Aiming for a #HealthyEU. Countdown to European elections - eHealth? Show me the money (or at least the savings)
16.05.14
The ‘e’ in eHealth needs to stand for ‘evidence’ if we want to drive Better Outcomes in a sustainable way. That’s at least the conclusion I have drawn from a couple of events I have participated in over the last month. I’ve just returned from the Commission’s eHealth forum – part of the Greek EU Presidency – and a couple of weeks ago I attended a very good event on health organised in London by Wired magazine. I have, then, had quite a dose of inspirational hyperbole on Big Data, the Internet of Things and a vision of Wearable Tech that will email my doctor if my blood pressure gets out of control… I am inspired. But I also have some questions.
Whether it’s the ‘cool’ startups of the Wired world, with new ways of using apps, sensors or social media; or the slightly more policy heavy big stuff like, making sure e-prescribing works, it is clear that the eHealth agenda is broad-based and here to stay. There is good reason for this. We are on the cusp of revolution in many aspects of healthcare: from the way we organise services, to the way we treat people, the way we develop new knowledge about disease and better target new therapies, and much more. I want to focus here, though, on one particular issue and that is the promise of greater efficiency.
The common thread that ran through both events was the strong implication that all this new technology will not only make things easier and improve patient outcomes, but it will also make health systems more efficient. This is the Holy Grail! Europe spends around €700bn on the management of chronic disease right now and with the number of over 65s likely to increase by 75% by 2060, improving the quality and efficiency of care is essential if we are to avoid breaking the proverbial bank.
This challenge has been well known for some time, and it is not for the want of trying that the numbers still look challenging. During the course of our recent Health and Growth project, we reviewed a sample of around 70 government programmes aimed that improving disease management and drive greater efficiency in health services often with a strong element of eHealth. The frustrating conclusion of our exercise was that, in most cases, there was hardly any proper evaluation evidence on whether any of these programmes worked – let alone saved any money. This is a problem, particularly if tens or even hundreds of millions of Euros are spent on pilots that don’t’ go anywhere. ‘Pilotitis’ is a common complaint from the eHealth and efficiency community. But a pilot will lead to positive change if rigorous evaluation evidence that asks all the right questions about effectiveness and cost effectiveness are built in from the start.
In medicines, we are used to an obligation to provide evidence on effectiveness and cost effectiveness – more than any other part of the health system. Getting past ‘pilotitis’ in eHealth and the broader issues of disease management, needs to learn from this and start investing more, not just on new technology but on the data that will help us understand if it is helping!
