Big Data in Health

A new study on Big Data in Public Health, Telemedicine and Healthcare identifies examples of the use of Big Data in Health, and puts forward recommendations covering 10 relevant fields: awareness raising, education and training, data sources, open data and data sharing, applications and purposes, data analysis, governance of data access and use, standards, funding and financial resources, and legal and privacy aspects.

In the context of this study, “big data in health” refers to large routinely or automatically collected datasets, which are electronically captured and stored. Using Big Data in health has many potential benefits. It may contribute to, for example, increasing the effectiveness and quality of treatments available for patients, widening possibilities for disease prevention by identifying risk factors at population, sub-population, and individual levels, improving pharmacovigilance and patient safety, and reducing inefficiency and waste.

The study’s 10 recommendations are aimed at maximising opportunities Big Data can bring to public health in the EU – to improve the health of individual patients as well as the  performance of Member States’ health systems. All recommendations are underpinned by principles such as the need to uphold ethical standards and the privacy or safety of citizens, and to include stakeholders – such as patient advocacy groups, when implementing them.

To read the full report on Big Data in Health on the ec.europa.eu website

Effective, accessible and resilient health systems

The European Commission’s Expert Panel on Effective Ways of Investing in Health has just been renewed for three more years, running until May 2019. The aim of the Panel is to provide the Commission with independent advice from a variety of sectors  to support modern, responsive and sustainable health systems.

The Panel’s new members cover a wide range of disciplines, including human medicine, public health and economics. It will support the Commission’s efforts to provide evidence-based policy-making using both country-specific and cross-country knowledge and will support the agenda on effective, accessible and resilient health systems.

More information about the Expert Panel on Effective Ways of Investing in Health on the ec.europa.eu website.

Longer life, but not necessarily healthier life

Life expectancy now exceeds 80 years in most EU countries according to the new report “Health at a Glance: Europe 2016“, but these are not always healthy life years. Around 50 million people in the EU suffer from several chronic diseases, and more than half a million people of working age die from them every year, representing an annual cost of some €115 billion for EU economies. Three fundamental changes are needed if this is going to change:

  • more effective health systems: 550,000 people of working age die every year from potentially avoidable diseases. 16% of adults are obese now (up from 11% in 2000) and one in five is still smoking. Many lives could be saved firstly, by focusing more resources on health promotion and disease prevention strategies and secondly, by improving the quality of acute and chronic care.
  • more accessible health systems: 27% of patients go to A & E due to the lack of availability of primary care; an average of 15% of health spending is paid directly out-of-pocket by patients with large disparities between countries; and poor Europeans are on average 10 times more likely to have problems in getting proper healthcare for financial reasons than more affluent ones. Member States’ policies should focus on reducing financial barriers to healthcare, strengthening access to primary care, and reducing excessive waiting times.
  • more resilient health systems: Across the EU the share of the population over 65 has increased from less than 10% in 1960 to nearly 20% in 2015 and is projected to increase to nearly 30% by 2060. Population ageing, combined with increasing rates of chronic diseases and budgetary constraints, will require changes in how we deliver healthcare, including developing eHealth, reducing hospital stays by organising services better in primary and community care, and spending more wisely on pharmaceuticals, including by making full use of opportunities for generic substitutions.

More information about Improving Health Systems on the europa.eu website

Digitising European public services

Delivering on its Strategy to create a Digital Single Market, the European Commission has developed plans to help European industry, SMEs, researchers and public authorities make the most of new technologies.

It has created a set of measures to support and link up national initiatives for the digitisation of industry and related services across all sectors and to boost investment through strategic partnerships and networks. It also proposes concrete measures to speed up the development of common standards in priority areas, such as 5G communication networks or cybersecurity, and to modernise public services.

The Commission will also set up a European cloud that will give Europe’s 1.7 million researchers and 70 million science and technology professionals a virtual environment to store, manage, analyse and re-use a massive amount of research data.

People and businesses are still not reaping the full benefit from digital public services that should be available seamlessly across the EU. The Commission has developed an e-government action plan that will modernise digital public services and make the EU a better place to live, work and invest. It has suggested 20 measures to be launched by the end of 2017, including a digital single gateway to help users operate across borders and a cross border e-health service.

Find more information about the Digitising of European Industry on the europa.eu website

Can a mobile phone help you stop smoking?

Tara Duthie, who lives in Stirling, Scotland tried to quit smoking four times in 5 years. Then, in 2015 aged just 49, she had a heart attack – it was a wake-up call she could not ignore. She started using an app to help her stop smoking which not only gave her information about physiological changes but also had little games that she could play to distract herself for the 3 or 4 minutes a craving for a cigarette would last.

Smart phone apps that help with lifestyle change are growing in popularity. However, few public health authorities have mechanisms in place to regulate their quality or have a strategy to guide how they could be used for health promotion.

