EVENT SUMMARY: EU health stakeholders at the Gastein Forum call for a strong political commitment for safer care to tackle HAIs and AMR

“The next challenge is to implement standardised electronic surveillance of AMR and HAIs in more than 8,000 European acute care hospitals, the ECDC is ready to help make this happen.”

Andrea Ammon, Director of the European Centre for Disease Prevention and Control (ECDC)

 

On 2nd October 2019, Health First Europe organised the “Data for safer care” workshop at the European Health Forum Gastein to explore the disruptive role of data in shaping effective patient safety strategies and develop effective healthcare-associated infections’ (HAIs) surveillance systems.

The moderator of the session Dr Josep Figueras, Director of the European Observatory on Health Systems and Policies , introduced the topic highlighting the potential of data-driven solutions for safer care and the EU’s role in sharing relevant data on patient safety as well as guiding member states to developing a common strategy to improve patient safety.

Data collection and surveillance strategies are needed to foster patient safety and tackle 8.8 million cases of HAIs in EU, along with the threat posed by antimicrobial resistance (AMR). HAIs are a severe threat to patient safety and the most frequent adverse events during care delivery: a total of 228.000 acute care hospital patients and long-term facility residents acquire at least one HAI in any given day in the EU (1 in 15 patients and 1 in 26 residents). Comparable and aggregate data should be collected to guide efficient and transparent patient safety programmes, structures and policies. To facilitate mutual learning, common indicators need to be developed through cooperation between Member States and the European Commission, considering the work of relevant international organisations.

Keynote speakers opened the discussion by sharing their expert opinions on the potential of surveillance systems along with their perspectives on the barriers to their effective implementation. The first part of the debate focused on the main barriers to the implementation of data-driven solutions for safer care, from infrastructures to investment. Federico Lega, President of the European Health Management Association (EHMA), stressed that one of the most important missing pieces is a common vision and commitment to make safer care a strategic, operational and ethical priority. This also means to work across settings to improve data quality and boost leadership for the uptake of data-driven solutions and the use of electronic records.

With respect to the infrastructural barriers to effectively implement electronic surveillance systems, many participants highlighted the differences between hospitals’ software and the resulting lack of interoperability to connect and communicate amongst systems. On data collection and sharing tools, Paul Garassus, President of the European Union of Private Hospitals (UEHP), emphasises that strategic investments in IT are required to develop ‘smarter hospitals’ to improve efficiency in data and patient records exchange between family doctors and private and public hospitals. In addition, many delegates attending the meeting raised the point of differences in terminology, methodology and legal barriers. Health care settings often have access to a massive amount of data without the right insights for interpreting and translating them to enable improvement actions.

Behind those challenges, we can count on many drivers and champions to make AMR and HAI surveillance systems across Europe a reality, starting from the European Centre for Disease Prevention and Control (ECDC). “We are ready to help make this happen in more than 8,000 European acute care hospitals”, stated Dr Andrea Ammon, ECDC Director.

Looking at the drivers for the correct implementation of surveillance systems, participants stressed the importance to promote a ‘safety culture’ in health care settings and the need to put patients’ experience at the heart of infection prevention and control programme. Fiona Garín McDonagh, from Becton, Dickinson and Company (BD), emphasised how patient experience is “at the heart” of what health care aspires to be, adding that “healthcare-acquired infections negatively disrupt this experience. Strong leadership, an effectivepatient safety culture and innovative technology can go a long way in preventing a large percentage of infections and diseases.”

A better use of data and investment in infrastructures starts from political commitment.  Neda Milevska, from the International Alliance of Patients’ Organizations (IAPO), stressed that “through a strong political commitment, a large share of HAIs can be prevented with simple and effective measures”, advocating for an easier access to data for patients across Europe, allowing them to be actively involved in their health decisions.

A first step for achieving a common vision and political commitment, at least to tackle AMR, has been the creation of the EU-JAMRAI, the EU Joint Action on AMR and HAIs, aiming at fostering synergies amongst EU member states by developing effective health policies. Germán Peñalva, researcher at the EU-JAMRAI and the Institute of Biomedicine of Seville (IBIS), presented the preliminary results of the Joint Action and stressed that “timely, regular” monitoring of indicators related to HAIs is a “key factor to design, implement and improve prevention and control strategies. Yet, this monitoring requires professional leadership and institutional support.”

The second part of the workshop aimed at facilitating the exchange of national best practices amongst the participants of the debate. Fernando Simón, director at the Centro Coordinador de Alertas y Emergencias Sanitarias of the Spanish health ministry (CCAES), explained how in Spain developed a brand-new surveillance system, to collect and exchange smart health data across hospitals, boosting efficiency and reducing errors. On the same line, Sinikka Salo, from the Finnish Ministry of Social Affairs and Health, described how “ICT, big data and new technologies, like AI, represent an opportunity to improve patient safety”. She also added how “the EU could promote the creation of common reporting standards and common platforms for the collection and sharing of information”; a best practice example is a Finnish online platform to anonymously report medical adverse events, where instead of “blaming people”, hospitals collect data to improve patients’ treatment and compensate them.

Concluding the two-hour debate, Melina Raso, Director of Health First Europe, called for a joint vision and joint effort of all the health care stakeholders to push for a strong political commitment for safer care in order to tackle HAIs, the most common adverse events in health care settings. The demand comes 10 years after the adoption of the 2009 European Council recommendation on patient safety, Ms Raso highlighted the need to move gradually from disease surveillance systems based on notifications by health care professionals to systems that make direct use of health care data. This will occur only with a greater understanding of data-driven innovation tools for safer care along with the involvement of the political, public health and societal actors.

 

The photos of the events are available on our website and on Flickr.
The key messages of the key contributors are available here

EVENT SUMMARY: ENSH Roundtable debate – Time to Act: #STOPSEPSISEU

How can health stakeholders and EU policymakers work to improve the management of sepsis in all health care settings? How to raise awareness on the burden of SEPSIS?

The 3rd roundtable debate of the European Network for Safer Healthcare was organised by Health First Europe in the European Parliament on 25 September 2019.  Kindly hosted by MEP Simona Bonafè (S&D, Italy), the meeting brought together health stakeholders, national representatives and the European Commission to exchange best practices on how to better tackle the burden of sepsis and to discuss joint efforts that need to be in place to improve sepsis prevention, diagnosis and early treatment.

Sepsis is a major public health emergency due to its high mortality and economic cost.  As emphasised by MEP Bonafè, “Sepsis is a global health crisis and a major challenge for patient safety. Sepsis is a global killer, accounting for 7 to 9 million lives lost every year (equivalent to 1 death every 3.5 seconds). In Europe alone, it is conservatively estimated that more than 3.4 million individuals develop sepsis each year, of whom 678,000 die”. Those who survive may face lifelong physical or psychological consequences, including disabilities. Moreover, sepsis is the pathology with the highest hospitalization costs. In Europe, the costs of severe sepsis amount to typically 23.000-42.000 € per sepsis period per patient. Indirect and long-term costs are much higher, accounting for social costs. However, many studies and organisations suggest that the number of deaths due to sepsis as well as the cost for the health care system are largely underestimated. Sepsis is intrinsically interlinked with antimicrobial resistance (AMR) and healthcare-associated infections (HAIs). Infections which do not respond to first-line antimicrobial therapy due to AMR, may progress to sepsis rapidly. Delays in diagnosis of sepsis and lack of antibiotic stewardship programs are key drivers of the misuse of broad-spectrum antibiotics as a ‘last ditch’ attempt to improve outcomes. Therefore, it is time for MEPs to “work with the Commission and the Council to support the development of consistent national sepsis action plan across Europe”, as stated by MEP Bonafè.

The WHO Sepsis Resolution gives a template for a structured approach to sepsis prevention and management. Unfortunately, and as clearly pointed out by MEP Bonafè, “only very few European countries have followed the call of the WHO Resolution on Sepsis to develop national Action Plans for improving the prevention, early recognition, and management of sepsis in both adults and children”.  In order to fill this gap and tackle the burden of sepsis, the World Health Organization will be working as from next year on developing clinical management guidelines for sepsis, as presented by Dr Mercedes Bonet from the WHO’s Department of Reproductive Health and Research. Those guidelines will cover every health care settings, going from the first contact with the patient to the intensive care unit.

Tackling sepsis requires a broad and multi-level approach. Awareness on sepsis is a way to save lives: changing how sepsis is measured, diagnosed and treated is everybody’s responsibility, from citizens to patients, and health care workforce.

