e-Health: improving health and healthcare through the use of information and communications technologies
The "e-Health" action plan shows how to use information and communications technologies (ICT) to provide better quality healthcare throughout Europe, at a stable or lower cost, and to reduce waiting times and errors. The aim of the action plan is the creation of a "European e-Health Area" and it identifies practical steps to achieve this by developing electronic systems for health records, patient identifiers and health cards, and the faster rollout of high speed internet access for health systems to allow the full potential of e-Health to be delivered. The ultimate aim is for e-Health to become the norm among the healthcare profession, patients and the general population by the end of the decade.
Communication from the Commission to the Council, the European Parliament, the European Economic and Social Committee and the Committee of the Regions of 30 April 2004 entitled "e-Health - making healthcare better for European citizens: An action plan for a European e-Health Area" [COM(2004) 356 final - not published in the Official Journal].
The "e-Health" action plan forms part of the strategy set out in the European Union's eEurope action plan, the purpose of which is to make the advantages of the information society available to all European citizens.
The main objective of the "e-Health" action plan is to enable the European Union (EU) to exploit the full potential of online health systems and services within a European e-Health Area.
There are three main target areas:
- addressing challenges common to all the Member States of the EU and creating the right framework to support e-Health;
- setting up pilot actions to jump start the delivery of e-Health; and
- sharing best practices and evaluating progress.
ADDRESSING COMMON CHALLENGES
Health authorities have an important role to play
The action plan proposes that, by end of 2005, each Member State develops a national or regional roadmap for e-Health.
Interoperability of health information systems
The need to identify a person and transmit medical information unambiguously throughout Europe is an important component of the interoperability of health information systems.
The action plan therefore proposes that the Member States agree by the end of 2006 on a common approach to patient identifiers and the definition of interoperability standards for health data messages and electronic health records. This should take account of best practices, relevant standardisation efforts and developments in areas such as the European Health Insurance Card and identity management for European citizens.
Mobility of patients and health professionals
Patients and health professionals are becoming increasingly mobile within the European Union.
The EU has already adopted a Communication on patient mobility and work is already underway to improve information on the subject. Progress is being made in particular through the health systems working party.
Enhancing infrastructure and technologies
Under the action plan, during the period 2004-2008 Member States should support the deployment of health information networks for e-Health based on fixed and wireless broadband and mobile infrastructures and Grid technologies.
Conformity of e-Health systems
Many European countries have already proceeded with accreditation of e-Health systems that have become models for other regions.
By mid-2005 the European Commission should produce a summary of European best practices as guidance for Member States.
The Member States should then, by the end of 2007, adopt conformity testing and accreditation schemes following successful best practices.
Considerable investment is required for any development or modernisation of systems and services. Consequently, under the action plan, a collaborative approach to supporting and boosting investment in e-Health should be undertaken among Member States by the end of 2006.
Legal and regulatory issues
According to the action plan, by the end of 2009 the European Commission should undertake activities in collaboration with Member States to:
- set a baseline for a standardised European qualification for e-Health services in clinical and administrative settings;
- provide a framework for greater legal certainty of e-Health products and services liability within the context of existing product liability legislation;
- improve information for patients, health insurance schemes and healthcare providers regarding the rules applying to the assumption of the costs of e-Health services;
- promote e-Health with a view to reducing occupational accidents and illnesses and support preventive actions in the face of the emergence of new workplace risks.
SETTING UP PILOT SCHEMES
A considerable number of pilot schemes in the field of e-Health are underway or about to be launched in the European Union.
Information for citizens and authorities on health education and disease prevention
As part of its work providing information for citizens, the Commission is currently preparing an EU-wide public health portal which should be operational by the end of 2005. The portal will give citizens a single point of access to information on public health, as well as on health and safety in the workplace.
The Commission is also working to enhance ICT tools to improve health threat early warning, detection, and surveillance measures.
Towards integrated health information networks
Major efforts are currently underway to establish health information networks. By the end of 2008 the majority of European health organisations should be able to provide online services such as teleconsultation (second medical opinion), e-prescriptions, e-referral, telemonitoring and telecare (remote monitoring of patients in their own homes).
Promoting the use of cards in healthcare
There are two types of cards that can be used in the healthcare sector: the health card, which may carry emergency data such as blood types, pathologies and treatments, and the health insurance card, which was launched on 1 January 2004 and replaces all the paper forms which were needed to benefit from medically-necessary care while on a temporary stay abroad.
Activities will be launched in the Member States to promote the use of these cards. It is also expected that the implementation of an electronic health insurance card will be adopted by 2008.
MONITORING OF PRACTICES
Disseminating best practices
e-Health must be supported by the widespread dissemination of best practices. These should include the impact on access to healthcare and on its quality, assessments of cost benefits and productivity gains, as well as examples of addressing liability in telemedicine services, reimbursement schemes, and accreditation of e-Health products and services.
Best practice will be spread through meetings held between the Member States and supported by the European Commission. Alongside this, the European Commission should, by the end of 2005, establish an effective way of systematically disseminating best practices.
Between 2004 and 2010 the European Commission will publish a biennial study on the progress made in implementing e-Health.
THE EUROPEAN UNION AND E-HEALTH
Why does the EU need to develop its e-Health systems and services?
For some years European countries have been facing rising demand for health and social services as a result of an ageing population and higher income levels, although the funding available remains limited. At the same time, citizens have higher expectations and the mobility of patients and of health professionals has increased. Huge quantities of medical information are difficult for the authorities to manage.
Developing e-Health systems and services should help solve these problems. It could in particular help reduce costs and improve productivity in such areas as billing and record-keeping, reducing medical error, cutting down on unnecessary care, and also in improving the quality of healthcare.
Today at least four out of five European doctors have an internet connection, and a quarter of Europeans use the internet to get information about diseases and health matters. These encouraging figures indicate that e-Health systems and services will develop rapidly.
European Community research funding has supported e-Health to the tune of EUR 500 million since the early 1990s, with total investment through co-financing being around twice that amount. Many of today's success stories are the product of that research. All this has helped to create a new e-Health industry with a turnover of EUR 11 billion. Estimates suggest that by 2010 up to 5% of health budgets will be invested in e-Health systems and services.
This action plan is only part of the EU's response to the huge challenges that health services across the EU are facing. Two further examples include action on patient mobility and the benchmarking of national reforms of healthcare systems.