Slides from National eHealth Summit, 30 Sept 2015 at Carton House, Kildare: Dr Tapani Phia, Head of Unit, eHealth & Health Technology Assessment, European Commission. #eHealthSummit15 http://www.ehealthsummit.ie http://mhealthinsight.com/2015/09/25/mhealth-insights-from-the-ehealth-summit/

1. The EU eHealth Strategy:
Connecting Member States
Tapani Piha
Head of Unit
eHealth and Health Technology Assessment
Health Systems and Products
2nd National eHealth Summit
Carton House, Kildare, 30 Sep 2015
#ehealthsummit15

3. • Implementing disruptive
innovation schemes,
using any innovative
concept, product and
service that can create
new markets by applying
new sets of rules, values
and models which will
ultimately disrupt and
overtake existing markets
by displacing earlier
technologies and
alliances, …tp 27.9.2015

4.
"The
physician's
role
is
changing
significantly,
and
the
ways
how
pa7ents
use
the
know-­‐how
of
the
doctor
will
diversify."
Dr
Heikki
Pälve,
CEO,
Finnish
Medical
Associa7on
Finnish
Medical
Journal
27
March
2015,
p.
849

5. Consequences for
Patients & Doctors
• Responsibility moves more to the patient
• Role of the doctor changes substantially: guiding
treatment and coaching
FINNISH MEDICAL
JOURNAL
tp 10.05.2015

6. eHealth and the European Union

7. Benefits
Strategic Intent
Ireland

8. eHealth – why an EU co-operation?
• eHealth has great cross-border potential, and is not bound to
local setting
• Quality argument: Ensure continuity and quality of care across
borders provided in emergencies or on occasional basis
• Research argument: enhance the quality of eHealth research,
more data →EU wide, better pilots →many MS; share experience
• Shortage of resources: address the lack of funding and legal
expertise by pooling resources and expertise
• Economic argument: strengthen the eHealth market by
promoting interoperability and addressing its fragmentation
jb / tp 27.9.2015

9. Connecting Member States for
health data exchange
MS
Hospitals
GPs
(…)
MS
MS
tp 27/09/2015

11. Developing EU policy & support measures
• Research & Development activities (since 1989)
! Research Projects, > 450 projects, > €1 billion
! Cooperation with health services, industry, universities
• Policy instruments (since 2004)
! Communications, Recommendations, Directive(s)
! Stakeholders'Group (users, industry)
! Strategy studies, road maps, evidence
• Support to deployment (since 2007)
! Market validation and implementation
! Competitiveness and Innovation
• Work with national health systems (since 2011)
! Collaboration of MS in the eHealth Network
! Deployment of the results of projects
Adapted from From Flora Giorgio, 2010
3.9.2014
ICT for Health budget:
~ 75 Million €/year

12. eHealth Action Plan 2012-2020
• eHealth Network ⇒
• eHealth Interoperability Framework ⇒ Legal issues
• Green Paper on mHealth ⇒
tp 27/9/2015

13. Policy Instruments
for eHealth in the EU
" Directive on patients' rights in cross-border care
" eHealth Network
" 2nd Joint Action on eHealth
" Financing
" Horizon 2020: research and innovation (since 1989)
" Connecting Europe Facility: implementation (2015)
" Strategy for the Digital Single Market
" Adopted by the Commission 6 May 2015

14. HALF
of
EU
enterprises
provide
mobile
devices
for
business
use
276.5
million
EUR
turnover
of
EU
B2C
eCommerce
(2012)
14%
of
EU
SMEs
selling
online
29%
of
EU
enterprises
use
e-­‐Invoices
28%
EU
enterprises
use
Social
media
38%
EU
venture
capital
DIGITAL
BUSINESS
DIGITAL
ECONOMY
72%
of
EU
individuals
uses
INTERNET
regularly
900
000
estimated
demand/
supply
gap
by
2020
150
Million
subscriptions
fixed
Broadband
130
mobile
subscriptions
per
100
people
ICT
drives
1/3rd
EU
GDP
growth
1995-­‐2007
2.4%
of
workforce
+
4.1%
yearly
employment
growth
ICT
professionals
55%
work
outside
ICT
sector
7%
of
GDP
Size
of
the
digital
economy
6%
of
Gov't
R&D
17%
of
business
R&D
by
ICT
sector
ICT
sector
4.4%
ICT
in
Other
Sectors
17%
EU
patents

15. All
sectors
are
dependent
on
ICT
ICT
spending
by
category
of
actors
(%
of
total
spending
on
ICT
in
2012)
Source:
OECD
Consumer
33%
Financial
Services
10%
Telecom
9%
Government
8%
Services
8%
Manufacturing
8%
Transporta?on
5%
Healthcare
4%
Retail
Trade
3%
Wholesale
and
Distribu?on
3%
Hospitality,
Hotels
and
Leisure
3%
Energy
and
U?li?es
2%
Construc?on
2%
Natural
Resources
1%
Educa?onal
Services
1%
SG/tp 16/6/2015
Healthcare
4%

16. • Geoblocking
• Copyright
• E-commerce
• Parcel delivery
• Reducing VAT burden
Better access for
consumers and
businesses
• Telecoms market
• Media services
• Platforms and intermediaries
• Trust and security
Advanced digital
networks and
innovative
services
• Data economy
• Inclusive digital economy and society
• Interoperability and standardisation
Enhance the
digital economy
Health →
telemedicine
+ mhealth
SG/tp 16/7/2015

