This document brings together a series of papers covering:

• Citizens’ E-Health
• E-Health and Health Services
• E-Health in Practice
• E-Health and Labor Challenges.

"In Chapter 1, we understand why health infor mation should be made available directly to patients and why electronic information is the best means of information sharing. A few important aspects related to these issues are laid down: trustworthiness and comprehensibility. Information should be available to patients in all languages so that when faced with such information, all patients can have the opportunity to understand it with the maximum level of responsibility and data security. Moreover, another feature of modern technologies is technical interoperability, which should be seen as a future ‘must do’ so that information becomes not only mobile but accessible. In light of this, e-health should bring with it the simplification of administrative procedures and should be a source of education and evaluation for the medical profession, facilitating the patient-doctor relationship. In this sense, the two major problems identified in Chapter 1, data protection and interoperability raise a common set of questions that need to be answered in the future: what type of legislation is needed to ensure simultaneously data protection and interoperability, what funding should be allocated for this and how can we bypass connectivity issues?

"Chapter 2 tries to answer just that, explaining why we are so sure that e-health is a tool that empowers citizens. It will deliver key services such as rapid access to medical records, making it possible that a chronic disease could even be remotely monitored or that 5 million yearly prescription errors could be avoided. Thus, it improves the management of healthcare and what is essential to remember is that we know it works. A similar program has already been implemented in Sweden and people there could tangibly feel that it delivered on its promises. In addition, Malta, Germany, Slovenia and Slovakia have developed ID cards where health and illness information is accessibly stored.

"Chapter 3 explains two aspects of ICT technologies: that projects such as the Virtual Physiological Human were a success and that in spite of being an advanced technological tool e-health is still in its infancy and has even greater potential for innovation. Hence, this chapter explains in specific terms what e-health does and most importantly what it could do in practice.

"Chapter 4 [talks] of present and future challenges that affect the medical profession and overall, the EU and its patients. Two articles both recognize that under the pressure of an ageing population phenomenon, healthcare services need the digitisation that could be brought by e-health investments. In this sense, the main points voiced refer to training professionals in the best way possible, facilitating for them both hardware and software material."

The report "sets out the background, overarching vision and next steps [...] for the future of the NHS".

Priorities described in the report include:

• "Stronger and more proactive focus on public health and helping people stay healthy, with more support to tackle childhood obesity, alcohol misuse and smoking.
• Clearer and simpler routes to finding the right care 24/7.
• As much care as possible delivered closer to home, with treatment of major trauma, heart attack and stroke care within specialised centres.
• Improving the lives of those with long-term conditions by ensuring that patients can take a full part in their own treatment and care, including the use of health plans and more assistive technology to help people manage their own conditions.
• Improving patient experience by ensuring privacy, dignity and cleanliness, and by providing more information and choice."

"Dans sa session du 15 avril 2005, le gouvernement en Conseil a adopté le Plan National pour la Promotion de la Qualité qui constitue une démarche globale pour l’amélioration de la qualité, inévitable pour consolider la place économique et financière d’un pays.

Corrigan JM, Donaldson MS, Kohn LT et al. Crossing the Quality Chasm. A New Health System for the 21st Century. Washington, DC: Institute of Medicine, National Academy of Sciences, National Academies Press; 2001.

1. Care based on continuous healing relationships--care whenever its needed, not just through face to face visits
2. Customisation based on patient needs and values
3. The patient as the source of control
4. Shared knowledge and free flow of information
5. Evidence-based decision making
6. Safety as a system property
7. Transparency: all information available, including the system’s performance on safety, evidence based practice, and patient satisfaction
8. Anticipation of needs
9. Continuous decrease in waste
10. Co-operation among clinicians

Basic premise: "The fundamental aim of modern healthcare is to make the best match between patient need (both recognised and unrecognised) and expectations, and to deliver care in a timely, efficient manner that achieves maximum benefit for the least cost"