Simona Guagliardo / May 2018
Digital innovation brings about new opportunities for health systems to become more effective, sustainable and accessible. It can help improve people's health and quality of life, advance medical research, avoid wasteful spending, deliver more patient-centred services, empower patients, and spur new businesses and opportunities for economic actors. Barriers to the digitalisation of healthcare, however, exist and require adequate attention.
On 25 April, the European Commission presented its communication on enabling the digital transformation of health and care, as part of its efforts to shape the European Digital Single Market (DSM).
The communication identifies action areas to ensure the secure and free movement of health data in the digital single market. It announces measures that address the lack of data interoperability and common standards to facilitate the exchange between different healthcare institutions, both within and across countries. It puts forward actions to pool genomic and other health-related information across Europe to boost research and spur the development of personalised medicine. It also presents ways to promote the scaling up of digitally-enabled person-centred care models, encouraging national authorities to create favourable market conditions for technology suppliers.
The Commission’s plan addresses the major technical and market-related barriers to digital innovation in healthcare. It fails, however, to focus on a critical precondition for a swift deployment of digital health solutions: citizens’ ability and willingness to engage in the transition. In fact, the success of the digital transformation will hinge on the empowerment of and endorsement by healthcare professionals, patients, and caregivers. Education and trust are key in this respect.
The health workforce needs to be equipped with digital skills and develop interdisciplinary approaches to patient care. Similarly, it is essential to improve citizens’ and patients’ health and digital literacy, targeting, in particular, the older segments of the population and the less educated. This empowerment will enable equal access to health services and make it possible for people to engage actively. The communication says little about how to improve digital skills. In this area, the Commission should encourage and support member states in adapting medical education to the digital revolution age, and in developing education programmes for patients and citizens.
Trust is also crucial, as citizens must be assured that their health data is adequately protected. As of 25 May 2018, the management of personal health data will be subject to the General Data Protection Regulation (GDPR). The communication does not suggest concrete measures to raise awareness among citizens and ensure a full understanding of the legislative framework that will protect health data privacy. The Commission could play an important role in this regard, supporting EU-level communication campaigns to explain to citizens how their health data privacy will be protected. Similar actions should target the business sector and the organisations processing health data to clarify what their obligations are.
To fully reap the benefits of digital innovation, it is essential to develop a comprehensive approach that takes equally into account the secure and free movement of health data, the development of digital infrastructures, and the need for education and trust. Concrete actions to promote digital literacy, fit-for-purpose medical training and confidence in the digital transformation must be proposed and funded, both at the EU and the national level. This transformation will require political commitment, stakeholder engagement, capacity building, and, not least, sustained investments. In short, it calls for a bold political and financial commitment.
The Commission’s plan outlined in the communication aims to support member states and advance the digitalisation of healthcare. The creation of a Digital Europe Programme and the new Horizon Europe in the recent budget proposal for 2021-2027 echoes this ambition.
But if European health systems are to become fit for the future, the EU and national governments must work together to define this comprehensive approach. As a starting point, there is a need to acknowledge that, without citizens’ empowerment and endorsement, technological progress is pointless and is likely to lead to inequalities in access to health services.
Secondly, member states will need to back the Commission's digital health agenda and follow through during the upcoming EU budget negotiations by funding the required actions appropriately. The financial gap caused by Brexit, the resulting burden sharing among the member states, and other significant issues such as border management and security will undoubtedly dominate the discussion. Nevertheless, national governments and EU policymakers should not miss this opportunity to live up to the expectations of European citizens calling for more decisive action in health at the EU level.