Smart Digitalization

Table of contents
1. Introduction 3

2. Modern Digital Health 6

Greek market 6

E-prescription project
Care Across
RESPI

6

9

9

Polish market 10

Luna 0

1
Diabdis 11

The robot for people with Alzheimer disease 11

Latvian market 12

Current E health trends 12

Current E health trends in Latvia 13

3. The Future 16

4. References 19

1. Introduction Aging of population is regarded as one of the most significant megatrends world is currently facing. According to L.A. Gavrilov and P. Heuveline: Aging of population (also known as demographic aging, and population aging) is a summary term for shifts in the age distribution (i.e., age structure) of a population toward older ages.1 An immense scientific progress allowed people to reduce the perinatal and infant mortality rates along with enabling older people (after 65 years) to live longer. Less and less people are being born each day, making workforce shrink2 .
Combining those two factors alone, one can clearly find in which direction our world is heading.

Historically it is possible to distinguish between several periods in the last century, taking into consideration trends within birthrate. U.S. population is a superior example, since the data is exceedingly accurate and its society is pretty complex demographically. A crucial phase for today’s world is associated with Baby Boom (1946-64). This occurrence, taking place right after
WWII made enormous impact on how the current population is shaped. It is necessary to keep in mind that approximately 80 million people died during those 6 years of war. General well-being and positive attitude after winning WWII led American citizens to procreate more than the diminishing trend would indicate.

1

Gavrilov L.A., Heuveline P. “Aging of Population.”

In: Paul Demeny and Geoffrey McNicoll (Eds.)

The Encyclopedia of Population. New York, Macmillan Reference USA, 2003
2

"UNdata: Crude birth rate (per 1,000 population)". United Nations. 25 August 2011. Retrieved 17 October 2011.

United States birthrate (births per 1000 population) from 1909.3

It is of great importance, since people born in these years are now from 54 to 70 years old, so are either on the verge of leaving the workforce or already outside of it.

Baby boom was an anomaly in trends, although it was inevitable to present it in order to indicate how particular factors might be combined and result in aging of population. Proceeding from United States to global population, it is crucial to indicate how rapidly it was growing through last one hundred years. At the dawn of 20th century, there were approximately 1,6 billion people living on the planet (half of them in Asia). In 1950 the number increased to 2,5 billion and 20 years later - 3,7. Here, one shall remark that the distribution of birthrate varies according to the continents. For instance Asian population rose from 1,4 to 3,1 billion between 1950 and 1990.
Less developed countries are more prone to enlarge their population. The overall number of people in those countries increased from 1,7 (1950) to 4 billion (1990). Combining China and India alone, in 1990 it was 2 billion people, which was around one third of total population on the planet. Developed countries’ share in number of citizens declined from 33% to 23% in years
1900-19904. Concluding, it is safe to to say that less and less people are being born currently.

On the other hand it is of critical significance to look into mortality rate. According to
United Nations Population Division world crude death rate diminished from 1,95 % per year in
1950 to 0,83% in 20155. One shall compare those trends over the years with birth rates in order to calculate and understand why the world population is still increasing. Once again taking data from
United Nations Population Division, it clearly indicates that the difference between people born and deaths is significant and positive (although it is diminishing as well)6. Coming to a conclusion
- despite declining trend, the world population was increasing.

Years

CBR

CDR

Difference

1950–1955

37,2

19,5

17,7

1955–1960

35,3

17,3

18

1960–1965

34,9

15,5

19,4

1965–1970

33,4

13,2

20,2

1970–1975

30,8

11,4

19,4

1975–1980

28,4

10,7

17,7

1980–1985

27,9

10,3

17,6

1985–1990

27,3

9,7

17,6

1990–1995

24,7

9,4

15,3

1995–2000

22,5

8,9

13,6

2000–2005

21,2

8,6

12,6

3

http://www.cdc.gov/nchs/products/vsus.htm "Vital Statistics of the United States, 2003, Volume I, Natality", Table 1-1
"Live births, birth rates, and fertility rates, by race: United States, 1909–2003."
4

Historia Powszechna Wiek XX Jakub Tyszkiewicz, Edward Czapiewski; Wydawnictwo Naukowe PWN SA, Warszawa
2010
5

UNdata: Crude death rate (per 1,000 population)

6

"UNdata: Crude birth rate (per 1,000 population)". United Nations. 25 August 2011. Retrieved 17 October 2011.

