The Strategic Requirements Board, responsible for the health care report on "Needs and options for future research in Information Society applications", has made a concise analysis on behalf of the European Commission's DG XIII, of both the positive and negative aspects of health care related realisations within the Fourth Framework Programme. The reporters have divided their critical remarks into four paragraphs, referred to as SWOT, which stands for Strengths, Weaknesses, Opportunities, and Threats. This review should serve as a useful guideline for the Fifth Framework Programme, since it addresses the mistakes, which have to be avoided by all means, as well as the successful initiatives that preferably should be continued or extended.
The invaluable merit of the Fourth Framework Programme consists in the creation and consolidation of a European collaborative platform with regard to health telematics. The various partners and organisations have been able to create a network of mutual assistance and expert advice with a high degree of accessibility. Excellent results have been obtained in fields like telemedicine, electronic health records, and shared care with a variety of innovative applications and services. A large number of pilot sites and demonstrators are currently active with every project able to show at least one success case.
The industry, including SME's, actively promotes the benefits of advanced information technology systems to the end-users. The latter are recognizing their needs in strict requirements and growing standardisation. For instance, in the area of Electronic Health Care Records (EHCR), concerted action and effort has been undertaken to connect and integrate different levels of health care delivery, thus avoiding needless and costly duplication to the patient's satisfaction. The European Health Telematics Observatory (EHTO) Web site, together with its national satellite sites, constitutes an ideal dissemination tool. The programme also displays a powerful focus on education.
Unfortunately, the reporters have detected some serious weaknesses in the overall structure. The worst of all is that the programme is certainly not being regarded as the European standard for harmonisation in health care delivery. The selected projects barely are concerned with current market tendencies or infrastructure requirements. Instead of searching for new approaches, both project managers and member states tend to follow in the steps of American or Japanese initiatives. In addition, the projects' selection is suffering from an appalling lack of coherence with too little attention for variation, innovation and content, thus weakening the framework's cement and core.
The industry - large companies as well as SME's - are insufficiently involved in the implementation process, due to the fact that academic purposes are offered priority over product development in many of the projects. As a result, positive outcomes are too seldom being disseminated to eventually interested customers, whereas only few applications finally reach the market. Except for the imaging and smart card sectors, European products tend to remain invisible. As for the Commission's procedures, they are far too slow to permit flexible introduction of products on the market. Partners are sometimes forced to compromise to such an extent the final project turns out to be only a dull reflection of the initial proposal.
Yet, the programme offers great opportunities to large parts of the population with regard to health prevention or chronic diseases management, in order to reduce costs by means of accurate diagnosis and treatment. Citizens are increasingly aware of the health care revolution, thanks to the deployment of the European telecommunications infrastructure, the explosive growth of Internet technologies and the WWW and innovative telematics solutions. New markets in Central Europe and the developing countries are emerging as well. Furthermore, the collaboration with other European programmes, external industrial or other sources, and both national and regional projects could help finance and implement some of the projects' results.
The Strategic Requirements Board experiences the lack of interest in the development of information technologies (IT) for health care purposes as a major threat. The Maastricht treaty as well as the health ministries of the member states show little engagement to invest in IT for the health sector. National and European budgets are even being cut down. The absence of a legal and administrative framework with regard to security, confidentiality, liability, and standardisation is bound to slow down the implementation of a European health telematics industry. Thus, the risk increases that both American and Japanese software and hardware companies will conquer a leading role in Europe. For more information, please, consult the analysis and full report on the Telematics Applications Programme Web site.