Supported > 500 ehealth projects with > 1 Billion since 1989 Current support : ca 100 Mil/year Action:

Enabling smart integrated care: Policies to foster interoperability of personal health systems Brussels, 18 January 2011 Healthy, active and independent: Personal Health Systems in the context of EU flagship initiatives Benoit Abeloos European Commission DG INFSO ICT for Health Unit

Who are we? ICT for Health Unit, Information Society and Media DG European Commission Supported > 500 ehealth projects with > 1 Billion since 1989 Current support : ca 100 Mil/year Action: 1. Research: Personal health systems (wearable, portable monitoring systems) Patient safety (clinical information systems for safer outcomes) Virtual Physiological Human : Modelling and Simulation of diseases 2. Policy development and support to deployment: Large scale pilots: epsos, Renewing Health ehealth Action Plan ehealth governance intiative, lead market initiative Interoperability, standardization, testing, certification European Innovation Partnership ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 2

Agenda ehealth and PHS drivers and trends EU2020, Digital Agenda for Europe and ehealth EU roadmap for ehealth Interoperability: present and future initiatives EC ehealth Pillars European Partnership Initiative on Active and Healthy Ageing ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 3

Challenges for the European Health Systems Citizens expectations for high-quality care Demographic changes How to offer high-quality & affordable care? Increased prevalence of chronic diseases Increased mobility of citizens and patients Staff shortages, unequal territorial distribution Reactive model of healthcare delivery Rising healthcare costs ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 4

Priority and activity fields mentioned in national policy documents (ehealth Strategies, EC study by empirica et al., 2010) Reported ehealth activities Total 2007 eh ERA Total 2010 eh Strategies DELTA EHR/Patient summary 27 27 +0 Standards (technical and semantic) 19 25 +6 eprescription 16 18 +2 Citizen card 22 23 +1 Professional card 7 10 +3 Patient ID 24 26 +2 Professional ID 13 17 +4 Telemedicine 23 27 +4 Evaluation 5 13 +8 Legal Activities 14 18 +4 ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 5

Remote Monitoring Benefits in Numbers US VHA study: Diabetes: 20.4% utilisation decrease CHF: 25.9% utilisation decrease COPD: 20.7% utilisation decrease Reduced hospitalisation Application of telemedicine and home health monitoring could avoid 5.6 million admissions to hospitals for chronically ill patients in MS Reducing diabetic death 11,000 deaths caused by complication ensuing from diabetes could be reduced in MS through the combined applications of EHR and disease management Source: EU Swedish Presidency, (2009) ehealth for a Healthier Europe!, p. 36 UK NHS on potential of self-care: Reduce GP visits by 40% Reduce outpatient visits by 17% Reduce hospital admissions by 50% Reduce hospital stay length by 50% Reduce days off work by 50% Philips Heart Failure Statistics UK: Clinical Evidence from RMT trials on Cardiovascular disease: 20-40% reduction in length of hospitalisation Ericsson and HealthServices24: Clinical Evidence from RMT trials on Cardiovascular disease: 60% reduction in admissions 90% of patients claim reassured ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 6

Hype Cycle for Telemedicine, Gartner 2008 Source: Gartner (June 2009) ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 7

Agenda ehealth and PHS drivers and trends EU2020, Digital Agenda for Europe and ehealth EU roadmap for ehealth Interoperability: past, present and future initiatives EC ehealth pillars European Partnership Initiative on Active and Healthy Ageing ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 8

Europe 2020 s flagships A flagship initiative for Smart sustainable and inclusive growth to develop an economy based on knowledge and innovation HEADLINE TARGETS Employment rate from 69% to 75%. Investing 3% of GDP in R&D Reduce greenhouse gas emissions by 20% (vs. 1990), renewable energy to 20%, 20% increase in energy efficiency. Reduce early school leavers to 10% (from 15%), increase population 30-34 with tertiary education from 31% to 40%. Reduce living below poverty by 25%, 20 million people out of poverty. 7 EU Flagship Initiatives SMART GROWTH SUSTAINABLE GROWTH INCLUSIVE GROWTH INNOVATION "Innovation Union CLIMATE, ENERGY AND MOBILITY "Resource efficient Europe EMPLOYMENT AND SKILLS "An agenda for new skills and jobs EDUCATION "Youth on the move DIGITAL SOCIETY "A digital agenda for Europe COMPETITIVENESS "An industrial policy for the globalisation era FIGHTING POVERTY "European platform against poverty 9 ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 9

