m-Heath personalisation 09/03/2015

M - HEALTH conference ( K4I) :

A. The EU population is changing dramatically because of a higher life expectancy and a

lower fertility: longer lives and fewer newborns. It is related to the changes of

cultural patterns, models of families, better conditions for life - and health care area

achievements. We are not only living longer, but we live longer being healthy. The

real challenge is - ageing society with all consequences. And the objective in today's

debate is - ICT for ageing well.

- The number of European citizens over 80 will double by 2025, and triple by 2060 ( 62

million), and the number of people over 65 years is expected to rise to 150 million of

European population in 2060;

- The ageing of population can undermine the foundations of Europe's health and social

care systems. Labour markets, workforce and overall our cohesion - as a society - is at

risk, as the ratio of active vs. inactive people is shifting dramatically;

- So, we need keeping the elderly society in activity: by voluntary work, social activities,

cultural and educational involvement, new deliverables from health care area, and via -

silver economy development. In all those areas - the significance of Digital Game

Changer will increase;

- In our interconnected world, driven by breakthrough technologies, the right

innovations for active and healthy ageing can help citizens stay active and independent

for more years, while saving costs for governments and creating profits for businesses;

- The Digital Single Market, better to express it in broader terms - the European Digital Package: can support a fair, more sustainable and prosperous society for

elderly generations. And it concerns many dimensions of the digital revolution, also e-

health field.

B. What we really need for e-health development ?

- Point one: it is crucial to have a developed infrastructure : fast internet, accessabile socially and geographically, with possibilities of super high quality traffic

management, ensuring precise ( in miliseconds) delivery of data. It means direction

to 5G, and well described specialized services related to the public goods, as

eg.health care goals. We also need the high performance computing infrastructure

development for fast processing the data and secure storages, addressed to the health

care challenges - it will be the basis for real personalization of treatments, therapies;

- Point two: it is significant to know, that at the same time we should avoid digital exclusion of some parts of the society. We need to develop e-skills for having all

m-Heath personalisation 09/03/2015

people, also elderly included into the digital health. It requires special programs and

responsability. Avoidance of the digital, social exclusion is one of the most important

challenges of cohesive society;

- Point three: it is key to have clear rules of personal and privacy data protection, harmonized in Europe, and in relation to the sensitivity of health data - all over the

world. This is not a barrier and burden, this the background for the trust - key for

new relations between patients, doctors, and providers of medical services;

- Point four: it is important to have standarization of many procedures, not redundant, but adjusted to the needs of clear assesments of the state of the health. The doctors'

decisions should be based on real, comparative evidence and give both sides the real

certainty of the taken procedures - it is important for the new framework for liability

requirements;

- Point five: it is fundamental to include the technological opportunities into the health care area system. In less than two decades, Internet and mobile phones have totally

changed our communication methods. Mobile phones have already revolutionized the

access to emergency care, and the Internet has proven its usefulness in terms of

health-related education, self assesment of the state of health and information for

patients. Over 100,000 smartphone have been created health apps. Medical use of

new technologies has become a fully-fledged field of scientific research. The number

of mobile applications is on the rise, from coaching to prevention, screening,

diagnosis, monitoring, therapeutic education, adaptation of care and orientation

toward treatments. Engineers, bio-statisticians and clinicians are working together

to develop new forms of telemedicine that serve patients and health professionals.

Connected devices are the latest innovation in this ongoing revolution. The increasing

miniaturization of sensors and the spread of smartphones have spurred the growth of

these new tools, which make it easier for people to monitor their healthcare data on

the go and share it with medical professionals if they so choose;

- Point six: it is very important to understand how the e- health solutions can simplify the organisation and order in the area of health by delivering fast access, modernising

the work of clinics and hospitals, building the real orientation on patients in

management. This is the way for better and more transparent accountablity of

services. In addition, e-health can give us many cost effective business models - not

only for savings, but for improvement the medical services and the quality of life of

the ageing society;

- Point seven: it is valuable to understand the key benefit related to the new model of health care. The expression connected health, or m-health, has come into

widespread use to designate a breakthrough hat is not just technological, but also

social. Internet, connected devices generate new knowledge for users and lead to the

personalisation of care. In this new paradigm, there is an increasing interest in

m-Heath personalisation 09/03/2015

healthy individuals, not only with the purpose of treating or caring them, but

especially of helping them to manage their health better, supported by a continuous

monitoring;

- Point eight: it is important not only to include new technologies' achievements to the health care, but also to integrate existing health care models, especially oriented at

silver generations with new opportunities given by technologies. It is related to the

two models: more traditional and more innovative forward-looking frames. The first

is based on a strong trend towards products and services which provide personal

assistance through human interaction supported or enabled by the technology - there

are many examples in Central Europe and the South countries. The second is based

on a role for much more automated services and processes - there are many cases in

Scandinavian, Anglo-Saxon, and continental countries. Both models require, now - to

become more tailored and personalized;

- Point nine: it is the open problem: how to finance this paradigm shift ? As some experts suggest :" Long-term financial sustainability rests on the balance of

stakeholders' "gives" and "gets" across the value chain". The "get" means the package

of all forms of utility received from services and products - produced and delivered:

this is the m-health implementations, with all improvements, efficiency and reduced

costs. The "give" is the perceived price of products, services or payments contributed

to the value chain, which is key for the economic side. There is no doubt - we need

now to combine efforts of the business, the app economy fast development results

with the ways for financing research, experiments by European funds from Horizon

2020. We need stronger cooperation and public-private-partnership at the area of

e-health. I hope, that it is possible. Also, we should consider - how users/patients can

contribute in the transition processes of building the future structure of e-health. But,

the fundamental question is - who will be the economic buyer of the future model of

m-health ? National Health Systems ? With stronger participation of the

clients/ individuals ? How to develop the discussion on that topic, and consider - that

in some poorer countries the possibility of generation some sources for this shift

paradigm will be very limited. What kind of the role the particular countries should

play ? What is the task for European Union institutions ? And - how and when we

will be able to create the big demand of the m-health services, which - as a market

power can change everything, also our recent predictions. The list of questions is

long... But, let us make this list - longer and longer, because it is needed for further

analysis and debates;

- Point ten: it is a key - to know what kind of benefits m-health can bring for medical services personalization:

Deliverance of educational content, preventative information and on-the-

spot guidance to healthcare professionals and patients

m-Heath personalisation 09/03/2015

Real-time monitoring of patient condition using sensor networks

Direct delivery of treatment and care at scale and at distance by mobile

telemedicine

Collection, transfer and analysis of the clinical data - which is so important

for comparison datasets, their processing and using for recent assesments of the threats

in the health care area.

All those benefits, all those advantages are also, and very often first of all - addressed to

the elderly people.

C. I believe that Europe is ready to start the paradigm shift towards personalised

m-health. However, many conditions still need to be fulfilled.

1. Building a better understanding and awareness on many different fields

2. Education and training of professionals: how to deal with the new personalised

approaches

3. The engagement of patients and health care providers

4. To ensure a flexible regulatory framework

5. Development of common criteria and standardisation that will allow evaluation,

certification and recommendation of mHealth. There is a need for standards (e.g. for

quality, safety, usability and communication)

6. And last, but not least - to find the formula and sources of financing transition

period to the e-health model ( also with financing the research needs), and - probably -

to change radically ( ? ) the ways of financing the health care area in the future.

D. So, there is the way - for ICT ageing well.

Michal Boni, MEP

Brussels, 9th March, 2015