Q & A with Ilias Iakovidis; Deputy Head of the ICT for Health Unit of the European Commission
Brenda Wiederhold: Today I am in Brussels, interviewing Dr. Ilias Iakovidis from the European Commission. Dr. Iakovidis, I would like to start by asking what your current position is at the Commission?
Ilias Iakovidis: I am currently acting as Head of Unit of the ICT for Health, General Directorate Information Society.
B.W.: Can you tell me what the significance is of healthcare events that you help to organize?
I.I.: We try to present past projects to politicians, industry members, users, stakeholders, and health care professionals in order to involve them in the large-scale innovation and deployment process. In 2010 we held a spring event targeting policy and politicians, and the fall event focusing on market forces.
B.W.: And how did you become interested in technology and health care?
I.I.: I had an accidental interaction with cardiologists at my university when I was a PhD student in the US, which ultimately led to my thesis. After finishing my PhD, I was called by the Biomedical Engineering Department in Canada to prove my PhD work. I applied my theory into practice as a post-doc and later, as a research associate at the Montreal Heart Institute. I applied for a research officer position at the European Commission while working in Canada, and that came to fruition in 1993. Now here I am – a “Eurocrat” managing R&D and policy in the domain of health informatics, now known as eHealth.
B.W.: Can you tell me about the European Commission’s role in health care and technology?
I.I.: The European Commission has huge framework programs to facilitate research and innovation, but it has a very weak mandate in healthcare, which is left to the Member States. Through the window of a single market for eHealth systems and services, the Commission has been one of the first international funding organizations to focus on interdisciplinary projects and research in eHealth since the end of the ‘80s. We invested early, and gradually increased. So from $10 million a year at the end of the ‘80s, we are now at $100 million a year. In the late ‘90s we started working with Member States, policy, industry, users, stakeholders, and associations. We then created European associations of eHealth stakeholders like EUROREC, EHTEL, and began policy work and deployment, based on solid research ground.
B.W.: It seems you have also been very involved in EU-US cooperation, is that correct?
I.I.: Yes. We are involved in policy and research with the US, supporting global interoperability. Last December Vice-President of the European Commission Neelie Kroes and United States Secretary of Health and Human Services Kathleen Sebelius signed a Memorandum of Understanding with the common aim to create new markets and growth opportunities for industry in the eHealth sector in both the EU and the US.1 As well the ARGOS eHealth Pilot Project expands the impact of eHealth Week across the Atlantic: it develops and promotes common methods for responding to global eHealth challenges in the EU and the US.
B.W.: Are American universities involved in the European research initiatives?
I.I.: Certainly. We had a special call inviting US organizations to join our Virtual Physiological Human (VPH) initiative 2 projects. We are in close contact with several US funding agencies working on VPH, mainly multi- scale modeling and simulation.
B.W.: What would you consider the ICT for Health’s main achievements for the past two years?
I.I.: I think the biggest achievement was getting EU Member States to agree to form a high-level eHealth governance initiative.
B.W.: And what do you see some of the main initiatives being – moving forward for the remainder of 2011 and beyond?
I.I.: We are working to break the legal barriers on patient identification and professional authentication, to increase awareness of benefits by health professionals and patients, and to get the health care professionals and patients personally involved with eHealth.
B.W.: People talk a lot about how technology can improve healthcare, but what do you think are some of the main impacts that it will have on the individual’s healthcare?
I.I.: We focused all of the ‘90s on connectivity – linking all the departments within a hospital, hospitals with GPs, pharmacies, labs, payers and authorities. Now, we’re involving every person as a node of that network, receiving and sending vital information. In the near future, we could see people accessing their records online, booking appointments, requesting repeat prescriptions and volunteering for research trials. You give the right tools to the patients and you get them to have a “response-ability” to cope with their condition.
B.W.: In other words, empowering the patients. Yes?
I.I.: Yes. We try to give the patient some kind of map or GPS to navigate through the road of health, for their own sake.
B.W.: So do you see the individual EU citizen embracing the technology now, or do you think most people are standing back waiting?
I.I.: There are very big variations. That’s why health care systems are so different. The way a health care delivery system is organized has to do with the relation between a citizen and the state. If they are very trusting of each other, it works marvelously. You can see Denmark as an example. We’re going from a trust between people like me and the doctor, to trust between me and a system. That’s huge – for some cultures, it’s an inconceivable jump.
B.W.: Several years ago, it seemed like there was not as much in the mental health care arena with technology. But now it seems there is an emphasis on that. Are there more things coming across with mental health care?
I.I.: Yes. Until last year, we consciously kept away from the human mental condition because it was too complex for us to deal with. So for the first time, we entered into the game of mental disease and looking at the bigger picture, but through quantitative measurements if possible.
B.W.: Can you tell me some of the biggest obstacles of incorporating technology into healthcare as we go forward?
I.I.: Organization and skills are the prerequisite for getting benefits out of eHealth, and if you don’t have them, IT is just another expense. In addition, there are other challenges such as legal issues, incentives, trust among the stakeholders and finally technology. The technological components exist, but an integrated, userfriendly interface and a relevant kind of semantic interaction is not yet there.
B.W.: What are you most proud of in all these years at the Commission?
I.I.: I am very proud to have taken part in developing a vision of patient-centered care, as in 1994, and then seeing results materialize 10 years later. I also want to mention the renewing of the EU eHealth research agenda twice: introducing personal health systems in 1998 – by forging stronger cooperation with biomedical engineers, and biomedical informatics by forming strong synergies with the system biology community in 2002 that lead to our VPH Initiative in 2005.
B.W.: And now, what are your recommendations to researchers seeking funding from the European Commission?
I.I.: A researcher should really understand what it is that can and has to be done; what can be funded at the European level, and what he can do nationally. Also, he should not present a proposal that he is not fully devoted to, because European money is very competitive and very expensive money. It requires a really big effort and commitment.
B.W.: I think it is nice having different disciplines from different organizations, and different countries and cultures working together to solve a problem. I think that is unique to Europe right now.
I.I.: Yes. Since we began funding projects in ’89, we went through a phase of community building. We wanted people to create somewhat of a single market of researchers in Europe. I think we are almost there. Now we need to focus on existing challenges that need to be solved at the EU level.
B.W.: Any predictions on new trends that you see in this area?
I.I.: The one that we’re betting on is the stronger engagement of people. Some call it m-health or u-health. People will become more immersed in medical knowledge, so they will be able to form an opinion and give feedback. Another trend is personalized medicine. It’s not only about your treatment; it’s about your condition as a whole. This is a very difficult challenge to accomplish.
B.W.: Thank you for your time.
President of Virtual Reality Medical Institute (VRMI) in Brussels, Belgium. Executive VP Virtual Reality Medical Center (VRMC), based in San Diego and Los Angeles, California. CEO of Interactive Media Institute a 501c3 non-profit Clinical Instructor in Department of Psychiatry at UCSD Founder of CyberPsychology, CyberTherapy, & Social Networking Conference Visiting Professor at Catholic University Milan.