What is telemedicine?

Telemedicine is about interaction between either a patient and a health professional or between two or more health professionals without direct physical contact. It has a long history in the provision of medical care over a distance starting from telephone and video consultations. From its niche activities until the 1990s in aviation, maritime, space, defence and disasters settings, it has evolved to embrace everyday teleconsultation and monitoring involving specialists. Currently, the term TeleHealth is being used as a synonym, although we prefer to consider that the term TeleHealth includes Telemedicine as well as the use of ICT for health prevention purpose.

We further consider TeleHealth as a subset of eHealth. Under the eHealth term, one has indeed also to include the infrastructure needed to run telemedicine and telehealth services, as well as several applications that supports the health care delivery process such as the Electronic Health Record …

What is telemedicine in practice?

Today’s telemedicine applications include teleconsultation, telemonitoring and counselling involving medical specialists. Concrete examples include - telemonitoring of diabetes patients, telecommunication between different healthcare providers, international experts providing teleconsultation to dermatologists, blood pressure measurement from a distance, online consultations with general practitioners and cardiologists, transmission of X-ray images in emergency cases, transmission of critical bio signals of the patient from emergency site to the hospital, telemonitoring of cardiac patients, online consultation / monitoring in remote areas, transmission of sounds, images and videos recorded by primary care doctor to a specialist, video-conferencing between medical staff, monitoring the daily activity of a person living with dementia or video-conferencing for psychiatry, teleeducation for Continuous medical Education.

What is the role of telemedicine in the current healthcare paradigm shift in Europe?

As healthcare in Europe is currently evolving from reactive to preventive care and from a hospital-centred to a person-centred system, telemedicine provides a viable solution to increased demand for personalised preventive care at a distance, in particular for care at home.

In particular, as the number of the European ageing population with a number of chronic conditions is soon expected to outweigh the capacity of hospitals and traditional nursing staff, telemedicine is expected to become a major contributor to supporting both health and social care as well as the quality of life of elderly people living at home. How does telemedicine fit the EU’s eHealth strategy?

Telemedicine is an integral part of the EU’s eHealth strategy adopted in 2004 and ,telemedical applications are developed as part of that strategy. In addition, as eHealth was identified as one of the six most promising fields for creation of innovation-rich products and services in the EU’s Lead Market Initiative (December 2007), the initiative’s eHealth lead market action plan identifies telemedicine as one of the sectors on which innovative solutions for public services should be created.

How does telemedicine contribute to the EU’s Lisbon goals?

The EU’s Lisbon Agenda is about creating more growth and jobs. Telemedicine addresses these challenges by allowing the emergence and creation of a completely new market of health care providers, consisting mainly of SMEs that can play a major role in supporting the delivery of future health care through provision of care at home.

SMEs providing health and social care at home will both alleviate the pressure on national health systems and boost the European economy by potentially creating millions of new jobs.

How can SMEs be part of the delivery of telemedicine?

As part of a sustainable health and social care in an ageing European society, a new type of health service industry, mainly consisting of public and private sector SMEs is emerging in Europe. This emerging industry is comprised of new innovative health service professionals delivering competitive quality medical care for premium health services and bringing quality of life for citizens and patients, who do not want to, or cannot, be cared for in hospitals.

This new breed of health service providers is positioned somewhere between traditional health professionals and the IT industry and seeks to combine high medical quality with entrepreneurship and sound business understanding. Their revenues would come both from social reimbursement schemes and elsewhere.

Examples of telemedicine SMEs?

Among the SMEs we have recently met that fit with that new type of health service industry, one can find:

· PHTS (DE) http://www.phts.de/phts

· Vitaphone (DE) http://www.vitaphone.de

· Medgate (CH) http://www.medgate.ch

· Telbios (IT) http://www.telbios.it/

· Medix (CH) http.//www.medix.ch

This list is only illustrative and not exhaustive, neither at company nor at health service type level.

What are the current challenges for efficient and sustainable telemedicine?

Use of telemedicine services in the EU member states is currently delayed due to long testing phases of both EU and nationally funded telemedicine pilot projects. Lengthy pilot phases are due to the lack of a global vision of the role of eHealth in the transformation process of healthcare and the lack of, until recently, appropriate and ready to use interoperable – and secure - communication infrastructures. It is also due to poorly documented and unproven return on investment (ROI) models, the unclear and restrictive legal environment and the lack of reimbursement schemes for telemedicine by both statutory and private health insurance schemes.

What is EHTEL doing on telemedicine?

EHTEL (the European Health Telematics Association) represents over 200 key actors in the field of eHealth and provides a platform to all European eHealth stakeholders to exchange information, identify challenges and find solutions towards making eHealth real for all.

The recent EHTEL report entitled ”Sustainable Telemedicine: paradigms for future-proof healthcare” provides for its members, politicians, healthcare professionals, providers and insurers as well as other stakeholders a snapshot of the state of the art of European, national and regional level progress towards sustainable telemedicine services. The report presents the current achievements and best practice examples drawn from a number of either on-going or completed pilot projects across. On this basis, it emphasize a set of Recommendations towards a larger scale deployment of telemedicine services. An annex to the report provides an overview of EHTEL national member state reports on telemedicine. These country reports outline the vision and objectives of countries’ ministry of health’s vision on telemedicine and presents national telemedicine strategies. The individual reports also explain how telemedicine is positioned within the eHealth strategies and roadmaps of each country.

What is the main message of the report?

Based on the national member state reports and overall European achievements in telemedicine so far, EHTEL sets out a number of recommendations for achieving sustainable telemedicine services in Europe by 2020. These include: · facilitating change in everyday operations for health care professionals and patients;

· using patient-centred telemedicine to involve and engage professionals and patients in the overall eHealth strategy;

· establishing a culture of interdisciplinary and cross-sectoral collaboration between different specialised medical fields;

· formulating explicit national strategies, scenarios and business models for sustainable telemedicine;

· establishing a European support framework to coordinate progress and future deployment of sustainable telemedicine.

What are the activities of the EHTEL telemedicine Task Force?

So far, the EHTEL Telemedicine Task Force has focused its activities both on learning from the experience gained by health professionals already using telemedicine services and on the sustainability criteria of these services. It has also addressed the patient’s and citizen’s concerns on telemedicine and drafted a specific Patient’s Charter for eHealth in the framework of an EU funded project called Healthware (http://healthware.alcasat.net/).

Next, the Task Force will consider business aspects of telemedicine as well as some medical aspects related to the management of chronic diseases. At global level, EHTEL is in the process of combining its efforts with the International Society for Telemedicine & eHealth (ISfTeH) to contribute to the realisation of their shared goal of advancing the use of Telemedicine and eHealth for better health and care for all.

Media Contact

Jacqueline Bowman
Scope Communications
Tel: + 32 2 307 39.62
Mobile: +32 472 54 45 78
e-mail: jacqueline.bowman@scope-communications.eu

EHTEL Contact

Marc Lange
Secretary General
Tel: +32.2.230.15.34
e-mail: Marc.lange@ehtel.org
web : www.ehtel.org