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e H e a lt h f o r u m w e d n e s d a y 1 4 MAY 2 0 1 4 I SSUE 0 3
Give Health an e-Chance
“Europe’s goal is to make systems patient-centred; the eHealth Forum addressed major issues and
showed the way forward for healthcare reform, cross-border provision of health and care services,
the value of innovation and the development of the eHealth market.
The importance of e-services such as e-prescription, digital patient history and patient registries were
extensively discussed in numerous sessions. Substantial progress was made as regards the Green Paper on mHealth and the guidelines for e-prescription systems. The Forum placed great emphasis on
Silver Economy, as well as personalised and integrated care in Horizon 2020, ageing populations and
chronic patients further to scaling up the activities of Action Groups and Reference Sites. The event
was graced by the EU-US MoU on eHealth and the EU-US Business Marketplace and Cooperation Assembly in interoperability and workforce skills. Patient empowerment, synergies, the transformation
of the traditional healthcare landscape and medical practice were also thoroughly discussed.
In conclusion, it was made perfectly clear that Europe must move forward under a common vision
and agenda, in a coordinated way, so as to improve citizens’ and patients’ quality of life through the
use of eHealth solutions and other digital innovations as enablers of change.” C. Papanikolaou
Hellenic Ministry
of Health
Hellenic Center for Disease
Control & Prevention
Greek Presidency of the EU Council
- 1st Semester 2014
Horizon 2020
ec.europa.eu
This project is co-funded by E.U. Horizon 2020 Research & Innovation Programme
www.ehealth2014.org
CONTENTS
02 ePrescription for
Patient Safety, efficiency
and continuity of care
03 4TH EU-US eHealth
Marketplace & 2014
Transatlantic Health IT &
Evidence and decision making
when going beyond pilots
04 Clinical Governance:
the use of e-tools and CDA
documents & epSOS Industry
Team and Open Source
Community workshop
05 Ageing Well Network
06 Secrets of Telehealth
07 Leading Service Innovation
in Health & Care - EHTEL Event
& Patient access to health
data in Europe
08 Photo Gallery: eHealth
Official Dinner by the Sea
e H e a lt h f o r u m w e d n e s d a y 1 4 MAY 2 0 1 4 I SSUE 0 3
ePrescription for Patient Safety,
efficiency and continuity of care
A
s interoperability of ePrescriptions
is an important enabler for the
continuity of care in cross-border situations, there are several fully deployed
national ePrescription systems in Europe today and many towards their deployment. There are also cross-border
services already in place to serve specific objectives of neighbouring Member States/regions. However, challenges still remain to be addressed,
particularly in terms of unique identification of pharmaceutical products
that will improve safety and combat
fraud. The interactive session, with
the participation of Christos Halaris,
Kyriakos Souliotis, Vasiliki Mantzana,
Jesus Maria Macias, Päivi Hämäläinen
explored the needs, practices and responses to challenges.
The role of ePrescription in the improvement in safety and efficiency
of care was explored by Konstanty
Radziwill, Jamie Wilkinson, Jose Luis
Cobos and Matyas Lakatos, General
Manager, Amgen, Greece & Cyprus,
who spoke of the “Informed outcome and decision making through
e-Prescribing”. Panagiotis Telonis and
Richard Torbett presented the regulatory aspects and the industry perspective in information sharing. National strategies for the deployment of
ePrescription were presented by Brigitte Drewes, Loredana Luzzi, Tatjana
Prendja-Trupec and Nicolas Luc.
The subjects addressed included the
presentation of national (Greece) regional (Spain), and cross border (FI, SE)
implementation examples; reflections by
health professionals on issues and challenges to be addressed (doctors, pharmacists, nurses); reflections by the Regulators and the Pharma Industry on unique
identification and e-verification of medicines (EMA, EFPIA); as well as comments
on the above with a view to todays’ and
emerging national strategies.
On eHealth Forum 2014 website
(ehealth2014.org), see a detailed pres-
entation of the Spanish ePrescription system which is based
on the SNOWMED-CT (Systematized Nomenclature of Medicine - Clinical Terms) terminology.
Spotlight on eHealth in Nursing
Mr José Luis Cobos Serrano, representing the Spanish General Council of Nursing, presented the “e-cuidados” (e-care)
project which constitutes a unique platform (software) for
the management of good nursing practices.
