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European Medical Students’ Association
Association Européenne des Étudiants en Médecine
www.emsa-europe.eu
External Meeting Report
6th eHealth Stakeholder Group Meeting
Felix MACHLEID, European Health Policy Director (EHPD) 2017/18
Lina MOSCH, European Health Policy Director Elect
Justinas BALCIUNAS, EMSA Permanent Officer
Minutes
Tour de table
Investigation on the implementation of eHealth in the medical curriculum by EMSA
DG SANTE specific topics
Start of new Joint Action eHAction
Report from the working groups - state of play and discussion
Citizens and Data (confirmed by Anne Moen EFMI)
Care continuum (confirmed by Anne Carriazo RSCN)
Interoperability and standards (confirmed by Christof Gessner HL7)
New and shifting balances (Kjartan Olafsson, UEMO)
Reimbursement (confirmed by Michael Strübin, MedtechEurope)
Discussions on the eHealth stakeholder groups ending
Short recaps from recent events
The EESC opinion on Digital transformation of health and care
First Meeting of Member States for the Implementation of the Declaration of Cooperation
Towards Access to at least 1 million sequenced genomes in the European Union by 2022
European Commission Recommendation on establishing a European electronic health record
exchange format
DG CONNECT specific topics
State of play on new call for mandate eHSG (current mandate ends Spring 2019)
Upcoming H2020 calls
State of play on the European Innovation Partnership on Active and Healthy Ageing
Presentation by BEUC position paper on eHealth: recommendations and principles
E M S A . H E A L T H . E U R O P E . T O G E T H E R. ___________________________________________________________
Rue Guimard 15 1040 Brussels, Belgium Tel : +32 2732 72 02 www.emsa-europe.eu
[email protected]
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Background of Meeting
EMSA is an official member of the eHealth Stakeholder Group (eHSG) of the European Commission (EC)
for the period 2016 - 2018. “The eHealth Stakeholder Group is expected to contribute to the
development of legislation and policy related to eHealth. Policy areas of specific interest include
relevant actions of the Digital Single Market Strategy and the eHealth Action Plan (2012-2020).” 1
The mission of the eHSG is to:
1. “Give input on the design, implementation and evaluation of eHealth policy activities, in
particular on the implementation of the eHealth Action Plan 2012-2020;
2. Discuss and give input on the deliverables of the Joint Action supporting the eHealth Network;
3. Advise the Commission on eHealth-related activities by preparing reports and opinions and
submitting relevant data.” 2
The following graphic is a visualisation of EMSAs involvement in the field of eHealth on EU level.
Time and Venue
Time: 12th of October: 09:30 - 17:00
Venue: Albert Borschette Conference Center, room 1C; Rue Froissart 36, 1049 Brussels
Participants at Meeting
Most of the stakeholders were represented in the meeting. The full list of members of the eHSG can
be found here.
1 Compare: https://ec.europa.eu/digital-single-market/en/news/ehealth-stakeholder-group-members
2 Compare: http://ec.europa.eu/transparency/regexpert/index.cfm?do=groupDetail.groupDetail&groupID=2769
E M S A . H E A L T H . E U R O P E . T O G E T H E R. ___________________________________________________________
EMSA Secretariat Rue Guimard 15 1040 Brussels, Belgium tel : +32 2732 72 02 [email protected] www.emsa-europe.eu
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Content of Meeting
In general the meeting focused on updating the stakeholders on the current state of play of activities
and future means of action of DG SANTE (Directorate-General for Health and Food Safety) and DG
CONNECT (Directorate-General Communications Network, Content and Technology) and the different
working groups within the eHSG.
Minutes
Tour de table
Stakeholders presented themselves and shortly briefed on what they have been working lately and
what input they will give in this.
Investigation on the implementation of eHealth in the medical curriculum by EMSA
EMSA presented the results of the survey on the medical student’s opinion on eHealth and its
implementation in the medical curriculum.
The presentation was well received by the other stakeholders and the commission who gave
important input on how to follow-up on our work.
