Ilias Iakovidis PhD

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Empowering citizens through e-health
Regions working for a Europe for
Patients Committee of the Regions Brussels, 5th
February 2009

• Ilias Iakovidis PhD
• Deputy Head, "ICT for Health Unit
• Information Society Media DG
• European Commission

http//europa.eu.int/information_society/activitie
s/health/index_en.htm
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Terminology

• Computers process - data
• Humans interpret data and obtain - information
• ICT for Health solutions include products,
  systems and services for health authorities,
  professionals, patients and citizens that support
  improvements in health care (access, quality,
  efficacy/efficiency) as well in education and
  research.
• Synonyms eHealth, Health Informatics, Health
  Telematics
• Telemedicine is a category of eHealth systems
  services

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eHealth (ICT for Health)

• 1. Clinical information systems
• a) Specialised tools for health professionals
  within care institutions
• b) Tools for primary care and/or for outside the
  care institutions
• 2. Telemedicine systems and services
• 3. Regional/national health information networks
• and distributed electronic health record systems
  and associated services
• 4. Secondary usage / non-clinical systems
• a) Health education and health promotion of
  patients/citizens
• b) Specialised systems for research, public
  health

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Definition agreed with the eHealth Industry
Stakholders Group reporting to the i2010 sub
group on eHealth
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Towards eHealth Deployment Step 1 Health
Information Networks Connecting providers
Messaging, EHR, HP tools, on line services
Emergency
Hospital
GP
Pharmacy
Health Centre
Secure Networks
Region 3
Mobile, Wireless Broadband
mobile PC
Region 2
Region 1
Mobility
Home
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EU World Leader in deployment in primary care
(EC Study 2007)
87.4
80
69
66.1
62.5
62.3
55.2
44.4
15.1
13.9
2.7
0.9
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EU GPs using a computer during consultation, in
(EC Study 2007)
100
Random samples of 6,789 GPs in 29 countries
66
3
Source empirica ICT and eHealth use among GPs
in Europe 2007, Bonn April 2008
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GPs Electronic exchange of patient data by
purpose (selected countries)
Source empirica ICT and eHealth use among GPs
in Europe 2007, Bonn April 2008
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Interoperability across bordersLinking basic
information between patient summary systems or
giving access to physicians to patient summary in
your home country
Direct access of physicians when legal
Patient Summary 1
Patient Summary 2
Secure Networks
Country or Region 2
Country or Region 3
Country or Region 1
Mobility
Standardised exchange/access to common data sets
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EC Recommendation on Interoperability of cross
border electronic health record systems
COM(2008)3282

• Aims at enabling coordinated care by connecting
  people, systems and services
• Provides Member States and relevant bodies with
  basic principles to address the existing
  challenges in implementing EHR interoperability
• Identifies different levels of actions
• Political, Organisational, Technical, Semantic,
• Important issues standardisation, certification,
  conformance testing, education and awareness
• Need for concerted action among all Member States!

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Factors determining a health status of an
individual population
? Quality/Efficacy of Healthcare services ?
Lifestyle what we eat, drink, breath, ?
Physical and social environment ? Genetic
blueprint /profile at birth ? Acquired genetic
changes ICT important tool for all
factors! (not only health delivery systems)
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Towards eHealth Deployment Step 2 Connecting
individuals with providers/Health Information
Networks
GP
Pharmacy
Hospital
Emergency
Health Centre
Secure Networks
Region 3
Mobile, Wireless Broadband
mobile PC
Region 2
Region 1
Mobility
Home
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eHealth for Sustainability

• Efficiency productivity to do more with less
• From hospital-based to patient-centred care
• From late disease to early health
• Two main areas
• Preventive medicine
• Chronic disease management
• Empowering the patient (training, monitoring ..)
• Predictive medicine
• Molecular medicine
• eHealth for the economy Lead Market sector

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From hospital-based to patient-centred care

• Boario telecardiology
• 35-47 reduction in hospital admissions (in
  various studies)
• 12 reduction in outpatient visits
• UK studies
• Wireless Healthcare (2004) Early discharge from
  hospitals -gt
• up to 85 reduction in weekly care costs
• Cost of telecare at home with 24 hours response
  1/3 of the cost of a nursing home place
• Potential of Mobile Monitoring in Germany
• Up to 1.5 billion/year savings through early
  patient discharge
• (Assuming 3 days less hospital stay for 20 of
  patients)

