will resolutely implement the European Union’s eHealth Action Plan 2012-2020.
This underscores the need for a high level of standardisation and interoperability among the different information and communication systems within health services, namely on the legal, organisational, semantic and technical level. “The absence of established national and international standards hinders the optimisation of the potential of eHealth. An effective infrastructure requires interoperability and coordinated data management. The implementation of eHealth innovation is not merely a question of technology, however, but of awareness, mindset and action on the part of health care actors as well,” Zilgalvis said.
“As one would expect, the reinforced and especially networked application of information technologies is supported by healthcare authorities at several levels, especially given the anticipated improvements in care quality and patient safety,” said Dr Peter Brosch of the Austrian Ministry of Health. He sees the establishment of the impending Austria-wide application of the Electronic Healthcare Record “ELGA” as the central eHealth project and as a model for the cross-sectored use of modern IT. The application of international standards had been established at the very conception ELGA, which will assure the future interoperability of systems.
“The availability of technological solutions is usually not the problem,” Dr Brosch said. “Both at the national and at the international level, legal and semantic interoperability should be ensured equally ranking along with the technical. Besides data protection, precise personal identification and an array of interconnected legal factors are critical issues for the future use of eHealth.”
“There has long been too much focus on the technological aspect, while organisational challenges and change management were forgotten. But the question of integrating telemedicine into modern supply structures is crucial,” eHealth expert Peeter Ross of the Estonian eHealth Foundation told the EHFG. “The organisational culture of healthcare institutions has to be made fit for eHealth, which also goes hand in hand with a strengthening of patient-centeredness.”
Embedding eHealth into routine practice
“Embedding eHealth into everyday practice among health service providers is the biggest challenge. eHealth needs to become a training focus for all healthcare professionals,” said Heleen Riper, Professor of eMental-Health and clinical psychology at the VU University in Amsterdam. Pioneers such as the UK, Denmark, Sweden, the Netherlands or Germany should be the draught horses for other EU countries as the European Union takes on a key role in the systematic establishment of modern information and communication healthcare technologies.
Even though concerns about the storage of health data should be taken seriously, the required high level of data protection and data security should not be transformed into a sceptical objection to eHealth innovations per se, Prof Riper stressed: “Digital options have long been part of the world in which we live, closing them off would be anachronistic. eHealth must be grasped as an opportunity for patient empowerment and autonomy.”
Better access, more equal opportunity
Commission expert Pēteris Zilgalvis does not believe that information and communication technologies in healthcare would create or reinforce social inequalities and barriers: “We mainly see the positive trend of improved health care access. Telemedicine, an important area of eHealth, allows regular monitoring of chronic diseases among people living far from health facilities while saving them tedious travel. Vital parameters and their variations can be captured; hospitalisations, routine contacts and length of stay in health care facilities can be reduced and the independent lifestyle of patients can be strengthened.”
Prof Riper added that “pan-European studies clearly demonstrate the effectiveness of eMental-Health, including the treatment of depression and the proven benefits of low-threshold access as well as cost-cutting effects.”
The European Commission is funding many research projects on the potential of telemedicine. The “Master Mind” project, for example, deals with the use of telemedicine for treating depression. The “United4Health” project, involving about 12,000 patients, aims to apply telemedicine services in treating diabetes, COPD and cardiovascular diseases, while referring back to the results of earlier projects such as “Renewing Health”.
“We need an incentive system for the various stakeholders and a clear implementation plan. It is better to realise individual eHealth services step-by-step than to delay implementation because of its complexity on the whole,” said Peeter Ross of the Estonian eHealth Foundation.
“Electing Health – The Europe We Want” is the motto for this year’s EHFG. Around 600 participants from more than 50 countries are attending the most important health policy conference in the EU to exchange view on key issues affecting European health systems. The future direction of European health policy is the key topic on the conference agenda.
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