Peter Wintlev-Jensen ICT for Inclusion DG Information Society and Media EU Commission ICT for Health, Ageing and Accessibility

ICT for Health

Health sector in EU Health sector in EU: 9.3 % of workforce, > 15 M people (retail 13.0 M, business services 13.3m) Health expenditure > 8,5 % of GDP and grow at a pace of 4% a year (faster than EU economic growth) potential to reach 16% of GDP in EU by 2020 (Healthcast 2020, PWC) ICT penetration is low compare to other sectors. There is great potential for productivity gains.

Challenges for European Health Delivery Systems Ageing population Rising costs of healthcare Growing expectations of citizens Improving Patient safety Addressing mobility of patients

Prescriptions 80% Disch. Letters 81 % Lab. reports 95 % Reimbursement = 95 % Referrals =80% Estimated cumulative benefit by 2008: ~ € 1.4 bil.

Support to Deployment: eHealth Action plan: COM(2004) 356 final ‘ Main areas of activity –National/regional roadmaps –Common approaches for patient identifier –Interoperability standards for EHR and messaging –Boosting investments and uptake in eHealth –Certification and labeling –Legal framework, certification of qualifications –Yearly Ministerial conferences & exhibitions (next in SLOVENIA 4-6 May 2008) –World of Health IT yearly conferences

Creating the conditions Recommendation on Interoperability (2007) Working with other Commission services –DG SANCO on cross border health services –DG ENTERPRISE, MARKET, REGIO, COMPETITION on Lead market innovation, legal framework, Innovation, financing with Member States on eHealth Action Plan, and with International bodies for worldwide exploitation of EU know-how and industry

Facilitate the Deployment Large Scale Pilots ( CIP) Service pilots with interoperability as the central theme aiming to achieve and demonstrate a “federated” solution across borders Participation on voluntary basis Focus for 2007: –Patient summary (unforeseen situations) –Medication data (for ePrescription)

For improvement of care – Saving lives –ICT infrastructure for Continuity of care, Personalisation, prevention and improved patient safety For increase of productivity- Saving Money –Cost benefits possible when eHealth combined with appropriate organization and skills For economic development- eHealth Market –To facilitate sustainable growth of transparent and innovation friendly eHealth market. Current market size estimated at € 20 Billion The WIN 3 approach for eHealth

–Personalisation of Healthcare Personal health system € 72 Million Call 1 deadline 8/5/07 –Improving Patient safety & avoiding medical errors € 30 Million Call 1 deadline 8/5/07 –Predictive Medicine – Virtual Human Modelling/simulation of diseases € 72 Million Call 2 deadline 9/10/07 EU invests in Research, FP7 ICT Challenge 5

-Prevention & Personalisation  citizen empowerment to manage own health status  emphasis in preventative lifestyle  management of chronic diseases  independent living -In the form of  Wearable, implantable, portable systems  Point-of-care systems (biochips)  Smart home environments Personal Health Systems

ICT for Patient Safety Advanced computerised adverse event systems: –Identification of common patterns in safety-relevant events beyond reporting nosocomial infections and/or Adverse Drug Events (ADE). –New tools for prediction, detection and monitoring of adverse events and other relevant information. –Decision support systems, intelligent medication delivery (e.g. RFID- based), and adverse event reporting systems through innovative data mining and integration techniques of existing databases –Emerging technologies like semantic mining should be explored through multimedia databases. –Include validation leading to quantitative benefits.

1.Integrating information relating to disease from the level of molecule, cell, organ, organism, population 2.Modelling and simulating disease related processes and human physiology 3.Predicting risks and developing more effective treatments or prevention programmes The Virtual Physiological Human (Predictive medicine)

Basis is the International physiome project The VPH research roadmap is developed by project STEP New basis for: Personalised (Patient-specific) healthcare solution Early diagnostics & Predictive medicine The Virtual Physiological Human - concept

Computational framework for multi-scale in-silico model(s) of the human physiology and a toolbox for simulation and visualisation. Patient specific model from bio-signals and (multimodal) images including molecular images Technologies involved: –Data mining, knowledge discovery tool, semantic integration, databank, biomedical imaging, modelling, simulation and visualisation techniques, HealthGrid (infrastructure and tools) The Virtual Physiological Human - technology