  • Awareness on sepsis is a way to save lives. As highlighted by Marvin Zick of the Global Sepsis Alliance “Not everybody in the world has to know about sepsis, but everybody has to know somebody who does”.
  • Sepsis protocol for the detection should be placed anywhere (meaning in all health care settings) and anytime: every doctor evaluating a patient with an infectious disease should evaluate if this patient presents an organ failure.
  • With a probability of 40% to die, sepsis needs to be recognised and treated rapidly. As commonly agreed, there is an urgent need to work for a better detection and diagnosis of sepsis. However, many health care settings lack the requisite resources and diagnostic capacity to implement current sepsis management,test patients at risk,provide in real-time results to the clinicians to reduce mortality and to permit a continuous adjustment of the treatment based on the obtained results and reduce the empirical therapy.

It is critical to work together at a local, national, European and global level. This roundtable needs to be perceived as a kick-off meeting for broader actions combining the expertise and relevance of each participant to tackle the burden of sepsis. In this respect, the European Union has an important role to play in the fight against sepsis, by means of

  • Promoting European epidemiological studies to delineate the real burden of sepsis in Europe under the guidance of the European Commission and the European Center for Disease Prevention and Control (ECDC). In this framework, the interoperability of existing national or regional patient-level datasets should be facilitated to better understand the epidemiology of sepsis and the link with antibiotic resistance.
  • Designing a comprehensive Pan-European Infection Management Program under the European One Health Action Plan on AMR launched by the European Commission, that includes:
  • Research on prevention of infection risks including an increased capability of early recognition of resistant bacteria and of compromised host response.
  • A common sepsis code for emergency care which requires hospitalization for antimicrobial therapy, and which suggests a suspect of organ dysfunction: a criteria of sepsis.
  • Development and harmonization of existing international guidelines on the identification, diagnosis, and treatment of sepsis to ensure efficient and consistent cross-border implementation.
  • The launch of a European Observatory for sepsis to carry out comprehensive analysis of sepsis impact on public health and costs, as well as to identify best practices in prevention, identification and management of sepsis fostering future European guidelines.
  • Raising awareness of sepsis across Europe by launching a European Sepsis Awareness Week

EVENT SUMMARY: My City-Lab Talk Series – Tackling Heart Failure in Europe: Accessing Innovation & Fostering Integrated Care

The latest meeting of the City-Labs Talk Series “Tackling Heart Failure in Europe: Accessing Innovation & Fostering Integrated Care” took place on September 11th, 2019. The event was organised by the City-Labs team to discuss how to improve care to tackle the burden of heart failure, from diagnosis and prevention to reduction of risk of death throughout integrated care models and solutions.

Why heart failure care is so important for public health? Heart failure is a common condition which occurs when the heart is unable to pump enough blood to meet the body’s needs for oxygen and important nutrients. At least 15 million people live with heart failure in Europe and one in five people can expect to live with heart failure at some point in their life. Heart failure accounts for 5% of all acute hospital admissions in Europe and is the leading cause of hospitalisation in people over the age of 65. As pointed out by the moderator of the debate, Brandon Mitchener (Instinctif Partners), the burden of heart failure is rising due to an ageing population, and health care systems need to get ready to tackle this issue quickly.

The meeting provided an opportunity to present the Handbook of the Heart Failure (HF) Policy Network (Health First Europe’s member), designed to drive policy changes that could make a meaningful difference to care for people living with heart failure. Ed Harding, representing the HF Policy Network, stressed the great physical and psychological burden that heart failure represents for European citizens and health systems. Mr Harding explained that integrated management and multidisciplinary care are essential to provide optimal heart failure care. Multidisciplinary and integrated care is about delivering the best care possible through care plan with a focus on the needs of the individual patient at each stage of their condition. Regular follow-up, access to advanced treatments, psychosocial support, therapeutic education, continuous assessment and regular medication/device review are the essential features of an optimal heart failure care.

With early diagnosis and right care, hospitalisation can be reduced by up to 30%. Yet, the number of early diagnosis remains low, people with heart failure do not see the right specialists, and few patients are followed up properly after discharge. In order to make a shift towards a multidisciplinary and integrated model of care for heart failure, the HF Policy Network calls on governments to recognise heart failure as a financial sustainability challenge for health care systems and to demonstrate measurable improvement on minimum standards.

Alex Lefevre from Roche Diagnostics Belgium presented the key challenges to access innovation for heart failure risk patients:

  • Missing data and statistics on the cost effectiveness of integrated management and multidisciplinary care for heart failure
  • Differences amongst hospitals in the implementation of guidelines aiming at reducing heart failure hospital readmission
  • Health apps which do not fit the patients’ use and needs

Some solutions and actions to tackle these challenges were presented during the discussion, e.g. the development of tools to help doctors follow up with the different guidelines, fostering education on the monitoring and follow up tools, and take patients’ perspective into account in the development of digital solutions and apps.

Damien Gruson, coordinator of My City-Lab, emphasised the impact of heart failure on public health and public expenses: 50% of heart failure patients will die in the 5 years following their diagnosis; 1 in 4 people will be re-hospitalised within a month. Mr Gruson stressed that primary points of care, where access to laboratory tests is facilitated, are part of an integrated and collaborative approach to ambulatory care to support heart failure patients. Such point of care will give the possibility for patients to get their laboratory results in a short time, allowing health care professionals to act quickly. These settings have the advantage of gathering different medical specialities and to speed up the process to prevent and treat cardiovascular conditions.

Heart failure remains a substantial and complex challenge. Every person living with heart failure has a unique journey. Integrated management and multidisciplinary care can support patients and address the unique needs. A takeaway of the discussion is the need to recognise heart failure as an urgent challenge for health sector, requiring a holistic and multidisciplinary approach to bring a meaningful improvement in the care of people living with heart failure.

Please click here to see the pictures of the event.


My City-Lab project – financed by the European Regional Development Fund (ERDF) – aims to create two new primary care structures, called My City-Lab, integrating the innovation of laboratory medicine and mobile health. The scope of the project is to facilitate access to laboratory tests as part of an integrated and collaborative approach to ambulatory care of a chronically ill individual, as well as to contribute to the dynamic monitoring of patients with chronic diseases.

EVENT SUMMARY: HFE & My City-Lab “Profiling the health worker of the future”

Profiling the health worker of the future: digital skills, innovation and collaboration to meet the new demands of care

On 18 June 2019, Health First Europe as partner of My City-Lab project organised a workshop, entitled “Profiling the health worker of the future: digital skills, innovation and collaboration to meet the new demands of care” within the EHMA 2019 Annual Conference in Espoo (Finland). The lively exchange of views among policymakers, academia, worker organisations, student associations and industry aimed to define the perfect profile of health worker of innovative models of care, such as the one promoted by My City-Lab project, as well as to identify systematic changes in the education and organisation of the health workers needed to implement new models of care. My City-Lab is an initiative financed by the European Regional Development Fund (ERDF) which aims to better integrate the innovation of laboratory medicine and mobile digital solutions into health care systems.

The final goal is to facilitate access to laboratory tests as part of a collaborative approach to ambulatory care of chronically ill individuals, as well as to contribute to the dynamic monitoring of patients with chronic diseases. A city-lab site will soon open in Brussels, its workforce should reflect the changing health care eco-system: patient-centred, connected and collaborative.

Speakers’ slides

Event Pictures

Event videos

The brainstorming session, moderated by EHMA President, Federico Lega, saw the contribution of worker organisations, student associations, patients’ representatives, industry, policy makers and health care management experts from all over Europe. They brought into the debate their unique perspective over the challenges of health management and education and the core competences of the workforce of innovative and patient-centred health care models, such as the one promoted by the City-Lab project.

Health care is highly labour intensive and one of the largest economic sectors in the EU – accounting for approximately 17 million jobs (8% of all jobs). Population growth, ageing societies, and changing disease patterns are expected to drive greater demand for well-trained health workers in the next 15 years. As stressed by Melina Raso, Health First Europe Executive Director, implementing new model of integrated care (as the one promoted by My City-Lab Project) requires a radical transformation of skills and core competences of the health workers.

