It has been great to follow and engaged online via Twitter – and great live-streaming  – with participants of World of Health IT (WoHIT) 2016 in the historical city of Barcelona. And what a great team of active Ambassadors they had on site keeping the channels of communication open to all! From Stefan Buttigieg (@stefanbuttigieg) to Danielle Siarri (@innonurse) I could almost taste the great food they enjoyed!

From genomics to cybersecurity, and much more besides, this huge and successful inaugural exhibition in Barcelona advances the conversation

I hope to attend in person in future years of WoHIT but in the meantime, I hope to see many of you in Malta for eHealth Week 2017!


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Next week – May 12th at 6pm CET,  I’ll be joining an HIMSS Europe & SKIPR organised Twitter chat (using the official Hashtag: #eHealthChat) entitled “Up-scaling health-IT: time to break the bottleneck“.

Voices across Europe will be discussing Trust and Standards. It’s one of the main themes of eHealth Week in Amsterdam in June (Read more and register here!).

From the patient’s perspective, both Trust and standards are critical if you want to move forward with eHealth

From the trust perspective, we can’t go beyond niche adoption without that by participants. Clinicians need to trust it, and patients too. And legislators, public health monitoring etc. It would be foolish to do that even if somehow people did go forward without confidence. Security is critical. Arguably clinical data is the most sensitive and the volume generated is growing year on year as we strap more instruments to ourselves, aim for paperless, and connect the machines and systems together.

And where do I start with Standards?!

Interoperability – or the lack of it right now – is the biggest issue for me to date. Time and time again we hear of brilliant innovations, and trials here and there. but nothing hooks together. It’s a problem within one urban area, it’s a probably nationally, and , frankly, as far as I’ve witness, somewhat non-existent at a multinational, european level.

Furthermore  ‘wellbeing’/’fitness’ solutions such as platforms provided by Apple, Google,Microsoft,  Samsung, Withings (soon-to-be-Nokia), Fitbit, etc, to name but a few, don’t always have common great experience with interoperable standards of their own and for now remain relatively distinct from clinical data.

I keep going b ack to one, probably erroneous analogy, but one that resonates for me: If the world of Finance can do it – individua accounts, globally, networks of cash machines, credit cards, merchants etc, why can’t medicine? The answer is: We can. Let’ make it happen!

I’m impatient and keen to see more integration. It’s not there for technical but also legal reasons. Often for good reasons. But a great discussion on how to move forward on this seems smart and a great reason for this chat!

Join us, on May 12th, at  6 PM CET (5 PM GMT / 12 PM EST / 9PST). It’s in English and moderated by the excellent minds of Christina Roosen, VP, Public Affairs, HIMSS Europe (@croosen @himsseurope ) and Ruud Koolen, Editor in Chief, Skipr, @Ruud_Koolen / @skipr

Oh and don’t forget to use the Official Hashtag: #eHealthChat !

See you there!


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This post was written for, and published by, HIMSS Europe on the 11 March 2016, in the run up to eHealth Week 2016 in Amsterdam. 

The kind of healthcare innovations we find ourselves discussing today are a natural extension to the never-ending innovation medicine has always been about. Always learning, always improving for the betterment of the health and comfort of the people it serves.  An extension from diagnosis and treatment into an even increasing focus of prevention, and better management of the condition. Ignoring this continued innovation, the opportunities to transform the daily lives, at some point and to varying degrees, of hundreds of millions of European citizens would be tragic.

At eHealth Week in Amsterdam, organised by HIMSS Europe, the Dutch Ministry of Health and the European Commission I’m confident we’ll see the fruits of much innovation.

For those who have infrequent interactions with the health service, current healthcare delivery probably seems  OK, but even within this ‘silent majority’, there remains scope for each and every one of us to be better taken care of and for opportunities for preventative or early warning of need for care to interject. Innovative solutions to improve education through communication is hugely important too for public health.

