C. Papanikolaou C. change.” of enablers as innovations digital other and solutions eHealth of use the through life of quality patients’ and citizens’ improve to way, as so acoordinated in agenda, and vision acommon under forward move must Europe that clear perfectly made was it In conclusion, discussed. thoroughly also were practice medical and landscape healthcare traditional the of transformation the synergies, empowerment, Patient skills. workforce and interoperability in sembly As Cooperation and Marketplace Business EU-US the and eHealth on MoU EU-US the by graced was event The Sites. Reference and Groups Action of activities the up scaling to further patients chronic and populations 2020, ageing Horizon in care integrated and personalised as well Economy, as Silver on emphasis great placed Forum The systems. e-prescription for guidelines the and mHealth on per Pa Green the regards as made was progress Substantial sessions. numerous in discussed extensively were registries patient and history patient digital e-prescription, as such e-services of importance The market. eHealth the of development the and innovation of value the services, care and health of provision cross-border reform, healthcare for forward way the showed and issues major addressed Forum eHealth the patient-centred; systems make to is goal “Europe’s e-Chance an Health Give Hellenic Ministry Hellenic Ministry of Health of This project is co-funded by E.U. Horizon 2020 Research & Innovation Programme &Innovation Research 2020 E.U. by Horizon co-funded is project This Hellenic Center for Disease Disease for Center Hellenic Control & Prevention e Healt Greek Presidency of the EU Council Council EU the of Presidency Greek - 1st Semester 2014 - 1st Semester h forum wednesday 14 MAY 2014 I www. Horizon 2020 ehealth2014.org ec.europa.eu - - the use of e O T d Cl 04 08 P 08 da 07 S 06 Agei05 mmu Co w Ev T Ma 4TH EU-US03 e an Pa e 02 CONTENTS i & Pa n H e r ff ocume he Le a n tie ide an t SSUE d c r n E in a ici m an P e ecrets h tie ketp n go r fo on rescripti a al i s o n n al D al on di a t o Gallto er n an ce n ic n &Ca th Saf t n n g t a d Ope it ti al Goval lan ur i la n &epS ts g S ll Net ll We 03 i n r wo y nn g b of T of t ccess o uit &2014ce et - d decisi erv pe tic H t er by the S e ool n So H y, eff y of c re -EHTE yon er e elehe k ice Innova th al y: e e shop O s an nan urce al S In o he d pi icien H wo on m a IT & IT th e

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t > Daily Newsletter e Health forum wednesday 14 MAY 2014 ISSUE 03

ePrescription for Patient Safety, efficiency and continuity of care

s interoperability of ePrescriptions Manager, Amgen, Greece & Cyprus, entation of the Spanish ePrescription system which is based Ais an important enabler for the who spoke of the “Informed out- on the SNOWMED-CT (Systematized Nomenclature of Medi- continuity of care in cross-border situ- come and decision making through cine - Clinical Terms) terminology. ations, there are several fully deployed e-Prescribing”. Panagiotis Telonis and national ePrescription systems in Eu- Richard Torbett presented the regu- Spotlight on eHealth in Nursing rope today and many towards their de- latory aspects and the industry per- Mr José Luis Cobos Serrano, representing the Spanish Gen- ployment. There are also cross-border spective in information sharing. Na- eral Council of Nursing, presented the “e-cuidados” (e-care) services already in place to serve spe- tional strategies for the deployment of project which constitutes a unique platform (software) for cific objectives of neighbouring Mem- ePrescription were presented by Bri- the management of good nursing practices. ber States/regions. However, chal- gitte Drewes, Loredana Luzzi, Tatjana The Spanish General Council of Nursing is the regulatory lenges still remain to be addressed, Prendja-Trupec and Nicolas Luc. body of the nursing profession in Spain where there are cur- particularly in terms of unique identi- The subjects addressed included the rently 250,000 registered nurses. This body participates on fication of pharmaceutical products presentation of national (Greece) re- the prescription of medicines and medical devices in Spain, that will improve safety and combat gional (Spain), and cross border (FI, SE) in virtue of the Medicines Law of 2009, and for that purpose fraud. The interactive session, with implementation examples; reflections by the “e-cuidados” tool has been set up. the participation of Christos Halaris, health professionals on issues and chal- The platform is based on the principles of safety, confiden- Kyriakos Souliotis, Vasiliki Mantzana, lenges to be addressed (doctors, pharma- tiality and traceability, which allows nurses’ actions to be Jesus Maria Macias, Päivi Hämäläinen cists, nurses); reflections by the Regula- recorded at all times and can be integrated into other sys- explored the needs, practices and re- tors and the Pharma Industry on unique tems, making it very interoperable. The nursing language sponses to challenges. identification and e-verification of medi- and methodology has been incorporated in order to promote The role of ePrescription in the im- cines (EMA, EFPIA); as well as comments standardisation of nursing care and thus unify operating cri- provement in safety and efficiency on the above with a view to todays’ and teria in both primary care and specialised care. Moreover, in of care was explored by Konstanty emerging national strategies. the field of drug prescription we could prevent up to 80% of Radziwill, Jamie Wilkinson, Jose Luis On eHealth Forum 2014 website iatrogenic or adverse effects. The Spanish General Council of Cobos and Matyas Lakatos, General (ehealth2014.org), see a detailed pres- Nurses has trained 120,000 nurses in this platform.

