From: e-Health, the combined use of information society =
technologies=20
(ISTs) in the health sector, is moving up health policy agendas =
at the=20
European, national and regional levels. Productivity gains from the =
optimization=20
of healthcare systems and achieving cost reductions are prime goals, =
while=20
healthcare providers, health insurance organizations and politicians at =
all=20
levels (EU, national, regional) are drawing up plans to support =
healthcare by=20
means of the application of modern ISTs. In particular, EU policy has =
set up=20
specific action plans (eEurope2002 and eEurope2005eHealth and the Ageing Society
Marcelino=20
Cabrera,
IPTS
eHealth is an empowering tool for European citizens = and, in the=20 context of an ageing society, for active independent living by older = people in=20 an enlarged European Union with considerable income disparities and=20 heterogeneous healthcare systems. In this Special Issue, the topics = discussed=20 are in one way or another related to the context of an ageing society, = while=20 highlighting bottlenecks and prominent technological trends that need = policy=20 attention.
Health and social care for the elderly can be = provided with new=20 services based on appropriate ISTs, such as so-called "independent = living"=20 services. However, policy-related technological and organizational = aspects of=20 strategic plans are key factors for success in satisfying the real needs = of the=20 elderly. The cost-effectiveness of new assistive technologies enabled by = mobile=20 and "ambient" systems, wearable and embedded devices, as well as new = business=20 and services provision models, will need to be assessed.
The case of emerging mHealth services (mobile health) = is=20 illustrative for its potential impacts on the financial and liability = schemas=20 since insurance systems may have to accommodate new expenses as a result = of=20 services delivered by mobile phone providers. Also, mHealth services = will have=20 implications for the provision of care itself, resulting in changing = paradigms=20 for healthcare professionals and patient-clinician relationships.
When combined with location data processing, mobile = terminals=20 will improve eHealth possibilities. Clearly these services will rely not = only on=20 location information, but also on the mobility of the terminals. = However, before=20 widespread use can be made of location-based healthcare services, a = number of=20 privacy issues will have to be addressed. The potential large-scale = tracking of=20 ordinary citizens (whether deliberate or incidental) will certainly = raise=20 ethical concerns that could cause delays in the deployment of these = services,=20 thus postponing the realization of their benefits.
The privacy issue can be extended to what it is = agreed will=20 become the central piece of information around which many = citizen-oriented=20 eHealth applications will be developed, i.e. the electronic health = record (EHR).=20 With the EHR, it will be possible to enable access to relevant = information,=20 collaboration between healthcare providers and telecare more = effectively.=20 However, confidentiality and privacy are critical issues that will need=20 widespread consensus among all stakeholders (public authorities, medical = professionals and citizens). The EHR, as the cornerstone of many = developments in=20 this field, undoubtedly deserves focused and coordinated actions at all = levels,=20 including EU-level.
One important, but often under-emphasized, = prerequisite for the=20 introduction of new ISTs in the health sector is the acquisition of new = types of=20 skills by citizens, patients, doctors, nurses and other healthcare=20 professionals. Without human resource development through appropriate = education=20 and training, healthcare faces major obstacles to the crucial = knowledge-sharing=20 process. This is particularly relevant considering the under-investment = in=20 training and education that is endemic in the health sector.
The above-mentioned topics =96and there are many = others not=20 discussed here due to space limitations- suffice to give an idea of the=20 challenges that eHealth raises, particularly for time-pressed = policy-makers, who=20 need to grasp at a glance the various scientific and technological, = economic,=20 political and social dimensions. In this context, roadmaps are valuable = ways of=20 presenting and analysing the causal and temporal relations between = successive or=20 parallel steps. Equally valuable are the results from existing foresight = exercises. These results can help to gain a better understanding of the = expected=20 evolution of the demand side of eHealth during the next two decades.=20
Marcelino Cabrera, IPTS
Tel.: +34 95 448 83 62, fax: +34 95 448 83 39, e-mail: marcelino.cabrera@jrc.es<= /A>
1. http://europa.eu.int/information_society/eeurope/2005/index_en.htm<= /U>
2. European Council meeting in Lisbon set an ambitious objective for = Europe=20 to become the most competitive and dynamic economy in the world. To = achieve=20 this, the Council later endorsed the above mentioned action plan = entitled=20 "eEurope =96 An Information Society for All".