Interview with Adrzej Rys: Pooling resources and sharing best practice to improve access to healthcare
17th June 2015
The EU is establishing platforms and channels for Member States to work together in achieving shared objectives that promote universal access. In this interview, Andrzej Rys Director, Health Systems and Products, DG Health and Food Safety, describes a number of these initiatives
Question: The EU is becoming more involved in discussions about national health systems. What role do you see for the EU in promoting Universal Health – as in the theme of the conference – and making healthcare systems accessible – as in the topic of the session at which you are talking – in the following areas:
Best practice – What role is the EU taking in identifying best practice and helping member states to learn from each other?
Answer: While organising and delivering healthcare is the responsibility of national governments, the EU role is to complement national policies by helping them achieve shared objectives through pooling resources and exchanging best practices. The EU has set up various initiatives and platforms to facilitate such exchanges. Some examples are:
- The Innovation Partnership on Active and Healthy Ageing, a new collaboration model which aims to support innovation in Europe’s healthcare systems. The Partnership brings together regions, health authorities, researchers, health professionals, businesses, regulators and patient organisations to examine new ways of addressing the challenge of an ageing population. The collaboration has supported the partners to work together on various issues, such as adherence to treatment, frailty, integrated care and age-friendly environments. The Partnership has also developed a strategy to scale-up successful practices and replicate them in other EU regions and countries. Through the wide deployment of such innovative practices, we expect to promote patient-centred health and care services and improve the health status and quality of life of European citizens, and help them live longer in good health.
- The High Level Group on Nutrition and Physical Activity, the EU platform for action on diet, physical activity and health, the Committee on National Alcohol Policy and Action, the European Alcohol and Health Forum, and the Expert group on social determinants of health and health inequalities. These are all fora supported by the Commission where the Member States and stakeholders discuss their challenges, options and actions. This helps identify areas of common interest and approaches worth developing, adapting and trialling.
- In parallel, the Health Programme, via the co-funding of relevant initiatives, further supports Member States’ learning, policy-making and implementation processes. This is the case of the Joint Actions on Nutrition and Physical Activity, Alcohol-related Harm, HTA and eHealth.
- Regarding Europe’s health systems, following a reflection process the Commission agreed with Member States to establish an expert group on Health Systems Performance Assessment (HSPA). The group, jointly coordinated by Sweden and by the Commission, is a forum for exchanging expertise and best practice in assessing and improving the performance of health systems of EU countries.
Question: Health Technology Assessment – How is the EU helping member states to use health technology assessment to ensure budgets are spent to the best effect, whilst ensuring the safety and quality of services?
Answer: At a European level, cooperation on health technology assessment (HTA) is being fostered and encouraged through the establishment of the HTA Network, which gathers all Member States, Norway and Iceland, on a voluntary basis. It aims to support cooperation between national authorities or bodies responsible for HTA. A collective approach to HTA is essential to avoid the duplication of work across the EU, support equity of access and to ensure the safety and quality of health technologies.
European cooperation on HTA involves “Joint work” which means sharing common tools and templates, applying agreed methodologies, and producing joint reports to be reused in national and regional assessments. The EU can support Member States to use HTA if they are ready and willing to work together for this unified goal. Given the financial difficulties faced across Europe in recent years, it is time for clever collaboration between Member States to best use our resources to reach a shared vision of healthier European citizens.
Question: Digital Health – What part is the EU playing in promoting the adoption of digital innovations such as mhealth, ehealth and other technologies that hold the potential of increasing productivity and widening access?
Answer: At an EU level we recognise that digital innovations may help the quality of and access to care, improve health outcomes and help counteract the rising healthcare costs and the challenges linked to an increasing cross-border element to healthcare. Whereas Member States are responsible for their health systems and supporting and implementing digital innovations and initiatives, the EU will continue to support and assist them in the development of eHealth. It will do this through research and innovation funding opportunities and platforms for collaboration.
An example is the eHealth Network established under the cross-border healthcare directive. This Network consists of representatives of national authorities responsible for eHealth and acts as a forum for cooperation, support and guidance to increase the use of eHealth services in EU countries. It facilitates agreements on the safe and efficient management of electronic health data. In addition, the Commission supports Member States in the deployment of eHealth solutions on ePrescription and Patient Summary through the Connecting Europe Facility fund.
Finally, on 6 May 2015 the Commission adopted a Digital Single Market Strategy which includes a set of actions on interoperability and standards for eHealth, which will be taken at EU level.
Question: Restructuring and integration – There is a move to restructure and become more integrated, not only between primary and acute care, but also health and social care. How can the EU promote this to ensure health systems provide patient-centred seamless care, in particular for Europe’s growing cohort of older adults and people with chronic diseases such as diabetes?
Answer: We are approaching the collaboration with Member States on integration of care through the information provided by the reflection process on modern, responsive and sustainable health systems and through the advice of the expert panel to provide advice on effective ways of investing in health. In particular, the expert group on Health Systems Performance Assessment is working to identify tools and methodologies to support policy makers in assessing the performance of integrated care systems. This work will look into different models of integrated care and try to identify the patterns which are common to all good practice cases.
Question: Innovation – Health systems are notoriously resistant to innovation. What can the EU do to help them become more receptive?
Answer: Recent developments in the EU economies reinforced the necessity to reform and modernise healthcare systems. The EU is helping Member States to improve cost-effectiveness through the use of sound innovation, assessed in terms of its potential to improve the performance of healthcare systems, through the European HTA and eHealth networks. Technology has to be part of the solution. The EU and the Member States can benefit from working together to determine which technology and model of innovation can best enable the major changes that are needed.
On digital technologies, the EU aims to help health systems to adapt to innovation by improving infrastructure, promoting interoperability and fostering the development of standards as part of the Digital Single Market Strategy. Furthermore, the Commission provides financial support to EU countries for the deployment of eHealth solutions by lowering the threshold to adapt these new digital innovations. The EU also supports public private partnerships in several research areas like the Innovative Medicines Initiative, to ensure that the results of research and innovation are applied as they become available.
The EU has also put networks in place, for example on eHealth and HTA, which facilitate better communication between Member States. Such communication and collaboration is essential to help national health systems adapt to new innovations. As part of these networks the EU funds Join Actions through which Member States work together to share information, increase efficiency, avoid duplication and increase cost-effectiveness. With regard to medicines for human use, the Commission has set up an Expert Group on Safe and Timely Access to Medicines for Patients (STAMP) to provide advice and expertise to the Commission services in relation to the implementation of the EU Pharmaceutical legislation, as well as programmes and policies in this field, in particular with a view to optimising the use of current regulatory tools for timely access of patients to innovative medicines.
Question: Budgets – What contribution can the EU make to ensuring post-crisis health budgets are sustainable and that measures such as the introduction of co-pay or cutting of services does not impact on the poorest people most?
The overall aim of health system reforms featured in Memoranda of Understanding or in Country Specific Recommendations within the European Semester is to maintain access to quality healthcare. Moreover, the Commission will continue to advise that, when pursuing health reforms, equity considerations are taken into account to safeguard access to quality healthcare and sparing the more vulnerable. The Commission regularly discusses the impact on access to healthcare of the measures implemented as part of the on-going dialogue it holds with the Member States concerned and will continue to monitor the situation closely.