The Digital Agenda for Europe (DAE) May 2010 The overall aim of the Digital Agenda is to deliver sustainable economic and social benefits from a digital single market based on fast and ultra fast internet and interoperable applications. Aims at a sustainable digital society: Empowering citizens Accessible eservices Infrastructure for fast and ultra-fast broadband Trust and security on the Net ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 10

The Digital Agenda for Europe ehealth Renews commitment to ehealth by: Patient empowerment support patients access to ehealth services, including patients records + telemedicine services Sharing knowledge for better care minimum data set for patients summaries Interoperability standardization, certification and testing ICT for Health Benoit Flora Giorgio Abeloos May Enabling 18 2010 smart integrated care WS 18 th Jan 2011 11

European Digital Agenda Standardisation We need effective interoperability between IT products and services to build a truly digital society Key Action 5: As part of the review of EU standardisation policy, propose legal measures on ICT interoperability by 2010 to reform the rules on implementation of ICT standards in Europe to allow use of certain ICT fora and consortia standards ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 12

The Digital Agenda for Europe ehealth Key Actions: Key Action 13: Undertake pilot actions to equip Europeans with secure online access to their medical health data by 2015 and to achieve by 2020 widespread deployment of telemedicine services Key Action 14: Propose a recommendation defining a minimum common set of patient data for interoperability of patient records to be accessed or exchanged electronically across Member States by 2012 ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 13

The Digital Agenda for Europe ehealth Other Actions: Foster EU-wide standards, interoperability testing and certification of ehealth systems by 2015 through stakeholder dialogue Reinforce the Ambient Assisted Living (AAL) Joint Programme to allow older people and persons with disabilities to live independently and be active in society. ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 14

Agenda ehealth and PHS drivers and trends EU2020, Digital Agenda for Europe and ehealth EU roadmap for ehealth Interoperability: challenges, past, present and future initiatives EC ehealth pillars European Partnership Initiative on Active and Healthy Ageing ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 15

The EU roadmap for ehealth 3 Towards the full picture of the individual s health status 2 Connecting individuals with Health Information Networks 1 Linking all the points of care Time 1990s Today ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 16

Step 1 Linking all the points of care General Practitioners Health Authorities Hospitals Social Service Secure data networks and interoperable applications Nursing Homes Labs Homecare ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 17

Step 2 Connecting individuals with Health Information Networks Hospital General Practitioner Patient at home Data acquisition Data communication and feedback Homecare Data processing & analysis Devices for multi-parametric monitoring Medical Expertise Decision Support System Intelligent Analysis ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 18

Step 3 Towards full picture of individual s health status Biosensors Biochips Environmental Data Genomic data Phenomic data ICT Systems ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 19

Agenda ehealth and PHS drivers and trends EU2020, Digital Agenda for Europe and ehealth EU roadmap for ehealth Interoperability: challenges, past, present and future initiatives EC ehealth pillars European Partnership Initiative on Active and Healthy Ageing ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 20

EC ehealth pillars 6. EC Recommendation on EHR Interoperability (2008) 5. Telemedicine and PHS 4. Cross border Directive (draft) 3. Standards, Interoperability testing and certification 2. ehealth Action Plan - COM(2004)356 final 1. Research (FP) ec.europa.eu/information_society/activities/health/policy/index_en.htm ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 21

EC instruments: 7th Research Framework Programme (FP7) Personalisation of Healthcare Personal health system 60 M in 2011 and 2012 Patient safety Safer surgery, detection of public health events, clinical care and research 35 M in 2011 and 2012 Predictive Medicine Virtual Physiological Human Modelling/simulation of diseases 68 M in 2011 and 2012 ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 22

EC ehealth pillars New ehealth action plan to be published during Q4 2011 Online consultation published during Q1 2011 2. ehealth Action Plan - COM(2004)356 final ec.europa.eu/information_society/activities/health/policy/index_en.htm ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 23

EC ehealth pillars 3. Standards, Interoperability testing and certification EC Recommendation on EHR Interoperability (2008) ec.europa.eu/information_society/activities/health/policy/index_en.htm ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 24