2005–2010

20,3

8,5

11,8

2010–2015

19,4

8,3

11,1

Taking into consideration data presented, it is clearly visible why the population is becoming older. Less people are being born and less are dying. Combining it with increased life expectancy at birth (68,7 years currently7) it stands for the occurrence of population aging.
Governments are no longer able to deny how important for the economy and society this trend is.
Taking for instance increasing the retirement age in Poland in 2013 by Polish Parliament is just one of many8. Today’s world is not able to afford social benefits, when the workforce to old people ratio is in decline. Artificial regulations and distinctions have to be made by governments in order to ensure fluency of financial flows. Alongside with economic threats, it is plainly visible that this trend creates vast opportunities for entrepreneurship. With larger life expectancy and overall number of people being older than 65 (especially in rich and well-developed countries) comes growing market of people with needs yet to be satisfied. Thus, the intent of this paper is to concentrate on adapting to the current situation and making the most of it.

7

https://www.cia.gov/library/publications/resources/the-world-factbook/geos/xx.html Central Intelligence Agency The
World Factbook
8

http://rf.gov.pl/aktualnosci-z-rynku/zabezpieczenie-emerytalne2/
Ustawa_podwyzszajaca_wiek_emerytalny_do_67_lat_podpisana_przez_Prezydenta_RP__20820,Rzecznik
Finansowy ,Ustawa podwyższająca wiek emerytalny do 67 lat podpisana przez Prezydenta RP

2. Modern Digital Health
Greek market e-Health has been intensively and thoroughly investigated in Greece in the last decade. Many authors like Chronaki, et al., (2006), Siaperas and Lazanaki (2008), Siakas and Siakas (2009),
Angelidis and Giest (2010) explored the issue. On the other hand pioneers in e-health like
Pangalos and Anagnostopoulos (2014) extensively and in depth explored the New Greek National
E-Prescription System, among others. Their contribution is valuable in promoting the e-health services in the country.

Siakas and Siakas (2009) first investigated the degree of application of e-health in Greece. Both literature review and a survey of 165 respondents provided useful information. They claimed that due to the fast development of Information and Communication Technologies (ICTs) in the entire world and the spread of the Internet use in public administration, organizations and households, new approaches are being integrated in the domain of public health. Moreover, the growth of electronic services concerning health, commonly called e-Health, has provided new opportunities to different interested parts, such as public administration, health personnel (doctors, nurses and administrative health care staff), and patients. Additionally, stakeholders in related services and businesses, such as pharmacy, laboratory and preventing health care have been benefited. They found that e-health services aim to provide information on medical terms and conditions, statistics of certain health conditions, as well as communication between patients, health personnel, pharmacies, laboratories etc. Independently of the geographical location of the stakeholders, they can be consulted or helped on subjects of individual or professional concern.
The findings indicate that there is a high readiness for e-Health services in Greece, both among the health professionals and the citizens. The authors clearly mention that some professionals already use a number of e-Health services and those who do not are willing to be trained in eHealth issues in order to offer such services to the public.

One of the most interesting parts in e-health is the e-prescription. Pangalos and Sfyroeras (2012) presented the E-prescription project

E-prescription project
According to Pangalos and Sfyroeras (2012) the "e-Prescription" project in Greece is a digital social service which aims to unify all national social insurance funds through a fully integrated ePrescription platform that supports the management and monitoring, while also controlling the lifecycle of drug prescription. This cycle begins with the drugs prescription or laboratory test referrals, from monitoring their issuance until payment of the final beneficiaries and encompasses the clearance of the transactions of all national social insurance funds, doctor visits and electronic medical act referrals. With e-Prescription patients benefit from a reduction of difficulties over prescription insurance coverage, they enjoy a more simple process, especially when it comes to renewals of prescriptions. And, of course, less mistakes are made due to misreads. At the same time there is less paperwork for the health authorities and less unproductive time spent on bureaucratic procedures.

