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© HIMSS Analytics | eHealth TRENDBAROMETER Q4/2018

1www.himss.eu/analytics

Annual European eHealth Survey 2018

Results, October 2018

Health IT predictions for

Europe

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TABLE OF CONTENT

• Introduction & methodology page 3

• Survey questions page 4

• Results

Key findings page 5

Current eHealth priorities page 7

Current eHealth challenges page 9

eHealth trends (next 2-3 years) page 11

IT as enabler to improved patient safety and care page 13

Digital maturity and amount of digitised patient data page 14

Sufficiency of IT budget for 2018/2019 page 15

Governmental direction and support for eHealth page 16

Availability of clinically focused IT representatives page 17

European eHealth role model page 18

Business expectations page 19

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HIMSS ANALYTICS – WHO WE ARE

HIMSS Analytics in Europe provides healthcare organisations, governments and industry with extensive data resources and services about the adoption and use of Information and Technology. HIMSS Analytics’ offerings include market intelligence, research and IT adoption assessments for topics like Electronic Medical Records, Medical Imaging or Continuity of Care. These offerings are designed to provide eHealth professionals with insights and guidance on their digital transformation journey.

EHEALTH TRENDBAROMETER – METHODOLOGY

Objectives o Continuous evaluation of trends and issues in the European eHealth sector:2 – 4 survey waves per year, with both varying and recurring topics

o Provide insights into current and desired states of eHealth in Europe

o Enable discussions within the European eHealth community

Study design o Structured quantitative online survey

o Quick completion (time-to-complete is < 5 min)

o Survey language(s): English, German

o Participation via personal email invitation or via public link on www.himss.eu and other channels

Target audienceand participants

Key audience: eHealth professionals from several European countries, especially:

o IT staff, administrative staff, and clinicians from health facilities (e.g. CIOs, CEOs, Physicians, Nurses)

o Professionals from health-IT related software and consulting companies

o Professionals from other eHealth related sectors (e.g. health authorities, research, journalism)

Number of participants: 300 – 500 per survey wave

Survey period o Typical field time: 2 months

o Specific field time for „Annual European eHealth Survey“

September – October

Access all eHealth

TRENDBAROMETER‘s here:

www.himss.eu/healthcare-providers/ehealth-trends

http://www.himss.eu/healthcare-providers/ehealth-trends

http://www.himss.eu/healthcare-providers/ehealth-trends

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SURVEY QUESTIONS

1. What type of organisation are you working for?

2. What are the biggest eHealth PRIORITIES for healthcare providers at the moment?

3. What are the main eHealth CHALLENGES healthcare providers currently face?

4. What do you see as the biggest eHealth TRENDS within the next 2 – 3 years?

5. Is IT seen as an enabler to improved patient safety and care within your organisation?

6. How would you rate your organisation in terms of digital maturity?

7. What percentage of patient data in your organisation is digitised?

8. Do you think your organisation has sufficient IT budget for the next 12 months?

9. How would you describe the amount of central (governmental) direction and support you receive to progress your eHealth agenda?

10. Which of the following roles are established and financially supported in your organisation, in addition to the Chief Information Officer (CIO)?

11. Which country do you consider being a role model for eHealth innovation in Europe?

12. How will the environment for eHealth innovation and investment in your country develop over the next 12 months?

„Annual European eHealth survey“

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KEY FINDINGS

eHealth Business climate: The business trend for eHealth continues to be positive but has flattened after a midyear peak in 2018.

Lessons on eHealth in Europe5

Lesson 1: It’s the patient, stupid!The patient (or actually the citizen) receives the key attention from eHealth professionals over the next years. Several facets of patient empowerment are identified

as the biggest eHealth TRENDS, most importantly patient-generated data (through wearables or other tools and gadgets made for “consumers”) as well as health

records that are owned and managed by patients/citizens.

