Health on-line quality and ethics in the focus at European Health Forum Gastein

Bad Hofgastein 29 September 2000The possibilities of modern communication have revolutionised developments in health care. However, problems have remained the same. This was reason enough to focus on IT developments at this year's European Health Forum Gastein. The discussion of approximately 500 participants at the Third European Health Forum Gastein on the topic "Information and Communication in Health" concentrated on financing, quality, and ethical matters. Mr. David Byrne, European Commissioner for Health and Consumer Protection, and Dr. Günther Leiner, President of the EHFG, expressed their views in a joint press conference, organised at the conclusion of the EHFG conference.


European health policy entered a new stage when the European Union Health Strategy was announced on May 16th this year. This innovative strategy covers a comprehensive programme, replacing the eight former ones which phase out this year and in 2001. European Commissioner for Health and Consumer Protection, David Byrne, presented the six-year programme of 300 million euro to the EHFG audience as "the biggest single project of the European Commission". One of the aims is to improve health care information with a focus on the latest developments in health.

According to Mr. Byrne, health information must be valuable, reliable, sound and ethical. Consumer confidence in the Internet is capital. Therefore, the EU Action Plan "Health on-line" has been launched to introduce a health telematics infrastructure for the primary and secondary health care providers by 2002. The priority catalogue contains securing comprehensive information in e-health, the adaptation of quality criteria and certificates, the creation of connections between national and international health networks, as well as checking the legal basis of e-health until the end of 2001.

This last item should clarify the influence of existing laws on the practice of e-health, including the reliability of on-line health information, data security, international contracting, certification of medical treatment, and advertising for and sale of pharmaceutical products. The European member states and the Commissioners for Health and Consumer Protection, Enterprise, Single Market, and Information Society will be carrying out this project together with the private sector. Until the end of 2002, the infrastructure for the use of e-health should be implemented by the member states.

"Information holds for benefits to patients in all remote areas of the European Union", stated Mr. Byrne. Whereas the EU tries to enforce equal access to modern information technologies for all citizens through the e-Europe programme, the reality differs substantially according to the Euro-barometer poll results of May 2000 yet. Less than 50 percent of European physicians are currently taking advantage of the extensive offer of medical databases on the Internet as well as the possibilities of communicating with colleagues from all over the world, according to Dr. Günther Leiner, President of the EHFG.

With less than 40% of panel physicians being equipped with computers, Austria, the host country of the conference, is undersold only by Portugal, France and Greece as tail-light with 20 percent. With reference to the law regulating quality of treatment, doctors should be forced to modernise the technical equipment of their offices, as Dr. Leiner insisted. In France, this process has started recently. Physicians are obliged to send their invoices via computers. The positive side-effect is a push in modernisation. France has been rated the country with the best health system by the latest World Health Organisation (WHO) World Health Report 2000.

While physicians have to catch up in most European countries, the number of Internet patients is growing continuously. About 68,5% of the doctors are confronted with patients who have already searched for information relating to their diseases on the Web, according to a study of the Health on the Net Foundation (HON). Information found is reaching from diagnosis to treatment advice for children's diseases and the virtual hospital. Although an estimated 100.000 health-related Web sites provide information of all sorts, the quality of this information is highly questionable. Studies prove that 70 to 80 percent of health information on the Internet is wrong, incomplete or outdated. The solution approach currently followed and also discussed at the EHFG, aims at self-regulation. Therefore, a label for quality information will be designed in order to protect patients from dilettantism on the Internet.

Additionally, the growing quantity and availability of health data through telemedicine, including chip card systems and the Internet, make a new form of ethical principles in health care necessary. Such "info-ethics" need to meet the criteria of protection of medical data , secrecy, agreement to the use of the data, safe data transmission, transparency, and joint decision-making. Seen from an economic point of view, the step forward towards the information age no doubt will pay off. Up to 20 percent of health care costs could be saved through the use of information technologies, as stated by the EHFG experts.

The costs savings would come from an efficient data management and the development of decentralised health care. Telemedicine makes high-quality services available even in remote areas. This does not only save costs, but also comes closer to the patient. The unnecessary doubling of services, such as x-ray, can be avoided since data is available quickly over large distances. Home surveillance and care systems save travel time and costs for patients as well as for health care professionals. Commissioner Byrne believes that there will be an interactive co-operative process between the member states and the Commission for all these matters. More EHFG news is available in this issue's article Adoption of quality criteria of the essence for health Web sites.

Leslie Versweyveld

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