11.G. Round table: Resilient health systems: harnessing health information to improve population health

Abstract   Health systems are built to improve the health of the population. When the COVID-19 crisis hit Europe, the sustained performance of these health systems was challenged. The resilience of these health systems, defined as the ability to absorb, adapt, and transform to cope with shocks (Observatory, 2021), was found to be different in the many European countries, leaving some important lessons to be learned and best practices to be showcased to help countries assess their own response to the COVID-19 pandemic and support efforts to strengthen health systems in Europe. A common denominator is health information; the data and information that is needed to monitor the health of patients as well as the general population. Especially in times of crisis, the availability and trustworthiness of these data is of utmost importance. The COVID-19 pandemic showed that within a substantial number of European countries, health information systems were not always equipped to accommodate the data and information flows that were needed in order for researchers to provide the best available evidence to underpin health policy decisions. Ad-hoc surveillance and monitoring systems were set up (under emergency legislation) and clear governance of health information was lacking. In addition, sharing data and information across European borders and ensuring comparability of data and indicators proved to be difficult in a timely manner during the COVID-19 crisis. This resulted in a European landscape with different national and federal health policies, based on sometimes poor scientific findings. However, when the crisis progressed, numerous national and international initiatives were set up aiming to harmonize the available health information and as of now, many of these initiatives are forming a solid foundation of the health systems, rendering their performance sustainable for the future. In this workshop, which is organized as a round table discussion, we will discuss the resilience of health information systems in European countries, with regards to lessons learned from the COVID-19 crisis, barriers to sharing health information within and across borders, best practices and future perspectives. The topic will be highlighted from multiple perspectives, bringing together experts from different backgrounds, including the European level (European Commission and European Observatory on Health Systems and Policies), the country level, and the perspective of European projects. The audience will be able to provide their view on the different topics through an interactive voting poll during the session. Throughout the session, the exchange of knowledge, experiences and opinions with the audience will be facilitated by the chairs. Key messages • Population health information plays a key role in times of crisis, with trustworthy information flows facilitating evidence-informed policies and decision-making. • Sharing and harmonising health information is key to building resilient healthcare systems that are prepared for the future. Speakers/Panellists Ebba Barany European Commission, Luxembourg, Luxembourg Cianrán Nicholl European Commission, JRC, Ispra, Italy Kenneth Grech Public Health Medicine, Mater Dei Hospital, L-Imsida, Malta Miriam Saso Sciensano, Brussels, Belgium Anna Sagan European Observatory on Health Systems and Policies, London, UK


Background:
Digital communication technologies had a crucial role during the COVID-19 pandemic, with the internet and Social Media as highly frequented sources for retrieving health information.University student's health and well-being were highly affected and most interaction with peers and professionals migrated to the digital realm, which made digital health literacy (DHL) a key competence to navigate digital health environments.The main goal of the study was to explore DHL of students in Germany.

Methods:
A cross-sectional online survey among students (N = 14916) from 130 universities in Germany was implemented as part of the global Covid-HL Network, collecting data on DHL, physical and mental health, SoC and sociodemographics.Data was analyzed using univariate, bivariate and regression analyses.

Results:
Assessing the reliability of information (5964/14,103, 42.3%) and determining commercial interest of information posed the most difficult tasks (5489/14,097, 38.9%).Difficulties were revealed for finding information (4282/14,098, 30.4%).Female students reported lower DHL and social media use was associated with lower judgment skills.38% of all students reported low and very low well-being and 29% reported at least two health complaints weekly, while health outcomes follow a social gradient (lower SES and gender).Regression analysis showed significant association between SoC and well-being (OR: 1.2-2.03)and health complaints (OR: 1.58-1.71).Higher future worries were with low well-being (OR: 2.83) and multiple health complaints (OR: 2.84).

Conclusions:
There is an urgent need to enhance DHL and SoC of students and implement health promotion strategies, using target group specific intervention.Gender and socioeconomic differences must be taken into account and interventions could be delivered within the university.Measures should also address student mental health.

