European Commission’s ICT for
Health Agenda
Royal College of Physicians, London 15 July 2010
Flora Giorgio
Unit H1 – ICT for Health
DG INFSO
European Commission
Overview

EC and eHealth


Vision
Instruments

eHealth in Europe – some facts

What’s next
ICT for Health – Flora Giorgio – RCP, 15 July 2010
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EC vision for Health :
ICT to support the paradigm shift
From ‘curative care’ to ‘preventive care’
From ‘hospital-based’ to ‘patient-centred’
HOW?
By using ICT to enable collaborative, personalised care  empowering
By aiming at sustainability of healthcare systems  reengineering
eHealth works!
when combined with proper organisation
user acceptance and skills
ICT for Health – Flora Giorgio – RCP, 15 July 2010
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DG INFSO Policy & support measures in eHealth
DG INFSO, ICT for Health budget: ~ 100 Mill EUR/year
 Research & Development activities (since 1989)
 Research Framework Programmes
 To date > 450 projects, > €1 billion
 In cooperation with health services, industry, universities

Policy instruments (Since 2004)
 Communications, Recommendations, Directive(s)
 Liaison with MS - i2010 subgroup on eHealth
 Stakeholders' Groups (Users, Industry) ; EU Health Policy
Forum
 Strategy studies, road maps, evidence

Support to deployment (Since 2007)
 Market validation and implementation
 Competitiveness and Innovation Programme:
fostering cooperation among MSs
ICT for Health – Flora Giorgio – RCP, 15 July 2010
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EC instruments:
7th Research Framework Programme (FP7)
 Personalisation of Healthcare
Personal health system
 Patient safety
Safer surgery, detection of public health
events, clinical care and research
 Predictive Medicine – Virtual Human
Modelling/simulation of diseases
 BUDGET: ~ 85 Mill EUR/year
ICT for Health – Flora Giorgio – RCP, 15 July 2010
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EU Policy & support measures
 Research & Development activities (since 1989)
 Research Framework Programmes
 To date > 450 projects, > €1 billion
 In cooperation with health services, industry, universities

Policy instruments (Since 2004)
 Communications, Recommendations, Directive(s)
 Liaison with MS - i2010 subgroup on eHealth
 Stakeholders' Groups (Users, Industry) ; EU Health Policy
Forum
 Strategy studies, road maps, evidence

Support to deployment (Since 2007)
 Market validation and implementation
 Competitiveness and Innovation Programme:
fostering cooperation among MSs
ICT for Health – Flora Giorgio – RCP, 15 July 2010
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EC Recommendation on Interoperability
of cross border EHR systems
C(2008)3282 Policy
 Aims at enabling coordinated care by connecting people,
systems and services
 Provides MS & their relevant bodies with basic principles to
address the existing challenges in implementing EHR
interoperability
 Identifies different levels of actions:
 Political, organisational, technical, semantic,legal
 Interoperability testing and certification
 education and awareness
ICT for Health – Flora Giorgio – RCP, 15 July 2010
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Interoperability of EHR systems
 Interoperability cannot be solved (especially semantic) without direct
involvement and leadership of Healthcare professionals and their
community
 DG INFSO will support further R&D in semantic interoperability
 Role of organizations such as RCP is crucial both on national and
international levels
 Political and organizational levels of Interoperability as well as other
aspects are being addressed by eHealth Governance Initiative
ICT for Health – Flora Giorgio – RCP, 15 July 2010
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eHealth Governance Initiative
 A mechanism to link operational projects to political objectives
 Facilitate cooperation between MS at three levels:
 Political
 Strategic
 Operational (epSOS and similar future initiatives)
 Make sure that successful initiatives and/or cross border cooperation are
noted and taken up by decision makers at national level
 Timelines: 2010 for 3 years (subject to positive evaluation/negotiation)
 Proposed budget: JA 1Mill EUR (50% EC) + TN 500k (100%)
ICT for Health – Flora Giorgio – RCP, 15 July 2010
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EU Policy & support measures
 Research & Development activities (since 1989)
 Research Framework Programmes
 To date > 450 projects, > €1 billion
 In cooperation with health services, industry, universities

