EHealth Development in Selected EU Countries: Barriers and Opportunities

Abstract

Information and Communication Technologies (ICT) have become an essential tool used in all areas of society and health sector is no exception to this regard. Though eHealth is one of the most dynamic areas of health care, usage of ICT solutions is considered low compared to other sectors of economy. EPP eHealth project aims at identifying common needs in the area of eHealth, exploring the best available solutions and stimulating the market with the aim of creating a Public Procurement of Innovation (PPI) / Pre Commercial Procurement (PCP) strategy for the eHealth sector. The project goal is to understand health care public procurers’ unmet needs in eHealth. Project consortium conducted desk research study and qualitative research to investigate barriers and opportunities of eHealth development. Desk research shows that use of both PPI and eHealth differs in countries participating in the project (Denmark, Poland, Spain and the UK). This can be attributed to a variety of reasons, including the structure of health care (different healthcare system models) and cultural differences among mentioned countries. Barriers of eHealth development on the EU level were defined as: - Lack of awareness of, and confidence in eHealth solutions among patients, citizens and healthcare professionals, - Lack of interoperability between eHealth solutions, - Limited large-scale evidence of the cost-effectiveness of eHealth tools and services, - Lack of legal clarity for health and wellbeing mobile applications and the lack of transparency regarding the utilisation of data collected by such applications, - Inadequate or fragmented legal frameworks including the lack of reimbursement schemes for eHealth services, - High start-up costs involved in setting up eHealth systems, - Regional differences in accessing ICT services and limited access in deprived areas. When analysing barriers specific to four participating countries as well as those in common, one can point at limitations in good quality internet connection, problems with data transfer and – what could be described as obvious barrier to all innovations – resistance to change. At the same time there are some opportunities of eHealth development: - Further development of eHealth to support a more transparent, targeted, efficient and productive health system that also reduces failures and length of hospitalization. - Anticipated steady increase in need for eHealth and telemedicine solutions, related to ageing society and medical staff shortage, - Growing interest of private sector, - Governmental investment in pilot projects, - Planned revision of legal acts aimed to adjust them to eHealth, Preliminary analysis of qualitative research outcomes already shows important differences in eHealth perception (understanding). Polish health care is still struggling with digitalization of medical records. Hospitals’ CEOs often present conservative approach to investing in eHealth solutions considering them not essential and not economically feasible. At the same time in Spain eHealth is perceived as an important factor that can help hospitals not only save money in an unfavourable economic situation but also provide health care to poor regions in a more economic (cheaper) way. Moreover, Spanish stakeholders put a lot of hope in future support of eHealth in decision making processes. UK units incorporate eHealth solutions in their everyday functioning. They also consider it one of means to face financial crisis but are required by law to put a lot of focus on its overall impact of health care efficiency based on e.g. mortality rates, emergency admissions, lengths of stay, etc. Representatives of stakeholders involved in Danish health care seem to focus on the ability of eHealth solutions to develop patient empowerment and increase patients’ involvement in the way health care is provided. Despite important differences in perceiving eHealth and level of its development, representatives of all countries point out similar type of barriers. Most importantly it is the case of stakeholders’ attitudes and lack of funds. Another important challenge is the uncoordinated development of eHealth initiatives, that results in a variety of pilot projects but not in sustainable, comprehensive improvement. Interestingly lack of technology not once was considered a barrier and interviewees from various countries agreed that it is not the case of used technology, but rather the way of its usage. Analysis of barriers, opportunities and expectations related to eHealth gives reasons to cautious optimism regarding its future. Taking into account growing society needs, societal changes (demographical and cultural) as well as development of ICT, more intensive use of eHealth seems inevitable.