eHealth development and implementation are prioritized areas in Europe, both on EU and National level. In March, a ministerial meeting on eHealth will be held in Barcelona in connection to eHealth Week 2010 and World of Health IT Conference where hopefully, some important issues on how to bring eHealth implementation and interoperability forward. In order to reach the goals set up in the i2010 eHealth Action Plan, actions need to be taken quickly.
A 2008 study by the Sectoral Business Watch (SeBW) provided an assessment of the situation of eHealth standardization and implementation. The report put specific focus on electronic health records (EHRs) since these are a prioritized area among policy makers.
The main issue reported by SeBW is the outspread use of conflicting standards and specifications across the EU. Further, due to incorrect implementation of technical specifications there are examples showing that different versions of the same standard may be in conflict. Interoperability is thereby rarely made possible.
The reason why this situation has emerged is due to four different types of barriers: Political- governmental support for the development of prominent eHealth standards is low; as is the incentives for electronic communication which otherwise could spur innovation. SDO- many different SDOs are developing eHealth standards and each wish to realize positive returns. Hence the incentives to agree on one common standard are low. Company- ICT firms selling middleware for interoperability are thought to prosper on the use of conflicting standards and manufacturers are unwilling to adopt the most common standards due to expensive pricing. ICT user- on the user side barriers to adoption of interoperable standards are mainly related to cost; cost for searching, conversion, upgrading etc.
In 2009 the European Commission EHR IMPACT report on socio-economic impacts from interoperable EHRs was released in late 2009. The results, based on a number of case-studies, show that in all cases socio-economic benefits exceed the costs, albeit after a period of some time.
The EHRI report calls on policy makers to provide a dynamic climate and incentives for the development and implementation of interoperable EHR systems. A second plea is made that policy makers are aware of the time frame necessary to start reaping the benefits, in order to allow investors and other stakeholders enough time to complete projects; the strategic goal should be better healthcare rather than more cash
Recent European developments include a collaboration between ISO, CEN and HL7 formed to reach a harmonized standardization of eHealth solutions in the EU. This could prove vital for the further implementation of EHRs since conflicting standards for the collection and classification of data are one of the main barriers. Other important collaboration projects include epSOS (Smart Open Services for European Patients) which aims at enabling EU citizens to seek medical care in other member states.
It is clear that much work remains to be done in the EU which will take time and therefore, it is important that actions are taken soon. Looking at the WoHIT agenda, many interesting questions are up for discussion; such as healthcare 2.0 services, eHealth user platforms etc. Let’s just hope that policy makers take heed to the EHRI report and listen to stakeholder voices from the different conferences. Because time is ticking; and for every tick, the reaping of eHealth benefits move further away.