Policy instruments (Since 2004)
 Communications, Recommendations, Directive(s)
 Liaison with MS - i2010 subgroup on eHealth
 Stakeholders' Groups (Users, Industry) ; EU Health Policy
Forum
 Strategy studies, road maps, evidence

Support to deployment (Since 2007)
 Market validation and implementation
 Competitiveness and Innovation Programme:
fostering cooperation among MSs
ICT for Health – Flora Giorgio – RCP, 15 July 2010
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11
epSOS
• AIM: Implement test and validate interoperability of
- Patient summaries and ePrescriptions
• epSOS I (2008 – 2011) – 23 Mill (11Mill EC)
– 12 EU Member States
– 29 beneficiaries
– industry team via IHE (with about 35 members)
• epSOS II (extension, 2011 – 2013) – 14 Mill (7 EC) - ?
– about 20 Member States plus CH, NO, TR
– about 50 beneficiaries
12
Core epSOS services (I)
• Patient Summary:
– Only core data (administrative, medical, medications)
– extracted from respective national or regional summary/EPR
• ePrescribing:
– full prescription data set
• All data fully structured and coded,
– assuring full semantic interoperability
• Automatic translation into other languages & alphabets
eHealth in Europe - some examples
ICT for Health – Flora Giorgio – RCP, 15 July 2010
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Patterns of eHealth use in Europe (I)
Electronic storage of
individual medical
patient data
Use of a computer
during consultation
with the patient
Use of a Decision
Support System (DSS)
Transfer of lab results
from the laboratory
e-Prescription (transfer
of prescription to
pharmacy)
Average index score
EU27
4.0
3.7
3.3
2.3
2.0
0.6
0.5
0.3
2.1
EU27+2
4.0
3.7
3.3
2.3
2.0
0.6
0.5
0.3
2.1
DK
4.8
4.8
4.6
3.8
4.8
3.0
3.7
4.9
4.3
NL
4.9
4.5
4.7
3.7
4.2
1.8
1.3
3.5
3.6
FI
5.0
4.7
5.0
4.3
4.5
0.7
2.7
0.0
3.4
SE
4.8
4.1
2.4
4.1
4.1
0.6
0.7
4.0
3.1
UK
4.8
4.3
4.7
3.1
4.2
1.9
1.3
0.3
3.1
BE
4.2
4.3
3.8
2.5
3.7
0.4
0.6
0.1
2.4
DE
4.6
3.2
3.6
3.2
3.2
0.2
0.2
0.0
2.3
EE
4.9
3.0
4.7
3.6
2.0
0.2
0.1
0.0
2.3
HU
5.0
4.6
3.2
3.8
0.6
0.1
0.1
0.0
2.2
ICT for Health – Flora Giorgio – RCP, 15 July 2010
Transfer of
administrative patient
data to reimbursers or
other care providers
Transfer of medical
patient data to other
care providers or
professionals
Electronic storage of
individual
administrative patient
data
Electronic transfer of patient data
Country
Electronic storage Computer use in
of patient data
consultation
„Frontrunners“
„Followers“
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Courtesy Empirica
Patterns of eHealth use in Europe (II)
Electronic storage of
individual medical
patient data
Use of a computer
during consultation
with the patient
Use of a Decision
Support System (DSS)
Transfer of lab results
from the laboratory
e-Prescription (transfer
of prescription to
pharmacy)
Average index score
BG
4.7
4.2
3.8
2.1
0.3
0.4
0.2
0.1
2.0
FR
3.7
4.1
3.6
1.5
1.6
0.7
0.2
0.1
2.0
AT
4.0
3.7
2.7
2.1
1.9
0.7
0.6
0.1
2.0
ES
3.4
4.1
3.3
2.1
1.5
0.2
0.6
0.2
1.9
IT
4.2
3.4
4.1
2.4
0.4
0.1
0.4
0.0
1.9
IE
3.2
3.6
2.8
1.9
2.0
0.5
0.1
0.0
1.8
SK
4.5
2.6
3.6
3.2
0.2
0.1
0.1
0.0
1.8
CZ
3.4
3.4
3.0
2.3
1.2
0.5
0.3
0.0
1.7
PT
3.7
3.2
3.2
2.3
0.1
0.3
0.4
0.1
1.7
LU
3.5
3.7
2.9
1.2
1.4
0.0
0.0
0.0
1.6
ICT for Health – Flora Giorgio – RCP, 15 July 2010
Transfer of
administrative patient
data to reimbursers or
other care providers
Transfer of medical
patient data to other