Lesson 2: EMR-maturity is (still) an important factor to prioritize eHealth projects.The implementation of Electronic Medical Records (EMRs) is often on top of the agendas of healthcare providers in most of the surveyed countries. Once a country

has reached a certain level of EMR-maturity - the priorities shift towards patient empowerment.

Lesson 3: IT security and inadequate IT budgets are a critical combination.Healthcare providers are challenged by the risks of weak IT security infrastructures. Hacks and ransomware attacks are happening more and more frequently, with

potentially devastating effects. In the context of reported insufficient IT budgets, this is increasingly alarming.

Lesson 4: Successful digital transformation is a team play, and your CIO might need some further support.Digitally advanced countries and organisations already have created and added new team members to their digital transformation leadership. Since IT departments

have received much more responsibilities over the last years, the Chief Information Officer (CIO) is likely to need further support. While still rather rare in general,

the C-suite for digital leadership is likely to expand and could soon comprise Chief Clinical Officers, Chief Nurse Information Officers, Chief Innovation Officers and

Chief Digital Officers. If you don’t have them all in your health facility, trust or group, you might (not yet) be in trouble. If you have none of these positions

(established and funded), think about it.

Lesson 5: It’s the same (good) old story: Innovative and mature eHealth can be found in the Nordics and the Netherlands.We are sure you have heard this before, and in fact many of you confirmed it in this survey: Visit the Nordics (especially Denmark and Sweden), Estonia and

the Netherlands if you are hungry to see modern eHealth in action.

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Software vendor (15%)• Sales/Marketing Professional

(37%)• Chief Executive Officer (CEO) (23%)• Organisational and Corporate

Governance (8%)• IT Staff (6%)• Software Developer (5%)• Quality Management Staff (4%)• Chief Information Officer (CIO) (2%)• Other position (15%)

Consulting company (12%)• Chief Executive Officer (CEO) (41%)• Organisational and Corporate

Governance (12%)• Sales/Marketing Professional (11%)• Other position (36%), e.g. Consultant,

Director, Advisor, Analyst…

Governmental health authority (10%)• Organisational and Corporate

Governance (22%)• IT Staff (13%)• Chief Information Officer (9%)• Chief Executive Officer (5%)• Other position (51%), e.g.

Advisor, Project Manager…

Health facility* (46%)• Chief Information Officer (CIO) (22%)• IT Staff (22%)• Medical Profession (Physician) (17%)• Chief Medical Officer (CMO) (7%)• Medical Profession (Nurse,

Pharmacist...) (7%)• Chief Executive Officer (CEO) (5%)• Organisational and Corporate

Governance (5%)• Researcher/Scientist (3%)

• Quality Management (2%)• Others (10%)

SAMPLE DISTRIBUTION – SURVEY PARTICIPANTS

Geographic distributionRespondents’ occupation

n=571

Countries or regions with more than 30 participants are shown individually.

*„Other“ respondents are from other European countries like:Greece, Poland, Russia, Turkey…

Country n

Germany 99

Spain 56

Netherlands 55

Switzerland 54

Italy 47

United Kingdom 32

Denmark 30

Sweden 26

Austria 25

Norway 25

Ireland 22

Belgium 21

Finland 21

France 15

Portugal 10

Others* 33

Total 571

Others (17%)• Researcher/Scientist (32%)• Organisational and Corporate

Governance (9%)• Chief Executive Officer (CEO) (8%)• Sales/Marketing Professional (8%)• Other position (43%), e.g. Business

Developer, Project Manager, Analyst…

*Health facility: e.g. hospitals, outpatient practice, social care centres

OrgType

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CURRENT EHEALTH PRIORITIES – BY TYPE OF ORGANISATION

What are the biggest eHealth PRIORITIES for healthcare providers at the moment?[Total including “others”; multiple choice: 3 responses possible]

EMR implementations continue to be a top priority in European health facilities, although the intensity has declined compared to last year results. Second and third highest priorities relate to initiatives to integrate and use patient-generated data as well as to improve the access for patients to their health information. These two patient-related priorities are currently less important for healthcare providers than for governmental health authorities. We expect those topics to become even more important over the coming years as the shift to consumer-driven health(care) is likely to accelerate.

