What's your No. 1 message about e-health?
It seems to be on a regional basis, or in pockets. It seems to me member states haven't taken ownership of it yet. We are encouraging member state to engage a bit more with benchmarking, patient access and reimbursement. Governments haven't yet engaged with this stuff. They don't realise the financial savings that there are because home treatment is something that will save considerable sums of money.
Do you think member states don't realise the potential savings, or do you think they are more focused on cutting budgets now?
That's the problem with health – it's not a cost, it's an investment […] Technology is driving capacity for patients to look after themselves with some supervision.
If e-health is only being practiced in pockets, are you afraid some people are being left behind?
Yes. There are many pilot schemes throughout the EU, in many different regions, the UK, Spain, Italy, France, Catalonia. All of these places are promoting it on a regional basis. It's quite understandable it is coming from the ground up, but it needs now to grow into the national level and get governments to take some kind of ownership, to identify the need for some funding and see what sort of scope there is for reimbursement.
What role should the EU play?
Always a problem when you're talking about health at an EU level: competence is an issue. And particularly in the area of health care, there isn't the competence at the EU level to deal with these things […] However, the EU is uniquely placed to talk about interoperability, this is an obvious one. [It can] bring member states together so you get the regions to get bigger, get onto the national level.
Health First Europe wants interoperability between country health systems by 2012. That sounds ambitious.
The interoperability part, that's technology, that might be the easier part to do rather than getting hearts and minds behind it.
Yes, but it needs a lot of money and a lot of coordination.
We have interoperability in banking charges, that has been largely solved now. If you force the pace, this after all is really a technical issue.
The directive on cross-border health care just passed. How do you see that playing out?
[The EU is] not opening a very wide door, but can deal with situations that arise. Patients can get access [to health care] from member states and get reimbursed at the member state-level where they live. Whether it's going to burgeon into something bigger, I have my doubts.
Health First Europe recommends that funds for health care are allocated proportionally. What are you hoping for?
As you know, lots of people, as they get older, hope to live in their own environment and prefer not to live in a nursing home, and that's the possibility with remote support that e-health and telemedicine can provide […] We have the technology, the interoperability is being built, but let's not forget this is a patient-focused exercise. Let's not lose sight of that at the member-state level. Talk to patients about this, this isn't just a technology for technology's sake, there's a purpose.
Is there an area of e-health you think needs more funding?
A huge amount of technology is already there. For the benefit of patients I'm not sure there needs to be more attention to that. I think attention needs to go into making the patient aware of what it is they can do and making member states aware of what can be done for patients as they get older to keep them out of nursing homes and hospitals.
