European Commission must invest in eHealth

Last week on ScienceOmega.com, Dr Paul De Raeve, Secretary General of the European Federation of Nurses Associations (EFN), presented a cluster analysis of results taken from a survey of European eHealth experiences. The survey, which was completed by both patients and healthcare professionals (HCPs), gauged opinions surrounding eHealth, and collected additional information such as whether or not respondents had experience with these technologies.

I interviewed Dr De Raeve to find out how he sees the future of eHealth within European healthcare systems…

How, in your opinion, can eHealth benefit Europe?
I think that we are coming into a new era of healthcare systems; an era of redesign. This, I believe, will happen whether we like it or not. In light of the austerity budgets that we have had since 2008, I think that we need to look again at how we do things, why we are doing them, and who they should be done by. We need modern tools for a modern healthcare sector, and I see eHealth as one such tool.

Take, for example, a diabetic patient who has been prescribed insulin for the past 20 years. Does that patient really need to have a face-to-face meeting with a GP, just to obtain a new prescription? I don’t think so. In this scenario, eHealth could assist both patients and HCPs. The patient gets ownership of his or her illness, and the HCP is able to allocate their time more effectively. Of course, such technologies must be based upon the foundation of good, face-to-face practices. If tomorrow, I have doubts about my prescription, of course I should visit my physician. It is merely a question of striking the right balance.

How did you compare the views of patients with those of HCPs?
Cluster analysis was a big help in allowing us to compare the two sets of respondents. If we had used standard statistical analyses, it would have been harder to achieve this result. If you and I complete a survey by grading our views, cluster analyses allow us to identify how similar we are. It is important for us to explore the differences and similarities between the opinions of providers and users. From a nursing perspective, it is good to openly discuss these matters, and from a patient’s perspective, this discourse is empowering.

Your findings suggested that those who had used eHealth tools – whether HCPs or patients – seemed to view the matter in a more positive light than those who had no experience of such technologies. Do you think that the public’s understanding of eHealth is adequate?
No, I do not. We need to do more to improve this situation, and this goes beyond ‘awareness raising’. At times, I dislike this turn of phrase, as it can imply putting a story in a newspaper and nothing more. For me, we need to move beyond this. It is important for HCPs to inform patients about eHealth and the advantages that it can offer. Industry also needs to become more involved. At present, companies are designing tools that are never adopted in practice, and we need to change this situation. Patients need to be consulted from the time that a device is conceived to the point at which it is brought to market.

Take for example patients with terminal cancer. The designers of eHealth technologies need to communicate with these people, and ask them what tools they really need. If it is not necessary for you to stay in hospital and you want to return home to ensure that the quality of your remaining life is of a high standard, how can technologies help you to do this? Sadly, there are many patients in this position, so why not consult them? In this way, patients themselves can play a crucial role in the development of new technologies. HCPs should also be considered. eHealth technologies should be user-friendly, not only in relation to patients but also in regard to medical professionals. If HCPs are seen to have confidence in eHealth tools, this is likely to be transferred to their patients.

If eHealth is to become an effective tool, what other things do we need to get right?
As I said, since 2008, budgets have been cut and that’s a reality. We need to start from this position and realise that governments are setting priorities within priorities within priorities. If I travelled to Athens right now and said, ‘Invest in this eHealth toolkit’, I would not be warmly received. This is the context in which we must work. As a result, I strongly believe that the European Commission should allocate its funds more effectively, to benefit the citizens of the European Union. There are €87bn of funds available to the Commission, so why not use them to help the healthcare sector? Why don’t we support HCPs and patients by investing in areas such as eHealth? I don’t need more research; I need action!

We know that this is possible. The evidence says that we can do it, but we need more support from the Information Society and Media Directorate-General, headed by Commissioner Neelie Kroes and Director-General Robert Madelin. Policymakers, industry, HCPs and patients are all in the same boat. We all need to take responsibility for our healthcare sector.

From 2014 to 2020, the Commission will have a budget of €87bn available for social and cohesive purposes. Currently, only three per cent is being spent on the healthcare sector. Only three per cent! The rest goes towards beautiful buildings, bridges and many other things, but not to health. HCPs and patients need more of this money, and we also need to help industry advance related technologies. We need to ensure that we make the most of the limited resources that we have, and we need to achieve the best possible outcomes. If we can increase the current allocation of three per cent to an investment of 9 per cent by 2015, I will be a happy man.