[WG-P3] Fwd: ISPI Clips 155.108: EU - Trust remains key barrier to eHealth

Mark Lizar mark.lizar at gmail.com
Thu Apr 7 09:49:00 EDT 2011

Interesting Article on the Wire today.

Begin forwarded message:

> ISPI Clips 155.108: EU - Trust remains key barrier to eHealth
> ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
> This From: EUobserver.com, April 5, 2011
> http://euobserver.com
> Trust remains key barrier to eHealth
> http://euobserver.com/893/31958
> 05.04.2011 @ 16:22 CET
> EUOBSERVER / DIGITAL AGENDA - In the not-too-distant future, you may  
> be able
> to access your own medical records, make an appointment with your  
> doctor,
> re-order a prescription, track your blood pressure, check test  
> results or
> receive actual care all electronically.
> It's called e-health and EU policy-makers like the idea very much.
> They say electronic medical records will save time, and help reduce
> diagnostic or other medical errors. Routine monitoring could be  
> carried out
> at home while those with rare diseases would not have to travel to  
> be seen
> by specialists in other regions.
> "E-health applications can make it possible that your medical data  
> travels
> with you or is only one mouse click away from the operating theatre  
> in case
> of emergency," says EU health commissioner John Dalli.
> Pilot e-health programmes within member states are already under  
> way. One in
> Paris, for example, has linked up a geriatric centre with a university
> hospital, allowing specialists to interact directly with patients.  
> This
> means dermatologists can check ailments such as bedsores via  
> videolink while
> cardiologists can check ECG tests remotely.
> In Hull, in the north of England, a tele-health service for heart  
> patients
> sees them set up with electronic equipment at home once they are  
> discharged
> from hospital. This allows them to record their weight, blood  
> pressure and
> pulse as well as any other usual symptoms. The data are then sent  
> via a
> secure server to a tele-health nurse.
> E-health roll-out is happening steadily across all member states. In  
> Sweden,
> more than 85 percent of all prescriptions are transferred from  
> doctor to
> pharmacy electronically while in Belgium, plans are underway to use  
> the
> electronic ID card for all health service and insurance-related
> identification.
> More prosaically, e-health is expected to save money in the long run  
> while
> helping Europe deal with the societal pressures of an ageing  
> population,
> requiring frequent healthcare interventions, but not necessarily  
> hospital
> stays.  <| Powered by www.ISPIClips.com |>
> "Health systems are under pressure from ageing population, the  
> rising costs
> of new technology and medicines, heightened patient expectations and  
> global
> economic challenges. Everybody is looking for solutions," says Dean
> Westcott, deputy president of ACCA, an accountants association that  
> has been
> involved in projects evaluating e-health solutions.
> We firmly believe eHealth has an important role to play in delivering
> efficient and effective health care," he said at a recent conference  
> on the
> issue.
> E-health is part of a broader Digital Agenda for the EU. The European
> Commission wants citizens to have online access to their medical  
> health data
> by 2015 and is pushing for widespread telemedicine (health and  
> medical care
> via interactive media) by 2020.
> But while e-health is being strongly promoted by Brussels, many  
> questions
> remain unanswered.
> Where is my data?
> Among the most important concerns data storage and privacy. If all  
> medical
> records are available electronically, it raises the question of how  
> secure
> they are, who has access to them and how a patient gives consent for  
> this
> access. It is also not clear where or what entity should store the
> information.
> "This [personal] information is highly sensitive," Ophelie Spanneut  
> from the
> European consumers association, BEUC, says. "What happens if someone  
> has HIV
> and the employer or insurance company finds out?"
> A recent study in the Netherlands indicates the potential problems.  
> It found
> that 75 percent of hospitals were lax regarding internet security  
> rules.
> "In all countries, trust in e-health systems by both citizens and
> professionals has been identified as one of if not the key challenge.
> Privacy is recognised as the most sensitive aspect of electronic  
> health
> record systems," says a report on e-health strategies published in  
> January
> by the European Commission.
> One of the most controversial questions is whether patients should  
> actively
> give their consent to their e-health records being created or the  
> eHealth
> records are created automatically unless a patient expressly says  
> otherwise.
> In Belgium, France, Italy and Spain, patients have to 'opt-in'  
> before their
> health data may be stored electronically. But in Estonia, Poland,  
> Slovakia
> and Sweden, the records are created automatically.
> There is also the question of whether the data is stored in a  
> centralised
> system (such as in the Czech Republic and Finland) or decentralised  
> (Belgium
> and the Netherlands). France, meanwhile, has chosen a third way. It  
> allows
> patients to choose a data host for their health records.
> A hi-tech future for health could also mean a new division in  
> healthcare -
> with those with technological know-how and access getting better  
> treatment
> than those without.
> "What happens when you're not literate? What happens when you are  
> not able
> to access the system and access the self-management of care that  
> certain
> e-health solutions demand of you," asks Monika Kosinska, Secretary  
> General
> of the European Public Health Alliance.
> Patient associations, meanwhile, worry that too much emphasis on  
> technology
> will mean losing sight of the importance of human contact in  
> healthcare.
> Making systems work with one another
> The single biggest practical problem is the fact that member states  
> systems
> are not compatible with one another - they vary not only from member  
> state
> to member state but also within national borders. In Brussels, for  
> example,
> it is not possible to electronically transfer patient information  
> from a
> hospital in the Ixelles part of the city to the Edith Cavell  
> hospital, some
> 20 minutes away.
> Language is a big issue for the electronic exchange of information. In
> Europe alone, this implies compatibility over 20 languages and three
> alphabets.
> Making systems interoperable also requires both financial investment  
> and a
> change in culture - from introducing technological solutions and  
> thinking in
> hospitals to getting them to co-operate with other points in the  
> system such
> as heath care centres and social services.
> The bottom line is money. The potential long term financial benefits  
> of
> eHealth will need to be offset by investment now - a time of  
> squeezed public
> financing.
> Fabian Zuleeg, chief economist at the European Policy Centre, asks  
> where
> this investment will come, noting that future funding of health  
> systems is
> likely to stem much more from the private sector while patients will
> increasingly be expected to put their hands in their pockets as the  
> line
> between what is medical intervention, what is a health intervention  
> and what
> is a lifestyle issue grows increasingly blurred.
> "We are already seeing that for certain medical technologies -  
> monitoring
> technologies for example - it is actually the patient who are  
> purchasing
> them or paying significant amounts of money for them," he says.
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