“Digital European Health Systems Will Be Also More Resilient”

November 9, 2020

The report suggests that if we want to achieve long-term sustainability, security, accessibility, and resilience in our health systems, spending on software, databases, and ICT services should be increased. Could you please specify how to invest smartly to ensure the digital health system's sustainability, instead of investing in technologies that only make healthcare even more expensive?

To invest smartly can be as simple as shifting all paper-based systems to electronic ones. Digitalizing hospitals – by moving to a digital documentation system and integrating data into it – can significantly improve clinical outcomes and patient care. One such example in our Digital investment plan is Portugal's Cascais hospital, where e-records have simplified drug administration, reduced nurses' shift time, and accelerated recovery time for patients.

This clearly shows the link between upgrading health systems and long-term saving of money and resources that can be better directed at improving diagnostics and treatment, rather than in administration and data collection.

By 2025, 60 percent of EU citizens should use health and care services provided online

Besides improving the digital infrastructure, encouraging uptake of new technologies also has great potential to optimize resources and create savings for health systems in the long run.

Take artificial intelligence: there are now promising applications that can catch the onset of cancer and other diseases long before any human doctor can, enabling early treatments. Investing in AI is also crucial for prevention and patient experience, from improving research (there are examples where months of research can be reduced to hours) to automating online consultations through chatbots that can determine urgency and need for an onsite consultation.

One of the recommendations is that by 2025, 60 percent of EU citizens should use health and care services provided online, and one in three Member States should offer cross-border access to electronic health records. It means that some digital gaps will remain. What actions do you suggest to remove health inequalities related to digital literacy and access to digital services?

While we support 100 percent use of online services and health data, in line with the European Commission's recommendation, we are also conscious that the infrastructure to achieve this is not yet there in the many Member States. Therefore, we have set ambitious yet hopefully achievable goals, which, as you rightly pointed out, must go hand in hand with closing the gap in digital skills and literacy. In our upcoming policy recommendations for data-driven EU healthcare systems, we suggest a three-fold approach:

  • Digital upskilling and modernization of curricula: up to 70 percent of health professionals report not using digital solutions due to gaps in knowledge and skills in data analytics. Clearly, our health systems' future viability will depend on digital-savvy doctors, nurses, and clinical staff in general. This must cover training for healthcare professionals and the inclusion of digital skills in the education systems from an early age.
  • Digital health literacy: the most recent survey shows that more than 50 percent of the EU's population has insufficient or limited health literacy. Likewise, European experts agree that there is low awareness of being able to access EHR systems, hampering cross-border health literacy.  We cannot wait for the next pandemic to invest in digital to address this problem. Improving citizens' understanding of and trust in digital health services will strengthen telehealth, which in turn will help ensure that everyone – especially those in rural areas, vulnerable groups, and the elderly – can benefit from continuity of care, even in times of pandemics and lockdowns.
  • Using AI to predict future health jobs demand: impactful training and education policies require a solid base of evidence. Policymaking would benefit from the creation of a European AI-powered skills forecasting project, including the health sector. A good example already in place is the "Be The Change" project by Belgian DIGITALEUROPE member AGORIA, which offers an algorithm-based analysis to predict the impact of policy and social measures on the shape of the Belgian labor market.

The adoption of electronic health records stands at just 3 percent in Europe. The problem is not the technology itself but many other factors, such as digital literacy or trust in technologies, policies, and workforce shortages. Where do you see the chance to increase EHR adoption in a short period significantly?

As well as a bold legal framework supported by the Member States, investment is urgently needed to digitize, connect, and secure Europe's fragmented health data systems. Some countries have made significant advancements: Austria, for example, has rolled out its nation-wide EHR five years ago, in collaboration with DIGITALEUROPE member Siemens Healthineers, and today 97 of the insured population are enrolled users.

How can we replicate this at the European level? I think any solution must include these three pillars:

  • A trusted and patient-centered system: as I've said before, we need to invest in digital skills and digital health literacy to ensure everyone – from medical staff to patients – has access to personalized and effective e-health services.
  • Interoperability: EU-wide standards are crucial to ensuring EHR is compatible across borders and will accelerate not only EHR adoption but broader health data sharing for multiple purposes, including research and clinical trials.
  • Connectivity and digital infrastructure: we won't be able to access and use health data if, first, we don't have secure, high-quality connectivity and broadband penetration. Similarly, robust IT infrastructure and equipment will enable healthcare centers to reach digital maturity, as well as facilitating uptake and interplay of smart devices for better telehealth.

How can we use the power of data to improve the quality of health services, driving the progress in medicine, science, and development of the next innovations?

We recently released two papers on how to create more modern and resilient healthcare systems. A top priority in these papers – that we have in agreement with the European Commission – is to ensure all Member States have a harmonized data act and a dedicated health data authority that can accelerate the processing of primary and secondary data, in accordance with the GDPR.

There are already such examples in Finland and France. However, neither is going far enough to include the private sector nor the scope of data that can be used. Additionally, a common European framework is necessary so that data authorities and rules operate in the same way to avoid a fragmented map.

A second important point is establishing the right legal framework that allows health data to flow within and across the Member States. We believe that this is best done by widening the scope of health data exchange, in line with the Commission's recommendations. This will form the basis of a patient-centered, interoperable, trust-based Common European Health Data Space.

What are your key ideas for investments in digital healthcare?

In our Digital investment plan, we propose two main ideas. The first one is modernizing and securing the EU's health systems by investing in digital tools, equipment and infrastructure, and upskilling medical staff. The second one is harnessing health data for the benefit of patients and research alike, for instance, by shifting to electronic health records and by investing in secure IT health applications.

What I'd like to highlight is that these are not revolutionary initiatives. The technology is already there and similar projects are already being carried out at the regional or national level. For instance, in collaboration with DIGITALEUROPE member Philips, the Netherlands has developed an online portal allowing Dutch hospitals to share patient information during the pandemic, facilitating the transfer of infected patients between hospitals to avoid local overload in intensive care units.

Now the real challenge is ensuring that these national pilots can be developed at a large scale and result in harmonized, more digital, and more resilient European health systems. To do this, all Member States will have to coordinate their investments and we hope our Digital investment plan will be of inspiration for them.

Download the full report "How to spend it: A digital investment plan for Europe."