Finland’s objectives during its presidency of the Council of the European Union 2019
Integrated digital services for the citizens – healthcare and social systems as test sites
- digitalisation, artificial intelligence and robotics in all policy areas – possibilities of digital services, AI and robotics are utilised as part of all care system development
- focus on citizens’ possibilities to maintain their own wellbeing (digital services for self-evaluation and self-care)
- focus on digital services for promotion of welfare and preventing harms
- ecosystems for developing platforms and e-services in private-public co-operation (platform economics)
Enhanced knowledge management – management based on real time information
- ensuring that multisector data sources are accessible for knowledge management and business intelligence
- building the needed know-how and infrastructure for understanding cross-sector phenomena – capabilities to analyse consequences and effectiveness
- utilisation of artificial intelligence in analytics and knowledge management
Ensuring participation in digital society
- ensuring participations for everyone – preventing exclusion
- customer orientation and customer participation in all development of digital procedures and services
Utilising data for research, innovation and business development
- ensuring that multisector data sources are accessible for research, innovation and business development activities
- digital single market for health data
- ecosystems for care service providers, researchers and companies for R&D in cooperation
- European cooperation of centres of excellence (e.g. genomic data, cancers, neuroscience)
Ensuring security and ethics – renewal of legislation for digital development
- data security and cybersecurity must be ensured in all situations
- ethical principles for digital health services are needed, especially concerning use of AI for analysing personal data and how AI is changing the working life
- legislation needs renewal: it is essential to study how digitalisation could change care systems and services while remodelling legislation
Priorities of Finland’s Presidency
During its Presidency of the Council of the EU, Finland will consider topical objectives and initiatives in digital health and prepare EU targets that support Finland’s own digital transformation targets and link them to European development.
Finland will continue to develop and implement the Council conclusions on digital health ([i]) adopted during the Estonian Presidency. Estonia and Finland are pioneers in digital health, which gives Finland’s Presidency a positive starting point for influencing decision-making in the EU. Finland will also consider the discussions on eHealth digital infrastructure ([ii]), held during the Austrian Presidency, and the potential outcomes from the Romanian Presidency.
In particular, Finland will seek support from Croatia, Germany and Portugal to achieve results. Finland’s contacts with previous and future presidencies are discussed in a separate paper.
Digital health themes during Finland’s Presidency
Next, the paper will discuss briefly the relevance of each theme for Finland and for the EU as a whole. The themes are presented in order of importance.
Direct digital health goals for the EU, which can be implemented through the meetings of the eHealth Network and within the framework of the eHealth Joint Action.
- Developing eHealth digital infrastructure, addressing semantic and other technical standards and reinforcing the EU framework for cross-border exchange of health data.
- Finland prioritises initiatives that allow a wide-ranging utilisation of datasets and the integration of healthcare, social services and social benefits. Finland has recently introduced the SNOMED CT system.
- The Austrian Presidency highlighted the need to develop European collaboration[iii] in eHealth digital infrastructure, such as software and funding, and to increase collaboration to achieve semantic and technical interoperability. The eHealth Network is in the process of drawing up guidelines on the matter. The network has had many heated debates about using the SNOMED CT.
- In January 2019, Finland and Estonia were the first European countries to allow cross-border health data exchange by introducing a joint system of e-prescriptions.
- Developing a framework for cross-border exchange of health data is a central proposal in the Commission communication on digital transformation. It is linked to the Commission recommendation to establish a format for European Electronic Health Record Exchange ([iv]), adopted in February 2019, and to the Commission proposal to clarify and strengthen the status of the eHealth Network.
- Future of the EU’s horizontal initiatives: cybersecurity, eID, GDPR and overall trust in data systems
- Identity management and sustainable and secure use of data are seen as Finland’s competitive advantages. Finland is also active in the field of cybersecurity and cyber diplomacy.
- The Commission considers horizontal initiatives necessary for success in different sectors. That is why an eIDAS authentication system is planned for the data exchange project. It would make it easier to consent to the use of data in cross-border cases. Other important matters at the EU level include trust-enhancing measures, Internet governance, cyber capacity building and increasing security in the cyber domain (EU’s cybersecurity strategy 2017[v]).
- Promoting
inclusion in an increasingly digital society and preventing digital exclusion
- Finland has outlined that digital services must be accessible, user-friendly and equally available even when individuals do not have personal access to digital services. Digital transformation increases productivity and quality of services and improves the equality, health and wellbeing of people. Digital solutions must promote inclusion and social wellbeing and reduce inequalities ([vi]).
- Although a Commission communication from 2018 lists as goals the ensuring of equal access to healthcare service and the tapping of the potential of digital health in reducing inequalities, in practice best results are achieved by improving digital literacy and digital opportunities ([vii]).
- Comprehensive
digital services to promote wellbeing and ways to maintain work and functional
capacity
- Finland has developed a number of good practices, such as online health advice services.
- The EU has supported many development projects in health promotion and health service provision, but Member States have been slow to implement the projects and cooperate with other Member States.