17. Patients’ rights in Cross-border Healthcare
Directive 2011/24/EU
A major step towards a Europe for Health

18. eHealth Network
• Article 14 of Directive
• Leads cooperation of
Member States
• Gives direction to eHealth developments
• Adopts guidelines
• Patient summary data
• ePrescriptions
tp 10/05/2015

19. eHealth
Network
Political
body
Preparatory
body
eHealth
projects
The eHealth Network
– A Strategic Tool
tp 15/09/2015

20. Joint Action supporting
the eHealth Network
under the 3rd Health Programme
Ireland
• Department of Health
• Health Service Executive
tp 27.9.2015

21. Guidelines on ePrescriptions
dataset for electronic exchange
under the cross-border Directive
eHealth Network
Brussels
18 November 2014 Release 1

22. What do
the guidelines address?
22
Rules in
the guidelines

24. eHealth Digital Service Infrastructure
under the Connecting Europe Facility
tp 13.7.2015

25. 2014-2015
Maintain and develop
interoperability assets,
handover to CEF
tp/mk 27/9/2015
2013-2015
Use common IT building
blocks in different public
policy areas
2008-2014
Pilot the service infrastructure
for cross-border health
eHDSI under CEF 2015 ->
Rely on the eHealth Network Guidelines
Implementation by Member States and Commission

26. eHealth Digital Service Infrastructure
the CEF funded project
Core services
Horizontal Building Blocks
eID, …
eHealth Building Blocks
terminology server, …
NCP
Hospitals
GPs
(…)
Member State's
connection to
the EU network
NCP: National
Contact PointNCP
tp 27/09/2015
NCP

27. T
E
C
H
N
I
C
A
L
Stork
epSOS eHDSI
Guidelines
eHealth NetworkP
O
L
I
C
Y
PILOTING DEPLOYMENT
CEF
gp/tp 27.9.2015

28. CEF WP 2015
AdoptedBudget of € 15 Million
(over 4 years)
CORE SERVICES
€ 7,5 Million
GENERIC SERVICES
€ 7,5 Million
Building Blocks
eID, eDelivery,…
eHealth-specific
Services
• ICT infrastructure
• Terminology svcs
• NCP mngmt
• …
Par?cipa?on
in
the
OpenNCP
Community
Deployment
of
Na?onal
Infrastructure
for
cross-­‐
border
exchange
of
data
INEA
manages
Member
States
Call for
Proposals
75% EU
financing

29. Connecting Europe Facility CEF
- supports building of the connections
December 2014
The 2015 Work Plan
allocates € 15 mill.
to eHealth
November 2015
Call for proposals
to Member States
March 2016
Member States sent
proposals
2016-2018
Implementation
tp 14/09/2015

30. Examples of policies and actions
supporting eHealth data exchange

31. Regulation on eIdentification
• Creates an EU legal framework for mutual recognition
and acceptance of eID and eSignature
• The Regulation supports a cross-sectorial use of the
notified eIdentifciation systems
23 July 2014
Published in
OJ L 257/73

32. Legal Study on
Electronic Health Records:
Overview of national laws
• Every country and region is in the process of progressively adapting legal
rules to enable EHR sharing
• Each national and regional legal framework is different, and needs to be
read in its specific context
• Typologies or classifications of these frameworks are difficult to make and
not very useful
• Question: is diversity of national and regional legal frameworks an obstacle
for cross-border sharing?

33. mHealth

34. Trends in mHealth
Health and fitness apps are among the fastest
growing apps categories in terms of use, with
time spent in health and fitness apps growing
51% over the year to August 2014.
Localytics,
September 2014
Apps + Wearable Devices =
Future of Mobile Health

35. mHealth potential – "triple win"
• Potential for citizens
→ More empowered patients, self-management, engagement
→ More accurate diagnosis and treatment
→ Earlier detection, increased prevention
→ Quality of life
→ Access
• Potential for healthcare
• Market potential

36. Green Paper on mHealth
• Public consultation to stakeholders on how to overcome
the main challenges to mHealth deployment:
• data protection
- big data
• legal framework
- liability
- safety and transparency
• mHealth’s role in healthcare systems
- reimbursement models
• interoperability
• international cooperation
• web entrepreneurs' market access

37. Next steps in mHealth
! Processes with stakeholders
! Code of Conduct on privacy and security - (DPD Art 27)
! Guidelines for assessing validity of data for the purposes of
linking apps to the electronic health records
! Revision of medical devices guidelines - after adoption of
medical devices regulation
! mHealth deployment under Horizon 2020
! Use of big data in healthcare, security, health literacy
! Commission-WHO-ITU initiative on evidence-gathering
and exchange of best practices – innovation hub

38. Summary - priorities

40. Priorities for healthcare
" Enabling all actors to benefit from telemedicine
and mHealth through measures in the context of
Digital Single Market
" Creating European infrastructure to exchange data
" Legal and technical arrangements for exchange
" European Reference Networks
" Align EU standardisation activities in ehealth
" Electronic patient access to health records
" Secondary use of health data (Big Data)
tp 27.9.2015

41. DG Health and Food Safety site
http://ec.europa.eu/health/ehealth/policy/index_en.htm
DG Connect site
http://ec.europa.eu/digital-agenda/en/eu-policy-ehealth
@EU_HEALTH
@EU_Commission @EU_eHEALTH
@V_Andriukaitis

42. eHealth adoption by General Practitioners 2013
Source: Benchmarking Deployment of
eHealth among General Practitioners (2013)
Composite index
tp 27/9/2015

43. Health Objectives
for the EU cooperation on eHealth
" Patients empowerment
" Access to healthcare
" Quality and safety of healthcare
" Sustainability of health systems
tp 3.9.2014 43

44. Barriers