Tag Archive for: OECD

eCAN’s Steering Committee unveils the first achievements of the Joint Action

Some participants of the second eCAN Steering Committee Meeting

The Steering Committee meeting of eCAN has been held today, May 11th, in a virtual format and with more than forty participants from beneficiary and affiliated entities. The meeting has served for the different Work Packages to present the progress achieved on the first quarter of 2023 and share their upcoming assignments. 

The reunion has been welcomed by Matthias Schuppe, responsible for preparing DG SANTE’s work on the ‘Europe’s Beating Cancer Plan’, Maren Hunds, member from the European Health and Digital Executive Agency (HaDEA), Dheepa Rajan from the European Observatory on Health Systems and Policies and Caroline Berchet, health economist at the OECD Health Division. The four professionals have spoken at the beginning of the meeting, stressing the importance of the JA and the possibility of establishing synergies in the near future with other entities and European initiatives. 

While all the Work Packages were able to share their progress, the bulk of this Steering Committee focused on the two pilots that eCAN is developing in teleconsultation and telemonitoring, which should be launched on June. 

eCAN’s first achievements 

Following the agenda, OECD and WHO/OBS, as eCAN observers, highlighted their supporting role to the overall project’s progress. The JA has been selected as example of project linked to quality of life in an exhibition of European projects organised by DG SANTE within the framework of the European Week Against Cancer (EWAC). 

WP8’s presentation has been focused on stakeholders’ identification and engagement. The colleagues from Greece have organised and taught four workshops for eCAN participants between April and May. As for the upcoming tasks, WP8 will soon conduct a gap analysis and assess the training needs of patients, caregivers, and clinical experts. They will also develop an educational framework and training materials. 

Andrea Pace, from the IRCCS Regina Elena Cancer Institute (IFO-IRE) has conducted both presentations of Teleconsultation (WP5) and Legal, ethical framework and cybersecurity (WP6), focused on the initial development of the JA’s pilots. 

Halfway through the Steering Committee, the Telemonitoring team (WP7) has also given some insight into its work until now. This includes partially completing the landscape of remote surveillance of patients and the ongoing development of the telemonitoring system to start pilots testing. In fact, they show several mock-ups of the application that will be used to monitor patients participating in the study. 

Progress on sustainability, evaluation and communication 

The past and following months have also been addressed by the entities belonging to Austria, Poland and Spain, and they have discussed the risks, gaps and opportunities that they expect to experience in the upcoming weeks.  

The Sustainability Work Package (WP4) has finalised all preparations on the Country Factsheets, documents that compile information on different territories’ preparedness, legislation and initiatives on cancer and digital health. They have been verifying the available data over the past months and country factsheets will soon be sent for external validation. 

The team responsible for the Evaluation (WP3) is about to finalize the second progress report and is preparing the cost and consequence analysis framework together with the protocol for the SWOT analysis. Both milestones are scheduled for July 2023. 

Finally, the Communication team (WP2) has presented their campaign for the European Week Against Cancer (EWAC) and showed the recent content published on the website (interviews, news, newsletters…) and social media, with TikTok emerging as one of the most prominent social networks for eCAN. The Spanish team has already submitted two deliverables, the most recent one being the updated version of the Communication and Dissemination Plan. The main ahead tasks for the communication team include preparing the first Annual Report and start organising the project’s final conference. 

Towards the first half of the Joint Action

The Joint Action “Strengthening eHealth including telemedicine and remote monitoring for health care systems for cancer prevention and care”, launched in September 2022, is approaching its first year. 

The summer months will be crucial for its progress and evolution, as many important milestones will be reached, with the start of the pilots being the most important one. At the same time, the first anniversary of eCAN will also serve to take stock of what has been achieved so far and to preview the outcomes that this European initiative could provide. Such progress will be monitored and explained in more detail at the next Steering Committees. 

The use of telemedicine skyrocketed during the COVID-19 pandemic

The use of telemedicine, or remote clinical consultations, was limited in most countries before the pandemic, held back by regulatory barriers and hesitancy from patients and providers. In early 2020, as COVID‑19 massively disrupted in-person care, governments changed the playfield and acted decisively and broadly to promote the use of this discipline.  

