From health policy to practice: medical imaging as an example for improving patient outcomes through technology adoption
Wednesday, 6 June 2018
European Parliament, Brussels
On 6 June 2018, the European Society of Radiology organised the event “From health policy to practice: medical imaging as an example for improving patient outcomes through technology adoption”, kindly hosted by Member of the European Parliament Dr Biljana Borzan (S&D, Croatia), at the European Parliament in Brussels. The meeting brought together MEPs, European Commission officials and health stakeholders (both public and private) to discuss the importance of effectively implementing health policies and legislation in clinical practice to benefit patient outcomes.
Dr Borzan officially kicked off the 90-minute meeting with a strong statement calling for a realistic balance between harmonisation and the widely-acclaimed diversity of healthcare systems across Europe. In her view, healthcare systems in the EU should be strengthened through “applying common standards to drive quality for patients, safeguarding patients’ rights to care across borders, and enhancing the mobility of health professionals”.
Over the last decade, the EU institutions successfully concluded negotiations on legislative files in the field of healthcare; Dr Borzan cited the Medical Devices Regulation and the Patients’ Rights Directive as examples of legislation that uphold patient safety and quality of care in an innovation-friendly environment, spurring technological progress in healthcare. In light of the recent proposal for a Regulation on Health Technology Assessment (HTA), Dr Borzan pledged support to the European Commission’s initiative aimed at jointly assessing the clinical added-value of a new health technology in comparison with existing technologies already placed on the market. It is, however, paramount to properly implement these legislative initiatives to facilitate a transformation to more resilient healthcare systems that put innovation and patient outcomes at the centre. Dr Borzan urged the EU institutions to proactively work together with stakeholders such as patient organisations, the medical professional societies, and industry bodies, to ensure legislative initiatives improve clinical practice and result in better patient outcomes.
Prof. dr. Paul M. Parizel, Past-President of the European Society of Radiology (ESR) and chair of the meeting, showcased how medical imaging has embraced technological innovation in efforts to optimise the care pathway of patients. He stated that “modern-day medical imaging is the cornerstone of a correct diagnosis and guides the path towards the most appropriate treatment and follow-up of patients.” He compared the role of imaging to that of a GPS navigation system, which helps drivers to find their way safely and surely, to optimize their route and avoid traffic. In a very similar fashion, radiologists can help their colleagues choose the most appropriate imaging tests for patients and steer them towards an accurate diagnosis. His words perfectly illustrate that medical imaging is firmly embedded in a multidisciplinary care process integrating different medical disciplines to ensure targeted, personalised, and cost-effective patient care.
Prof. Parizel emphasised the uptake of tools developed by the radiology sector to comply with EU legislation, e.g. the Basis Safety Standards (BSS) Directive and other legislation affecting medical imaging, and to implement best practices. He reiterated calls to equally focus on both policy development and implementation in practice, stating that “policy-making does not end with the publication of a new regulation in the EU’s official journal”. He highlighted that a lot of added-value is generated as part of the policy implementation process through the cooperation of patient organisations, medical professionals, and industry collaborating with policy-makers to translate policies into practical benefits for patients and society.
Dr Andrzej Rys, Director responsible for Health Systems, Medical Products and Innovation at the Directorate-General for Health and Food Safety of the European Commission, and a radiologist himself, presented a number of ground-breaking EU-level initiatives designed to accelerate the uptake of innovative solutions in healthcare systems across member states. Recently, the European Commission released a proposal for a regulation on Health Technology Assessment (HTA), aimed at creating a support framework and procedures for HTA cooperation and establishing joint clinical assessments to evaluate the added-value of new health technologies. According to Dr Rys, the proposal’s scope also covers medical devices and complex treatments in addition to medicinal products in order to further stimulate breakthrough technological developments in healthcare. The European Reference Networks were announced as a successful initiative to share cross-border expertise and knowledge among healthcare providers to better treat patients affected by rare and complex diseases. The institutionalisation of cross-border cooperation and knowledge transfer under the European Reference Networks provides a unique opportunity to facilitate innovation through common research projects and clinical trials.
Dr Rys shed more light on the European Commission’s signature initiative to drive innovation in healthcare, the Communication on enabling the digital transformation of health and care in the Digital Single Market. With this programme, the European Commission seeks to foster citizens’ access to health data and increase interoperability and exchange of health data through better integrating infrastructure across member states. He argued that capacity-building initiatives to connect health data would moreover put health providers and industry in a better position to achieve real progress in terms of research, prevention, diagnosis and personalised treatments. Being aware of stakeholders’ concerns regarding implementation and impact, Dr Rys underlined that projects are due to be piloted in the coming months, further citing the recently signed ‘Declaration on 1 million sequenced genomes’ as a first step to putting the digital health objectives into practice.
