How Europe can make the most of health’s tech revolution

It has become a truism to talk about how information technologies have transformed our world beyond recognition. Like many other evolving sectors, rapid advances are being seen in healthcare, from smarter drugs, wearable devices and connected processes. One of the most exciting revolutions has been the development of digital health, bringing together digital analytics and gene mapping technologies to make treatments more personalised and precise.

This field gathers emerging areas like telemedicine, mobile apps, genetics, eHealth, remote monitoring and big data. For example, e-health services and mobile technologies like tablets and smart phones are helping doctors and patients monitor and control health from afar, and intervene if necessary. Combined, they promise to improve healthcare management, making treatments easier and more efficient for both patients and practitioners.

So how does this relate to the European Union?

For all the potential that digital health offers, there are still many barriers to rolling it out across Europe, as regulators struggle to keep up with the pace of technological change. Key issues need to be addressed such as: how to standardise implementation, while securely managing access to electronic records; promoting computing capacity to handle big data, while ensuring interoperability; and deciding who will pay.

A major step was taken on 10 May when the European Commission unveiled the midterm review of its digital single market strategy, with a crucial section devoted to digital health. The Commission recognises how digital health technologies can help improve lives and livelihoods, while addressing systemic challenges for healthcare systems.

“They can offer cost-effective tools to support the transition from a hospital-based healthcare model to a patient-centred and integrated one, improve access to care, and contribute to the sustainability and resilience of healthcare systems,” the review says. “Health data generated can enable the early detection of infectious outbreaks and accelerate development of medicines and medical devices, and stimulate innovative healthcare solutions such as telemedicine and mobile health applications.”

The Commission said it is working with interested governments on the issue of medical information transfers, from the cross-border electronic transfer of health records to the use of e-prescriptions for medication for travelling patients: it expects a system to be operational by 2020 so patients can access and transfer their complete electronic health record when receiving healthcare abroad. When it comes to advanced data infrastructure and data analytics, the review points to the European Reference Networks created this year as an example of “what Europe can achieve by pooling medical expertise and data for faster diagnosis and treatment of rare and complex diseases.”

At the same time, the Commission released a Eurobarometer survey revealing how Europeans are slowly waking up to the digital health opportunities. It found that almost a fifth (18%) of Europeans have used online health and care services in the last 12 months, that over half (52%) would like online access to their medical and health records, and almost two thirds (65%) would be willing to give their health and personal wellbeing data to their doctor or healthcare professional.

It comes on the back of an agreement by OECD Health Ministers meeting in Paris in January 2017 to set up a national health data governance framework to encourage the availability and use of personal health data while promoting the protection of privacy, personal health data and data security.

Governments are finding other ways to advance their digital agenda by working closely with other digitally focused countries. Health remains a key discussion point. In April, the Nordic-Baltic Ministerial Conference on Digitalisation in Oslo issued a joint declaration on boosting cross-border digital service infrastructures. It said, “the principles of free movement of data, as well as cybersecurity and personal data protection,” are essential to a digital strategy. The recent hacking of the UK National Health Service (NHS) demonstrates how important strong and coordinated cybersecurity and personal data protection are.

While there is a need to cooperate more closely, the pace at which digitalisation occurs will vary by member state. As healthcare is and will remain a member state competency.

The steady moves to clear up the regulatory and technical environment raise important questions for healthcare. As new openings emerge, how will digital disruption impact specific sectors and respective value chains? As data collection practices expand in scale, how do businesses, practitioners and institutions set standards and procedures, such as consent to personal data collection and use? And how can businesses and authorities fill the gaps in basic digital infrastructures, from data collection and pan-European health cards, to connectivity between hospitals and community care and interoperability between regions.

For example, the European Public Health Alliance (EPHA), a network of non-profit health organisations, says “the move towards digital health could exacerbate existing health inequalities, warning of an enduring digital divide on access to technologies, characterised by factors like age, gender, geographical location and socioeconomic status.”

More work needs to be done to clarify the legal framework. Later this year, the Commission will publish a communication, “addressing needs and scope for measures in digital health and care, in line with legislation on the protection of personal data, patient rights and electronic identification.” This will cover issues such as secure cross-border access to electronic health records; supporting data infrastructure to advance research in areas such as rare, infectious and complex diseases; and improving feedback and interaction between patients and healthcare providers.

The Commission is also preparing an initiative on the cross-border free flow of non-personal data, expected in the autumn, which officials say will be based on “principles such as free movement of data, portability of data and/or availability of certain data for regulatory control purposes”.

The digital single market review demonstrates how the Commission has turned its attention to healthcare, a sector that was barely mentioned in the original 2015 digital single market strategy, and is now placed next to areas such as transport, energy and the financial sector.

The new focus reflects how much digital technologies – social, mobile, analytic and cloud – have already disrupted the healthcare sector. Digital tools are gradually changing how patients and professionals communicate and interact with each other to compile, monitor and analyse their health data. Players in the healthcare sector will need digital health strategies in the same way that almost every conventional business has had to implement an internet strategy. The Commission’s latest efforts show how it wants to ensure that the regulatory framework keeps up with the technological change.

The EU may now be recognising the potential of digital solutions to address issues like chronic and infectious diseases, and to ease the strain of an aging population on national health systems. But innovation will be essential for Europe to stay on top of its health challenges. Technology is continuing to evolve and as the EU clears away the technical hurdles, Europe’s healthcare sector will have to learn how to navigate the challenges and opportunities of this new regulatory environment.

 

Words by Leo Cendrowicz, Felicia Vaz, Nicholas Elles & Elizabeth de bony

 Photo: CC/Shuttershock

 

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