‘The transformation of health care in Europe will be influenced largely
by putting prevention at the heart of European health systems’
MEP Irena Joveva
The virtual meeting of the European Parliament’s Interest Group on Innovation in Health and Social Care entitled ‘Prevention at the heart of European health systems’ took place on Tuesday 8 December 2020. The aim of the meeting was to bring together policymakers and representatives from patients’ groups and healthcare associations and academia to discuss how to invest in secondary prevention and preparedness to optimise public health response to health threats, how to implement good practices and policy actions to foster screening and early diagnosis in Europe and to highlight the critical role of clinical laboratories in fostering access to screening.
The virtual table was opened by HFE interim Director Brandon Mitchener, who reminded everyone of the importance of the EU4Health initiative to strengthen the resilience of the EU healthcare system. He noted that the focus of this meeting, and its contribution to the initiative, was to show the critical role that screening and early diagnosis can play in detecting illnesses before any symptoms are noticeable and to curbing the progression of diseases, thus maximising quality outcomes for patients while reducing costs.
The discussion was hosted by EP Interest Group Co-chair MEP Irena Joveva (Renew Europe, Slovenia), who highlighted the impact of the COVID-19 pandemic on exposing the vulnerabilities in the European health systems and stressed the critical importance of bringing together different groups and stakeholders to better inform policy decisions. She furthermore noted that most current healthcare systems focus on tackling the later stages of all diseases, instead of attempting to prevent diseases themselves. She stressed that secondary prevention provides a better chance of curing diseases and helping people live happier and more productive lives. She also underlined the importance of awareness and education and encouraged the meeting to make several concrete proposals for the future of the European Health Union.
The first part of the discussion was focused on finding the most effective manner in which Europe can invest in secondary prevention and preparedness to optimise the public health response to health threats. Elisabeth Dupont, European Regional Manager of the International Diabetes Federation, provided an overview of the devastating impact that the pandemic has had on patients with diabetes as well as the burden that diabetes itself creates both health-wise and economically in Europe. She noted that 75% of diabetes costs in Europe are associated with complications that are preventable. She pointed out that while primary prevention is important, secondary prevention can also enhance the length and quality of life for patients as well as save valuable health care resources as it allows for their re-distribution in other areas. Finally, she recommended driving the digitalisation of health services including creating electronic health records and telemedicine, fostering the integration of care across all sectors, and implementing guidelines and best practices.
Isabel Rubio, President of EUSOMA and a board member of the European Cancer Organisation, highlighted that prevention is the most cost-effective public health strategy. It leads to better survival-rates, especially with cancer patients, due to the detection of tumours at an early stage. She noted that there are disparities in terms of cancer screening programmes throughout Europe as many countries lack them, but most importantly, that there are inconsistencies in terms of the data used by screening programmes as well as an apparent lack of quality assurances. She stressed that this leads to the inability of researchers to properly compare compare data for the different screening programmes across the continent. Finally, though noting that there are many challenges to create new screening programmes, she recommended the implementation of a European cancer dashboard that monitors screening coverage and performance and the creation of a European platform for screening agencies to facilitate rapid best practice-sharing as well as boosting of EU research initiatives supporting screening related policy needs.
Following questions directed to the previous speakers, the meeting moved on to a discussion of policy actions needed to help foster secondary prevention and promote the role of clinical labs in public health. Tanja Valentin, Director of External Affairs of MedTech Europe, stressed that Europe needs a paradigm shift from managing sickness to preserving health, and said intervention at the right time is crucial, but not always the case. She highlighted three examples of how secondary prevention could be beneficial, one of helping to prevent heart failure using diagnostic information to care for the condition and avoid acute episodes. Her second example was on the prevention of AMR, which kills tens of thousands of Europeans a year, and how technology can help prevent it. Finally, she highlighted the use of digital solutions in the fight against COVID-19. Lastly, Ms Valentin recommended to re-think care delivery through task shifting (for example from doctors to nurses, hospitals to GPs, etc.) and using enablers such as technology as well as creating financial incentives to allow for the transition of health systems from those that tackle diseases to systems that prevent them.
The last contribution was given by Damien Gruson, Head of the Department of Clinical Biochemistry at the Cliniques Universitaires Saint-Luc in Brussels. He highlighted the multitude of uses and the future opportunities that technology can provide to medicine. He stressed the need for cooperation between sectors as well as the need for integrated care, as care itself is currently being transferred from hospitals to patients’ private homes due to a reduction of the length of treatment in hospitals since the 2000s. He also mentioned that although the COVID-19 virus has accelerated the use of technology by medics, much more of this needs to be done to ensure early diagnosis, identify groups with higher risk and help patients to avoid exposure to other infections. For this, Dr.. Gruson showed how remote monitoring and data science could be used, such as with biomarkers, but he also highlighted that this needs to be done in a multidisciplinary format that includes the involvement of both patients and healthcare workers.
In the ensuing discussion, panellists agreed that prevention needs to be helped with crucial training by all stakeholders through a peer-reviewed system, but that age and other factors could limit the use of technology. Panellists also agreed that for the implementation of data compatibility throughout Europe a dashboard for quality indicators is needed for several diseases as well as the standard approaches to the collection and organisation of data. Overall, participants agreed on the multi-faceted approach that is needed to put prevention at the centre of European health systems.