The use of digital technologies in healthcare presents new innovative prospects for the future of healthcare across the EU and Eastern Partnership regions. New eHealth technical solutions are being developed, which have the power to revolutionise traditional medicine through patient-centric and data driven healthcare. Many opportunities and solutions in the EU and the Eastern partner countries can transform healthcare towards a digital approach. However, certain challenges remain to the implementation of new solutions.
EU4Digital discussed the future of digital health with an expert in this field, Professor Henrique Martins, who provided insight into the opportunities ahead and challenges to overcome in order to reach the full potential of digital technologies in healthcare. He is a medical doctor trained in internal medicine, who holds a Masters and PhD in Management and has worked in the area of digital health for over 20 years.
The end-goal of eHealth is the shift in the focus of healthcare provision from a doctor and hospital-centric approach to a patient and wellness-centric focus, through the use of digital technologies. This translates as using digital systems to simplify patient data into one single Electronic Health Record, which can be made available to different health practitioners, or to use ePrescriptions to give patients the mobility to access prescribed medicines more easily. eHealth also means using modern technologies such as artificial intelligence (AI) or big data software to support disease prevention policies by signalling potential abnormalities or risks in the data.
In terms of future solutions in the EU and the EaP, the use of Electronic Health Records and ePrescription are high on the agenda. These rely on the availability of interoperable digital systems to allow for the exchange of health information. A future priority is to enable these solutions to be available across borders. This would mean allowing a citizen from Luxembourg travelling to Croatia on holiday to be able to collect their medicine prescribed in Luxembourg at a pharmacy in Croatia. Cross-border ePrescription pilots are being conducted within the EU, which in the future could also be trialled within the EaP region or even between the EU and the EaP regions.
The challenge in cross-border eHealth lies in the interoperability of digital health systems. Professor Martins uses the banking sector as an example. Financial banking is a cross-border service where citizens of one country can take out money from an ATM in another country. This relies on your home bank and the foreign bank having similar operating systems, which can talk to each other and exchange banking information such as the account numbers and amount. In eHealth, cross-border data exchange is also needed, except health data is not always just numbers, but can also be text and images, which adds a layer of complexity. Common standards to ensure similar operating systems and digital tools are a key element to enable information sharing. The other challenge in cross-border eHealth is the interoperability of medical competence, which is required for ePrescription when one country must recognise the prescription of a health professional from another country.
“Seamless flows of health information and health data between relevant organisations, regions and even countries is the next threshold for eHealth. This relies on the development of harmonised and interoperable eHealth services at national and regional level,” highlights Martynas Daugirdas, eHealth Stream leader in the EU4Digital Facility.
Robotics and the use of artificial intelligence (AI) are another future opportunity that could transform healthcare. The image of fully autonomous humanoid robots treating patients is more science-fiction than reality, but the use of robotic parts to support health professionals and patients is already a growing area according to Professor Martins. For example, a robotic arm could be used by orthopaedic health professionals to help them treat patients by providing extra support or strength to move and manipulate limbs. The use of exoskeletons – a digitally-enhanced mechanical support frame – is already being prototyped within the EU to aid the rehabilitation of stroke patients, helping them to recover their ability to walk in less time than traditional physiotherapy practices alone.
In these new advanced technological fields of AI and robotics, the Eastern partner countries may have an advantage as they develop new hospitals and health facilities. These can be fitted with advanced internet technology and wireless so as to make an environment more suited to novel digital tech. In European countries where the hospitals are sometimes housed in buildings centuries old, it can be more difficult to retrofit the wireless infrastructure that would be required.
In the future, digital health technologies could also be focused on bringing healthcare services closer to the patient. In hospitals, emergency rooms currently rely on triage systems to prioritise patients most urgently in need of care. With the application of new technology, this could be supported with digital interfaces where patients would provide their symptoms through an application, which would then be assessed digitally using standardised symptom-tracking protocols to allocate different levels of priority. Professor Martins adds that some healthcare competences could be brought closer to the patient at home via digital means and advanced telemedicine. For example, instead of travelling to the see the doctor to ask a few questions and receive a prescription, medical kiosks could be established so that patients can interact with a doctor from a distance and receive the same answers and prescription. These decentralised units would still rely on a strong central healthcare provision, which would act as the main hub of digital trust and provider of the digital services.
With any data-driven system, ensuring the privacy and security of the data is essential. Health data is confidential and personal, which makes data privacy a crucial pillar of digital health. Systems and protocols must ensure that data privacy is guaranteed for patients’ health data, in compliance with data privacy legislation, so that the citizen can control the access to the data. Security and trust systems must also be put in place to guard against unauthorised access. Health data must be stored in cyber-resilient and secure systems to ensure security. Trust systems are an important part of providing this security, with the use of electronic identification of patients and practitioners to grant access to the data.
Apart from technical constraints, other challenges are related to people and how new solutions can be integrated into the current healthcare environment. For technology to be useful and transformative, it has to be accepted and used by the practitioners and end-users. If a tool is designed for the patients but they do not perceive the value, or if there is a skills gap hindering them from using the technology, then the digital tools are not providing value. Professor Martins underlines that ‘People-to-people interoperability’ is needed so that people’s skills and mindsets towards the digital health technologies are also interoperable and able to work with a number of tools in different settings. This means ensuring that both patients and health professionals have access to training in digital eHealth skills related to the technologies available.
A further solution to encourage the uptake of new digital tools is to highlight the benefits that digital health technologies can bring to patients and health professionals. The COVID-19 pandemic has brought healthcare and eHealth to the foreground, through the combination of digital and health data in tracking apps to limit the spread of the infection. However, in a more traditional setting, Professor Henrique Martins highlights the importance of the patient’s voice in advancing eHealth: “Making the patient ask their own health professionals for digital health services is a very powerful way of showing the tangible reasons for the adoption of these solutions and the benefits they bring to them.” A dialogue between health professionals and patient can be a way to encourage and engage them in new eHealth capabilities.
Among these opportunities, solutions and challenges, the main thread is how best to use technology to provide better, more sophisticated and personalised healthcare to citizens. It may not be about the number of different technologies, but interoperable and utilised systems that can enhance and empower citizens’ access to healthcare.
The European Union, through the EU4Digital Initiative, is working with the Eastern partner countries to support the development of national frameworks for eHealth and harmonised systems among the EaP and the EU. To read more about the objectives and progress made in eHealth, visit the eHealth thematic page.