2. How developed is eHealth in the European Union? Is there a big gap between the EU and the Eastern Partner countries?

The EU faces many of the same general health issues 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, data protection, digital identification and IT security that create a great environment for 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, while Eastern partner countries have advanced through many individual – but less concerted – eHealth projects. 

Moreover, the EU has standardised ePrescription and Patient Summary service definitions to enable cross-border pilots between member states. The trend now in the EU is to move towards preparing the eHealth infrastructure to be ready for Artificial Intelligence, genomic data and personalised medicine initiatives.

3. So what exactly does EU4Digital do in the area of eHealth?

EU4Digital works to assess the state of health data management in Eastern partner countries and to develop guidelines so that the capabilities of health information exchange and management are in harmony with EU best practices and with the realities of Eastern partner countries. Ideally, this means that data that conforms to the same norms is interoperable among various organisations, stakeholders and even across borders, which is important in providing better care for patients, no matter where they are.

Another aspect of eHealth covered by EU4Digital is the online collaboration platform that will allow stakeholders from Eastern partner countries to share best practices in eHealth from their countries and collaborate for further development. The purpose of this is to promote leading practice and have a dedicated space for eHealth information, learning materials and key expert communication.

Additionally, EU4Digital aims to facilitate Eastern partner countries’ participation in EU initiatives to foster communication, innovation and the adoption of new solutions, particularly regarding the challenges of caring for an ageing population, including remote medical consultation services, data analysis for better diagnostics, smart home technologies, social and activity programmes.  

Also, EU4Digital aims to facilitate Eastern Partner countries’ participation in the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA), which has a repository of good practices implemented in European countries regarding many of the challenges mentioned above.

4. You highlight interoperability as a key priority, but what does it mean: what difference will it make to me as a patient?

Interoperability is the ability of different systems, organisations or countries to exchange health information and use it meaningfully. That means the participants must be able to understand and interpret the shared information correctly, which basically means using the same standards and processes to provide an eHealth service.

Interoperability is especially crucial in the health sector, as this domain is heterogeneous and complex, covering diverse actors ranging from providers to complex sets of patients who visit and may be registered in several health care institutions. Moreover, as national governments often provide a range of public services, every healthcare system often consists of a peculiar mix of private and public services that are often badly integrated. A healthcare provider can offer a specific type of services, and thus deals with a subset of patients and their information, which requires well developed interoperability between institutions to share the overall picture of a patient. There are further issues in the international space and among EU member states, where healthcare collaboration is often hindered by differences in the eHealth vocabulary used and different interpretations of the same notions, which prevents effective cross-border collaboration.

Lack of interoperability translates to various problems facing citizens as they attempt to access health services in different institutions and countries. Therefore, interoperability will improve the health of every citizen in the Eastern partner countries. Our vision is that in 10 years’ time, when a patient from Country A needs urgent care in Country B, healthcare providers will have immediate access to information on which medications the patient is sensitive or allergic to. This summary of a patient’s health condition is crucial when making urgent life or death choices that characterise the healthcare sector.

5. What exactly is the eHealth collaboration platform? Who will benefit from it and how?

The eHealth collaboration platform is the new channel for regional collaboration between eHealth experts in Eastern partner countries. While it will be closed to the general public, it will serve as a collaboration space for professionals of Eastern partner countries in their work on developing common eHealth guidelines and, in the future, services. This platform will facilitate international eHealth development and harmonisation initiatives in the region.

The contents of the platform will range from calendar and meeting management to guideline projects and deployment plans. To implement this, a portal platform will be used, which offers a cloud document repository and collaboration tools as well as no code page creation within separate user areas for different groups.

This platform will facilitate knowledge sharing between experts as they implement initiatives in their home countries. This will allow to accelerate and optimise reforms in the region by highlighting the best performance examples and enabling partners to avoid the pitfalls experienced in neighbouring countries.

6. What are the EU initiatives in which Eastern Partner countries can take part? What kind of programmes are we talking about?

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 information articles about innovation in eHealth to event attendance and more active roles like taking part in the Action Group and Reference Site programmes.

Participation in EIP on AHA promotes information sharing and networking, which means that, for example, a member of the Reference Site programme can become aware of a solution implemented in an EU member state and through the programme apply to adopt it in their region and vice versa.

Since there are many levels of participation, anyone can find a way to participate – from individuals to organisations, including governmental entities, private sector companies, research-oriented institutions and social organisations.

7. What might eHealth systems in the region look like in five years? How will EU4Digital have helped?

The health care of the future can be imagined as seamless patient mobility from provider to provider, country to country, as well as health care provision continuity and informed decision making for better health outcomes. Cross-border eHealth infrastructure will allow any citizen travelling abroad to receive prescribed medication from a local pharmacy. The sharing of patient summaries will help doctors to understand patients’ medical history and avoid mistakes when prescribing medicine. In addition, a growing medical tourism industry will offer citizens a chance to receive a higher quality of care and reduce costs. 

The EU4Digital eHealth team is aiming 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 of eHealth in the Eastern partner countries, and identified each country’s challenges and priorities. The set of guidelines will serve as a basis for establishing cross-border ePrescription and Patient Summary services in the region. 

We have identified four directions for the region, which are recommended as key enablers for further action and positive change in eHealth in the future:

1. Defining a Comprehensive and Actionable Digital Health strategy.
2. Establishing a robust Financing and Operational model.
3. Establishing and operationalising Digital Health governance.
4. Digital Health Architecture Development and Governance.