ECH Campus Leadership Summit: Ilias Lakovidis

Ilias Iakovidis PhDDeputy Head, "ICT for Health“ Unit

Information Society & Media DGEuropean Commission

http://europa.eu.int/information_society/activities/health/index_en.htm

Empowering patients through e-health

Empowering patients through e-health

European Connected Health Leadership SummitBelfast 6-7 May, 2009

Health sector in EU

• Employs 9.3 % of workforce, > 15 M people (retail 13.0 M, business services 13.3m)

• Health expenditure > 8,5 % of GDP, growth at 4% a year (faster than EU economic growth), potential to reach 16% of GDP in EU by 2020 (Healthcast 2020, PWC)

• Health care is information intensive sector but ICT penetration is low compare to other sectors.

• There is great potential for benefits for individuals, society and economy when ICT, leadership and skills come together

••• 3

eHealth (ICT for Health)eHealth (ICT for Health)eHealth (ICT for Health)eHealth (ICT for Health)

1. Clinical information systemsa) Specialised tools for health professionals within care institutions b) Tools for primary care and/or for outside the care institutions

2. Telemedicine systems and services

3. Regional/national health information networks

and distributed electronic health record systems and associated services

4. Secondary usage / non-clinical systemsa) Health education and health promotion of patients/citizens b) Specialised systems for research, public health

*Definition agreed with the eHealth Industry Stakholders Group reporting to the i2010 sub group on eHealth

eHealth for SustainabilitySome examples

• 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

eHealth works:Efficiency and productivity

• National and Regional Health information Networks

improve 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

• 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

http://www.good-ehealth.org/

http://www.ehealth-impact.org/

http://www.epractice.eu/

eHealth Market in EU

• Potential eHealth is currently the fastest growing industry of health

sector, estimated at € 20 Billion, 2% of Health expenditure Other EU markets: Pharma € 205 Bill.,

Medical Technology € 64 Bill.

By 2010, a double digit growth rate of up to 11% is foreseen for eHealth, driven by a search for more productivity and performance (source: Datamonitor 2007)

• Challenges Standardisation Interoperability Business model & financing

Region 3

Hospital

Home

Pharmacy

Health Centre

mobile PC

Mobile, Wireless

&Broadband

Emergency

Secure Networks

Region 2

Mobility

Region 1

Step 1 (past EU R&D activities) Health Information Networks

Connecting providers: Messaging, EHR

GP

0

10

20

30

40

50

60

70

80

90

Using PC

Using electronic patien data storage

Routinely using PC in consultation

Internet access

Connecting with broadband

Using 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

87.4%

80%

66.1%69%

62.5%62.3%

55.2%

44.4%

13.9%15.1%

2.7%0.9%

EU World Leader in deployment in primary care (EC Study 2007)

IT use among primary care physicians in seven countries

EU GPs using a computer during consultation, in % (EC Study 2007)

Source: empirica: ICT and eHealth use among GPs in Europe 2007, Bonn April 2008

100%

66%

3%

Random samples of 6,789 GPs in 29 countries

94 93 92

84

7673 72

66 65 6459

54

47

3227

21 20 18

118 3

66

5956

77

10095 94

72

81

0

10

20

30

40

50

60

70

80

90

100

FI

UK

EE

NL

NO

DK IS IT

BG

BE

SK

FR

DE

ES

EU

27

HU

PT

CZ

LU IE AT

SE

CY

MT

RO EL SI

PL

LT

LV

GPs: Electronic exchange of patient data by purpose (selected countries)


Lab results from

laboratories

Admin data to

reimbursers

Medical data to care

providers / professionals

Admin data to other

care providers

Prescription to

pharmacies

Medical data cross

border

EU27 39.8 15.1 10.3 9.7 6.3 0.7

BE 73.5 2.5 12.9 12.9 1.6 0.9

BG 5.3 9.7 3.4 5.8 2.4 1.0

DK 96.2 47.9 73.6 74.0 97.3 1.9

EE 39.3 5.3 1.3 1.3 0.7 0.0

NL 83.8 45.4 26.0 27.5 71.0 4.7

FI 90.0 7.6 54.8 20.8 0.4 0.4

SE 82.4 8.2 13.1 15.7 80.9 1.5

UK 84.9 43.2 26.5 31.5 5.1 0.4

NO 88.2 18.6 34.8 25.5 2.9 0.5

Country orRegion 3

Secure Networks

Country or Region 2

Interoperability across bordersLinking basic information between patient summary

systems or giving access to physicians to patient summary in your home country

Mobility

Country or Region 1

Patient Summary 1Patient Summary 2

Standardised exchange/access to common data sets

Direct access of physicians when legal

EC Recommendation on Interoperability of cross border electronic health record

systems COM(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

Need for concerted action among all Member States!

