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Document 21
From:
 (SANTE)
To:
 (SANTE); 
 (SANTE); 
 (SANTE); 
(SANTE)
Subject:
Debrief from meeting with Siemens, 04 July 2018
Date:
lundi 9 juillet 2018 09:23:18
Attachments:
SHS_Vision_Digital-Heatlh_White-Paper_FINAL.PDF
Dear all,
Several representatives of Siemens met with our Director Andrzej Rys on 4th July:

 EMEA, Siemens Healthineers AG

 France and Head of Zone “France, Belgium and
Western Africa”, Siemens Healthineers AG

 Belgium, Siemens Healthineers AG

 Government Affairs and Policy,
 EU Offices, Siemens
Healthineers AG

, Government Affairs and Policy, Director Policy and Reimbursement
Strategy, Siemens Healthineers AG
I was asked by Andrzej to attend the meeting. 
 and 
 from B3, and the
B3 
, were also present.
Siemems had provided the attached paper ahead of the meeting. In this paper, they call for the
establishment of a European Centre for Digital Health.
During the meeting, Siemens indicated their interest in digital health infrastructure for: 1)
connecting EHRs, 2) managing an interconnected set of devices such as medical imaging
machines, and 3) pooling the data from the previous two points to develop AI algorithms.
posed the question of how industrial partners can contribute to the interoperability work
of Pillar 1 of the Communication on the digital transformation of health and care.
Andrzej mentioned that the European Centre for Digital Health is an interesting idea and asked
whether this would be in the form of a PPP. He mentioned that it is unclear what the
Commission’s appetite for new PPPs might be in the new MFF and therefore asked Siemens
to explore whether the European Centre for Digital Health can fit within existing PPP
instruments.
Siemens responded by indicating that they will check with respect to the IMI PPP and they will
also develop the concept for the European Centre for Digital Health further.
At Andrzej's request, I mentioned the work of the study on ESIF investments in health, the 6
thematic areas it covers and the workshops. Siemens is interested to hear about the
outcome of the workshops.

White Paper: Digital Health in Europe
Introduction
This white paper sketches Siemens Healthineers concepts on digitalising health in the European Union and
examines strategies and visions for collaboration between the EU, its Members States and third parties in
the field of Digital Health. Moreover it suggests creating a nucleus of pan-European expertise to accelerate
the pace of digitalisation in healthcare in Europe and position Europe at the forefront of this global trend. It
is a first stock-taking of ideas and should be used as a basis for further discussions within the European
Commission and the Member States to examine the scope for further col aboration.
The establishment of a Digital Single Market is at the centre of EU policy makers. The European Commission
identified healthcare as one area where digitalisation will be especially beneficial for European citizens and
their healthcare systems´ sustainability alike. Improved diagnosis, better treatment, cultivating a more
favourable working environment for clinicians, soliciting patient feedback, ensuring greater continuity of
care and promoting better patient care after discharge, as well as the exploitation the growing potential of
connected care are a key interest in this regard.
As in other sectors, medical and health data are raising exponential y, opening up new possibilities in
diagnosis, treatment and research. New opportunities are arising from improved data analytics and
Artificial Intelligence since such capabilities contribute to precision medicine, clinical decision support
systems for health professionals and mobile health tools for individuals to manage their own health and
chronic conditions. A long standing debate of utmost importance in Europe and beyond is the lack of
compatibility (interoperability) of established health IT solutions and arising new digital solutions. This stil
hinders the uninterrupted flow of data within a hospital, within networks, within national states, between
EU Member States and beyond. This is specifically true in cross-border and international initiatives.
Solutions and approaches with a strictly patient centric focus will improve health outcomes.
Digitising Healthcare in Europe
The populations in EU Member States are aging and the number of citizens with chronic diseases and multi-
morbidities is growing rapidly. This creates a chal enging environment for the sustainability of healthcare
systems. At the same time, more and more aspects of professional as well as private life are being digitised
and enormous amounts of data are being generated already today – and it will be much more in the future.
The availability of this data and the advancing capabilities to process and analyse it create a unique
opportunity to improve health and care as we know it today and the efficiency and transparency of its
delivery. Furthermore, completely new approaches to managing health, diagnosing and treating diseases
and organizing care will occur1.
Digitalisation in healthcare will enable healthcare providers to increase value by transforming the delivery
of care, empowering patients, improving patient experience and by transforming care into precision
medicine focusing further on the individual needs of each and every patient. In diagnostics as well as in
therapy, advanced analytics of medical and health data will help to improve diagnostic precision and
outcomes. IT solutions, algorithms, AI and health data play an ever more important role in processing
diagnosis-relevant patient information in a comprehensive and sustainable way and offer new prevention
approaches. Especial y increased diagnostic quality can ensure saving money by reducing down streaming
1 To ensure that this evolution is based on common European values regarding citizens’ rights, data privacy and market behaviour, the EU and its
Member States need to play a major role in shaping and implementing Digital Health by combining its excellence in medical science and technology
with its strength and powerful legacy of putting citizens at the heart of its policies and ensuring safety and security for al .
White Paper „Vision for Digital Health in the EU“, Version 1.0, 
1