Stakeholder organisations and healthcare associations should be considered as key actors in co-shaping and implementing EU health policies to effectively benefit patients, was the key message delivered by Mr Pascal Garel, Chief Executive of the European Hospital and Healthcare Federation (HOPE). He precisely described how stakeholders can fulfil a bridge function between the EU institutions and national and regional actors, which are crucial to making EU policies work for patients and professionals within the field of healthcare. He demonstrated how associations can support the complex process of stakeholder involvement by actively taking part in expert groups to provide expertise and build up a mutually beneficial relationship with EU institutions. He further launched a call to strive for a truly cross-sectoral approach, involving stakeholders operating both inside and outside healthcare, to address developments with a lasting impact on healthcare systems. He concluded by urging EU institutions to guarantee stakeholder involvement ‘by design’, referring to the proposed framework on HTA as a unique opportunity to firmly embed this concept in a legislative text.
Speakers widely agreed that better patient outcomes should drive the discussion on how to turn theory into practical benefits. In this sense, Dr Erik Briers, representing the ESR Patient Advisory Group, emphasised that patients should be the centre of activity and advocated for shared decision-making in clinical practice and research. As pointed out by Dr Briers, patients would benefit from multi-professional teams consisting of skilled healthcare professionals that are capable of managing patient outcomes throughout the entire care pathway, from diagnosis to follow-up care. He furthermore advocated for improved accessibility of radiologists, and medical doctors in general, while an interactive relationship is key to empower patients within the framework of diagnosis and treatment. Patient engagement is not limited to face-to-face interaction, but also encompasses the availability of easy-to-understand and accessible radiology reports and patient summaries, empowering patients to take up a more prominent role in clinical decisions affecting their health.
Member of the European Parliament Mrs Lieve Wierinck (ALDE), whose participation demonstrated the strong commitment of EU policymakers’ to engage with stakeholders on health policies, agreed to calls for a multidisciplinary approach, saying that “it is important that we do not look at these aspects in isolation, but that we tackle them all together”. A right balance should be found between actively engaging with patients and concentrating on clinical practice through implementing practical solutions within hospital departments. Mrs Wierinck also suggested to highlight the patients’ role in contributing to efficiency gains in cancer care processes, specifically with regard to cancer.
Mr Michael Hübel, Head of Unit Radiation Protection and Nuclear Safety at the European Commission’s Directorate-General for Energy, informed participants that radiation protection is not only conceived as a traditional health policy, though the topic should be taken into account when formulating health policies that risk exposure to radiation. He noted that basic safety standards were already put in place by the Euratom Treaty in 1957, stressing however that medical imaging has been an area subject to rapid technological developments. He emphasized that the reviewed Basic Safety Standards Directive, which entered into force in 2014 and applies since February 2018, is adapted to a changing environment to guarantee appropriate safeguards to both patients and the medical workforce. Stakeholders, among others the ESR, were praised for their initiatives to meet the highest safety standards. In this context, Mr Hübel explained that the European Commission, stakeholder organisations, and national authorities are intensively collaborating to monitor and assess implementation across Europe. He concluded that radiation protection standards serve as drivers for technological innovation, as it pushes the medical workforce and industry to search for procedures meeting ever-higher safety standards.
Mrs Nicole Denjoy, Secretary General of the European Coordination Committee of the Radiological, Electromedical and Healthcare IT Industry (COCIR), outlined the industry’s mission to continuously strive for better patient outcomes in a challenging regulatory environment. She noted that industry has put a lot of efforts into complying with legislation, for example the Medical Devices Regulation, which is however a time-consuming process that requires stakeholders to work together to ensure implementation improves patient safety and preserves innovation. Mrs Denjoy called on policymakers to use the proposals for the Multiannual Financial Framework and the new framework programme “Horizon Europe” to bolster the EU’s position in the area of research and development. A coherent funding system should be developed within the context of “Horizon Europe” that makes available sufficient resources to invest in both pharmaceutical products and medical technologies. She concluded that industry expects the EU institutions to put forward consistent and smart legislation that supports manufacturers and researchers in developing technological innovation for maximising patient outcomes.
The meeting ended with a wrap-up of key messages, presented by Prof. Parizel, and a lively discussion allowing stakeholders to ask questions and exchange views with the panel. Participants agreed on the need for a strong stakeholder involvement across sectors in shaping and implementing legislation to enable innovation to thrive and to make legislation work for patients and healthcare professionals at national and regional level.
The ESR would like to express its profound gratitude to Dr Biljana Borzan, MEP, for hosting the event, and to thank all speakers and participants for their valuable contributions and unwavering support to raise public awareness of these important issues.