"We can use ICTs to transform the health system by putting the individual at the centre"

 Foto: UOC

Foto: UOC

Cristina Sez
Albert Barber, director of the eHealth Center


Thanks in great part to the progress and improvements made in medical science during the last century, our life expectancy is now double that of our forebears. The challenge we now face is how to enjoy this "extra" life in good health because, obviously, no one wants to spend their old age being ill. The health systems have a key role to play in this. Albert Barberà Lluís has headed the UOC eHealth Center, southern Europe's first academic centre specialized in e-health, since July 2019. Its mission is to research and reflect on the transformations that healthcare systems must undergo in order to respond adequately to future health challenges, such as providing healthcare services to an increasingly older population and becoming more fair and participative. 

Holder of a bachelor's degree in Chemistry and Pharmacy and a doctoral degree in Biochemistry and Molecular Biology from the University of Barcelona, Barberà has a wealth of experience in research and knowledge and innovation management in the field of biomedical and health research. Before joining the UOC, he was general manager of Health Research and Innovation for the Government of Catalonia, and, before that, director of Biocat.


What does e-health mean?

It is a concept that was created some years ago and refers specifically to the application of information and communication technologies (ICT) to the area of health. Internet and ICTs are already transforming the world, our society, our social relations and education, and now they are starting to have an impact on the health system. They are very useful for moving towards a system that is more sustainable, equitable and participative, within the context of an ageing society, increasing prevalence of chronic diseases and increased cost of new drug treatments.

People have been talking about e-health for some time. Initially, it was very closely associated with concepts such as telemedicine or the use of medical devices to monitor chronically ill patients. With the enormous progress that has been achieved in technology, along with the emergence of new health challenges and society's reflection on what kind of health system it wants, e-health is now viewed as a cross-cutting tool that is essential if this revolution in our health system is to become a tangible reality. We are working towards a system that puts the individual at the centre as an active partner in promoting their own health.

Could you give an example of how e-health has been applied?

One good example is the shared medical record, which is one of the major challenges currently facing health systems in Catalonia, Spain and Europe as a whole. We have the right to access our health data and it should be possible for us to take our health records with us, wherever we go; for example, if I travel to another country, I should be able to receive medical care there based on my medical records.

In addition, by sharing data with other European healthcare systems, we can conduct epidemiological studies, disease prevention actions, identify risks for certain diseases, etc. This can be particularly useful for rare diseases, for example. With certain extremely rare diseases, there are only a few patients in any given country. It is not really feasible to have doctors who are experts in these diseases in every country. It makes more sense to work on an European scale. If we share information, data and research, we can provide better care for these people. The need for an integrated healthcare system is a current topic of debate in Europe.

You say that we have the right to access our medical data. Why is this important?

Your data belong to you and having this information enables you to make decisions. For example, if we take the case of a patient with terminal cancer, if that patient has all the information, they can decide with their doctor whether or not to receive a treatment that will add another month to their life, but at the cost of side effects that will diminish their quality of life. The more control you have over your data, the better your decisions will be. ICTs can help empower patients. However, we also need to teach patients how to use them. One of the things we research at the eHealth Center is precisely how we can facilitate this empowerment process. Because it is one thing to be informed because we have found information on Google and quite another to be able to separate the wheat from the chaff.

Do you think that integrating the use of ICTs also has beneficial effects for the system?

Absolutely. Using artificial intelligence (AI) and algorithms, it is possible to analyse large quantities of data, make correlations and detect patterns that otherwise would go unnoticed. They can also improve the process' efficiency without having to increase the budget: algorithms can help us identify which patients are exposed to a risk of disease and tailor the services offered to them. Any qualitative information about patients should improve the quality of care provided.

Artificial intelligence can also help improve diagnoses. One example is dermatology, where there already exist algorithms linked to telemedicine services that can provide a diagnosis. Many healthcare systems suffer from a shortage of these specialists, which results in long waiting lists. With the help of AI, we can analyse a photograph sent to the dermatology department from the primary care centre and give a preliminary diagnosis at the hospital without having to see the patient. If it looks like further attention is required, we can then make an appointment for that patient.

You have been director of the UOC eHealth Center since July 2019. What objectives does this research centre pursue in the field of e-health?

The eHealth Center is more than just a research centre. It was formed two years ago, imbued with the UOC's distinctive research philosophy and an approach that favours interdisciplinarity and transdisciplinarity. Up until then, the UOC had focused on the links between the internet and society, the internet and education, and so on, but, after creating the Faculty of Health Sciences, the UOC saw the need to create a centre that would carry out research on the intersection between ICTs and health and, at the same time, encourage reflection on the issues involved. And so, the eHealth Center was born with an unequivocal mission to transform. We conduct research because, as a university, we want to bring about change in society, based on evidence and scientific data. This research is very much geared towards finding out how ICTs will transform healthcare and how citizens use technology to care for their health and become more empowered. Our interest is more focused on understanding what health is, on how health can be generated and maintained, than on finding treatments for diseases.

We want to transform the healthcare system, to make it sustainable and equitable, and we firmly believe that without the changes brought about by ICTs, this simply will not be possible. We create tools at the eHealth Center to enable the healthcare system to decide how it wants to bring about this transformation. We are already working with the Catalan Ministry of Health on issues related to digital literacy training for health professionals, based on the knowledge gained by our researchers who have been working for some years on digital literacy training for the general public. We also work with hospitals in Catalonia to help them define their digital strategy.

What are the eHealth Center's forthcoming challenges?

Strengthening the research and transformation produced internally by the centre. We should not forget that we are an academic centre, within a university, that was formed to conduct research. During these last two years, we have concentrated on helping the centre to grow and increasing its visibility, and our presence has been received very positively in both the Spanish and international ecosystems. However, the fact is that there is not much research on e-health and there is little academic reflection about how e-health can impact on and transform the healthcare system. This is in large part why we are already partnering with centres in Canada, Norway, Australia and the Netherlands, among others. We also need to leverage the UOC's status as a centre working in collaboration with WHO to further the role of e-health in this transformation.

Now we need to increase our critical mass, consolidate the UOC's distinctive cross-cutting nature. And to do this, we will need all the talent we have, from experts in psychology, computer science and health to law practitioners, economists, philosophers, specialists in communications and in other disciplines. Between them, they can contribute different outlooks and reflections that will enable us to work on issues such as law and health, algorithms, artificial intelligence and ethics.