On 21 June, Dr Antonyia Parvanova MEP hosted a roundtable entitled 'Ehealth at the heart of patient safety, efficiency and clinical governance: how innovation can benefit healthcare systems' jointly organised by ACCA (the Association of Chartered Certified Accountants) and Hanover, at the European Parliament in Brussels.
The main conclusions of the roundtable indicate that eHealth has a rich and wide-ranging potential but its implementation still faces obstacles, including a lack of compatibility between eHealth systems. More legal clarity, political will and dissemination of best practices are urgently needed.
This event, which brought together more than 60 European and national experts, helped to feed into the current second eHealth action plan debate and to contribute to the dissemination of much needed best practices and the large-scale deployment of eHealth solutions.
The speakers included:
- Andrzej Rys, Director Health systems and products, DG SANCO, presenting the view of the SANCO Directorate of the European Commission in a key note speech.
- Mark Millar, Chief Executive, Milton Keynes NHS Foundation Trust and ACCA council member, who presented the ACCA study Collaboration and communication technology at the heart of good clinical governance.
- Debbie Guy, Lead Nurse H@N, Nottingham University Hospitals NHS Trust, who gave the point of view of medical professionals working with ICT applied to patient safety.
- Francesco Bortolan, responsible for the ICT services for the Department of Health of the Veneto Region – Italy, who presented a case study on 'the Veneto ehealth experience: a platform for integrated care'.
- Nicola Bedlington, Secretary General of the EU Patients Forum, charring the point of view and positions of patients.
- Paul Timmers, Director ICT addressing societal challenges, DG INFSO, presenting the INFSO Directorate of the European Commission’s views on ehealth and the work of the Commission.
- Petra Wilson, member of the European Governing Council, HIMSS, who presented the point of view of healthcare managers.
Dr Parvanova explained: 'The second eHealth action plan is now being prepared by the European Commission services. In that context, today’s event should help increase awareness of the benefits and opportunities of eHealth, which were very well illustrated by both case studies presented. Concrete work and initiatives already existing in the field of eHealth are needed to bring an evidence-based dynamic for the development of eHealth at EU and national level. We should now continue working with all stakeholders on delivering concrete measures and action, with one final objective: the provision of safe, efficient and high-quality care for the benefit of both patients and health professionals.'
Main highlights of the discussions
The debate started with a key note address by Andrzej Rys, Director for Health systems and products at DG SANCO who indicated that eHealth is a priority to help provide high quality and cost-effective healthcare to more people over Europe. He presented the new eHealth Network that will help ensure patient safety and continuity of care across Europe. Co-operation is the key element for a successful eHealth application and the European Commission has, in this spirit, launched the European Innovation Partnership on Active and Healthy Ageing. He was echoed by Paul Timmers, Director of ICT addressing societal challenges at DG INFSO during his presentation.
It was followed by a case studies session which clearly showed how technology can limit hospital stays for patients, and when a hospital stay is necessary, to make it the least constraining and distressing as possible.
The first case study was based on a new study on patient safety, efficiency and clinical governance produced by ACCA in collaboration with the European Commission in May 2011.
Mark Millar, Chief Executive of the Milton Keynes NHS Foundation Trust and ACCA council member and Debbie Guy, Lead Nurse H@N (Hospital at Night) at the Nottingham University Hospitals NHS Trust presented the results of the study, which describes the benefits of ICT to support improved delivery of clinical service outside core working hours at Nottingham University Hospitals NHS Trust.
The Nervecentre software with Cisco medical grade network offers both clinical benefits, in improving patient safety and quality of stay, clinical governance, data handover quality and security, as well as financial benefits as it frees up staff time, helps allocate resource utilization and reduce the length of stay.
Using MAST methodology, the ACCA study has shown that the introduction of collaborative technology at Nottingham University Hospitals NHS Trust has enabled significant improvements to be made to the operation and management of out of hours services. Senior nurses, who previously spent most of their time on administration, now spend the majority of their shift on the ward providing direct clinical care to patients. Over the year, this equates to an additional €412,000 or 8,000 hours reinvestment in service delivery. The workforce management solution also identified opportunities for the better utilization of resources which has resulted in annual cost savings of €133,000. Further savings of €401,000 are expected from improved discharge procedures which will result in reduced length of stays . The study gives evidence base of real financial return on investment. The concept of dark green money - cash benefits, as opposed to light green - cash releasing opportunities - underlined the huge benefits health IT can bring in quality and safety as well as in pure financial benefit.
Francesco Bortolan responsible for the ICT services for the Department of Health of the Veneto region presented a case study on 'The Veneto eHealth experience: a platform for integrated care', through two ambitious projects: Health Optimum and the DOGE project.
The first project is a telemedicine project aimed to support different specialties (Telelaboratory; telecounselling service for neurosurgeons). The second is a regional project to develop a network of services to share clinical data and documents between different players of the care process (Local Health Authorities, General Practioners, and Paediatricians).The Veneto study in highlighting Health Optimum has shown how relatively simple technology can greatly improve the care of in Stroke Management and Oral Anticoagulation Therapy (OAT).
It showed that in terms of technology many of the problems have been solved - what is needed is the right organizational framework to make the most of telemedicine to allow patients to be treated at home and on the move.
Broader discussions were also held during a lively panel debate led by Dr Parvanova and featuring Nicola Bedlington, Director of the European Patients Forum; Paul Timmers, Director ICT addressing societal challenges; DG INFSO; and Petra Wilson, member of the European Governing Council, HIMSS.
Exploring the policy options towards more innovative solutions and more efficient healthcare systems, they settled on some key elements:
- People focus: a panelist made it clear that eHealth solutions can only work if they are people-focused. It was also said that patients should be at the heart of the policy-making: patient involvement is a core element of good eHealth policy implementation. For patients to be involved, they need to be informed and some speakers called for a EU-wide strategy on health literacy and information to patients.
- Simplicity: speakers mentioned that in order to enable eHealth innovation, simplicity is the key element. It was argued that there is no point developing eHealth tools that doctors cannot use and which do not help them in their work. Simple tools should be the main focus of innovation, thus allowing broader use of eHealth policies.
- Barriers to eHealth: The potential of eHealth, if properly harnessed, is rich and wide-ranging but its implementation faces some obstacles, including a lack of compatibility between eHealth systems. eHealth innovation will help address challenges facing Europe’s healthcare systems such as demographics, sustainability, and increased demand for quality and access.
- We need more policy coherence, legal clarity and political will to accelerate efforts to create e-health solutions and inter-operability of technologies and systems across EU countries.
- A change of the mind set is also essential for a broader eHealth use, as well as a change in work practices.
- Increasing awareness: increasing awareness on the benefits and opportunities of eHealth is the first step towards its good application. The two case studies (Nottingham University Hospital and the Veneto Region) are concrete examples of what can be done, and it should be replicated. There is a clear need for the dissemination of best and good practices and initiatives such as the ones carried out by the Nottingham University Hospital and in the Veneto Region.
- EU target:The results of the case studies show that, if used well, eHealth can add significantly to the EU stated target of adding two healthy years to every citizen’s life.
- The speakers all agreed that the European Commission should work closely with the European Parliament and all the stakeholders to address these obstacles and to meet the ambitious targets of the Digital Agenda and in particular of the European Innovation Partnership on Active and Healthy Ageing. Collaboration between both public and private sectors, as well as with the health professionals, the patients and the technology assessment bodies is essential for patient safety, continuity of care across Europe, and for an improved healthcare system.