Strategic objectives aiming to influence on long-term basis the EU’s digital target setting and project implementation in health and social services. Finland’s aims to promote the objectives during and after its Presidency in the Council and in the eHealth Network.
- Secondary use of health data and genomic data: using data for research, development and innovation purposes and for knowledge-based management
- This is an important objective in the Finnish healthcare reform. Finland can offer best practices in how to incorporate the secondary use of health data into legislation and into practical applications.
- The Commission has discussed the secondary use of health data and genomic data in its communication on enabling the digital transformation of health and care in the Digital Single Market, especially under the second area of action in the communication ([viii]). Already 19 EU Member States have joined the 1+ million genomes initiative on cross-border exchange of genomic data from 2018. The 2018 Commission communication on the digital transformation of health and care, and especially its second area of action, also discusses “real world data”, genomic data and big data.
- Harnessing and promoting health technologies and health platform solutions in the EU single market
- A Finnish example of a coordinated initiative is the Health Sector Growth Strategy. Finland sees the platform economy as a possibility, and it is a common digital theme during Finland’s Presidency. In the health sector, it is important to build a well-functioning integrated system of different kinds of solutions and applications deploying platforms and health technologies.
- The Commission sees e-health as an important part of the Digital Single Market, as evidenced for example by the communication on the digital transformation of health and care. In 2016 ([ix]) and 2018 ([x]) the Commission issued proposals on the platform economy, but these do not have any health-related elements.
- Artificial intelligence and robotics supporting healthcare: use and ethics
- Promoting artificial intelligence is a strong priority for Finland. AI and robotics play key roles in making the services and service systems more efficient. They also create significant business and export opportunities for companies.
- In 2018, the Commission issued a communication and a coordinated plan on artificial intelligence. While the documents discuss the health sector, they propose little concrete measures ([xi]). The Commission’s High-Level Expert Group on Artificial Intelligence (AI HLEG) published guidelines on trustworthy artificial intelligence on 9 April 2019 ([xii]). In the field of robotics, the EU has funded a number of health-related projects, but there is no clear policy on health.
- Artificial intelligence is expected to be one of the priorities of the forthcoming German Presidency of the Council of the EU.
- Integration of health and social data systems
- At European level, Finland is a pioneer in the integration of healthcare and social welfare services, and integrated IT systems are a key condition for successful service integration.
- In many EU Member States, healthcare and social welfare services are miles apart with low levels of interoperability, despite common agreement on the integrated care approach. Better integration of IT systems in the EU will require that integration projects are included in the action plans of the multiannual financial framework 2021–2017.
Tools for Finland and the Presidency
Finland aims at a long-term effect that continue beyond its Presidency of the Council of the EU, which it can achieve by working actively and consistently in the eHealth Network and in the Joint Action, called eHAction, which is a collaborative action between the Member States participating in the network.
Tools during Finland’s Presidency:
- drafting Council conclusions on the Economy of Wellbeing (EPSCO)
- drafting papers in other fields, such as the single market, and presenting presidency conclusions on the basic principles of data economy
- promoting Commission proposals and chairing work in the Council, focusing especially on the MFF and the Digital Europe programme
- being active in the eHealth Network meetings in June (Bucharest) and November (Brussels)
- organising meetings in Finland: the Ministry of Social Affairs and Health will organise the Silver Economy Forum on 9–10 July, the High-Level Conference on the Economy of Wellbeing on 18–19 September and the CXO meeting on 26–27 September among other meetings; of the other Presidency meetings, the High-Level Conference on Data Economy on 25–26 November 2019 is the most relevant one for digital health, although health and care topics will not be on the meeting agenda
References
[1] Summary
of a background document by Jukka Lähesmaa, which is based on files prepared
for the government programme negotiations.
[i] See Council conclusions 2017.
[ii] See Agenda point 2 (Investment in eHealth digital infrastructure), eHealth Network meeting of 13 November 2018, https://ec.europa.eu/health/ehealth/events/ev_20181113_en
[iii] The eHealth Network plans to adopt guidelines on the matter in its meeting in June 2019.
[iv] Commission recommendation to establish a format for European Electronic Health Record Exchange (2019).
[v] https://ec.europa.eu/digital-single-market/en/cyber-security
[vi] Digitalisation supporting health and wellbeing. The digitalisation policy for the administrative branch of the Ministry of Social Affairs and Health 2025 (available only in Finnish). http://julkaisut.valtioneuvosto.fi/bitstream/handle/10024/75526/JUL2016-5-hallinnonalan-ditalisaation-linjaukset-2025.pdf
[vii] European Parliamentary Research Service. Bridging the digital divide in the EU – Briefing, December 2015.
[viii] See Digital transformation (2018)
[ix] https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:52016DC0288&from=EN
[x] http://ec.europa.eu/newsroom/dae/document.cfm?doc_id=50095
[xi] Communication and coordinated plan on AI (2018)
[xii] See Artificial Intelligence Ethical Guidelines (2019), presented by the AI HLEG Chair Pekka Ala-Pietilä: https://ec.europa.eu/digital-single-market/events/cf/digital-day-2019/item-display.cfm?id=23428