On this note, Loukianos Gatzoulis from Directorate-General for Health and Food Safety from the European Commission gave a thoughtful overview of the changing demand of care and the role of new technologies and models of care to effectively address this change. Ageing, multimorbidities, complex needs require new approaches, aiming at integrating of health and social care as well as at providing an adequate number of well-trained professionals. These challenges require new model of care, shifting from “silo-specialisation” towards a multi-disciplinary approach, where health care workers can safely share patients’ data across settings, effectively collaborate in care plan and work in partnership with social workers.

Laboratories can play a vital function in building health care integrated systems and in the care continuum, by bridging the gap between different settings and the patients, ultimately breaking those silos. Most of the medical decisions are based on test results, by investing in data processing, analytics and talented health care workforce, medical labs and primary care settings can bring stakeholders together and ensure timely, evidence-based decisions. Health care professionals can be the drivers of this shift towards this new and 2 integrated model of care.

Therefore, European health care systems should create the right conditions to promote this new model of care, more integrated, preventive and closer to the patients.

(1) A first condition to shape this new model of care is to rethink the relationship between patients and health care professionals: primary care and lab professionals have a great role to play in re-centring care around the patient, fostering partnership with the patients and the care givers, who see and share the same information. Looking at the bigger pictures of the triangle of health care professionals, patients and technology providers, their relations need to be assessed and re-organised in a way that fit the future of care. In this frame, the role of education is essential to connect the dots of the triangle and meet the new technological challenges.

(2) Secondly, appropriate resources should be in place to tackle workforce shortage and promote primary care and laboratory settings. As highlighted by Bert Van Caelenberg from EUROFEDOP, heath care remains an issue of financial resources: some European countries do not have the resources to retain their health care workers who leave for better economic prospects. Not every country can reward graduates equally, so medical professionals leave. EU member states should look deeper into the challenges of workforce shortage and brain-drain and assess how those impact on personal lives, on patient safety and quality of care in each country. Better social security systems, increased wages and equal working condition across borders shall ensure health care providers are where they need to be.

(3) Lastly, but most importantly: health care decision-makers should identify and foster the core competences of the worker of the future. During the debate, participants identified a wide-ranging list of competences needed for the workforce of innovative primary settings and medical labs, such as:

  • Soft skills (from partnering to communication) and ethical competences
  • Digital skills e.g. basic ICT knowledge, online interaction competences, data collection and monitoring skills, service competences and guiding skills in digital environment
  • Management skills, leadership as well as multi-actor service co-development competences
  • Flexibility

Above all, the majority of the participants recognised partnering skills as the key competence for the whole health care workforce.

Partnering skills can be defined as the ability to apply a collaborative relationship between settings, professionals as well as patients. The end purpose is to work towards shared goals and deliver practical solutions to system challenges or complex and chronic health conditions. The health care worker of the future shall use partnership as a learningmechanism that teaches how to better deliver and coordinate care across settings and over time. With respect to digital skill profiling, it is crucial that health care workers of integrated and city lab models possess sufficient skills and knowledge to make the best out existing digital solutions and bridge the gap between settings. As presented by Tanja Valentin (MedTech Europe), digitalisation allows two main things: it shrinks time (for example on text results) and connects the dots, the players and the key information in a new way, both essential elements to build an integrated health care system.

Nevertheless, participants agreed that the training of the health care professionals might not keep pace with technological developments. The latest survey presented by Marta Simoes from European pharmaceutical students’ associations (EPSA) shows that 75% of pharmacists claim to have no or almost no education on digital health, while 90% of them believe that digitalisation of health care shall change the pharmaceutical curricula and profession for the better, those training combining theory and practices as well as promote inter-professional collaboration. As stressed by Outi Ahonen, Senior Lecturer of Laurea University of Applied Science, health care professionals can be bold and innovative in reforming practices if only they have the right education to make it happen, from informatics to media literacy.

The debate saw also the contribution of Walter Sermeus from Leuven Institute for Health care Policy and Anu Söderström from the Council of Occupational Therapists for the European Countries (COTEC) who stressed digital solutions’ value in order to shift to sustainable and better connected model of care, nevertheless technologies in itself cannot tackle the challenges of the workforce, it is only a tool that health care settings shall use in the most effective way.

With respect to flexibility as a one of the core skills, Lasse Lethonen, representing the Expert Panel on effective ways of investing in health, introduced the concept of task shifting within and between health care settings, concept which is illustrated in the Expert Panel’s opinion on task shifting in health care systems. The Expert Panel’s opinion argues that tasks can and shall be shifted within health care settings, from health workers to patients and their carers, to machines, and to other health workers. Those shifts imply that those involved must be convinced of the rationale for change, flexible in changing tasks and settings and strongly supported in implementing it. Professionals other than physicians, e.g. nurses, medical laboratory professionals, pharmacists, can undertake substantially expanded roles compared to what has traditionally been the case, with the adequate trainings to carry out their function in integrated teams with informationsharing.

The ultimately message of the debate was that Europe shall invest in integrated models and city-lab settings to transform care to better tackle ageing society, changing patterns of diseases, new technologies and decentralisation of organisational structures. Health care workers and management have the chance to lead this transformation, only their vision and expertise can shape the health care systems of the future. In order to make this happen, they need to be placed in a leading role, involving them in decision making and giving them the right tools and trainings to meet the new challenges of health care delivery.

Speakers’ slides

Event Pictures

Event videos

Click here for more information about EHMA 2019 annual conference

City-Labs is a project financed by the European Regional Development Fund (ERDF) which aims to integrating the innovation of laboratory medicine and mobile health. The scope of the project is to facilitate access to laboratory tests as part of a collaborative approach to ambulatory care of a chronically ill individual, as well as to contribute to the dynamic monitoring of patients with chronic diseases, always fostering sustainability. 

EVENT SUMMARY: My City-Lab Talk Series – A greener health: how to foster environmental sustainability in healthcare

The My City-Lab Talk Series meeting “A greener health: how to foster environmental sustainability in health care” took place on May 14th, 2019. The event was co-hosted by the My City-Lab and Metrolab Brussels projects, both funded by the Brussels Capital Region through its ERDF program. The aim was to discuss to what extent healthcare systems could reduce their environmental footprint, without affecting delivery and quality of care.

As the third largest employer worldwide and a major consumer of resources, health care has the potential to make a significant impact in sustainability strategies. Health care is the only sector generating all existing classes of waste, with 20% being dangerous, infectious, toxic or radioactive in nature. As pointed out by the Moderator of the debate, Bernard Gouget (IFCC – International Federation of Clinical Chemistry), sustainability is a key issue in the health care sector which needs to be addressed urgently to better cope with the challenges of the raising demand of care. Arianna Gamba, from Health Care Without Harm, stressed that behind environmental challenges, there are still big opportunities to drive to the health care sector in a more sustainable path. Health care industry is responsible for 5% of the global carbon footprint, which contradicts the nature of hospitals: saving lives. By polluting, health care settings contribute to a lower quality of life among their patients and society as a whole. Measures like substituting toxic chemicals and improving the transportation system around hospitals can be good solutions to reduce pollution. Additionally, the supply chain of purchased goods and services is estimated to contribute to two-thirds of hospitals’ carbon footprint: European health systems face the challenges to implement sustainable procurement policies and achieve a more sustainable organisation. Within the scope, it is worth mentioning that one of the barriers is that recycling plants often do not accept uncontaminated hospital residues (e.g. clean plastic packaging) since they treat it as hazardous medical waste. There is a need to raise awareness about sustainability among the healthcare sector and its key stakeholders to reduce its environmental footprint.

During the debate, Michele Calabrò (European Health Management Association) emphasised the importance of the topic for the industry workers, who are longing for implementing innovative solutions with a long-term approach. Mr Calabrò also stressed sustainability is very much linked to eHealth, which can bring efficiency to the system while reducing resources’ surplus along with their carbon footprint. Hence, education and digital literacy are key to implement a sustainable approach to care, by educating people in changing their mindset and focus on quality rather than cost, looking more at the long-term benefits.

Still on digitalisation, the Coordinator of City-Labs project, Damien Gruson, highlighted that productive cities are green and innovative. Prevention and education can be used by means of digitalisation to reduce the size of the carbon footprint, providing an opportunity for efficiency. Mr Gruson proposed as a possible solution new tools to integrate and track data on hospital waste. Additionally, by having a qualitative data approach, AI solutions could be used to define patients experience to make heath care delivery more efficient: technology can be used specially to not overuse the services and avoid repetitive tests.

