Two days ago, on the 8th of June, the EU Council agreed on a Draft Directive on cross-border care. While this is not the final step for full adoption of this important document, the positive vote of the EU Council is opening a new perspective on cross-border care and on the use of eHealth as a tool to facilitate the mobility of EU citizens. 

This legislative document was designed to facilitate the mobility of people around Europe for tourism, work and study by offering them reimbursed health services in any of the 27 EU countries, under some good sense conditions. The main elements that would ease the access to cross-border care are related to:

• as a general rule, patients will be allowed to receive healthcare in another member state and be reimbursed up to the level of reimbursement applicable for the same or similar treatment in their national health system if the patients are entitled to this treatment in their country of affiliation;
• in case of overriding reasons of general interest (such as the risk of seriously undermining the financial balance of a social security system) a member state of affiliation may limit the application of the rules on reimbursement for cross-border healthcare; member states may manage the outgoing flows of patients also by asking a prior authorisation for certain healthcare (those which involve overnight hospital accommodation, require a highly specialised and cost-intensive medical infrastructure or which raise concerns with regard to the quality or safety of the care) or via the application of the "gate-keeping principle", for example by the attending physician;

• in order to manage ingoing flows of patients and ensuring sufficient and permanent access to healthcare within its territory a member state of treatment may adopt measures concerning the access to treatment where this is justified by overriding reasons;
• member states of treatment will have to ensure, via national contact points, that patients from other EU countries receive on request information on safety and quality standards on their territory in order to enable patients to make an informed choice;
• the cooperation between member states in the field of healthcare is strengthened, for example in the field of eHealth and through the development of European reference networks which will bring together, on a voluntary basis, specialised centres in different member states;
• the recognition of prescriptions issued in another member state is improved; as a general rule, if a product is authorised to be marketed on its territory, a member state must ensure that prescriptions issued for such a product in another member state can be dispensed in its territory in compliance with its national legislation. See Press release here.

The last two elements are important elements for facilitating from a political and practical point of view the implementation of interoperable eHealth solutions at EU level. But what would be the impact of interoperable eHealth at EU level? Some year ago, a study performed by the Nordic Telemedicine Centre from Norway outlined that the cross-border flow of citizens is estimated at 1% of the total population and the potential benefits of fully interoperable eHealth systems could be as high as 560 million Euros, culminating at 8 billion Euros, if we take into account the regional benefits.

This important step will underpin the Digital Agenda of the EU Commission which is designed to support Europeans with better health care, safer transport, new media opportunities and easier access to goods and services. The important policy elements outlined by the EC, that the industry fully supports,  are the policy elements related to the implementation of a EU “Health Passport” by 2015:

• Key Action 13: Undertake pilot actions to equip Europeans with secure online access to their medical health data by 2015 and to achieve by 2020 widespread deployment of telemedicine services;
• Key Action 14: Propose a recommendation defining a minimum common set of patient data for interoperability of patient records to be accessed or exchanged electronically across Member States by 201256;
• Other actions:
• Foster EU-wide standards, interoperability testing and certification of eHealth systems by 2015 through stakeholder dialogue;
• Reinforce the Ambient Assisted Living (AAL) Joint Programme to allow older people and persons with disabilities to live independently and be active in society.

We hope that these new political elements will facilitate the implementation of eHealth based on open standards and architecture and that will open a real EU market in the area of eHealth avoiding fragmentation of information and lack of communication between health providers and users.

Dr Octavian Purcarea

Director – Industry Market Development Europe

World Wide Health Team

Microsoft