Pangalos and Sfyroeras (2012) clearly explored the objectives, the structure of the system and its benefits as follows:

Objectives
Thus, Pangalos and Sfyroeras (2012, p. 237 )consider that an e-Prescription system can be defined as ‘the computer-based support for the creation, transmission, dispensing and monitoring of pharmacological therapies’. However, it is obvious its scope and objectives differ from country to country. The Greek national e- Prescription system has been developed in line with the international general principles and objectives. One of the characteristics that make however the

Greek national e-P system different is the priority that has been given from the first day of its introduction in providing a tool for the effective control and rationalization of expenses and for improving transparency in the Social Insurance System. With the pharmaceutical expenditure for
Greece rising up to 2.7% of GDP before the introduction of the e-P system (versus an average of
1,8% for the rest of European countries), the implementation of a nationwide e-P system was hoped to provide a powerful tool for limiting medication costs, especially those related to abuse, over-prescribing and fraud. This is a remarkable observation and should carefully be considered.

Structure of the system
As for the structure of the system, they show that the Greek National e-Prescription system covers the electronic processing of prescriptions for outpatients and inpatients insured under the national insurance carriers. Significant emphasis has been given from the beginning into two major objectives: improving patient safety and quality of care, and better utilization of resources.
The system also aims to provide an open, modular, EU compatible e-prescription environment, interoperable with other national e-health applications and third-party information systems.

The system was first introduced in early 2011 and covers today more than 95% of all prescriptions prescribed in Greece. It is available through the Internet and provides a standalone electronic entry system that offers a safe prescription submission, identified by a unique number.

The overall structure of the Greek e-prescription system

Source: Pangalos and Sfyroeras (2012)
The system is working as follow. E-Prescriptions are generated by the prescribing doctor and stored in the national e-Prescriptions database, from where they are subsequently invoked by any pharmacy for execution. In the case of a hand-written prescription, the e-prescription can also be generated at the time of its execution by the pharmacist. The verification of the executed transactions from the pharmacies is done off-line by the Health Insurance Organizations - the ePrescription system is only used in this case for cross-checking. The Greek National ePrescriptions (e-P) system is web-based and is accessed only by authorized users, using appropriate credentials for identification and authorization. They believe, that this is a very important proposal since it aims to reduce the prescription costs keeping the provided services in high level.

The design reveals that prescribing doctors generate prescriptions that contain all information needed for both medical and administrative purposes. These include the patient’s and doctor’s social security identification number, the diagnosis code details of the prescribed medicines, the patient’s participation share of payment of each drug, etc. This makes the e-P system a powerful tool not only for assisting public health monitoring and planning, but also for improving administrative control, transparency and rationalization of medication expenses. By using the new

e-P system, patients can also choose, for the first time in Greece, the drug they wish or can afford from a list of equivalents, including generic drugs. That makes the control of expenses more effective. As for the Benefits and Results obtained, the new e-Prescription system has already resulted in important changes towards better use of medications and utilization of resources. Pangalos and
Sfyroeras (2012) reveal that the system has already proved that can help patients by providing easier prescription and medication pick-up procedures, fewer difficulties over prescription insurance coverage and an increase in patient safety, while it can also help pharmacists by reducing the number of mistakes by misreads, increasing the time spent towards critical issues concerning drug therapy matters, providing a competitive advantage over other pharmacists who do not adopt e-prescribing and an overall simplification of the claiming procedure. Moreover, the system can also help physicians gain quick on-line access to patient information, better formulary adherence and alignment with guidelines, on-line notification of drug interactions and a review of the cost of prescription produced.

