EUROPEAN COMMISSION HEALTH AND CONSUMER PROTECTION DG. Directorate C: Public Health and Risk Assessment Unit C2 - Health information

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1 1 EUROPEAN COMMISSION HEALTH AND CONSUMER PROTECTION DG Directorate C: Public Health and Risk Assessment Unit C2 - Health information DRAFT SUMMMARY REPORT NINTH MEETING OF THE HEALTH SYSTEMS WORKING PARTY Luxembourg, November 2007 Chair: Mr. Helmut Brand (Leader of the Health Systems Working Party) Co-chair: Mr. Artur Furtado (Administrator SANCO C/2, Health Information) List of participants, other documents and contributions related to the meeting are available at: website of DG SANCO: Reported by NIVEL Scientific Assistance Office 1. Welcome 2. Approval of the agenda The agenda was formally adopted. 3. Approval of the minutes The minutes of the Working Party minutes of June 2007 were formally adopted without any amendments. 4. Update of the Scientific Assistance Office (SAO) a. HSWP website Mr. Walter Devillé (SAO) gave a demonstration of the Health Systems Working Party (HSWP) website ( and the HSWP Share Point site (see presentation). Once PHEA (Public Health Agency) has taken over the work of SAO, the HSWP website/sharepoint will be transferred to PHEA. b. Newsletter Given that the SAO project will phase out in May 2008, one or two HSWP newsletters will be produced in the coming half a year. c. EUPHA Workshop The current state of health system indicators development in Europe Mr. Artur Furtado (DG SANCO) gave a report on the HSWP workshop held at the EUPHA Conference in Helsinki on October (see presentation). The workshop fits into the proactive strategy of the SANCO to create more visibility of the Working parties. There is no concrete cooperation yet between EUPHA section on Health Systems and DG SANCO. 1

2 2 d. HSWP Glossary: update and further methodological steps Mr. Ernst Spaan (SAO) gave an update on the work that has been done concerning the HSWP Glossary (see presentation). The draft Glossary is available via the HSWP SharePoint site and HSWP members have been requested to review and comment on it. It was proposed to 1) ask specialists to produce first drafts of the various sections; 2) a selected panel of generalist members will review their specific section and propose changes; 3) SAO revises, puts the Glossary on SharePoint, invite further comments from HSWP; 4) SAO revises glossary; 5) if no further comments, the section is accepted. SANCO stressed that at least a consensus on the terminology used in HSWP projects is needed. If possible, also link up with OECD/WHO definitions, other EG groups (ISO) working on standardization, and other initiatives (e.g. SNOWMED, public health language, UK). It was agreed to follow the procedure above and to focus part of the next HSWP meeting on discussing and working on the Glossary. 5. ehealth developments a. Scenario s for ehealth (working paper) The ehealth 2020 initiative aims to identify knowledge gaps, inform the public about SANCO work on ehealth and stimulate cooperation with Member States. At the moment a SANCO working paper has been drafted which will be made available to the HSWP. Mr. Artur Furtado sketched the SANCO vision on future ehealth encompassing a structured public ehealth space ('MyHealthSpace') on Internet, which could be accessible, for instance, via a TV screen (see presentation). b. ehealth Lead Market Initiative (LMI) Mr. Michael Palmer (DG Infso) gave an update on the ehealth Lead Market Initiative (see presentation). ehealth is one of the areas identified for speeding up market development. In 2008 the ehealth Recommendation on interoperability will be published, and in December 2007 a TeleHealth Conference 2007 will be held in Brussels. The next steps in the Lead Market Initiative will be the Interservice Consultation on the ehealth Recommendation and a possible roll-out and extension of the Lead Markets approach ( ). HSWP is requested to feedback on issues of certification, standardization, legal aspects and interoperability. 6. ESTAT: update on latest developments Ms. Dorota Kawiorska (EUROSTAT) presented an update on work done at ESTAT (see presentation). In December 2007 will be the 2 nd round of the expenditure data collection (OECD-EUROSTAT-WHO common data collection: Systems Health Accounts Joint Questionnaire), and in 2008 the third. In 2008 the non-expenditure data list of medical procedures will be revised based on results of the Hospital Activity Data Project 2 and the WHO classifications. The Member States have been consulted on the availability of patient mobility data in registries on hospital discharges. All metadata and methodological information will be included in the EUROSTAT s New Cronos database. There are some differences in definitions used by OECD and EUROSTAT: the Systems Health Accounts Glossary will be updated/revised ( The Regulation of the EP and Council on public health and health and safety at work statistics had its first reading in October

