policy recommendations for wider implementation of telemedicine peeter ross, md, phd e-health...
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Policy recommendations for wider implementation of
telemedicine
Peeter Ross, MD, PhD
e-Health expert, Estonian eHealth Foundation, Estonia
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Content
• Overview of current situation in the implementation of telemedicine services
• eHealth Task Force report Redesigning Health in Europe for 2020
• Policy recommendations for deployment of telemedicine services
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The project consortium
• Region of Southern Denmark• Auvergne, France• Catalonia, Spain• Estonia• Malopolska, Poland• Norrbotten, Sweden • North Norway• Scotland, UK • Veneto, Italy
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New technologies and e-services in healthcare
• Healthcare is lacking behind of other service industries at least 10 years
• Healthcare organisation usually is not adopting the free market rules what would promote the use of innovation and disruptive technologies
• Implementation of e-health services depends in large extent on political decisions.
• Decisions must be in solid basis
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Main goal of policy recommendations
• To improve • Patient care
• Safety• Quality
• Healthcare system efficiency • Market development for regional
SMEs
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Difficulties to put telemedicine services into routine operation
• The reasons are complex• Clinical, economical, organizational,
technological, legal and safety requirements
• Political issues are on different levels• European• National• Regional and • Local
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Political levels (1)
• In EU the healthcare decisions are made according to the principle of subsidiarity
• Policies concerning provision of healthcare services should always be made at the lowest possible level
• EU level • Legislative documents• Recommendations with no legal
power
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Political levels (2)
• Most recent documents• eHealth Task Force report –
Redesigning Health in Europe for 2020• Europe 2020 Strategy• Digital Agenda for Europe• EC Communication on Telemedicine for
the Benefit of Patient, Healthcare Systems and Society.
• EU Directives that have direct influence on telemedicine services
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Political levels (3)
• Policy recommendations on national, regional and local level coincide in many aspects
• In not yet mature and diverse European telemedicine market the differentiation between levels is not reasonable because of variabilities between Member States healthcare administrative structures
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eHealth Task Force Report.Redesigning health in Europe for
2020
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Redesigning health in Europe for 2020 – recommendation 1
• A new legal basis for health data in Europe • Create a legal framework and space
to manage the explosion of health data
• Create the conditions for the integration of user-generated data with official medical data so that care can be more integrated, personalised and useful for patients
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Redesigning health in Europe for 2020 – recommendation 2
• Create a 'beacon group' of Member States and regions committed to open data and eHealth• EU facilitates this by creating the central
space for national initiatives to flourish and be shared.
• Successful models developed in different regions or countries can be disseminated
• A leadership group from regions and countries that have invested in eHealth applications could be pioneers
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Redesigning health in Europe for 2020 – recommendation 3
• Support health literacy• Health literacy efforts should begin in
school• Indeed, citizens can only exercise
control over their own data – and subsequently use the data – if it is both in an understandable language and format with user friendly interfaces
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Redesigning health in Europe for 2020 – recommendation 4
• Use the power of data• Health institutions must publish the data on
their performance and health outcomes. This information should be regularly collected, comparable and publicly available
• This will support a drive to the top as high performing organisations and individuals can be identified and used as an example to inspire change
• In health, performance is not just how efficiently the system operates but also the patient experience of the care
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Redesigning health in Europe for 2020 – recommendation 5
• Re-orient EU funding and policies• The majority of public funding at EU and
national level allocated to eHealth has been invested in centralised, large-scale, top-down solutions
• These have failed to address and integrate the user experience sufficiently
• The next phase should see investment in tools that citizens can use to support their wellbeing and manage their lives
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Regional Telemedicine Forum Policy recommendations.
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Regional Telemedicine Forum Policy recommendations.
• Presents the identified policy recommendations, developed by each RTF partner
• Includes a brief description of the meaning of the policy
• Reports a case description, referred to the related policy
• An example of how the policy was successfully applied by one of the RTF partner and which results are obtained
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Regional Telemedicine Forum Policy recommendations.
• Limitations• RTF partnership decided to suggest
policy recommendations which are each based on a concrete case of problems for the wider implementation of telemedicine services.
• This can limit the problematics and the field of application
• Still important beginning to face the problem and to overcome existing barriers.
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Policy recommendations.Economic area
• New reimbursement models• Integration of evidence based
documentation throughout the decision-making
• Development of evidence, including clinical, organizational and economical aspect and quality of service
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Policy recommendations.Information technology
• Development and implementation of an infrastructure for electronic health data sharing
• Use of ICT based on international standards to create interoperable systems
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Policy recommendations.Political area. Educational area
• Political area• Create political leadership, including
better guidance on what the politicians need to decide on
• Educational area• Postgraduate education • Integrate training of usage of
telemedicine services in academic area• Improve patient empowerment by
training patient and caregivers
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Policy recommendations.Organisation. Legal
• Organisation• Apply a multidisciplinary approach to
development of services, including sufficient involvement of clinical expert
• To link the clinical and economical levels throughout the development of telemedicine
• Legal• Early clarification on legal matters throughout
the service development
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Conclusion
• Successful implementation of telemedicine demands• Actions at regional level by addressing the main
beneficiaries and barriers• Exchange of good practises • Evidence of successful telemedicine to build
trust and acceptance• Make of use of solutions offered by information
technology