eu ehealth agenda - etsi · 2009-04-02 · using pc using electronic patien data storage routinely...
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EU eHealth Agenda
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Ilias Iakovidis
ICT for Health Unit
DG Information Society and Media
European Commission
WHO ARE WEICT for Health (eHealth) Unit, European Commission
Information Society and Media DG
Supported > 500 eHealth projects & pilots (> €1 Billion) since 1989 Current support (ca € 100 Mil/year)
Major focus in 90’s: Regional Health Information Networks,
Electronic Health Records, Homecare/telemedicine
Today’s focus:
I) Research- Personal health systems (wearable, portable monitoring)
- Patient safety (Clinical information systems for safer outcomes)
- Modelling and Simulation of diseases (Virtual Physiological Human)
II) Policy and support to deployment eHealth Action plan, Lead market initiative,
Recommendation on Interoperability, Deployment of telemedicine
Large Scale Pilots, certification of Electronic Health Record Systems
eHealth for SustainabilityeHealth for Sustainability
• Efficiency & productivity – to do more with less
• From ‘hospital-based’ to ‘patient-centred’ care
• From ‘late disease’ to ‘early health’
• Two main areas:
� Preventive medicine:
− Chronic disease management− Empowering the patient (training, monitoring ..)
� Predictive medicine:
− Molecular medicine
• eHealth for the economy – Lead Market sector
• Boario telecardiology:
� 35-47% reduction in hospital admissions (in various studies)
� 12% reduction in outpatient visits
• UK studies:
From ‘hospital-based’
to ‘patient-centred’ care
From ‘hospital-based’
to ‘patient-centred’ care
•� Wireless Healthcare (2004): Early discharge from hospitals ->
up to 85% reduction in weekly care costs
� Cost of telecare at home with 24 hours response = 1/3 of the cost
of a nursing home place
• Potential of Mobile Monitoring in Germany:
� Up to €1.5 billion/year savings through early patient discharge
(Assuming 3 days less hospital stay for 20% of patients)
See EC Communication on Telemedicine COM(2008)689 final
ec.europa.eu/information_society/activities/health/policy/telemedicine/index_en.htm
eHealth worksOptimal results when eHealth tools when combined
with proper organisation and skills
• National and Regional Health information Networksimprove quality, efficiency, and will save next year € 80 Mil/year in Denmark (Medcom) and € 60 Mil/y in Czech republic (IZIP)
• ePrescription improves patient safety, saves € 70 Mil/y in Sweden
• Personal Health Systems and Telemonitoring can provide care at the point of need, reduce length of hospitalisation (by 20 -40% for heart patient in UK)
• Direct Online information Services such as NHS Direct online–empower patients, avoid unnecessary hospitalisation, support lifestyle choices, save € 110 Mil/year
www.good-ehealth.org www.eHealth-impact.org
http://www.epractice.eu
60
70
80
90
Using PC
Using electronic patien data storage
Routinely using PC in consultation
Internet access
Connecting with broadband
87.4%
80%
66.1%69%
62.5% 62.3%
55.2%
EU World Leader in deployment in primary care(EC Study 2007)
EU World Leader in deployment in primary care(EC Study 2007)
0
10
20
30
40
50Using decision support software forprescribing or diagnosis
Accessing other health institutions networks
Occasionally using PC to illustrate to patient
Regularly using PC to illustrate to patient
Exchanging administrative data withreimbursing organisations
Occasionally using Internet and electronichealth networks to provide telemonitoring tohome-patientsRoutinely using Internet and electronic healthnetworks to provide telemonitoring to home-patients
55.2%
44.4%
13.9%15.1%
2.7%0.9%
EU eHealth agendaPast R&D activities
Current policy and support to deployment
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Current policy and support to deployment
HospitalPharmacy
Health Centre
Emergency
Secure Networks
Towards eHealth Deployment: Step 1 Health Information Networks
Connecting providers: Messaging, EHR, HP tools, on line services
Towards eHealth Deployment: Step 1 Health Information Networks
Connecting providers: Messaging, EHR, HP tools, on line services
GP
Region 3
Home
mobile PC
Mobile, Wireless
&Broadband Region 2
Mobility
Region 1
Policy Action:2004 Communication and Action Plan
� Bringing the benefits of eHealth to EU citizens faster
(Quality of care, patient safety)
� Borderless European Health Information Space for
individual care, public health and research individual care, public health and research
� Increasing mobility of patients and professionals;
cross-boarder co-operations
� To facilitate growth and transparency of eHealth
Market; to decrease Market Fragmentation
•
Interoperability across borders
Linking basic information between patient summary systems or giving
access to physicians to patient summary in your home country
Interoperability across borders
Linking basic information between patient summary systems or giving
access to physicians to patient summary in your home country
Patient Summary 1Patient Summary 2
Direct access of physicians when legal
Country orRegion 3
Secure Networks
Country or Region 2
Mobility
Country or Region 1
Standardised exchange/access to common data sets
2008: Emphasis on Interoperability
• Support to projects, events, education on interoperability
• Mandate (M 403) given to CEN, CENELEC, ETSI to provide standards on (http://www.ehealth-interop.nen.nl)
1) patient and health practitioner identifiers;
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1) patient and health practitioner identifiers;
2) the patient summary;
3) an emergency data set.
