Check against delivery.
Mr President, Mr Bowis, Ladies and Gentlemen,
I am grateful for your invitation to address this COCIR summit. This offers a good opportunity to discuss ideas on how we can move forward on a number of important fronts.
We all recognise the major challenges that health systems are facing today:
- an ageing population with the accompanying rising burden of chronic diseases, multi-morbidities, and permanent risk factors;
- greater patient expectations alongside often expensive new treatments; against a backdrop of
- limited public resources for health and constant pressures to reduce expenditure.
On top of this, we face a shortage of healthcare workers. By 2020, a gap of up to 2 million health workers is predicted in the EU. This is due to retirement among an ageing health workforce and insufficient new recruits to take their place.
All these elements together put the sustainability of health systems at risk and threaten the quality of care.
At the same time we observe a fast development of new technologies that can help us to address these challenges. Innovative devices that enable people with – for example heart problems or diabetes – to constantly monitor their health status. Being connected to their doctor or a healthcare facility alerts can be easily triggered to prevent severe courses of their disease.
This is a clever way to reduce number of heart attacks and other premature deaths.
The way our care systems are organised today – for example "vertical" approaches to individual diseases, or separate and disjointed systems of health and social care – means they are ill-prepared to meet these challenges.
So naturally we need to look for new and effective solutions to improve the performance of our health systems and deliver quality healthcare.
Digital technologies are providing new and improved tools to support the modernisation and adaptation of health systems.
Integrated care is a fundamental component in pursuing successful health system reforms.
And I would emphasise the need to consider a holistic approach, based on the real needs of citizens – focused not only on prevention and keeping people in good health but also on preserving their autonomy and functional capacity.
Reorganising health systems to an integrated care approach is far from simple – but we already have identified good practices.
For example the European Innovation Partnership (EIP) on Active and Healthy Ageing has been pursuing this new approach and is showing encouraging results.
In several regions across Europe, we find good practices offering insights into how to design and implement effective integrated care.
The Commission has linked the results of the EIP Action Group on Integrated Care to the work that Member States carry out on Health Systems Performance Assessment (HSPA).
This year, the HSPA expert group focuses on performance assessment of integrated care. The outcome of the collaboration between the EIP and HSPA groups will be available early next year.
I welcome that this week, at the European Summit on Digital Innovation for Active and Healthy Ageing, stakeholders have been discussing a blueprint – a “shared vision” – to mobilise investment in innovative approaches that can transform health and social care systems, enabled by digital technologies.
Digital solutions have an important role to play in integrated care. They can provide the “glue” to help connect the various actors across the health and social care sectors and ensure their effective collaboration.
Digital technologies have the potential to fundamentally change the way healthcare is delivered. They can improve the effectiveness, accessibility and resilience of our health systems.
In recent years, EU policies have repeatedly emphasised the importance of eHealth. The Digital Single Market Strategy refers to this as a technology “critical” for the deployment and success of the digital single market.
Under this Strategy, a series of actions on eHealth were announced last April with the package of Communications on digitising European industry.
These actions aim, for example, to improve interoperability and to support the exchange of health data among health systems, in particular in relation to prescriptions.
The EU supports this with funding from the Connecting Europe Facility (CEF) – a key tool to support interconnected trans-European networks including digital services in the health sector.
eHealth has now reached an important phase where activities are focussed on the creation of a European infrastructure to support the cross-border exchange of ePrescriptions and patient summaries.
This will become active in 2018 with as many as 16 Member States taking part.
Digital technologies such as telemedicine will also be piloted within the ground-breaking initiative of European Reference Networks (ERNs).
European Reference Networks will facilitate access to diagnosis, treatment and provision of affordable, high-quality and cost-effective healthcare for rare or low prevalence and complex diseases and conditions for patients of all ages.
The first networks will shortly be approved by Member States and will become operational in early 2017.
Innovation in access and provision through new health care models and innovative medical solutions will be the cornerstone of the ERN model.
The premise for establishing ERNs is that expertise and knowledge should travel instead of the patient. eHealth and telemedicine will be the main tools to allow the ERNs to function effectively. These networks will – I am sure – prove instrumental in paving the way for a more general use of telemedicine technologies.
Multidisciplinary teams of medical specialists connected through a dedicated IT platform will meet as a virtual clinical board, using telemedicine to discuss the patient's case. These virtual clinical boards will change the way of providing clinical advice and will become the standard tool for all ERNs.
The Networks will have a strong research dimension, identifying research gaps and triggering research collaboration among members. This will generate new evidence, leading to new insights into rare and complex diseases and new medical devices and drug therapies with potentially far-reaching benefits for patients.
With eHealth devices we collect big amount of data which can be used for scientific research on diseases, to improve the efficacy of treatments.
The package on Digitising industry includes the European Cloud Initiative which will provide European science, industry and public authorities with a world-class infrastructure to store data, with high-speed connectivity to transport data, and powerful computers to process data.
In my view, we should provide this kind of infrastructure for health data also in Europe to be able to absorb the full potential of Big Data for the improvement of the health of individuals.
Trust and security are also two vitally important issues that need to be properly addressed in "scaling up" the use of digital innovations in health and care.
The new European Data Protection rules adopted in April improve the protection of personal data and give greater control of their use to citizens. The new rules reinforce and clarify citizens' rights and offer some flexibility to businesses and public services.
Clearly, it is crucial to carry the public with us as we embrace the digital future. An important part of this is ensuring the privacy and security of individuals.
The vision of the Commission is to ensure that digitally enabled innovation for health, demographic change and wellbeing translates into a triple win for Europe:
- On the quality of health and care for patients;
- On sustainable health and care systems that can cope with the ageing population; and
- In terms of economic growth and job creation in digital health and care innovation.
Another area which continues to gather momentum is EU cooperation on Health Technology Assessment (HTA).
Today, there are over 50 HTA agencies in the EU. This leads to a high degree of fragmentation, duplication of efforts, a lack of standardisation and poor coordination. The current EU cooperation on HTA needs improvement in order to better contribute to the sustainability of healthcare systems.
In September, the Commission published an Inception Impact Assessment setting out where we currently stand on HTA and outlining options for the way forward. And in October we launched a public consultation.
This new HTA initiative builds on over two decades of EU cooperation on HTA which focused on two pillars: the Joint Actions – also known as EUnetHTA – and the HTA network. Whilst the Joint Actions build up technical and scientific expertise, the HTA Network provides strategic guidance.
While we are only at the beginning of the latest Joint Action, it is nevertheless important to start a reflection process now on what should happen regarding EU cooperation on HTA beyond 2020, when the Joint Action expires.
In our Inception Impact Assessment we identified four main areas which warrant attention:
- Sustainable financing;
- Uptake and implementation of achievements so far;
- Duplication of efforts; and
- Significant discrepancies between national procedures and methodologies.
These concerns are shared by many stakeholders.
We recognise that "one size does not fit all" in this field. We need to reflect carefully on the specificities of different technologies. We also need to respect the subsidiarity principle and the distribution of competences between the EU and the Member States.
I would encourage you to participate in the consultation and would very much welcome your contributions.
Ladies and Gentlemen,
It is clear that we must seize the opportunity to create a Europe where health systems are digitally connected and, above all, where all European citizens have access to high quality healthcare.
Thank you for your attention. I wish you all a fruitful and enjoyable summit.