Ministers of Health of the Member States of the European Union and delegates from 30 countries and stakeholders' representatives met on 10 May 2011, in the framework of the Ministerial e-Health Conference organised jointly by the European Commission and the Hungarian Presidency of the Council of the European Union. Presidency Declaration.
The Conference was a major opportunity for policy makers and stakeholders to share best practices, their achievements and methodologies, as well as to discuss the main policy priorities to facilitate the use of ICT in health to contribute to better, safer and more sustainable healthcare systems.
A strong commitment to e-Health and chronic disease management has been demonstrated in the past by Member States, notably through: the adoption of Council conclusions on Safe & efficient healthcare through e-Health (December 2009); Council conclusions on innovative approaches for chronic diseases in public health and healthcare systems (December 2010); endorsement of the European Commission's “Europe 2020 strategy” and its related flagship initiatives "Digital Agenda for Europe" and "Innovation Union"; the establishment of the e-Health Governance Initiative and ultimately the adoption of the Directive 2011/24/EU on the application of patient's rights in cross-border healthcare.
It is important to emphasize that
1. e-Health and telemedicine could support health systems transformation to respond to the challenges of demographic ageing, scarcity of resources, shortage of health professionals, the increase in chronic diseases by enhancing the provision of timely and appropriate healthcare for all and the more effective use of services and capacities in the health sector;
2. e-Health and telemedicine solutions can also contribute to public health, self-care and community care;
3. ICT has beneficial effects in the care of patients, in particular those with disabilities and suffering from chronic diseases;
4. appropriate use of ICT solutions in chronic disease management in particular self-management, self-treatment and continuous remote monitoring, results in health gains by enabling patients to continue to live independently and to improve their quality of life are acknowledged;
5. the application of e-Health solutions enables patients to take more responsibility for the improvement of their own health and quality of life;
6. the application of e-Health solutions contributes to mutually beneficial cooperation between doctors and patients;
7. the wider use of ICT in healthcare is a fundamental condition to the development and implementation of innovative care solutions, as well as the introduction of new generation applications and innovative care models, efficient patient pathways;
8. investments in e-Health and telemedicine to enhance the affordability of health systems are needed;
9. ICT solutions can contribute to improve sustainability, safety and efficiency of health systems, by significantly improving the efficiency and efficacy of care, health outcomes and reducing hospitalisations;
10. health professionals’ organisations and medical scientific societies be interested in and support the further use of e-Health and telemedicine in clinical practice;
11. e-Health solutions can contribute to EU level dialogue aiming at mutual learning and sharing of experiences;
12. in some chronic diseases there is still a need for more research and evidence, including large scale clinical trials, more targeted socio-economic analyses, and the development and validation of healthcare delivery models for preventive and predictive care;
13. lack of comparable data collecting measures is a major hurdle to the deployment of e-Health solutions by limiting opportunities data analysis can bring for improving performance, enhancing patient safety, and making sound investment decisions;
14. coordination of all policies related to e-Health (from support to research and deployment, to develop a legal framework in specific areas like medical devices, patient safety, information security and interoperability) should be strengthened.
It is important that the following actions receive special attention:
Member States should enhance their cooperation on e-Health (Article 14) and participate in the network of national authorities responsible for e-Health in the framework of implementing Directive 2011/24/EU on the application of patients' rights in cross-border healthcare.
Member States should make use of the upcoming Ministerial meetings to identify concrete areas where joint progress can be realised, to define common objectives and indicators and to set their own related targets; and revisit both at the 2012 e-Health Ministerial Conference.
The process should be started on the basis of areas and targets such as those listed in the annex and based on their national/regional priorities as established in the European Innovation Partnership on Active and Healthy Ageing.
Structural Funds to support e-Health applications contributing to health system improvement and innovation should be used effectively.
The deployment of evidence-based telemedicine systems and services, in particular in the area of remote disease management where strong evidence on efficiency and clinical benefits exist should be supported and facilitated.
Information to patients as well as professionals’ education regarding the use of new technologies should be facilitated.
e-Health and telemedicine applications’ targets shall be based on current evidence of the impact of e-Health and telemedicine in specific domains, for example, in diabetes, cardiovascular diseases, and chronic obstructive pulmonary disease. Areas of impact could include inter alia, the reduction of hospitals admissions, reduction in length of hospitalisation, improved quality of life, and increased care worker productivity.
Guidelines addressed to health professionals, in close cooperation with relevant professional associations and scientific societies, for implementing innovative tools aiming at enabling integrated health services, e.g. chronic diseases management services, tools for better use of human resources and capacities in the health sector and access to appropriate, safe and quality healthcare should be developed and adopted.
Building on ongoing cooperation , and on forthcoming Community initiatives common measures, to achieve interoperability of e-Health systems should be developed and implemented.
Steps, including agreements on semantic and terminology related issues, to enable data analysis for research and public health purpose should be taken, in line with legislation on the protection of privacy of personal data.
Achievements of epSOS and epSOS-II projects should be sustained and extended.
A minimum common set of data to be collected and exchanged across Member States on chronic diseases should be developed.
The European Commission is invited to:
support Member States in their efforts to deploy e-Health solutions for chronic disease management;
encourage the development of clinical guidelines that support e-Health and other innovative solutions where clinical benefits and effectiveness has been widely experienced;
support research in e-Health solutions, in particular large scale pilots, models for preventive care, personalised medicine and comparative effectiveness research;
support cooperation between Members States on effectiveness of e-Health technologies (Health Technology Assessment for e-Health applications) as to ensure sustainable investments in the health sector;
support efforts to strengthen data collection and analysis on the deployment and take-up of e-Health solutions, aimed at enabling evidence-based decision making;
support Member States in developing their own quantitative targets, based on common objectives and identifying progress indicators, in the context of the next e-Health Action Plan.
ANNEX: This annex provides examples of possible targets based on existing evidence which could be adopted by Member States
Member States, together with the European Commission and other stakeholders could establish concrete targets for monitoring e-Health and telemonitoring deployment and its impacts set against an agreed timeline for achieving the targets. Such targets need to be based on evidence of the causal linkage between the deployment and the measured effects. Suggestions are provided below.
By increasing use of telemedicine and telemonitoring solutions:
reduce (to a measurable extent) hospitalisation of chronic heart failure patients
reduce (to a measurable extent) the use of healthcare resources (i.e. hospitalisations, emergency care, primary care visits) by diabetes patients, while ensuring optimal management of the condition ,
improve the quality of life and/or quality-adjusted life years (QALY) and/or disability adjusted life years (DALY), measured according to agreed international methodologies.
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