Among the most important achievements of the Commission’s eHealth and Wellbeing Unit during 2014 was the work on the Green Paper on mHealth and its public consultation, which opened and closed last year. “We were trying to spread the initiative across Europe and to remove barriers to the empowerment of citizens using mHealth tools”, said Peteris Zilgalvis.

There were also interesting accomplishments and progress in the road map of the Memorandum of Understanding on eHealth with the United States.

Besides, the Unit was looking at interoperability, ePrescription and cross-border issues internationally, which is also a way to open markets and create more opportunities for SMEs and industry.

These efforts are important while getting ready for the Connecting Europe Facility, a cross-border infrastructure of the European Union that seeks to facilitate the transference of health records, health summaries, and ePrescription from one EU member state to the other.

Consultation on mHealth

Member states wish to grasp as many opportunities as possible, e.g. regions which are running the healthcare systems; however, some of them, e.g. cross-border “elements”, such as digital single market for health apps and the single market, have to be seen in a broad sense. The Commission would start with consultations and discussions with stakeholders on the various actions that the Commission could propose to address the areas of concern, which include trust, security, evidence and the digital single market.

The truth is that the European Commission is not involved in designing a series of guidelines on mHealth, though many of the EU’s suggestions are in relation to a code of conduct or guidelines, but this doesn’t bind the Commission. In the perspective, some directives or a regulation should be created to address the mHealth and well-being apps and/or digital goods more generally.

Implementation of eHealth records at a European level

Both through the adoption of the guidelines on patient health summaries by the eHealth network and through tools such as public procurement innovation the Commission encourage the digitalization of health records utilising standards.

Besides, there are some research priorities on eHealth in the Commission’s digital agenda. For example, the Commission has opened tenders, which emphasize the virtual physiological human-computer modeling of the organs and the empowerment of the patient. In the future Commission will be following the directions of mHealth and virtual physiological human, as well as cyber security issues related to systematic security (security of the entire system). Specifically, the EU institutions want to include mHealth sources of data, the databases in the member states and the regions and cross-border transfer.

For example, recent Eurobarometer survey showed that 6 out of 10 of European had looked for health information on the internet in 2014. However, EU citizens have not enough health literacy to properly use the information they find; it has to be improved. This is something that it is being undertaken at a regional or member state’s level, but the Commission is trying to help through the follow-up actions in the research dossier, and work in collaboration with other stakeholders. It is very important because digital health citizen empowerment could not be an excuse for making vulnerable groups more vulnerable in order to make sure that the tools increase access, not decrease it, for some part of the population.

Such vulnerable groups are generally citizens that suffer from lower rates of employment and who have worse health are also those who do not have access to internet or do not use it. So these are the people we have to target to increase the access and their health literacy, their empowerment.

There are good examples of going where the citizens are. In Scotland, for instance, they are using satellite TV-Sky TV boxes-, which are often in a lot of the homes that don't use the internet. Or for instance, in Estonia, they are thinking of even using ATM machines to access public services (e-Government) for people who are not normally using internet at home. So, it's not about asking citizens to come to digital but digital services going to where the citizens are, argued Peteris Zilgalvis.

Citizens' main concerns about eHealth

People are concerned that it's complicated to use the system, or that it will lead to them not having access to a doctor, for instance. The Commission’s idea is to increase access to eHealth and to increase empowerment.

When a citizen doesn't need to see a doctor, or has limited access (usually people who live in rural areas), the aim is that patients’ data go in a secure manner to the doctor or the health system. At the same time, the user-centric approach is taken by the nurse, the health professional or the citizen. It is not enough to say: "Here is a complicated procedure, go and use it". The design has to have a citizen or a professional user at the center from the very beginning. It has to fit the way real people use these tools.

Besides, important is that eHealth addresses the challenge of the aging society; eHealth is one of the best tools because older citizens often suffer from lower mobility. It can be a way to coordinate care, to deliver social and medical care together, which is called "integrated care". This idea is dealt with in the European Innovation Partnership on Active and Healthy Aging. There's a whole set of actions that are addressing how better serve this important part of the population, including the economic opportunities, the so-called “silver economy”. This group of citizens shall be served better while at the same time create opportunities for growth and jobs.

Hence, the role of social media in citizens' empowerment is very important because in a lot of cases citizens can look for support at people who are in a similar situation, whether they are ill and suffer from the same affliction, or healthy people who are saying "it's difficult to get out and jog, or to stay on my diet due to the holidays..." People can really share best practices and support one another in a social interaction.

Main challenges for the EU’s sustainable healthcare

The EU is dealing with several challenges: partially the aging of the population and the rise of chronic diseases, and the growing costs that they involve. Here, Commission’s plan is to use the prevention agenda that is linked to mHealth and empowered citizens, as way of finding ways to keep the older citizens healthier longer. This way they'll reach the stage of older citizen already on better health, because they will have been monitoring their health in conjunction with their doctor by using these tools.

Therefore, the main events on eHealth in 2015 will be the eHealth Week in Riga during Latvia’s Council Presidency’s event in addition to the Barcelona Health 2.0 event. This conference will be emphasizing the empowered citizen; the conference’s slogan is "Me Health" (Mobile eHealth), and it will be focusing on the follow-up of the Commission’s Green Paper. So, empowered citizens, interoperability and apps (as part of the prevention agenda), all this will be linked to the digital single market and the social market in a broad sense, including social innovation and not-for-profit arrangements.

See more on the European Digital Agenda website (European Commission)

Other links:

- Research in eHealth (Agenda Digital Europea);

- European Innovation Partnership on Active and Healthy Ageing;

- Ambient assisted living joint program, Jan 26, 2015;

- Interview with Peteris Zilgalvis, Head of Unit Health and Wellbeing in European Commission; In:

http://www.mobilehealthglobal.com/in-the-news/interviews/46/interview-with-peteris-zilgalvis.