The EU and e-health: a European disease
By Philip Ebels
Healthcare, strictly speaking, is none of the EU's business. It is a sensitive issue that member states have largely preferred to keep in their own hands. They have allowed the EU to do little more than "support, co-ordinate, or supplement."
It is only when healthcare enters the realm of, say, competition or fundamental rights, that the European Commission is allowed to draft legislation - like on the harmonisation of medical devices, or more recently, patients' rights in cross-border healthcare.
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On e-health, therefore, much of the Brussels oeuvre consists of communications, recommendations, action plans, conferences and the odd pilot project.
It is one of the reasons why the adoption of e-health across the continent has been slow.
Already in 2004, when e-health was first put on the European agenda by way of a six-year action plan, the EU envisaged "a seamless exchange of health information across Europe." Eight years later, that remains little more than a pipedream.
In fact, much of the action plan does. "Nearly all actions of importance were delayed and some have not been fulfilled at all," according to the commission's assessment report, published in August 2011, which describes the plan as "naive."
"Increasingly, the EU is realising the complexity of the issue," says Joerg Artmann of research company Empirica, who have conducted several studies on e-health for the European Commission. "The real obstacle is never the technology. It is the different legal systems."
This was the case with today’s most prominent pilot project, epSOS, which is to lay the groundwork for a union-wide system of easily exchangeable patient data by 2015.
"It is the apogee of years and years of discussion and rewriting," says Artmann. "It is a kind of laboratory test to understand why things take so long. It is unbelievably hard."
The European Commission is not letting itself be put off too easily, however.
It believes e-health will not only help solve the problem of having to provide more healthcare with less money, when half of Europeans are old, but also boost the economy.
Together with the EU presidency, it continues to organise its annual e-health week - the next will take place in Copenhagen from 7 to 9 May - when national health ministers traditionally declare their support to the deployment of e-health across the continent.
It made e-health part of its Digital Agenda, a plan to digitise the European economy by 2020, and aims to give citizens online access to their medical data by 2015 and to achieve the widespread use of telemedicine services by 2020.
In 2008, it identified the e-health industry as one of six so-called Lead Market Initiatives, markets that are believed to be innovative and enjoy particular attention from the EU's harmonising efforts.
More recently, the European Commission convened both an e-health network and an e-health task force of national authorities and experts in the field respectively, to consult on the way forward and to provide input for, yes, a new action plan, to be presented after the summer this year.