However, Pangalos and Sfyroeras (2012) mention that future extensions are also under implementation. Several new functions are currently integrated in the system, including new eId procedures that will further enchance its security. A number of new use cases and the integration of patient summary functionalities are also currently studied through the SoHealth project. The
SoHealth project is supported by European funds; it is coordinated by Aristotle University of
Thessaloniki (AUTH) and aims to support the nationwide implementation of e-Health by demonstrating how the EU concepts and approach may be transferred at the national level. The system includes the development of a new national paradigm of interoperability based innovation, in the form of added value services, around the national e-prescription infrastructure. Its implementation is based on best current EU practices, experience and knowhow. The EU eHealth
EU interoperability framework in the domain of e-prescription and patient summaries (including medication summaries) is adopted in the national Greek context. This is done by transferring the epSOS collaboratively developed international concepts to the national environment of the
Electronic Governance for Social Security (EGSS – IDIKA in Greek) e-prescription activities.

Two innovating start up firms in Greece are the the

‘Care Across’ http://www.mitefgreece.org/careacross-internet-web

and the REPSI http://www.mitefgreece.org/respi-biotechnology-medicine

The Care Across is a digital health startup focusing on cancer while the REPSI assists people with asthmatic problems.

According to their data, as they are presented on their official web pages, they are acting as follow:

Care Across
Its mission is to assist people who are affected by cancer through reliable information, useful tools, psychological support & advice from experts. On the other hand, the vision of Care Across is to expedite faster more effective oncology research, and medical interaction that will meliorate patients’ & caregivers’ quality of life. The company has deep experience in business, technology
& oncology-and a strong drive to confront a disease that affects millions of people worldwide.

The problem: Research has shows that very little data is collected from patients’ experiences that only 4/10 appointments with oncologists lead to data recording; even less is actually used.
Traditional data collection methods (e.g. in clinical trials) are slow and target stiff research hypotheses -particularly harmful as R&D shifts towards pointing treatments. Moreover, 87% of clinical lawsuit fail to recruit patients on time, every day a pharmaceutical company’s trial is detained, it loses an estimated $8m.

The Solution: Care Across enables access to cancer patient data through indirect access to patients themselves: the platform allows members to interact in an anonymous, private & safe way. Data is collected throughout these interactions, as well as through concrete structured questionnaires. This offers the industry deep longitudinal data without restricting it to a stiff research hypothesis. Care Across enables companies to recruit patients to clinical trials online via our advanced trial search & matching engine.

(http://www.mitefgreece.org/careacross-internet-web/)

RESPI
RESPI helps Asthmatic patients live a healthy life with a management based on the patient’s smartphone. It consists of a smartphone enabled spirometer and a connected mobile app that gives disease monitoring and coaching. Patients can have an proximate, quantified assessment of their lung health, supporting decisions on rescue medication and physical exercise, whereas physicians have access to the patient’s deep pneumonic profile, enabling the optimization of the patient’s treatment.

The Problem: Chronic Pulmonary Diseases react on millions of people and is currently 3rd cause of death. Despite the predominance, there is no standardized system for self-management of pulmonary health and patients often mis-medicate leading to symptom aggravation, unnecessary hospitalization and premature death. The default of in situ monitoring, prohibits physicians to practically optimize dosage and medication type, adding a huge weight to both their

pulmonary health and the economy of healthcare systems.
The Solution: Respi features a personalized management system for chronic respiratory disease, based on the patient’s health record with the use of their smartphones. It consists of a smartphone enabled spirometer and a connected interpretive mobile application that gives customized disease monitoring and coaching. Using the golden

standard of pulmonology, Spirometry, Respi creates a deep patient profile to be used for optimizing medication, incentivizing patients and supporting patient and physician-side decisions. Polish market It is common for socio-economic developing countries to face the problem of population ageing. According to the World Bank910 both Polish ageing society and fertility rate are emerging.
Poland's situation is under speculation whether it can keep its economic development on high level due to the rapidly changing trend. Despite the fact that situation in each Polish voivodship is slightly different, Poland's overall situation can be summed up by its common characteristics: low fertility rates, population ageing (increased percentage of elderly people in the society and longer life expectancy), emigration and decline of the population.11

According to the Central Statistical Office of Poland number of people aged 0 - 15 declined about 15% (data for years 2002 - 2014). So-called group of adult people (aged 15 - 65) was constantly growing till 2008 and after that time slowly declining. All in all, in 2014, 2% growth of the population in that age scope was noted. The highest growth rate of population was noted in age group 65 < with increase for about 18%.