Consequently, the number of teleconsultations reached unprecedented numbers, playing a vital role in maintaining access to care, but it wasn’t enough to offset reductions in face-to-face care. This is one of the conclusions reached by a recent study published by the Organisation for Economic Co-operation and Development (OECD), entitled “The COVID-19 Pandemic and the Future of Telemedicine“. 

The document also proposes policy priorities for using telemedicine in the near future like learning more about which patients are using remote care services, why they are using these services and what happens after they use them. It is as well highlighted the need to investigate whether telemedicine payment and prices are creating economic signals and incentives that promote value for money. Finally, foster integration between remote and in-person care services is needed so that these are fully coordinated and part of a seamless care pathway. 

Telemedicine before the SARS-CoV-2 

Prior to the pandemic, nine countries (Estonia, Hungary, Iceland, Ireland, Korea, Luxembourg, Mexico, Türkiye and the United States) allowed only in-person medical consultations. While it was possible to use telemedicine services in other states, many governments had specific requirements to telemedicine that effectively disincentivised its use. And although the number of services was growing in territories such as Australia, Canada and Portugal, teleconsultations were only between 0.1% and 0.2% of all appointments, according to the study. 

Among the nations that participated in the OECD Survey on Telemedicine and COVID‑19, 23 out of 31 are currently allowing teleconsultations to be performed by health workers other than doctors, six more that before the pandemic (Estonia, Germany, Iceland, Luxembourg, Portugal and the United States). 

Doctor teleconsultations in OECD countries, 2020. / OECD

Despite the rapid adoption of policies to promote the use of telemedicine, only seventeen countries state that rules and regulations governing the provision of telemedicine services are well established and clear. 

An uncertain future 

During the pandemic, eight countries (Belgium, Czech Republic, England, Estonia, Hungary, Korea, Latvia and Luxembourg) have begun paying for teleconsultations through government/compulsory schemes, and other eight (Belgium, England, Estonia, Germany, Hungary, Ireland, Latvia and Switzerland) have done the same for remote patient monitoring services. 

However, many of the changes that have enabled greater use of teleconsultations during the pandemic are temporary and have not become permanent. For example, in sixteen OECD countries, changes to regulations are transitory and subject to ongoing or periodic review, just like changes regarding financing in twelve states. 

Given the circumstances, it is unclear whether remote care substitutes for or complements in-person care, and whether telemedicine adds value when it does not deliver extra benefits and could be replaced with cheaper alternatives with identical or better outcomes.

Reference:

OECD. “The COVID-19 Pandemic and the Future of Telemedicine”. OECD Publishing (2023)

EU Country Cancer Profiles point out large inequalities in cancer mortality rates between and within EU countries

EU Country Cancer Profiles point out large inequalities in cancer mortality rates between and within EU countriesOECD

The first Country Cancer Profiles under the European Cancer Inequalities Registry state significant inequalities in cancer mortality rates between and within EU member states. These reports reveal that varying exposure to risk factors for cancer and the different capacity of healthcare systems to provide timely and free access to early diagnosis, as well as high-quality cancer care and treatment, partly explain these inequalities. 

The Country Cancer Profiles consist of a concise yet comprehensive analysis of cancer burden and policies in the 27 EU states, plus Norway and Iceland. The documents were launched last 1st of February 2023 at the ‘Cancer – Equity, excellence and innovation: modern cancer care for all’ conference, co-organised by the European Commission and the Swedish Presidency of the Council of the European Union.  

During the event, the Head of the Health Division at the Organisation for Economic Co-Operation and Development (OECD), Francesca Colombo, highlighted some of the report’s key messages. All of them rely on the idea that “there are large and unacceptable inequalities across the European Union. No matter what indicator you look at, you will find differences across countries, differences across population groups; and much of these is something on we can act”, emphasised Colombo. 

Inequalities across the European Union

The difference in mortality rates becomes substantial when comparing central and eastern European countries to the remaining EU countries. Even within the same state, relevant inequalities across population groups are visible. According to Caroline Brechet and other OECD representatives, “cancer mortality rates are 75% higher among men than women across EU countries”, while “less educated individuals have higher mortality rates for nearly all types of cancer than their more highly educated counterparts”.  

Addressing these disparities requires national and international efforts to identify the EU’s main challenges regarding cancer continuum care, targeting population groups, sharing best practices between member states and boosting comprehensive prevention policies. 