The Spanish General Council of Nursing is the regulatory
body of the nursing profession in Spain where there are currently 250,000 registered nurses. This body participates on
the prescription of medicines and medical devices in Spain,
in virtue of the Medicines Law of 2009, and for that purpose
the “e-cuidados” tool has been set up.
The platform is based on the principles of safety, confidentiality and traceability, which allows nurses’ actions to be
recorded at all times and can be integrated into other systems, making it very interoperable. The nursing language
and methodology has been incorporated in order to promote
standardisation of nursing care and thus unify operating criteria in both primary care and specialised care. Moreover, in
the field of drug prescription we could prevent up to 80% of
iatrogenic or adverse effects. The Spanish General Council of
Nurses has trained 120,000 nurses in this platform.
www.ehealth2014.org
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e H e a lt h f o r u m w e d n e s d a y 1 4 MAY 2 0 1 4 I SSUE 0 3
4TH EU-US eHEALTH MARKETPLACE
& 2014 TRANSATLANTIC HEALTH IT
eHEALTH COOPERATION
ASSEMBLY - ECONOMIC
OPPORTUNITIES CREATED
BY EU-US COOPERATION
ON eHEALTH / HEALTH IT
T
he bilateral relationship between the European Union and the United States
in the eHealth/Health IT sector has many dimensions--economic, social,
political and commercial. All of these areas present excellent opportunities for
companies, universities, non-profit organizations and governments to work together on a variety of possible projects. What are some of the considerations
for making decisions on which of these opportunities to pursue and exploit? This
panel, with representatives from government, industry and a trade association,
discussed some of these considerations, and how collaboration between these
stakeholder groups can advance these objectives.
Brian O’Connor, European Connected Health Alliance presented the leading efforts to bring together stakeholders to form local/regional eHealth ecosystems
in Europe. From the government point of view, Mr Andrew McCormick, Permanent Secretary at the Department of Health, Social Services and Public Safety of
Northern Ireland analysed a key stakeholder’s role in helping with deployment
of eHealth, while, Mr Octavian Weiser, representing a large, multinational company with strong healthcare and eHealth business internationally, showed the
industry’s perspective. The discussion modulated, on behalf of the U.S. Department of Commerce, Mr Matthew Hein, eHealth industry analyst with a view to
help U.S. companies increase their exports.
[Evidence and decision
making when going
beyond pilots]
>We learn from the past by looking towards the
future, according to this session. Some of those
forward-looking visions are provided by several
large-scale initiatives that have been launched with
the financial support of the European Commission.
Their aim is to deploy innovative telemedicine
services and integrated care services, both in real
life and in a large diversity of European regions.
Three initiatives were introduced in this session,
the objectives of which are: to provide evidence of
clinical effectiveness and quality of life improvement
emerging from specific interventions in different
settings; and to assess economic and organisational
outcomes. The experience of Renewing Health
demonstrates that some evidence can be provided
through an approach that uses Randomized
Controlled Trials. However, to better assess
the economic and organisational impacts of an
intervention, a real-life based approach is needed.
This is one of the lessons that both United4health
and Smart Care have learned, and are applying.
Smart Care adds a social care dimension to that of
health care.
www.ehealth2014.org
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e H e a lt h f o r u m t u e s d a y 1 3 MAY 2 0 1 4 I SSUE 0 2
Clinical T
Governance
the use
of e-tools
and CDA
documents
Joint Event of
the eHealth Forum 2014
& 40th Panhellenic
Medical Congress
his joint event organized by Athens Medical Society and HL7 Hellas
aimed at bridging differences between
the healthcare professional and eHealth
Communities by promoting the created
added value of new standard based eservices for clinical governance. The
event is split into two sessions one being integrated as a parallel event within
the eHealth Forum 2014 and the other
within the 40th Panhellenic Medical
Congress. This event addresses issues
such as clinical governance, cross border healthcare, health care records and
patient summary applications, reuse of
standards and best practices of HL7 CDA
use for clinical governance.
Today, at the session “Clinical Governance: the use of e-tools and CDA documents”, with the presence of Dr. Clemens Auer, Secretary General, Federal
Ministry of Health, Austria and Lefteris
Thireos SG AMS & HL7 Hellas as chairs,
the experience from Kaiser Permanente
organism and the e-prescription in
Greece was shared by Jamie Ferguson,
VP Health IT Strategy & Policy, Kaiser
Permanente and Dr Haralampos Karanikas, Dr Lefteris Thireos respectively.
