We Need To Accelerate Adoption Of Digital Health Services In Europe

8 November 2018
Digital Health
How should the transformation of healthcare systems across Europe be supported by  European governments? Healthcare is a very important matter for the prosperity of the European society. With a growing ageing population and the need for international mobility, governments have the responsibility to set the right framework for their citizens to live better and healthier in their own country and elsewhere in Europe. The digital transformation of healthcare is fast-paced and national governments are getting increasingly engaged in that process. For instance, EU Member States have signed up to support the European Commission’s communication for the transformation of health and care in the digital single market. AI can accelerate the diagnosis and better treatment of rare diseases for almost 30 million people in the EU who are affected by one of the 6,000 life threatening rare diseases, and it is important not to separate the work for better healthcare from the work of enhancing new technology. Both are closely linked, and Member States are in close dialogue with the European Commission to leverage Artificial Intelligence in Europe. In addition, there is a strong momentum to fund the creation of advanced skills in developing these technologies as well as commitments to fund 5G infrastructures at national level. All these initiatives will accelerate the creation and adoption of new innovative services for healthcare. Such technologies will also help to alleviate the costs the States assume for public health, foster a patient centric approach where health records and prescriptions can cross EU borders and create a massive genome data base to prevent and treat rare diseases. The French government plans to spend 1.5 billion Euros over the next 5 years to support research in the Artificial Intelligence field, collect data and encourage start-ups. Does the digital transformation need more financial support from the state or should it be accelerated by a digital-friendly regulatory environment? Healthcare and the wellbeing of citizens is a joint responsibility for the Member States and companies. In the end the answer is both, as they have the same interest and these options are closely interconnected. On the one hand, there needs to be a strong cooperation between the private and public sector. On the other hand, there needs to be strong support in the Member States contributing and matching investments being made by the European Commission. Which country in Europe has passed the friendliest regulations to help to speed up the adoption of digital health? That is somehow difficult to determine, but traditionally the Nordic countries are front runners on digital health development and digital health records. However, all countries have their own specificities. The challenge is not the development of innovative solutions but the speed to make them available on the market. I visited a Nordic Pharma company who has developed a great solution that can diagnose skin diseases with 99% accuracy and shorten the patient journey by 6 to 8 months. However, due to regulatory shortages in the EU, they face difficulties to bring the product to the market and to the hands of patients and doctors. In China and US, similar innovative solutions are launched every day and gaining market share to big global companies. If Europe wants to be serious about developing future health solutions, it must be conscious that it is now time to leave room for new ways of embracing innovation.  One of the methods we are debating is “sandboxing”, this means basically developing a limited, safe environment for testing new solutions for a given period without facing regulatory restrictions.
AI can accelerate the diagnosis and better treatment of rare diseases for almost 30 million people in the EU
The Nordic countries have defined health registers providing important data. Eastern Europe has great software programmers. I have seen academic institutions in the western and southern EU Member States doing very promising projects. For instance, Curie Institute Bioinformatics in France has partnered with Intel to use high performance computing and AI to accelerate gene research in treating cancer, pharmaceutical MSD has created a chatbot for doctors in Italy to access important information in their work with immune-oncology, or Philips is pioneering a digital pathology to accelerate clinical diagnostics, where deep learning AI is analysing massive data sets for the detection of cancer. There is no EU Member State that can develop AI alone. The collective strength of the EU project can help drive cross border health services to a market of over 600 million people. What are the legislative pillars of a digital-driven economy? The efforts to free up public data either through the re-use of public sector information (e.g. PSI Directive) or the regulation for the free flow of non-personal data will be important to develop machine learning algorithms. In addition, the free flow of data both personal and non-personal will be key for R&D and the treatment of patients in Europe. We have a strong framework to build trust through the GDPR but the implementation needs to be done in a harmonised way, and make sure it does not stop the doctors and researchers in reaching their goals, that is to develop ways to prevent or cure diseases. I have met several doctors and researchers who told me they are frustrated because they cannot use data in their work to treat patients anymore after the implementation of the GDPR. For sure that was never the intention, and if true this can really harm citizens with severe illnesses. When it comes to digital policy, it is important to involve doctors and hospital professionals in the dialogue. We also need to encourage cybersecurity certifications to be voluntary. More urgency is needed for 5G across the whole EU, even in the most rural and remote regions. Finally, it is mission critical for Member States to include and promote life-long learning skills and digital skills in their education systems and training programmes.   [caption id="attachment_25390" align="aligncenter" width="640"]Cecilia Bonefeld-Dahl, Director General of DIGITALEUROPE Cecilia Bonefeld-Dahl, Director General of DIGITALEUROPE.[/caption]   How can countries economically benefit from the digitalization of healthcare? Does it make economic sense to invest in digital solutions? The public health expenses represent about 8.4% of the EU GDP. Not only can digitalisation bring down operational costs, but these funds could be spent for preventive and predictive care solutions based on AI and other technologies. Digital solutions can reduce the administrative burdens, remove waste in public spending, analyse and process extremely large amounts of data to identify health risks and accelerate the creation of cure for life threatening diseases. It also opens new opportunities for people with disabilities and for our most senior citizens to remain active and included in society through important communication technologies. In addition, the development of drugs or therapies using genomics can be researched at greater speed for a fraction of the cost. Finally, it also provides citizens control over their health information, access prescriptions around the world and create a wide range of opportunities for people to improve their lifestyles. There is an urgent need that the design of health systems should be done closely with patients and health professionals. Both must have a say in ensuring that healthcare remains relevant, easy to use and valuable. Seeing the expertise and enthusiasm in all parts of the continent, there is no doubt that Europe has the potential to lead in these areas. What is the best way to break data silos in Europe and make big data across Europe available for research purposes? This is the primary goal of the European Commission’s communication on the strategy for the transformation of health and care for the digital single market, which we strongly support. There will be the development of an exchange format for health summaries and prescriptions and a database with a target of 1 million genomes for research. There is a need for the GDPR to be implemented in a harmonised way so that research can re-use the data for the development of treatments beyond the reason it was collected for. What could the healthcare sector learn from other industries to make digitalisation successful, faster and sustainable? I would recommend looking at the consumer electronic market. The speed and adoption of technology moved very fast once people got control over their data, giving rise to social platforms and music streaming sites. It is also a sector that attracts a lot of investor capital. I am convinced that the digitalisation of healthcare marks the beginning of a greater and healthier future for Europeans.