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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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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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