According to the data given hereinbefore the countries affected by this megatrend must take security arrangements in order to prevent a catastrophic tendencies. These are mainly changes in medical sector. The need for patent security has been increasing for 6 years so far.
Data presented by European Patent Office in 2014 showed that number of Polish patents increased about 22% comparing to the previous year. Most of them were IT and biotechnology branches. Having acknowledged the current situation in Poland which is common for most of
European countries, Polish scientist decided to overtake the forecasts and take care of the aging society. The problems that are caused by increasing number of elderly people are connected with medical sector which is unprepared for the occurring trend. WBJ portal12 notices increased Poles' awareness towards health - it states that inter alia thanks to Internet access people know their life is in their hands. If it was not for Internet, digital health would be still in its infancy. In Polish market mobile applications such as "My Treatment" or "My Calendar" help people to control better their medical condition.

We would like to present a few Polish inventions that will definitely help to alleviate the progeny of this trend and are far beyond simple mobile apps.

Luna 13 Because of rapid increase of ageing society, the number of people complaining about orthopedic and musculoskeletal injuries is directly proportional. Those inconveniences can be

9

http://data.worldbank.org/indicator/SP.DYN.TFRT.IN

10

http://www.worldbank.org/en/news/opinion/2012/06/14/poland-aging-and-the-economy

11http://www.oecd.org/cfe/leed/

OECD - LEED project

12

http://wbj.pl/poles-digital-health/

13

http://egzotech.com/

treated (apart from medicaments) also by physiotherapy. According to the boneandjointburden14 website 3 out of 4 people aged 65 and more are affected by musculoskeletal diseases.

To answer need to treat orthopedic, Polish company EGZOTech created rehabilitation robot named Luna for orthopedic and neurological patients. The robot's usage is to exercise, diagnose and monitor the performance. Thanks to the electromyography Luna detects even slight muscle force which makes it unique in the market. This invention helps both physiotherapists to perform rehabilitations and people to move naturally and exercise on their own.

Diabdis 15 Although diabetes is genetic, environmental aspects plays a huge role in morbidity.
Diabdis can be used by people suffering from first and second type of diabetis - and the second type occurs in inter alia elderly group of people.

By attending the program you will receive a special device which will send the parameters from your glucometer directly to your application on smart phone and to the Diabtis website. Your end glycemia results will be diagnosed and analysed by the specialists. You can also rely on their help in order to brighten your health condition. Anytime you can contact with doctor, nurse, detician or psychologists - you can simply ask questions on the dedicated platform.

The robot for people with Alzheimer disease161718 Neurologists from Lublin leaded by professor Konrad Rejdak from Medical University of
Lublin is working together with scientists from Germany, Greece, Italy and Spain on creating a robot which will help people with early and moderate stadium of Alzheimer. The robot is perfect for people suffering from dysmnesia, so the memory issues resulting in forgetting things needed to be done, especially if those can be seriously dangerous when forgot. This invention will help people in their daily duties e.g. turning the stopcock, taking medications. The robot has its own daily routine which can be programmed and this will surely help people suffering from Alzheimer disease to make patient aware in which areas it has weaknesses and how to cope with them.

14

http://www.boneandjointburden.org/

15

http://diabdis.pl/dlaczego-diabdis/

16

http://lublin.wyborcza.pl/lublin/1,48724,15872133,Robot__ktory_poda_leki__Wynalazek_lubelskich_naukowcow. html 17
18

