The Prague Declaration has been prepared in cooperation with the EU Member States and commented within the i2010 Subgroup on eHealth. As the conference is not intended for the EU Member States only, the Czech Presidency has offered to the other countries participating in the conference the possibility to adopt this Declaration.
The benefits of eHealth for a safer and more efficient health sector have long been recognized by expert stakeholders. Since 2003, a series of annual eHealth high level conferences have assessed the progress of the Member States on the way to effective and patient-friendly health services based on the application of latest information technologies. A number of recent eHealth initiatives from the Member States and the European Commission have been providing additional support to launching new projects for better and more effective health services. These initiatives stress the need to keep the momentum so that the potential advantages of gradual deployment of ICT in the health sector are not compromised by barriers of legal, technical, economic or any other nature.
We consider it crucial that the benefits of eHealth applications and services are further enhanced and properly distributed among all the relevant stakeholders:
- eHealth for individuals (patients and healthcare professionals alike)
For individuals, eHealth brings new possibilities in terms of increasing quality and effectiveness of services. eHealth provides new tools to take care of patients with chronic diseases. Within the European context, it can facilitate implementation of cross-border healthcare and contribute to the continuity of care.
For society, eHealth represents a challenge for interoperability, e-literacy, and accessibility of new technologies. It also presents great opportunities for research and development. The Lead Market Initiative earmarked eHealth sector as one of the strategic areas with high growth and innovation potential.
eHealth offers solutions that can bring enormous savings. If properly deployed, eHealth could contribute to the transformation of the health sector and change substantially business models of healthcare facilities. These issues are gaining in importance in current economic climate putting increased pressure for delivery and cost efficiency in all sectors of the economy, the health sector being no exception.
Although significant progress has been achieved since the last eHealth conference, today we have decided to move further and address those areas which are important for the full utilization of eHealth potential. Member States are therefore encouraged to take concerted action on telemedicine, interoperability and European cooperation including exchange of best practices.
- Moving forward on telemedicine deployment
The Commission's Communication on telemedicine(1) from November 2008 outlines the areas for improvement and presents an action plan aimed at full exploitation of the opportunities offered by telemedicine. Building the confidence of patients as well as that of health professionals in telemedicine services, bringing legal clarity and solving technical issues, as well as facilitating market development are identified as the main challenges. A clear commitment within Member States to handle above-mentioned items will secure that the market of telemedicine applications is less fragmented and not limited to one-off and small-scale projects.
- Interoperability and development of common standards
The rapid acceptance and take-off of eHealth depends to a large extent on a common set of standards for electronic health records, patient summaries, emergency data and other services. The lack of interoperability has been identified as one of the main areas to address, as already laid out in the existing EU action plan on eHealth. While several initiatives fostering the adoption of standards are making progress(2), an agreement on a consistent set of EU-level harmonized standards is lacking. The main objective of these initiatives is to facilitate access to health care to all EU citizens wherever they happen to work or travel(3). Key elements to achieve interoperability are associated with ontological and semantic standards as well as technological standards. The implementation of the eHealth Interoperability Standards Mandate M403 is an initiative that should be widely supported for enabling interoperability of eHealth systems and services in Europe.
- European cooperation and exchange of best practices
The annual eHealth high-level conferences bring a unique opportunity to exchange best eHealth practices between EU Member States. A benchmarking study on ICT use among European general practitioners(4), released last year, revealed a large gap between Member States and between readiness and actual use of eHealth. While most health professionals are now routinely using ICT, there is substantial scope for improvement in what concerns the interconnection of the electronic networks of different health actors. The electronic exchange of patient data and the ICT-supported interactions between health professionals and with patients also require additional developments before becoming established, working routines.
What next? Special attention to be paid to three areas
While many initiatives are ongoing, we have for the immediate future identified three areas to which special attention should be paid in order to facilitate the development, implementation and usage of new eHealth services and solutions.
- Fulfilling existing strategic goals and setting new ones
EU Member States declare their intent to fulfil the goals set out in the i2010 initiative, eHealth action plan and specific national strategies to promote eHealth in the European Union. In relation to the drafting of new initiatives we consider it necessary that eHealth issues are given relevant space. The above-mentioned Commission communication on telemedicine urged Member States to assess their needs and priorities in telemedicine by the end of this year. Any new national eHealth strategies which result may be presented at next year’s conference.
- Patient safety and empowerment
The introduction of new ICT in the health sector has a positive effect on patient safety and quality of care. Member States are encouraged to strengthen the involvement of patients via communicating targeted patient safety policies and solving legal and ethical issues. The data protection and privacy issues also require special attention since they have a significant impact on eHealth uptake. It is therefore important to seek a common approach to optimize existing directives on data protection and privacy.
- Governance structure for eHealth
The eHealth sector has now reached a level of maturity that requires consideration to be given to the most appropriate arrangements for Europe-wide governance. All Member and partner European states are invited to take part in discussions on the options for new arrangements. These discussions are determined by the need to achieve interoperability and speed-up deployment so that patient safety and continuity of care can be ensured within the Member States as well as at the cross-border level.
Call for action on building an eHealth area for European citizens
The Member States and the European Commission endeavour to facilitate the building of a European eHealth area which will enable access to healthcare for all citizens. For this purpose continued efforts are needed, particularly in the areas of telemedicine services deployment, interoperability as well as Europe-wide cooperation and exchange of best practices. Member States are encouraged to adapt their national eHealth strategies so that the individuals (patients and healthcare professionals), society and economy are all the beneficiaries of eHealth’s positive effects. The Member States are also urged to participate in discussions about a Europe-wide governance structure for eHealth that will give additional impetus to the introduction of new services and removing existing obstacles.
1. COM(2008) 689: Telemedicine for the benefit of patients, healthcare systems and society
2. For example the recent Commission's communication on cross-border interoperability of electronic health record systems: COM (2008) 3282 or epSOS (Smart Open Service for European Patients) project.
3. Work is also under way as regards the Directive on application of patients' rights in cross-border healthcare.
4. Benchmarking ICT use among General Practitioners in Europe, final report, April 2008 (by empirica in association with Ipsos)
For further information:
ICT for Health
European Commission - Information society and Media DG
Office: BU31 06/73 B-1049 Brussels
Tel: +32 2 296 41 94
Fax: +32 2 296 01 81