A new Communication from the European Commission, “Enabling the digital transformation of health and care in the Digital Single Market: empowering citizens and building a healthier society”, published last month, provides an updated vision for digital health as an integral part of the Digital Single Market (DSM). Welcomed by many stakeholders, including patient and professional organisations, it includes a number of activities to be coordinated at EU level. The aim to “promote health, prevent and control disease, help and address patients’ unmet needs and make it easier for citizens to have equal access to high quality care through the meaningful use of digital innovation”, echoes the requests of the Health Inequalities and eHealth report that EPHA drafted for the eHealth Stakeholder Group in 2014. However, there remains a need for a comprehensive follow-up to the eHealth Action Plan 2012-2020 and appropriate governance: it is important that digital health does not evolve in a separate silo from other health issues. Trust and widespread acceptance can only be secured if population health is explicitly prioritised ahead of the economic development of the digital / tech sectors, and if patients and professionals alike feel the benefits of digitisation in a meaningful way.
Representing the Commission’s response to the December 2017 Council Conclusions under the Estonian Presidency, a key affirmation of the new Communication is that “citizens have the right to access and share their health data”. The results of the DSM mid-term review consultation reveal that a majority of respondents are in favour of having more access to their health data and they also support sharing the data. The objective of the eHealth Digital Service Infrastructure being developed by the Commission – with ePrescription and patient summaries as case studies in a number of Member States in 2018 – is to gradually incorporate other tools such as Electronic Health Records (EHR).
Apart from access to / sharing health data, the Communication includes two more pillars, namely better data to support a range of health-related activities including research and disease prevention, and citizen empowerment and person-centred care. While the first is focused on “secure exchange of genomic and other health data”, clearly there is a data and research gap in many public health related areas – including cross-border threats like antimicrobial resistance and infectious diseases – and more comprehensive and better data are required to close it. Yet it is also important to find the right balance in collecting and analysing “big” data coming from different sources (including patients themselves, e.g. via mHealth apps and wearables), especially if such data is drawn from unreliable sources including social media.
While making much reference to the perceived need to boost Europe’s innovation potential, support SMEs and boost the digital health economy, crucially, the document also cites the Sustainable Development Goals and the European Pillar of Social Rights – acknowledging that digitisation can contribute to reducing health inequalities and supporting universal health coverage. The question is whether the eHealth Network of countries will be able to agree on further joint initiatives that could create a level playing field for digital health to reduce the current disparities between countries (in terms of infrastructure, interoperability, availability and access). Also, given ever higher numbers of people excluded from national health systems – including the long-term unemployed and poor, the homeless, Roma communities, and increased numbers of undocumented migrants there is a greater need to provide basic healthcare services for all. Digital solutions could play a central role in ensuring at least basic health services for everybody living in Europe, regardless of geography, income, legal or health status.