BLOG: Data creators to data innovators
As basic healthcare IT infrastructure is almost established across Europe, there is a growth opportunity for solutions that will enable providers to derive meaningful insights from the data being aggregated by electronic health record (EHR) and hospital information systems (HIS). Healthcare IT solutions that augment basic infrastructure such as clinical decision support tools, applications for data sharing, integration, privacy and security, healthcare business intelligence, and big data analytics will see a boost in growth in the coming years.
Technology trends influencing the European healthcare market
All major countries in the European Union (EU) have a digital health plan in varying stages of maturity as part of the EU eHealth action plan as well as national initiatives. The time has come for healthcare IT to elevate from data collection and storage to data integration, sharing and analysis across solutions and care delivery mechanisms, and latest technology developments will have a key role in achieving this.
1. Artificial intelligence and machine learning enables clinical decision support
Europe is becoming a hotbed for AI innovations in healthcare especially with proven benefits for clinical decision making especially as a diagnostic tool. For example, AI will play a big role in diagnostic imaging by complementing radiologists with advanced interpretation and imaging informatics supports. There are several partnerships centred on AI and machine learning in the Europe such as Google DeepMind and IBM Watson with NHS England for digitisation of care. Furthermore, Europe is also home to several companies focusing on AI such the German Research Center for Artificial Intelligence (DFKI), which is the largest research centre in the field of artificial intelligence and has several projects in eHealth and wellbeing.
2. Blockchain for healthcare information management
Blockchain is hailed as a key technology that has capabilities to transform how healthcare information is stored, shared, secured, and paid for, and given the right use cases it has the potential to effectively address the key challenges in healthcare information management. In Europe, there are very few examples of how blockchain is being used in healthcare in large deployments, however, the Estonian healthcare system is a front runner in using blockchain for healthcare data security. EHealth authority of Estonia together with Guardtime integrates the latter’s keyless signature infrastructure (KSI) blockchain into the Oracle database of its EHR to provide data security to 1.3 million healthcare records of its citizens.
3. Big data analytics and Internet of Things (IoT) for strategic insights
Healthcare systems across Europe deal with large amounts of data with IoT enabled connectivity, and big data analytics will have a key role to play to generate value from the information that is being aggregated. Several pan-EU pilot projects on big data were initiated recognising its potential to create savings up to 2% of GDP across health systems in the EU. Some of the projects include BIG - Big Data Public Private Forum since 2012 to the more recent proposal for developing a European wide connected Electronic Health Records Organisation (EHRO) for using patients’ health data across member states to improve outcomes. There are also examples of providers partnering with big data companies such as in the case of Alder Hey Children’s Hospital’s partnership with IBM Watson to create UK’s first cognitive hospital. This project is part of the big data research collaboration between IBM and STFC Hartree with an overall budget of £315m (approx. €357m), 65% of which has been contributed by IBM and the rest is funded by the government.
4. Telehealth for managing ageing population and chronic diseases
OECD estimates indicates that on an average 34.1% of the population in EU-28 countries suffer from a long-standing illness or health problem and this is higher in EU-5 countries, especially in the elderly population over 64 years of age. Benefits of telehealth to address the healthcare needs of ageing and diseased population have been demonstrated with successful pilot projects such as the Renewing Health project which was the largest randomised controlled trial study in telemedicine in Europe. However, the uptake of telehealth in Europe is relatively low as there is a need for scalable business models. Proven use cases for integrating telemedicine into care pathways as recommended by the United4Health is based on its care delivery models from 14 regions in Europe and provides guidelines for mass deployment of telehealth. Furthermore, establishment of interoperability framework based on international standards will be a key driver for telehealth in Europe in coming years.
5. Incentive-based population health management gains popularity
Preventive care models for outcome-based care with specific focus on elderly care and chronic disease management is expected to result in significant cost savings. There is increasing focus on chronic disease management programmes for PHM and this is leading to integration of health, care and support services. For instance, Germany leads the way in Europe with 9,966 disease management programmes (DMP) for six chronic diseases and caters for 8% of the insured population. Success of DMP in Germany can be attributed to the financial incentive, not only to the German statutory health insurance system (SHI), but also to the physician. Effective PHM requires buy-in and commitment from all the key stakeholders including providers and payers, and there are several examples where participation of insurers is encouraged in digital health programmes to share the costs; for instance, Techniker Krankenkasse (TK), a leading SHI provider has a pilot project for reimbursement of video consultations by practitioners.
6. Pharmaceutical companies use digital channels for patient engagement
The pharmaceutical industry is going through a major transformation phase with a beyond the pill strategy where the company is also investing in consumer-centric technologies to justify the incremental value of new therapies. For instance, Roche acquired mySugr, a mobile diabetes management platform and Novo Nordisk launched a diabetes management mobile app in partnership with Glooko. Both the companies are focusing on engaging patients through awareness and educational content. There are also biopharmaceutical companies using gamification to drive compliance and medical adherence such as Boehringer Ingelheim with its gamified support program called RespiPoints, which is a free online programme that rewards patients when they report they have taken their medication, read educational information and refill prescriptions.
7. Quantified-self and wearables drives healthcare consumerism
Connected healthcare has come a long way beyond the advantages offered by wearables and mHealth applications, and has led to healthcare consumerism centred on a drive for quantified-self. There is increasing affinity for patients and their caregivers to take an active part in healthcare decision making to ensure positive health outcomes and this is urging a culture of self-management in Europe. For instance, a majority of the chronic disease management (CDM) programs in Germany revolves around self-management outside the hospitals and the quantified-self movement is gaining popularity, with about 60% of the population using digital health platforms, mainly mHealth apps, with12% of the population using wearables. Similarly, NHS England is driving self-management programmes for CDM in the UK through targeted activities such as a self-management website, the health foundation self-management resource centre, the self-care forum and the expert patients programme. There are several companies in this space using healthcare data to enable self-management such as Health Unlocked; a UK based social networking service for health that is supporting patients to self-manage by providing relevant and tailored health content, information and services directly to patients.
The way forward
Adoption of key healthcare IT solutions such as EHR, HIS and e-prescribing solutions is close to 80% across Europe. However an integrated ecosystem of healthcare IT solutions is far from being established and to overcome this challenge, there is a strong push for interoperability. In 2017, overall areas of focus for eHealth strategies across the EU were an establishment of data sharing standards, interoperability, and integration of healthcare and welfare plans with healthcare IT, in addition to final stages of implementation of EHR. The latest technology trends are expected to have a positive impact on the healthcare IT landscape in Europe as industry goes through a convergence where all the major stakeholders - providers, payers and patients - have an active role to play in care transformation.