Speech – Opening address at eHealth Week

10 May 2017, St Julian’s, Malta

Your excellencies, ministers of health, Commissioner Andriukaitis, esteemed guests, ladies and gentlemen,

It is an honour and a privilege as Regional Director of WHO/Europe to be here today, and to join with all of you in opening eHealth Week 2017.

At WHO/Europe, we think and talk a great deal about eHealth and how it is being implemented in the 53 Member States of the WHO European Region. In public health, as in many other sectors, technology and innovation have begun to flow through everything we do. We often look at this from the perspective of what eHealth brings to public health, but today is my opportunity to turn the tables and say: let’s look at what public health brings to eHealth.

WHO firmly believes that eHealth is a key component of achieving universal health coverage – a collective expression and commitment by Member States to the basic human right of equitable access to health care without the risk of financial ruin or impoverishment. The concept of universal health coverage lies at the heart of WHO/Europe’s policy framework Health 2020, and underpins the achievement of the United Nations Sustainable Development Goals.

EHealth supports the achievement of universal health coverage in many ways. It helps to provide services to remote populations and underserved communities, facilitate training of the health workforce, provide accurate and timely patient information through electronic health records, and improve the operations and financial efficiency of health care systems.

Viewed through this lens of universal health coverage, eHealth can reach marginalized populations, reform health information systems, offer new modes of health care delivery, and reduce the payments that individuals are forced to make when confronted with ill health. Indeed, eHealth is a powerful strategic asset to employ, and European Member States clearly recognize this.

As of today, 70% of countries in the Region have a national eHealth policy or strategy and 93% report that public funding is available for eHealth programmes. We have no doubt as to the scale at which Member States are investing in eHealth.

To support such investments, WHO, the International Telecommunication Union and the European Commission this year signed an agreement to establish a mobile health (mHealth) knowledge and innovation hub. This will support Member States in implementing national programmes for using mobile phones and other wireless technologies in health care.

We cannot, however, achieve these noble health goals on the basis of a business model alone. It would be naïve to think otherwise. Public health exists hand in hand with governments, who are charged with health sector development and leadership, and yet governments are not the ones driving the majority of innovation. For this reason, we are now urging the eHealth community to think beyond the business model and see the bigger picture of supporting public health goals and achieving national health priorities.

The theme of this year’s eHealth Week is “Data for health: the key to personalized, sustainable care”. This shines a very welcome spotlight on a core function of WHO: health information. At WHO/Europe, we believe that reliable and high-quality health information is the backbone of solid public health policy. We know that policies must be informed by good, reliable evidence and be supported by a sound legislative framework. Implementing policy without evidence is simply reckless.

WHO/Europe is committed to improving health by improving health information. Through the work of the European Health Information Initiative (EHII), a multistakeholder framework, we are improving the information that underpins health policies and their implementation in the Region.

The EHII fosters international cooperation, methods and tools to support the exchange of expertise, build capacity and harmonize processes in data collection and reporting. The output of this work is available via the European Health Information Gateway. Here, reliable, curated health data and information can be accessed in user-friendly formats for comparison and extraction.

Individuals also face the challenge of making informed choices about their own health and well-being. This is about communication, not just data. Can we really make informed choices when the available health information is fragmented, incomplete or expressed in a way that most of us do not understand?

At WHO, we are often the ones asking the difficult questions. We know that if we do not ask now, we may not have the opportunity to ask in the future. For decades, we have been racing to implement technology at every twist and turn in the road, and there is no doubt that there are still many areas of inefficiency that need eHealth in order to improve. But are we sure that we are really having an impact?

At a time when inequalities are growing and various societal groups are increasingly marginalized and discriminated against, is technology protecting us, or exposing us? Is it enabling us, or alienating us?

In a generation or less, for example, entirely new approaches to clinical care will operate by drawing on a wealth of information from data sets so large we simply cannot imagine them. These approaches, however, raise a number of ethical and moral concerns. We also know that countries still have quite a long way to go before they are appropriately prepared to adopt such innovations. In fact, only 6 countries in the Region have a national policy or strategy regulating the use of big data in the health sector, and only 4 have a national policy or strategy regulating the use of big data by private companies. How can we have the freedom to use this data to innovate without running risks that we have not yet envisaged?

We are together here today because there are societal and ethical values that eHealth needs to adopt, promote and abide by. Public health, on the other hand, needs innovation. We need a systematic, practical and ethical framework that we can use as a basis for any technological innovation. We can only expect the pace of innovation to increase, and as it does, we all need to be attuned to and respectful of the human rights and equity issues that emerge. This includes the right to health for all, no matter how fast technology changes.

So what we need is a beautiful marriage between public health and eHealth – but before any wedding, there has to be an engagement, a commitment. This brings me back to WHO/Europe’s participation in eHealth Week, as a celebration of our commitment and dedication to reaping the benefits of eHealth for all.

Thank you.