Even if occasional, there is also probably a better way, to say nothing of the economic impact, than the disruption of organising and making the visit to your General Practitioner or other clinician to get a relatively simple issue addressed. And for those of us with more complex medical needs, the opportunities for transformation seem truly open-ended, given how little has changed – from the patient’s perspective – since the dawn of the connected phone, the internet and consumer-focused technology more broadly.

As much as human contact is important – looking into the eyes of your doctor inherently reassures and will have certain advantages for the clinician too, there must surely be scope for technology to replace some of this in-person interchange.

The fear of the unknown shouldn’t blind us from the problems of today

We also shouldn’t be too starry-eyed about the current level of interaction we are able to have with doctors. Intermediaries: administrative personnel or other clinical support team are often part of the picture and access and data doesn’t flow flawlessly or without error. The financial and resource pressures on systems across Europe to sustain the existing delivery models will only increase.

There is however a danger; imposing ‘solutions’ on patients. Some of us live with our conditions for decades, and they’re as much part of our daily lives as anything else we do.

Perhaps more than ever, the delivery of healthcare has to become more personalised. Innovations need to be designed and implemented as a partnership, not least if it requires encouraging people to wear or install equipment into their homes. And dare I mention it: for all the opportunities for long term economic opportunities for countries as a whole, there is presumably going to need to be a mature conversation about the up-front investment requirements. Who will pay for the wearable? Who will train the patient?  Somehow populations – clinicians and patients – across Europe and beyond need to have a voice in what they want, and ultimately be prepared to pay as a society.

Let’s discuss on Twitter about the pros and cons of innovation in healthcare – #eHealthChat

With all these thoughts in mind, I am really excited to participate in the live tweet chat on 12 April at 6 pm CET organised by HIMSS Europe and ICT&Health on such an exciting topic in healthcare at the moment: Innovation. We will discuss the pros and cons of innovation, reading different people’s experience with innovation, both the success stories and the challenges which still need to be overcome. Through these conversations we will be able to overcome our fears of the unknown to make innovation a positive reality.

I look forward to talking to you on Twitter! Don’t forget to use the official hashtag #eHealthChat!

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This post was written for, and published by, HIMSS Europe on the 11 March 2016, in the run up to eHealth Week 2016 in Amsterdam. 

When I first became unwell, almost 20 years ago, the specialist told me that dialysis and other clinical care should be managed around my life and not my life around the condition. I loved the philosophy and I aspire to that goal. In so doing I’m prepared to risk a paradox with more self-management to liberate the most burdensome aspects.

As we progress deeper into the 21st century, innovations enabling mobile, remote and other aspects of health tech can provide tools to do this. Reducing the patient in the person is ultimately what it comes down to. Less disruption for ourselves, those we are close to, and to our work.

We now enjoy a much greater access to informed sources and an ability share experiences with fellow patients thanks to the internet. Now we have the emergence of wearable sensors and connected devices in the home, giving us a much richer – and frequent – picture of what is going on with our bodies.

More time living, less time as a patient

Helping us to adjust home treatments will help us avoid hospital visits, and when we really need to go (or communicate with the doctor remotely) we can be alerted. This builds confidence for the patient and the doctor, and results in less disruption.

The good news is that we have already seen progress. A the time home, my dialysis machine had zero capability of recording, let alone feeding back data to the doctor’s 200km away. An outpatient appointment could only deliver a fraction of information and a lot could change between. Solutions now exist. For diabetics, for example, devices provide much more regular readings, adjustment opportunities, and a record for the clinician to review. And there are connected scales, blood pressure cuffs, thermometers and smart watches.

But there’s more to do and I’m inpatient! Thankfully the Dutch Ministry of Health, the European Commission and HIMSS Europe organise the eHealth Week 2016 in June which will no doubt deliver the latest solutions and thinking.

Smart interpretations of trends, warnings, and individual tailoring. And perhaps above all: we need to find a way to improve, dramatically, how the data picture is shared in a coherent, legal and helpful fashion with health providers and patients without multiple siloed data streams – a troubling picture already starting to emerge – overbearing the recipient. Fail on this and the data may not be used safely or to its full potential. Furthermore, training, financing and consent are all part of a complex picture that are ultimately probably harder to sort out than the technology itself, to say nothing of the fact that not everybody wishes to have bits of equipment strapped to their bodies.

