eHealth – where are we now?

What is eHealth?

eHealth, also known in many contexts as digital health, involves a broad group of activities that use electronic means to deliver health-related information, resources and services: it is the use of information and communication technologies for health. eHealth covers the use of technology in strengthening health systems and health information systems and includes areas such as electronic health records and interoperability of data; mobile health or mHealth; telehealth, where a patient can consult with a health-care worker using Skype or even a simple telephone; wearable technologies (fitness trackers, medical devices, etc.); and technologies to support integrated care. These technologies are already being actively used in Europe today. eHealth also addresses social media in health, health analytics and the domain of big data, which is on the agenda for the 66th session of the WHO Regional Committee for Europe.

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What are the top eHealth priorities for the WHO European Region?

Working under the umbrella of the European Health Information Initiative (EHII), key priorities for eHealth in the Region are:

  • strengthening national eHealth and health information systems in Member States to enable effective health systems reform and achieve the Health 2020 policy goals;
  • supporting Member States in their adoption of eHealth as a tool to achieve universal health coverage and the health-related Sustainable Development Goals;
  • guiding Member States in their investment and use of technology to underpin the development of evidence-informed health policy;
  • leveraging the use of technology to empower individuals in making informed decisions about their own health and well-being.

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Why was WHO/Europe’s participation in eHealth Week 2017 so important?

eHealth Week was a unique opportunity to demonstrate that eHealth is important to the development of international public health. This year’s theme, “Data for health: the key to personalized sustainable care”, provided an opportunity to shine a spotlight on the main health information issues that countries face when reforming their health systems. It brought into focus how eHealth empowers the individual at the centre of their own health and well-being – facilitated by health information. It was also a chance to look at the role of technology in developing integrated models of prevention and care. Lastly, eHealth Week gave us an opportunity to build and strengthen relationships with key international partners working in the field of eHealth in the Region, with the aim of developing a united regional agenda for eHealth. This will be an important factor in advancing the adoption of eHealth across the 53 Member States of the Region.

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What action is WHO/Europe taking to support eHealth in the Region?

Partnerships that offer active collaboration and coordination are key. WHO/Europe is continuing open and active relationships with partners such as the European Commission, the Organisation for Economic Co-operation and Development (OECD) and the World Bank. Together we can develop and promote eHealth, with the aim of providing harmonized support to Member States. We are engaging with Member States via the EHII to strengthen their capacity to utilize eHealth as a strategic asset in reforming national health information landscapes. Also under the umbrella of the EHII, we are continuing to support international development of eHealth standards and frameworks for data exchange and interoperability. Finally, WHO/Europe’s eHealth and Innovation Unit is actively seeking cross-divisional collaborations to demonstrate and strengthen the role of eHealth in many different areas of health including mental health, health technologies, health systems, and women and children’s health – but this is only the beginning.

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What has WHO/Europe achieved so far?

The 2016 report “From innovation to implementation – eHealth in the WHO European Region” was a major success and revealed for the first time that eHealth is becoming a strategic asset for health policy-makers. In particular, eHealth is being used systematically to strengthen health systems performance and increase capacity for countries to gather and analyse health information.

WHO/Europe is committed to the development and support of mHealth through the WHO-led Be He@lthy, Be Mobile global initiative on noncommunicable diseases. This initiative takes a systemic approach to mHealth by helping governments build their capacity for running large-scale health programmes based on the success of current mHealth services. Practically speaking it takes current initiatives in mHealth (e.g. apps to promote heathier lifestyles) and scales them up to the national level.

In another landmark achievement, this year WHO, the International Telecommunication Union (ITU) and the European Commission signed an agreement for the establishment of an mHealth knowledge and innovation hub in Europe, to foster collaboration between research and other stakeholders. We expect this to provide a reliable, industry-independent source of advice and support to countries on the many technical and strategic aspects involved in developing national mHealth programmes.

Through the work of the mHealth knowledge and innovation hub and support to existing mHealth guidelines in Europe, the aim is to bring innovative products and services to the public and improve strategy and policy-making regarding mHealth.