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4TH EU-US eHEALTH MARKETPLACE & 2014 TRANSATLANTIC HEALTH IT eHEALTH COOPERATION [Evidence and decision ASSEMBLY - ECONOMIC making when going OPPORTUNITIES CREATED beyond pilots]

BY EU-US COOPERATION >We learn from the past by looking towards the ON eHEALTH / HEALTH IT future, according to this session. Some of those forward-looking visions are provided by several large-scale initiatives that have been launched with the financial support of the European Commission. he bilateral relationship between the European Union and the United States Their aim is to deploy innovative telemedicine Tin the eHealth/Health IT sector has many dimensions--economic, social, services and integrated care services, both in real political and commercial. All of these areas present excellent opportunities for life and in a large diversity of European regions. companies, universities, non-profit organizations and governments to work to- Three initiatives were introduced in this session, gether on a variety of possible projects. What are some of the considerations the objectives of which are: to provide evidence of for making decisions on which of these opportunities to pursue and exploit? This clinical effectiveness and quality of life improvement panel, with representatives from government, industry and a trade association, emerging from specific interventions in different discussed some of these considerations, and how collaboration between these settings; and to assess economic and organisational stakeholder groups can advance these objectives. outcomes. The experience of Renewing Health Brian O’Connor, European Connected Health Alliance presented the leading ef- demonstrates that some evidence can be provided forts to bring together stakeholders to form local/regional eHealth ecosystems through an approach that uses Randomized in Europe. From the government point of view, Mr Andrew McCormick, Perma- Controlled Trials. However, to better assess nent Secretary at the Department of Health, Social Services and Public Safety of the economic and organisational impacts of an Northern Ireland analysed a key stakeholder’s role in helping with deployment intervention, a real-life based approach is needed. of eHealth, while, Mr Octavian Weiser, representing a large, multinational com- This is one of the lessons that both United4health pany with strong healthcare and eHealth business internationally, showed the and Smart Care have learned, and are applying. industry’s perspective. The discussion modulated, on behalf of the U.S. Depart- Smart Care adds a social care dimension to that of ment of Commerce, Mr Matthew Hein, eHealth industry analyst with a view to health care. help U.S. companies increase their exports.

