Paul De Raeve, Secretary General of the European Federation of Nurses Associations, considers the importance of digital transformation to support high-quality patient healthcare
The promise of digital transformation within health and care has raised hopes and expectations. EU citizens/patients are expecting access to their health data – anytime, anyplace – trying to become more involved and empowered in managing their own health conditions. Facing challenges of time and complexity, nurses require timely access to accurate and relevant health data, to better organise the continuity of care and as such, facilitate better health outcomes.
The ability to access and share health data is unfortunately not yet happening. Although some initiatives have been taken to make progress, frontline healthcare barriers still exist. However, the engagement of frontline nurses to build solutions based on a ‘co-creation” approach is needed to move from ‘theory’ to ‘practice’. Co-creation as the way forward to effectively implement digital transformation of the healthcare sector will be key to have a better understanding of how citizen/patient and nurses want to achieve better work processes and health outcomes.
Value of digital innovation
The value of digital innovation in bringing benefits for citizens, patients and health systems will depend on trust. Health data, data that frontline healthcare professionals collect, need to be integrated with the EU Electronic Health Record (EHR) to boost continuity of care and integrated care. Innovation in health should empower patients and frontline nurses, moving towards an integrated care system based on proactive/empowered health-aware patient/citizen. We need to ensure that the information technology and communication (ITC) tools and the data revolution support and facilitate the shift towards a resilient health and care system and supports nurses to deliver frontline high quality and safe care. Therefore, it is key that the medical, nursing and other relevant health professional data are integrated into the EHR to boost continuity of care and as such, build trust: citizen and patient’ trust is a central concept in developing digital tools.
Due to the current lack of end-user co-creation, there is much patchwork, too many digital health apps and tools, leading to a kind of ‘blockage’ for the end-user. The need of patients and citizens to be able to access their own health data is becoming an important priority at the EU level, however, it is central that such tools respond to real frontline needs and facilitate their daily work, allowing healthcare professions to spend more time on the frontline with the citizens/patients.
Advancing healthcare sector interoperability
In their daily practice, nurses may benefit from greater access to knowledge and constant support for the analysis of complex data. Continuity of information has the potential to support the integration of care, alongside its quality and safety. When nurses plan their care, revise medication, and think of clinical interventions, interoperability can support care practices and reduce errors significantly, provided health data warehouse, and specifically, the EHR, functions to support the workflow of the nurses. It can also ensure constant knowledge sharing/training for every healthcare professional (HCP), which is essential when digitalising the healthcare sector. Considering that the main task of frontline nurses is direct patient care, there is an intrinsic human touch that cannot be replaced by anything else – not even the most advanced technology. But in both cases, a robust EHR will augment and supplement nurses’ abilities to perform their duties with the integration of clinical pathways. Arguably and in principle, purpose-specific well-designed and implemented interoperable EHR have the potential to assist frontline HCP to reduce some of their workloads. Nurses are integral to the design, development, and deployment of health information technologies.
Creating EU health data spaces
It is, therefore, key that coordinated action and end-user co-creation will need to guide EU digitalisation developments to make policies and IT solutions “fit-for-practice” in all EU Member States. The full potential of the EU EHR will be exploited when different national systems of EHR become interoperable with each other, or when a cross-national EHR system gets implemented in the EU. Inclusive governance structures and transparency are essential to supervise the use and re-use of health data. The creation of common data spaces and appropriate data sharing mechanisms would allow citizens, patients, healthcare professionals and researchers to access non-personalised data from countries, pooled across different key sectors, of which Smart4Health and IEHR, in which EFN is a key stakeholder representing the end-user, are important developments. Strengthening data quality, governance, security and interoperability are key to build trust among end-users, and as such trust in digitalisation of the healthcare sector. EU projects, such as Smart4Health (S4H) and InteropEHRate (IEHR) form a good basis for creating value of the digitalisation of the healthcare sector and as such, could empower the co-created European Health Data Space.
Developing an EU health data platform for a citizen-centred health record EU-EHR exchange can pave the way for the full deployment of citizen-centred solutions and services in a digital single market for wellbeing and healthcare, through easy-to-use, secure, constantly accessible and portable health data and services, thus advancing citizens’ health and wellbeing and digital health innovation. The expected impact is to enable the citizen to use their own health data, and with whom to share it. As we move forward in co-designing the EU Health Data Space, the end-user engagement must be central throughout the whole process of designing the EHR and digital health tools to simplify the work of health professionals in the ultimate goal to improve health outcomes.
- EFN Report on Digitalisation (EFN European Parliament Event 05/02/2020), February 2020.
- Leveraging the trust of nurses to advance a digital agenda in Europe: a critical review of health policy literature (https://open-research-europe.ec.europa.eu/articles/1-26/v2)
(By Paul De Raeve, at Al, Open Research Europe, May 2021).
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