Challenges Global Cross border dimension, within EU, 27 MS International dimension, outside EU EU wide standardization is a prerequisite Complexity 4 levels of Interoperability: political, organizational, semantic, technical Testing and certification Clear, practical roadmap and guidelines are needed Infostructure and shared services are needed maintenance of developed assets Stakeholder s main concerns Personal Data Protection Authentication of patients and care providers ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 25

CIP ICT-PSP Large Scale Pilot on cross-border ehealth interoperability epsos : 23 participating countries To deploy concrete cross border services ensuring safe, secure and efficient medical treatment for citizens travelling across Europe: Patient Summary for EU Citizens eprescribing for EU Citizens To build on existing National ehealth Projects and use experiences and knowledge from all Member States http://www.epsos.eu/ ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 26

Standardization: M403 recast M403 Phase 1 results Final report available at http://www.ehealth-interop.nen.nl Processes and methodology: use case definition and prioritization standards development profile development and maintenance profile quality assurance test plans and tools sharing of best practices in deploying ehealth Projects Proposal to develop Workshop Agreements, not Standards M403 recast to address DAE action on standardisation ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 27

EU US Cooperation Initiated in 2005 MoU signed in December 2010 eu_usa_mou/index_en.htm Need for a joint vision on internationally recognised and utilised interoperability standards for electronic health record systems http://ec.europa.eu/information_society/activities/health/policy/ The Argos project to support cooperation ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 28

Present efforts-ongoing ongoing projects ehr QTN Thematic Network on Quality and Certification of EHR systems Promotion of certification (in 27MS) Validation of EuroRec functional statements, certification tools and procedures Hitch Healthcare Interoperability Testing and Conformance Harmonization Define and agree on a roadmap for Interoperability Conformance testing Smart PersonalHealth Interoperability of connected Personal Health Systems (PHS) with the wider ehealth domain Promotion and stakeholders workshops ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 29

Other related interoperability projects STORK Secure identity across borders linked Goal to establish a European eid Interoperability Platform 36 beneficiaries, 17 member states Status: ongoing NetCards NETC@RDS service for the electronification of the European Health Insurance Card Initial deployment of the electronic version of the European Health Insurance Card 16 member states Status: ongoing ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 30

EC ehealth pillars 5. Telemedicine and PHS Studies: Methotelemed: A framework methodology to assess the effectiveness of telemedicine applications in Europe (to be published) SIMPHS: Strategic Intelligence Monitor on PHS (ongoing) Staff Working Paper on the applicability of existing EU legal framework to telemedicine services ec.europa.eu/information_society/activities/health/policy/index_en.htm ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 31

Large Scale PHS Pilot: Renewing Health Objective: deployment of a large-scale pilot " to validate in real life settings the use of existing PHS for innovative types of Telemedicine services and to prepare for their wider deployment. Funding: 7M Started in February 2010. Duration: three years. Focus on three chronic conditions: diabetes, CVD and COPD Participation: 9 Regions in 9 Member States (IT, ES, GR, DK, SE, NO, FI, AT, DE) Assess with a validated methodology: Clinical outcome Patients/users satisfaction Economic evaluation Organisational aspect. www.renewinghealth.eu ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 32

EC wide initiatives for ehealth 6. Cross border Directive (2 nd reading) ec.europa.eu/information_society/activities/health/policy/index_en.htm ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 33

Directive: Cross-border healthcare and ehealth Proposal for a Directive of the European Parliament and of the Council on the application of patients' rights in cross-border healthcare. Aims are to provide for rules for facilitating the access to safe and high-quality cross-border healthcare and to promote cooperation on healthcare between Member States, in full respect of national competencies in organizing and delivering healthcare. Reached a political agreement on a common position to allow for the second reading in the EP in order to have the Directive adopted as soon as possible. Article 14 on ehealth Commission s role in elaborating guidelines on: data to be included in patients summaries methods for enabling use of medical information for public health and research. common identification and authentication measures to ensure transferability of data in cross-border healthcare ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 34

Agenda ehealth and PHS drivers and trends EU2020, Digital Agenda for Europe and ehealth EU roadmap for ehealth Interoperability: past, present and future initiatives EC ehealth Pillars European Partnership Initiative on Active and Healthy Ageing ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 35