Totaln = 566

Softwarevendorn = 84

Governmentalhealth authorityn = 56

Consulting companyn = 68

Health facilityn = 260

Updating hardware or network resources

Reorganisation of health systems

Medication safety

Use of mobile devices

Telemedicine

Improve clinician access to information

Integration and use of patient-generated data

IT security

Improve patient access to information

Data exchange with external partners

EMR implementation

Archiving and documentation

Enterprise Imaging

Results from 2017Valid responses 2017: Total: n = 548.

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CURRENT EHEALTH PRIORITIES – BY COUNTRY OR REGION

The results are a reflection of different policy and regulatory priorities which exist in different countries as well as the already achieved level of digital maturity of healthcare delivery organisations. As such eHealth priorities vary by country/region: EMR implementations are a top priority in Germany (24%) and Switzerland (23%), but play a minor role in more EMR-mature countries like the Netherlands (3%), Spain (6%) or the Nordics (8%). Healthcare providers in the Netherlands are highly engaged in improving patient access to information and to organize external health information exchange.

• Improve clinician access to information (17%)

• Improve patient access to information (14%)

• Integration and use of patient-generated data (14%)

• Reorganisation of health systems (13%)

• Integration and use of patient-generated data (15%)



• Data exchange with external partners (21%)

• EMR implementation (24%)• IT security (15%)

• EMR implementation (23%)

• Data exchange with external partners (17%)

• EMR implementation / IT security (14%)

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EMR implementation 24% 14% 3% 8% 6% 23% 12% 15%

Integration and use of patient-generated data

7% 13% 15% 14% 15% 8% 11% 11%

Improve patient access to information

6% 11% 24% 12% 14% 8% 14% 11%

Improve clinician access to information

6% 11% 6% 11% 11% 8% 17% 10%

IT security 15% 14% 7% 10% 10% 9% 8% 10%

Data exchange with external partners

7% 2% 21% 9% 7% 17% 9% 9%

Reorganisation of health systems

4% 11% 5% 13% 9% 10% 9% 9%

Use of mobile devices 8% 7% 6% 7% 9% 6% 2% 7%

Telemedicine 7% 7% 2% 9% 8% 1% 3% 6%

Medication safety 4% 5% 5% 4% 6% 3% 5% 5%

Updating hardware and/or network resources

6% 2% 3% 1% 3% 1% 4% 3%

Archiving and documenting 5% 4% 1% 1% 1% 4% 3% 3%

Enterprise imaging 0% 1% 1% 1% 0% 0% 1% 1%

n 99 47 54 103 56 54 32 566

What are the biggest eHealth PRIORITIES for healthcare providers at the moment?

Top 3 answers

Bottom 3 answers

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Consultingcompanyn = 68

CURRENT EHEALTH CHALLENGES – BY TYPE OF ORGANISATION

What are the main eHealth CHALLENGES healthcare providers currently face?[Total including “others”; multiple choice: 3 responses possible]

IT Security is the main eHealth challenge for healthcare providers. This is compelling different from 2017 (6%). Many other topics are perceived to be challenging as well. The fact that they receive ratings which are very close to each other indicates that eHealth professionals are challenged from many angles at the moment. But they also hide provider- and country-specific differences (see next page). From the perspective of consulting specialists, healthcare providers are challenged by a lack of support from political stakeholders, which makes it harder for them to focus and invest into the right tools, people and processes.

Totaln = 568




IT security

Being GDPR-compliant

Patient empowerment and self-management

Resistance from clinical staffto use eHealth solutions

Mobile health: Implementing the right tools

Lack of leadership

Lack of political direction

Struggles with EMR implementation

Finding & hiring sufficiently skilled employees

Interoperability standards (e.g. HL7, XML…)

Funding

Big data analytics

Legislation issues (other than GDPR)

Results from 2017Valid responses 2017: Total: n = 542.

