Mid May saw the annual gathering of European policy makers and project participants at the eHealth Forum in Athens. Almost every other presentation I attended considered the citizen as the center around which health and social care should be organized. This would help boost the adoption of eHealth technologies, as they focus on bringing care directly to patients. This is one of the key policy priorities in Europe's future vision for health. Unfortunately, the governmental, provider, and clinician perspectives were still overwhelmingly present. Surely, initiatives working from these perspectives claim to put the citizen at the center as well. But in reality, they only put the patient in the center of their own specialized and hence fragmented care processes. Rather than continuing on this path to fragmentation, what would happen if the citizen would be the true starting point for a most personal care experience?
Personal digital experience
Today's digital revolution puts powerful tools in the hands of the citizen. These tools enable us to really promote and strengthen the citizen's perspective on health and social care. A Personal Health Record, or PHR, for each citizen is part of my vision for the future of health. A PHR is a digital place to safely store medical data, and to use this data in new smart ways. Such a personal health record can function much like your smartphone: it holds crucial data and allows you to install apps to interact any which way you see fit. Choose and book according to your needs, priorities, and financial possibilities. I'm convinced this will help overcome some of the problems we are facing with eHealth adoption today. Let me illustrate this with three examples.
Patient access to medical data
The European Commission has made patient access to their Electronic Health Record Data a priority. Imagine what could happen if you were to use this data in combination with PHR services. For instance, you could quickly fill out an online questionnaire on your health history, prior to your first visit to a medical specialist. Or you could use it to create an optimal training schedule, that takes into account your current condition and treatment goals. The demand for such access to EHR data would quickly change from being a policy priority to a real demand by patients in daily life.
Currently ePrescribing is operational in only a few European countries. Even these leader countries have been slow to reach high levels of adoption, mostly because it has proven to be hard to motivate or incentivize professionals to invest in technology and change their routines. Badly designed solutions might also have hampered the uptake. What could happen once patients become part of the dynamics, using their PHR to follow up on their prescriptions and to remind them of their daily medication routine? Given a choice, guess where they will go to get their prescriptions filled. As soon as professionals see their business slowing down, the decision to adopt is much easier to make.
Providers and governments are attempting to engage the patient with a variety of telehealth applications. These range from simple telemonitoring for women in a slightly risky pregnancy, to intricate home monitoring systems for frail and dementing elderly people. Not having a common platform, such as a PHR, makes it costly and cumbersome to actually succeed in making the patient part of the care process. So let's turn it around and consider the PHR as much part of the network as are the EHR's of the providers.
Make it personal
From a patient's perspective, eHealth in its current form is not about putting the patient at the center, but about throwing a scattered set of technologies at the patient to make healthcare cheaper and the lives of the professionals easier. Some of these initiatives are very successful for limited groups of patients. But none of them are expected to scale to a level that actually addresses the core issue of healthcare reform across Europe: sustainable growth of health services, within tight financial and workforce constraints. Requiring newly developed services to take the citizens – and their personal health records – as the starting point will make all the difference.