Quality/Efficacy of Healthcare services

Lifestyle: what we eat, drink, breath, …

Physical and social environment

Genetic “blueprint” /profile at birth

Acquired genetic changes

ICT – important tool for all factors!

(not only health delivery systems)

Factors determining a health statusof an individual & population

Factors determining a health statusof an individual & population

Exogenous Determinants(Nurture)

Endogenous Determinants(Nature)

Health delivery system

Region 3

Hospital

Home

Pharmacy

Health Centre

mobile PC

Mobile, Wireless

&Broadband

Emergency

Secure Networks

Region 2

Step 2:Current EU activitiesConnecting individuals with providers/Health

Information Networks

Mobility

Region 1

GP

• Boario telecardiology: 35-47% reduction in hospital admissions (in various studies) 12% reduction in outpatient visits

• UK studies: 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)

From ‘hospital-based’ to ‘patient-centred’ careFrom ‘hospital-based’

to ‘patient-centred’ care

See EC Communication on Telemedicine COM(2008)689 finalec.europa.eu/information_society/activities/health/policy/telemedicine/index_en.htm

Integrated Health Records

EnvironmentalData

Biosensors

Phenomic data

Genomic data

Biochips

Step 3: The full picture of individual’s health status

Step 3: The full picture of individual’s health status

New Options for Disease Management

New Options for Disease Management

Diseaseprogression

Mortality& costs

Geneticpredis-position

First cellmutations

asympto-maticdisease

Diseased cells release biologicalmarkers

First symptoms/manifestation

Diseaseproliferation

Environmental trigger

Currentapproach

In vitromarkers

Diagnostic (anatomic) imaging, biopsies

symptomsdiagnosis

•Non-personalizedmedication

•Chemotherapy•Radiotherapy•Surgery

Followup

Molecular ImagingMolecular Imaging

MolecularMedicineapproach

Molecular Therapy

Molecular Therapy

DNAscreens

Proteinscreens

Monitor TreatmentMonitor Treatment

EarlierPersonalizedIntegratedEfficient

Philips Presentation

EU Wide eHealth Policy and support to deployment

EU Wide eHealth Policy and support to deployment

1. eHealth Action Plan - COM(2004)356 final

2. I2010 flagship initiative - ICT for Ageing Well

3. Lead Market initiative for Europe (eHealth)

4. EC Recommendation on EHR Interoperability (2008)

5. Telemedicine Communication - COM(2008)689 final

ec.europa.eu/information_society/activities/health/policy/index_en.htm

EU Wide 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)

ConclusionsConclusions

• ICT has shown impact on sustainability but this impact needs to scale. patients need to take more active role in health & care

and use ICT in their health/wellness management (changing consumer behavior pattern)

stronger focus but health delivery system on prevention and early diagnosis,

• ICT has great potential in: enabling novel approaches for personalised medicine

(cross-disciplinary and multi-stakeholder research)

fostering global research (International effort)

••• 22

For further informationFor further information

• INFSO H1 Policy site:

http://ec.europa.eu/information_society/activities/health/index_en.htm

• Research site:http://cordis.europa.eu/ist/health/index.html

• Interactive Portal:http://www.epractice.eu



http://cordis.europa.eu/ist/health/index.html

http://cordis.europa.eu/ist/health/index.html

http://www.epractice.eu/

••• 23

AnnexAnnex

EU GPs using a computer during consultation, in % (EC Study 2007)