The Chief Technology Officer, Health
Level 7 International, John Quinn,
spoke on “The emerging role of eHealth
standards and standards development
in global economy”, while Ch. Xanthopoulakis PDEng, Senior Software Designer, Philips Research presented the
application of HL7 CDA Personal Health
Monitoring Reports in “Interconnecting Patient Home Telehealth and the
United Kingdom NHS”.
The last part of this event was dedicated to the presentation of the perspective and role of HL7 Affiliates regarding
Patient Summaries and CDA, by representatives from HL7 Italy, Croatia, Romania, UK and Greece.
On Thursday, May 15, the second part of
the eHealth Forum 2014 – 40th Panhellenic Medical Congress joint event will
take place at the Athens Hilton Hotel
(Terpsihori B, 19:30-21:30) were the Greek
case of Integrated Management of
clinical Guidelines with the support of IT
Tools will be discussed. Representatives
of the public sector, such as the Greek
Ministry of Health and IDIKA, as well as
the private (Intrasoft International) and
HL7 will participate in this event.
epSOS
[Industry Team
and Open Source
Community
workshop]
A
t the first part of this workshop, Miroslav Koncar
(Oracle) presented an overview of epSOS organization and architecture offering basic knowledge
about what epSOS is, which problems it solves and
what the results have been.
In 2008 the European Commission started a large
scale pilot to not only design but also test on a large
scale the cross-border communication of patient information. As a result, the pilot has yielded a set of
services that benefits all European patients who seek
healthcare abroad - hence the name, Smart Open
Services for European Patients (epSOS). In his presentation, Miroslav Koncar covered the basic setup of
epSOS in terms of organization, architecture, specification and implementation. He also talked about
the crucial role of industry in shaping this project,
as well as the benefits and drawback of open source
software.
The epSOS semantic Interoperability paradigm was
presented by Jacob Boye Hansen (CareCom) to show
how epSOS has facilitated true semantic interoperability between all European member states; how epSOS created an intermediate ‘language’; how translation and transcoding was made and how the ever
evolving coding systems are kept in sync.
The epSOS large scale pilot has yielded a viable infrastructure on both organizational, legal, technical as
well as the semantic level. The latter aspect proves to
be one of the most challenging in this project - how
to enable health professionals to provide care to foreign patients by overcoming the language barrier.>
www.ehealth2014.org
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e H e a lt h f o r u m w e d n e s d a y 1 4 MAY 2 0 1 4 I SSUE 0 3
>epSOS has provided an ingenious and
creative solution to make sure each
nation participating in this project can
take ownership of the translation and
transcoding of medical coding systems.
One of the major achievements of the
epSOS project was bringing people together around a common need - cross
border healthcare. People from several countries and diverse education and
experience background, played the
privileged game of designing a possible future. Regarding technical interoperability, those people organized as
an open community called OpenNCP
Community which the vision is: “design and develop a set of Open Source
Components (OpenNCP) that can be
adopted by Participating Nation, to
build their local implementation of
the epSOS NCP.” In his talk, Licínio
Mano (Portuguese Ministry of Health,
SHARED Services) provided a glimpse
about best practices, achievements
and challenges ahead for the OpenNPC Community.
epSOS has produced a number of
common components for building
National Contact Points (NCPs) used
in cross-border health services. The
components culminate in an open
source ready-to-deploy NCP implementation, OpenNCP. Konstantin
Hyppönen representing Kela (The Social Insurance Institution of Finland)
and Marcelo Fonseca (iUZ, Portugal)
provided insights into the architecture
of OpenNCP, covering questions about
the technical design behind the epSOS
services. The use and implementation
of IHE profiles, semantic components,
end-user portals, and security services
were described in a techy but intelligible way. Also, some insights about
the used development tools, the integration and testing strategies were
presented. First-hand experiences of
using OpenNCP in a nation-wide setup
were shared, followed by an open discussion on epSOS.
The workshop chaired Juergen Wehnert, Gematik mbH (Germany) and Dr.
Alexander Berler, Industry Team Steering Committee (Greece).
ageing well network
ICT Solutions
for Independent
Living In
Own Home
T
he AgeingWell Network parallel
session focused on the need of interaction in collaboration of developers, service providers, public authorities
and end users in the development and
adoption of ICT / mHealth solutions for
independent living for the growing elderly population of Europe.
