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Cyprus's new National Health Service and future European health

2018; Elsevier BV; Volume: 392; Issue: 10157 Linguagem: Inglês

10.1016/s0140-6736(18)32163-9

1474-547X

Georgina Kyriakoudes, Soulla Louca, Behrooz Behbod,

Health disparities and outcomes

In 2019, Cyprus is expected to introduce its new National Health Insurance System, 13 years after Myria Antoniadou's World Report,1Antoniadou M Can Cyprus overcome its health-care challenges?.Lancet. 2005; 365: 1017-1020Summary Full Text Full Text PDF PubMed Scopus (9) Google Scholar which identified the Mediterranean island's health-care challenges. With the new National Health Insurance System, Cyprus will become a primary-care-driven country, and it will be the latest European Union (EU) member state to have a universal health-care system.2Samoutis G Paschalides C The sun is shining on Cyprus's National Health Service.Lancet. 2017; 390: 360Summary Full Text Full Text PDF PubMed Scopus (3) Google Scholar Toomas Hendrik Ilves, chairman of the EU eHealth Task Force to “redesign health in Europe for 2020”, notes that successfully ensuring health-care access for all EU citizens depends on information-technology application and data use.3EURedesigning health in Europe for 2020. Publications Office of the European Union, Luxembourg2012Google Scholar In Cyprus, patient medical records are generally paper based and highly fragmented, which increases the risk of duplicate investigations and of patients being prescribed unsuitable medication. The new health-care system, combined with the changes in data management in compliance with the EU General Data Protection Regulations (GDPR), indicates promising positive changes. Some of the issues relating to data management could be addressed through the use of blockchain technology. This technology is an open, distributed ledger that offers advantages such as enhanced data privacy, security, access, accuracy, completeness, and interoperability.4Iansiti M Lakhani KR The truth about blockchain.https://hbr.org/2017/01/the-truth-about-blockchainDate: 2017Date accessed: July 12, 2018Google Scholar Combined with big data, artificial intelligence, and machine learning, blockchain could optimise disease-prediction models and the interpretation of diagnostic investigations. These improvements could help health-care providers make accurate and timely decisions on patient management. However, there is an ongoing discussion about the impact of GDPR on the use of blockchain technology, which must be solved before the implementation of blockchain. In March, 2018, the University of Nicosia consulted stakeholders in Cyprus about the implementation of a unified, blockchain-based, electronic health-record system. Stakeholders included government officials, insurance representatives, health-care professionals, patients, researchers, and blockchain-technology experts. Stakeholders identified both potential advantages and disadvantages to the use of blockchain. In addition to those already mentioned, reported advantages included patient empowerment due to ownership and control of their own data, transparency, and reduced insurance fraud. Concerns about the technology involved its maturity and the right-to-be-forgotten, as blockchain based records are immutable. The stakeholders agreed that the next steps for the introduction of blockchain-technology use in Cyprus should include: the education of all relevant stakeholders to contribute to the gradual reversal of cultural resistance; the implementation of system pilot tests to identify limitations, resolve issues, assess acceptability by users, and identify opportunities for new applications of the technology before universal adoption; and the development of specific laws to regulate the technology, provide standardisation, and protect users. To truly “redesign health in Europe for 2020”,3EURedesigning health in Europe for 2020. Publications Office of the European Union, Luxembourg2012Google Scholar perhaps the EU should also consider stepping out from the boundaries of national systems towards the development of a European system: since patients travel regularly to other EU member states, their records should not be available only to their country of origin or their economic and political region. We declare no competing interests. We thank all participants who attended and contributed to our stakeholder roundtable discussions.