E-health: The 21st-century house call

The e-health market has witnessed robust growth during the past 20 years thanks to increasing broadband/Internet penetration and a broader public awareness of good health. According to a GSMA report, the global e-health market is projected to grow to USD160 billion in 2015, making for an annual growth rate of 16%. Dr. Patrice Cristofini, Member of the Board of Directors at the European Health Telematics Association (EHTEL), provides a glimpse of the general state of e-health development, particularly in Europe, and challenges to different stakeholders.

By Linda Xu

The e-health market has witnessed robust growth during the past 20 years thanks to increasing broadband/Internet penetration and a broader public awareness of good health. According to a GSMA report, the global e-health market is projected to grow to USD160 billion in 2015, making for an annual growth rate of 16%. Dr. Patrice Cristofini, Member of the Board of Directors at the European Health Telematics Association (EHTEL), provides a glimpse of the general state of e-health development, particularly in Europe, and challenges to different stakeholders.

E-health for all

WinWin: What are the differences between e-health, telehealth, and telecare?

Dr. Cristofini: Telehealth means the provision of health services at a distance using a range of technologies, such as telephone or video consultation to support diagnosis. Telecare relates to the remote or enhanced delivery of care services to people in their own home or community. The concept of e-health is the broadest, covering nearly all aspects of healthcare issues. It mainly involves two areas – infrastructure and services. Telehealth and telecare belong to the service part.

E-health is generally a matter of transferring, exchanging and managing data between public health institutions and citizens by using ICT solutions. The main target of bringing ICT solutions in healthcare is to seamlessly connect all stakeholders such as hospitals, insurance companies, general practitioners (GPs), the pharmaceutical industry, and regional public health agencies with patients at the core. For patient care, these advanced technologies enable remote patient monitoring, better transporting information to patients and improving access to health advice, and quicker access to emergency services. For healthcare practitioners, the technologies also help to deliver better training and improve disease surveillance, data collection, and management of patient records, thus enhancing service transparency and accountability.

WinWin: The ITU views “e-health for all in 2015” as a credible and realistic objective. What are the key drivers that can propel that growth?

Dr. Cristofini: The general environment is the first driver. Take Europe, as an example. By 2025, one in five Europeans will be over 65 years old. The rising aging population puts increasing pressure on public healthcare resources. Meanwhile, in many regions, we haven’t produced enough doctors to serve the aging population. The enormous social demands will compel policymakers to invest more to facilitate technologies growth so as to address the shortage of doctors.

As for individuals, there has been growing awareness of using health-related information available online and managing personal health records by themselves. They demand customized care, differentiated services, and ubiquitous and timely access to professional advice and expertise. Besides, the advancement of ICT technologies contributes to speedy connectivity and better access. The availability of mobile devices also facilitates health monitoring and remote diagnosis.

WinWin: E-health holds the promise of fulfilling many of the communication needs of stakeholders, but what specifically are they?

Dr. Cristofini: As more and more patients tend to access information and manage their personal records via mobile phones and tablets, their big concern is where their personal data is hosted and who accesses their records besides themselves. Therefore, for individuals, the connection needs to ensure the security and confidentiality of the patients’ data. Cloud storage technology can help in this circumstance.

Currently, economic constraints are a huge challenge for hospitals, especially as we are suffering an economic downturn. On average, public funding accounts for 70% and private funding 30% in terms of healthcare investment in Europe. Hospitals need to break the barriers to an open platform so as to share with other hospitals the hefty IT investments in upgrading obsolete infrastructure. Cloud computing technology can greatly satisfy such requirements and swiftly adapt to hospitals’ changing demands.

The pharmaceutical industry has also changed their paradigm by transferring their focus from doctors to patients. In the past, they heavily relied on doctors to promote their drugs and cared less about patients. Currently, they pay more attention to patients. When they do clinical trials before launching new drugs, they need to know as soon as possible if patients have side effects, with the aid of ICT technologies. This will help them adjust their strategies and make decisions if they need to advance or stop further investment.

The continental health

WinWin: According to Europe’s digital agenda, the costs of health and social care will rise substantially to about 9% of the European Union’s (EU) GDP in 2050. What is the current state of e-health development in Europe?

Dr. Cristofini: In general, the EU’s commitment to e-health dates back to 1989, when the EU began to invest its Community Research and Technological Development (RTD) budget in healthcare computing technologies. Then, the 2002 eEurope Initiative was launched, which stated the need to implement user-friendly and interoperable e-health infrastructure systems through national and regional networks for medical care, disease prevention and health education. Later, the EU adopted the e-Health Action Plan in 2004 to facilitate development of interoperability approaches for patient identifiers, medical data messaging, and electronic health records (EHRs). The holy grail of the plan is to make sure that citizens, irrespective of their country of origin or residence, can have access to their EHRs and emergency data from any part of Europe. The principal objectives of the plan lie in five aspects: 1) promoting safe and efficient healthcare; 2) empowering and supporting citizens; 3) enabling patients’ mobility; 4) improving access to care in isolated areas for deprived or vulnerable citizens; 5) developing a European e-health market.

ICT solutions such as videoconferencing, electronic prescription, and real-time decision support systems play an important role in fulfilling these goals. Right now, the most common e-health applications among European member states have been EHRs, citizens’ public health portals, health cards, and e-prescriptions. However, the e-health market in Europe is quite fragmented. The limited coordination of e-health policies and projects has led to limited data interoperability. Twenty-eight member states have their own ethical, financial, and legislative issues. The European Commission lacks the absolute power of making decisions to promote e-health growth, so it takes time to make a complete European e-health market a reality.

WinWin: What are the e-health business operational models in Europe?

Dr. Cristofini: As I mentioned, public funding for healthcare investment, particularly ICT technologies, takes up 70% of funding. Given the ongoing economic crisis, we try to involve more private funding in this sector. Generally, one party builds the network infrastructure and the other pays for its generated data traffic. With the penetration of cloud computing technology, related operational models such as SaaS and IaaS are applied and end customers pay for what they access and utilize.

WinWin: ICT solutions can be the most powerful ally in maintaining cost-efficient and high-quality healthcare service. Can you give us an example on how ICT solutions are effectively utilized in Europe?

Dr. Cristofini: Recently, we launched e-health applications in Korian, a leading European nursing home. We applied Huawei’s video conferencing and telepresence solutions in Korian’s different branches. The idea was to facilitate different caretakers and patients in different branches to communicate seamlessly and collaborate more effectively, thereby upgrading their working efficiency and cutting operational cost. The further plan is to enable family members’ remote connection with their senior relatives, so as to strengthen their social links. We have ambitions to spread these solutions widely in Europe.

In with a BANG

WinWin: Please predict the e-health growth from an ICT perspective.

Dr. Cristofini: A sustainable infrastructure serves as a basis to facilitate smooth connection among stakeholders as data will witness exponential growth. My prediction can be summarized as one word, BANG, with B for biotechnology, A for atomic nanotechnology, N for new ICT solutions, and G for genomics. The healthcare industry, particularly the areas relating to biotechnology, atomic nanotechnology, and genomics, will undoubtedly generate huge amounts of data. We need to host, transport and analyze this data. ICT solutions like cloud computing and big data will make a difference.