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23rd Jul 2019

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Putting the 'e' in e-health

  • Old-fashioned scalpels. 'It is only matter of time before we drop the 'e' in e-health' (Photo: zpeckler)

The 'e' for electronic has become a familiar sight in front of words like mail, book, or commerce, but health has long been spared the token affix of the digital age. Until recently that is. Now e-health has arrived and, say some, is set to revolutionise traditional healthcare.

Unlike its fellow affixees, e-health is rather difficult to define. It refers not to a thing or a single practice, but to a series of trends in healthcare that owe their existence to the emergence of new communication technologies, in particular the Internet.

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One is telemedicine - the provision of clinical healthcare from a distance.

It existed long before the arrival of the Internet. Psychiatry could be practised over the telephone, for example. But it is only recently that patients are able to make video calls and get a live diagnosis of, say, a sore spot on their skin, or test their own glucose level and send the results off for analysis.

Another trend is the emergence of the mobile phone as a medical device. There is a rapidly growing market for medical apps, designed both for patients and doctors.

There are those that track your exercise and the amount of calories you burn, tell you what to do when your kid gets hurt, or monitor your vital signs, from your sleep cycle to your heart rate, turning your iPhone into an electrocardiographic (ECG) machine.

Doctors are also making increasing use of them. There are apps to calculate complex medical formulas, give access to pharmaceutical encyclopedias, or display scans in such a way that allows phones to be used as a diagnostic instrument.

Then there is the emergence of the e-patient movement. The e-patient, instead of passively undergoing generic medical treatment, actively records their own health data - from blood pressure to DNA sequence - and educates themselves to be able to make their own choices. Individuals are becoming consumers of healthcare, rather than patients, and the doctor is the consultant.

And, finally, there is the trend towards making a person's medical data more easily available both to the individual and to different health care institutions across the continent or even the globe.

Ideally, the e-patient would argue, there would be a global cloud of electronic health records so that, for example, if you break your leg while skiing in France, the local practitioner would be able to see that you have broken it before and download the X-rays that were made at the time.

The European disease

Yet for all its benefits, e-health in Europe has remained more talked about than practised. According to a 2011 study conducted for the European Commission, only eight percent of European hospitals monitor patients at home.

“There needs to be a shift in education,” says Birgit Beger, secretary general of the Standing Committee of European Doctors. “Not only on the side of the doctors. Patients also need to learn to trust these new technologies.”

But, she says, e-health is the future. “It is only a matter of time before doctors in Europe start adopting these technologies. But first, e-health has to prove itself. Doctors will only adopt it if it has proven to be better than traditional practice.”

The availability of patients’ data, according to the same study, is also patchy. Only five percent of European hospitals have some form of electronic data exchange with counterparts abroad, and only four percent grant patients online access to their electronic health records.

To blame, in part, is Europe’s diversity. The EU has little say in the field of healthcare and its member-states all use different data systems. Even within member-states, big differences can occur. “Sometimes even within cities, or even within hospitals,” says Beger.

On top of this, not everybody is as comfortable as our imaginary e-patient with the online storage of personal health dossiers. There have been security breaches before. “Data in the hands of government is not always more secure than in the hands of companies,” says Sophie in ‘t Veld, Dutch liberal MEP and parliament’s most ardent privacy defender. “On the contrary, it is often less secure.”

Evolution, revolution

But still there seems little doubt that e-health is going to change the face of healthcare, in Europe as everywhere else.

Some, like American cardiologist and author of a new book on the future of healthcare Eric Topol, say it is “a revolution waiting to happen”. Others, like Birgit Beger, say it will be more like a rapid evolution. “In the end, it will be the same human body,” she says.

The e-health industry is young, but growing fast. Ten years ago, it was “microscopic”, says Anna Lefevre Skjoldebrand, chair of the Eucomed eHealth Task Force and member of the board of Eucomed, the Brussels lobby for the medical technology industry. But over the last two years particularly, “it has exploded."

Today, according to Eucomed, e-health is the third largest industry in healthcare, after pharmaceuticals and medical devices.

And tomorrow, says Lefevre Skjoldebrand, we might not even call it e-health anymore. “It is only matter of time before we drop the 'e' in e-health.”

Trust remains key barrier to eHealth

In the not-too-distant future, you may be able to access your own medical records, make an appointment with your doctor, re-order a prescription or receive actual care all electronically. But eHealth raises almost as many questions as it does answers. Read more in the EUobserver April FOCUS on Digital Agenda

Power to the patient

Doctors, it is said, are not what can be called early adopters of new technologies. Any healthcare revolution, then, will have to come through patients. Or rather, consumers, because patients of the 21st century make their own decisions.

E-health business is good business

The e-health industry is growing fast. Ten years ago, it was "microscopic". But over the last couple of years, it has "exploded". Today, it is the third largest industry in healthcare.

The EU and e-health: a European disease

Healthcare, strictly speaking, is none of the EU’s business. On e-health, therefore, much of the Brussels oeuvre consists of communications, recommendations, action plans, conferences and the odd pilot project. But even that seems too ambitious.

E-health

E-health is already the third largest sector in the healthcare industry after pharmaceuticals and medical devices. With new technology fundamentally changing doctor-patient relations and posing new questions on privacy, EUobserver explores the issues.

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