http://medicus.lublin.pl/2014/12/post-1270/

http://www.rynekseniora.pl/rynek_opieki/105/lubelscy_naukowcy_przetestuja_robota_na_pacjentach_z_wczesnym_ alzheimerem,4168.html Latvian market
The health is one of the most important aspect for survival of humanity and this topic have always been in top prioriHes – how to provide people with protecHon of exisHng known and unknown diseases, how to ensure human well being and healthy living, how to prevent people from incurable diseases, etc.
Whole healthcare sector have always been one of the most sensiHve topics, as it is related to society as such. This sector can be divided in several parts – pharmaceuHcals, hospitals, other healthcare providers.
One of the aspects affecHng healthcare is changing demography.
Before analyzing opportuniHes in healthcare sector we need to understand the exisHng trends in it.
There are several trends that are posiHvely affecHng healthcare sector. One is The aging populaHons, when the medium life expectancy is increasing or when ferHlity rates are decreasing, and the baby boomers, generally people born aQer WWII during years 1946 – 1964 when there was huge increase in number of new born in these years. Now they all are aged between 50 and 70 years. The second trend refers that there is growing number of people living longer with chronic diseases such as heart diseases, cancers, diabetes, stroke, arthriHs, hepaHHs C, even obesity.
The third trend that has caused changes in healthcare system is due to technological advancement.

We need to understand the soluHons for exisHng health care ecosystem with the latest and modern way – The 21st century’s opportuniHes using technological advancement.
Latest technology industry is already working on a lot of different innovaHons providing these soluHons. The latest innovaHons in digital health care have achieved a scope of new technologies that include wearable devices, telehealth, smart devices for monitoring and diagnosHcs, even tracking of paHent.

Current E health trends
The new digital era in medicine have already changed daily life of different specialist, meaning that now with accessible devices doctors are beVer able to record and store the informaHon of paHent.
However, even though the situaHon allows us to record, analyze and maintain the paHent’s informaHon, it has no use, if this data can be seen only by the specialist that recorder it. The efficiency starts when all necessary doctors related with patent’s disease can be able to see and analyze, without having tangible prescripHon of disease history.
Latvian current e health has not gone far from where it was at the beginning when starHng this project with developing the united digital system.
On the basis this system would unite data base of paHent’s medical history that can be seen by paHent itself, doctors, hospitals and pharmacies. The main target was to create more effecHve way how to control and cure paHents that require regular health checks, like people with heart diseases or diabetes.
Medical technology companies now are making higher emphasis on products that are able to diagnose the disease and cure paHents with more effecHve, cheaper and faster way.
Here are some medical technologies available.

1. OpHcal scanner for analyzing mols
•

Made by MELA Sciences

•

This technology can do the job that previously could be done only by surgical intervenHon. Dermatologists have developed the technology that could analyze if mole can cause potenHal skin cancer threats. This technology is a tool that help dermatologist to see if the surgical biopsy of removing mol is necessary. This technology helps to avoid costs of unnecessary procedures for analyzing the potenHal threat of mol.

2. Biosensor for diabetes
•

Made by Echo TherapeuHcs

•

This biosensor can analyze blood through skin, avoiding needles for this purpose.
This gadget has a toothbrush looking detail that removes only the liVle bit of the top level of skin cells just that much to have the signal that biosensor can read.
AQer collecHng the informaHon of blood counts the data is sent to remote monitor, that checks and analyzes paHent’s glucose levels and alarms if something has went out of opHmal range.

3. Telemedicine
•

Made by InTouch tecnologies

•

Remote presence robots are robots can move around hospitals and making health checks of paHents, monitoring their vital signs and managing their individual charts.
They have mobile system that help them to navigate around avoiding crushing in busy hallway, medical monitoring equipment, and two way video screen that work similar as video camera help doctor at other side of screen see and analyze the situaHon around.

Current E health trends in Latvia

NaHonal Health Service in Latvia has developed informaHon technology based system that will serve the database funcHon. It will unite all collected data related to paHent in wireless form, in order that anyone who has permission would be able to see it. The purpose of this system firstly is to improve the healthcare system in Latvia and to promote the ability from the paHent to have the access of his own data whenever needed, by that promoHng more effecHve curing and recovery process.

Secondly, NaHonal Health Service of Latvia is certain that this system will decrease waiHng
Hme that paHent has to spend while ge`ng the necessary curing process. For example, spending Hme to visit Family doctor if paHent is located in different city or even country.
WaiHng in line for physical check up. Registering for European Health Care Card, etc.
Furthermore, the other goal for this system is to simply increase the efficiency of exisHng healthcare system, by increasing the security of paHent’s personal data, decreasing the amount of paper works that doctor should do, in order to maintain the paHent’s data.

