Europe Charts Way Forward For Digital Health Solutions Digital Health 03/10/2019 • Elaine Ruth Fletcher Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window) Bad Hofgastein, Austria – Whether its work or leisure, Europeans are moving more and more between different countries on the continent – but their health records generally lag far behind. And this can create big barriers to the treatment of chronic health conditions, not to mention effective diagnosis and treatment in emergencies, said members of a panel on digital health Thursday at the European Health Forum (Gastein). Until just recently, even filling a prescription across borders was challenging, said Clemens Martin Auer, EHFG President and Special Envoy for Health for Austria’s Federal Ministry for Labour, Social Affairs, Health and Consumer Protection. Marco Marsella “We need data that can travel from one country to another seamlessly,” said Marco Marsella, head of the European Commission’s Directorate-General for Communications Networks, Content and Technology (DG Connect). Finland and Estonia took one small step in that direction earlier this year by agreeing to a system of e-prescription exchanges, said Auer, and that model is now being followed by some 21 other countries. But Auer said it will still take time for real transformation to occur. On the plus side, the European Commission in 2019 issued a set of clear recommendations for harmonized standards that would ease the flow of e-health data between countries, while also protecting people’s privacy. But countries still need to formally adopt the new EU guidelines to unlock the electronic gates. And once standards are formally in place, health care providers across the region will need to start updating and adapting their own electronic records systems– a process that would take considerable time considering the large and fragmented health care infrastructure that exists. Fragmentation a Hallmark of Health Sector Services “We should stop promising heaven on earth, when it comes to the health sector, there is no other sector that is as fragmented,” declared Auer. In Austria alone, there are 10,000 outpatient medical clinics, 130 hospitals, and 1200 pharmacies, as well as facilities such as nursing homes, he noted in a follow-up interview. ”They all have totally different digital equipment operating. So this is a barrier; we need to invest in a new generation of digital infrastructure.” Clemens Martin Auer Paradoxically, digital transformation could be more expensive for more affluent developed countries, which began investing in electronic patient information systems ten or 20 years ago. “When these systems were instituted, the purposes were totally different. It was not about sharing data. It was about optimizing internal processes,” Auer observed. “But we have to speed up. We don’t want the Googles and Amazons to take over the field of patient data sharing – although I don’t think they would succeed.” The first wave of data sharing for e-prescriptions took place under the European Framework of CEF – Connecting European Facilities, Auer said. The first countries were Finland and Estonia, now 21 member states are part of this first wave of cross border sharing of prescriptions and patient summaries, which started only in the spring, although countries are not yet sharing lab results or imaging. “The next step would be that the European Commission as well as its member states will agree to only fund infrastructures that create an interoperable eco-space. So if a hospital in Stuttgart procures a new hospital information system, it will also be able to communicate with Paris or Lyon. “The standards exist. One is the European Commission recommendation for electronic health record exchange formats. The others are guidelines agreed to by European Union member states on infrastructure requirements. Now, we have to politically take up these standards. And then we will see an acceleration of services. This is one of the last missing links. And once these are adopted, we will see an acceleration of services.” As for consumer concerns about data protection and data security of health records, Auer said that he is convinced that European data and privacy laws are robust enough to reassure patients that sensitive health information will not accidentally fall into the hands of third parties such as potential employers or creditors. “There is a huge political consensus among the people who are responsible for the health care system that for the sake of the continuity of care, of processes and outcomes, we have to share data. And we also have sound regulation when it comes to data protection and data security; in general as a European region, on a policy level, we did our homework.” Digitalization with a ‘Human Touch’ Another critical aspect of the digital revolution in health is ensuring that new e-health applications are serving patients and health care workers needs, rather than introducing new apps or gadgets that could be difficult for some patients to manage. “Whenever anyone thinks about digital, they think about an app, but digital is about all sorts of settings that may not be patient care, but support the patient care,” pointed out Indra Joshi, Digital Health & AI Clinical Lead of the National Health Service (NHS) England. “Digitalization is so driven by technicians sometimes that we lose the main point of why we are doing this in the healthcare sector,” added Auer. “And the healthcare sector needs this to improve the quality of health care.” The needs are endless. They range from digital solutions that can provide for more seamless continuity of care; to technologies that free doctors and nurses from mundane tasks; as well as methods to facilitate the aggregation of big data for research. “Digitalization has the potential to increase the outcomes and the quality of processes,” said Auer, “But we need to think more about what does a doctor or nurse really need to get rid of the more routine work, and to free up health care professionals to provide more personalized treatment.” As Chief Innovation Officer at one of Israel’s largest health funds, Clalit, Ran Balicer spends considerable time thinking about how such innovations can be put into the service of more people-centred health systems. “There is a fear that digital transformation and Artificial Intelligence (AI) will reduce the human touch,” Balicer said. “This could not be further from the truth. In their daily work, physicians are doing too many repetitive tasks that do not require their unique skills. “AI will allow doctors and nurses to go back to their real purpose. Digital transformation would offer us an opportunity to move away from the tyranny of reactive medicine and move towards proactive and preventive care,” he stressed. “Assisted by data and AI, we can locate those patients in need of care before they actually become symptomatic,” he added. “AI will also allow us to move from ‘intuitive’ medicine to more field-safe mechanisms [for diagnosis and treatment]. Today 30% of care is wasted and human error is the third cause of death.” “Overall, I think that this will allow us to have more of the human touch.” (left-right) Marco Marsella; Ran Balicer; Clemens Martin Auer; Indra Joshi Image Credits: NHS England, European Health Forum Gastein, European Health Forum Gastein, European Health Forum Gastein. 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