Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-24T03:00:08.029Z Has data issue: false hasContentIssue false

Towards a European Health Data Ecosystem

Published online by Cambridge University Press:  09 October 2020

Nadina IACOB
Affiliation:
Researcher, Centre for European Policy Studies (CEPS), Brussels, Belgium; email: [email protected].
Felice SIMONELLI
Affiliation:
Senior Research Fellow, Centre for European Policy Studies (CEPS), Brussels, Belgium; email: [email protected].

Abstract

The digital health ecosystem is rife with opportunities to improve healthcare through data-driven services in the European Union (EU). The value of health data, in the multiple forms in which they come (from health records to lifestyle data collected by smartphones or wearables), can truly emerge when they are allowed to flow in the ecosystem within a governance framework supported by all relevant stakeholders, with trust as the common and clear thread underpinning it. The coronavirus pandemic has provided an additional impetus for change, showing the importance of coordination and adequate communication between Member States and quality data to inform decision-making. Significant challenges remain, however, in order to achieve a fully integrated European digital health ecosystem, including: (1) the potentially diverging rules set by Member States at the national level and the need for an EU framework for the secondary use of health data; (2) the need for transparency and accountability for sustaining a data-sharing framework involving public authorities, research organisations, industry and citizens; and (3) the need for interoperable data and processes. Taking stock of these challenges, this article puts forward policy recommendations to enable the provision of pan-European data-driven healthcare services and to build a transparent and trustworthy framework for citizens.

Type
Articles
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 European Commission, Communication from the Commission to the European Parliament, the Council, the European Economic and Social Committee and the Committee of the Regions, A European strategy for data, COM/2020/66 final <https://eur-lex.europa.eu/legal-content/EN/TXT/?qid=1593073685620&uri=CELEX%3A52020DC0066> (last accessed 17 July 2020).

2 J Núñez Ferrer, “Reading between the lines of Council agreement on the MFF and Next Generation EU” (2020) 2020-18 CEPS Policy Insights <https://www.ceps.eu/ceps-publications/reading-between-the-lines-of-council-agreement-on-the-mff-and-next-generation-eu/> (last accessed 11 September 2020).

3 C Auffray et al, “Making sense of big data in health research: Towards an EU action plan” (2016) 8(71) Genome Medicine <https://doi.org/10.1186/s13073-016-0323-y> (last accessed 17 July 2020).

4 S Salas-Vega, A Haimann and E Mossialos, “Big Data and Health Care: Challenges and Opportunities for Coordinated Policy Development in the EU” (2015) 1(4) Health Systems & Reform 285–300 <https://doi.org/10.1080/23288604.2015.1091538> (last accessed 17 July 2020).

5 A Renda and R Castro, “Towards Stronger EU Governance of Health Threats after the COVID-19 Pandemic” (2020) 11(2) European Journal of Risk Regulation 273–82 <https://doi.org/10.1017/err.2020.34> (last accessed 17 July 2020).

6 C Safran et al, “Toward a national framework for the secondary use of health data: an American Medical Informatics Association White Paper” (2007) 14(1) Journal of the American Medical Informatics Association 1–9 <https://doi.org/10.1197/jamia.M2273> (last accessed 17 July 2020).

7 G Fagherazzi and P Ravaud, “Digital diabetes: Perspectives for diabetes prevention, management and research” (2018) 45(4) Diabetes & Metabolism 322–29 <https://doi.org/10.1016/j.diabet.2018.08.012> (last accessed 17 July 2020).

8 X Wu, X Guo and Z Zhang, “The Efficacy of Mobile Phone Apps for Lifestyle Modification in Diabetes: Systematic Review and Meta-Analysis” (2019) 7(1) JMIR mHealth and uHealth e12297 <https://doi.org/10.2196/12297> (last accessed 17 July 2020).

9 LP Garrison Jr et al, “Using Real-World Data for Coverage and Payment Decisions: The ISPOR Real-World Data Task Force Report” (2007) 10(5) Value in Health 326–35 <https://doi.org/10.1111/j.1524-4733.2007.00186.x> (last accessed 17 July 2020).

10 B Collins, “Big Data and Health Economics: Strengths, Weaknesses, Opportunities and Threats” (2016) 34 PharmacoEconomics 101–06 <https://doi.org/10.1007/s40273-015-0306-7> (last accessed 17 July 2020).

11 VR Suvarna, “Real world evidence (RWE) – Are we (RWE) ready?” (2018) 9(2) Perspectives in Clinical Research 61–63 <https://doi.org/10.4103/picr.PICR_36_18> (last accessed 17 July 2020).

12 European Commission, supra, note 1.

13 Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data, and repealing Directive 95/46/EC (General Data Protection Regulation) OJ L 119, 4.5.2016, pp 1–88.

14 M Karampela, S Ouhbi and M Isomursu, “Exploring users’ willingness to share their health and personal data under the prism of the new GDPR: implications in healthcare” (2019) 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Berlin, Germany, 2019, pp 6509–12 <https://doi.org/10.1109/EMBC.2019.8856550> (last accessed 17 July 2020).

15 European Centre for Disease Prevention and Control, “Resurgence of reported cases of COVID-19 in the EU/EEA, the UK and EU candidate and potential candidate countries” (2020), p 8 <https://www.ecdc.europa.eu/sites/default/files/documents/RRA-Resurgence-of-reported-cases-of-COVID-19-in-the-EU-EEA.pdf> (last accessed 17 July 2020).

