Health without frontiers

EU thinking on e-health has been expanded to include the views of actual users of e-health services – a move welcomed by Helene Richardsson

What do we actually mean when we talk about e-health? The area is big and complex and I know that there are many definitions of what it actually means. There are many of us working in the field, trying to get the European roadmaps for IT within healthcare/e-health going in the right direction, and many of us met up in Slovenia at the e-health conference hosted by the Slovenian presidency last month.

Judging from the conclusions of the conference it is clear that there has been a change – a big change – when it comes to the people who are actively involved in developing e-health policies. In some of the earlier conferences, the participants were mostly politicians and industry groups, but now we are seeing a clear shift towards involving stakeholders from the user side. Since I am the chair of the e-health user stakeholder group, it is obvious that I am delighted to say that this is the case.

The e-health user stakeholder group is an advisory group of the i2010 subgroup on e-health, working under the coordination of the European commission’s information society department. It represents users of IT in health settings, including health professionals, patients and citizens. However, e-health for me is about so much more than what is covered by the mainstream IT strategies in the member states. For patients, the most important issue is how to get in contact with the care-givers: they want to bypass the telephone waiting queues and get that appointment or advice straight from their doctor. This is hard, at least in Sweden where I happen to live. To solve this, there are now IT systems that make it possible for the primary care provider to call back the patient, who no longer has to wait for ever on the phone. This is a convenient and simple solution that makes life easier for both doctor and patient.

At the same time, e-health is also making it easy for patients to get in contact with their doctor via email – for example to ask for a new prescription – without the need to book an appointment. It is also making it possible for patients to care for themselves, with the help of a little relevant information found on the internet – at least in the case of certain ailments. The last time I personally used the internet for health information was when my daughter reacted to medication I had given her for a cold, and I realised that the cough mixture contained lactose, which she is allergic to. The allergic reaction was bad, but nowhere near as bad as the appendicitis I thought she actually had, until I went online. Through the internet I found the relevant information concerning her lactose intolerance, and realised that there was no need to rush her to hospital: her appendix is still there and my daughter is happy.

Modern technology is also helping me keep in touch with an aged relative, Birgit, who lives in a remote part of northern Sweden. She has a hearing problem and I have almost given up on talking to her on the phone, but we can still communicate over the internet. She doesn’t have any children of her own, but she keeps track of her nieces and other family members travelling all over the world through the internet. Her own friends are slowly disappearing – and that is something that will happen to all of us if we manage to reach the venerable old age of 90, as she has. She orders clothes through the internet as well as books, since the reading material she can find in the village where she lives is not to her liking. The web also lets her pay her bills and helps her find answers to the tougher crossword clues. In short, she can have a more active life with the help of the computer. Of course, this is not directly linked to the care process or the classic definition of e-health, but I honestly believe that a good quality of life can be just as vital in keeping us out of doctors’ surgeries as access to medical information.

None of what I have described above would have been possible without access to high-speed internet, nor the fact that we have many bright and competent old people who like to stay in touch with reality, even if they can’t participate as actively as they once did. As Birgit puts it, “my body might be tired, but there is nothing wrong with my brain”. I hope that I can be just as active as Birgit when I turn 90.