Personally speaking, addressing these hurdles is worth the end goal. More time living, less time as a patient.

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Official eHealth Week ’16 Press release:

eHealth Week programme announced

  • The Netherlands is amongst the leading countries in eMental Health practice
  • Privacy Code of Conduct to protect mHealth data
  • The added value of Personal Health Records
  • The human aspect of eHealth

3 March 2016, The Hague, Netherlands

Today the Dutch Presidency of the EU Council, the European Commission and HIMSS Europe announced the programme for eHealth Week, an event that will take place from 8 until 10 June in Amsterdam. Experts from across Europe will share best practices, amongst others about eMental Health, the online prevention and treatment of mental health conditions.

The Netherlands is one of the leading countries in eMental Health practice. Two out of three Dutch mental health care institutions apply eMental Health in their care provision and in the communication with patients. According to research from GGZ Netherlands, approximately 100.000 Dutch patients make use of eMental Health. Moreover, between 60 and 70 per cent of Dutch mental healthcare patients are receptive to the idea of eMental Health.

All in all, the programme of eHealth Week will provide a variety of sessions connected to the themes: Empowerment of the People, Trust & Standards and Social Innovations & Transitions. For more information about the programme please click here.


How to protect your privacy while using mHealth apps

A Code of Conduct can help App developers are often small companies or individuals and may lack the legal expertise to take complex data protection rules into account and apply them to their mobile health apps. This coincides with the current lack of trust by citizens in these apps as demonstrated by the results of the European Commission’s mHealth Green Paper consultation and other studies.

In order to improve this situation and to help app developers comply with data protection principles, one year ago, the European Commission, together with the industry, launched the development of a Privacy Code of Conduct for mHealth apps. This initiative will be discussed in a dedicated session of the second theme, “Trust & Standards“, where representatives from different sectors will address the latest draft of the Code of Conduct and next steps.

Pēteris Zilgalvis, Head of Unit Health and Well-Being at DG Connect at the European Commission, said: “I am happy that this initiative moved forward so rapidly and I hope that it can soon be presented to the Article 29 Working Party, the independent European working group on data protection. Once approved by them and applied in practice, I believe the Code of Conduct will be a great step towards increased trust in mHealth apps.”

The added value of Personal Health Records

In one of the sessions connected to the “Empowerment of the People” theme, experts will discuss the added value of Personal Health Records and how their use can be integrated and implemented on all levels. For patients with health information and data in multiple places it is difficult to keep track of their medical records. With the use of Personal Health Records patients can collect, track and share information about their health. Improving the ‘information’ position of the patient is a precondition to achieve empowerment and self-management.

“The conversation about Personal Health Records comes at an important time in Europe, where it is common for patients to travel within the continent on a regular basis. How are we all expected to keep track of our records? Can we find common ground? This session will address important eHealth aspects which affect all stakeholders alike and promises to be extremely insightful”, said Christina Roosen, Vice President of Public Affairs at HIMSS Europe.

Ethical aspects of eHealth: do we pay enough attention to the human aspect?

Also featuring in the programme, will be a discussion around the critical technical breakthroughs that are leading to humans to be increasingly replaced by machines, technologies and robots. Replacing human contact and how to deal with these issues when scaling up new initiatives will be the point of focus during one of the sessions connected to the theme “Social innovations & Transitions“. Experts will share opinions and develop practical guidelines for practical initiatives.


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This post was written for, and published by, HIMSS Europe on the 15 February 2016, in the run up to eHealth Week 2016 in Amsterdam. It was also published, in abbreviated form, in Dutch, on ICT 

Through choice or circumstance, millions of Europeans live in another EU state. A further 180 million or so do so on temporary visits according to Eurostat. And like me, some of these citizens live with a chronic medical condition and find themselves immersed within the realities of more than one health care system at some point in their lives.