DG SANTE specific topics
Start of new Joint Action eHAction
The 3rd Action to Support the eHealth Network was launched in June 2018 and is in alignment with
the eHealth Action Plan 2020. The main priorities can be grouped in 4 areas: A. Empowering people,
B. Innovative Use of health data, C. Enhancing continuity of care regarding legal challenges and
directives / guidelines, D. Overcoming Implementation Challenges like interoperability, eSkills for
E M S A . H E A L T H . E U R O P E . T O G E T H E R. ___________________________________________________________
EMSA Secretariat Rue Guimard 15 1040 Brussels, Belgium tel : +32 2732 72 02 [email protected] www.emsa-europe.eu
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professionals, data protection and security, evaluation of eHealth. 21 countries are active in
eHAction, 9 countries are collaborative stakeholders. The stakeholders within the eHealth stakeholder
group are part of the Working Package 2 on Dissemination, which is led by Portugal. The network
expects to facilitate cross-border healthcare across the EU, to overcome barriers in implementation
of eHealth into national policies, sustainability and provide necessary policy support. EMSA is part of
WP4 (Empowering people) WP8 (Integration in national policies and sustainability) and WP 5.1
(Governance and big data).
Deliverable lifecycle
1. Creation (WPx Leader + WP1)
a. list stakeholders, invite for workshop, co-creation, survey ideation
2. Discussion/Revision (WPx Leading discussion + WP1 + WP2)
a. QM, RM, all WPL/Co L, Public consultation (WP2), web-site (WP2), working document
review)
3. Dissemination
a. eHN approval
There will be 2 information notes:
● D2.1 dissemination and stakeholders engagement strategy
● D2.4 Leaflet & Booklet
Questions from stakeholders and discussion:
● What is the difference between partners and stakeholders? Will the stakeholder group be
redundant at one time?
○ The joint action is going to work and all the stakeholders can express their interest to
join or can be selected by the Commission. Stakeholders will be able to give input in:
Co-creation on the deliverables or in the moment of the revisions
● Will there be workshops?
○ Each workpagage should organize different workshops that eHealth stakeholders can be
invited to.
E M S A . H E A L T H . E U R O P E . T O G E T H E R. ___________________________________________________________
EMSA Secretariat Rue Guimard 15 1040 Brussels, Belgium tel : +32 2732 72 02 [email protected] www.emsa-europe.eu
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○ Comment: maybe stakeholders should not be selectively invited but should be able to
take part if they feel concerned with the matter.
Report from the working groups - state of play and discussion
Citizens and Data (confirmed by Anne Moen EFMI)
Citizens are extremely heterogeneous in use of digital health data and digital health literacy skills.
Patient should be able to collect, curate and control their health data. A code of conduct base on the
4 “Es” (Engaged, Equipped, Enabled, Empowered) should guide future policies and development of
health innovation.
Care continuum (confirmed by Anne Carriazo RSCN)
The group emphasizes that the EC can set directions but health remains in the hands or national or
even regional authorities. All the information however should be traceable. The recommend to focus
on healthy lifestyles promotion, stakeholder engagement and leadership, empowering and engaging
people, an overall balanced approach (top down and bottom-up), to share important information and
results, to protect data security and privacy. EMSA commented that t we found in our survey that a
majority of medical students with patients having access to their health data. We have to keep this
discrepancy in mind and how we can overcome it. Comments from the group were that according to
the law patients have the right to their data so the question is not if we make it available but how.
One way would be to make the consent for access to health data interoperable. Health data is the
ownership of the patients, it is unfortunate that young people lack the knowledge.
