Pushing at the doors of innovation

Supporters of technological advances are impatient to see closer collaboration.

Medical technology

There is a need for a more balanced debate on technology’s role in health, according to John Wilkinson, chief executive of Eucomed, the European medical technology industry association. The potential for improved health is greater than the take-up by health systems, and industry is ready to play its part in innovation, he says. “It is used to finding new ways of doing things, whereas health systems are not always so flexible or ready to adapt.”

In October, Eucomed aims to launch a call for change across the EU in the face of rising costs, tighter budgets and greater demand for healthcare provision. It is preparing to bring new data into the argument, and to address the organisations that pay for care, as well as clinicians. Added value in innovation will be its focus, and in return it will urge that savings generated by innovative technology are reflected in the overall financing strategies of the organisations that pay for care.

Eucomed is fortified in its approach by a series of recent EU pronouncements that support technology development – most notably the Council conclusions of June that spoke of medical devices delivering innovative solutions “that could improve health and quality of life” and “contribute to addressing the sustainability of healthcare systems”.

Medicines technology

Technology will be vital in translating recent advances in biological science into treatments for patients, according to Michel Goldman, executive director of the Innovative Medicines Initiative, a €2 billion joint undertaking between the European Commission and the pharmaceutical industry.

“The way that information is shared and exploited will be crucial, because one of the biggest challenges today is the fragmentation of knowledge,” he says. At present, across the range of diseases and the number of teams in academia and biopharma companies all working in parallel, “information is wasted because it is not pooled, work is duplicated, and gains that could be made from merging knowledge are not obtained”.

To remedy this, new technology – and especially ICT – will in his view be essential. He lists computer-based breakthroughs in testing procedures, documentation systems and imaging precision. He advocates a new focus on standardisation of the new tools that technology is making available, so that a brain-scan will give the same results whether it is conducted in Brussels, Baltimore or Brisbane. “This”, he says, “requires highly accurate additional research on technologies”.

The heads of major pharmaceutical companies have come to accept the need to mutualise risk and share knowledge, he says – “although inside companies, the culture is still often very protective and reluctant to share information”. Making people comfortable with a collaborative approach is just as important as the technologies themselves, he says.

Properly exploited, technology and collaboration could, Goldman says, produce genuine simplification and streamlining of processes to constrain the soaring costs of innovation, resulting in better patient care at lower cost.

IT equipment manufacturers

Hartmut Schaper, senior vice-president for health services international at Siemens Healthcare, says that despite ICT’s growing importance in health, the sector lags a long way behind banking or logistics. But wider use is being driven by advances such as personalised medicine or new diagnostics, and the exponential increase in data generation that paper-based systems simply cannot cope with.

IT-generated efficiencies are also increasingly in demand, with the ever-closer involvement of the organisations that pay for healthcare. Patients as consumers are also more demanding both over their own access to data (for instance to avoid repeat X-rays), and over ensuring privacy of their data.

But Europe’s fragmented market and diverse national healthcare systems are impediments, Schaper says. “EU countries could co-operate better in making cross-border healthcare more accessible, and in facilitating exchange of patient data.” This will require greater standardisation, and a better balance between protecting privacy and ensuring efficient data collection and transmission, he says.

The EU should promote more focused and better co-ordinated initiatives to support the adoption of valuable innovations, and could stimulate training of clinicians in the use of healthcare IT. “Since technology is not country-specific, this could be done through pan-EU initiatives,” he says.

Software manufacturers

Europe is not fully exploiting its international lead in applying ICT to health, according to Elena Bonfiglioli, senior director for health Europe at Microsoft. “It is already happening in pockets of innovation, expertise and excellence. The challenge is to up-scale those,” she says.

Properly deployed, ICT can make a major contribution to prevention as well as treatment, she says, and this remains insufficiently explored. The ingredients are there, she says, listing options across the range of health technologies from large and small companies. Now, she says, it is time for enterprise policy in the EU to support that market.

The approach should be from the perspective of industrial policy rather than taking e-health as the starting point. “This is where Europe is strong, with thousands of partners who create ICT-based solutions,” says Bonfiglioli. These, she says, should benefit from incentives for innovation. But she is yet to be convinced that the vision, imagination and commitment are there at political level. She is insistent on crucial factors such as integrating e-health applications with cloud computing. She says of EU policymakers: “I am confident that they care, but not that they dare.”

Researchers

Françoise Meunier, director-general of the European Organisation for Research and Treatment of Cancer, says progress in technology is opening the way to more targeted and personalised treatment, through understanding of molecular pathways and of genetic abnormalities, and of patients’ responses to treatments.

Now these critical factors need defining more precisely, she says, through greater collaboration and further refinements of technology. Meunier urges a new model of partnership – with funding for co-operation at clinical level – to secure European success, with funding bodies from charities to governments promoting pan-European research instead of focusing mainly on national research.

Drug developers

Technology brings opportunities for cost reductions in the conduct of clinical trials of new medicines, according to Ingrid Klingmann of Pharmaplex, a consultancy. In particular, the electronic case-report form holds huge potential to reduce the need for labour-intensive and costly visits by trial monitors to the hospitals or clinics where trials are being carried out, and to allow remote supervision of the data that investigators are entering, with the possibility for immediate evaluation. But Klingmann points to persistent problems in the multiplicity of systems, with a risk of passwords and codes being forgotten or data from different studies becoming mixed up.