Policy-makers in the EU are promoting an array of digital health programs, such as the European Health Data Space unveiled earlier this month. But lack of awareness and knowledge could stymy their impact. Kristine Sørensen, a digital health literacy expert based in Denmark says digital health literacy varies across countries, regions — even within families. “I prefer to call it a digital spectrum,” she said.

Recent Eurostat data show that people are increasingly turning to the internet to seek health information online in Europe. But the rates are uneven. In Finland, 80% of adults sought information about their health online last year; in Germany just 45%. A 2021 WHO report found that over the past seven years, despite a slight upwards bump during the pandemic, health literacy in Germany had actually declined.

Birgit Bauer is a patient expert and health communication specialist in Germany, who will speak at a panel on patient empowerment and digital health ecosystems at HIMSS22 Europe in Finland next month. Many older Germans are hesitant about digital tools, and sometimes do not even have WiFi. But healthy younger people don’t see a need for it either, she said.

“When you come to say, digital health, a lot of them say, ‘I’m healthy. I don’t need that.’ So they are maybe not so interested in it.”

EASE OF USE IS IMPORTANT

Trust is crucial in encouraging the uptake of digital health systems, according to Anne Moen, professor of health informatics and nursing at the faculty of medicine in the University of Oslo. Nordic countries have long-established digital services, with many interactions with government already occurring online. In Norway, the same authentication process is used in banking as in health. “That comes with an additional convenience factor,” she said.

Moen, who is also part of the panel on digital health ecosystems at the HIMSS22 Europe event in Helsinki (14-16 June), is the coordinator of Gravitate Health, a public-private partnership funded by the Innovative Medicines Initiative that aims to improve patient adherence to care protocols by providing them with actionable, evidence-based digital information about their treatment. Clear and easy-to-use design is vital to ensure a systems’ success, she says.

“You have to be clever and careful in order to have systems where the logic is easy to follow in the system. I think it is also a question of carefully selecting what we do first in order to capitalise on an initial good experience – and again it’s coming back to giving attractive services that people want to use,” she said, citing the example of the EU’s cross-border e-prescription service.

DIGITAL HEALTH CAN EXCERBATE INEQUITIES

Digital health has risen on the agenda of the EU. Sørensen describes its goals as “very ambitious.” Solutions, however, remain at member state level, she said.

Some countries or regions offer adult education in digital health; and an initiative in Germany is providing digital health training in schools. Young people need to learn to distinguish good information from bad, Sørensen explained. “We’re dealing with digital natives now, the younger generations. They may not have the same challenges as we see with elderly today but they will have other challenges. They have been overexposed to media.”

Bauer says that the EU must publicize its digital health programs more widely not just on radio, newspapers and television, but also in doctors’ offices and community buildings to better engage citizens.

Without such efforts, research shows that digital health can worsen health inequalities. As Sørensen said, “it becomes an enabler for those who can—but a barrier for those who can’t.”

Find out more about this topic and more as we reimagine health at the 2022 HIMSS European Health Conference & Exhibition (14-16 June 2022).