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CURRENT EHEALTH CHALLENGES – BY COUNTRY OR REGION

What are the main eHealth CHALLENGES healthcare providers currently face?

The results vary widely: funding is (and remains) a particular big challenge for healthcare providers in the UK. Dutch healthcare providers are challenged by resistance from clinicians to use eHealth and mobile solutions (because they have a lot of them implemented already). Providers from Germany and the UK have difficulties to hire the right specialists, which has also been a key issue last year already. And providers in Italy are challenged by more or less everything at the same intensity.

• Lack of leadership (12%)

• Patient empowerment and self-management (11%)

• IT security (14%)• Finding and hiring sufficiently

skilled employees (12%)• Interoperability

standards (15%)• Funding (12%)

• IT security (10%)• Interoperability

standards / Patient empowerment and self-management / Struggles with EMR implementation (9%)• Funding (16%)

• Big data analytics (12%)

• Funding (22%)• Interoperability

standards (19%)

• Resistance from clinical staff to use eHealth solutions (14%)

• Interoperability standards / Patient empowerment and self-management (13%)

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Funding 12% 7% 10% 9% 16% 12% 22% 12%

Interoperability standards (e.g. HL7, XML…)

11% 9% 13% 8% 10% 15% 19% 10%

IT security 14% 10% 9% 11% 9% 9% 8% 10%

Finding and hiring sufficiently skilled employees

12% 7% 9% 5% 4% 9% 14% 8%

Struggles with EMR implementation

8% 9% 4% 11% 3% 7% 6% 8%

Lack of leadership 4% 7% 9% 12% 7% 11% 5% 7%

Lack of political direction 8% 9% 6% 8% 10% 8% 2% 7%

Mobile health: Implementing the right tools

7% 9% 12% 8% 10% 10% 1% 7%

Resistance from clinical staff to use eHealth solutions

5% 9% 14% 7% 3% 11% 5% 7%

Patient empowerment and self-management

3% 9% 13% 11% 11% 5% 7% 7%

Being GDPR-compliant 8% 9% 3% 4% 7% 4% 2% 6%

Big data analytics 2% 9% 6% 6% 12% 5% 6% 5%

Legislation issues (other than GDPR)

9% 4% 1% 9% 4% 5% 1% 5%

n 99 47 54 103 56 53 31 568

Top 3 answers

Bottom 3 answers

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EHEALTH TRENDS – BY TYPE OF ORGANISATION

What do you see as the biggest eHealth TRENDS within the next 2 – 3 years?[Total including “others”; multiple choice: 3 responses possible]

In 2018 the next 2-3 years look quite similar to what they looked like in 2017. This indicates that no new big topic suddenly appeared on the surface pushing the known ones aside. It also suggests that progress in the key areas identified last year has been slow and there’s still a lot to be done. So, again, the hottest topics in the near future will be: patient (owned) health records, health information exchange with external providers, patient self-monitoring initiatives and EMR implementations. Contrary to the hype, and consistent with last year’s results, blockchain-based solutions will be implemented rarely over the next few years.

Patient self-monitoring

Population Health Management

Use of mobile devices by clinical staff

Provision of telemedicine services

Data analytics

Artificial intelligence

Personalised medicine

EMR implementation and adoptionby healthcare providers

Health information exchangewith external providers

Patient Health Records

Disruption of traditional healthcareprovision by new players

Blockchain


Totaln = 567




Resultsfrom 2017

Valid responses 2017: Total: n = 1173.

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EHEALTH TRENDS – BY COUNTRY OR REGION

What do you see as the biggest eHealth TRENDS within the next 2 – 3 years?

