High consequence infectious diseases in Europe - the need for an expert clinical support service
Brantsæter A., Henrichsen S., Leport C., Lund B., Skrindo I., Mora-Rillo M., Wolf T., Dunning J., Vairo F.
Background and objective: During the 2014 Ebola virus disease outbreak in West Africa, the Centers for Disease Control and Prevention and the World Health Organization hosted telephone conferences for an ad hoc network of clinicians involved in the care of medically evacuated patients to Europe and the US. This informal network has also proved valuable during subsequent outbreaks and has revealed the need for a digital communication platform for clinical consultation and information sharing. Work package (WP) 10 of the EU Joint Action SHARP addresses case management and infection prevention and control in response to high consequence infectious diseases (HCIDs). Among the WP activities, a feasibility study of an expert consultation platform for HCIDs is ongoing. Here we report our preliminary results. Methods: We searched literature for references to existing digital platforms and consulted colleagues and authorities in Europe about their experiences. We solicited legal and technical advice, and drew on experiences from the COVID-19 pandemic. Results: The use of a digital expert clinical support service remains challenging with respect to availability of technical solutions, legislation, and funding. A digital platform should feature facilities for clinical consultations and information sharing among experts, but may also provide a channel for other requests, e.g. international referral, and deployment of equipment, staff, and therapeutics. The European Reference Network (ERN) operates a digital platform that has many of the required features. Some legal challenges remain, but these may be resolved by further development of European Health Union legislation, e.g. the European Health Data Space. Conclusion: There is a need for a formal network of European clinicians with expertise in HCIDs, a need for a digital platform meeting defined technical and legal criteria, and a need for long-term funding. One solution could be to establish a new clinical network for HCIDs within the ERN.