3 3 7. Patient Safety Ms. Marianne Takki (SANCO C5) gave a presentation on definitions, types and European actions concerning patient safety (see presentation). Patient Safety is a priority for 2008 (as confirmed by the High Level Committee). The definitions used are linked to the SIMPATIE project. A Patient network proposal has been submitted to SANCO and is currently under review. 8. New Programme of Community Action in the field of health and consumer protection a. Implementation calendar and modalities b. Priority setting Mr. Daniel Mann (DG SANCO C1) presented the New Programme of Community Action in Health and Consumer Protection The final document will be presented early The main objectives of the programme are: Improve citizens' health security, Promote health including the reduction of health inequalities and Generate, and disseminate health information and knowledge. In the health information strand special attention goes to gender and child health. The total budget is EM 321,5 of which EM 26 to PHEA and EM 9 for administration. In 2008 there is about EM 45,2 for projects. The various financing mechanisms will be: Co-financing, Call for Tenders, Joint financing by SANCO and MS, Operating grants, and Joint actions with other DGs. For conferences a separate co-financing mechanism will be used. c work plan The Work Plan 2008 has been finalised. In the future there will be more consultation of projects to be included in the Work Plan and also more streamlining and prioritisation of content. Priority now is given to projects which improve the health of European citizens, as measured where possible by appropriate indicators, including the Healthy Life Years indicator; projects reducing health inequalities in and between EU Member States and regions; projects involving new actors for health in sustained and co-operative actions, both at regional or local level and across participating countries. This includes the public sector, the private sector and stakeholders among wider civil society whose aims are not limited to public health. Attention is also given to promote the dissemination and use of the results of each project as well as knowledge transfer. The Call for proposals will be issued in February Additional Calls for tenders will be published throughout the year. SANCO considers the actual overall framework as useful, but as of yet cannot confirm whether the structure will remain as it is. SANCO may co-fund projects of other DGs if it is considered priority area, but is not aimed at funding missing links of other DGs. Regarding dissemination of projects outcomes, SANCO has its own publication channels, but aims at fostering innovative dissemination mechanisms among projects; more effort is needed to reach target audiences. The point was raised as to the role of SAO until the new programme is consolidated. The desired overview of work done on patient mobility was brought up. According to SANCO there are no immediate plans to create a related observatory; many information is already available and work on professional mobility is coming up. SAO proposed to deal up to May 2008 with the HSWP Glossary, Newsletters and an update of projects for the NCA/NWPL. 3