E-prescrip)on of medicine (SPC)
E-sick leave
E-health card
Transparency of data
The descripHon of medicine will be wriVen electronically, aQer showing ID card paHent can receive medicine in pharmacy
Electronical prescripHon of sick leave
Electronical card showing the paHent’s health history, medical tests, diagnosis
PaHent’s ability to see who has seen and who has access to his health data
+ No worry for illegible handwriHng
+Harder to falsify these prescripHons
+ Sick leave in paper form will not be needed to bring for employer because it can be seen electronically +The data will be accessible for paHent and doctor outside the walls of medical insHtuHon
+The database will warn doctors if paHent’s has some kind of allergies before prescribing medicine
+PaHent will be able to control who is able to see his data, and forbid access aQer his opinion

Staring with April 1st 2014 this system has started to be implemented in reality under the law from Cabinet of Ministry “About the regulaHons of united electronic healthcare database implementaHon.” That the all medical insHtuHons should implement this system.
In December 1, 2015 the changes for this law were imposed, that starHng from December
1st 2016, this United Healthcare database implementaHon is mandatory for all medical insHtuHons and pharmacies.

From historical data it is possible to see that Estonia managed to implement this system within 13 years.
1. In 2001 Estonia developed plan for implemenHng E-health.
2. In 2005 Estonia created fund for E-health

3. In 2008 Estonia finish the project and establish the law for medical staff to impose this system in daily life
4. In 2014 aQer planned to invest 2,8 billion Euros, they have already spent 15 billion Euros, for this project.
AQer 13 years (in 2015) of implemenHng this system Estonia has managed to have 98% of all medical prescripHons in digital version and 98% of Family doctors are working in E-health system.
At the moment Latvia is in the phase when the ERDF funded E-health portal has been launched.
From this example, it is possible to predict that even though Latvia has suffered from some struggles while implemenHng this E-health system, it sHll shows that this process is not possible to adopt fast, however, aQer implementaHon is done, the system guarantees more effecHve treatment process. E-health is playing huge role in every European Union’s country by helping to save up financial resources and Hme for both, employees in medical sector and paHents itself. This project will not only ensure the effecHve treatment process locally but also globally improving that the data of paHent can be delivered also to other hospital or medical insHtuHon in other county of EU.

3. The Future
-

Demand for digital Health, needs of humanity it answers, help it serves.

Information System has great potential to reduce healthcare bottlenecks, cut cost and will thrive to make lives better both for patient and providers. Technology can be integrated to streamline the processes, but important question is, do we need to look back and see if end consumers benefitted. The purpose of choosing the topic in future demand for digital health, it’s need of humanity it answers and help it serves. As the recent study by William Rusnak, MD who also happens to be Medical Information Advisor at NeuMD.com19 an Online medical resource helping both patients and practitioners with a sole motive of taking complex operations and make them simpler. Mr Rusnak writes in his research blog, “What $21 Million for Doctor on Demand Means for Providers”, “I’m not an oracle, but this is certainly a pivotal moment for healthcare. The company is aggressively promoting its flat fee of $40 per 15 minute video visit, without any waiting time and accessible 24/7 in most parts of the U.S. The service will likely thrive on minor illnesses like colds and rashes, but what is this telling us as physicians?”. The trend is growing and will continue to thrive but continuity suffers and more reliance is put on proper documentation. To analyze the direction of the trend several research have been conducted and are huge data is under review. But a recent report at McKinsey20 global Institute’s conducted by
David Champagne, an associate principal in McKinsey’s London office, Amy Hung is a specialist in the New Jersey office, and Olivier Leclerc is a director in the Southern California office. The digital revolution continues to transform healthcare fundamentally, and many people believe that a tipping point is within reach. In 2014, digital health investments topped $6.5 billion, compared with $2.9 billion a year earlier21. This raises a critical question for pharmaceuticals companies now is how to stay ahead of these changes. Successful ones will rethink their cultures and capabilities, and adopt a new, longer-term mind-set that fosters innovation and strategic moves. There are three themes discussed further to the conclusion stem:

1. Dramatic changes in the traditional roles and dynamics of healthcare stakeholders have fundamental implications for pharmaceutical companies.