care providers or
professionals
Electronic storage of
individual
administrative patient
data
Electronic transfer of patient data
Country
Electronic storage Computer use in
of patient data
consultation
••• 15
Patterns of eHealth use in Europe (III)
Electronic storage of
individual medical
patient data
Use of a computer
during consultation
with the patient
Use of a Decision
Support System (DSS)
Transfer of lab results
from the laboratory
e-Prescription (transfer
of prescription to
pharmacy)
Average index score
CY
2.8
3.8
1.6
0.5
0.5
0.1
0.1
0.0
1.2
MT
2.5
3.3
1.4
0.5
0.5
0.2
0.3
0.0
1.1
SI
4.3
1.4
0.9
1.4
0.5
0.4
0.0
0.1
1.1
EL
2.5
3.2
1.0
0.4
0.2
0.2
0.2
0.1
1.0
PL
2.7
2.4
0.5
0.6
0.5
0.7
0.1
0.0
1.0
RO
2.3
2.2
1.1
0.3
0.2
0.2
0.1
0.0
0.8
LT
1.9
1.0
0.4
0.4
0.4
0.8
0.1
0.1
0.6
LV
1.3
2.3
0.1
0.1
0.1
0.0
0.0
0.0
0.5
NO
4.9
4.5
4.7
4.1
4.4
1.1
1.7
0.1
3.2
IS
5.0
4.6
4.2
3.2
2.6
0.3
0.9
0.9
2.7
ICT for Health – Flora Giorgio – RCP, 15 July 2010
Transfer of
administrative patient
data to reimbursers or
other care providers
Transfer of medical
patient data to other
care providers or
professionals
Electronic storage of
individual
administrative patient
data
Electronic transfer of patient data
Country
Electronic storage Computer use in
of patient data
consultation
••• 16
www.medcom.dk
Prescriptions
80%
Disch. Letters
81 %
Lab. reports
95 %
Estimated cumulative
benefit by 2008: ~ € 1.4 bil.
ICT for Health – Flora Giorgio – RCP, 15 July 2010
Reimbursement
Referrals
13290 = 95 %
40113 =80%
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••• 17
Diraya´s objective
Integrate the healthcare information of
every citizen
A
SINGLE
HEALTH
RECORD
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19
Diraya: integrated healthcare in
Andalusia
 Unique health record number for all citizens
 Regional EHR shared between
- Primary care
- Hospital outpatient specialised care
- Hospital-based emergency care
- Pharmacies (prescription database)
- Hospital inpatient care: under implementation
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Diraya’s key elements
A SINGLE Health Record for each citizen
2
Unified ACCESS to all services
3
All relevant information STRUCTURED
4
Developed by the practitioners/users
KEYS
1
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Diraya
Building blocks
DATA
ANALYSIS
ePrescription
RECETA XXI
HEALTH
RECORD
Central
Booking
Maco
ICT for Health – Flora Giorgio – RCP, 15 July 2010
Orders /
CPOE
Citizens Data Base
Structured
Resources
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22
Utilisation 2009
 37.8 million primary care consultation sheets
 2.7 million hospital emergency care episodes (76%)
 790,000 hospital outpatient specialised care episodes (103,000 in
march-2010: 25%)
 93 million consultations scheduled through Diraya:
 Primary care: 82 million (5.6 million by internet)
 Specialised care: 11 million
 70 million electronic prescriptions
 89 million dispensing procedures
ICT for Health – Flora Giorgio – RCP, 15 July 2010
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What’s next
ICT for Health – Flora Giorgio – RCP, 15 July 2010
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Europe 2020 strategy and
Digital Agenda
 Adopted May 2010
 A flagship initiative for Smart sustainable and inclusive growth to develop
an economy based on knowledge and innovation.
 Aim at sustainable Digital society