Maguelone Vignes (Metrolab Brussels) made an important connection to primary care approach. She stressed that a part of the solution could be reintegrating health care facilities in the city, specially by fostering primary care in order to avoid unnecessary hospitalisations, to ultimately benefit the patients and saving unnecessary resources and costs. Primary care centres are more efficient since they focus on prevention rather than reacting when a patient is already ill.

Health care settings have a major role to play in reducing environmental impact by using their resources more efficiently, designing ‘greener’ buildings, fostering digitalisation and promoting primary care. Projects such as My City-Lab and Metrolab Brussels aimed at creating effective and sustainable settings to make this happen, and ultimately putting citizens at the core of the health care settings of the future.

Please click here to see the pictures of the event.


My City-Lab is a project financed by the European Regional Development Fund (ERDF) which aims to integrating the innovation of laboratory medicine and mobile health. The scope of the project is to facilitate access to laboratory tests as part of a collaborative approach to ambulatory care of a chronically ill individual, as well as to contribute to the dynamic monitoring of patients with chronic diseases, always fostering sustainability. 

Metrolab Brussels (MLB) is a trans-disciplinary and inter-university laboratory for applied and critical urban research, funded by the Brussels Capital Region through its ERDF program (2014-2020). The action of MLB consists in the design, implementation and coordination of a dozen of research projects, all directed towards a single public policy, the ERDF-Brussels program. Urban ecology is one of the topics covered by the project, a key element for city’s growth and citizens’ wellbeing.

EVENT SUMMARY – Personalised Medicine and the Big Data Challenge

Personalised medicine has become a key topic in EU health debate, with its goal of giving the right treatment to the right patient at the right time. On 27-28 March 2018, the European Alliance for Personalised Medicine & Bulgaria Alliance for Person and Personalised Medicine organised the conference “Personalised Medicine and the Big Data Challenge”. The event pulled together leading experts in the arena drawn from patient groups, researchers, healthcare professionals to industry. The conference aims at highlighting the role of healthcare in creating a Europe that functions optimally and encouraging stakeholder interaction on the potential and realistic possibilities in the personalised medicine age.

With rising healthcare costs and individual health systems being increasingly challenged, personalised medicine and genomics could have the potential to impact the health of all of us and provide diagnostic, economic and efficiency benefits, ensuring that patients receive the right information and the right care. This could ease the burden on healthcare systems and lead to a healthier and, thus, wealthier, Europe.

Among the participants, Dutch MEP Lambert van Nistelrooij remarked: “personalised medicine is not just an idea, it is the new reality. And there is no doubt that genomics has a huge role to play in its development and growth“; while MEP Alojz Peterle, a cancer survivor, spoke about the European Parliament efforts in the field and the activities of Specialised Treatment for Europe’s Patients group of  in the Parliament.

The key guest of the event, Vytenis Andriukaitis remarked the importance of eHealth solution to foster health quality: “Helping Member States to implement digital solutions throughout public health sectors, healthcare and cure systems is an absolute priority for me, personally, and for the Commission.

Still on digital health, the participants discussed Big Data and their role in healthcare. Today the health sector generates immense volumes of clinical, genetic, behavioural and environmental data,  collected through an array of devices. This information offers incredible opportunities for citizens, provided that personal data are protected. The use of Big Data for regulatory decision-making on medicines is not without challenges yet, i.e. the fragmentation of data sources and the lack of accessibility. The European Commission stressed in many occasions that Data economy, together with cybersecurity and online platforms, remain an area where further action is needed. Everyone is now looking forward to the upcoming Communication on digital health and on the announced pilar on health data sharing for research and better health outcome.

All the information on the event are available here.

Conference’s report enclosed below.

 

EVENT: My City-Lab Talk Series “A greener health: how to foster environmental sustainability in healthcare”

My City-Lab Talk Series 

A Greener Health: How to foster environmental sustainability in healthcare

Tuesday, 14 May 2019, 17.30 – 19.00
Metrolab Brussels (Quai du Commerce, 48 1000 Brussels)

The purpose of this informal debate is to offer a real and dynamic discussion among key stakeholders and policymakers on how to foster on sustainability in healthcare sector and which approach can reduce environmental footprints, from digital management for efficient use of resources, designing ‘greener’ buildings, to primary care settings to reduce hospital admissions and costs.

As the third largest employer worldwide and a major consumer of resources, healthcare has the potential to make a significant impact on European sustainability strategies. Taken as a whole, health sector consumes a large amount of energy and resources and produces major streams of emissions and waste. Healthcare is the only sectors generating all existing classes of waste, with 20% being dangerous, infectious, toxic or radioactive in nature. Furthermore, the healthcare sector is itself a major energy user. A European hospital consumes on average 300 Kw of thermal and over 100 Kw, of electrical energy per square meter per hour, accounting for 5% of CO2 emissions. Therefore, reducing hospital admissions is not only critical for human health but also for environmental and financial costs.

Healthcare settings have a major role to play in reducing environmental impact by using their resources more efficiently, designing ‘greener’ buildings, and fostering primary care. However, environmental actions to tackle climate change and reduce healthcare impact shall not affect the quality of care, the safety of patients and healthcare workforce, while keeping down the cost and the waste of resources.

Keynote contributors:

BERNARD GOUGET – The International Federation of Clinical Chemistry and Laboratory Medicine
ARIANNA GAMBA – Health Care Without Harm
MICHELE CALABRÒ – European Health Management Association
DAMIEN GRUSON – City-labs project
MAGUELONE VIGNES – Metrolab

My City-Labs project – financed by the European Regional Development Fund (ERDF) – aims to create 2 new primary care structures, called City-Labs, integrating the innovation of laboratory medicine and mobile health.  The scope of the project is to facilitate access to laboratory tests as part of an integrated and collaborative approach to ambulatory care of a chronically ill individual, as well as to contribute to the dynamic monitoring of patients with chronic diseases.

Metrolab Brussels (MLB) is a trans-disciplinary and inter-university laboratory for applied and critical urban research, funded by the Brussels Capital Region through its ERDF program (2014-2020). The action of MLB consists in the design, implementation and coordination of a dozen of research projects, all directed towards a single public policy, the ERDF-Brussels program. Urban ecology is one of the topics covered by the project, a key element for city’s growth and citizens’ wellbeing.

EVENT SUMMARY: ENSH Roundtable on patterns to tackle AMR – Designing effective HAI prevention and control programmes in Europe

We need to have a clear link in our mind between HAIs and AMR. Infection prevention and control are key actions to reduce antibiotic misuse, fight the spread of resistant bacteria and ultimately save lives.
John Bowis, co-Patron of Health First Europe

The 2nd roundtable debate of the European Network for Safer Healthcare was organised by Health First Europe in the European Parliament on 29 January 2019. With the support of MEP José Inácio Faria (EPP, Portugal) and MEP Lieve Wierinck (ALDE, Belgium), health stakeholders, national representatives and the European Commission, met to discuss the implementation of effective infection prevention and control programmes to reduce healthcare-associated infections (HAIs) and to tackle antimicrobial resistance (AMR).

HAI prevention and control is a core element to tackle AMR. The link between AMR and HAIs is undeniable. Data from the European Centre for Disease Prevention and Control shows that out of 671k infections with antibiotic-resistant bacteria in European countries in 2016-2017, 63% were healthcare-associated infections. Plus, the occurrence of an infection increases the use of antibiotics.

1 in 15 patients in acute care hospital acquires a least one healthcare-associated infection on any given day. Every day these infections result in prolonged hospital stays, long-term disability and high costs for patients, family and healthcare settings. HAIs put a great pressure on health systems, causing significant morbidity and mortality. A total of 8.8 million HAIs were estimated to occur each year in European hospitals and long-term care facilities. More than half of HAIs are considered avoidable through prevention and control programmes. How can we implement successful strategy to save lives and reduce the economic costs related to HAIs and AMR?

MEP Lieve Wierinck, co-hosted of the debate and rapporteur of the European Parliament’s opinion on the Report on the One Health Action Plan against Antimicrobial Resistance(AMR) (2017/2254(INI))  stressed the urgency of this matter “We all know the indication that if we don’t act now, more people will die from AMR than from cancer by 2050”.

According to Andrea Ammon, Director of the European Centre for Disease Prevention and Control (ECDC), infections’ control and prevention is a condition to stop AMR. The key actions needed to be in place to tackle resistant bacteria are:

  • Prudent use of antibiotics (only when needed, correct dose, correct dose intervals, correct duration);
  • infection prevention and control (hand hygiene, screening, isolation);
  • new generation of antimicrobial agents (with a novel mechanism of action, research, development).

