sustainable competence in advancing healthcare
European Coordination Committee of the Radiological, Electromedical and Healthcare IT Industry
sustainable competence in advancing healthcare
European Coordination Committee of the Radiological, Electromedical and Healthcare IT Industry

Digital Health Blog

Spring is here, it's time to talk about Interoperability…..

Interoperability is part of COCIR’s DNA. It lies at the heart of our member’s businesses but is also a central piece of the European, national and regional digital health strategies. Everyone in the digital health ecosystem, including policy makers, understands its vital importance but few are able to grasp the steps needed to make it a reality.
“Lack of interoperability is both a reason for, and a result of, market fragmentation. It perpetuates market fragmentation and creates significant barriers to entry, especially for innovators and SMEs." (Blueprint for the Digital Transformation of Health and Care, 2016.) Yet lack of interoperability also presents a major hurdle for advancing the quality and efficiency in European health systems. It prevents data sharing and hinders the ability to maximise the full potential of digital innovation.
This inability to deploy interoperable digital health solutions across European countries remains a barrier to scaling up of integrated care. However, at the same time we see an increasing uptake of mobile health and Internet of Things technologies within the health, social and wellness sectors. Welcome as this trend is, it poses new challenges both for open interoperability and for seamlessly integrating information in a manner that enables delivery of integrated care.

Over the last six years, COCIR has been intensifying communication around the vital importance of adopting international standards. We have worked tirelessly with our partners to accelerate interoperability in the healthcare domain. Achieving interoperability is completely feasible; putting a carefully-planned and well-managed process in place from the outset will smooth uptake. We believe that interoperability should be a step-wise process that can be effectively organised around the following six stages, as described in our publication, “Opens external link in new windowWhy Interoperability is Critical to Support Integrated Care in Europe”.

1.    Identify use cases from an end-user perspective, describing the proposed eHealth functionality in medical terms (e.g. E-prescription), avoiding using technical language including and including glossary, scenario, actors, privacy requirements and variations.
2.    Select profiles and standards that support the selected use case.
3.    Refine data content, including document templates, metadata, master files, and terminology.
4.    Write interoperability specifications (implementation guides) that describe the standards / profiles selected, the refined data content and other project specific local needs.
5.    Organise testing by preparing test cases and adopting a test environment for implementers to demonstrate component interoperability and by organising cross-implementer connectivity testing.
6.    Educate end-users on interoperability: Develop communications materials to familiarise end-users on the benefits and impact of Interoperability.

However, a clear process and practical guidance on how to advance in each stage is not enough. The ’bottom-up’ approaches that have been used for many years have proved ineffective in reducing fragmentation. There must also be a top-down approach combined with political leadership expressed at national level. Policy makers need to put eHealth interoperability at the heart of their health policy strategies and make it a personal mission. Digital technologies will only deliver the much-needed transformational changes to our health systems if international standards are widely adopted and supported by politicians at European and national levels. Success needs interoperable IT systems to be in place.

Of course, it is critical to ensure collaborative and joint effort from all stakeholders- including industry - if we want to be successful. However, policy makers hold the key to offering incentives. For example, they could reference relevant standards within procurement processes and public tenders, or build an “interoperability partnership” with their local IT teams, as part of a joint effort to embed this critical element in any health initiative with an IT component.

COCIR is continuing its work closely with Opens external link in new windowIHE and Opens external link in new windowPCHAlliance, further developing specific guidance for policy makers and reinforcing the critical role of these organisations will play in the interoperability landscape. The guidance we are developing builds on the paper we published last year entitled ‘Opens external link in new windowWhy Interoperability is Critical to Support Integrated Care in Europe?

This week, COCIR is taking part in the Opens external link in new window2017 IHE Connectathon, Europe’s largest European eHealth testing event. Other key stakeholders present include national and regional government representatives, standards development organisations and healthcare providers.

As we move ever closer to integrated care models and coordinated care , we should not forget that interoperability is critical to providing better, more efficient care. Let’s continue to work closely to make eHealth interoperability the rule, rather than the exception.

More to come soon.

Nicole Denjoy
5 April 2017



The public are ready for mHealth; are stakeholders ready to scale up to match?

Mobile Health has been identified as a potential game-changer for health and care delivery. What does the popularity of consumer wearable health technology tell us about the future?

In a recent address to the European Parliament, Commissioner Vytenis Andriukaitis noted that “the fast pace of development in digital technologies, in particular mHealth applications, brings considerable opportunities for healthcare in Europe. Mobile health is a promising field for innovation and better health outcomes. It is an important part of the digital revolution.”

The Opens external link in new windowWorld Mobile Congress, one of the leading annual platforms for showcasing developments in technology will have a session dedicated to the future of digital health.