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his joint event organized by Ath- Clinical Tens Medical Society and HL7 Hellas aimed at bridging differences between Governance the healthcare professional and eHealth Communities by promoting the created the use added value of new standard based e- services for clinical governance. The of e-tools event is split into two sessions one be- and CDA ing integrated as a parallel event within the eHealth Forum 2014 and the other documents within the 40th Panhellenic Medical Congress. This event addresses issues such as clinical governance, cross bor- Joint Event of der healthcare, health care records and the eHealth Forum 2014 patient summary applications, reuse of & 40th Panhellenic standards and best practices of HL7 CDA Medical Congress use for clinical governance. Today, at the session “Clinical Govern- epSOS ance: the use of e-tools and CDA docu- ments”, with the presence of Dr. Cle- mens Auer, Secretary General, Federal [Industry Team Ministry of Health, Austria and Lefteris and Open Source Thireos SG AMS & HL7 Hellas as chairs, the experience from Kaiser Permanente Community organism and the e-prescription in Greece was shared by Jamie Ferguson, workshop] VP Health IT Strategy & Policy, Kaiser Permanente and Dr Haralampos Karani- t the first part of this workshop, Miroslav Koncar kas, Dr Lefteris Thireos respectively. A(Oracle) presented an overview of epSOS organi- The Chief Technology Officer, Health zation and architecture offering basic knowledge Level 7 International, John Quinn, about what epSOS is, which problems it solves and spoke on “The emerging role of eHealth what the results have been. standards and standards development In 2008 the European Commission started a large in global economy”, while Ch. Xantho- scale pilot to not only design but also test on a large poulakis PDEng, Senior Software De- scale the cross-border communication of patient in- signer, Philips Research presented the formation. As a result, the pilot has yielded a set of application of HL7 CDA Personal Health services that benefits all European patients who seek Monitoring Reports in “Interconnect- healthcare abroad - hence the name, Smart Open ing Patient Home Telehealth and the Services for European Patients (epSOS). In his pres- NHS”. entation, Miroslav Koncar covered the basic setup of The last part of this event was dedicat- epSOS in terms of organization, architecture, speci- ed to the presentation of the perspec- fication and implementation. He also talked about tive and role of HL7 Affiliates regarding the crucial role of industry in shaping this project, Patient Summaries and CDA, by repre- as well as the benefits and drawback of open source sentatives from HL7 Italy, Croatia, Ro- software. mania, UK and Greece. The epSOS semantic Interoperability paradigm was On Thursday, May 15, the second part of presented by Jacob Boye Hansen (CareCom) to show the eHealth Forum 2014 – 40th Panhel- how epSOS has facilitated true semantic interopera- lenic Medical Congress joint event will bility between all European member states; how ep- take place at the Athens Hilton Hotel SOS created an intermediate ‘language’; how trans- (Terpsihori B, 19:30-21:30) were the Greek lation and transcoding was made and how the ever case of Integrated Management of evolving coding systems are kept in sync. clinical Guidelines with the support of IT The epSOS large scale pilot has yielded a viable infra- Tools will be discussed. Representatives structure on both organizational, legal, technical as of the public sector, such as the Greek well as the semantic level. The latter aspect proves to Ministry of Health and IDIKA, as well as be one of the most challenging in this project - how the private (Intrasoft International) and to enable health professionals to provide care to for- HL7 will participate in this event. eign patients by overcoming the language barrier.>