100%

66%

3%

Random samples of 6,789 GPs in 29 countries

94 93 92

84

7673 72

66 65 6459

54

47

3227

21 20 18

118 3

66

5956

77

10095 94

72

81

0

10

20

30

40

50

60

70

80

90

100

FI

UK

EE

NL

NO

DK IS IT

BG

BE

SK

FR

DE

ES

EU

27

HU

PT

CZ

LU IE AT

SE

CY

MT

RO EL SI

PL

LT

LV

Access to broadband in practices


Access to broadband in practices

9188 86

82

73 72

6258

5451 49

4439 37 36 36

33 32 32 32

23

15

5

4440

74

48 48

93

59

80

0

10

20

30

40

50

60

70

80

90

100

EU

27

EU

27+

2 FI

DK

SE IS NL

BE

NO

UK

EE

LU FR LV SI

MT IT IE EL

DE

CZ

AT

ES

HU LT PL

PT

CY

BG SK

RO

Connectivity: to other GPs


Access to electronic systems of other health actors: GPs

6259

51 50

32

25 2521 21

1511 11 10 9 7 6 6 5 5 5 4 4 011 10

34

21 21

68

22

35

0

10

20

30

40

50

60

70

80

90

100

EU

27

EU

27+

2 FI

DK

NL

SE IS ES IT SI

BE

UK

NO PT

EE

FR

BG AT

PL

MT

HU

CZ IE LU DE

EL

SK LT CY

RO LV

Use: storage of medical patient data

Store of identifiable patient data

35

67

75

76

77

79

81

85

91

92

35

67

76

77

77

79

81

85

92

92

0 20 40 60 80 100

Radiological images

Treatment outcomes

Vital signs measurements

Ordered examinations and results

Medical history

Symptoms or the reasons for encounters

Laboratory results

Basic medical parameters

Medications

Diagnoses

EU27+2 EU27


0

10

20

30

40

50

60

70

80

90

100

% GPs connected to secondary healthcare(hospitals and/or specialist)

Electronic exchange of data for at least one purpose

0

10

20

30

40

50

60

70

80

90

100

%

Connectivity: to specialists


Specialist practices

64

44 43

33

17 16 1410 8 7 7 7 6 5 5 4 3 3 3 3 3 1 07 6

20

11 12

70

11

29

0

10

20

30

40

50

60

70

80

90

100

EU

27

EU

27+

2

DK FI

NO

BE

NL

SE

AT

ES SI

FR

EE IS DE

UK

CY

BG

MT

LU PL

HU

CZ

LT IT SK EL IE PT

RO LV

Connectivity: to hospitals


Hospitals

75 73 72

61

44

32 31

2319

14 13 11 9 8 7 6 5 4 4 4 4 0 010 10

47

20 21

76

24

51

0

10

20

30

40

50

60

70

80

90

100

EU

27

EU

27+

2

DK

NO FI

NL

BE

UK IS SE

EE

AT

ES IE PT IT MT

LU FR

HU SI

CZ

PL

CY LT EL

BG SK

DE

RO LV

Connectivity: to health authorities


Health authorities

64

51

29

2116 15 13 13 13 11 11 11

7 7 7 5 5 5 4 4 3 3 110 9

1817 17

78

1318

0

10

20

30

40

50

60

70

80

90

100

EU

27

EU

27+

2

EE

DK

UK LT IT PT

FR IS SI

ES PL

NO IE AT

MT FI

BE

SE

BG

RO NL

LV CZ

LU HU

DE

SK

CY

EL


Link to insurers (reimbursers)

Admin data with reimbursers routinely

45 43

2623

1915 14

10 8 8 5 5 4 3 3 3 3 2 2 1 1 0 05 4

1915 15

48

13

21

0

10

20

30

40

50

60

70

80

90

100

EU

27

EU

27+

2

DK

NL

UK

FR PL

LT AT

NO IE SI

CZ

BG SE FI

EE

PT

HU

SK

DE

MT

CY

EL

BE

ES

RO IT IS LV LU

GP Attitudes towards ICT use in healthcare

ICT improves the quality of healthcare services

1,6

1,1

1,4

0,7

1,4

1,61,5

1,0

1,5 1,51,6

1,2

1,5

1,3 1,2

1,7

1,4

0,9

1,4

1,7 1,7

1,4 1,5 1,41,4

1,5

1,2

1,7

1,41,31,3

EU

27

EU

27+2

BE

BG

CZ

DK

DE

EE

EL

ES

FR IE IT CY

LV LT LU HU

MT

NL

AT

PL

PT

RO

SI

SK

FI

SE

UK

IS NO

Agree strongly

Agree somewhat

Disagree somewhat

Disagreestrongly

Don't know


ECH Campus Leadership Summit: Ilias Lakovidis

Health & Medicine

Transcript of ECH Campus Leadership Summit: Ilias Lakovidis