The child of two different EU nationals, and later living in third Member state, it hasn’t always been easy to keep a consistent and reliable information state for my health. To date I have been the guest – across borders – of 15 different hospitals and visited tens of general practitioners and depended on an even great number of specialists.

There is impressive work to implement reliable and interoperable systems within respective European countries, but I have yet to see evidence for much hope when it comes to information flows, when you cross from one to another country.

And yet, we have a policy context across the European Union where citizens are mobile and furthermore enjoy various rights to cross-border healthcare, so is it not important that the we start to think about how the data can match this?

Nothing has changed over the past 20 years.

As things stand it is as if the innovation of information technology simply never existed, with clinicians sending ad-hoc patient information, usually in paper form, between one another. And this assuming that they are minded to cooperate, linguistically interchangeable and have the time to spare.

Retroactively requesting records, can also prove challenging. Handed over after weeks or months, and if my torturous experience has anything to go by, in an often incomplete state, it’s not a tenable approach.

The only certain continuity – present at all those different appointments, assessments or overnight stays is the patient. With little other option the patient ends up giving a verbal (and layman’s) history to the doctor of the moment. However, with the tools currently available it is impossible to be comprehensive once you get beyond a tonsillectomy, assumes a compos mentis patient and demands a forgiving consultant.

It’s time to build the foundations, for now and for the future.

I am excited to be attending the eHealth Week 2016 (link it to the website) in June. With the main slogan, “You, at the heart of transition”, it gives me great hope that the spotlight turns to the patient’s perspective, currently almost untouched territory, ripe for thought and innovation.

Just perhaps the notion of a “data hub” residing within the profession, or perhaps just who has access to the keys, needs to be turned on its head, to build reality where the patient is empowered to hand over an accurate picture of their health. Not least to be best placed to address the issues of the future where there will be shift akin to the transformation “always-on” internet following the punctual “dial-up”. No longer an appointment or a test, but 24 hours per day of data creation with mHealth and remote monitoring etc.

Many of the challenges at a national level including around “patient portals” aren’t be mutually exclusive but I hope the groundwork can be built with a thought to interoperability at the pan-european level to match the movement and clinical access policies many citizens already take advantage of.

(Very approximate figures, to give an idea of population flows were based on: Eurostat: EU citizenship – statistics on cross-border activities

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This past week, Zeraph launched a funding campaign on Kickstarter for their ‘Flow’, which in addition to hooking up to the phone via Bluetooth, it has a light giving a quick indication of anomaly, and also promises not to require skin contact:

“One of Flo’s key strengths over many thermometers is that it never touches the body and doesn’t require constant cleaning. This greatly reduce the risk of contamination and can be used on multiple children in a short period of time. As such, it is great for those who work closely with kids. Flo is also quiet and will not wake up a sleeping baby, as it does not make a sound or touch the body.

It follows the Consumer Electronics Show in Las Vegas, unveiling by Withings of their own “Thermo”, a thermometer equally for its time, designed to get readings fast through multiple rapid sensor readings,and synced via Wifi to the Withings platform (available on the web and smartphone).

How accurate both are, I am not qualified to say, but it’s great to see the phone/cloud as a platform for the history and perhaps above all the speed and ease of a reading put at the forefront. and, After the various blood pressure and scale products we’ve had on the market for the past several years, it would appear to be the next obvious solution.
Here’s a video to the Flo’s promotion video:

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We continue to see the inevitable – and for me, welcome, ‘medicalisation’ of wearable as time and technology marches forward.

I have long argued that the devices we see today in the tech-consumer world are all ‘wellness’ / fitness type gadgets. Often little more than a modern pedometer, perhaps with a gyroscope and software algorithms to increase the accuracy and an app /social-component to make it engaging/fun. They’re increasingly cheap to make, and small and light to wear. And of course they don’t need regulatory approval as a medical device.

Earlier today respected Paul Sonnier shared a hopeful – but perhaps still early stage – “SenseGO” sock from The Hebrew University of Jerusalem.