4 4 9. Specific project reporting a. SIMPATIE (Safety Improvement for Patients In Europe) Mr. Benno van Beek gave an update on the SIMPATIE project (see presentation): Outputs of the project are a mapping exercise in 22 countries, a Good Practice Compendium, a Vocabulary, 43 indicators developed on risk, harm reduction and specifics on patient safety. In December there is a final conference. A proposal for a follow-up project (EU Network on Patient Safety; EUNetPass) has been submitted and is under review. b. HDP2: Hospital Activity Data Project 2 Mr. Gerrie Lierens and Mr. Erwin Bensdorp gave an update on the HDP2 project (see presentation). Project is now in phase 2. Meta data are available and data collection for has to be finalized. For 22 Member States data are available on diagnosis and procedures. The data have to be expanded with external causes, cross border activities and out patients data. The procedures shortlist is ready. Further data collection is planned for spring HDP2 constructed a classification system on procedures: it was questioned whether the codings by procedure were complete and adequate; the CEEQNET project showed that there are hardly any comparable data. HDP2 procedure data are validated: the same procedure as EUROSTAT is used and Member States were asked to re-check the processed HDP2 data. The data are reliable and good quality: they are useful to analyse trends, but less so for analysis at detailed level. c. ECHIM update: issues, news for HSWP Mr. Walter Devillé replaced Hugh Magee and presented an update on ECHIM work and on additional indicators (see presentation). The long-list is considered final. On 18/19 October 2007 the ECHIM core group discussed the shortlist (71 indicators). The list of proposed additions to the short-list needs to be shortened. SAO will put the list of proposed additional indicators on the HSWP SharePoint for comments and ranking, and will coordinate the communication with ECHIM. 10. General project overview (Georgios Margetidis, Public Health Agency PHEA) a call projects in the field of HSWP PHEA considers projects linking outcomes to policy level as important. Contracts of projects of the 2006 round have been signed: palliative care, PHAMEU, Dynamo-HIA, EHR- Implement, EUROHMAP, EUPHA b call for proposals evaluation For the 2007 round more HSWP projects are selected for contract negotiations: EU Registry for Cataract surgery, Avoiding mortality: indicators for health systems, EU network for Patient Safety (EUNetPas), Centres of reference for adolescent diabetes, Inequalities indicators, Electronic coding for long-term care, rare disease national Plan construction, health care border regions cooperation policies. On the reserve list are 2 possible HSWP projects: Promoting patient safety and Pharmaceutical health information system. 4

5 5 c. General issues concerning project evaluation/ project management The evaluation procedure was explained (see also: The overall acceptance rate of proposals was 23-24% (23 out of 88 evaluated proposals granted). Some projects previously funded (secretariats) were not considered because 2007 is the last year of the current programme and projects overlapping the 2 programmes were not seen as a priority. Ideally, projects should start in 2008 and extend way into the new program period. Concerning the discontinuation of funding for some networks, the new financing mechanisms in the new programme should be considered and proposals may be re-submitted. 11. Electronic patient record systems: Vision, good practice, benefits Mr. Karl Stroetman (Empirica) gave a presentation on electronic patient record systems, current state of affairs, its benefits and problems in implementation (see presentation). The presentation dealt with how to define the electronic health record (EHR) and presented empirical evidence and case studies. Any ehealth project may fail if it does not focus enough on the policy dimension and implementation. A technological focus is insufficient, management/organisation are often the key to success. New publications were presented: Patient Safety & ICT (DG INfSo) and Patient Safety Policies in the EU. 12. IT for innovation in health services/ health care systems Mr Peter Georgieff gave a presentation on a Delphi study (FAZIT) (see presentation). The research aimed at assessing the (desired) changes in health technology: how, what uses, what is technically feasible and desirable, what are the barriers? Examples were given of outcomes of the Delphi study. Main obstacles to new health technology applications are confidentiality and acceptability by the general public. 13. The governance of the regional health system and the revision of the health institutions' workflows Prof. John Wilkinson gave a brief overview of the health system in England (see presentation). Notable current issues are the funding pressures ( payment by results ), patient choice and increased demands for a person based service, increased emphasis on community based provision, external inspection and accreditation, increased specialisation, junior doctors hours (in the context of the European Working Time Directive) and ageing. The old pillars of health care (e.g. evidence based, etc.) are still in place, in spite of the current market-driven approach to health care provision. An example of a small hospital trust was discussed, namely the potential benefits of this model to the administration, the staff and the population it serves. A new tool was presented: SHAPE - Strategic Health Asset Planning and Evaluation Tool. See: Germany representative to report on the new health Law Mr. Martin Schoelkopf (German MoH) was not present due to illness; no replacement could be found at short notice. 15. Any other business Major event Med-e-Tel Conference 2008 (April 2008, Luxembourg). More at: 5

6 6 ehealth High level Conference (May 2008, Slovenia) Next HSWP meeting The next meeting will be held in April One day will be devoted to finalizing the work on the Glossary and the other for the regular HSWP meeting. 6