Market potential, interoperability, cost
effectiveness and sustainability of solutions are key drivers in the development
of solutions, while putting the client in
the epicenter of the design, implementation and evaluation of ICT solutions
is of paramount importance. A number
of solutions focusing on accessibility,
health prevention, quality of life, follow
up and continuous care was presented.
Key barriers to the adoption of technologies were discussed such as interoperability, the effective and pragmatic
implementation in times of a financial
crisis, the scaling up of solutions and
increased fragmentation of the market. These eventually lead to limited
investment and slow adoption. It was
www.ehealth2014.org
noted that the nature of the market is
such that currently the adoption of ICT
/mHealth solutions from the individual
customer is not very effective because
of the need for significant infrastructure, development of clinical tests of
large scale, cost effectiveness and trust
to the selected health care providers.
At the second part of the session the
end users (municipalities, health care
providers and senior citizens associations) presented their perspective. Key
points were the need to improve seniors’ involvement in the development
of ICT solutions and intergenerational
communication. It is important to facilitate learning interest by talking and
informing, investigating, listening and
encouraging seniors; also creating accessible, secure and user-friendly environments; and finally consulting experts such as gerontologists, etc.
For more information about the AgeingWell Network please visit the website: http://ict-ageingwell.net
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e H e a lt h f o r u m w e d n e s d a y 1 4 MAY 2 0 1 4 I SSUE 0 3
The Secrets of Telehealth
how to deploy services in routine care
F
or decades, telemedicine and telehealth
projects have been receiving a lot of attention from innovative healthcare professionals.
However, only a few projects have successfully
shifted from lab to routine care. Even fewer
have gone from small- to large-scale deployment. Lack of clinical evidence, user adoption,
reimbursement and business models have often been identified as the main explanations
for this situation. An element that has been
much less studied is the lack of deployment
method. Unquestionably, this is also a pitfall.
Several organisations and key players in telemedicine across Europe have decided to join
forces. They have launched the Momentum
project to work on how to deploy telemedicine, by analysing those initiatives which have
been successfully deployed and identifying the
reasons why they were successful. The project
is funded under the ICT Policy Support Pro-
gramme (ICT PSP) as part of the Competitiveness and Innovation Framework Programme
of the European Commission.
This session was the first opportunity to access
the initial results of the project, a list of 18 critical success factors that cover overall context (i.e.
cultural readiness and financing); management
aspects (the need for leadership, for a business
plan, for change management); legal and security issues (including liability or the regulatory
environment for data management); and technology considerations (including interoperability). They are collected in a short document with
annotations available at http://telemedicinemomentum.eu/18-factors.
These factors require further validation, and
the publication of this list begins a public consultation phase. Indeed, according to the first
of this session’s speakers, Marc Lange, Secretary General of EHTEL and coordinator of the
Momentum project, “Telemedicine in Europe
suffers from ‘pilotitis’, a glut of technology experiments that have received start-up subsidies from public or commercial sources to get
them off the ground, but which cease to exist
once the subsidy is withdrawn. Our success
factors will help the ‘doers’ move their projects
into routine care and scale them up to provide
real benefits to patients in Europe.”
Rachelle Kaye, AIM & Maccabi Healthcare Services (Israel) and Peeter Ross, eTervis (Estonia)
followed with presentations on the managing aspects of telemedicine deployment, while Ellen K.
Christiansen, Norwegian Centre for Telemedicine
(NST) analysed the legal, regulatory and security
issues, Tino Marti, TicSalut (Spain) presented the
ICT perspective. Finally, Dr. Steffen Sonntag, Gesellschaft für Patientenhilfe DGP mbH, Munich,
Germany presented the case of the “German society for patients assistance” (DGP).
eHealth
Forum 2014
was
a success!
More than 1,278 participants
from 38 countries
and 150 speakers from
around the globe joined
the eHealth Forum 2014
in Athens.