Apparently there’s also a similar concept on the horizon already, but I felt it was worth discussing from an ‘evolutionary’ perspective.

If you read the source article, you can sense the rapprochement from something less wellbeing/fitness/motivation focused and closer to the medical arena. Put simply the concept could potentially go as far as to reduce the number amputations by giving the all-important preventative warnings – something that remote monitoring, close-proximity solutions will increasingly thrive at.

It’s not some sort of magic bio-sensing chemical change detector but a mesh of sensors capable of detecting pressure thus preventing the formation of ulcers. Frankly I find it quite ingenious.

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This year it feels like it’s actually happening: consumer focused health tech is happening.

And yes, fitness bands are as plentiful as TVs, but this year it seems the focus has moved – ever so slightly – away from merely fitness, and more towards health.

Much of how it’s marketed ends up being a question of regulatory hurdles, but it’s exciting to see the shift.

Check out your hemoglobin? No problem. Buy a relatively inexpensive device – Embar (from Ceracor) and enjoy non-invasive readings, and results/graphs etc on your smartphone. It currently seems marketed to athletes, rather than as a medical instrument but perhaps before too long this sore of technology could help millions with renal, hepatic and other chronic conditions.

Check your wriggling infant’s temperature and have the hope of it being a reliable reading ? The newly announced Thermo from Withings may be up your street with 16 sensors taking 4000 measurements in 2 seconds (and presumably some relatively intelligent software engine to interpret all that).

There’s also an actual blood pressure watch-looking device from Omron. It’s not using PST – which we have to hope can be the future – but that means it’s legal and hopefully accurate!

And for all I tire somewhat of the pedometer type bands, the downward trend in pricing is exciting. It gets people to understand the benefits of having continuous data about their wellbeing. It gives company the revenue, an ability to scale , recruit talent, and ultimately generate more specialised products which may not otherwise have been possible.

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Official eHealth Week ’16 Press release:

THE HAGUE, THE NETHERLANDS – (HealthTech Wire / News) – The Dutch Ministry of Health, Welfare and Sport, the European Commission and HIMSS Europe officially announced the themes of eHealth Week 2016 in Amsterdam earlier on today. Empowering People, Trust & Standards and Social Innovation & Transition will be the three main topics which will be addressed during the three day conference in June. The patients will have a prominent role during the event, reflecting the focus which is being placed on people and citizens who are using eHealth in the Netherlands and across Europe.

eHealth Week  is an official part of the Presidency of the Netherlands in the Council of the European Union, which will take place from 1 January until 30 June 2016. During eHealth Week 2016, over 2,000 international experts in IT and healthcare, public institutions, professional and patient organisations are expected to attend.

The Dutch Minister for Health, Welfare and Sport, Edith Schippers, highlighted the importance of eHealth Week taking place in the Netherlands: The Netherlands is a pioneer in the area of innovative products and services in the healthcare sector. Whether it concerns diabetes, e-mental health, healthy ageing or equipment for diagnostics, Dutch companies are a global actor and are highly regarded. They can mean a great deal for the healthcare sector and the patient.”

Martin van Rijn, Dutch State Secretary for Health, Welfare and Sport added: Technological developments succeed each other rapidly. It is our job to make sure that new technologies will lead to better healthcare where people who need support and healthcare are key.”

Empowering people

This theme will address self-empowering eHealth for patients and healthy citizens in order to enable them to be more active in managing their own health. It will also explore how elderly people can continue to live independently and how eHealth applications can better meet the needs of users.

Trusts and Standards

Proper legal frameworks are a precondition for healthcare providers, enterprises and member states to be able to exchange data.  Legal clarity is also necessary to ensure trust among the public in eHealth solutions and applications. Proper standards and technical solutions are needed to make systems interoperable and connect the different actors. The objective of the theme is to exchange knowledge on how to promote and enhance trust in health IT systems and how to increase the use of standards in eHealth.