cost. The European Union is well equipped to support this digital transformation by building on the cross-
border health directive and utilizing its role as a facilitator in research and its translation into (clinical)
routine.
Digitalisation will impact the entire value chain in healthcare: From research, development and
production to planning workflows, equipment and staffing of hospital, from digitising existing products and
services to entirely new, purely digital solutions and business models. Moreover, Artificial Intelligence as a
multi-faceted instrument in healthcare, its advance algorithms and deep learning abilities hold the
potential to transform care delivery and cultivate precision medicine. AI in the future will support each step
in the process, from patient examination to detection, characterisation, diagnosis, and therapy decision. A
standing debate of utmost importance in Europe and beyond is the lack of compatibility of established
health IT solutions and arising new digital solutions. This still hinders the uninterrupted flow of data within
a hospital, within networks, within national states, between EU Member States and beyond. This is
specifically true in cross-border and international initiatives. Solutions and approaches with a strictly
patient centric focus will improve health outcomes of EU citizens while overcoming sectoral and national
barriers by using binding standards thereby unleashing the full potential of digital health in Europe.
Driving the change together by engaging stakeholders and creating multistakeholder platform - from
medical societies to patient organisations, from hospitals and payers to industry actors to support the
European Union and the Member States’ activities will strengthen the digital transformation of healthcare.
Siemens Healthineers will co-create the transformation from raw data to diagnostic information to better
patient outcome to innovation in sustainable healthcare.
Vision for Digital Health in Europe
On April 25, 2018, the European Commission adopted the “Communication on enabling the digital
transformation of health and care in the Digital Single Market; empowering citizens and building a healthier
society”. It sets the pathway for further action in the upcoming years by stating that “health data and
advanced data analytics can help accelerate scientific research, personalised medicine, early diagnosis of
diseases and more effective treatments.”2
Data and information driven solutions will help EU Member States working together on their common
challenges such as making their healthcare systems more sustainable, to cooperate more efficiently on
cross-border health issues and to improve overall patients’ care. To fully explore the potential of driving the
digital transformation together, we need to pool our resources and leverage on Europe´s diversity in
science, medicine, technology and other adjacent fields of expertise. Only if we leave the perspective of
“fragmentation” behind and embrace and build on the potential of multiple European strongholds in
academia, clinical and technology, we will be able to play a prominent role in the global race for digital
health. One necessity for that is to better streamline existing and newly emerging activities between
Member States and between Member States and the European Union – not to do less, but to gain more by
facilitating exchange and collaboration.
Thereby Siemens Healthineers suggest establishing a European Centre for Digital Health to streamline
European expertise and become a global y leading power in Digital Health. This European Centre for Digital
Health is meant to global y shape and drive digital health as well as to evaluate the evolution towards
digital health. The concrete projects of the Centre are aligned with the ´priorities of the European
Commission as defined in the Communication on Digital Health from April 25, 2018 and could embrace
existing initiatives like MEGA. The European Centre for Digital Health will play a prominent role in driving its
own projects forward as well as integrating and streamlining all EU activities in the fields of digital health.
2 https://ec.europa.eu/digital-single-market/en/european-policy-ehealth
White Paper „Vision for Digital Health in the EU“, Version 1.0, 
2

