Thursday 8 December 8h00 – 9h00
Room JDE 63, Committee of the Regions
Interpretation available in ES/IT/EN
Welcome and approval of agenda
The Chair, Birgitta Sacrédeus welcomed participants to the last meeting of the year. She informed attendees about the logistical arrangements.
The agenda of the meeting was adopted as proposed. The purpose of the meeting was to receive an update from the European Commission regarding the work carried out in eHealth at the European level and to hear some experiences in the field from regions. Since the Committee of the Regions signed a Memorandum of Understanding (MoU) with WHO last month, Mr Uno Petersen, Vice-Chair of CoR IRGHW, intervened to briefly introduce the document.
1. MoU between the CoR and WHO: A new Partnership for Health – from Global to Local
Mr Karsten Uno Petersen, Vice-Chair of CoR IRGHW
Mr Uno Petersen informed that a Memorandum of Understanding (MoU) between the CoR and the WHO was adopted on 21 November 2016 as a result of a long process. Generally, WHO is very much interested in collaborating with regions since the regional level is extremely important regarding the health issues. He further added that working at the regional level is a good idea and the CoR is the best partner for this purpose due to the responsibility that ultimately lies in the regions.
2. eHealth: The Digital Single Market Strategy and Healthcare
Ms. Katja Neubauer, Team Leader eHealth, DG SANTE, European Commission
Ms Neubauer informed that one of the Juncker Commission’s priorities is to make the EU’s single market fit for the digital age and the work on eHealth in the European Commission (EC) is carried out in this political framework. She emphasized that there is a growing understanding that eHealth can contribute to digital growth rather than representing additional costs. The Digital Single Market Strategy seeks to provide the essential interoperability and standardisation in the area of health, including mHealth and telemedicine. eHealth is not prominent in the Strategy, yet critical to achieve it.
The European Commission has been active in implementing the Strategy through legislation, other initiatives and communications aiming to ensure better access for consumers and businesses to digital goods and services across Europe, creating the right conditions for digital networks and services to flourish, and maximizing the growth potential of the Digital Economy. eHealth is present in two specific contexts: interoperability and standardisation of ICT. More specifically, the ICT standardisation plan is to speed up standardisation in three areas: eHealth, transport and energy.
Under the eGovernment Action Plan, eHealth is included under the digitalisation of public services and cross-border mobility. The European Commission strives to make cross-border ePrescription and patient summaries available. They also foster deployment of telemedicine and tele-monitoring, in particular a) in the context of the European Reference Networks, b) by supporting Member States (MS) in developing a report and a recommendation on patients’ access to their health data, and c) by developing guidelines on the security, safety and interoperability of mHealth apps.
Ms Neubauer also talked about the digital service infrastructure (DSI), connecting healthcare providers across Member States (MS). However, in order to make the cross-border dimension a reality, the electronic summaries and ePrescriptions should exist at the national level in the first place. In some MS, there are only paper prescriptions available. The EC works towards setting up an eHealth National Contact Point (NCP) in every MS. The idea is to have different national structures connected to the eHealth NCP. eHealth NCPs would further be connected amongst each other by a secure peer-to-peer network. The benefits to the patient would include a better continuity of care, access to patient information in a secure way, reduction of repetition of diagnostic procedures, reduction of avoidable medical errors, etc.
The eHDSI is funded under the Connecting Europe Facilities (CEF) and will be able to fund 16 out of 20 MS that submitted their applications. The implementation process has already started and the first group of MS will start the exchange of information in the second half of 2017. Currently the EC is trying to allocate more money to allow the remaining MS to join. First exchanges are foreseen to happen in Sweden, Finland and Estonia. After 2020, the eHealth DSI should become sustainable.
3. Big Data in eHealth projects
Dr. Josep Redón, INCLIVA (Valencian Biomedical Research Institute)
Mr Redón presented the experience of the Community of Valencia. He mentioned that together with the ageing population and clustering of chronic diseases, healthcare costs are rising faster than the GDP. Subsequently, what needs to be considered in the following years is the confluence of economic and social change. Earlier this year, the European Commission organised a meeting in Luxembourg to discuss big data in health. Mr Redón gave an example of big data definition in health saying that it encompasses high-volume, high-diversity biological, clinical, environmental and lifestyle information collected from a number of individuals, from single individuals to large cohorts, in relation to their health and wellness status, at one or several points in time.
The eHealth structure in Valencia is as follows: every individual has a number linking all information coming from different care providers, including ePrescriptions and data from hospitals. For example, the system of prescription Gaya also includes the information if medicines were bought from the pharmacy or not. The data helps to distinguish which patients fall in the clinical risk groups by age, those algorithms are automatically calculated and made available for the physicians.
Another example of big data use in a multilevel research could be on obesity. The conclusions suggest that a social network is important and that risk factors include obese friends or living in cities with poor access to physical exercise.
There are 24 healthcare departments in Valencia and big data may give an overview of how much funding these departments use. The potential of research offers bigger scope and new prospects by giving access to the “real world”. This leaves a large space for future improvement and possibilities.
The biggest challenges faced by Valencia are integration of different sources of information; confidentiality of data; uniform regulatory requirements giving access to data across the 17 communities in Spain; and interoperability among different systems aiming towards one European network.
Catalonia Region intervened to say that Catalonia is aligned with the way Valencia is working. Regarding the eHDSI, he regretted to hear that Spain was not among the 20 MS who applied to participate in the call. However, he informed that Catalonia is very active working on the projects involving ePrescription.
Ms Neubauer advised Spain that even though the call to join the project for this round was closed, there was still a possibility to join the Expert Groups. This would give a possibility to participate in meetings and apply for the funding in the next round.
Answering a question about the European regulation on eHealth records, Ms Neubauer admitted that even though she would like to do more, the EU competencies in this area are limited. The EC has set up the eHealth network but joining it is voluntary.
Another question regarded if it would be possible for regions to join the European system directly, bypassing the national level. Ms Neubauer said that this is already happening to a certain extent and gave an example of Belgium. For the moment, there is a possibility for joining the European system gradually, for instance, opting for only receiving the record/ePrescription from another MS but not yet sharing their own data.
Mr Redón called for uniform rules all over Europe. He gave an example of Sweden in 1998, where all data was government owned by law and could be used for research. In Valencia, there are many interfering entities like ethical committees and etc., which complicate the advancement. During the aforementioned meeting in Luxembourg, there were many discussions related to data privacy.
Close of meeting
The Chair thanked the Committee of the Regions for hosting the meeting and the speakers, as well as the interpreters. She closed the meeting by wishing everyone happy holidays and hoped for the continuation of our work together in the future.
The next meeting of the CoR Interregional Group on Health and Wellbeing will take place in late March. Further information about this meeting will be circulated soon.