• Launch of Large Scale Pilots on interoperability of emergency and medication data – CIP (7/08)
• Calls for proposals: � EHR certification (CIP June 08)
� Conformance testing (FP7-Call 4 Nov 08)
� PHS interoperability (FP7-Call 4 Nov 08)
EC Recommendation on Interoperability of cross border EHR
systems C(2008)3282
• Aims at enabling coordinated care by connecting
people, systems and services
• Provides Member States and relevant bodies
with basic principles to address the existing
challenges in implementing EHR interoperability
• Identifies different levels of actions:
� Political, Organisational, Technical, Semantic,
� Important issues: standardisation, certification,
conformance testing, education and awareness
Hospital
Pharmacy
Health CentreEmergency
Current R&D focus (since 1999 - )
Connecting individuals with Health Information Networks
Secure Networks
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Region 3
Home
mobile PC
Mobile, Wireless
&Broadband
Region 2
Mobility
Region 1
Secure Networks
A Communication on Telemedicine:October 2008
• Telemedicine experiences exist nation and Europe wide
• Increasing deployment due to:
� Technical reasons: Broadband, personal health systems
� Financial reasons: Moving patients from hospitals to home; � Financial reasons: Moving patients from hospitals to home;
solutions for chronic disease management
� Other reasons:
• Geographical, Patient empowerment, Involving family in
care process, Elderly people, Skill shortage
• Challenges: legal environment, reimbursement,
business models, evidence, acceptance, awareness,
technical
Competitiveness Innovation Programme Policy Support Programme (CIP ICT PSP)
• Large Scale Pilot (epSOS)
23 beneficiaries, 12 countries
6 national Ministries of Health
• Thematic Network on
eHealth Interoperability
(CALLIOPE)6 national Ministries of Health
15 Competence Centers
31 companies through IHE-Eur
11 Million EC funding
36 months
� 27 beneficiaries
� 30 months
� 500k EC funding
Implementation, support to policiesepSOS: Approach and Expected Outcome
• One large Scale Pilot
� Patient summary for unexpected care
� ePrescription/medication records
• With a common architecture• With a common architecture
• Built on Member States’ solutions and users’ needs (‘bottom up’)
• Thought as long lasting solution at European level
• Scalable and sustainable, adaptable to new situations
Lead Market Initiative
1. Market fragmentation, lack of interoperability
4 main barriers to eHealth market development
1. Market fragmentation, lack of interoperability
2. Legal Uncertainty
3. Lack of availability and access to finance
4. Lack of procurement
The “future”: EC Research Activities
-Quality/Efficacy of Healthcare servicesQuality/Efficacy of Healthcare servicesQuality/Efficacy of Healthcare servicesQuality/Efficacy of Healthcare services
- Lifestyle: what we eat, drink, breath, … Lifestyle: what we eat, drink, breath, … Lifestyle: what we eat, drink, breath, … Lifestyle: what we eat, drink, breath, …
Factors determining a health statusof an individual & population
Factors determining a health statusof an individual & population
Exogenous
Health delivery system
- Lifestyle: what we eat, drink, breath, … Lifestyle: what we eat, drink, breath, … Lifestyle: what we eat, drink, breath, … Lifestyle: what we eat, drink, breath, … - Physical and social environment Physical and social environment Physical and social environment Physical and social environment
- Genetic “blueprint” /profile at birthGenetic “blueprint” /profile at birthGenetic “blueprint” /profile at birthGenetic “blueprint” /profile at birth- Acquired genetic changesAcquired genetic changesAcquired genetic changesAcquired genetic changes
Exogenous Determinants
(Nurture)
Endogenous Determinants
(Nature)
WHAT can ICT contribute
Environmental
Biosensors
Genomic data
Biochips
New and Future Activities
Towards full picture of individual’s health status
New and Future Activities
Towards full picture of individual’s health status
EnvironmentalData
Phenomic data
ICT Systems
Genomic data
The Virtual Physiological Human is a methodological and technological framework that once established will enable the investigation of the human body as a single complex system.
