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Workshop on Standardization in E-Health
Geneva, 23-25 May 2003


"Europe: TM-Alliance, facilitating eHealth interoperability"

As eHealth is progressing rapidly in Europe in the last decade, thousands of private and public solutions are being developed in parallel. The situation is nowadays a complex mixture of heterogeneous states of maturity, hardly exportable and almost impossible to interconnect. If we add to these complicated technical parameters, the inherent complexity of the different cultures and health systems across the continent, the likelihood of reaching consensus becomes rather limited. Above all, the intricacy of the legal infrastructure in the European countries complicates the puzzle to a critical point.

Although, on the one hand the European Institutions have a head start in tackling the challenges of advance healthcare and telemedicine, the absence of a clean slate makes it extremely complicated to bring together the diverse solutions. Initial steps in telemedicine were based in providing communications infrastructure (providing networking to health institutions and professionals). The provision of services was designed to give solution to particular problems, without consideration of interfacing with other disciplines, centres, regions, and, even less so, to countries.

Though health is not a mandate of the European Union, it is certainly a part of its policy. Certain rights of the citizens have to be ensured across the continent, such as those referring to the quality of care, the freedom of movement and the protection of personal data. The importance of these rights in the European mentality is expressed in strong legal restrictions regarding data handling, which were not taken into consideration by the initial telemedicine developers. Thus many technical solutions, proposed in the past or applied in other countries, are unable to fulfil these requirements. The complexity of the picture is increased by the significant European cultural differences.

Time is a key issue. In the past, small specific solutions were developed without sufficient consideration for the full business case across the eHealth market. This bottom-up approach may be too slow for the current needs of European healthcare stakeholders; it is imperative that there is also consensus and convergence of parallel developments in eHealth infrastructure. In order to optimise eHealth services for the citizen across regional and national borders, while at the same time protecting the rights of the European citizens, this process necessitates facilitation at all levels and by all means. The Telemedicine (TM) Alliance consortium consisting of the European Space Agency, ESA, The World Health Organisation, WHO, and the International Telecommunication Union, ITU, initiated cooperation in 2002 in building a vision for provision of Telemedicine and eHealth to European citizens by 2010. In the course of the analyses performed and the activities undertaken by the consortium, an evident need of a super-national, objective and non-biased assessment and coordination body appeared.

The TM-Alliance is very conscious of the relevancy of interoperability as a key point of its general goal of facilitating the deployment of eHealth services, promoting a holistic approach and supporting coordination, in cooperation with the European Commission.

While recognising that there are already several organizations and groups in the EU contributing in various capacities towards eHealth harmonisation, the TM-Alliance sees its role as being an interface coordination body in standardization with three key tasks:

  • to gather different expertise to cooperate for the definition of the interfaces and common required standards.
  • to facilitate consensus,
  • to disseminate the agreements among the national policy makers, key players and mass media.

The importance of these activities is underlined by the fact that private investment and progress in eHealth is being hampered because of the uncertainty of what platforms/infrastructure will be applied across Europe. By uniting its eHealth efforts and facilitating the realization and establishment of advanced eHealth infrastructure functionalities, interfaces, technologies and applications, Europe has a golden opportunity to lead the advanced world in this challenging domain and increasing the business opportunities for European industry in this exponentially expanding sphere.

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Updated : 2003-05-12