Successful deployment of Personal Health Systems presupposes the existence of favourable policy and political support

Brussels 13 June 2007For almost a decade the European Commission activities in eHealth have supported a vision of person-centric health care systems - a vision that breaks away from the current way of delivering health care. This vision is best expressed by the so-called Personal Health Systems (PHS). PHS represent a new generation of eHealth systems in the form of, for example, wearable and portable systems and tools in the hands of patients or citizens. PHS are realised by integration of ICT such as biomedical sensors; micro- and nano-systems; mobile, wireless and broadband communications; user interfaces; digital signal processing and intelligent algorithms.

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The conference on "Personal Health Systems: Deployment opportunities and ICT research challenges", held February 12-13, 2007 in Brussels, Belgium, aimed to consolidate the results of this period of research, development and service validation in the area of PHS in Europe and to further demonstrate the impact of PHS on the prevention and management of diseases, citizen empowerment and independent living of people in need. In addition the conference aimed to stimulate the debate on issues relating to market development and policy support to Member States and regions in deploying PHS systems. The full conference report is now ready and available.

Although the vision for PHS to take health care out of the hospital, bring it to the home and embed it into people's lives is clear, little deployment has happened so far. The barriers to deployment originate at different levels and are associated with a multitude of technological, cultural, legal, political and market-related factors. Equally poly-parametric is the way of addressing them and will require active participation of all stakeholder groups.

The report emphasises the influence of the health professionals who have a key role in implementing the required organisational changes. The changed situation of the patient or citizen now being responsible for his or her own health, necessitates the definition of new skills. Education in IT is a crucial element in the training of health professionals, as is their impact on promoting new programmes for disease prevention and management. PHS transform the patient from a passive health information provider to an active information user. Therefore, several issues arise related to safe handling, sharing and continuous flow of information. Additionally, there are still open issues regarding professional liability and responsibility in case of failure.

The reality of an ageing society constitutes a special challenge for the health care sector. The rapporteurs note that ICT-based services will generate new models facilitating paradigm shifts to interface, procedural and organisational dimensions of medical and social care. There are indeed bottlenecks to develop the potential of ICT and ageing, mainly connected to the low use of these technologies in the health care and social sectors, and, not to forget, by the elderly themselves, as well as the mismatch between the offer and the demand. The future policies should address the user needs with a holistic approach to ageing, favouring the dialogues and ICT awareness among stakeholders, and stimulating the investment and deployment of the needed ICT infrastructure and services, as the report states.

In their closing remarks the rapporteurs on the one hand stress that existing best practices in the field demonstrate that PHS represent a fundamental advance in the delivery of health services, the prevention of diseases and the provision of substantial savings on the health care cost. On the other hand, they write that it is still necessary to undertake the collection of large scale clinical evidence to define models that optimally integrate PHS into existing or new health care delivery models and persuade the patients and health professionals that these technologies will help to prolong lives or have a better quality of life.

Successful service pilots have already demonstrated the value of sharing commitment and benefit in eHealth. If different interests and resources are combined efficiently it is possible to gain benefits for all parties and hence successfully deploy eHealth services, according to the rapporteurs' belief. Three boundary conditions however have to be fulfilled for a business case: 1) insurance companies need to reduce cost; 2) doctors should not loose their patients; and 3) the role of the physician should be maintained.

In summary, although significant scientific challenges still remain, technology is not any longer the limiting factor, albeit that interoperability still constitutes an issue. Several directions must be explored and education has to play a bigger role to improve performance and disseminate the potential of the new technologies. The deployment has to be done within the Member States, but this procedure needs time, according to the conference rapporteurs.

It is important that national policy should have ICT at its core and at the same time is willing to promote the introduction of organisational changes and reimbursement incentives. In comparison with the United States and Japan, Europe is lagging behind due to its inability to change, through the difficulty of abandoning old technologies. There are still many things to do, although many technologies have been demonstrated to be already available. Member States need to continue, and take initiatives being pushed spontaneously - without any funding from the European Union - to pave the way towards a successful innovation.

The Conference report was written by Zoi Kolitsi from the Ministry of Health and Social Solidarity in Greece and by Maria Fernanda Cabrera Umpierrez from the Technical University of Madrid in Spain. You can access the full report at the European Commission's Information Society website.


Leslie Versweyveld

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