Interoperability and standards (confirmed by Christof Gessner HL7)
The report introduces a very detailed roadmap for the achievement of more and better
standardisation. The group claims that a flow of trusted data builds the basis of a well-functioning
health system. According to the authors, a key element for widely introducing equal standards and
interoperability in healthcare is the respect for differing perspectives of the stakeholders. Therefor,
the working group introduces an “eStandards Compass” which shall help stakeholders building up an
understanding of other perspectives. When actually implementing standards and interoperability
features, this should take place in a concrete setting where stakeholders co-create, govern and align
their solutions along the eStandards life cycle. An open question at the end of the presentation was
how the work that has been already done in terms of standard setting could be endorsed and re-used
/ improved. CPME criticized that some key stakeholders were not consulted to give input to the
report, for instance physicians as end users of health technologies. The stakeholders agreed that in
the end, it is not about creating many different standards but about using them to achieve better
health.
New and shifting balances (Kjartan Olafsson, UEMO)
The group points out health care professionals are change aversive and non- adaptive to eHealth
solutions. The aim of the paper is to finding ways to bridge the gap in order to promote a meaningful
digitalization. Comments from the stakeholder were that all problems should be put into perspective.
E M S A . H E A L T H . E U R O P E . T O G E T H E R. ___________________________________________________________
EMSA Secretariat Rue Guimard 15 1040 Brussels, Belgium tel : +32 2732 72 02 [email protected] www.emsa-europe.eu
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It was welcomed that ehealth is not only shown form its positive side. They expressed the need for
user centered development in terms of co-creation involving all users in the process. They suggested
to discuss specific barriers / doubts about eHealth by different professional groups in this report as
we are multidisciplinary group.
Reimbursement (confirmed by Michael Strübin, MedtechEurope)
Aim: adoption of the report, dissemination at an event in Q1 2019.
Discussions on the eHealth stakeholder groups ending
The stakeholders discussed a possible umbrella paper based on all subgroups from the group. This
might take some extra time because the stakeholders would have to consult their respective board.
The papers should be published for the wider audience. If each group is going to present their own
statement there should be a template to have a consistent format. The conditions under which these
papers have been written should be made clear to the readers.
Short recaps from recent events
The EESC opinion on Digital transformation of health and care
ESSC supports the vision of the Commission of people centered care and strengthening the
sustainability of health and care systems through the digital single market. Citizens should decide if
and when to share their health data. The aim should be to reduce the time spent in hospitals & assist
recovery of patients and to overall increase quality of health and care.
First Meeting of Member States for the Implementation of the Declaration of Cooperation Towards
Access to at least 1 million sequenced genomes in the European Union by 2022
Many European countries have signed this member state initiative. The meeting concluded to aim to
build a research cohort of at least 1 million whole genomes in the EU and to establish a “good
genomics practice group” to identify the key components of the initiative and ensure good use and
outcomes of genomics data. More information of the initiative can be found here. The declaration of
the meeting can be accessed here. The next meeting will focus on deciding who should be sequenced:
Healthy or ill citizens.
European Commission Recommendation on establishing a European electronic health record
exchange format
The Recommendations are in line with the 3 pillars expressed in the Communication on the Digital
Transformation of Health and Care. The overall aim to find the technical means to build up on the
right of the citizens to their health data and to parties they decide through their EHRSs, in a secure
manner. Elements to address are: to promote interoperability and secure access and use of health
data, to work towards common technical specifications for European exchange format of EHRs, to
monitor the uptake of the European EHR exchange format
E M S A . H E A L T H . E U R O P E . T O G E T H E R. ___________________________________________________________
EMSA Secretariat Rue Guimard 15 1040 Brussels, Belgium tel : +32 2732 72 02 [email protected] www.emsa-europe.eu
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DG CONNECT specific topics
State of play on new call for mandate eHSG (current mandate ends Spring 2019)
The mandate of the groups ends in Feb 2019; In the light of the Communication published in April a
different policy framework was created for the stakeholders. A discussion of the future of the group
started. In general, a continuation of the group was emphasized. It is a good forum in terms of the
Commission consulting relevant stakeholders.