See EC Communication on Telemedicine COM(2008)689
final ec.europa.eu/information_society/activities/
health/policy/telemedicine/index_en.htm
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Connectivity to patients homes
Source empirica ICT and eHealth use among GPs
in Europe 2007, Bonn April 2008
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EU in support of Telemedicine - Innovation
cascade
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CIP ICT-PSP Call 3 2009
ICT for patient-centered health service

• Proposed Funding Instruments

1. Pilot A
2. Thematic Network
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CIP ICT-PSP Call 3 2009 ICT for patient-centered
health service

• Conditions and characteristics
• To focus on at least one of the following chronic
  conditions Cardiovascular Diseases (CVD)
  Chronic Obstructive Pulmonary Disease (COPD)
  Diabetes.
• To target 6 to 8 healthcare providers (regional,
  local healthcare authorities). Regional
  healthcare authorities should obtain endorsement
  from their corresponding national ministries to
  participate in the pilot.
• Support is focused on measuring the effectiveness
  and scaling up

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EU Wide Strategy
5. Telemedicine Communication - COM(2008)689 final
4. EC Recommendation on EHR Interoperability
(2008)
3. Lead Market initiative for Europe (eHealth)
2. I2010 flagship initiative - ICT for Ageing Well
1. eHealth Action Plan - COM(2004)356 final
ec.europa.eu/information_society/activities/health
/policy/index_en.htm
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Towards eHealth Deployment Step 3 Seeing the
full picture of individuals health status
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New Options for Disease Management
Philips Presentation
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ICT for Health Unit support for Research
development (FP7)

• Personalisation of Healthcare
• Personal health system
• 72 Million (M) in 2007, ( 63 M in 2009)
• Patient safety-avoiding medical errors
• 30 M in 2007, ( 30 M in 2009)
• Predictive Medicine Virtual Human
• Modelling/simulation of diseases
• 72 M in 2007, ( 68 M in 2009)

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Conclusions

• ICT has shown impact on sustainability but this
  impact needs to scale.
• patients need to take more active role in health
  care and use ICT in their health/wellness
  management (changing consumer behavior pattern)
• stronger focus but health delivery system on
  prevention and early diagnosis,
• ICT has great potential in
• enabling novel approaches for personalised
  medicine (cross-disciplinary and
  multi-stakeholder research)
• fostering global research (International effort)

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For further information

• INFSO H1 Policy site
• http//ec.europa.eu/information_society/activitie
  s/health/index_en.htm
• Research site
• http//cordis.europa.eu/ist/health/index.html
• Interactive Portal
• http//www.epractice.eu

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Annex
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25
EU GPs using a computer during consultation, in
(EC Study 2007)
100
Random samples of 6,789 GPs in 29 countries
66
3
Source empirica ICT and eHealth use among GPs
in Europe 2007, Bonn April 2008
26
Access to broadband in practices
Source empirica ICT and eHealth use among GPs
in Europe 2007, Bonn April 2008
27
Connectivity to other GPs
Source empirica ICT and eHealth use among GPs
in Europe 2007, Bonn April 2008
28
Use storage of medical patient data
Source empirica ICT and eHealth use among GPs
in Europe 2007, Bonn April 2008
29
IT use among primary care physicians in seven
countries
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GPs connected to secondary healthcare(hospitals
and/or specialist)
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Electronic exchange of data for at least one
purpose
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Connectivity to specialists
Source empirica ICT and eHealth use among GPs
in Europe 2007, Bonn April 2008
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Connectivity to hospitals
Source empirica ICT and eHealth use among GPs
in Europe 2007, Bonn April 2008
34
Connectivity to health authorities
Source empirica ICT and eHealth use among GPs
in Europe 2007, Bonn April 2008
35
Link to insurers (reimbursers)
Source empirica ICT and eHealth use among GPs
in Europe 2007, Bonn April 2008
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GP Attitudes towards ICT use in healthcare
Source empirica ICT and eHealth use among GPs
in Europe 2007, Bonn April 2008