Is eHealth the answer?

eHealth - information technology applied to healthcare to give it its full term - is set to revolutionise patient care and how healthcare systems can be structured and managed. But if eHealth is the answer, why isn't Europe embracing this technology?

eHealth is supposed to make the healthcare system more patient-oriented, and if plans go ahead, an electronic version of the European health card will make it easier for patients to be reimbursed when they are treated in another Member State, while the internet will allow patients to find out more about their health and ask questions.

Currently worth around €20 billion, eHealth has the possibility to grow, and suppress the growth of the traditional health industries, namely pharmaceuticals and the medical device markets, at least that's according to the report eHealth in Europe by the European Commission.

Europe's aging population and increase in chronic lifestyle illnesses pose serious challenges and strains to the sustainability of governments' national health and social care systems, which are mostly based on public financing. It is estimated that the cost of chronic diseases represents some 60 percent of total healthcare expenses.

According to the World Health Organisation (WHO), eHealth is one of the most rapidly growing areas in the health sector at the moment and the UN organisation argues that eHealth should be an essential component of any plans and strategies for health system reform in the 21st century.

Health expenditure in the European Union is therefore expected to increase from nine percent of the EU gross domestic product at present to around 16 percent by 2020, according to Healthcast 2020.

"The health sector is, however, very information intensive, so advanced information and communication technologies can make healthcare systems more cost-effective, allowing more funds to be spent on healthcare and less on administering it," said the European Commission.

A recent report by the former Swedish EU presidency estimated that each year nine million bed-days could be freed up in Europe through the help of computer-based patient records alone, working out to the value of nearly €3.7 billion.

It's believed that eHealth could help heathcare in many ways, including a doctor sending a prescription directly to the pharmacy, speeding up the patients process of obtaining medicine; to a hospital accessing the electronic health record of a new patient from another country; or even a government setting up an information website for the prevention of child obesity, euobserver.com states.

Implementing eHealth

So why hasn't eHealth been implemented if it's the answer to a more efficient healthcare system? Despite the many advances in technology over the last few decades, deployment of the technology has lagged behind as obstacles obstruct it. Legal, political, cultural and market-related factors are in many cases a hurdle for eHealth development while, more technically, there is a lack of interoperability between the systems developed for eHealth use.

Also, there are issues related to privacy when it comes to eHealth is another barrier for European countries where the protection of privacy is essential.

Last month, Germany decided to put the implementation of its national eHealth smart card on hold due to concerns of security and confidentiality.

The German smart card project is one of the largest in Europe and intends to eventually provide every German citizen with an electronic card carrying their health data, medical history, prescriptions and insurance status.

Technology

Public attitudes towards eHealth can also be a blocking factor, argues the European Health Telematics Association (EHTEL). "We are close to having the technology we need, including interoperability of information and the systems that share it, but we are not yet there in terms of cultural change of mentality, nor the flexibility to collaborate and share among actors."

EU health ministers meeting last December called on member states to boost initiatives enabling the deployment and use of eHealth services as the central means to enhance quality, access and safety in healthcare. The ministers also called on the European Commission to update the European Action Plan on eHealth, as well as strengthen and increase e-health activities across the 27-member bloc.

Under the EU's subsidiarity principle, health and healthcare systems remain the responsibility of member state governments. However, the European Commission has an indirect impact, as it is involved with the market growing activities connected to eHealth.

Since the early 1990s, the EU has in total contributed more than €500 million of research funding to the development of eHealth tools and systems. EU-supported projects have helped place Europe in a world-leading position in the use of regional health networks, electronic health records in primary care and deployment of smart cards, in particular, according to the European Commission.

The eHealth market is currently around two percent of total healthcare spending in Europe, but has the potential to more than the double of that almost meeting the market for medical devices or half of the pharmaceutical market.

It's believed that if eHealth is completely achieved, it will not only have a positive effect on financial pressures over the medium and long term, but additionally, overall, it will improve patient management, service and safety.

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