Social Innovation and Transition

Often, much emphasis is placed on the technical aspects of eHealth. However, scaling up eHealth also requires a different mindset on co-operation, organisational and cultural innovation – organising healthcare in a smarter, more efficient and effective way. In this theme, the social aspects of implementation and innovation are key. This theme will stimulate implementation, scale and use of eHealth and discuss where, why and how implementation and upscaling has been successfully achieved and how best practices can be replicated.

Christina Roosen, VP Public Affairs for HIMSS Europe, also revealed the significance of the confirmed themes: “Patients, doctors, nurses and healthy people actively following their health status will change the way that healthcare is delivered, not institutions. eHealth Week will focus on the people that are changing the health care system, and this starts with the power of patients”.


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Some ‘patients’ – usually people with chronic condition who use health services as much as many use their local supermarket – are pushing for more, many techies are fiddling about with the emergency of tech-driven fitness, and the big companies [Apple, Alphabet/Novartis, Microsoft, Fitbit etc] know they’re on to something. And, not to be forgotten, the ever-increasing number of ‘Health hack’ conferences are popping up worldwide.

The demand is insatiable, and I’m delighted to see it’s finally happening.

Right now many of the consumer gadgets are just that  – toys. They rarely have the capability or indeed the legal, regulatory, approval to go beyond incentives for a better lifestyle. None of them can really make health claims, but they’re all hovering around the field.

From social competitiveness with Nike Fuel points, peer-pressure rankings from the number of paces you’ve walked, pretty pictures of food you’re suppose to eat, they are however, building a platform to bolt on much more interesting and valuable clinical capability.

The bridge from taking a pulse to a good indicator of blood pressure  – or glucose reading – is surely not all that far off.

Take the Apple Watch: Launched with enormous fanfare and Apple was keen to show off its ‘state of the art’ ‘top secret’ ‘health and fitness lab’ to accentuate what it saw as an important component of the wearable.

The bulging ceramic (or glass on the lower-cost model) back plate is rumoured to be  technically capable of more than reading a pulse. Perhaps by the 2nd or 3rd generation, we could dare to hope that this back plate will do a heck of a lot more, including blood pressure readings (via PST). Now, whether they market it as blood pressure remains to be seen. I suspect ultimately it will depend on legal rather than technical decisions.

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Official eHealth Week ’16 Press release:

AMSTERDAM, THE NETHERLANDS – (HealthTech Wire / News) – eHealth Week, the leading eHealth event of Europe, will take place in Amsterdam on 8 – 10 June 2016. This was announced in Amsterdam yesterday during the Info Day about the eHealth Week. The event is organised by the Dutch Ministry of Health, the European Commission and HIMSS Europe. eHealth Week is an official part of the Presidency of the Netherlands in the Council of the European Union which will take place from 1 January until 30 June 2016. During eHealth Week 2016, over 2,000 international experts in IT and healthcare, public institutions, professional and patient organisations are being expected.

“eHealth can improve outcomes for patients”

Director Paul Timmers, Digital Society, Trust and Security, DG Connect, European Commission, stated during the meeting: Digital solutions can empower citizens to manage their health, while health and care systems can improve their efficiency and cope with the increasing demand from an ageing population. eHealth can not only save time and costs, using resources more efficiently and avoiding duplication, but also improve outcomes for patients.”

The latest eHealth developments will be discussed during the eHealth Week. Presentations will be delivered by high level speakers through workshops, sessions and interactive panel discussions. eHealth Week will bring together government and ministerial delegations as well as the private sector, thus encouraging productive discussions around how these two areas complement each other and what lessons can be learned.

Christina Roosen, Vice-President at HIMSS Europe added: “We are particularly excited to be announcing next year’s host country as The Netherlands as one of the most digitally mature countries in the EU. It is home to one of the three HIMSS EMRAM  Stage 7 hospitals in Europe as well as having eight Stage 6 hospitals: it is an ideal place for the European eHealth Community to come together. We hope to gather eHealth leaders from every region in Europe to encourage knowledge sharing so we can strive towards our common goal: to advance healthcare through information technology.”


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