In 2004, the European eHealth Action Plan initiated a commitment by all European Union member states to develop a national or regional roadmaps for eHealth. This study confirms that good progress has been made on these strategies and roadmaps across the continent. Furthermore, by providing a transparent view of the current eHealth national landscapes, there is now more potential for working together in a clear and synergistic way.
Compared to other sectors of European economies, the deployment of information and communication technology applications by health systems has been severely lagging behind. However, Europe's health care policy makers are now aware of this crucial gap, and an improvement is at hand. The information from current policy papers and national experts, collected by the eHealth European Research Area (ERA) project, shows that an important step towards wider deployment of eHealth solutions has been made.
During the last few years, 22 European governments have published specific documents about their intentions and priorities in the field of eHealth, such as eHealth strategies, roadmaps, or action plans. Five countries mention eHealth as a priority topic in wider national "e" strategies, usually under the umbrella of eGovernment or other more comprehensive strategies in the development of the Information Society.
Most of the official documents that focus on eHealth have been published since 2003. However, some countries like Denmark, Finland, or Norway had already adopted initial eHealth policies during the second half of the 1990s. Others like Germany started public discussions involving a wide variety of stakeholders during the same era.
eHealth is increasingly becoming an integral element of national health system objectives. It is seen as a key enabler in wider contexts like improving the quality and efficiency of public services, or speeding up the development towards knowledge driven societies.
In two-thirds of the countries reviewed, the deployment of ICT-based systems is directly linked to health policy objectives. In ten countries eHealth is a central part of the national overall health system strategy. In 14 countries eHealth has a more focused objective, which is usually cost containment, efficiency, or improving the quality of health care services.
Current political, administrative and monitoring structures are often not sufficient for the effective deployment and further diffusion of beneficial eHealth solutions. Focused goals and measures for immediate and medium term actions are the next step towards actual introduction of ICT in health services. More than half of the fact sheets make reference to a clearly defined set of short- and medium term priorities.
These priorities range from the implementation of stand-alone applications, to the building of national eHealth infrastructures by connecting existing local and regional networks, to the set-up of comprehensive, national, electronic health record systems and national authorities to oversee and guide these developments. Specific objectives include the introduction of eCards, other methods of identifying patients, or web portals for citizens and health professionals. Interoperability standards, including semantic issues as well as the legal and regulatory framework required for complex, large-scale endeavours are also high on the priority lists.
Each country concentrates on a subset of these kinds of aspirations. Indeed, across the board there is a high degree of consistency with the priorities stated in the European Union eHealth Action Plan. However, public health issues or the need for focused eHealth training and introducing eHealth in education curricula are seldom mentioned. Another notable omission in the fact sheets is attention to reimbursement and other socio-economic aspects, such as effectiveness of resource allocation, sustainability, economic efficiency or change management, all issues that fall squarely under Member States' authority.
The development of eHealth not only brings about new opportunities, but also new risks. In order to ensure that these risks are minimised, and that citizens are protected from the misuse of data, the legal framework provided by the European Data Protection Directives is essential. Several European Union member countries have started to implement, or plan to do so, legislation in a number of areas, including patients' rights, privacy, certification of patient records related software, public information, or digital signatures.
The report is the outcome of research in the context of the eHealth ERA project, which is implemented by empirica GmbH - co-ordinating partner, Germany; STAKES, Finland; CITTRU, Poland; ISC III, Spain; CNR, Italy; and EPSRC, United Kingdom, based on a Co-ordination Action contract with the European Commission.
The eHealth ERA team owes a great debt to all the national representatives of the European i2010 Subgroup on eHealth as well as to their and other national experts in Member States and the other countries covered by the report, who contributed to and reviewed the fact sheets. The report can be accessed at the web site of the European Union.