According to the latest e-health report, “From innovation to implementation – e-health in the WHO European Region“, the health authorities of 22 countries in the Region promote the development and adoption of m-health (mobile health) in the health sector. Around a quarter (11 countries) report that their health authorities regulate mobile devices and software for quality, safety and reliability. In 7 countries the health authorities play no role in the development or adoption of m-health. The report further shows that, when governments sponsor m-health programmes, they are also more likely to provide incentives and guidance on innovation and evaluation, as well as regulation for their use.

For more information about mobile health and smoking on the euro.who.int website

Governance of patient registries

Patient registries, which were designed for patients with shared characteristics, have been an important source of the data needed to assess clinical performance, provide health technology assessment or assess policy implications on a local, regional, national and in some cases international level. As a result, hundreds of registries have been set up, ranging from paper based spread-sheets in a physician’s office to international rare disease initiatives coupling clinical and genetic data as well as bio-banks.
In the last fifteen years information technology has enabled clinicians to collect, share, compare and analyse large amounts of patient data.
A recent EU-funded project has produced a set of Guidelines to provide practical advice on how to set up and manage patient registries as well as to enable secondary use of data for public health policy and research. These Guidelines should make life easier for those setting up new registries or redesigning already functioning registries and those exchanging data across registries.
To read the full 232 page Guidelines on the ec.europa.eu website

European eHealth Network

The Joint Action to support the eHealth Network (JAseHN) was launched in 2015 and is now in the process of setting up a cross-border network to exchange Patient Summaries and ePrescriptions, by focusing on the following objectives:

  • enable seamless cross-border care and secure access to patient health information between European healthcare systems, particularly with respect to the exchange of Patient Summary and ePrescription.
  • contribute to patient safety by reducing the frequency of medical errors and by providing quick access to patient health information, as well as by increasing the accessibility of a patient’s own prescriptions, also when abroad.
  • provide medical personnel with life-saving information in emergency situations and reduce the repetition of diagnostic procedures.

To read more about JAseHN and download their leaflet from the jasehn.eu website

E-health in practice

A new report gives an overview of the developments and benefits of using e-health, with 29 cases from across the European Region.

E-health is a broad concept, defined as the use of electronic means to deliver information, resources and services related to health. Many terms are included in e-health, such as:

  • electronic health records;
  • mobile health, or m-health;
  • telehealth or telemedicine;
  • health-related e-learning;
  • social media for health;
  • health data analysis and “big data”

The following examples illustrate different uses of e-health:

Improving appointment systems in the former Yugoslav Republic of Macedonia

Before 2011, patients in Skopje experienced long waiting times to see doctors and have diagnostic tests. The MojTermin (My Time) system made it possible to book appointments online and receive text message reminders and for decision-makers to access a live dashboard to see referrals, prescriptions and requests in real time. The system was so successful in reducing waiting times that it rapidly expanded from a pilot project to become a key part of public and private health care in the former Yugoslav Republic of Macedonia.

First nationwide electronic health record system 

Estonia launched its electronic record system in 2008, becoming the first country in the world to fully implement such a system nationwide, with records covering an individual’s medical history from birth to death. Information on the health of 1.35 million people (98% of the population) is now in the system, and e-prescriptions account for 98% of all prescriptions issued. The electronic record system forms part of the broader eEstonia electronic public services, which, in addition to e-health, include e-taxes, e-schools, e-commercial registries and e-elections.

Training medical students in using a multilingual, virtual, simulated patient

11 countries in the Region have created a multilingual, virtual, simulated “patient” that responds and behaves in the same way as a real patient being seen in a primary care setting. It can be used by medical students in different countries with different languages. The system simulates a clinical interview with a virtual patient presenting with symptoms of one or a combination of illnesses.

To read the report From Innovation to Implementation on the who.int website

eHealth guidelines for nurses

The EU-funded Ens4Care project has developed five guidelines for European nurses and social workers on how to use eHealth for:

  • promoting a healthy lifestyle and prevention
  • clinical practice
  • skills development for advanced roles
  • integrated care
  • nurse ePrescribing.

The ENS4Care network brought together 24 partners from all over Europe, with a mix of professional associations in nursing and social care, nursing regulators and unions, informal carers, patients, researchers and research communities, civil society representatives and industry. They collected a total of 122 existing good practices of using eHealth tools by nurses and social workers at both national and regional levels.

To find out more about the eHealth Guidelines and the project itself, go to the ens4care.eu website

E-health in Europe – from innovation to implementation

This report describes the development of e-health in the WHO European Region and the trends that are emerging in 2016. It is based largely on data collected from the 2015 WHO Global eHealth Survey.

It includes case studies of successful implementations in various countries and the practical application of e-health in various settings. It provides evidence of an increasing appetite for e-health and indicates tangible progress in the mainstreaming of technology solutions across the European Region to improve public health and health-service delivery.

To read “From innovation to implementation – eHealth in the WHO European Region” on the euro.who.int website.