The World Health Organization defines eHealth simply as “the use of information and communication technologies (ICT) for health”. Healthcare professionals will certainly not be replaced by technology any time soon, but the use of information exchange technologies can help in many ways:
- Patient-centred approach results in knowledgeable and empowered patients.
- Healthcare professionals can focus most of their attention on the patient rather than filling in forms.
- Patients receive quality care because creating, storing and sharing digital information avoids duplication of clinical procedures.
- Patients experience reduced waiting times due to online registration.
- Pharmacists can minimise their administrative paper trail burden by using ePrescription services.
- Analysis of health data helps innovation.
- Supports disease prevention.
Electronic Health Record (EHR) is a core element, allowing the collection of information about care events and from different health care providers. This results in a single, comprehensive EHR for each individual, which eases collaboration between different health care institutions and practitioners in a transparent way. The goal of eHealth is to ensure secure access to information about patient health at the right time and the right place, and thus to ensure the continuity and quality of healthcare services for better health outcomes.
The EU faces many of the same general health challenges seen in Eastern partner countries, such as an ageing population, leading to a similar need to optimise and modernise healthcare services.
The European Commission has established the Digital Single Market as one of its main priorities and digital health care services are part of this strategy. The EU has already adopted legislation on medical equipment, health data protection and sharing, digital identification and secondary use of data, which creates a great environment for EU eHealth services. Many EU countries have been quick to adopt eHealth strategies, which led to political commitment and an accelerated and well-orchestrated development of eHealth services. At the same time, Eastern partner countries have advanced through a plethora of individual, less harmonised eHealth projects. Moreover, the EU has implemented the myHealth@EU initiative. This provides ePrescription and Patient Summary cross-border health services between individual Member States, with more eHealth services to come. The trend now in the EU is to move towards opening up health data to secondary use, thus preparing the eHealth infrastructure for Artificial Intelligence, genomic data analysis and personalised medicine. At the EU level this is to be achieved by the HealthData@EU initiative.
The EU4Digital eHealth thematic area assesses the state of health data management in Eastern partner countries and develops guidelines so that the capabilities of health information exchange and management are in harmony with both EU best practices and the realities of Eastern partner countries. Ideally, this means that data conforms to the same norms and is interoperable among various organisations, stakeholders and even across borders. This interoperability results in better care for patients, no matter where they are.
Another aspect of eHealth covered by EU4Digital is the online collaboration platform that allows stakeholders from Eastern partner countries to share best practices from their countries. This is a dedicated space where experts can sign in to collaborate and communicate to further eHealth development.
Additionally, EU4Digital facilitates Eastern partner countries’ participation in EU initiatives to foster innovation and the adoption of new solutions, particularly remote medical consultation services, data analysis for better diagnostics, smart home technologies and social and activity programmes. EU4Digital also facilitates Eastern partner countries’ participation in the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA). This has a repository of good practices that are implemented in European countries regarding many of the challenges mentioned above.
Interoperability is the ability of different systems, organisations or countries to exchange information and use it meaningfully. For this, participants must interpret shared information correctly, which means using the same standards and processes for an eHealth service.
Interoperability is crucial in the health sector, as this domain is heterogeneous and complex, covering diverse actors ranging from providers to patients, who may be registered in and visit multiple health care institutions. Moreover, healthcare systems often consist of a unique mix of poorly-integrated private and public services.
A healthcare provider may offer only a specific type of service, and thus deal with a subset of patients and their information. This requires well-developed interoperability between institutions, so an overall picture of a patient can be shared.
International healthcare collaboration among EU Member States is often hindered by differences in the eHealth vocabulary used. This results in different interpretations of the same notions and prevents effective cross-border collaboration. Lack of interoperability translates to various problems that citizens face as they attempt to access health services in different institutions and countries. Improved interoperability may effectively improve the continuity and quality of healthcare services experienced in the Eastern partner countries, resulting in a happier and healthier population.
The EU4Digital eHealth thematic area created the eHealth collaboration platform as a dedicated private channel, where eHealth experts in Eastern partner countries can sign in and contribute to regional collaboration. It aids professionals in establishing common eHealth guidelines and, in the future, services. This platform facilitates international eHealth development and harmonisation initiatives in the region.
The contents of the platform range from calendar and meeting management tools to guideline projects and deployment plans. The portal offers a cloud document repository and collaboration tools as well as no-code page creation within separate areas, for use by different groups. This platform facilitates knowledge sharing between experts as they implement initiatives in their home countries. This allows the acceleration and optimisation of reforms in the region by highlighting the best performance examples and enabling partners to avoid any pitfalls experienced in neighbouring countries.
Eastern partner countries are encouraged to participate in the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) run by the European Commission. The programme has many levels of interaction, from browsing through informative articles about innovations in eHealth to attending events, and more proactive roles like taking part in the Action Group and Reference Site programmes.
Participation in EIP on AHA promotes information sharing and networking. For instance, a member of the Reference Site programme can become aware of a solution implemented in an EU Member State and apply to adopt it through the programme in their region, and vice versa. Different kinds of participants are accepted – from individuals to organisations – including governmental entities, private sector companies, research-oriented institutions and social organisations. Another initiative is MyHealth@EU, which focuses on piloting and implementing electronic cross-border health services in the EU. The current service offering includes Patient Summary and ePrescription, with a future vision to include laboratory results, medical images, various reports, etc. Currently, the possibility to include eligible countries outside the EU is being discussed. Thus, Easter partner countries may be able to participate in MyHealth@EU in future.
Future healthcare can be imagined as a seamless and mobile patient experience from provider to provider and from country to country, as well as a continuity of health care provision and informed decision making for better health outcomes. Cross-border eHealth infrastructure and the ePrescription service will allow any citizen travelling abroad to receive prescribed medication from a local pharmacy. The sharing of Patient Summary information will help doctors understand patients’ medical history and make evidence-based clinical decisions.
The EU4Digital eHealth team aims to develop standards and guidelines to support cross-border health care in the Eastern partner countries, which is only possible when common understanding and cooperation is reached. To make this happen, the team has conducted an analysis of the current state of play regarding eHealth in the Eastern partner countries, and identified each country’s challenges and priorities. The resulting set of guidelines will serve as a basis for establishing cross-border ePrescription and Patient Summary services in the region.