Equity and Ethics in Health is the theme of the 1994 forty-fourth session of the WHO-Europe Regional Committee of Health Ministries, to be held in Copenhagen 12-16 September 1994. Issues of equity and ethics are considered central to making effective choices about policy to cope with the major health challenges Europe faces today.

There are major disparities in health and in opportunities for promoting health between and within countries.

As stated in the introductory paper of the WHO-EUR session : “the stability and coherence of the whole European region is threatened if conditions deteriorate too far in some countries in relation to others. Within countries, we all pay the price of letting injustice continue. If the most disadvantaged in society are left to carry the heaviest burden, then increases in crime, in insecurity and in violence are seen for everyone”.

Simultaneously, Jacques Delors in the “White Paper” of the Commission of the European Communities underlines the progressive degree of maturity of the “information society”, the opportunity to put together what is already available and to move from a fragmentary to a coherent approach towards the common good. “What is missing is less money than the willingness to devote it to the essential”. Telematics in health care aims at improving quality, economy and efficacy of care and health services. AIM (Advanced Informatics in Medicine) is the Community programme of research and development is this area.

In 1994, a large number of information systems are operational. They can be used to improve health care delivery. If shared through telematics, they could become instrumental to reduce inequities in the European Region.

It was therefore felt necessary to organise an international symposium that assembled representatives from various organisations (WHO-EUR, European Union, experts in health care and in telematics) as well as representatives from a great number of Member States (from Ministries of Health, health services and informatics) in order to make specific recommendations for the WHO-EUR Regional Committee.

This volume presents the results of the EFMI/WHO-EUR cosponsored working sessions devoted to “Case-Based telematic systems towards equity in health care” held in Brussels, at the School of Public Health of the University of Louvain from June 22 to June 24th, 1994.

The symposium recommended, in particular to give a priority to “Case-based information systems”, (based on individuals and population-related) in order to make the appropriate choices for improving equity in health care. Telematics is readily accessible, for example with Internet, in an easy way that might be used directly by clinicians and epidemiologists.

The present book is the expression of common views that associate information systems, telematics and health care for the benefit of the patient. Actions proposed to improve progressively patient care, resource management and quality of care in Europe include curative as well as preventive measures. They should, therefore, give hope to achieve greater equity.

Recommendations are addressed to the WHO-Europe Regional Committee of Health Ministries, as well as to the relevant governing bodies of the Member States of the European Union, the scientific societies for medical informatics of EFMI and IMIA, for consideration and implementation.