BLOG: A look into the crystal ball - The European eHealth agenda for 2018

Europe is great. You start to think about a blog post on next year’s eHealth agenda, and within minutes you find yourself studying online dictionaries in various languages because you realise that predicting the future is not the same in different parts of our world.

Grätzel von Grätz

The English language includes the “fortune-teller” for example. It is an expression that reminds us of “making a fortune” and that suggests that the future is something that might be worth looking forward to. Many continental European languages don’t know about “fortune tellers”. There is simply no similar expression. They know the profession, of course, but they use different, far more ambiguous wording.The German “Seher” and the French “voyant” are looking into the same crystal ball, but unlike their British fortune-telling colleagues, they don’t necessarily expect to find something positive there. When you come across a “Seher” in a German folk tale, you know that this will not be a story to read to children. So what will shape the European eHealth agenda in 2018? Take a look at my top five, and you can decide whether to call me a “fortune-teller” or a “Seher” in the end.

    • Artificial Intelligence. No surprise here. We are confronted with reports and research on an increasing number of impressively accurate IT tools that interpret images or ECG data, that advise on when to consult a doctor or that suggest proper therapies. The year of 2018 will be when these tools start hitting real-world care on a broader scale. The FDA has just certified the first Apple Watch accessory as a medical device: an ECG-meter that replaces the normal Apple watch wristband and that can be used in combination with activity tracking in a machine-learning environment to detect atrial fibrillation. It won’t stop there.
    • Regulatory challenges. Decision support tools with or without machine learning are coming of age, and this will force regulators to make up their minds on how to address them properly. The recent European Medical Device Regulation will make it tougher for healthcare IT tools that need medicinal product certification to make ends meet. As a way to reduce healthcare IT-related risks, this approach can only be justified if, at the same time, regulators pull out of as many as possible low-risk IT tools altogether. The FDA published its draft guidance on medical decision support tools only days ago. In it, the agency suggests to withdraw from certifying, for example, digital guideline tools or medication alert systems that only replicate knowledge available in public databases. Europe: This is the way to go!
    • The return of diversity. For years, we have looked at Sweden, Denmark, Estonia, and, more recently, Austria and the UK when it came to studying examples of how to successfully introduce digital health information exchange. What all these countries have in common is rather monolithic healthcare systems that are run by either the national government or by state-like national insurance providers. In 2018 we will witness countries with diverse, federal, and partly private healthcare systems like the ones in Germany, Switzerland, the Netherlands or France beginning to catch up. The Germans will give up their resistance to first-line telemedicine support. The Dutch will agree on personal health record standards. And the Swiss will continue to mold their electronic patient record landscape – proving that healthcare digitisation does not necessarily mean healthcare system centralisation.
    • The way to the cloud. Cloud-based healthcare IT tools will continue on their way towards higher acceptance in healthcare, even in countries that have demonstrated slow adoption.  One of the big drivers will be cybersecurity, and the other one will be the implementation of universal patient rights. Both are considerably easier in cloud-based architectures.
    • The end of the app bubble. Something will happen in the healthcare-related app economy, but it is hard to predict what and when. Several years in a row now, the numbers of healthcare apps and healthcare app publishers have risen sharply, while download numbers are more or less flat or only increasing slightly. This doesn’t look sustainable. The record in eHealth related venture capital financing that we will see in 2017 might be the last record of this kind for a while. That’s what the “Seher” says. There might be one or two more years of this kind, argues the “fortune-teller”.

    Philipp Grätzel von Grätz

    (Germany) specialises in medicine, health policy and, in particular, eHealth and information technology in healthcare. He is one of Europe’s leading journalists in the field and author of the German book Connected Health.

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