As mentioned previously, political agendas and current levels of digital maturity significantly impact the variation of country- or region-specific trend perceptions. Patient (owned) health records will be high on the agenda everywhere, excluding the Nordics where this is (mostly) already a reality. The Nordics, but also the Netherlands and to some extent the UK and Spain, which have high levels of digital maturity in healthcare, can already move on to work on other topics, like patient-self monitoring or the use of AI solutions. A disruption of the healthcare market by new players, such as the digital giants or smart start-ups is not expected to happen quickly in Europe.

• Artificial Intelligence (14%)

• Patient self-monitoring (through health wearables) (13%)

• Patient Health Records (21%)• Health Information Exchange (14%)

• Patient Health Records (14%)• Provision of telemedicine

services (by providers) (13%)

• Patient Health Records (18%)• Personalised medicine (15%)

• Patient Health Records (14%)• Data Analytics (13%)

• Patient self-monitoring (through health wearables) (13%)

• Patient Health Records (12%)

• Patient Health Records (25%)• Patient self-monitoring (through

health wearables) (15%)

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Patient Health Records (owned and managed by citizens, not clinicians)

14% 18% 25% 11% 14% 21% 12% 15%

Health Information Exchangewith external providers

9% 3% 14% 7% 7% 14% 11% 10%

Patient self-monitoring (through health wearables)

5% 9% 15% 13% 10% 6% 13% 9%

EMR implementation and adoption by healthcare providers

12% 10% 3% 6% 1% 10% 10% 9%

Artificial Intelligence 9% 7% 7% 14% 10% 8% 10% 9%

Personalised medicine 10% 15% 5% 11% 12% 5% 7% 9%

Data Analytics 3% 12% 7% 11% 13% 10% 6% 8%

Provision of telemedicine services (by providers)

13% 11% 5% 5% 11% 3% 9% 8%

Use of mobile devices by clinical staff

9% 6% 4% 6% 8% 9% 8% 7%

Population Health Management 6% 5% 6% 9% 6% 5% 11% 7%

Disruption of traditional healthcare provision by new players (e.g. Apple, Google, Amazon, Startups, etc.)

7% 3% 8% 7% 5% 7% 3% 6%

Blockchain 3% 1% 1% 0% 3% 2% 0% 2%

n 99 47 54 103 55 53 31 567Top 3 answers

Bottom 3 answers

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IT AS ENABLER TO IMPROVED PATIENT SAFETY AND CARE

Is IT seen as an enabler to improved patient safety and care within your organisation?[Total including “others”; only participants who are working in a health facility]

There’s hardly any doubt among eHealth professionals working “on-the-ground”, i.e. within health facilities, that IT is an enabler to improved patient safety and care; 96% (2017, 95%) of survey respondents say this is – at least somewhat – the case. The perception in the Netherlands is more sceptic than in Germany or Spain, and it dropped quite significantly compared to last year’s results…

Yes Somewhat No

Totaln = 259

Spainn = 19

Nordic Countriesn = 34

Switzerlandn = 29

Italyn = 19

United Kingdomn = 18

Netherlandsn = 28

Germanyn = 49

(2017: 64%) (2017: 31%) (2017: 5%)

Valid responses 2017: Total: n = 236.

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DIGITAL MATURITY AND AMOUNT OF DIGITISED PATIENT DATA

While there’s much talk about eHealth and digital transformation, it appears that health facilities overall have not made too much progress over the past year – at least in terms of self-perception. Clearly, electronic medical records are more common than paper-based ones, overall almost three quarters (73%) of patient data are reported to be digitised. In the Netherlands and the Nordic countries this is even true for nearly 90% of patient data. In terms of self-perception Italians and professionals from the Nordics are most confident about their organisation’s digital maturity.

How would you rate your organisation in terms of digital maturity? [mean values; scale from 1 ”not mature at all” to 10 “extremely mature”; only participants who are working in a health facility]

What percentage of patient data in your organisation is digitised?[Scale from 0% - 100%; only participants who are working in a health facility]

Digital Maturity (self-assessment) Patient Data in Digital Format (self-assessment)

Extremelymature

Not mature

at all 1

10

Total

*

*

* When comparing the HIMSS Analytics Electronic Medical Record Adoption Model (EMRAM), maturity scores for Italy were much lower than for hospitals in the Netherlands or the Nordics.