But the last one can be effective only with the correct implementation of the first 2 measures.

Surgical site infections (SSIs) and catheter-associated urinary tract infections (CAUTIs) were brought to the center of the debate. CAUTIs and SSIs are the most common HAIs in EU, representing almost 30% of the total burden of HAIs. More than half of these infections are preventable, indicating that lowering the burden of HAIs in Europe is not only an achievable goal but also an imperative. The estimated number of preventable infections and deaths annually is quite significant: for CAUTIs, studies estimate up to 9k of human lives saved, while for SSIs above 4,4k.

The prevention of SSIs is complex and requires the integration of a range of preventive measures before, during and after surgery. Plus, the implementation of these measures is not standardized worldwide. To prevent SSIs, experts suggest developing evidence-based strategies (from hair and wound management to skin antisepsis) along with surveillance programs and alert systems. In order to provide international guidelines and trigger a behavioral change, WHO issued in 2016 its Global guidelines on the prevention of surgical site infection, which were presented by Prof Benedetta Allegranzi, coordinator of WHO infection prevention global unit. However, large inconsistencies and lack on implementation in the of the recommendations in hospital is still too high.

As pointed out by several speakers, both SSIs and CAUTIs require a multidisciplinary approach and a good balance between evidence-based measures and pragmatism. Up to 75% of CAUTIs can be avoided with few actions, from the reduction of the catheters’ size to good maintenance. Specifically, Dr Brigitta Lytsy, (representative of JAMRAI) stressed the importance of bottom-up approach and the damage brought by unnecessary catheters (over 25% of patients in hospitals get a urinary catheter and 60% of all urinary catheters are unnecessary and in place too long).

Dr Jesús Rodríguez Baño, President of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID). remarked three essential actions for implementing successful control strategies: better training for healthcare professionals, quality standards and accreditation, and prioritisation; while safety is a cross-cutting requirement for all the areas. Above all, healthcare professionals’ skillset is the essential ingredient for a successful implementation. Training on operating procedures for decontamination and sterilization as well as a clear definition of competencies for infection control team component can really make a real difference in the quality of care. Also, infection control programmes shall include measurable objectives and indicators, with regular evaluations.

The roundtable was enriched by the contribution of national experts on AMR and HAI screening programmes and surveillance systems from the Netherlands, the UK and Belgium. They presented three important lessons learned in the path for the reduction of AMR/HAIs. First, we shall never underestimate the power of awareness raising campaigns; they have shown great outcomes in reducing antibiotic consumption in ambulatory care and in fostering hand hygiene. Second, the benefits of infection prevention and antimicrobial stewardship teams outweigh the costs. This is an important finding to prove the value for money and consequently call for further investment on stewardship programs. Finally, mandatory HAI surveillance outputs are essential to monitor progress on controlling infections and for providing epidemiological evidence to inform action to reduce them. Data can ultimately support the national healthcare systems objective of improving the quality and safety of services and promoting patient choice by providing access to information on systems’ performance.

In the light of these lessons learned, what can policymakers do to shape and implement effective prevention and control programme? As MEP Faria remarked – while HAI prevention and control are under the remit of the Health Ministries of Member States, EU institutions can still provide a useful political arena to shape future policy and raise awareness on patient safety and HAI prevention. Infections’ management need strong political commitment and clinical leadership that stretches across silos in healthcare provisions.

HFE co-patron, John Bowis, wrapped up the discussion, stressing that working together is critical to tackle public health emergencies such as AMR and HAIs. We need to have a clear link in our mind between HAIs and AMR and that infection prevention and control are key actions to reduce antibiotic consumption.

The European Commission and Parliament shall keep AMR and HAIs prevention and control among the key priorities of the next years in order to ensure the continuation of the EU Action Plan and providing measurable indicators about its implementation. It is important to encourage and support Member States to put in place and monitor national targets for the surveillance and reduction of AMR/HAI through holistic action plans under a “One Health approach”.

Please click here to see the pictures of the event.

EVENT SUMMARY: My City-Lab Talk Series – Diabetes care in the digital age: accessing innovation and fostering self-care

The third meeting of the City-Labs Talk Series took place on November 22nd, 2018. The event, entitled “Diabetes care in the digital age: accessing innovation & fostering self-care”, was organised by the City-Labs team to discuss the impact of digital solutions on the improvement of diabetes care and how promoting access to these technologies can enhance quality of care.

Diabetes is one of the greater public health threats of our time, affecting over 60 million Europeans (about 10.3% of men and 9.6% of women aged 25 years and over). Diabetes prevalence is increasing among all ages across Europe, killing about 3.4 million people annually. Good management of this condition can save lives, prevent complications and ultimately contain increasing healthcare costs. Patients have been provided with several digital solutions which help them unlock the power to control blood glucose levels, plan nutrition, take medication consistently, work out, and keep track of medical visits, etc. The participants discussed digital technologies and their potential to improve self-care and patient outcomes, as well as the conditiones sine qua non for their uptake, from literacy to access.

As pointed out in the first remarks by Barbara Kerstiens (European Commission), the major challenge to prevent and manage chronic conditions, such as diabetes, is the required change in life style. A drastic shift in daily routine is needed to avoid complications and ensure a good self-care. Also, from the perspective of Directorate-General for Research and Innovation, it is essential to foster research to better understand how diseases are evolving over time and better ways to make diagnosis. On this point, Ms Kerstiens reminded that the proposal for the next research and innovation framework programme, Horizon Europe, shall allocate under the cluster health over 7 billion’s budget to foster health throughout the life course, non-communicable and rare diseases and digital technologies for healthcare.

Ignacio Garamendi from the International Diabetes Federation, together with the young advocate Ewout Gubbels, brought the patients perspective to the discussion. As consumers, we are free to make our own choices (being their healthy ones or not) and it has become complicated to encourage citizens to improve their life style and better manage their condition(s). In his remarks, Mr Garamendi identified three key policy actions that all the stakeholder involved must consider: (1) fostering the uptake of digital innovation, (2) promoting digital literacy as well as (3) encouraging patient engagement.

Ewout Gubbels added “being a diabetic patient is a full-time job”, which require good organisation and commitment. Digital tools (from wearable solutions to keep track of their blood glucose to mobile apps for physical activity) can help patients to build a new routine and prevent complications, but sometimes the flow of information can be overwhelming (in some cases not enough accurate information can also be detrimental). To avoid confusion and frustration, digital solution’s providers must guarantee the accuracy of the shared data.

Thanks to the inputs of Tanja Valentin, from MedTech Europe, the participants also discussed how assessing the value of innovative technologies in diabetes care. There is a wide scope of e-products, which makes necessary to assess which technologies fit the purpose and can bring real benefits to the patients. The missing piece of the puzzle is a new value-based model to measure outcome and to understand how to better value innovative solutions. For doing so, we need to know the cost of any intervention, the benefit of treatment, and the role played by each component of the care pathway.

The meeting saw the contribution of Guillaume Gustin, representing of City-labs team, who presented EGLE app. Throughout constant monitoring and connection with your doctor, the app aims at bridging the gap between patients and clinical labs, which is specifically needed for chronic disease patients given the regularity of their checks. He stressed that a daily monitoring is essential to avoid complications and ensure a better quality of life. He stated that, due to the growing healthcare demand, “physicians lack of time and we also lack of physicians”. Mobile solutions have the potential to tackle these deficiencies through improving self-care and access to health data. To make this possible, literacy and acceptance shall be enhanced.

Diabetes presents a substantial and complex challenge. The technological revolution on the horizon can help patients and providers to face all of its complexities. But solutions need to be assessed stressing the patients’ outcome. A takeaway of the discussion is the need to find a ground-breaking formula on value-based healthcare which can transform care, starting with diabetes.

Please click here to see the pictures of the event.


City-Labs is a project financed by the European Regional Development Fund (ERDF) which aims to integrating the innovation of laboratory medicine and mobile health. The scope of the project is to facilitate access to laboratory tests as part of a collaborative approach to ambulatory care of a chronically ill individual, as well as to contribute to the dynamic monitoring of patients with chronic diseases.

EVENT SUMMARY: My City-Lab Talk Series – Biobanking: indispensable tool or ethical concern?

