eHealth requires harmonisation across Europe, according to experts at the European Health Forum Gastein

Bad Gastein 08 October 2005The electronisation of health care systems is running at full speed now in virtually all European states. Whether it is for administrative procedures, electronic prescriptions or the use of chip cards as replacement for conventional administrative systems, national health officials everywhere anticipate considerable savings. In a conference of experts held on the topic of eHealth at the European Health Forum Gastein (EHFG), the biggest health policy event in the European Union, the chances for this development were underscored, though experts also warned of several problems.


The EHFG accords the topic of electronization in health care substantial attention as well. Under the slogan "e-health" in virtually all European countries far-reaching changes in the organisation of health care are being initialised and to some extent have already been implemented. From the exchange of experiences experts anticipate particularly ample benefits for the individual countries concerning the difficult process of implementing the new structures.

"If international harmonisation of the systems is not intensively undertaken, particularly within the European Union, then the organisation of health services by chip card will pose major difficulties", warned Reinhold Mainz, chip card expert in the German Ministry of Health. As a result of the increasing mobility of Europeans, it is natural that health services will be more frequently consumed. While "paper can still be sent from one country to another, basically insurmountable hurdles are being created as a result of incompatible electronic systems."

The magic word is "interoperability". This means that either the chip card can be used abroad or that communication between the systems is possible without restriction. The efforts at establishing this common basis are bundled into the "eHealth Action Plan". During the length of the programme, which lasts until 2010, uniform patient identification systems, the basis for transmission of electronic health data as well as uniform quality standards for eHealth products and services are to be established. In addition to technical harmonisation, however, harmonising the legal frameworks is also of major importance.

A pressure group for European Union-wide standardisation already exists: in 2004 Germany, Austria, France, Norway, Slovakia and The Netherlands established the "Interoperability Initiative for a European eHealth Area". That time is pressing demonstrates the diversity of the eHealth programmes currently underway throughout the European Union.

"Particularly in the new European Union states, projects from the Baltic States to Hungary and on to Slovenia are in high gear", stated Gérard Comyn, head of the European Union Commission division "ICT for Health". "To even a larger extent than member countries in the west, these states can make enormous progress in quality, customer friendliness and cost-efficiency as a result of eHealth."

The European Union has also set ambitious targets with its new health strategy. Merged with the issue of consumer protection and to be implemented in 2007-2013, the programme strives for a much more substantial degree of European co-ordination in health policy measures among member states. At the European Health Forum Gastein, Bernard Merkel, the European Commission's Health and Consumer Protection Directorate General, stated: "It is not a matter of European health policy but that health policies which are now the responsibility of individual states are to be co-ordinated more effectively than before."

The reasons for this are manifold. First, it is clear that the battle against major health risks, namely the threat of pandemics such as the current example of bird flu, has no substantial prospects for success on a national level. "Global threats can only be countered in the scope of international co-operation", stated Bernard Merkel.

The second important reason is that a "single health market" is in many respects already a reality. "This was not a political intention, but instead a logical consequence of the unification of Europe", stated Bernard Merkel. "Patients have far more options today than in the past to consume health services abroad and medical experts are also taking advantage of the opportunities on the free labour market, which poses increasing challenges in medical care for several countries." There are numerous problems as a result of this, particularly the question of who bears the costs of medical treatment abroad or who is responsible for the costs of medical malpractice which occur in treatments abroad. "If there is no European co-operation in this regard, there is at the very least a danger of serious complications."

Furthermore, the European Union-wide co-ordination of health policy measures provides new opportunities for quality improvement: innovations can be adopted faster in other countries, which will save not only on cost, but as a result of more rapid implementation of best practice standards, the quality of health services can also be significantly increased.

Finally, the European Union health strategy also aims at strengthening patients' rights and for stronger integration of civil society institutions in the health care system: "Here there are enormous differences in the European Union states, and particularly in the new member countries there is still an enormous need to catch up. In an area of such vital importance as health, we have to put the idea of European civil rights into practice", stated Bernard Merkel.

The European Health Forum Gastein, which took place for the 8th time between 5 and 8 October this year, was in every respect a complete success. With 630 participants from 61 countries, last year's attendance figures were exceeded by a solid 20 percent and a new record achieved. More information is available at the European Health Forum Gastein Web site.

Leslie Versweyveld

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