National and regional governments play a critical role in advancing the adoption of Continua Design Guidelines for interoperable connected health, in a number of ways. Where they develop and run national electronic health record (EHR) systems, they can define the conditions and technical interfaces through which people can share their personal health data. Where government agencies are the buyers of personal connected health products (for example in some single-payer systems), they have the choice of which systems to buy. In other systems, governments can issue reference and guidance documents for public and private health service providers on what products to buy.
Alas, most governments hesitate to take a position. Some wait for the marketplace to sort things out. They are risk averse, and with good reason: they manage public funds and the public trust. Policymakers hear of other standards and guidelines in the field and are concerned about backing the wrong horse. They hear the siren call of some companies that offer integrated solutions and ease of use, but that may trap them in vendors’ lock. In most cases, government agencies require assurance that the Continua Design Guidelines are the answer to the persistent lack of interoperability.
In Europe, governments are looking to Brussels. The European Commission indeed has issued guidance documents, for example the eHealth European Interoperability Framework (published in 2013, later refined in 2015) that reference the Continua Design Guidelines and others. However, the Framework stops short of an endorsement or recommendation. The eHealth Network, the instrument of the EU Member States to coordinate eHealth policies, has also hesitated to endorse standards; the project of a Joint SDO Platform to advise the eHealth Network on standards and interoperability appears stalled.
And, the June 2016 request from six governments to the eHealth Network to show more leadership on a telehealth framework remains so far unheeded. In their letter, health ministries and their agencies responsible for ICT systems endorsed the large scale deployment of telehealth systems, and acknowledged the Continua Design Guidelines as ‘the leading open framework for many technical interoperability aspects of personal connected health.’
Ultimately, the policymakers in the European Commission and the eHealth Network are risk averse, too. They also need assurance. This is where a recent report from the GSMA could make a difference. Digital Healthcare Interoperability: Assessment of existing standards and how they apply to mobile operator services, in order to provide global recommendations to increase their adoption, was just published in October and is available for download at www.gsma.com. Prepared primarily for an audience of mobile operators, this is an excellent, state of the art overview of standards in mobile digital health from a recognised, impartial player. Coming from an industry that has a lot to teach us about interoperability, this deserves, and hopefully will find, a wide audience.