Europe aims to kick-start e-health

Europe used to start at Calais: but the European Commission is trying to change all that, at least as far as the market in healthcare information and communications technology is concerned. Jon Hoeksma reports.

Continental Europe and its government institutions have tended to be a low priority for people working in the NHS. This is perhaps unsurprising, given that the European Union devolves responsibility for healthcare systems to its member states.

Yet there are now compelling reasons why anyone involved in NHS IT should start to pay interest to the policies now coming out of the EU on information and communications technology (ICT) in health.

Of particular interest to NHS trusts and purchasers should be the fact that the European Commission is strongly backing an approach based on common industry standards, interoperability and the accreditation of systems to core common requirements. Taken together, these measures have the potential to dramatically reduce the often prohibitively high cost of clinical systems.

Market traders

“Taken together, these measures have the potential to dramatically reduce the often prohibitively high cost of clinical systems.”The Commission has identified e-health as the first of six lead market initiatives (LMIs). These are intended accelerate growth in a strategic sector that offers benefits to the whole of Europe’s economy.

Other LMIs will follow in protective textiles, sustainable construction, recycling, bio-based products and renewable energies. The aim is to maximise the potential of each by reducing the cost of bringing new products or services into the market and cutting barriers to adoption.

In the case of ICT in health, the Commission says it will do this by promoting standards and interoperability between systems; removing legal and regulatory barriers; and improving procurement mechanisms.

A paper published in January 2008, Accelerating the Development of the eHealth market in Europe, says the e-health industry in the EU was estimated to be worth €21bn in 2006 and could be worth €30bn by 2012 if these measures are taken. Indeed, it claims ICT could become the third biggest industry in the healthcare sector.

UK ahoy

Within the LMI strategy, particular attention is paid to the development of two main areas: “telecare/homecare and clinical information in the primary healthcare sector.” It says strong growth is predicted in both areas and argues that European companies are well placed to take advantage in these sectors.

The identification of telecare/homecare is in line with the Department of Health’s emphasis on the need for technology to better support people at home, or to better support people with long-term conitions outside hospital settings. In April, England will begin large-scale telecare “whole system demonstrators” involving up to 7,000 people.

Primary healthcare, meanwhile,continues to be one of the jewels in the NHS’s digital crown, with almost 100 per cent of practices computerised, basic electronic prescribing in place and Choose and Book slowly rolling out so that doctors and patients can book acute sector appoinments online. Growing numbers of practices can also exchange patient records and receive test results electronically.

NHS opportunities

“If it can deliver, the nitiative holds out the prospect of giving NHS organisations access to a European market that includes many familiar vendors, in which products are increasingly based on common standards.” Interoperability and standards feature heavility in the National Programme for IT in the NHS (NPfIT), but in the acute sector, at least, its emphasis has been more on interoperability between standardised systems.

Two trends make the Commission’s focus on interoperability between non-standardised systems more important than it used to be. The first is the shift towards local ownership of the Programme, while the second is the clear shift towards a choice of accredited system that has already happened in primary care through the GP Systems of Choice initiative.

If it can deliver, the Commission’s initiative holds out the prospect of giving NHS organisations access to a European market that includes many familiar vendors, in which products are increasingly based on common standards.

To kick-start progress on interoperability, Accelerating the Development of the eHealth market in Europe says the Commission will shortly publish recommendations on e-health interoperability, aimed at “achieving a European health information space by 2015.”

In addition, steps are proposed for the certification of systems to common standards and specifications – similar to successful initiatives already underway in the US.

Can the Commission deliver?

One way and another, the Commission has a big wish list. Can it deliver? Legislation and policy initaitives have already shown that “Europe” can have a big impact on the NHS, even when it is working within its apparently limited remit to create a free market in goods, work and services.

The European working-time directive, for instance, has cost trusts a lot of money in extra salary bills, forced some significant changes in the way that hospitals work and significantly improved the working lives of junior doctors. Significantly, this new initiative comes through the Commission’s markets arm.

E-health is also an area in which the Commission has a proven track record. Through its various research activities over the past ten years, it has invested over €1bn in e-health projects, making it Europe’s biggest funder of research in the area by far.

In combination, therefore, the new LMI strategy and the Commission’s information society policies could not only reshape the e-health market, but the way that healthcare services are delivered. Good enough reason for NHS IT managers to look across the Channel, occasionally.

About the author: Jon Hoeksma is an award winning journalist and co-founder of the industry portal e-health-insider. This has a European sister site: www.ehealtheurope.net