The pressing challenge is to make mHealth operate on a scale that captures these benefits and passes on the improved outcomes and greater efficiencies that mHealth offers.

The experience among consumers should provide an inspiration, where a quiet revolution in mHealth has already taken place. At an individual level, the uptake of mobile technology in healthcare has been rapid. Measuring and monitoring aspects of our health through wearable devices is increasingly considered an essential component of modern well-being. Wearable technology, such as fitness trackers and continuous pulse and blood pressure, for example, monitors that link to smart phones via apps, are now commonplace.

Over the last 4 years, the mHealth app industry has experienced exponential growth, with over Opens external link in new window200,000 mHealth apps currently available on major app stores . At the Apple iOS store alone, there are around 44,000 apps classified under “medical” and some 83.000 appsOpens external link in new window classified under the category “fitness/health” . It is now part of the mainstream; wearable technologies such as Apple watches, Fitbits and Jawbone are now into their second and third generations.

This is no passing fashion; major ICT companies as well as SMEs have identified potential in mHealth. Technology companies, large and small, are investing strongly in developing their mHealth offerings. Clearly, this is a positive development that will help consolidate standards and arguably will accelerate the wider uptake of mHealth

This should offer inspiration to mHealth champions; the public is clearly ready to embrace mobile, wearable technology that will drive mHealth. However, it should also provide a warning. The market for mobile health and fitness technology was not planned; as a result it has established by growing organically and developing in unforeseen ways. This has led to competing standards and a lack of oversight on the accuracy or reliability of the information generated. This underlines the pressing need for a proactive and structured approach to establish mHealth; the risk posed by unplanned uptake of technology is too great.

First and foremost, Member States should develop reimbursement models for mHealth services and, more generally, support a coherent mHealth strategy across their health and care systems. This is also one of the 5 key recommendations included in COCIR’s mHealth high level position Opens external link in new windowpaper released last year.

Unlocking the transformative potential of mHealth in a way that ensures it will work effectively and safely also needs a coordinated EU policy approach. This will establish an effective and agreed enabling framework, which will in turn will encourage all stakeholders to invest the time and resources needed to upscale mHealth. It will also go a long way to addressing the numerous barriers that remain to the wider integration of mHealth into Europe’s health and care delivery structures. These include insufficient scientific evidence, policy fragmentation around mHealth, unjustified restrictions to the free-flow of data, budgetary constraints and competing priorities.
The success of consumer wearable for health tells us that mobile health technology will be part of the future for healthcare. For that reason, Europe needs a clear overarching vision on mHealth that provides clear alignment with the medical devices regulatory framework.

COCIR will continue its efforts to gather intelligence and support their members while using mHealth solutions to contribute to sustainability of healthcare systems.

More to come…

Nicole Denjoy
28 Feb. 2017



2017: The Digital Health Year

It has sometimes felt as if Europe was waiting for the breakthrough that truly defined the Digital Health revolution. However, in reality, the revolution has already happened, without fuss or fanfare. Quietly and unobtrusively, healthcare systems now increasingly rely on digital technology; it is now embedded as part of modern healthcare management. In the future, 2016 will be seen as the year Digital Health reached critical mass; 2017 will be the year when it is recognised as mainstream.

As 2017 will be pivotal for Digital Health, COCIR wants to take the opportunity to reflect on recent evolutions and what future developments will require. For this reason, COCIR plans to publish a series of articles, opinions and presentations that helped shaping current thinking on the future of Digital Health. We will also look forward to what will be the landmark events during such pivotal year.

Probably the standout event in a busy year was the Opens external link in new windowCOCIR 2016 Third Annual eHealth Summit, held in December under the umbrella of the European Commission’s Summit on Innovation for Active and Healthy Ageing. Keynote speaker Vytenis Andriukaitis, EU Health Commissioner singled out the contribution of digital technology in modernising healthcare. He also reminded the audience of the Commission’s vision of ensuring that “digitally enabled innovation for health, demographic change and wellbeing translates into a win for Europe.”

Digital Health is poised to improve the quality of health and care for citizens while helping create the sustainable health, wellness and care systems needed to meet the demands of Europe’s ageing population. At the same time, Digital health will also play an important role in job and growth of economies.

These are not ambitions or aspirations. These are real challenges for health and care, where digital technology is already proving to be a game-changer. Policymakers and society increasingly look first to technology to maximise the benefits of healthcare. As we move towards truly integrated care, society as a whole will embrace digital technology as part of their health and wellness.

The posts over the coming weeks will give you a flavour of what to expect - and what to look out for - in this pivotal year.



Nicole Denjoy

18 January 2017