2. It is time to reimagine them as a solutions company, not asset companies.

3. The technology is ready, but pharmaceutical companies must change if they are going to enable and harness it more successfully.

Conclusion also leads to a deep understanding of the fact that success in digital health will require forging ahead beyond the pack mentality and embracing experimentation and risk taking, developing a collaborative culture and challenging barriers to sharing. The idea is to reinvent companies by building capabilities beyond traditional healthcare and updating the current operating model.

Plan for future Usage (Plans that are long distance but possible to develop, “dreams of the future” Technology is revolutionizing our understanding and treatment of disease, says the founding director of the Icahn Institute for Genomics and Multiscale Biology at New York’s
Mount Sinai Health System. Most companies makes a conscious and deliberate decision to embrace digitization and the information revolution. In an interview with Dr. Eric Schadt,

19

Nuemd.com/blog/21-millin-doctor-demand-means-providers

20

http://www.mckinsey.com/industries/pharmaceuticals-and-medical-products/our-insights/the-role-of-big-data-inmedicine
21

StartUp Health Insights annual report 2014

McKinsey’s Sastry Chilukuri22 how data-driven approaches to research can help patients, in what way technology has the potential to transform medicine and healthcare system.

Until now the major focus of digitalization in healthcare has been processes and less on patient needs. Now patients around the worlds have grown more comfortable using digital networks and services, even for complex and sensitive issues such as healthcare
(successful websites DrEd, PatientsLikeMe, and ZocDoc are just three examples of this trend), we believe the time has come for healthcare systems, payers, and providers to go
“all in” on their digital strategies.

The term Future in Digital Health can be understood peeping into the past and brushing briefly the current trends. Schematically acquired data could give us understanding how our future healthcare would look like. The role of big data in the medicine is one where we can build better health profiles and better predictive models around individual patients so that we can better diagnose and treat disease. Mr Eric Schadt shares a great insight how data driven healthcare will lay stepping stone for our future healthcare solutions. Pointing out at the main limitation with medicine today and in pharmaceutical industry is our understanding of the biology of disease.

Solution offered for the limitation is quite simple, big data comes into play aggregating more and more information around multiple scales for what constitutes a disease. By integrating the big data and developing a model which will evolve with time and will be more productive and predictive for a given individual in the future.

Analysis of the future performances of the trends, possibilities to develop

The same technologies that revolutionized the commerce, transportation, and finance industries are bearing down on the $323 trillion healthcare industry, promising to simultaneously improve care while reducing costs. The scope of revolutionary technologies includes diagnostics and monitoring, wearable devices, Telehealth, Medical modeling, smart devices, data management, tracking and delivery, and much more. Non
Healthcare organizations that pioneered the healthcare digitalization began by trying to understand what their customers really wanted; they then build their initial digital products and services based on that information and methodically expanded their offerings and customer base from there. Industry experts believe this model would work for healthcare in future. Success however largely depends on the understanding patients’ digital preferences in both channel and service. But many digital healthcare strategies are still driven by myths or information that is no longer true. 

Internationally, observation has been made in the field of digital healthcare24 with regards to trends towards tools and services not only for professionals but also for patients and citizens. However, their impact on the patient-provider relationship and their design for special user groups, such as elderly and/or disabled needs to be further explored. In

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http://www.mckinsey.com/industries/pharmaceuticals-and-medical-products/our-insights/the-role-of-big-data-inmedicine
23

Digital healthcare innovation summit 2016 – Official Website

Robert Mittendorff, MD,MBA Norwest Venture Partners and Bill Geary, Flare Capital Partners.
24

International Journal of Medical informatics Volume 75, Issue 8, August 2006, Pages 565-576

Sabine Koch

general, there is lack of evaluation studies and further research which is critical in deciding the direction of future in Digital health trends. Benefits, impacts and limitations, of potential solutions and to overcome a number of hinders and restrictions, such as

1. Lack of standards to combine incompatible information systems;

2. The lack of an evaluation framework considering legal, ethical, organizational, clinical, usability and technical aspects;

3. The lack of proper guidelines for practical implementation.


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