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>epSOS has provided an ingenious and creative solution to make sure each nation participating in this project can take ownership of the translation and transcoding of medical coding sys- tems. One of the major achievements of the epSOS project was bringing people to- gether around a common need - cross border healthcare. People from sever- al countries and diverse education and experience background, played the privileged game of designing a possi- ble future. Regarding technical inter- operability, those people organized as an open community called OpenNCP Community which the vision is: “de- sign and develop a set of Open Source Components (OpenNCP) that can be ageing well network adopted by Participating Nation, to build their local implementation of ICT Solutions the epSOS NCP.” In his talk, Licínio Mano (Portuguese Ministry of Health, for Independent SHARED Services) provided a glimpse about best practices, achievements Living In and challenges ahead for the Open- NPC Community. Own Home epSOS has produced a number of common components for building National Contact Points (NCPs) used in cross-border health services. The components culminate in an open he AgeingWell Network parallel noted that the nature of the market is source ready-to-deploy NCP imple- Tsession focused on the need of in- such that currently the adoption of ICT mentation, OpenNCP. Konstantin teraction in collaboration of develop- /mHealth solutions from the individual Hyppönen representing Kela (The So- ers, service providers, public authorities customer is not very effective because cial Insurance Institution of ) and end users in the development and of the need for significant infrastruc- and Marcelo Fonseca (iUZ, ) adoption of ICT / mHealth solutions for ture, development of clinical tests of provided insights into the architecture independent living for the growing el- large scale, cost effectiveness and trust of OpenNCP, covering questions about derly population of Europe. to the selected health care providers. the technical design behind the epSOS Market potential, interoperability, cost At the second part of the session the services. The use and implementation effectiveness and sustainability of solu- end users (municipalities, health care of IHE profiles, semantic components, tions are key drivers in the development providers and senior citizens associa- end-user portals, and security services of solutions, while putting the client in tions) presented their perspective. Key were described in a techy but intel- the epicenter of the design, implemen- points were the need to improve sen- ligible way. Also, some insights about tation and evaluation of ICT solutions iors’ involvement in the development the used development tools, the in- is of paramount importance. A number of ICT solutions and intergenerational tegration and testing strategies were of solutions focusing on accessibility, communication. It is important to fa- presented. First-hand experiences of health prevention, quality of life, follow cilitate learning interest by talking and using OpenNCP in a nation-wide setup up and continuous care was presented. informing, investigating, listening and were shared, followed by an open dis- Key barriers to the adoption of tech- encouraging seniors; also creating ac- cussion on epSOS. nologies were discussed such as inter- cessible, secure and user-friendly en- The workshop chaired Juergen Weh- operability, the effective and pragmatic vironments; and finally consulting ex- nert, Gematik mbH () and Dr. implementation in times of a financial perts such as gerontologists, etc. Alexander Berler, Industry Team Steer- crisis, the scaling up of solutions and For more information about the Age- ing Committee (Greece). increased fragmentation of the mar- ingWell Network please visit the web- ket. These eventually lead to limited site: http://ict-ageingwell.net investment and slow adoption. It was

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The Secrets of Telehealth how to deploy services in routine care or decades, telemedicine and telehealth gramme (ICT PSP) as part of the Competitive- Momentum project, “Telemedicine in Europe Fprojects have been receiving a lot of atten- ness and Innovation Framework Programme suffers from ‘pilotitis’, a glut of technology ex- tion from innovative healthcare professionals. of the European Commission. periments that have received start-up subsi- However, only a few projects have successfully This session was the first opportunity to access dies from public or commercial sources to get shifted from lab to routine care. Even fewer the initial results of the project, a list of 18 criti- them off the ground, but which cease to exist have gone from small- to large-scale deploy- cal success factors that cover overall context (i.e. once the subsidy is withdrawn. Our success ment. Lack of clinical evidence, user adoption, cultural readiness and financing); management factors will help the ‘doers’ move their projects reimbursement and business models have of- aspects (the need for leadership, for a business into routine care and scale them up to provide ten been identified as the main explanations plan, for change management); legal and secu- real benefits to patients in Europe.” for this situation. An element that has been rity issues (including liability or the regulatory Rachelle Kaye, AIM & Maccabi Healthcare Ser- much less studied is the lack of deployment environment for data management); and tech- vices (Israel) and Peeter Ross, eTervis (Estonia) method. Unquestionably, this is also a pitfall. nology considerations (including interoperabil- followed with presentations on the managing as- Several organisations and key players in tel- ity). They are collected in a short document with pects of telemedicine deployment, while Ellen K. emedicine across Europe have decided to join annotations available at http://telemedicine- Christiansen, Norwegian Centre for Telemedicine forces. They have launched the Momentum momentum.eu/18-factors. (NST) analysed the legal, regulatory and security project to work on how to deploy telemedi- These factors require further validation, and issues, Tino Marti, TicSalut (Spain) presented the cine, by analysing those initiatives which have the publication of this list begins a public con- ICT perspective. Finally, Dr. Steffen Sonntag, Ge- been successfully deployed and identifying the sultation phase. Indeed, according to the first sellschaft für Patientenhilfe DGP mbH, Munich, reasons why they were successful. The project of this session’s speakers, Marc Lange, Secre- Germany presented the case of the “German so- is funded under the ICT Policy Support Pro- tary General of EHTEL and coordinator of the ciety for patients assistance” (DGP).

eHealth Forum 2014 was a success!

More than 1,278 participants from 38 countries and 150 speakers from around the globe joined the eHealth Forum 2014 in Athens. In total, 70 exhibitors participated from Europe and US. Seventeen exhibitors was part of the US Pavillion, 4 Local Government, 4 Government Institutions, and 13 Start-Up companies.

