The HEALTHCARE Sector

OPEN DEI will be an essential pillar of the implementation of EU digitisation policies by addressing in particular the “support” to the Large-Scale Pilots (LSPs) and platform projects financed by the European Commission under the Digitising European Industries (DEI) Focus Area and currently ongoing, which work in different strategic sectors: one of them is the healthcare domain.

Description

Initial Digital Platforms in the Healthcare Sector

The “digitisation” of the healthcare system has been underway since at least the 1990s but has evolved slowly due to a number of major barriers. The main ones to highlight are the complexity of healthcare systems, the nature of the patient-healthcare professional relationship, the resistance of clinicians to change the way they work, and legal and ethical issues such as privacy and the sensitivity of healthcare data. Hence, an active collaboration between the various stakeholders has always and still is a prerequisite for success.

In the larger European area, the first large scale deployment of digital services in Healthcare was the implementation of electronic medical records (EMRs) in both primary care and hospitals in countries such as Denmark, Sweden and Israel and regions such as Andalusia (Spain) and Lombardy (Italy). EMRs have served as the foundation for the digital transformation of healthcare.

Over the past decade

Over the past decade, a number of national and regional governments have developed and implemented eHealth strategies which include national or regional Electronic Health Records (EHRs) aiming at ensuring continuity of care across the healthcare systems. The approaches for these digital platforms range from centralized or federated decentralized and distributed architectures.

In parallel, services such as electronic prescriptions have also been deployed on a large scale to address the question of data quality and consistency and administrative simplification.

Unfortunately, the organisational fragmentation of healthcare (into its different sectors, such as primary care secondary hospital care and long term care) and the differences in the organization of the health care systems (insurance based or not) continue to lead to similar fragmentation of digital systems in place. Other elements which have played a role in this fragmentation are: insufficient levels of investment in key infrastructure and infostructure building blocks, proprietary standards, insufficient coordination between authorities and the weight of legacy systems.

Challenges

Today’s Challenges for the Digital Transformation of the Healthcare Sector

There are a number of current challenges facing the healthcare sector in terms of its ongoing digital transformation. These often relate to specific types of technologies.

In response to today’s health care needs, mHealth offers a potential solution. It is playing a rapidly greater role in both health and social care, increasingly supplanting earlier technologies such as telemedicine and telehealth; in general, it enables communication among health care professionals and clinicians and patients using instant messaging and chat platforms such as WhatsApp. The challenge now is to integrate mHealth with existing EHR’s platforms to become an integral part of the overall digital system and network.

Other potential areas (including technologies) for digitisation in health care that can be supported by open digital platforms, reference architectures, open solutions and trusted networks are:

Sector Specific Platforms

A number of platforms, and associated ecosystems, have been developed during the last ten years in each of the specific sectors covered by OPEN DEI. Several are evident in the field of healthcare. Of importance to platforms are the platform-related activities identified as the “six Ps” by OPEN DEI. Besides platforms, the other five are: products, processes, people, partnership(s), and performance. In healthcare, various platforms have emerged at European level since 2010 and have developed their own ecosystem, including the following:

EPSOS

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UniversAAL

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AEGLE

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Significant Innovation Policy Initiatives and Ecosystems in the Domain

Significant Innovation Policy Initiatives and Ecosystems in the Domain

Various ongoing innovation policy-oriented initiatives can potentially help overcome the organisational fragmentation and build sustainability of interactions in the field. They include the following list of initiatives and ecosystems:

Several of these initiatives – especially AAL, EIP on AHA, and the JPI MYBL together – are currently exploring the possibility of forming larger post-2020 partnerships: a co-written joint statement outlines their synergies.

Significant Standards Initiatives in the Domain

From the beginning, electronic identification, interoperability and standardization have been and are still key issues. They have been addressed at national, international and European level e.g. with EU-funded projects aiming at enabling cross-border data exchange between these national and regional platforms. Several standardization initiatives, sometimes competing, have emerged at local, European and International levels. Recent efforts have tried to classify the standards against a reference framework and improve the usability of selected standards:

  • An eHealth Interoperability Framework (eEIF) has been defined and its refined version (ReEIF) has been adopted by the eHealth Network in November 2015. This common framework is a means for managing interoperability and standardisation challenges in the eHealth domain in Europe.
  • A Conformity Assessment Scheme (CAS) for Europe has furthermore been developed. It promotes the adoption and take-up of interoperability testing mechanisms for testing eHealth solutions against standards and profiles defined in the ReEIF.
  • The European Interoperability Framework (EIF) supported by the project ISA has also produced 47 cross-domain recommendations for the use of standards and specifications to set up interoperable digital public services.

Examples of standards initiatives and bodies in the healthcare domain include:

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OPEN DEI Next Steps

OPEN DEI Next Steps

First step would be to set up a “Task Force” comprising members from the different identified projects (all working in the Healthcare sector). The task force will collect requirements / needs / results from these projects. It will include the results of this work in the OPEN DEI Large Scale Pilot dashboard for cross-domain awareness channels on open digital platforms, reference architectures, open solutions and trusted networks.