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Report: EHTEL - Intel Workshop: eHealth 2020 – What Synergies for Europe?

More than one hundred eHealth-enthusiasts – representing a wide stakeholder spectrum and many Nationalities – joined in to discuss two main perspectives of the future of eHealth: 1) From Experience to Vision: Trusting eHealth; 2) From Vision to Actions: Synergies for the Future of eHealth in Europe. The objective of the workshop was to highlight what is needed both at European and Member State level to take eHealth services a significant step forward, i.e. beyond the mere deployment of infrastructures and supporting a long term vision for eHealth in Europe. The objective of this report is not to minute what has been said, but to highlight the key messages that have been delivered by the panellists and by the proactive audience.

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“Still a lot to do for making eHealth part of our real life. Don’t give up” opened Milan Cabrnoch, MEP and host of this workshop. This message has been well received, loud and clear. Under the title "From Experience to Vision: Trusting eHealth", the first panel reviewed conditions to create trust and acceptance on the user side, including health professionals, patients and citizens. The members of the panels where [Presentations download by clicking on the speaker's name]:

The panel moderator was Stephan Schug, Chief Medical Officer of EHTEL.

Some of the key messages on the conditions to develop trust in eHealth delivered by this panel are the following ones:

  • A stock tacking process, i.e. a review, aiming at deciding on the roll-out of eHealth components, needs to take into account the (1) the benefits of all those involved, (2) its workability in day-to-day operations (3) the way sensitive health data are protected.
  • As per the highest court of Justice, in Finland, which had to judge a violation of privacy in an EHR context, “Respecting the confidentiality of health data is […] crucial not only to respect the sense of privacy of a patient but also to preserve his or her confidence in the medical profession and in the health services in general.”
  • Trusting eHealth do not only require confidentiality of health data but also appropriate awareness raising and education in order to ensure:
    • User participation already at an early phase of the design of a system.
    • User understanding of how eHealth systems works.
  • The large public consultation from the Chain of Trust project reveals the fact that experiencing eHealth contributes to trust it and lower concerns about privacy.
  • Trusting eHealth requires transparency and openness about data usage and the levels of protection, leading to formal security policies based on risk analysis and a declaration regarding residual risk. In this respect, breaching notification systems are very important.

The conditions for patient consent have been evoked and participants have been referred to the recent opinion of the Article 29 on this issue (cf. press release - follow link). From the discussion it also emerged that the revision of the Directive on Privacy, i.e. the Directive on “the protection of individuals with regard to the processing of personal data and on the free movement of such data” (95/46/EC) may not consider eHealth-related issues as a priority topic.

Furthermore, participants have highlighted the need for “more Europe”, i.e. various European perspectives are concerned and have to be recognised when addressing eHealth related issues, including the “Single Market” perspective. It was however answered that “more Europe” needs to include the Member States and the other levels of power (i.e. the regional and local one) as to get acceptance by the citizens, one needs to be close to them.

Under the title “From Vision to Actions: Synergies for the Future of eHealth in Europe”, the second panel has been started by a report from the European Commission on the outcome of the public consultation on a second eHealth Action Plan 2012-2020.

Under the title “From Vision to Actions: Synergies for the Future of eHealth in Europe”, the second panel has been started by a report from the European Commission on the outcome of the public consultation on a second eHealth Action Plan 2012-2020.

The member of the panels where [Presentations download by clicking on the speaker's name]:

The panel moderator was John Bowis, former MEP.

The panel was launched by highlighting that (1) Synergies are defined as “Coordination of Compatible Actions” and that in the current economic context, they were of prime importance to deliver economies of scale; (2) eHealth has a price tag, but one should recognise that cutting back now on eHealth because of the economic situation would be a false economy: investment now can mean savings later. Furthermore, staff shortage is becoming an issue and Telemedicine can help addressing it.
Some of the key messages to be retained from this panel are the following:

  • Because of various initiatives are currently running on eHealth, the European Commission has decided to wait until they deliver their first results and has postponed the issuing of an eHealth Action Plan to November 2012;
  • There is a very broad consensus among the respondents to the public consultation on the priorities proposed by the European Commission;
  • The CALLIOPE Thematic Network has set recommendations for working together in implementing “eHealth for health”. We need now to move to actions. epSOS is an important step in that direction and the eHealth Governance Initiative is another one which will create the link between projects and the policymakers. The Article 14 of the Cross-Border Directive, i.e. the Directive on “the application of patients’ rights in cross-border healthcare” (2011/24) is even an opportunity to re-enforce this.
  • For eHealth services to be deployed on large scale, one need
    • A clear vision, with the necessary competences and some political courage,
    • Coordinated implementation strategies at local, regional, national and European level,
    • Competences and resources in change management.
  • The “Shift Left” is an example of a vision about “eHealth for health” and about reducing health care costs while improving quality of life.

 

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During the discussion, the point has been made on the fact that, too often still, the deployment of eHealth services is not sufficiently connected to the improvement of health and social care models. A reference to the concept of integrated care was made in this respect.

Coming back to the theme of the first panel, it was also underlined that too often the technology is in focus while psychology should prevail. In this respect, the expertise politicians have in the human nature has been underlined and can be considered as instrumental (but some education is required).

The session has been closed by echoing the interpellation of Milan Cabrnoch “Don’t give up”: the eHealth community is very enthusiastic and will not give-up!

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