ICT for Ageing and Inclusion

In the EU, the share of elderly in the population will double by 2050…… Elderly Dependency Ratio (Ratio of population aged 65 and over to population aged 15-64) Sources: EU Economic Policy Committee 2001; UN Population Prospects Publication (revision 98); IMF staff estimates

e-Inclusion and ICT & ageing in i2010 A Single European Information Space Innovation and Investment in research Inclusion, better public services & quality of life Action Plan on “Ageing Well in the Information Society” June 2007 Support to Ambient Assisted Living Joint R&D Programme, June 2007 European e-Inclusion Initiative “To be part of the information society”, Nov 2007

The e-Inclusion opportunity € 55 billions from increased participation to labour of currently unemployed who do not use Internet € 10 billions from increased participation to the labour force of the students currently not using Internet € 18 billions from increased productivity from new digital skills of the currently employed who do not use Internet € 10 billions of extra GDP growth from increase in output of the ICT industry by inclusive ICT € 30 billions of extra GDP growth due to impact of inclusive e-Government

EU e-Inclusion Policy European e-Inclusion Initiative (adopted 8 Nov 2007) e-Inclusion matters, but too little progress Raise awareness and commitment: –E-Inclusion « Be Part of It » campaign –High-Level Ministerial Conference 2008 Enable – Accelerate – Integrate –e-accessibility R&D, pilots (accessible digital TV), legislation; digital literacy –Ageing Action Plan (CIP pilots); inclusive e-services; marginalised groups (networking) –Cooperation (networking); benchmarking through Riga Dashboard; mainstreaming

The ICT and Ageing opportunity 80+ population: doubles until population: from 20% in 1995 to 25% in population: 21% has severe vision/hearing/dexterity problems Age-related impairments: 69 million in 2005 (84 million in 2020) Cost of pensions/health/long-term care: up by 4-8 % of GDP === // === Wealth and revenues of persons over 65 is over 3000 B€. Smart homes market will triple between 2005 and 2020 Early patient discharge by tele-health: save €1,5 billion p.a. (Germany) Tele-care technology: from institutional care costs of £21,840 to £7,121 including 24 hours response (UK) €50,000 on accessible website  access to 1.9 million new customers (Tesco)

So what’s in the way? Older people don’t use the Internet and find technology challenging –Only 10% of people over 65 use the Internet –Over 20% of the 50+ are seriously challenged in hearing, vision or dexterity –ICT is complex and requires special skills Ageing needs not yet in main-stream products –Insufficient awareness of market opportunities and users' needs –Older users needs not built into new designs and technologies –Fragmentation of research and innovation efforts Legal and technological barriers –Legal and Ethical issues not well developed –Lack of interoperability makes solutions expensive & difficult for elderly users Fragmented Markets –Differing public policies and reimbursement schemes –Unclear business models (Who pays?)

Ageing Action Plan – 3 wins! Improving the quality of life of elderly people, and of their relatives and carers Ensuring sustainability of health and social services in terms of financial and human resources Creating new jobs and business opportunities for European industries

Ageing Action Plan - 4 actions 2 Policy Actions 1.Raise awareness, shared understanding and common approaches 1.Ministerial debate 2-3 December 2007 in Lisbon 2.Innovation Platforms for Stakeholders at EU and nat. level 3.Roadmaps on ICT for Ageing Well 2.Create the right conditions – remove barriers –Best practice exchange and awards –Address legal barriers, national reimbursement schemes –ICT and Ageing Ethical issues, under Slovenian Presidency –Interoperability

Ageing Action Plan - 4 actions 2 Funding Actions “Covering the research and innovation value chain” 3.Prepare for the future through research and innovation –Framework Programme 7 long-term research (10 year time-to-market); technical requirements for interoperability; integration of components; new ideas –AAL Joint Programme Coordination of National R&D; application research and system integration (2-3 year time-to-market) 4.Accelerate investment in and take-up of proven solutions –CIP pilot projects, large scale trials, Innovative public procurement –Regions for Economic Change and mobilization of Regional Funds