Empowering citizens
Accessible eServices
Infrastructure for fast and ultra-fast broadband
Trust and security on the Net
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European Digital Agenda –eHealth
 Renew commitment to eHealth by:
 Patient empowerment – support patients access to eHealth services,
including patients records + telemedicine services
 Sharing knowledge for better care – minimum data set for patients‘
summaries
 Interoperability - standardization, certification and testing
ICT for Health – Flora Giorgio – May
RCP,18
152010
July 2010
••• 25
European Digital Agenda – eHealth
ACTIONS
The Commission will work with Member States competent
authorities and all interested stakeholders to:
•
Undertake pilot actions to equip Europeans with secure online
access to their medical health data by 2015 and to achieve by
2020 widespread deployment of telemedicine services;
•
Propose a recommendation defining a minimum common set of
patient data for interoperability of patient records to be
accessed or exchanged electronically across Member States by
2012 ;
OTHER ACTIONS:
•
Foster EU-wide standards , interoperability testing and
certification of eHealth systems by 2015 through stakeholder
dialogue;
ICT for Health – Flora Giorgio – RCP, 15 July 2010
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Conclusions
 EC and RCP
 Interoperability E H R
 Patient empowerment
 Be active at EU level to share your knowledge,
experience and leadership
 Research
 Policy
Leadership
 Deployment
from clinicians
To make progress in eHealth deployment
for better, more efficient and sustainable
healthcare systems
ICT for Health – Flora Giorgio – RCP, 15 July 2010
••• 27
Dates to remember:
 eHealth Strategy – closing event 16 September 2010, Brussels
 ICT 2010 Event, Brussels, September 2010 (Call 7 FP7)
 CALLIOPE - eHealth Interoperability, 16 November 2010, EP,
Brussels
 eHealth Ministerial Conference, Budapest, May 2011
ICT for Health – Flora Giorgio – RCP, 15 July 2010
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Thank you!
flora.giorgio@ec.europa.eu
For further information:
 INFSO H1 Policy site:
http://ec.europa.eu/information_society/activities/health/index_en.htm
 e-Newsletter:
http://ec.europa.eu/information_society/activities/health/newsletter/index_en.htm
 Research site:
http://cordis.europa.eu/ist/health/index.html
 Interactive Portal/Examples:
http://www.epractice.eu
www.good-ehealth.org
www.eHealth-impact.org
ICT for Health – Flora Giorgio – RCP, 15 July 2010
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European GPs using a computer during
consultation, in % (EC Study 2007)
100
90
80
100
95 94 94 93
Random
samples of
6,789 GPs in
29 countries
92
84
81
77 76
70
73 72 72
66 66 65
60
64
59 59
50
56 54
47
40
30
32
27
20
21 20
10
11
8 3
FI
UK
EE
NL
NO
DK
IS
IT
BG
BE
SK
FR
DE
ES
EU27
HU
PT
CZ
LU
IE
AT
SE
CY
MT
RO
EL
SI
PL
LT
LV
0
18
Source: empirica: eHealth use among GPs in Europe 2007, Bonn, April 2008
ICT for Health
© – Flora Giorgio – RCP, 15 July 2010
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European GPs data exchange with
hospitals (EC Study 2007)
100
Random
samples of
6,789 GPs in
29 countries
90
80
70
60
50
40
76
75 73
72
61
51
47
30
32 31
20
24 23
10
20 19
14 13
11 10 10
9 8 7 6 5 4 4 4 4 0 0
DK
NO
FI
NL
BE
UK
IS
SE
EE
AT
ES
IE
EU27
PT
IT
MT
LU
FR
HU
SI
CZ
PL
CY
LT
EL
BG
SK
DE
RO
LV
0
44
Source: empirica: eHealth use among GPs in Europe 2007, Bonn, April 2008
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© – Flora Giorgio – RCP, 15 July 2010
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