It was pointed out that it would be good to receive the documents beforehand in order to contribute
to them, consult members and give valuable feedback. Too many points on the agenda, so
stakeholders cannot contribute (CPME). More health organisations should be represented (ESD). So
far, the group was not really used as a source of consultation, because the tight agenda did not allow
it. The Commission has mainly used the form to present their work. The Commission should facilitate
the meetings for the different stakeholders rather in terms of coming together and working together,
not as it has been done so far. The frequency of meetings to quarterly meetings was proposed. The
Commission should be aware that the capacity of stakeholders present differs a lot, form
organizations who pay their representatives to organizations who do not. Asking the stakeholders for
input can put some immense burden in terms of workload on some organization and in consequence
decrease the effectiveness of the whole group. It was asked that the Commission should share their
views on the continuance of the group with the members first and then co-create a definite solution
(ECHAlliance). An E-Mail will be sent to the stakeholders in spring 2019.
Upcoming H2020 calls
Slides will be shared. Stakeholders are invited to the H2020 call. DDL: 14th of November
24th of April - call for 5 topics (eHealth and innovations...)
State of play on the European Innovation Partnership on Active and Healthy Ageing
The staff working document summarizing what has been achieved by EIP has been adopted and will be
published in the next days. Partners will be called to renew their commitment in 2019. A conference
of partners will take place in February / March 2019.
Presentation by BEUC position paper on eHealth: recommendations and principles
BEUC points out that consumers must have full control over their personal health data, especially in
the light of the electronic health record and that strong regulations and guidelines for eHealth
technologies are needed. Through GDPR a balance between the interests of scientific health research
and consumers protection should be achieved. AI in healthcare should be applied in full respect of eU
data protection rules. Consumers can only benefit from tools that respect privacy and security ba
esgn and by default principles. Digital health products and services must be safe and reliable to use. A
change of mindset is needed. Last, digital solutions should be promoted only along with access to an
affordable high-speed internet. The policy paper is supposed to be published the following week.
E M S A . H E A L T H . E U R O P E . T O G E T H E R. ___________________________________________________________
EMSA Secretariat Rue Guimard 15 1040 Brussels, Belgium tel : +32 2732 72 02 [email protected] www.emsa-europe.eu
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Follow Up
The European Support Division for eHealth is going to consider the input we received during the
meeting in the further analysis and follow-up of the EMSA survey on eHealth. In April, Lina is going to
use the results for a presentation at the Deans' meeting "Training Future Proof Doctors for the Digital
Society" organized by Erasmus University Medical Center Rotterdam (Erasmus MC) and DG SANTE in
April in Rotterdam. We were also offered options of publishing the results with the help of other
stakeholders. Since the mandate of the group is ending in February 2019 the next board will keep an
eye out for the all and apply for renewed mandate.
Finances
No reimbursement from EMSA was received or requested. Travel expenses were covered by the
European Commission.
Conclusions
The meeting was very beneficial for EMSA to attend in terms of staying involved in the work of the
Commission, networking and increasing our visibility. We received important feedback for our own
work and support to successfully advocate on it.
The Commission and the stakeholders have worked on eHealth since 2012 continuously. With rapidly
changing mandates it is difficult for a student organization like EMSA to stay involved in their work.
Regarding a sustainable and stable involvement of EMSA it was great to have the acting EHPD and the
EHPD Elect at the meeting to introduce Lina to the work of the group and the people present.
Thank you for taking the time to read our report. If you have any further questions feel free to
contact us via E-Mail.
E M S A . H E A L T H . E U R O P E . T O G E T H E R. ___________________________________________________________
EMSA Secretariat Rue Guimard 15 1040 Brussels, Belgium tel : +32 2732 72 02 [email protected] www.emsa-europe.eu
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Europeanly yours,
Felix MACHLEID
European Health Policy Director (EHPD) 2017/2018
E-Mail: [email protected]
Lina MOSCH
European Health Policy Director (EHPD) Elect
E-Mail: [email protected]
Justinas BALČIŪNAS
EMSA Permanent Officer
E-Mail: [email protected]
E M S A . H E A L T H . E U R O P E . T O G E T H E R. ___________________________________________________________
EMSA Secretariat Rue Guimard 15 1040 Brussels, Belgium tel : +32 2732 72 02 [email protected] www.emsa-europe.eu