16 Renda and Castro, supra, note 5.

17 By way of examples, see: B Moens, “Why is Belgium’s death toll so high?” (POLITICO, 19 April 2020) <https://www.politico.eu/article/why-is-belgiums-death-toll-so-high/> (last accessed 17 July 2020); L Ponciau, “Le Luxembourg, en zone orange, est-il victime de son dépistage massif?” (Le Soir Plus, 13 July 2020)

<https://plus.lesoir.be/312991/article/2020-07-13/le-luxembourg-en-zone-orange-est-il-victime-de-son-depistage-massif> (last accessed 17 July 2020).

18 Joint European Roadmap towards lifting COVID-19 containment measures, p 9 <https://ec.europa.eu/info/sites/info/files/communication_-_a_european_roadmap_to_lifting_coronavirus_containment_measures_0.pdf> (last accessed 17 July 2020).

19 M Ienca and E Vayena, “On the responsible use of digital data to tackle the COVID-19 pandemic” (2020) 26 Nature Medicine 463–64 <https://doi.org/10.1038/s41591-020-0832-5> (last accessed 17 July 2020).

20 CF Mondschein and C Monda, “The EU’s General Data Protection Regulation (GDPR) in a Research Context” in P Kubben, M Dumontier and A Dekker (eds), Fundamentals of Clinical Data Science (Berlin, Springer 2019) p 59

<https://doi.org/10.1007/978-3-319-99713-1_5> (last accessed 17 July 2020).

21 M Lehne et al, “Why digital medicine depends on interoperability” (2019) 2(79) npj Digital Medicine 2 <https://doi.org/10.1038/s41746-019-0158-1> (last accessed 17 July 2020).

22 See, among others: Communication from the Commission to the European Parliament, the Council, the European Economic and Social Committee and the Committee of the Regions, eHealth Action Plan 2012–2020: Innovative healthcare for the 21st century, COM/2012/0736 final <https://eur-lex.europa.eu/legal-content/EN/ALL/?uri=CELEX:52012DC0736> (last accessed 17 July 2020); Communication from the Commission to the European Parliament, the Council, the European Economic and Social Committee and the Committee of the Regions on enabling the digital transformation of health and care in the Digital Single Market; empowering citizens and building a healthier society, COM/2018/233 final <https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=COM%3A2018%3A233%3AFIN> (last accessed 17 July 2020).

23 European Commission, supra, note 1.

24 eHAction, EU Common Semantic Strategy in eHealth. Proposal Information Paper to eHealth Network (brief note) (2018), p 10 <https://ec.europa.eu/health/sites/health/files/ehealth/docs/ev_201811135_co0494_en.pdf> (last accessed 17 July 2020).

25 Commission Recommendation on a European Electronic Health Record Exchange Format, C(2019) 800 final <https://ec.europa.eu/digital-single-market/en/news/recommendation-european-electronic-health-record-exchange-format> (last accessed 17 July 2020).

26 Given the recent adoption of the Recommendation, its impact is still to be assessed.

27 BEUC, Google–Fitbit merger – Competition concerns and harms to consumers (2020) <http://www.beuc.eu/publications/google-fitbit-merger-competition-concerns-and-harms-consumers/html> (last accessed 17 July 2020).

28 A Renda, “Will privacy be one of the victims of COVID-19?” (CEPS In Brief, 23 March 2020) <https://www.ceps.eu/will-privacy-be-one-of-the-victims-of-covid-19/> (last accessed 17 July 2020).

29 European Medicines Agency, “Data anonymisation – a key enabler for clinical data sharing. Workshop Report” (2017), p 10 <https://www.ema.europa.eu/en/documents/report/report-data-anonymisation-key-enabler-clinical-data-sharing_en.pdf> (last accessed 17 July 2020).

30 RA Ford and W Nicholson Price II, “Privacy and Accountability in Black-Box Medicine” (2016) 23(1) Michigan Telecommunications and Technology Law Review <https://repository.law.umich.edu/cgi/viewcontent.cgi?article=1221&context=mttlr> (last accessed 17 July 2020).

31 European Commission, Commission Staff Working Document. Guidance on sharing private sector data in the European data economy, SWD(2018) 125 final <https://ec.europa.eu/digital-single-market/en/news/staff-working-document-guidance-sharing-private-sector-data-european-data-economy> (last accessed 17 July 2020).

32 This recommendation is also echoed in the report of the Strategic Forum for Important Projects of Common European Interest: Strategic Forum on Important Projects of Common European Interest, “Strengthening Strategic Value Chains for a future-ready EU Industry” (2019), p 48 <https://ec.europa.eu/docsroom/documents/37824> (last accessed 17 July 2020).

33 See: “Secondary use of health and social data” (Ministry of Social Affairs and Health, Finland) <https://stm.fi/en/secondary-use-of-health-and-social-data> (last accessed 17 July 2020).

34 Supra, note 25.

35 LM Babrak et al, “Traditional and Digital Biomarkers: Two Worlds Apart?” (2019) 3 Digital Biomarkers 92–102, 96 <https://doi.org/10.1159/000502000> (last accessed 17 July 2020).

36 The strategy, to be published in 2021, was announced as a key action of the Commission’s digital agenda for the coming years. See: Communication from the Commission to the European Parliament, the Council, the European Economic and Social Committee and the Committee of the Regions, Shaping Europe’s digital future, COM/2020/67 final <https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX:52020DC0067> (last accessed 11 September 2020).

37 Such issues are mentioned in the communication from the Commission on a European strategy for data: European Commission, supra, note 1, p 7.

38 K Spencer et al, “Patient Perspectives on Sharing Anonymized Personal Health Data Using a Digital System for Dynamic Consent and Research Feedback: A Qualitative Study” (2016) 18(4) Journal of Medical Internet Research e66 <https://doi.org/10.2196/jmir.5011> (last accessed 11 September 2020).