Ilias Iakovidis PhD

1
Empowering patients through e-health
European Connected Health Leadership
Summit Belfast 6-7 May, 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
2
Health sector in EU

• Employs 9.3 of workforce, gt 15 M people
  (retail 13.0 M, business services 13.3m)
• Health expenditure gt 8,5 of GDP, growth at 4 a
  year (faster than EU economic growth), potential
  to reach 16 of GDP in EU by 2020 (Healthcast
  2020, PWC)
• Health care is information intensive sector but
  ICT penetration is low compare to other sectors.
• There is great potential for benefits for
  individuals, society and economy when ICT,
  leadership and skills come together

3
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

3
Definition agreed with the eHealth Industry
Stakholders Group reporting to the i2010 sub
group on eHealth
4
eHealth for SustainabilitySome examples

• 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

5
eHealth worksEfficiency and productivity

• National and Regional Health information Networks
  improve quality, efficiency, and will save next
  year 80 Mil/year in Denmark (Medcom) and 60
  Mil/y in Czech republic (IZIP)
• ePrescription improves patient safety, saves 70
  Mil/y in Sweden
• Direct Online information Services such as NHS
  Direct online empower patients, avoid
  unnecessary hospitalisation, support lifestyle
  choices, save 110 Mil/year

www.good-ehealth.org
www.eHealth-impact.org
http//www.epractice.eu
6
eHealth Market in EU

• Potential
• eHealth is currently the fastest growing industry
  of health sector, estimated at 20 Billion, 2
  of Health expenditure
• Other EU markets Pharma 205 Bill.,
  Medical Technology 64 Bill.
• By 2010, a double digit growth rate of up to 11
  is foreseen for eHealth, driven by a search for
  more productivity and performance (source
  Datamonitor 2007)
• Challenges
• Standardisation
• Interoperability
• Business model financing

7
Step 1 (past EU RD activities) Health
Information Networks Connecting providers
Messaging, EHR
Emergency
Hospital
GP
Pharmacy
Health Centre
Secure Networks
Region 3
Mobile, Wireless Broadband
mobile PC
Region 2
Region 1
Mobility
Home
8
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
9
IT use among primary care physicians in seven
countries
10
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
11
GPs Electronic exchange of patient data by
purpose (selected countries)
Source empirica ICT and eHealth use among GPs
in Europe 2007, Bonn April 2008
12
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
13
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!

14
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)
15
Step 2Current EU activitiesConnecting
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
16
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
17
Step 3 The full picture of individuals health
status
18
New Options for Disease Management
Philips Presentation
19
EU Wide eHealth Policy and support to deployment
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
20
EU Wide 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)

21
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)

22
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

22
23
Annex
23
24
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
25
Access to broadband in practices
Source empirica ICT and eHealth use among GPs
in Europe 2007, Bonn April 2008
26
Connectivity to other GPs
Source empirica ICT and eHealth use among GPs
in Europe 2007, Bonn April 2008
27
Use storage of medical patient data
Source empirica ICT and eHealth use among GPs
in Europe 2007, Bonn April 2008
28
GPs connected to secondary healthcare(hospitals
and/or specialist)
29
Electronic exchange of data for at least one
purpose
30
Connectivity to specialists
Source empirica ICT and eHealth use among GPs
in Europe 2007, Bonn April 2008
31
Connectivity to hospitals
Source empirica ICT and eHealth use among GPs
in Europe 2007, Bonn April 2008
32
Connectivity to health authorities
Source empirica ICT and eHealth use among GPs
in Europe 2007, Bonn April 2008
33
Link to insurers (reimbursers)
Source empirica ICT and eHealth use among GPs
in Europe 2007, Bonn April 2008
34
GP Attitudes towards ICT use in healthcare
Source empirica ICT and eHealth use among GPs
in Europe 2007, Bonn April 2008