The second meeting of the City-Labs Talk Series took place on September 19th, 2018. The event, entitled “Biobanking: indispensable tool or ethical concern?”, was organised by the City-Labs team to discuss to what extent public health could benefit from biobanking. Key future ethical and technical challenges were also discussed.

Biobanks collect and store biological materials (e.g. blood, tissue or DNA) and related data for use in research. The data is considered as essential raw materials for the advancement of biotechnology, life science, drug development and basic human health. However, biobanks bring about important questions on privacy, research and medical ethics.

As pointed out in the first remarks by Anna Pia Papageorgiou (European Commission) the EU institutions and its member states are already looking at how to strengthen collaboration on data sharing (e.g. EU Declaration on genomics)  and foster knowledge in biosample management. In particular, she outlined a few of the initiatives that the Commission is taking around biobanking and to support the scientific community’s efforts towards biotech advancement. First, the long-term goals of the European Human Biomonitoring Platform (HBM) in which the Commission plans to assess the exposure of chemical impacts on human cells and any causal relationship between the chemicals and environmental aspects and disease or other health issues. Secondly, the creation of an HCA (Human Cell Atlas) where the goal is to develop a classification for every cell of the human body. Once completed both the HBM and HCA will provide a better understanding of the human body and how medicines and new technologies can better tackle diseases and chronic conditions.

The ethical and regulatory framework as well as the impact of the General Data Protection Regulation (GDPR) was discussed by the participants. As highlighted by Ms Papageorgiou, GDPR applies to the protection of patients’ privacy, a conditio sine qua non for expanding biobanks’ database and securely fostering data sharing. However, some clarity is needed over ownership of the genetic materials as well as common guidelines on the ethical purposes of the research. Another concern of biobanks is that often data are concentrated in the hands of a few private businesses, which is why better collaboration amongst biobanks and research centres is essential.

During the debate, Francesco Florinidi (Biobanking and Biomolecular resource Research Infrastructure BBMRI-ERIC) stressed the importance of cooperation to improve the standardisation of studies using biobanks. In the past, 78% of study results using biobank materials were not reproduced to a satisfactory level which in turn meant the results are difficult to aggregate. By improving the quality of the sample through creating and enforcing standards, future research will become more efficient and lead to more innovation. He also presented the objectives and the works of BBMRI-ERIC, a European research infrastructure for biobanking, which brings together all the main players from the biobanking field (i.e. researchers, biobankers, industry, and patients) to boost biomedical research. Ultimately, BBMRI-ERIC connects several biobanks in various countries so that researchers have access to a diverse variety of samples ranging in type and origin of material. The research infrastructure sets the ethical guidelines and ensures that those who are utilizing the materials and data are following the necessary procedures.

The discussion was enriched by the contribution of Mr Laurent Dollé (Biobanks Wallonia-Brussels) who illustrated the practices within the biobanking process necessary to make the results statistically significant and reproducible. However, with biomaterial and data sharing among different biobanks, it is essential that common guidelines are followed to make data heterogeneous and reliable. Mr Dollé also spoke about how GDPR legislation has affected the operations within biobanks, for instance by increasing expectations of patient outreach is the major change for researchers. It also remains difficult to get consent and share data among members of biobanks and researchers to determine how the engagement should occur and to what extent information should be shared with the patient.

Despite the potentials of biobanks in fostering research and scientific advances, biobanks are financially unstable because it is difficult for them to ensure the right amount of funding. Funding represents a key barrier for biobank facilities which are unable to charge all researchers for the use of biobanking materials. The boards of each biobank must then find other sources of funding.

On this note, Mr Laurent Dollé stressed that biobanking directors must create innovative business plans for ensuring a sustainable development.

Over the course of the discussion, participants identified three pillars supporting biobanking sector. The first pillar concerns patient and citizen care in which the goal is developing technologies and medicines that focus on how the biobanks are changing healthcare by allowing scientists to tailor the medicines. Secondly, healthcare professionals can increase quality of care offered with new medical technologies leading to more efficient diagnosis and treatment of disease. The third pillar includes medical researchers and scientists, essential for transforming data into findings.

If used correctly, biobanks’ data can be indispensable tools for the advancement of public health, provided that the objectives of biobank-based research are consistently defined for citizens and those who represent their interests. This group of stakeholders must be involved by policymakers in shaping future guidelines as well as implementing GDPR in biobanking sector.

 

Please click here to see the pictures of the event.


City-Labs is a project financed by the European Regional Development Fund (ERDF) which aims to integrating the innovation of laboratory medicine and mobile health. The scope of the project is to facilitate access to laboratory tests as part of a collaborative approach to ambulatory care of a chronically ill individual, as well as to contribute to the dynamic monitoring of patients with chronic diseases.

 

EVENT SUMMARY: My City-Lab Talk Series – Applications of AI in health, to solve societal challenges or to become one?

The future does not rely on technology alone,
AI can improve healthcare services without replacing humans

Pr. Damien Gruson, Coordinator of the City-Labs project

 

The first meeting of the City-Labs Talk Series took place on July 9th, 2018. The event, entitled “Applications of Artificial Intelligence (AI) in health: to solve societal challenges or to become one?”, was organised by City-Labs team to discuss applications of Artificial Intelligence (AI) in health and medical laboratory and what are the key challenges ahead.

This first meeting was the stage to spur debate on the potential opportunities and challenges of AI applications into the healthcare ecosystem. On one hand, AI based systems are capable of analysing their environment and take decisions with some degree of autonomy to achieve goals. AI offers applications across a diverse set of health areas, including administrative support, lifestyle management, wearables, diagnostics and virtual assistants. On the other hand, the development and implementation of AI solutions bring along socio-economic and ethical concerns, to be addressed to build better healthcare for patients and professionals.

Mr. Costica Dumbrava, Programme Officer for EU policies in eHealth and Ageing Policy, within the Directorate-General for Communications Networks, Content and Technology at the European Commission, stressed the EU’s commitment to put digital solutions at the service of its citizens and boost Europe’s competitiveness in AI. He highlighted that “AI is transforming our world as it presents new challenges that Europeans should meet to make AI work for everyone. More cooperation between citizens and the enterprises is needed to build partnerships, investments and trust”. Trust is a key word in this debate. AI’s uptake depends upon access to big data: collecting, storing, normalizing, and tracing data and patient records represent the first step for starting the AI revolution in health systems. But none of the latter is possible without patients’ trust.

As remarked by Mr Dumbrava, although sharing health data cross-border amongst healthcare settings can be beneficial to patients, there are still key issues in electronic forms, storage and sharing infrastructures across EU. Ms. Jelena Malinina, Digital Health Policy Officer, The European Consumer Organisation (BEUC), stressed that there are still too many challenges to face: from the potential risk of discrimination to data breaches and hacking. Potential employers’, insurance companies’ or clients’ access to personal health data might eventually lead to discrimination. Participants also debated to what extend AI application in health could contribute to inequality or equality, depending on the tools available to finance digital innovation. As highlighted during the discussion, we must remember that AI has the potential to reduce costs and thus give possibilities to reduce inequalities in healthcare access.

The Roundtable was also enriched by the contribution of Pr. Damien Gruson, Chef du Service de Biochimie Médicale, Cliniques Universitaires Saint-Luc and Coordinator of the City-Labs project. On data sharing, he highlighted that, from basic examinations and health monitoring at home (e.g. via apps and wearable solutions) it can facilitate decision making for health institutions as to whether the patient will benefit the most from the treatment and when / if interventions are needed.  Damien Gruson also stressed that AI innovation can be enabled only if the education of healthcare professionals, literacy as well as patients’ education are supported: “if you want a better implementation of treatment and prevention strategies that work, you should improve literacy. Today in Belgium, 50 % of the population suffers from a lack of literacy regarding health and prevention issues”.

The overall discussion pointed out the disruptive potential of innovative technologies and ICT solutions, while highlighting the key role of the human factor. Healthcare professionals, health providers and patients need to be educated and empowered to be able to guide the digital revolution and fully understand the potential benefits of digital innovation. From virtual nursing to administrative workflow assistance, AI applications can improve patient experiences, boost effectiveness of therapies and meet increasing clinical demand. Many are positive about the future of AI but there are still profound questions (both legally and ethically) that policymakers need to address quickly. Doctors must understand that they won’t be replaced, and patients must know that they won’t get everything needed for their health from a machine. A human element should remain if we want to build trust on AI solutions and data-driven transformation of healthcare system and moved toward an ‘augmented intelligence’ rather than artificial one.

 

Please click here to see the pictures of the event.