Other major milestones include adopting the Regional Committee resolution to “strengthen the use of evidence, information and research for policy-making in the WHO European Region” and the resolution to “strengthen people-centred health systems in the WHO European Region (framework for action on integrated health services delivery)”. The resolutions set the international agenda for eHealth and are providing a basis for future development of the field.

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How is WHO/Europe using eHealth to address health inequalities in the Region?

WHO/Europe addresses health inequalities through the EHII, which works with 33 partners, mostly Member States, to harmonize methods and tools, to build and sustain expert networks, and contribute to capacity-building in public health – ensuring that health policy is informed by high-quality, complete and accessible health information.

WHO/Europe also views eHealth from the perspective of Health 2020 and universal health coverage, providing strategic guidance to achieving intersectoral whole-of-government and whole-of-society approaches for addressing health inequalities and improving health. It is important that the implementation of eHealth is viewed in this context.

National eHealth programmes tackle health inequalities by strengthening patient-centred health systems and improving public health capacity. It is crucial that Member States systematically measure and address digital and health literacy among both health professionals and the public, to ensure eHealth services are successfully adopted and that health inequalities are reduced with the digitization of services.

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How are countries using mHealth solutions to support patient-centred care?

As technologies and mobile infrastructures mature, an increasing use of mHealth is being observed in patient monitoring, decision support in health-care settings, integrated care, educating and empowering patients in their own self-care, and raising awareness on key public health issues.

mHealth offers the ability to actively engage individuals in health care in ways that have previously not been possible, and participation extends beyond “just” consumption of health-care services. In various ways, individuals are valuable contributors to data regarding disease and public health concerns. For patients this means that their usage of services is analysed, deepening our understanding of needs and practice. This information can then be used to make improvements to the provision of health care.

Results from the 2016 WHO report on eHealth in the European Region show that many individuals use their mobile devices to access health information and health-care services:

  • 70% of Member States (32 countries) are using mHealth for patient monitoring and this is a key growth area across the Region;
  • 74% of Member States (34 countries) have programmes for mobile telemedicine or telehealth;
  • 61% of Member States (28 countries) offer medication adherence services though mobile technologies.

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What is the WHO position on patient-centric health care enabled by eHealth?

WHO recognizes the central role of the individuals making decisions affecting their own health and well-being, in partnership with health-care workers. The transition to patient-centred care models is evident in many Member States in the Region. Investing in patient-centred models of prevention and treatment, enabled by eHealth, offers opportunities to affordably improve health and provide greater patient satisfaction. This is an area that we expect to receive much attention in the future.

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What does WHO/Europe recommend on using big data in health-care service delivery?

For countries to effectively utilize big data, they need to place a specific focus on addressing the associated health information issues. They must also have a clear understanding of how big data will integrate with the national health information system and complement existing mechanisms for routine reporting. WHO/Europe recommends that Member States create and implement policies to regulate the use of big data in the public and private sectors. Through leadership and collaboration, data governance should be addressed at national levels, including privacy and data protection. Member States need to increase education and training for staff working in public health and health care on how to use big data and health analytics. Lastly, sustainable funding of health research and development is badly needed in the area of big data.

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Does WHO/Europe see eHealth as the solution to the Region’s health problems?

eHealth has undoubtedly become one of the most important strategic assets supporting the delivery of health care and facilitating effective health information exchange. Its value, when effectively implemented and managed, cannot be underestimated. eHealth is key to ensuring that health information and evidence is used by policy-makers. It is an important tool for countries to use, as we collectively work towards the goal of achieving better health and well-being. That is, and will always be, the goal and together we need to address many social, financial, cultural and technical aspects in order to achieve this.

As the role of eHealth is evolving, it continues to challenge our understanding of traditional processes and skill sets in clinical settings and the application of local and global evidence in developing health policy and effective public health action, while building on the good practice of the past. We are pleased to see Member States adopting eHealth both within and across their borders and will continue to support countries as they adapt to these changes.

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