E-Health Strategy: Why we need an Integrated Approach for Europe

From electronic patient records to telemedicine: The digitalization of healthcare in the countries of the European Union is progressing at different speeds. It is true that there are a large number of promising European initiatives dealing with e-health. However, a clear, European vision is still lacking. In an impulse paper*, we are calling for an integrated European e-health strategy. The paper shows why the EU will benefit from a single e-health market – and how a common e-health vision could be successfully implemented.


Until recently, the Coronavirus warning app by the German Federal Goverment could only alert against “German” risk encounters. In other words, it could not warn against risk contacts with people using a tracing app from Italy or Denmark, for example. This weak spot has now been corrected to a large extent: Thanks to the development of the so-called EU Federation Gateway Service, the tracing apps from various European member states have been able to exchange data across borders since this autumn.

The Corona Pandemic is just one example that makes one point very clear: Fragmented approaches do not offer fully sustainable solutions. In the fight against the corona virus, which knows no national borders, the states of Europe must develop common strategies to get the pandemic under control.

But a common strategy is not only a desirable objective in the fight against the pandemic. Already some time ago, the EU and its Member States recognized the potential of e-health to fundamentally improve healthcare, patient information and access to medical treatment. Accordingly, there are numerous strategic elements and corresponding actions to promote e-health at the EU level. However, these elements have not yet been integrated – in the sense of a coherent and effective comprehensive strategy.

From electronic patient files, access to telemedicine, national health portals, health apps for standard care to e-prescriptions, Europe is largely a mosaic of different approaches to solutions, and the pace of digital change varies. A common vision or a comprehensively integrated strategic approach to coordinating the existing efforts is still lacking. However, the European General Data Protection Regulation, the Medical Devices Regulation and the Internal Market for data already form a sound foundation for a European framework – in other words, for “e-health made in Europe”.

An integrated European e-health strategy would provide a framework for national strategies on the one hand and a focal point for cross-border activities on the other. It would also be a cornerstone for a citizen-oriented healthcare system – a healthcare system that makes full use of the opportunities offered by digitalization to facilitate patients’ access to qualified care services from any given location. And for one that optimizes cooperation and information flows between all those involved in the care process. Two examples: Firstly, EU citizens have the right to receive healthcare services in any EU member state, the costs of which are reimbursed in their home country. Secondly, the German EU Council Presidency has firmly established the European Health Data Space in its agenda. The intention is to create a common European area that will enable the exchange of data with the aim of improving care for the benefit of patients and promoting basic research in Europe.

How an integrated approach can succeed

So how can an integrated strategy succeed? We have summarized our answers to this question as impulses for an integrated European e-health strategy from three different perspectives:

  1. a citizen-oriented healthcare system that offers real added value for patients
  2. an economic perspective that illuminates the advantages of a united Europe competing with other major powers such as the U.S. and China in the field of digitization – while taking into account the principles of the European welfare state.
  3. a governance perspective, which looks at how e-health can be implemented in cooperation with the European institutions while respecting the competencies of the Member States.

No matter from which perspective you consider the current situation: In our view, an integrated strategy can only succeed if it is based on scenarios and includes clear communication formats that address all stakeholders.

This implies: Firstly, clear European objectives must be defined that take an eye to the future. A clear e-health strategy defines health policy scenarios in advance as potential tipping points, such as global market developments or the integration of new technological advances in healthcare. In this way, a harmonized European e-health market could react quickly to dynamic changes and enable flexible decision-making.

Secondly, a clear e-health strategy will engage citizens and all other EU stakeholders such as e-health providers, investors, service providers and other interest groups. To achieve this, a clear, targeted communication strategy about ” e-health made in Europe” is essential. Whether in the form of campaigns that address citizens on an emotional level and transparently convey the benefits and risks of e-health, or in the form of events, discussion groups or other discussion formats for a professional audience. An integrated strategy must be understood – and ultimately implemented and lived – by all those concerned.

The Bertelsmann Stiftung’s impulse paper* contains a total of seven recommendations for action for an integrated European e-health strategy. We will discuss a number of them in more detail in upcoming blog posts:

  1. an integrated European e-health strategy must be tailored to the needs of citizens.
  2. e-health must be used strategically in situations of  crisis such as the Covid 19 pandemic requires an EU-wide response.
  3. an integrated European e-health strategy must include the governance for a European health data space.

*Paper available in German with English recommendations for action.



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