City-Labs is a project financed by the European Regional Development Fund (ERDF) which aims to integrating the innovation of laboratory medicine and mobile health. The scope of the project is to facilitate access to laboratory tests as part of a collaborative approach to ambulatory care of a chronically ill individual, as well as to contribute to the dynamic monitoring of patients with chronic diseases.

EVENT SUMMARY: Shaping the future of public health towards screening and early diagnosis

On 7 June 2018, policymakers and health representatives met within the framework of the European Parliament Interest Group on Innovation in Health and Social Care, to highlight the critical role of secondary prevention to improve patients’ outcomes while contributing to the financially sustainability of healthcare system.

As pointed out in the first remarks of MEP Marian Harkin (ALDE, Ireland), regular exams and screening tests can detect a disease in its earliest stages, increasing the chance of curing it, improving better quality of life for all patients and reducing costs for the system. Screening tests are available for some of the most important noncommunicable diseases (NCDs). Despite significant disease-related strategies and approaches (e.g. Recommendation on cancer screening) set up by the European Commission to exchange good practices across member states, EU action on secondary prevention is still limited. Access to early diagnosis, which is a central component of secondary prevention, also varies across countries, challenging EU goal to give people equal access to high-quality healthcare.

During the debate, WHO Senior Advisor Ms Luminita Silvia Hayes illustrated new strategic priorities aimed at ensuring 1 billion more people benefit from universal health coverage; 1 billion more people are better protected from health emergencies; and 1 billion more people enjoy better health and well-being. Achieving this “triple billion” target could save 29 million lives by 2023, while bringing innovation and transformation in healthcare systems, and achieving the Sustainable Development Goals (SDGs), with a particular focus on SDG3.Innovative solutions are showing good results, such as in Slovenia relating to cardiovascular programmes, and solutions are being designed to more advanced approaches that require intersectoral actions. On 13-14 June 2018, WHO high-level regional meeting is being held in conjunction with the 10th anniversary of the signing of the Tallinn Charter. As emphasised by Ms Luminita Silvia Hayes, there is a ¨need to show our health systems are strong, resilient and adaptable to a changing environment¨.

Personalised medicines – defined as new medical model built around an individual – are new frontiers in health care designing tailored screening, early diagnosis and therapeutic strategy for the right person at the right time, determining the predisposition to disease and/or delivering timely and targeted prevention. In this frame, coordination between resources is essential to deliver better health outcomes, as pointed out by Ms Irene Norstedt, Head of Unit for Innovative and Personalised Medicine at DG Research and Innovation in the European Commission. Current projects, such as EuroGentest, aim to make a real difference in the field of rare diseases, standardising genetic testing, supporting professional services providing information to the public and promoting novel technologies into current practice.

Mr Davide Integlia, Director for Innovation at the I-Com – Institute for Competitiveness, highlighted how secondary prevention can reduce healthcare costs while innovating healthcare systems. To do so, resource planning model need to be revised, especially at the national level. Very modest resources are allocated to prevention policies, from 1.2 to 3.4% only. National governments mainly focus their attention on savings without a pluriannual strategy that allow healthcare systems to change the pattern of cost generation. National provisions should be less oriented to cost minimization and consider more principle like cost-effectiveness and provide measures based  on the evidence-based medicine, emphasised Mr Integlia. Moreover, the potential of Artificial Intelligence (AI) within mass screening programs for the prevention of diseases, such as diabetes or cardiovascular diseases, is considerable and would lead to a 10% cost saving for the National Health System.

The debate was also enriched by the contribution of Ms Peggy Maguire, Director General of the European Institute of Women’s Health, and Mr Johan Prevot, Executive Director of the International Patient Organisation for Primary Immunodeficiencies, on the value of screening in women health and newborns.

Statistics show the incidence and prevalence of certain diseases are higher among women, who yet remain the heaviest medicine users underrepresented in clinical trials, research and data. Healthcare systems should be highly more responsive to their health needs. Maternal health is a vital point for public health intervention to reduce the burden of illness and promote wellbeing. Also, cancer screening programmes are of utmost importance since cancer represents the second leading cause of death in EU women.

Furthermore, SCID newborn screening is becoming a reality in the world, but there is still slow uptake in the EU. Urgent actions need to be developed to tackle disparities between countries in line with other EU developments, such as the European Reference Networks (ERNs). Without early diagnosis and proper treatment babies will die before their first birthday.

MEP José Inácio Faria (EPP, Portugal) concluded the meeting calling for a real behavioural change. Patients play a vital role in implementing effective secondary prevention policy. Health literacy and awareness raising are key enablers to overcome stigma around diseases and to shift mindset towards health promotion prevention and early intervention tools.

As enshrined in the 5 Health First Europe Factsheets showcasing early diagnosis and screening examples already incorporated into the patient pathway, secondary prevention not only gives more chances to a better life to EU citizens but also paves the way for a more reliable and efficient health system. Although healthcare is a national competence, this should not turn EU policymakers away from working toward better coordination and mutual learning that will lead to more targeted, effective opportunities for prevention, treatment and care.

Please click here to see the pictures of the event.

EVENT SUMMARY – Lunch Debate “Hear The Future … and prepare for it”

On 6th March 2018 – in conjunction with the World Hearing Day – policymakers and European stakeholders met in the European Parliament to raise awareness on the social and economic impact of hearing loss in our society. The Roundtable aimed at spurring debate on the importance to foster access to hearing devises and rehabilitation services in order to prevent the significant social and economic costs of untreated hearing loss.

The event, titled “Hear The Future … and prepare for it”, was organized by four members of the Coalition on Hearing Loss and Disabilities (namely the European Association of Hearing Aid Professionals, AGE Platform, European Hearing Instrument Manufacturers Association, European Federation of Hard of Hearing People) and co-hosted by MEP Renate Sommer (Germany, EPP) and MEP Heinz Becker (Austria, EPP).

Following the welcoming remarks of MEP Renate Sommer, panelists discussed the important link between hearing and cognition as well as dementia risk in older adults. Very interesting researches were presented during the meeting. Bridget Shield, from Brunel University London presented her study on the social and economic costs of untreated hearing loss, also in term of lost productivity and social isolation.

Hélène Amieva, a Neuropsychologist and Epidemiologist working at Inserm in Bordeaux, presented her recently-published a study based on data from 3,777 persons aged 65+ who had been followed over a 25-year period. Her study shows that persons with untreated hearing loss are at a higher risk of being dependent on help from other persons in their daily life and that those using hearing aids have better chances of staying independent.

Shelly Chadha (WHO) presented the WHO 2018 campaign “Hear the future” aiming at drawing attention to preventive strategies to stem the rise and outline steps to ensure access to the necessary rehabilitation services and communication tools and products for people with hearing loss.

In line with the Manifesto on Hearing Loss and Disabilities, Anne-Sophie Parent (AGE Platform) stressed the need to foster awareness and tackle ageism. EU countries must remove age limits in disability support measures that prevent older persons with disabilities (such as hearing impairment) from enjoying their rights under the United Nations Convention on the Rights of Persons with Disabilities (CRPD).

The event marked a key moment to raise awareness of hearing loss impact and look at effective ways of facilitating access to innovative technologies. Now it is time for the European Parliament to keep up the debate on the significant costs of untreated hearing loss and how to act for better healthcare.

More information on the event are available here.

EVENT SUMMARY – To-Reach and Health First Europe Roundtable on Health Services and Systems Research

   

On 29th January 2018, To-Reach and Health First Europe co-organised a joint workshop entitled Identifying and transferring innovation in comparative Health Services and Systems Research. Hosted by MEP Patrizia Toia (S&D, Italy) at the premises of the European Parliament in Brussels.  The event was the first opportunity for project consortium representatives to publicly present the concept and objectives of To-Reach to the Brussels-based EU health policy audience.

Following the welcoming remarks of John Bowis (HFE President) and MEP José Inácio Faria (EPP, Portugal), Walter Ricciardi, Principal Investigator of the project and President of the National Institute of Health of Italy (Istituto Superiore di Sanità ISS), together with Ms Ellen Nolte, European Observatory on Health Systems and Policies, and Ms Natasha Azzopardi Muscat, President of the European Public Health Association, outlined the main aspects of To-Reach before responding to questions and feedback from the participants in what proved a lively high-level discussion that will feed into both ongoing and future project work.

Read here the full event summary on TO-REACH website

Here the photos of the event.

