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21 November 2009
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Report identifies barriers to eHealth standardisation 

Published: Monday 3 November 2008   

Conflicting ICT standards in the health sector are creating interoperability problems between computerised health information systems, leading to unnecessarily high costs of health services and missed opportunities for industry development, concludes an overview of eHealth development in the EU.

Background:

The lack of interoperability in ICT systems and services in the healthcare sector, such as electronic health records, patient summaries and emergency data sets, has been identified as a major obstacle to the widespread take-up of eHealth applications in the EU.

The development of interoperable healthcare systems across the EU 27 was defined as one of the main priorities of the bloc's eHealth Action PlanPdf external up to 2010.

A Commission RecommendationPdf external  on cross-border interoperability of electronic health record systems was adopted in July 2008. A large-scale EU pilot project, the Smart Open Services project (S.O.S.)external , was launched in July to test practical implementation.

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The "right" e-health standards for specific applications and examples of their concrete use are also lacking, reveals the studyPdf external , requested by the European Commission.

As well as the current bleak situation, the report identified several stakeholder-specific barriers that are complicating the adoption of future e-health standards:

  • Political barriers: Different national and regional health system standardisation approaches, low government support for standardisation and lack of incentives to communicate electronically.
  • Standards Development Organisations (SDO) barriers: The development of common standards is hindered by competition between different SDOs, which develop their own e-health standards and seek positive returns. 
  • Company barriers: Like SDOs, ICT firms seek positive returns from their standardisation efforts. Adoption of commonly used standards can be costly, while conflicting standards can be good for business of companies selling middleware or services to make systems interoperable.
  • ICT user barriers: Health service providers such as general practitioners and hospitals find it expensive to identify the best standards, convert existing data to correspond accordingly and purchase the relevant software upgrades.  

Meanwhile, the report underlines that "wide use of prominent ICT standards could impact positively on economic growth and competition and on the global competitiveness of manufacturers supplying ICT to the health sector".

Interoperable exchange of health information between healthcare organisations could also lead to "substantial" net savings for health service providers as well as improved service quality and streamlined health service processes, the authors said. 

In order to overcome the barriers, the authors recommend starting with the identification, at EU-level, of priority standards for strategic e-Health systems and services and the promotion of their uptake. Afterwards, more specific standards could be developed and conflicting standards harmonised. 

Next steps:

  • 4-6 Nov. 2008: The World of Health IT '08 conferenceexternal .
  • 25-27 Nov. 2008: The European Commission's ICT 2008 conferenceexternal

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