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[Patient access to health data in Europe]

>The SUSTAINS project is pleased to announce its joint working with the eHealth Governance Initiative in the preparation of a Briefing Paper which was launched this week to, and accepted by, the eHealth Network. This Paper made recommendations regarding patient health records and, notably, patient access to health data. The paper recommended that access to patient data should be about making health data meaningful and understandable. It is about moving patient access from the paper based to the digital world and about generating the added value that comes about with Leading service integrated health information portals. Creating innovation in convergence at the national level can also enhance and support access to patient data across borders or despite health and care borders. n the evening of 13 May 2014, at the Royal Olympic Hotel, a stimulating In addition to its co-operation with the Briefing Paper, OThought Leadership debate facilitated by EHTEL with the support of IBM and the SUSTAINS Project, sponsored by the European NHS24 (Scotland) attracted over 110 leaders in European health, care and technol- Commission, is recording success in its work to provide ogy. Under the beautiful Athenian sky, an hour-long discussion was animated by patients with access to their personal health records Professor George Crooks, EHTEL President and Medical Director, NHS24, Scotland. and other online services. Eleven Regions from across The evening was rounded off by conversations held over a pleasant Greek dinner. the European Union are participating in a joint learning Making sense of numbers is an important challenge. At this evening, statistics be- initiative as they introduce patient access to various gan to tell a meaningful story. The message was the need for a reform in health services within various Member States. The aim is to and social care that can result from a more extensive use of technology. Through investigate different approaches to implementing the figures quoted, the expert attendees began to formulate new ideas for the fu- such services and to identify lessons learned for other ture. Fighting chronic conditions - chief among them diabetes and its potentially healthcare organizations seeking to undertake such debilitating results - was often the lens through which the organisational and work in the future. technological challenges lying ahead were seen throughout the evening. Driving the work is the recognition that as people live longer, chronic diseases become more prevalent and medications and treatments more expensive, Among the evening’s memorable quotes: radical solutions will be required to ensure that future “A revolution is needed in 21st century healthcare,” and “we should focus on healthcare delivery is sustainable. By putting the where we need to be tomorrow, which is leading edge.” patient more closely in touch with the management of Alex Neill, Scottish Cabinet Secretary for Health and Wellbeing their own healthcare, the aim is to improve awareness and engagement leading to more effective and efficient “In a period of severe financial and social crisis, technology can be a bonus healthcare delivery including healthier lifestyles. for organisational reform.” The work of SUSTAINS supports the objectives of the Theodore Vontetsianos, Sotiria General Chest Diseases Hospital of Athens EU Digital Agenda 2020 specifically Action 75 of the “As a person with diabetes, you may spend close to 8,736 hours a year eHealth Action Plan namely to “give Europeans secure by yourself, dealing with your diabetes. Why not use technology to bridge online access to their medical health data and achieve that gap?” widespread telemedicine deployment” by 2015. Petra Wilson, General Secretary, International Diabetes Foundation A recent internal evaluation of SUSTAINS work revealed significant success in the implementation of a number “Innovation companies, such as IBM, now have 300,000 people around the of key clinical and administrative services across all of globe working on health and medical care.” the pilot sites. John Crawford, IBM

“By 2021, the region of Southern Denmark’s university hospital will have far The project was described in a presentation by fewer than its current 7,000 beds. How can this be done persuasively and Dr Stephan Schug, Chief Medical Officer of EHTEL, as easily? A living lab is a good part of the answer.” part of the Speakers Corner within the eHealth Forum Christina Wanscher, Health Innovation Centre of Southern Denmark on Wednesday 14 May. www.sustainsproject.eu

www.ehealth2014.org >p7 e Health forum wednesday 14 MAY 2014 ISSUE 03 ehealth official dinner by the sea

www.ehealth2014.org >p8 e Health forum wednesday 14 MAY 2014 ISSUE 03 gold sponsors

Silver sponsors

Supporters

Exhibitors

pcc hellas Patients’ Adherence

congress organiser

www.ehealth2014.org >p9