Based on the ideas of the International Physiome project
The Virtual Physiological Human (VPH) conceptThe Virtual Physiological Human (VPH) concept
The VPH research roadmap developed by project STEP in 2007:
www.europhysiome.org
- Personalised (patient-specific) healthcaresolutions
- Early diagnostics & predictive medicine
- Understanding diseases for the first timeacross several biological levels
Based on the IUPS Physiome Project
Genes Cellstructure-function
Tissuestructure
-function
Clinicalmedicine
Organstructure
-function
ProteinsLipids
Carbohydrates
mRNA
……
25,000genes
100,000+proteins
12 organsystems
1 body200+ celltypes
4 tissuetypes
Hunter, PJ and Borg, TK. Integration from proteins to organs: The Physiome Project. Nature Reviews Molec & Cell Biol. 4:237-243, 2003 (Peter Hunter 2007)
euHeart – Integrated Cardiac Care Using
Patient-Specific Cardiovascular Modelling
euHeart – Integrated Cardiac Care Using
Patient-Specific Cardiovascular Modelling
Development, personalization and validation of computational models of the heart to improve:
- Heart Failure- Coronary Artery Diseases
- Valves and Aorta
Shortcut to virtual_human_H_coronary_flow.mov.lnk
- Valves and Aorta - Resynchronization Therapy- Radiofrequency Ablation
Project coord.: Philips ResearchScientific coord.: Univ. of Oxford
17 partners (6 companies, 6 universities, 5 clinics)
Budget ~19M€ EC funding: ~14M€
INRIA
UOXF
Philips Research
ICT for Health Unit support for Research & development (FP7)
� Personalisation of Healthcare
• Personal health system
€ 72 Million (M) in 2007, (€ 63 M in 2009)
� Patient safety-avoiding medical errors
€ 30 M in 2007, (€ 30 M in 2009)
� Predictive Medicine – Virtual Human
• Modelling/simulation of diseases
€ 72 M in 2007, (€ 68 M in 2009)
Objective 5.3 –Virtual Physiological Human
(a) Patient-specific computer based models and simulation� Multiscale models and simulation of organs/systems targeting
specific clinical needs� Better understanding of the functioning of the organs and its
pathologies aiming at prediction/early diagnosis
(b) ICT tools, services and infrastructures for bio-medical
Budget: €63M FP7 ICT Call 6 Deadline April, 2010
(b) ICT tools, services and infrastructures for bio-medical researchers to support at least 2 of the 3 activities:
� Share data and knowledge
� Jointly develop and share models/simulators
� Create collaborative environments
(c) Support action on evaluation and assessment of VPH projects � Shared tools/infrastructure� Clinical achievements� Market potential / penetration
(d) Coordination or Support Actions in Biomedical Informatics� Sustaining cross-collaboration among different fields
Obj. 5.4 – International Cooperation on VPH
(a) Interoperability� Joint development of interfaces between scientific databases, web
services, mark-up languages, meta-data, ontologies
(b) Tools and services for global cooperation
� For modelling/simulation, curated models, interconnected libraries
Budget: €5M FP7 ICT Call 4 Deadline April 1, 2009
� For modelling/simulation, curated models, interconnected libraries and data repositories
(c) Contribution to global validation framework � Joint verification and validation of models wit reference to tools
developed for clinical applications.
Additional requirements:� Eligibility: Only on-going VPH related EU projects and to on-going
international projects that address one or more of the target outcomes a) b) c)
For further information
• INFSO H1 Policy site:http://ec.europa.eu/information_society/activities/h
ealth/index_en.htm
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• Research site:http://cordis.europa.eu/ist/health/index.html
• eHealth Task Force report:http://ec.europa.eu/information_society/activities/h
ealth/docs/lmi-report-final-2007dec.pdf
• Interactive Portal:http://www.epractice.eu