Current EU R&D and Innovation Support FP7 research, Challenge 7 Ageing Prototypes for independent living/active ageing Open Systems, Reference Architectures, Home Platforms Support: roadmaps, standards, S/E research, Int’l cooperation eInclusion Mainstreaming accessibility: –Deep embedding –Simulation ‘Virtual User’ Brain-computer interaction Marginalised young people Advanced research Generic, pan-European Exploration of new areas (+ pre-commercial procurement, Structural Funds) CIP deployment pilots Ageing Independent and healthy living Chronic disease monitoring eInclusion/Accessibility Accessible digital television Thematic networks on social capital, innovation & e-inclusion, active ageing at work High visibility Overcoming fragmentation Enable scaling up, investment Value chain cooperation Regional/rural/urban renewal

Objective : Call 1 ICT and Ageing Target Outcomes Expected Impacts Key Area Integration of advanced ICT prototype solutions for Independence at home, on the move or at work. Global Industrial and academic leadership in ICT and Ageing Providing basis for future solutions with highly increased efficiency and user acceptance Key Area Open Systems Reference Architectures, standards and Platforms for Independent Living and Active ageing Enabling cost-effective, multi- vendor solutions Enabling seamless and reliable integration of devices and services Support Measures RTD roadmaps, socio-economic research, Standards setting, international cooperation (US, Japan) A long term RTD agenda for ICT and Ageing, positioning European efforts in the global market, including standards, soc-econ.

Objective : Call 2 Accessible and Inclusive ICT Key Areas Deeply embedding accessibility in mainstream ICT. Methods and tools for computer simulation of user interaction and validation frameworks. Assistive solutions based on non invasive Brain computer interaction. Demonstration of accessible solutions in real life using context. Enable new market opportunities. Facilitate seamless interaction between accessible mainstream ICT and assistive solutions. Facilitate development and production of accessible ICT. Better understanding of ethical issues, market requirements barriers and cost benefit aspects. Supporting Measures Assistive technology constituencies coordination International cooperation Preparatory Actions ICT based Communication and shared environments for social inclusion of marginalized young people RTD capacity on ICT solutions for social inclusion. Target Outcomes Expected Impacts

CIP WP 2007: ICT for accessibility, ageing and social integration ICT to fully participate in society and the future knowledge economy. ICT to respond positively to the demographic challenge. e-Inclusion objectives in CIP ICT PSP – more accessible and usable ICT technology and the use of ICT to achieve a wider inclusion of the population in the information society. Three objectives: 1.ensuring minimum accessibility and usability of emerging ICT products and services for all (pilot projects) 2.making the best use of ICT to improve quality of life and healthcare of elderly people (pilot projects) 3.experience sharing, consensus building and visibility for ICT based solutions addressing ageing and inclusion. (Thematic networks)

CIP WP 2007: ICT for accessibility, ageing and social integration Expected outcomes: –innovative ICT solutions addressing the challenge of the ageing society and improving the inclusiveness of the information society –development of a range of business opportunities in high growth markets (accessible ICT products and services, ICT for independent living and care for the elderly) –European industry in a leading position to provide solutions for these markets at local, regional, European and international level

Stepping up research on Ageing Well through the AAL Joint Programme New Joint Programme between Member States on applied ICT research in Assisted Living technologies and services ( ) –National contribution of at least €150m –EC contribution up to €150m –Cofunding by Industry and Research ~ 50% –Total investment >€600m –Based on Art. 169 of the EU Treaty Complements longer term research - €400m in FP7 Linking National programmes to EU research

AAL Joint Programme - Characteristics Annual work programme with 1-2 focused calls/year from (probably first call in April 2008) –New ICT products and services for ageing well Smaller applied research/innovation projects –Organisations from at least three different participating states –With user involvement Co-funding by participants –National rules of participation apply Projects contracted through national agencies for nat. participants –Low barriers for participation –SME friendly

AAL Joint Programme – Objectives Foster the emergence of innovative ICT- based products, services and systems for Ageing Well Create/leverage critical mass of research, development and innovation at EU level Improve conditions for industrial exploitation, in particular SMEs

AAL Joint Programme – National Interest expressed so far  Interested Committed With more than 25 M€/Year Israel   

Conclusions eHealth, eInclusion and Ageing well in the information society - social necessity and economic opportunity ICT has great potential for providing solutions, but need for comprehensive policy support European Action plans launched by the European Commission

Further Information ICT on Cordis eHealth EU ICT and Ageing Well Initiatives Ambient Assisted Living Joint Programme Contacts: eHealth: ilias.iakovidis (at) ec.europa.eu eInclusion:peter.wintlev-jensen (at) ec.europa.eu