11.G. Round table: Resilient health systems: harnessing health information to improve population health
Abstract citation ID: ckac129.715 Organised by: EUPHA-PHMR, EUPHA-HSR, EUPHA-ECO, Sciensano (Belgium), PHIRI Chair persons: Petronille Bogaert (EUPHA-PHMR), Johan Hansen (EUPHA-HSR) Contact: Shona.Cosgrove@sciensano.be Health systems are built to improve the health of the population.When the COVID-19 crisis hit Europe, the sustained performance of these health systems was challenged.The resilience of these health systems, defined as the ability to absorb, adapt, and transform to cope with shocks (Observatory, 2021), was found to be different in the many European countries, leaving some important lessons to be learned and best practices to be showcased to help countries assess their own response to the COVID-19 pandemic and support efforts to strengthen health systems in Europe.A common denominator is health information; the data and information that is needed to monitor the health of patients as well as the general population.Especially in times of crisis, the availability and trustworthiness of these data is of utmost importance.The COVID-19 pandemic showed that within a substantial number of European countries, health information systems were not always equipped to accommodate the data and information flows that were needed in order for researchers to provide the best available evidence to underpin health policy decisions.Ad-hoc surveillance and monitoring systems were set up (under emergency legislation) and clear governance of health information was lacking.In addition, sharing data and information across European borders and ensuring comparability of data and indicators proved to be difficult in a timely manner during the COVID-19 crisis.This resulted in a European landscape with different national and federal health policies, based on sometimes poor scientific findings.However, when the crisis progressed, numerous national and international initiatives were set up aiming to harmonize the available health information and as of now, many of these initiatives are forming a solid foundation of the health systems, rendering their performance sustainable for the future.In this workshop, which is organized as a round table discussion, we will discuss the resilience of health information systems in European countries, with regards to lessons learned from the COVID-19 crisis, barriers to sharing health information within and across borders, best practices and future perspectives.The topic will be highlighted from multiple perspectives, bringing together experts from different backgrounds, including the European level (European Commission and European Observatory on Health Systems and Policies), the country level, and the perspective of European projects.The audience will be able to provide their view on the different topics through an interactive voting poll during the session.Throughout the session, the exchange of knowledge, experiences and opinions with the audience will be facilitated by the chairs.

Key messages:
Population health information plays a key role in times of crisis, with trustworthy information flows facilitating evidence-informed policies and decision-making.A key aspect of achieving UHC and reducing health inequity is ensuring the timely access to high-quality, safe and effective medicines across the world.The regulatory approval of such products in countries with limited regulatory resources can be lengthy, often compromising patients' timely access to muchneeded medicines.This resource-demanding process extends well beyond marketing authorisation, incl.for post-approval changes.The WHO Collaborative Registration Procedure uses the Stringent Regulatory Authorities' medicines evaluations (SRA CRP), a procedure that allows National Regulatory Authorities (NRAs) to leverage the work performed by Stringent Regulatory Authorities (SRAs) on scientific evaluations to decide on medical products approvals within their jurisdiction, through the concept of reliance.Reliance allows an authority to leverage the work performed by other authorities, such as scientific evaluations, to decide on medical products approval within their jurisdiction.This reduces duplication of regulatory efforts, resources and time, while maintaining national sovereignty.In the context of these processes, multi-agency partnerships and cross-border collaboration the role of European bodies, and specifically that of the European Medicines Agency (EMA) as a Stringent Regulatory Authority will be explored.The SRA CRP and its pilot has been evaluated, based on data and stakeholders' perceptions.The evaluation indicates that the procedure delivers on expected objectives and benefits, including shortened timelines (from submission to approval), reduced duplication of efforts and resources (human and financial).It also shows significant and long-term positive impact for the LMICs involved.Additional benefits include greater application of international harmonized standards, an added capacitybuilding component and an informed and high-quality decision-making at the NRA.The impact of the procedure can be seen through 59 approvals for 16 medicines in 23 countries.The key areas for improvement and recommendations include greater collaboration, communication and transparency between NRAs, applicants, SRAs and WHO, to facilitate interactions and regular sharing of information between stakeholders.It is key to optimise resource utilisation and to leverage synergies, and to this end, a centralized, live platform could be developed to share the status, progress and challenges of applications in real time including information related to post-approval changes.This panel will present the SRA CRP pilots and its evaluation, bringing together experts from regulatory agencies and multilateral bodies to elucidate the current degree and extent of collaboration, whilst attempting to role of the EU and of the EMA in these processes.The panelists will also have an opportunity to take questions from the audience and to discuss the contribution of the EU to global health, incl., timely access for people across the world.

Key messages:
The SRA CRP facilitates and accelerates the regulatory approval of quality-assured, safe and effective medicines by reliance on SRAs, while maintaining decision-making national sovereignty.The EU, via the EMA and the EUM4all and SRA CRP mechanisms, promotes international collaboration and reliance pathways for earlier access to medicines and contributing to global public health and UHC.