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Dr. Manuel Gonzalez-Garcia
I am a Swedish cardiologist who recently returned home after spending 2,5 years working in a postdoctoral fellow position at the Commonwealth Scientific and Industrial Research Organisation (CSIRO) in Brisbane, Australia. The CSIRO is the Australia’s leading publicly funded science organisation, and pays much effort, attention, and resources to the development, the clinical implementation and the evaluation of digital health solutions, with special focus on the use and effectiveness of e-Health for the management of chronic disease. This temporary position as research fellow in Australia combined with my background as a cardiologist and researcher in Sweden have provided me the opportunity (and challenge) to take stock of my experience of life and work in, literally, both sides of the world.
This piece intends to summarize some aspects of my recent e-Health research activity in Australia and provide a platform for the short exposure of my personal reflection after working in two different environments. To achieve some kind of methodological framework to my reflections, I will use the base of a recently published review paper about the hinders and drivers for the development and implementation of eHealth in daily clinical practice (1). But, beyond this framework, all the ideas here expressed are an expression of my personal and subjective opinion and should not be considered as the product of any literature review or ‘evidence-based’ material.
First, let me express some few words about the reason why I decided to move with my family to Australia and work at the CSIRO. At the time I decided to move to Australia withmy family, I was one of the hundreds of researchers and clinicians across Europe eager to start implementing and evaluating eHealth projects at my local clinic. In my particular case, I was interested in the implementation of a mobile app for patients undergoing Cardiac Rehabilitation (CR). For that, I counted on the enthusiasm of my colleagues and patients and the acquiescence of the local clinical leadership. Soon, I realised that this was not enough. In the hope of getting more solid answers (and knowledge) on why, what and how these types of studies could be conducted, but even more important, how the studies could be adopted in real clinical practice, I started looking for international institutions that could offer me this possibility. In this search I came across the eHealth unit of the CSIRO. Through this opportunity, I joined a multidisciplinary team including high skilled people in many different fields such as IT, software development, health economics, artificial Intelligence and robotics, statistics, epidemiologist and almost all fields of knowledge that can be considered relevant to implement e-Health projects. The proximity and close collaboration of CSIRO researchers with different health organisations and clinical sites all around the country allowed us to get the best clinical partners for each project. In addition to this, geographical and populational conditions of Australia are natural drivers for the development and implementation of eHealth solutions.
The following factors may influence the successful implementation of e-health in clinical routine practice (1):
I would like to finish this writing highlighting that the meaning of this text is not to compare the “idoneity or suitability” of respective health care systems or organisations for e-Health implementation in Europe and Australia. In fact, we should not consider the option to compete between us for the honour to be the first one achieving the successful integration and adoption of eHealth technologies in clinical practice. Rather, I would say that international collaboration is a key factor to achieve this integration. In this regard, I would like to mention the example of the Diversity-1 study (2), an initiative to validate an evidence-based Australian CR mobile platform in five different European public CR centres. Research initiatives like this could be seen as a seed for the creation of an effective collaborative e-Health implementation among clinical sites of the European Union (EU). The implementation of common pan-European eHealth programmes might do its bit to “build” a people-centred agenda towards an effective political construction of the EU.
Declaration of Interests: Author is principle investigatoe for the Diversity 1 study, no other conflicts of interest to declare.
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