As Colombo mentioned, policies on alcohol consumption are real examples that take a comprehensive approach and can be translated to the cancer field. In the case of alcohol, there is the PPPP approach, which combines Police enforcement to limit alcohol-related injuries, Protecting children from alcohol promotion, Primary health care and Pricing policies. 

The gender gap is still visible 

Looking at the report’s graphics and numbers, Francesca Colombo explained that cancer mortality rates have decreased over time in almost all member states. However, there are countries in which the efforts for reducing cancer mortality are not enough and where the gender gap is still visible. 

Although male mortality levels have decreased more than women over time, some countries present significant gaps. In this sense, Nordic countries perform better, showing more gender equity. 

Graphs on cancer mortality rates by country and gender indicate that female mortality levels among countries tend to be shorter than those we can find in data on men’s mortality. This fact suggests that efforts to reduce mortality among men need to be done in order to reduce the overall mortality rates. 

Graphic from OECD

Cancer mortality rates of men and women across EU countries. / OECD

Low social economic groups suffer higher cancer mortality rates 

The profiles also ratified how determinant socio-economic inequalities are in cancer mortality. The Head of the Health Division at the OECD suggested that prevention policies and interventions need to focus on social-economic disadvantaged groups and lower-educated groups.  

In this sense, the OECD representative explained that a large part of gender and socio-economic gaps are linked to modifiable risks factors for cancer, such as poor lifestyle, smoking, obesity or alcohol consumption. Colombo reiterated that addressing those inequalities “is probably where we can make the further gain”. 

References:

Berchet, Caroline, Dedet, Guillaume, Klazinga, Niek, and Colombo, Francesca. “Inequalities in cancer prevention and care across Europe”. The Lancet Oncology. 24,1: 10-11. (2023)  

OECD. “EU Country Cancer Profiles“. OECD Publishing. (2023) 

The Steering Committee meeting offers a glimpse to eCAN’s future

The First Steering Committee meeting offers a glimpse to eCAN's future

The Steering Committee meeting of the eCAN has been held today, January 30th, in a virtual format and with more than fifty participants belonging to beneficiary and affiliated entities. The meeting has served for the different work packages to present the progress achieved during the first five months of the Joint Action and share their planning until July 2023.  

In addition, the reunion has also given rise to some important announcements, such as the interest of the Organisation for Economic Cooperation and Development (OECD) to establish possible synergies with eCAN. These would include knowledge exchange and dissemination related to cancer inequalities or stakeholders’ involvement, as well as the possibility of getting support to improve the sustainability of the European project. 

Apart from the OECD, members from the European Health and Digital Executive Agency (HaDEA) have also intervened at the beginning, expressing their support to achieve the objectives of the JA. 

The first stages of the JA 

Following the order of the agenda, the vertical work packages Teleconsultation (WP5), Legal, ethical framework and cybersecurity (WP6), Telemonitoring (WP7) and Stakeholder engagement (WP8) have been the first ones to present, with a quick review of the work carried out in the first months and the challenges faced related to the project pilots and the identification of interested parties. 

The following months have also been addressed by the entities belonging to Italy, Cyprus and Greece, where they have discussed the risks, gaps and opportunities that they expect to experience until the summer of 2023. Ultimately, each work package has pointed out the inputs needed from the rest of the eCAN participants during this period. 

In the second part of the meeting, the transversal work packages Coordination (WP1), Communication (WP2), Evaluation (WP3) and Sustainability (WP4) have followed the same scheme, also delving into the status of their deliverables and the tasks to be developed until July. In addition, the Communication team has shown awaited features of the website, like the newsletter or the social networks accounts, as well as specific audio-visual materials designed to accompany important dates such as World Cancer Day, the 4th of February. 

After the respective presentations of all the WP leaders and the final exchange of questions and answers between the different attendees, emphasis has been placed on the opportunities for collaboration between the JA areas and the need to strengthen the flow of multilateral communication between all the entities implied.  

Milestones for the next months 

The Joint Action “Strengthening eHealth including telemedicine and remote monitoring for health care systems for cancer prevention and care”, started in September 2022, has still a long way to go until its end at the final months of 2024. 

However, this next five months will be crucial for its progress and evolution since many important milestones should be achieved: the Stakeholder analysis, the updated version of the Dissemination and Communication plan, the Progress Report, the pilot projects protocol and the start of the patients’ enrolment, etc. 

Such progress will be presented in more detail at following Steering Committees.