Putting the citizen at the centre of health and care re-design.The European Commission has set up a task force bringing together technology and health policy makers.

Authors: Roberto Viola (Director General DG Connect) / Xavier Prats Monné (Director General DG Sante)

Europe faces a major challenge with the sustainability and quality of health and care provision, as a consequence of demographic change and improvements in medical treatment. Public expenditure on health and long-term care has been increasing over the last decades in all EU Member States, and is expected to rise even further as a consequence of an ageing population. In 2015, it accounted for 8.7% of GDP in the EU and could reach up to 12.6% of GDP in 2060, according to the European Commission's Joint Report on Health Care and Long-term Care Systems and Fiscal Sustainability.

The Commission Communication on effective, accessible and resilient health systems concluded that Member States’ future ability to provide high quality care to all will depend on making health systems more resilient, more capable of coping with the challenges that lie ahead. And they must achieve this while remaining cost-effective and fiscally sustainable.

Digital technology can improve health and care provision, allowing citizens to live longer and more healthy life years (HLYs) and it can help innovating the way we deliver and receive health and care services.

Digital technology will redefine health and care

Digital technologies such as 4G/5G mobile communication, artificial intelligence or supercomputing offer new opportunities to transform healthcare systems. They enable new approaches to personalised medicine, independent living or integrated health and social care, accelerating scientific progress, early diagnosis of diseases and more effective treatments.

Technological innovations and their large-scale implementation bring along changes in service delivery and redefine healthcare.  Disruptive change is a key driver for the future according to the Commission Expert Panel on effective ways of investing in health. But the Panel underlined that disruptive innovations must also respect values of universality, equity and solidarity while delivering high quality, effective and safe health services.

But what does this transformation mean for every one of us in our daily lives?

Scientific advances translate into better results for people

Personalised medicine enabled by data analysis will benefit every citizen. Disease management supported by health data analytics will lead to drug therapies that are more effective, with less adverse effects and that can ensure improved quality of life. Physicians also increasingly embrace therapies supported by data analytics, which will minimize trial-and-error diagnosis and treatment, with benefits for providers and recipients of health and care services.

Supercomputing (also called High Performance Computing) already provides early detection of tumours in a simple, quick and precise way. In some cases, early detection is now possible in a few hours, whereas just 10 years ago it would have taken days or weeks, and in other cases would have been virtually impossible. Data analytics enabled by supercomputing allow for early diagnosis of genetic disorders leading to more effective (and timely) treatment and saving lives.

Innovation enables "people-powered" health and care provision

Health is more than medicine: it is about people helping themselves and helping other people. It is about dispersed health and care networks that work together in the interests of the citizen and it is about using people to re-design their own health and care services. Evidence shows that digital technology increasingly helps health and care professionals tapping into the wealth of information and skills in communities and to capitalise on this experiential knowledge for managing health conditions or maintaining healthy lifestyles.

Digitisation of health and care services can also improve patient-experience, and empower each of us to look after our own health. ICPNN, a digitally-enabled integrated care programme in the Netherlands, provides integrated health and community care support for adults over 75 living at home. It allows citizens to age in their own community for as long as possible and with as much involvement in the management of their own care process. In a period of two years, this programme led to a decrease of between 37% and 47% in consultations related to ageing-related problems (chronic conditions), and an equivalent increase in the perceived sense of wellbeing by the elderly population.

Large scale deployment makes more sustainable health and care systems

Too often the fruits of innovation are not reaped or there are unnecessary delays. Therefore deployment and implementing in practical healthcare and public health is a necessity. The Commission is working with the Member States to start exchanging e-prescriptions across borders in 2018. Cross-border telemedicine is a cornerstone of the European Reference Networks which will connect close to 1.000 clinics in Europe to diagnose and treat complex and rare diseases. Both schemes are supported by the Connecting Europe Facility and the system for exchange of prescriptions is based on a successful CIP project epSOS.

This shows the need for working with national health systems for upscaling. Examples are many:  IMM used digital platforms to re-engineer the delivery of pharmacy services for patients who are on multiple medication. The programme in Northern Ireland led to a reduction errors, increased time to readmission (20 days), faster medication rounds and faster discharge (> 90 minutes quicker).

The Horizon H2020 programme contributes significantly in the area of digital technology for health and ageing. In this context, the European Innovation Partnership on Active and Healthy Ageing provides a platform to link the efforts of many regions and ecosystems across Europe, some of which are recognised as reference sites on digital innovation for health and care. 

So what can we learn from the fast growing body of evidence suggesting digital technology can lead to better health and care for citizens?

Pooling resources to bridge the "digital" and "health" domains

The joint Commission and OECD report “Health at a Glance: Europe 2016” noted that improvement in the adoption of digital technology in both the primary care and hospitals is needed across Europe. Many governments from Estonia to Portugal have already embarked on active eHealth policy implementation.

In December 2016, top representatives from public health and care authorities, industry and civil society organisations presented the Blueprint on Digital Transformation of Health and Care to the European Commission. They identified some of the critical issues that can ensure digital transformation will mean "better care for citizens" and called on the European Commission to drive this much-needed transformation.

The need for EU cooperation in this field is now more important and urgent than ever. Just imagine for a moment if we were to pool EU resources to accelerate research in genetics or cancer treatment. Or if we could develop an "agile" enough system to ensure that not only patient summaries but full health records are exchanged and patients can get treatment across borders when necessary.

This system would harness the power of data exchange across different ecosystems (digital and health), in a way that generates new knowledge and translates this knowledge into better care services, early diagnosis and treatment of disease all across the EU.

This ambition is the driving force behind a new Task Force that we are launched to develop further the digital strategy in health of DG CONNECT (Communications Networks, Content & Technology) and DG SANTE (Health and Food Safety) and other European Commission DGs.

The Task Force will work across portfolios on developing concrete proposals to harness the potential of data and technology in order to deliver better health and care conditions in Europe. It will examine incentives and obstacles to achieve secure exchange of health data across the EU.

The Task Force will also define new actions to strengthen pan-EU cooperation networks that can contribute to the acceleration of genetic research and maximise the potential of supercomputing applications to analyse health data, reduce lead-times for the introduction of new treatments or enable more personalised health and care provision.

With citizens at the centre of health and care re-design, the Task Force will look into how technology can support seamless patient feedback, developing "people-powered" health and care systems that help define service needs and contribute to continuous improvement of health and care service provision across the EU.

This Task Force is the first step of the journey. Strengthening EU cooperation and avoiding fragmentation will serve patients, health professionals, national health systems and European industries.

We want to realise this vision, placing people at the heart of digital health and care redesign.

Let's join forces!