From Capsil Wiki

In Europe the picture is very fragmented with small scale pilots being the order of the day and little or no reimbursement policies or joined up thinking across countries. Recognizing this is in 2008 the European Commission published a report (1) aimed at identifying the underlying issues preventing the adoption of telemedicine technologies and recommendations/actions to stimulate its adoption. It stated that “Despite the potential of telemedicine, its benefits and the technical maturity of the applications, the use of telemedicine services is still limited, and the market remains highly fragmented. Although Member States have expressed their commitment to wider deployment of telemedicine, most telemedicine initiatives are no more than one-off, small-scale projects that are not integrated into healthcare systems”. It goes on to say …”Patients' compliance is high and some healthcare authorities have already acknowledged the need for these services. Yet, most telemonitoring services are still limited to the status of temporary projects without clear prospects for wider use and proper integration into healthcare systems. Commitment by healthcare providers and concerted action between all stakeholders are needed in order to ensure wider deployment of these types of services throughout the EU”.

The report identified three key areas that action needs to happen to stimulate the telemedicine market, these are;

• Building confidence in and acceptance of telemedicine services - The Commission has identified that there is a clear lack of ‘hard data’ that quantifies the return on investment of telemedicine and telemonitoring. Lots of small scale pilots have been carried out; however no large (national scale) pilot has been performed. The Commission’s position is that until this data becomes available, insurers are unlikely to enter the fold and get creative around reimbursement policy. The Commission has agreed to publish a commonly agreed set of guidelines for telemedicine across Europe as well as fund through the Competitiveness and Innovation Program framework (CIP), a large scale telemonitoring pilot project.
• Bringing legal clarity - The lack of legal clarity – in particular with regard to licensing, accreditation and registration of telemedicine services and professionals, liability, reimbursement, jurisdiction – is a major challenge for telemedicine. Cross border provision of telemedicine services also require legal clarification with regard to privacy. Only a few Member States have clear legal frameworks enabling telemedicine. In some Member States, for a medical act to be legally recognized as such, the physical presence of the patient and the health professional in the same place is required; this is a clear obstacle to the use of telemedicine. Moreover, there are often limitations in law or administrative practice on reimbursement of telemedicine services. The Commission has promised to support member states in the establishment of a Common European platform to support legal issues and generate policy regarding data flow, ownership and accountability within the European Union.
• Solving technical issues and facilitating market development – The EU has identified issues such as Broadband deployment and device interoperability as major issues needs to be addressed over the coming three years. It proposes to support industry and other efforts aimed at overcoming these problems with particular emphasis on interoperability.

References

• 1. Communication from the Commission to the European Parliament, the Council, the European Economic and Social Committee and the Committee of the Regions. “On telemedicine for the benefit of patients, healthcare systems and society”. Brussels, 4.11.2008 COM (2008) 689.

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