EVENT SUMMARY: Ensuring patient safety in healthcare is a challenge for the EU

Ensuring patient safety in healthcare is a challenge for many EU countries; national healthcare settings must regain the trust of their people when it comes to healthcare management”

MEP José Inácio Faria (EPP, Portugal)

On 5 December 2017, policymakers and health representatives met to discuss and assess the current situation of patient safety in Europe and how eHealth technology could reduce adverse events in all healthcare settings. The roundtable entitled Engaging patients in the digital revolution: A call to build smarter and safer healthcare systems was organized by Health First Europe and City-Labs, under the Patronage of the Estonian Presidency of the Council. The event was an opportunity to launch the HFE Declaration on Patient Safety which calls for a joint effort to prevent unnecessary harm across Europe.

MEP José Inácio Faria (EPP, Portugal), who chaired the roundtable, emphasised the need to embed patient safety as priority issue in public health policies and foster EU actions on quality of care. In this regard, MEP Faria was happy to announce the launch of the HFE Declaration for Patient Safety, which calls to reform and harmonise patient safety standards and practices to guarantee a safer healthcare. As he said “Through the Declaration, Health First Europe calls upon European stakeholders, policymakers, health authorities, healthcare professionals, providers and patients to join hands and sign up the Declaration online to prevent unnecessary harm across Europe”

The opening address was delivered by Mr Ain Aaviksoo, Deputy Secretary General on e-Services Development and Innovation at the Estonian Ministry of Social Affairs. He gave an overview of the Estonian Presidency’s efforts in boosting digitalization of services and the prospects of data-driven approach in healthcare (i.e. increased access and safety in healthcare; sustainability of health systems; movement of health data to boost innovation and research). As he underlined, “EU General Data Protection Regulation facilitates better use of health data: privacy means that personal data should not be secured from being used, but to be used”.

The digitalization of healthcare sector is still far away from being reached. MEP Yana Toom (ALDE, Estonia) and MEP Indrek Tarand (Greens/EFA, Estonia) pointed out few challenges including fostering digital skills of healthcare workforce, guaranteeing cybersecurity and tackling the lack of funding to ensure the highest patient`s benefit. MEP Tarand highlighted that “the costs of health care are increasing significantly and a paradigm shift in the health setting is needed to avoid stoppable harms and costs. However, as Member of the Committee on Budgets, I regret to see the constant lack of projects on patient safety and health quality.

Mr Niek Klazinga, Head of the Health Care Quality Indicators at OECD, gave his valuable contribution to the meeting by presenting Patient Safety Indicators along with the results of the OECD Report on the Economics of Patient Safety and nine priority areas for further R&D. While stressing the burden of adverse events in Europe, Mr Klazinga remarked that “patient harm is the 14th leading cause of the global disease burden. Around 15% of total hospital activity and costs are a direct result of adverse events. The most burdensome adverse event types include venous thromboembolism, pressure ulcers, and infections.”

Ms Katja Neubauer, Team Leader on Digital Single Market & eHealth at the European Commission, noted that EU citizens are ready to embrace eHealth solutions and data sharing: “while drafting the report of the Public Consultation on Healthcare in the Digital Single Market ran this year, I was very surprise to realise that over 80% of respondents agree that citizens should be able to manage their own data and that sharing health data can be beneficial”. She also gave an overview on the European Commission’s work for the digital transformation of healthcare outlining some key priorities, namely (1) giving citizens better access to their health data; (2) sharing health data for research, faster diagnosis and better health outcome and (3) using of digital services for citizen empowerment and patient-centered care.

The Roundtable was also enriched by the contribution of Prof. Benoît Macq, Université Catholique de Louvain, who presented a real example of how innovative technologies such as point-of-cares and self-tests are changing the landscape. Moreover, he shared the new created app called Eglé which is a tangible example of how the digital revolution can facilitate chronic disease monitoring.

MEP Alojz Peterle (EPP, Slovenia) gave the closing remarks stressing the great burden of unsafe care and healthcare associated infections as well as the importance to boost data collection and sharing: “we can be sure that patient safety will benefit from a truly European scheme which would aim to consolidate and share science-based data on adverse events and tackle faulty systems that lead people to commit mistakes”.

Although healthcare is largely a national competence, this should not turn EU policymakers away from working towards better coordination and support while addressing preventable harm. MEP Peterle concluded that “as enshrined in the Charter of Fundamental Rights of the EU, member States committed to ensure a high level of human health protection in the definition and implementation of the Union policies and activities. This is why health remains one of the main challenges of the EU and it should be, in my view, our first political priority”.

See the event’s pictures here.

EVENT SUMMARY: Boosting workforce to meet new demands in healthcare systems

On 28 November 2017, policymakers and health representatives met within the framework of the European Parliamentary Interest Group on Innovation on health and social care to spur debate on the role of innovation in supporting the re-organisation of health workers to build effective and sustainable healthcare delivery across Europe. In this frame, the meeting entitled Innovative Health Systems Reform: Boosting workforce to meet new demands in healthcare systems provided the opportunity to exchange views on the development of a sustainable, innovative and flexible health and social workforce bound to the citizen and able to provide a successful and sustainable healthcare delivery in the future, making health systems resilient to future changes.

European health system requires a deep reconstruction to ensure its sustainability: ageing society, the rise of chronic diseases, increased demand for primary care and personalised lifelong care are causing economic stress on health systems and their workforce. Therefore, rethinking healthcare systems is a priority. It is necessary to shift the focus from acute care episodes towards a person centred pathway.

As underlined by MEP Marian Harkin (ALDE, Ireland), “health workforce are the backbones of primary care solutions”. Since healthcare is highly labour intensive and one of the largest economic sectors in the EU – accounting for around 17 million jobs (8% of all jobs), the health workforce has an essential role to make the system innovative and contain healthcare expenditure.

In this regard, Prof. Jan De Maeseneer, Chair of the Expert Panel on Effective ways of Investing in Health, pointed out that “any effective changes in the system require a change in the workforce organisation”. He highlighted the crucial role of health workers in making a shift towards integrated and primary care models. Population growth, ageing societies and changing disease patterns are expected to drive greater demand for well-trained health workers in the next 15 years. However, according to the WHO, in Europe severe health workforce imbalances and shortages still exist. Encouraging primary care is what society needs as it strengthens social cohesion, reduce unnecessary hospitalisations, increase population health and, ultimately, make the system financially sustainable in the long run. As a result, it is vital to redesign professional roles by providing appropriate training and support, incentivise innovative care solutions, and engage a larger community of stakeholders including practitioners, families and informal caregivers. To make this happen it is critical to integrated health workforce in the primary care and transforming the educational models. “We need appropriated number of health workers with the appropriate skills”, said Prof. Jan De Maeseneer in his last remarks.

The critical role of healthcare workers in building sustainable healthcare systems was emphasised by Dr. Aurelién Perez, Policy Officer at the Performance of National Health Systems Unit in DG SANTE. According to the data published in the 2017 Companion Report of the State of Health in the EU, “proactive health workforce planning and forecasting make health systems resilient to future shocks”. Few challenges need to be urgently addressed to boost health workforce in Europe such as employee turnover and retention, imbalances in geographical distribution between rural/urban areas, skills mismatches and budget constraints. In this frame, improving health workforce planning and forecasting, proposing indicators to measure imbalances and mobility flow, enhancing recruitment and retention of health professionals, and anticipating future skills for health professionals (provision of care closer to home, growth of new technologies, expansion of e-health) are crucial steps to meet the new demands of healthcare and make the whole system more sustainable and innovative. Health workforce needs new skills and competences to cope with patients with multiple chronic conditions, to work within wider inter-disciplinary teams, adapt to the digital transformation of healthcare and new ways of care delivery, and allow better health promotion and disease prevention.

As underlined by MEP Karin Kadenbach (S&D, Austria), the provision of integrated care implies vital changes in the healthcare structures. It means to redesign the organisation of workflows, workforce development, education programmes and resource allocation. In line with this, policy makers should foster primary care and other community-based services, make investments in a right skills-mix of health workers and in new technologies, medical equipment and diagnostic techniques. Furthermore, integrating interprofessional education into the curricula for better outcomes will be vital to build a specialist primary care workforce and ensure a continuum of care, especially for people with chronic diseases. As policy makers we have to provide a supporting policy framework for healthcare workforce.

 

To know more about this subject, read our Discussion Paper.

Find the pictures of the event here.