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Policy recommendations for wider implementation of
telemedicine
Peeter Ross, MD, PhD
e-Health expert, Estonian eHealth Foundation, Estonia
Content
• Overview of current situation in the implementation of telemedicine services
• eHealth Task Force report Redesigning Health in Europe for 2020
• Policy recommendations for deployment of telemedicine services
The project consortium
• Region of Southern Denmark• Auvergne, France• Catalonia, Spain• Estonia• Malopolska, Poland• Norrbotten, Sweden • North Norway• Scotland, UK • Veneto, Italy
New technologies and e-services in healthcare
• Healthcare is lacking behind of other service industries at least 10 years
• Healthcare organisation usually is not adopting the free market rules what would promote the use of innovation and disruptive technologies
• Implementation of e-health services depends in large extent on political decisions.
• Decisions must be in solid basis
Main goal of policy recommendations
• To improve • Patient care
• Safety• Quality
• Healthcare system efficiency • Market development for regional
SMEs
Difficulties to put telemedicine services into routine operation
• The reasons are complex• Clinical, economical, organizational,
technological, legal and safety requirements
• Political issues are on different levels• European• National• Regional and • Local
Political levels (1)
• In EU the healthcare decisions are made according to the principle of subsidiarity
• Policies concerning provision of healthcare services should always be made at the lowest possible level
• EU level • Legislative documents• Recommendations with no legal
power
Political levels (2)
• Most recent documents• eHealth Task Force report –
Redesigning Health in Europe for 2020• Europe 2020 Strategy• Digital Agenda for Europe• EC Communication on Telemedicine for
the Benefit of Patient, Healthcare Systems and Society.
• EU Directives that have direct influence on telemedicine services
Political levels (3)
• Policy recommendations on national, regional and local level coincide in many aspects
• In not yet mature and diverse European telemedicine market the differentiation between levels is not reasonable because of variabilities between Member States healthcare administrative structures
eHealth Task Force Report.Redesigning health in Europe for
2020
Redesigning health in Europe for 2020 – recommendation 1
• A new legal basis for health data in Europe • Create a legal framework and space
to manage the explosion of health data
• Create the conditions for the integration of user-generated data with official medical data so that care can be more integrated, personalised and useful for patients
Redesigning health in Europe for 2020 – recommendation 2
• Create a 'beacon group' of Member States and regions committed to open data and eHealth• EU facilitates this by creating the central
space for national initiatives to flourish and be shared.
• Successful models developed in different regions or countries can be disseminated
• A leadership group from regions and countries that have invested in eHealth applications could be pioneers
Redesigning health in Europe for 2020 – recommendation 3
• Support health literacy• Health literacy efforts should begin in
school• Indeed, citizens can only exercise
control over their own data – and subsequently use the data – if it is both in an understandable language and format with user friendly interfaces
Redesigning health in Europe for 2020 – recommendation 4
• Use the power of data• Health institutions must publish the data on
their performance and health outcomes. This information should be regularly collected, comparable and publicly available
• This will support a drive to the top as high performing organisations and individuals can be identified and used as an example to inspire change
• In health, performance is not just how efficiently the system operates but also the patient experience of the care
Redesigning health in Europe for 2020 – recommendation 5
• Re-orient EU funding and policies• The majority of public funding at EU and
national level allocated to eHealth has been invested in centralised, large-scale, top-down solutions
• These have failed to address and integrate the user experience sufficiently
• The next phase should see investment in tools that citizens can use to support their wellbeing and manage their lives
Regional Telemedicine Forum Policy recommendations.
Regional Telemedicine Forum Policy recommendations.
• Presents the identified policy recommendations, developed by each RTF partner
• Includes a brief description of the meaning of the policy
• Reports a case description, referred to the related policy
• An example of how the policy was successfully applied by one of the RTF partner and which results are obtained
Regional Telemedicine Forum Policy recommendations.
• Limitations• RTF partnership decided to suggest
policy recommendations which are each based on a concrete case of problems for the wider implementation of telemedicine services.
• This can limit the problematics and the field of application
• Still important beginning to face the problem and to overcome existing barriers.
Policy recommendations.Economic area
• New reimbursement models• Integration of evidence based
documentation throughout the decision-making
• Development of evidence, including clinical, organizational and economical aspect and quality of service
Policy recommendations.Information technology
• Development and implementation of an infrastructure for electronic health data sharing
• Use of ICT based on international standards to create interoperable systems
Policy recommendations.Political area. Educational area
• Political area• Create political leadership, including
better guidance on what the politicians need to decide on
• Educational area• Postgraduate education • Integrate training of usage of
telemedicine services in academic area• Improve patient empowerment by
training patient and caregivers
Policy recommendations.Organisation. Legal
• Organisation• Apply a multidisciplinary approach to
development of services, including sufficient involvement of clinical expert
• To link the clinical and economical levels throughout the development of telemedicine
• Legal• Early clarification on legal matters throughout
the service development
Conclusion
• Successful implementation of telemedicine demands• Actions at regional level by addressing the main
beneficiaries and barriers• Exchange of good practises • Evidence of successful telemedicine to build
trust and acceptance• Make of use of solutions offered by information
technology
