As with most challenging issues, the answer is rarely black and white. While I am not in favour of stringent one-size-fits-all EU health care regulation, I would argue that it would be irresponsible not to coordinate things on a Union level in cases where there are clear positive effects for all Member States. Recently, the Covid-19 pandemic has of course been the obvious case, which has opened many eyes for the need of such cooperation. The unfortunate fact is that if we would have been better coordinated from the beginning, countless of European lives could have been saved. Although no one can say that we were not warned, it is of no use to dwell in the mistakes that have been made in the past. However, what we can strive to do, is to act responsibly in the future.
EU coordination on combating global pandemics is one thing, but I would also like to raise two other things connected closely to the current pandemic and to future health care challenges in general, where EU involvement will be needed.
First, I am talking about the increased digitisation of society. Already before the pandemic, it was of course very clear that the future is ever more digital. However, in the last year the development has been more rapid than anyone could have expected before the pandemic and we have suddenly all become used to being more online than offline. The health care sector is following suit.
Second, I believe we have yet to fully expose the effects on our mental health following a long time of social distancing. People will always react to issues in different ways and future studies might even suggest some Member State specificities in this matter. However, no Member State will go untouched. Previous initiatives, such as the European Framework for Action on Mental Health and Wellbeing, have unfortunately not received adequate follow-up and it is high time to take action.
In short, we are talking about the rising importance of eHealth and mHealth. Two very different topics but so very intertwined.
In an ageing continent, there is a constant push for improved and more efficient solutions in the health care sector. The eHealth solutions can bring a lot of savings in countries and regions with a shrinking pool of taxpayers, while at the same time providing more accessible and individualized help to people also living in remote areas, who might otherwise have difficulties reaching specialists.
When looking at the health sector from a European point of view, eHealth solutions not only provide opportunities to better healthcare access. By going digital, the barrier for international cooperation becomes lower, bringing further efficacy to the sector. An early example of this can be seen in Estonia and Finland, where the two countries share a common system for e-prescriptions.
Finland and Estonia can of course be seen as frontrunners in digitising their societies and the healthcare sector as a part of it. This can undoubtedly be attributed to the level of the digital literacy of the population (i.e. the ability of the population to find, read and process information online). Digital literacy and awareness of digitalized services is a key element in any potential success of an eHealth revolution.
We need to make sure that information about e.g., medication is shared and assimilated properly across platforms. This means that personnel need to be comfortable enough using the platforms to minimize mistakes. Patients on the other hand need to be comfortable enough using the platforms, so that they can be assured to have received and understood the often-vital information communicated through the platforms.
However, digital literacy alone does not guarantee comfort in using eHealth solutions. We must also realize that any digital solution is strongly connected to and relying on the use of data. It goes therefore, without saying, that data protection and patients’ willingness to share health data needs to be in the centre of the development of any eHealth platform. The sensitivity of data becomes even more exposed when talking about mental health, which might be connected to a stigma.
I am convinced that we will solve the above issues with eHealth and this way help our health care sector, which is running on a tight budget all over the Union. I am a true believer in people’s ability to learn and adapt to new norms, which are beneficial for the society. However, there is still one thing we need to keep in mind before putting all our chips unconditionally on eHealth.
A Swedish study from this year on the importance of caring relations in eHealth, has concluded among other things that in-person interaction was central to people’s perceptions of good caring relations. The importance of patient-nurse relations was particularly emphasized. We can assume that digital information literacy in Sweden is internationally very competitive and eHealth, especially in a sparsely populated country, can bring many benefits. But even in the case of Sweden, it cannot be advisable to fully embrace digital care, without any sort of essential in-person relations. An approach where the two will be combined in the best possible way needs to be the way forward.
In a year that we have discovered how well things can work remotely but at the same time in many cases how much the lack of social connection has affected our mental health, we should embrace the people centred technological solutions of the future without forgetting who they are for.
 Lindberg, Bhatt & Ferm; Older people and rural eHealth: perceptions of caring relations and their effects on engagement in digital primary health care, 2021