Europe 2020 s flagships A flagship initiative for Smart sustainable and inclusive growth to develop an economy based on knowledge and innovation HEADLINE TARGETS Employment rate from 69% to 75%. Investing 3% of GDP in R&D Reduce greenhouse gas emissions by 20% (vs. 1990), renewable energy to 20%, 20% increase in energy efficiency. Reduce early school leavers to 10% (from 15%), increase population 30-34 with tertiary education from 31% to 40%. Reduce living below poverty by 25%, 20 million people out of poverty. 7 EU Flagship Initiatives SMART GROWTH SUSTAINABLE GROWTH INCLUSIVE GROWTH INNOVATION "Innovation Union CLIMATE, ENERGY AND MOBILITY "Resource efficient Europe EMPLOYMENT AND SKILLS "An agenda for new skills and jobs EDUCATION "Youth on the move DIGITAL SOCIETY "A digital agenda for Europe COMPETITIVENESS "An industrial policy for the globalisation era FIGHTING POVERTY "European platform against poverty 36 ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 36 36

European Innovation Partnership (EIP) Announced in Communication on Innovation Union adopted by the European Commission on 6 October 2010 under Europe 2020 flagship initiatives A novel concept of the Commission to tackle societal challenges through linking research and innovation and uptake and turn them into opportunities EIP on Active and Healthy Ageing selected a pilot project to be launched by January 2011, followed within 6 month by a strategic work plan ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 37

AHAIP - why? Societal challenge ageing of the EU population Population 65+: 2008 81 mio 2060 151 mio Old-aged dependency ratio : 2008 4 to 1 2030 3 to 1 Socio-economic implications Budget constraints and unsustainable health and social systems average total spending on health care in the EU 27 by 1.5-2% of GDP by 2060 Total aged-related expenditure (inc. health, pensions, long-term etc.) by 4.75 % by 2060 in the EU average Shrinking workforce in the care sector and insufficient number of health specialists Innovation and active & healthy ageing Great market potential and promise of active and healthy ageing solutions - 9% of GDP in innovation capacity, but Innovation (in all forms) needed to address changing needs A number of bottlenecks and weaknesses, on demand and supply side, such as citizens' inability to use innovations, absence of incentives for innovation, lack of clear business models for integrated care, public procurement barriers, inadequate regulatory frameworks etc. ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 38

AHAIP what? Objectives and headline target A triple win for Europe enabling EU citizens to lead healthy, active and independent lives while ageing improving the sustainability and efficiency of social and health care systems developing EU and global markets for innovative products and services, thus creating new opportunities for businesses Overarching goal by 2020 increasing the average healthy lifespan (HLYs) in the European Union by 2 years (considering gender and MSs variations) and improve quality of life ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 39

Operationally innovative how? Building on coherent and integrated, stakeholder-led, citizen-centred and innovation driven actions Pooling available resources and expertise and creating incentives to innovate and fostering initiatives across different policy areas by bringing together all actors in active and healthy ageing related areas, from both the public and private sector at EU, national and regional level and bring about synergies Closing the gap between research and market in the area of healthy and active ageing by speeding up the uptake of innovation Matching supply and demand side by triggering demand driven measures and mechanisms (e.g. pre-commercial public procurement) Scaling up and multiply successful innovation at EU level, through demonstration pilots, trials and deployment with the use of different instruments Leveraging innovation in investment through better use of EU funding, e.g. new financial instruments, structural funds, FP7, EIB, but involving all stakeholders in financial contributions ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 40

Areas of work - work packages WORK AREA 1 ( work package 1 WP1) target individuals as patients and consumers by developing innovative solutions, clinical tests, medicines and treatments to combat and address major chronic and rare diseases WORK AREA 2 ( work package 2 - WP2) focus on social and health care systems by developing innovative policies and business models for more integrated care systems for the elderly (including home-based and self-care); EU wide cooperation on health technology assessment (HTA) WORK AREA 3 ( work package 3 - WP3) Focus on enabling the elderly to lead independent and active lives by promoting the development and deployment of innovative products, devices and services, including ICT-based, specifically suitable for the elderly ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 41

Milestones what next? On-line public consultation launch in Nov 2010, ongoing until 28 Jan 2011 Stakeholder event - 26 November, Brussels Identify first set of most feasible projects with high impact and commitment Preparation and endorsement of a strategic Implementation Plan in Q2 and Q3 of 2011. ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 42

Thank you! benoit.abeloos@ec.europa.eu http://ec.europa.eu/information_society/activities/health/policy/telemedicine http://www.epractice.eu ICT for Health Benoit Abeloos Enabling smart integrated care WS 18 th Jan 2011 43