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 ehealth 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-thespot guidance to healthcare professionals and patients

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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