Sunday, March 30, 2014

eHealth in the European Union: what's the diagnosis?

"Europe is facing a healthcare crunch as a result of our ageing population. By making the most use of digital tech, we can reduce costs, put the patient back in control, make healthcare more efficient and help European citizens to take an active part in society for longer. We have to keep our finger on the pulse!"– Neelie Kroes

What's the diagnosis?

According to two surveys in acute care hospitals (those intended for short-term medical or surgical treatment and care) and among General Practitioners (GPs) in Europe, the use of eHealth is starting to take off, with 60% of GPs using eHealth tools in 2013, up 50% since 2007. But much more needs to be done.
The main findings of the surveys include:
  1. Top performing countries for #eHealth uptake in hospitals are Denmark (66%), Estonia (63%), Sweden and Finland (both 62%). Full country profiles are available here.
  2. eHealth services are still mostly used for traditional recording and reporting rather than for clinical purposes, such as holding consultations online (only 10% of GPs hold online consultations)
  3. When it comes to digitising patient health records, the Netherlands take the gold with 83.2% digitisation; with silver medal for Denmark (80.6%) and the UK taking home bronze (80.5%);
  4. However, only 9% of hospitals in Europe allow patients to access online their own medical records, and most of those only give partial access;
  5. When adopting e-health, hospitals and GPs experience many barriers ranging from lack of interoperability to lack of regulatory framework and resources.
Commenting on the survey, Commission Vice President @NeelieKroesEU, said:
"We need to change the mentality in the healthcare sector rapidly. Six out of 10 GPs using eHealth shows that doctors are taking its temperature, but it's time for fever pitch! And only 9% of hospitals allow patients access to their own digital records? Come on! I want governments, high tech innovators, insurance companies, pharmaceuticals and hospitals to join forces and create an innovative and cost-efficient healthcare system –with more control and transparency for the patient."
Commissioner for Health, Tonio Borg, added: “eHealth solutions can generate better care for patients and greater efficiency for health systems. The surveys show that some Member States are clearly leading the way in using ePrescriptions and electronic records for the benefit of patients, and can provide a source of inspiration to others. I count on all Member States to seize the potential of eHealth solutions and to co-operate in this regard within our EU eHealth Network."

Why the long wait?

When asked why GPs were not using eHealth services more, their reasons were a lack of remuneration (79%); insufficient knowledge of IT skills (72%); the lack of interoperability of systems (73%); and a lack of a regulatory framework on confidentiality and privacy for email doctor-patient communication (71%).
The studies measured the use of digital tools and services in health: use of and access to electronic health records, tele-health, exchange of information between professionals etc. These services, if fully implemented, give patients more information, and more involvement in their healthcare, improved access to health advice and treatment and can make national healthcare systems more efficient.
eHealth tools include (a) Electronic Health Records -EHR, (b) Health Information Exchange - HIE, (c) Tele-health, and (d) Personal Health Records).

Health Information Exchange:
  1. 48% of EU hospitals share some medical information with external GPs electronically and 70% of EU hospitals with external care providers. Top performers are Denmark, Estonia, Luxemburg, Netherlands and Sweden (100% of their acute hospitals perform some level of health information exchange);
  2. GPs make only limited use of ePrescription and doctor-patient email interaction (32% and 35% respectively). The top 3 performers for ePrescription are Estonia (100%), Croatia (99%) and Sweden (97%), while the usage of email is led by Denmark (100%), Estonia (70%) and Italy (62%);
  3. Less than 8% of EU hospitals share medical information electronically with healthcare providers located in other EU countries.

Only 9% of hospitals offer patients the opportunity to be remotely monitored, which would reduce the need for hospital stays and thereby increase the safety of living independently. Fewer than 10% of GPs conduct online consultations with patients and fewer than 16% with other medical specialists online.
Useful links
eHealth on Twitter


European Commission