eHealth and the Ageing Society

Marcelino
Cabrera, IPTS

e-Health, the combined use of information society technologies
(ISTs) in the health sector, is moving up health policy agendas at the
European, national and regional levels. Productivity gains from the optimization
of healthcare systems and achieving cost reductions are prime goals, while
healthcare providers, health insurance organizations and politicians at all
levels (EU, national, regional) are drawing up plans to support healthcare by
means of the application of modern ISTs. In particular, EU policy has set up
specific action plans (eEurope2002 and eEurope20051)
to contribute to the development of eHealth across the EU and thereby achieve
some of the ambitious goals of the Lisbon strategy decided at the
European Council in Lisbon in March 20002.

eHealth is an empowering tool for European citizens and, in the
context of an ageing society, for active independent living by older people in
an enlarged European Union with considerable income disparities and
heterogeneous healthcare systems. In this Special Issue, the topics discussed
are in one way or another related to the context of an ageing society, while
highlighting bottlenecks and prominent technological trends that need policy
attention.

Health and social care for the elderly can be provided with new
services based on appropriate ISTs, such as so-called "independent living"
services. However, policy-related technological and organizational aspects of
strategic plans are key factors for success in satisfying the real needs of the
elderly. The cost-effectiveness of new assistive technologies enabled by mobile
and "ambient" systems, wearable and embedded devices, as well as new business
and services provision models, will need to be assessed.

The case of emerging mHealth services (mobile health) is
illustrative for its potential impacts on the financial and liability schemas
since insurance systems may have to accommodate new expenses as a result of
services delivered by mobile phone providers. Also, mHealth services will have
implications for the provision of care itself, resulting in changing paradigms
for healthcare professionals and patient-clinician relationships.

When combined with location data processing, mobile terminals
will improve eHealth possibilities. Clearly these services will rely not only on
location information, but also on the mobility of the terminals. However, before
widespread use can be made of location-based healthcare services, a number of
privacy issues will have to be addressed. The potential large-scale tracking of
ordinary citizens (whether deliberate or incidental) will certainly raise
ethical concerns that could cause delays in the deployment of these services,
thus postponing the realization of their benefits.

The privacy issue can be extended to what it is agreed will
become the central piece of information around which many citizen-oriented
eHealth applications will be developed, i.e. the electronic health record (EHR).
With the EHR, it will be possible to enable access to relevant information,
collaboration between healthcare providers and telecare more effectively.
However, confidentiality and privacy are critical issues that will need
widespread consensus among all stakeholders (public authorities, medical
professionals and citizens). The EHR, as the cornerstone of many developments in
this field, undoubtedly deserves focused and coordinated actions at all levels,
including EU-level.

One important, but often under-emphasized, prerequisite for the
introduction of new ISTs in the health sector is the acquisition of new types of
skills by citizens, patients, doctors, nurses and other healthcare
professionals. Without human resource development through appropriate education
and training, healthcare faces major obstacles to the crucial knowledge-sharing
process. This is particularly relevant considering the under-investment in
training and education that is endemic in the health sector.

The above-mentioned topics –and there are many others not
discussed here due to space limitations- suffice to give an idea of the
challenges that eHealth raises, particularly for time-pressed policy-makers, who
need to grasp at a glance the various scientific and technological, economic,
political and social dimensions. In this context, roadmaps are valuable ways of
presenting and analysing the causal and temporal relations between successive or
parallel steps. Equally valuable are the results from existing foresight
exercises. These results can help to gain a better understanding of the expected
evolution of the demand side of eHealth during the next two decades.

Contact

Marcelino Cabrera, IPTS

Tel.: +34 95 448 83 62, fax: +34 95 448 83 39, e-mail: [email-masked]

Notes

1. http://europa.eu.int/information_society/eeurope/2005/index_en.htm

2. European Council meeting in Lisbon set an ambitious objective for Europe
to become the most competitive and dynamic economy in the world. To achieve
this, the Council later endorsed the above mentioned action plan entitled
"eEurope – An Information Society for All".

Contents
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