Valid responses 2017: Total: n = 209/207; Italy: n = 12/13; Nordic Countries: n = 18/14; Netherlands: n = 27/26; Spain: n = 26/26; United Kingdom: n = 18/14; Switzerland: n = 25/26; Germany: n = 23/23.

2017 results

http://www.himss.eu/healthcare-providers/emram

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SUFFICIENCY OF IT BUDGET IN 2018/19

Do you think your organization has sufficient IT budget for the next 12 months?[Total including “others”; only participants who are working in a health facility]

The budget challenge remains, at least from a pan-European perspective. Similar to last year’s results, a majority (59%) of healthcare employees perceives their IT budget being too low. So it comes to no surprise that progress towards higher levels of digital maturity has not accelerated much (see previous slide). Results from individual countries or regions vary a bit if compared to last year. In 2018, the Dutch are mostly satisfied with their IT budgets, whereas professionals from UK and Spain being the ones most worried. Physicians & nurses remain a bit more concerned about the money as their IT colleagues.

… by profession 2018

Switzerlandn = 28


Italyn = 17

Germanyn = 40

Spainn = 18


Netherlandsn = 23

Totaln = 227

25%

75%

Physicians & Nurses

43%57%

IT Staff

… by profession 2017

Valid responses total 2017: n = 215 and by profession: IT Staff 2018: n = 48; Physicians & Nurses 2018: n = 44; IT Staff 2017: n = 115; Physicians & Nurses 2017: n = 40.

(2017: 44%) (2017: 62%)

Yes

No

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GOVERNMENTAL SUPPORT FOR EHEALTH

How would you describe the amount of central (governmental) direction and support you receive to progress your eHealth agenda? [Total including “others”; mean values; scale from 1 “inadequate” to 10 “adequate”]

eHealth professionals describe the amount of governmental direction and support slightly worse then in 2017 (4.8 in 2018 compared to 5.0 in 2017). Only eHealth professionals from governmental health authorities paint a slightly positive picture in this field. German eHealth professionals are under the impression that governmental support for eHealth is even weaker than one year ago, also indicating that their expectations towards the need for a push or a stimulus initiative in this field have grown further. At the same time their Dutch and Nordic peers are more satisfied with their own governmental programmes and retain their (already) positive perceptions from last year.

10Adequate

1Inadequate

… by Type of Organisation

10Adequate

1Inadequate

Switzerlandn = 44


Italyn = 41

Germanyn = 82

Spainn = 47


Netherlandsn = 42


Software vendorn = 73

Totaln = 477

Consulting companyn = 62

Governmental health authorityn = 44

… by Country / Region

2017 results

Valid responses 2017: Total: n = 470; Governmental health authority: n = 53; Software vendor: n = 86; Health facility: n = 193; Netherlands: n = 59; Nordic Countries: n = 81; Switzerland: n = 56; United Kingdom: n = 30; Italy: n = 25; Spain: n = 49; Germany: n = 57.

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AVAILABILITY OF CLINICALLY FOCUSED IT REPRESENTATIVES

Which of the following roles are established and financially supported in your organisation, in addition to the Chief Information Officer (CIO)? [Total including “others”; only participants who are working in a health facility; multiple answers possible]

Chief Innovation Officers (CINO) and Chief Digital Officers (CDO) are rather rare to find in European health facilities. They are more typical and established roles in the Netherlands and the Nordic countries than in Germany or the UK. Such positions are important to support the transformation of traditional analogue workflows and processes towards digital ones, moving everyone in the organisation to a digital mindset, driving value realisation and patient empowerment.

