Marco Marsella, Head of Unit, Directorate-General Communications Network, Content and Technology (DG Connect), European Commission, speaks to OAG about AI and digital transformation in healthcare
The European Health Forum Gastein (EHFG) 2019 press point on 3rd October 2019 explored the theme “The human touch in a digital world”, after which I spoke to Marco Marsella, who is Head of Unit, Directorate-General Communications Networks, Content and Technology (DG Connect) at the European Commission.
Following this press point, I discovered that digital transformation raises crucial questions about human relationships, a debate that is particularly important for the health sector, which is by deﬁnition dependent on human interaction. As the uptake of digital solutions within healthcare systems is increasing, there needs to be a stable balance between deploying digital solutions the highest standards of safety, privacy, security and trust.
Digital transformation & human relationships
Marco tells us his thoughts on why digital transformation is raising crucial questions about human relationships, a debate that is particularly important for the health sector, which is by deﬁnition dependent on human interaction. As the uptake of digital solutions within healthcare systems is increasing, should there be a stable balance between deploying digital solutions for the sake of better health outcomes and ensuring the highest standards of safety, privacy, security and trust?
The critical point around digital transformation in the healthcare sector is that it is dependent on human interaction and communication. One of the key enablers of this is transformation, Marco underlines, when it comes to the availability of data around the private life of the individual. He then goes on to elaborate on this crucial point in his own words.
“In that sense, to have a meaningful and trustful relationship with digital transformation, trust is, therefore, very important. Everything related to digital data has this component of safety, privacy, security and trust, so digital transformation in the healthcare sphere should and will depend on the conduct of the citizens from which you control the data. So, when it comes to that interaction, I think that it is critical and trustful, whatever kind of technologies are used in the healthcare sector.”
AI: A key driver of economic development
The interview then moves on to detail why AI has become an area of strategic importance and a key driver of economic development. I ask Marco what impact he sees AI having on Europe’s healthcare sector in the future. It is very important in this respect to understand how you can deploy digital solutions for a better outcome, bearing in mind the balance between safety, privacy, security and trust.
To ensure that you keep the trust, it is an approach which is both ethical and safety-related in addition to the privacy aspect, this is of paramount importance Marco tells us. He explains this in more detail and tells us about how the Active and Assisted Living (AAL) Programme deploys digital solutions.
“The interesting thing is that with the digital solutions employed in several healthcare sectors, you have the highest ethical standards applied. So, whatever the digital solutions might be taken out these can only be used in respect of high ethical and safety standards.
“In that sense, it is also important to engage in digital transformation, which aﬀects the organisation in terms of their cultural and other values. It is very important that with applications being prepared for digital transformation, we use a multi-stakeholder approach. This means that it is not just about creating a new digital technology in isolation and then trying to push it forward but understanding what that means at a local, national and regional level, as well as clinical applications, to engage in discussions with the healthcare professional that will one day use a new kind of technology in their workplace.
“Another approach at the European level that deploys digital solutions is the Active and Assisted Living (AAL) Programme, a research and innovation programme that looks at how technology can be taken up in real healthcare settings. It can be used to improve outcomes in care and the programme has been running for some years now.”
Marco then steers the conversation towards the European Innovation Partnership on Active and Healthy Ageing, which aims to make the European Union (EU) a place of excellence in innovation for healthy ageing. It sets out to promote discussion around this and the exchange of practices and the rationale for such activities is to foster a multi-stakeholder approach, whereby those who design technology meet those who want to update it and to have it accepted, Marco explains.
Commenting further on AI, Marco then explains that due to the technological revolution, this has resulted in a massive amount of data that is available. We now have the ability and the computing capacity on a level previously unknown. We can create artiﬁcial intelligence (AI) solutions which are very eﬀective, a point that Marco now develops in his own words.
“You can see the emergence of, practically every day, new solutions that are addressing prevention, diagnosis, treatment and care using AI. Analysing digital imaging has improved and this can be used to train speciﬁc technological solutions to address areas such as diabetic retinopathy and new solutions are arising from the research and going to the market.
“AI is also used for personalised medicine and can tailor intervention on the characteristics of the individual. It is not always used for diagnosis, treatment or operations but it is an evolution that we will see in terms of healthcare ethics.
“The Commission is supporting research and innovation through a number of European projects under the Horizon 2020 programme and this is complementing the activities that are going on in the Member States. During the next seven years of the Multiannual Financial Framework (MFF), we will continue to support research and innovation in health and digital transformation will continue to play an important role.”
What is important with AI, is that when it comes to the technological revolution, is to respect the fundamental rights, Marco tells me. In his view, this revolution, in a way, is beyond the healthcare but also in the tourism and agriculture sectors, for example. The Commission established a High-Level Expert Group on Artiﬁcial Intelligence in April 2019, comprising representatives from academia, civil society, as well as industry. They look at the trustworthy evolution of AI and have published ethical, legal and societal issues related to AI, including socio-economic challenges
The High-Level Expert Group supports the implementation of the European Strategy on Artiﬁcial Intelligence. This includes the elaboration of recommendations on future-related policy development and healthcare, Marco adds, is one aspect that will be covered by this High-Level Expert Group. While the beneﬁts of AI research go beyond clinical applications, Marco then says that the research and innovation programme of the European Commission will take this into account.
Marco then asks how can we put together the pieces into a coherent approach. He also wants to emphasise a Communication on enabling the digital transformation of health and care in the Digital Single Market; empowering citizens and building a healthier society, published in April 2018. Marco then details more on this in his own words.
“It is a European Framework for where we see advancements supporting digital transformation, with actions attached to it. Digital transformation takes stock of the fact that this will be data-driven. Firstly, we want to ensure that health data is controlled, of course, the citizens’ in full respect of the General Data Protection Regulation (GDPR), as well as security and cybersecurity standards. We want to make sure that we provide the groundwork for the Member States and stakeholders to realise that this health data is a key component of digital transformation.
“Secondly, we want to work on new kinds of data like genomic data and one of the initiatives is to lead by 2022 a cohort of 1 million genomes across the European Member States who are working together coherently in genomics. So we need to provide access to health data, look at new kinds of data, support emerging technologies and work to make sure that data is used to empower the individual to take better control of their health. This covers the full spectrum from prevention to care. This is clearly within the competencies of individual Member States and involves sharing best practices, supporting researchers and encouraging discussion.”
The European Commission’s wider aims
Moving close to the end of the interview, I ask Marco how the aforementioned these areas ﬁt in with the European Commission’s wider aim to support innovative digitally-enabled solutions and policies for people to enjoy healthy and independent living, relevant organisations and public sector to deliver high-quality and eﬃcient health and care services including personalised medicine, for example. Marco takes us back to his earlier point that stresses the importance of the multi-stakeholder approach, which is reﬂected within the European Commission, Marco stresses.
Certainly, they work hand-in-hand with the Directorate-General for Health and Food Safety (DG SANTE) and the Directorate-General for Research and Innovation (DG RTD) when it comes to healthcare research. Marco emphasises that eﬀorts are being directed to ensure that the instruments at their disposal support better outcomes and to improve healthcare systems to address the challenges that we have today in Europe. Marco then oﬀers his closing thoughts to this in-depth interview. Let’s leave the last words to him.
“The digital transformation of healthcare will progress and it is important to support this for obvious reasons including to beneﬁt citizens’, healthcare professionals of the Member States. We do this together with a very inclusive approach where we take into account the fact that we are dealing with data that is sensitive in nature, so we take into account the views of everybody.”
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