Besides the establishment of EU-wide research platforms, the promotion of digital health records for each
European citizen is of essential importance for the project.
The availability of all medical and health data is a cornerstone of providing high-quality care and
empowering citizens to actively manage their health. Every EU citizen will therefore have access to a
personal digital health record by 2022. This will be a holistic record accompanying the citizen throughout
life, including all medical and health data from birth to death. This health record will be citizen centric and
the citizens will have access to it via portal or app. The citizens will be able to actively manage their health
and il ness by being able to share their data with medical professionals as well as private individuals
(spouses, partner, children, parents…). . Citizens will also be able to add health related data from their
wearables or other devices into their record. To empower patients and citizens alike, the health record wil
include, amongst other features, feedback possibilities, provide transparency of treatment costs as well as
tools to increase health literacy of the citizens. Prevention strategies as well as post treatment care and
analysis will be included via portal or app. To ensure the uninterrupted flow of data and to ensure quality of
data interoperability will be ensured by binding international standards (e.g. IHE, DICOM, HL7, HL7 FHYR).
Citizens will have transparency as health professionals will be logged when accessing data. Citizens’ consent
is regulated via the health records and citizens also have the right to donate data.
The European Centre for Digital Health will look into various models of health records and how to best
implement them. A special focus will be on future technologies such as Blockchain and their added value
for citizens and health records.
The Centre will also develop and implement high potential and moon shot projects such as the “digital
twin
” project. The vision here is to create a virtual avatar for each European citizen, identical in genetic
make-up, medical history etc. so that medical interventions, reaction to certain medication or treatments
as well as post treatment behaviour can be tested on the virtual avatar before the intervention or
administration on the person. The Centre will bring together all necessary experts ranging from software
and virtual reality engineers, clinicians, industry representatives, patient groups to ethics and legal
specialities to investigate the potential of this moon shot project for the healthcare system of tomorrow.
Assuming that digital health solutions will become an integral part of health care in the future – from
wel ness and lifestyle to prevention and early diagnosis to treatment and the monitoring of rehabilitation
and after care – it is crucial that citizens and healthcare professionals are able to assess the options and the
related opportunities and risks. Today, there is a sharp discrepancy between different EU Member States,
different age groups and different professions with regards to the expertise and experience of engaging
with digital health solutions.
The Centre will bring together ongoing activities on Digital Health Literacy focussing on citizens (like the IC-
Health project3) and develop further activities to close gaps. It can leverage on all its other activities and
provide first hand and world class expertise and experience to educate citizens, but also especially
healthcare professionals. The training of these professionals – doctors, nurses and others – will apply a
“train-the-trainer” approach which multiplies the effect and ensures that the education reaches the people
in the countries and regions. Locally, the educational efforts are meant to link different age groups and
professions together in one shared discovery and learning experience, not only passing expertise along, but
at the same time building trustful relationships that foster cross-sectoral collaboration in healthcare. This
would include a better understanding of Cyber Security.
3 https://ichealth.eu
White Paper „Vision for Digital Health in the EU“, Version 1.0, 
3

The structure of the Centre could look like this:
The European Centre for Digital Health could have the following set-up, tasks, scope and goals:
European Centre for Digital Health
ƒ Become a global y recognised and leading Centre of Excellence in digital health.
ƒ Set European and global trends, become a global opinion leader and anchor European
values into the global digital health debate and projects.
ƒ Given the chal enges of European healthcare systems, the Centre shall focus on research
for predictive and prescriptive algorithms to improve prevention, tackle the most
threatening diseases and to ease chronic diseases.
ƒ Create a supercomputing infrastructure to ensure the necessary computing capacity and
processing power fol owing European privacy and data protection laws.
ƒ Set-up a secure Sandbox environment for start-ups and companies to test new innovative
digital solutions in a real-life simulation.
ƒ Issue challenges to the digital health community to
1. create new innovate solutions to pressing medical and technological challenges
2. offer vendors to test the interoperability of their solutions in the sandbox environment
(possibly create an interoperability showroom)
3. improve data and system security by inviting specialists to attack systems in a separate
secure Sandbox environment to find and continuously mend possible security risks
ƒ Attract, involve and cross-link the brightest European talents and best global potential
(data scientists, informatics engineers, clinicians, industry representatives).
ƒ Empower citizens by teaching health literacy to ensure that citizens are able to actively
manage their own data and are able to take informed decision about their health.
ƒ Involve and empower European regions by setting up several digital health hubs in
attractive and interested cities or regions (local health ups could have slightly different
thematic focus).
Fundament
1 Goal 1: Secure access to and exchange of health data
ƒ Establish and foster EU-wide platforms as basis for the Centre.
ƒ Promote digital health record for all EU citizens.
2
3
Goal 2: Health data pooled for research
Goal 3: Digital tools and data for citizen
and precision medicine
empowerment and person-centered
ƒ Based on the established EU-wide
healthcare
platform (goal 1)
ƒ Based on the established digital health
ƒ Innovative, competitive solutions and
record (goal 1)
best apps for adequate patient use
ƒ Innovative apps and solutions most
ƒ Moon shot project to further
valuable and best use for citizens need,
complement infrastructure and digital
medical chal enges and necessities of
solutions: digital twin as avatar for
the European health systems
each European citizen to predict
ƒ Promotion of health literacy of the
success of medical interventions and
citizens
test likely behaviour.
ƒ Challenges issued by the Centre set
ƒ Challenges issued by the Centre set
trend topics and accelerate innovation
trend topics and accelerate innovation.
White Paper „Vision for Digital Health in the EU“, Version 1.0, 
4