What are the ingredients for a sustainable digital health ecosystem?

EPHA’s keynote at the Polish eHealth Forum

EPHA Acting Secretary General, Sascha Marschang, gave a keynote speech to the “From reactivity to prevention” session at the 2020 Polish eHealth Forum. The presentation focused on the e-transformation in public health as a possible way to inspiring more preventive population actions and more actively engaged patients and health professionals. Normally held in Gdansk and one of the most important digital health events in the Central/Eastern European region, this year’s eZdrowia adopted a virtual format due to COVID-19.

EPHA’s presentation focused on some of the problems that could be solved by digital technology –among others, the potential for offering better prevention services  and tackling chronic diseases, reaching all population groups, getting people involved in co-managing their own health, reducing hospital admissions and health system costs – but also noted that the vision for the digital transformation of health and care outlined by the European Commission and WHO Europe presents a challenge. This is a result of fragmentation, data silos, concerns over security and privacy, the ‘digital divide’ (which also expresses itself in terms of differing levels of health literacy) and the need for effective investments to ensure that digital health can truly become an integrated part of European health systems. Citing examples of successful digital initiatives from across Europe, including interoperable ePrescriptions, health portals, Electronic Health Records, health worker decision support systems and app libraries, Marschang noted that it is time to reflect on what ‘Digital in all Policies’ means in practice given that the health sector is different from other sectors and personal health data are sensitive.

Following EPHA’s presentation, Professor John Middleton, President of the Association of Schools of Public Health in the European Region (ASPHER) talked about the international perspective in terms of transferring knowledge and science, but also addressing some of the practical hurdles enabling an effective take-up of digital health – from the existence of different technological infrastructures in different European countries to different attitudes and traditions around collecting and protecting data and the need to develop new professional skills required to harness the power of ‘big data’ in public health.

Anna Kozieł (World Bank) offered an even broader view, comparing the ‘digital turn’ in Europe with the rapid changes that occurring in countries in Asia and Africa, stimulated by accessible mobile technologies. In many places, governments and end users often have less sceptical attitudes towards new technology – and no legacy systems – which can galvanise them to introduce more proactive policies. However, tech enthusiasm can also backfire when technology and data fall into the wrong hands and security, privacy and human rights saeguards are inadequate.

One of the aims of the session was to stimulate the further development of a well-functioning and sustainable eHealth ecosystem in Poland, and Ms Koziel talked about her experience working on coordinated health projects in the country. While great leaps forward are being made, the road is still long given the many obstacles to establishing a joined-up and secure health data infrastructure, as Filip Urbański (National Health Fund) noted – changing the model from reactive to proactive involves many steps, including a cultural shift and stakeholder collaboration across sectors and government.

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