Totaln (2017) = 232n (2018) = 282

Chief ClinicalInformation Officer

(2017)

Chief Innovation Officer(2018)

Chief Digital Officer(2018)

Chief NursingInformation Officer

(2017)

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Chief Clinical Information Officer (2017)

12% 40% 60% 38% 49% 25% 55%

Chief Innovation Officer(2018)

5% 26% 36% 36% 25% 18% 0%

Chief Digital Officer(2018)

19% 16% 11% 27% 6% 7% 19%

Chief Nursing Information Officer (2017)

12% 13% 14% 14% 14% 14% 24%

n(2017)

26 15 35 37 35 36 33

n(2018)

43 17 26 28 16 28 16

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EUROPEAN EHEALTH ROLE MODEL – BY TYPE OF ORGANISATION & COUNTRY

Which country do you consider being a role model for eHealth innovation in Europe?[Total including “others”]

Overall, Denmark is perceived to be the leading country for eHealth innovation in Europe, followed closely by Estonia and the Netherlands. This order changes a bit between the different stakeholders. Estonia is the key role model for eHealth professionals from governmental health authorities, Denmark is the promised land for business consultants. The individual country perspective often is different: eHealth professionals from Spain, Italy or the UK value their own achievements much more than their colleagues from other countries. Perhaps this represents a communication opportunity missed.

Totaln = 464

Switzerland

Norway

Italy

Austria

Germany

United Kingdom

Estonia

Finland

Sweden

Spain

Denmark

Belgium

FranceOthers*

Netherlands

* Other countries: Portugal, Turkey, Poland




Health facilityn = 197 G

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Denmark 27% 17% 8% 28% 9% 43% 9%

Estonia 23% 3% 34% 13% 22% 4% 30%

Netherlands 16% 14% 21% 24% 16% 13% 13%

Sweden 7% 8% 11% 5% 9% 13% 9%

United Kingdom

1% 8% 5% 7% 11% 0% 26%

Finland 2% 8% 3% 17% 2% 4% 0%

Spain 0% 6% 3% 1% 24% 4% 4%

Norway 4% 0% 8% 2% 2% 4% 0%

Austria 6% 0% 0% 0% 0% 9% 0%

Germany 1%* 3% 0% 1% 0% 2% 4%

Italy 2% 22% 0% 0% 0% 0% 0%

Switzerland 7% 0% 0% 0% 4% 2% 0%

Belgium 0% 0% 5% 0% 0% 0% 0%

France 0% 0% 0% 0% 0% 2% 0%

Other 1% 11% 3% 2% 0% 0% 4%

n 81 36 38 88 45 47 23

Top 3 answers Bottom 3 answers*own country/region rated

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RESULTS – BUSINESS EXPECTATIONS

From a general perspective: How will the environment for eHealth innovation and investment in your country develop over the next 12 months?[Score for “Balance of business expectations” = (percentage “improve” – percentage “worse”)*100]

Bal

ance

of

bu

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exp

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ns

Very positive expectations

Very negative expectations

2015 – Q2 Q3

Results by country (2018 – Q3)

Q3

Worse Steady Improve n

Austria 12% 56% 32% 25

Denmark 7% 10% 83% 29

Finland 5% 14% 81% 21

Germany 7% 49% 43% 99

Italy 15% 49% 36% 47

Netherlands 2% 25% 73% 55

Norway 0% 44% 56% 25

Spain 4% 48% 48% 56

Sweden 4% 31% 65% 26

Switzerland 6% 50% 44% 54

United Kingdom 16% 31% 53% 32

All Countries 6% 40% 54% 570

2016 – Q2 Q3 Q4 2017 – Q2 Q3 2018 – Q1 Q2

Business prospects for the eHealth sector continue to be positive but have flattened over the past few months. Still, Dutch eHealth professionals remain to be particularly optimistic, 73% expect an improvement and only 2% believe the situation will become worse. In the UK, the dip seen last year appears to have been temporarily only, with ratings having picked up since then.

*UK: Q2 2018 not shown in chart due to low response rates during that survey wave

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Improved

Patient Care

and Health IT

Insights

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Germany

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