EU countries urged to embrace telemedicine 

Earlier this month (4 November), the Commission adopted a Communication to support and improve access for citizens and healthcare professionals to telemedicine services in Europe.

The EU executive is proposing various concrete measures to be introduced by all relevant actors, but especially by member states, to address three types of challenge  that are slowing down the take-up of services for care at distance: 

• Lack of confidence in and acceptance of telemedicine services; 
• lack of legal clarity, and; 
• technical issues related to facilitating market development.

According to the Commission, there is "limited evidence of the effectiveness and cost-effectiveness of telemedicine services on a large scale". Therefore, it argues that awareness, confidence and acceptance of telemedicine by health authorities, professionals and patients still needs to be strengthened.

"The paramount objective" in providing more legal clarity for the sector is to ensure that telemedicine develops "in such a manner that it benefits patient care while ensuring privacy and the highest standards of patient safety," notes the EU executive. Meanwhile, the lack of legal clarity with regard to licensing, accreditation and registration of telemedicine services and professionals, liability, reimbursement and jurisdiction are also hindering further development of the sector.

As for technical hurdles, the Commission underlines that  the ability of providers to enable full connectivity with all geographical areas in the EU, including rural and ultra-peripheral regions, is "a prerequisite for the deployment of telemedicine". The solution to this would be to provide broadband access for all. Furthermore, the Communication notes that interoperability and standardisation are crucial for widespread take-up of the new technologies. 

The EU executive underlines that regardless of the efforts in which itself and other stakeholders are willing to engage, "it is the member states' health authorities, primarily responsible for the organisation, financing and delivery of healthcare, that remain the principal actors with the ability to make telemedicine a reality".

"Telemedicine can radically improve chronically ill patients' quality of life and give people access to top medical expertise. It is our duty to make sure patients and health professionals can benefit from it. At the same time, the provision of remote healthcare services through ICT can optimise the use of scarce human and financial resources in the medical field," said EU Information Society Commissioner Viviane Reding, 

"The key to success is the full involvement of citizens, patients and health professionals," added Health Commissioner Androula Vassiliou. 

Eucomed, the voice of the medical technology industry in Europe, called on member states to contribute to the Commission initiative "by implementing the essential follow-up action at national level". 

Markus Siebert, chair of Eucomed's Working Group on Cardiac Rhythm Management Telemonitoring, said that "many of the critical responsibilities to make telemedicine a reality lie with member states," in particular regarding reimbursement of telemedical solutions, such as pacemakers and defibrillators, which are used for the remote monitoring of cardiac implants. "Whilst the funding for these implants would traditionally be the responsibility of member states, remote device monitoring is not a device in the traditional sense. It is a combination of a medical device and a surrounding service for the patient and the professional. New, innovative funding solutions are thus needed that do not disincentive the use of the monitoring devices," he added. 

Eucomed also supports all efforts to increase cooperation between health professionals and patients on telemedicine to improve confidence and acceptance, while taking into account ethical and privacy related aspects. If such innovation is to be permanently accepted, it is essential "that it meets the needs of the clinical community in terms of clinical effectiveness, safety and ease-of-use. In addition, medical professionals who use telemedical solutions, such as remote monitoring technology, need to be remunerated for their activities in a way that does not put them at a disadvantage compared to conventional activities," Siebert continued.