In total, 70 exhibitors
participated from Europe
and US. Seventeen exhibitors
was part of the US Pavillion,
4 Local Government,
4 Government Institutions,
and 13 Start-Up companies.
www.ehealth2014.org
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e H e a lt h f o r u m w e d n e s d a y 1 4 MAY 2 0 1 4 I SSUE 0 3
[Patient access
to health data
in Europe]
Leading service
innovation in
health and care
O
n the evening of 13 May 2014, at the Royal Olympic Hotel, a stimulating
Thought Leadership debate facilitated by EHTEL with the support of IBM and
NHS24 (Scotland) attracted over 110 leaders in European health, care and technology. Under the beautiful Athenian sky, an hour-long discussion was animated by
Professor George Crooks, EHTEL President and Medical Director, NHS24, Scotland.
The evening was rounded off by conversations held over a pleasant Greek dinner.
Making sense of numbers is an important challenge. At this evening, statistics began to tell a meaningful story. The message was the need for a reform in health
and social care that can result from a more extensive use of technology. Through
the figures quoted, the expert attendees began to formulate new ideas for the future. Fighting chronic conditions - chief among them diabetes and its potentially
debilitating results - was often the lens through which the organisational and
technological challenges lying ahead were seen throughout the evening.
Among the evening’s memorable quotes:
“A revolution is needed in 21st century healthcare,” and “we should focus on
where we need to be tomorrow, which is leading edge.”
Alex Neill, Scottish Cabinet Secretary for Health and Wellbeing
“In a period of severe financial and social crisis, technology can be a bonus
for organisational reform.”
Theodore Vontetsianos, Sotiria General Chest Diseases Hospital of Athens
“As a person with diabetes, you may spend close to 8,736 hours a year
by yourself, dealing with your diabetes. Why not use technology to bridge
that gap?”
Petra Wilson, General Secretary, International Diabetes Foundation
“Innovation companies, such as IBM, now have 300,000 people around the
globe working on health and medical care.”
John Crawford, IBM
“By 2021, the region of Southern Denmark’s university hospital will have far
fewer than its current 7,000 beds. How can this be done persuasively and
easily? A living lab is a good part of the answer.”
Christina Wanscher, Health Innovation Centre of Southern Denmark
>The SUSTAINS project is pleased to announce its joint
working with the eHealth Governance Initiative in the
preparation of a Briefing Paper which was launched
this week to, and accepted by, the eHealth Network.
This Paper made recommendations regarding patient
health records and, notably, patient access to health
data. The paper recommended that access to patient
data should be about making health data meaningful
and understandable. It is about moving patient access
from the paper based to the digital world and about
generating the added value that comes about with
integrated health information portals. Creating
convergence at the national level can also enhance and
support access to patient data across borders or despite
borders.
In addition to its co-operation with the Briefing Paper,
the SUSTAINS Project, sponsored by the European
Commission, is recording success in its work to provide
patients with access to their personal health records
and other online services. Eleven Regions from across
the European Union are participating in a joint learning
initiative as they introduce patient access to various
services within various Member States. The aim is to
investigate different approaches to implementing
such services and to identify lessons learned for other
healthcare organizations seeking to undertake such
work in the future.
Driving the work is the recognition that as people
live longer, chronic diseases become more prevalent
and medications and treatments more expensive,
radical solutions will be required to ensure that future
healthcare delivery is sustainable. By putting the
patient more closely in touch with the management of
their own healthcare, the aim is to improve awareness
and engagement leading to more effective and efficient
healthcare delivery including healthier lifestyles.
The work of SUSTAINS supports the objectives of the
EU Digital Agenda 2020 specifically Action 75 of the
eHealth Action Plan namely to “give Europeans secure
online access to their medical health data and achieve
widespread telemedicine deployment” by 2015.
A recent internal evaluation of SUSTAINS work revealed
significant success in the implementation of a number
of key clinical and administrative services across all of
the pilot sites.
The project was described in a presentation by
Dr Stephan Schug, Chief Medical Officer of EHTEL, as
part of the Speakers Corner within the eHealth Forum
on Wednesday 14 May. www.sustainsproject.eu
www.ehealth2014.org
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e H e a lt h f o r u m w e d n e s d a y 1 4 MAY 2 0 1 4 I SSUE 0 3
ehealth
official dinner
by the sea
www.ehealth2014.org
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e H e a lt h f o r u m w e d n e s d a y 1 4 MAY 2 0 1 4 I SSUE 0 3
gold sponsors
Silver sponsors
Supporters
Exhibitors
p c c
h e l l a s
P a t i e n t s’
A d h e r e n c e
congress organiser
www.ehealth2014.org
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