Earlier this month the European Commission published Redesigning health in Europe for 2020, the report of the EU Task Force on e-Health (press release here).
The report makes a number of recommendations, many of which reinforce the importance of effective, universally available fixed and mobile connectivity in helping to transform healthcare. Europe faces significant healthcare challenges as a result of changing demographics, but a new approach is needed if technology is to assist:
"Europe is aging, the proportion of the elderly in our countries is increasing, due both to fewer children as well as increased life spans...We know that in healthcare we lag at least 10 years behind virtually every other area in the implementation of IT solutions."As a consequence of an aging population, healthcare costs continue to increase:
"Healthcare is a constantly growing component of public finances, rising to 9 % of GDP and representing between 6% and 15% of government spending in most EU countries...Adding to this, are the fertility and mortality projections made by Eurostat stating that by 2060 the EU population will be both slightly bigger and considerably older than today. Most critically, the working age contingent – main contributor to the social protection systems – is projected to fall dramatically, whilst the share of elderly (65+) and very old (80+) population is projected to grow...Furthermore, the ongoing economic uncertainty brings into sharp focus the fact that current healthcare models are financially unsustainable. Thus, health systems may have been the pride of European democracies but they have not evolved to respond to the modern environment and are no longer fit for purpose."Technology can play a critical role but much needs to happen if it is to do so:
"A radical redesign of health is needed to meet these challenges, integrating health and social care services configured around the needs of the patient. Technology can help health systems to respond to these challenges, by delivering greater efficiency, lower costs and better health outcomes. However, healthcare is a decade behind most other sectors in adopting and using information technology tools and much of the innovation is being developed outside the healthcare system."A key opportunity exists in finding alternatives to expensive hospital care:
"One of the major expenses that dominates health budgets is hospital care which is expensive and not well suited to ongoing managing of chronic disease. Healthcare reforms seek to shift patient care back into homes and the community, redefining pathways for general care and urgent care. eHealth tools such as telemonitoring, remote health services and self monitoring will be important in reducing the burden on hospitals...The health sector has been slow to adopt new communication tools for a variety of institutional, economic and personal reasons. However, patients will increasingly demand that their health professionals and institutions use the same ubiquitous technology they use in everyday life, such as multi-platform apps. In general, new consumer products and services are developed to match the needs and interests of consumers, and framed by their understanding of what is valuable and useful. In contrast, in the health sector, decisions are made around the needs of the system itself and the interests of health professionals...The main benefits from this lever for change will accrue to citizens who will receive support for continuous health treatment and healthy living rather than only interventions."Prevention is better (and cheaper and more sustainable) than cure it seems. As elsewhere, the greatest benefits will only be realised if everyone is included and able to participate in eHealth:
"Those without the skills, capacity and opportunity to use eHealth risk being further excluded. New ICT tools have the potential to reduce these inequalities but they need to be designed to actively promote and enhance equity. This means ensuring that rural communities have access to services and that products are usable for patients with a diverse range of literacy and technical abilities. Service providers need to be aware that there may be sub-groups of the population that are outside the reach of eHealth tools – those without access to the internet / computers and individuals that choose not to interact intensively with technology. These ‘vulnerable communities’ and their needs need to be accommodated, because if not carefully planned, eHealth could disenfranchise rather than empower. Ensuring such accommodation will be the role of the safeguards built into the system."A new way of doing things is dependent upon using the available funding in new ways:
"The majority of public funding at EU and national level allocated to eHealth has been invested in centralised, large-scale, top-down solutions. These have failed to address and integrate the user experience sufficiently. The next phase should see investment in tools that citizens can use to support their wellbeing and manage their lives."Some progress is being made. This news item reports that Denmark, England and Scotland have been pioneers in the use of electronic communication in and across the health and social care sectors, integrating telehealth into standard patient treatments. There are further examples in this recent speech by Neelie Kroes, Vice-President of the European Commission responsible for the Digital Agenda, but there is still a long way to go it seems.