Health Information
Network Europe
Progress towards EPR in Europe’s hospitals
Are they ready for eHealth?
Véronique Lessens
Tromso, 24 May 2005
How did HINE get started?
HINE was established in 2001 to provide a comprehensive
service for one stop access to key eHealth information and:
• Be the premier European source of market information for
healthcare IT
• Help senior executives to anticipate and understand
healthcare industry changes
• Enable meaningful comparison between European and
other global eHealth markets
….. supported by EU and leading industry organisations
to meet business needs of healthcare stakeholders
2
HINE (24 May 2005)
© 2005 Deloitte
First comprehensive survey to
address European market unknowns
Installed base
900 hospitals
interviewed
in 15 countries
Suppliers
The HINE 2004
European
eHospital
Census
by
HBS
Sponsored by:
Agfa
Deloitte
HP
iSOFT
McKesson
Microsoft
Philips
SAP
Siemens
Usage patterns
3
HINE (24 May 2005)
© 2005 Deloitte
Are European hospitals ready for
eHealth?
3
2
1
4
Levels of sophistication
4
%
#
Decision support,
ePrescribing
2,13%
107
Clinical orders, results,
Advanced medical library
18,70%
941
Common MPI / integration
around patient number
87,34%
4395
PAS
98,87%
4975
Note:
• # = total number of installations across Europe
• Total population considered for forecasts is 5032 hospitals
across 15 European countries (acute hospitals larger than 100 beds)
HINE (24 May 2005)
© 2005 Deloitte
Significant differences from country
to country
Levels of
sophistication
Level 1
Level 2
Level 3
Level 4
%
#
%
#
%
#
%
#
Germany
99,47%
1448
91,05%
1326
22,63%
330
2,11%
31
France
97,76%
880
81,34%
732
5,22%
47
0,75%
7
100,00%
555
97,22%
540
13,89%
77
1,39%
8
Italy
96,77%
779
66,13%
532
12,90%
104
2,42%
19
Spain
100,00%
416
100,00%
416
26,00%
108
5,00%
21
97,96%
141
93,88%
135
30,61%
44
0,00%
0
Netherlands
100,00%
127
100,00%
127
31,11%
40
2,22%
3
Austria
100,00%
152
95,56%
145
46,67%
71
0,00%
0
Switzerland
100,00%
153
86,67%
133
24,44%
37
4,44%
7
Norway
100,00%
72
100,00%
72
28,00%
20
0,00%
0
Sweden
100,00%
90
88,00%
79
52,00%
47
12,00%
11
Denmark
100,00%
81
100,00%
81
15,00%
12
0,00%
0
Finland
100,00%
81
95,00%
77
5,00%
4
0,00%
0
Europe
98,87%
4975
87,34%
4395
18,70%
941
2,13%
107
UK/EIRE
Belgium
• Almost 100% of European hospitals have reached Level 1 and close to 90% Level 2.
• However, the results dropped significantly from Level 3 onwards. Only 2% of European
hospitals have reached Level 4.
• Overall the same trends could be observed in USA. If we consider Level 4 in Europe as
equivalent to the CPOE system in USA, then we could observe that the situation in USA
(close to 2,5% of US hospitals reporting having CPOE systems in place) is not significantly
different from the number of European hospitals at Level 4.
5
HINE (24 May 2005)
© 2005 Deloitte
Main storage medium in medical
records library
Media for storage/archiving - 2004
16,0%
Paper-based
14,1%
Microfiche
Scanned / Digitized
Fully computerized
4,2%
65,7%
• 66% of medical records still held on paper
6
HINE (24 May 2005)
© 2005 Deloitte
Hospital EPR performance in Europe
Mature market
• Administrative solutions have been the main focus together with service departments.
• Painfully slow progress towards hospital EPR. ePrescribing (not ETP) still a pipe dream.
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HINE (24 May 2005)
© 2005 Deloitte
Is the essential infrastructure in
place? (1)
EU Weighted
EU
Ratio Nb.
Weighted
Workstations
Av. Nb.
Workstations
per Bed
per Hospital
Levels of sophistication
4
3
2
1
8
EU Weighted
Ratio Nb.
Staff per
Workstations
Decision support,
ePrescribing
1614
1,5
2,5
Clinical orders, results,
Advanced medical library
585
1,2
2,9
Common MPI / integration
around patient number
536
1,2
3,7
PAS
282
0,8
5,1
HINE (24 May 2005)
© 2005 Deloitte
Is the essential infrastructure in
place? (2) – Fixed, mobile & wireless connected
workstations
Workst
ations
- Mean
%
Mobile
%
Wireless
9
DE
FR
UK/
EIRE
IT
ES
BE
NL
AU
CH
NO
SW
DK
FIN
294
383 1297
384
423
521
1050
680
597
977
2019 1555
984
3%
6%
4%
7%
2%
4%
7%
8%
17%
11%
6%
6%
12%
0,5% 2,6% 3,4% 0,5% 4,8% 0,4% 3,1% 2,8% 3,0% 2,5% 2,2% 5,6% 0,8%
HINE (24 May 2005)
© 2005 Deloitte
ICT spending pattern
ICT spending as a percentage of total hospital revenue - 2004
6%
6%
7%
29%
<1%
1 - 1.5%
1.5 - 2%
11%
2 - 2.5%
2.5 - 3%
3- 4%
>4%
19%
22%
• 70% of European hospitals spend less than 2% of their budgets on ICT, while 70% of their
US colleagues were spending more than 2% in 2004.
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HINE (24 May 2005)
© 2005 Deloitte
ICT spending patterns (2)
ICT spending in % Increase foreseen
Ratio per staff
Ratio per bed
Germany
1,8%
34%
1020
2020
UK+EIRE
1,7%
73%
1290
6040
France
1,5%
32%
680
1490
Spain
1,4%
69%
550
1490
Italy
1,1%
38%
790
2690
Belgium
2,1%
50%
1930
4080
Netherlands
3,3%
53%
1700
6340
Austria
2,2%
21%
4200
3490
Switzerland
2,0%
47%
2480
7540
Norway
2,6%
44%
1250
6750
Sweden
3,3%
48%
1570
8170
Denmark
2,5%
84%
1240
6140
Finland
2,8%
80%
2380
5420
EUROPE
1,8%
52%
1280
3710
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HINE (24 May 2005)
© 2005 Deloitte
Market drivers – Currently
Factors Driving Current
DE
FR
UK/
EIRE
IT
ES
BE
ND
AU
CH
NO
SW
DK
FIN
EU
16,65
15,99
6,17
8,79
5,16
15,14
16,02
5,89
13,59
8,67
14,58
10,00
15,28
11,69
5,99
3,61
6,58
6,06
13,55
11,62
9,32
0,56
5,53
13,67
11,88
11,43
1,67
7,81
Facilitate sharing of patient
information
3,69
6,25
3,33
5,69
6,94
14,05
11,82
9,33
10,29
5,33
10,83
5,00
8,33
7,76
Comply with government funded
policies
8,01
7,25
12,00
3,23
3,68
8,51
9,43
4,44
14,26
4,33
1,67
10,71
10,83
7,57
Improve security and privacy
provisions
4,69
13,01
3,08
11,57
9,15
4,05
2,16
14,80
5,15
11,00
5,00
4,29
4,44
7,11
Increase clinical capacity and
productivity
10,06
2,29
4,58
5,49
2,24
7,03
7,73
13,33
5,44
10,00
5,83
7,50
5,83
6,72
5,97
6,67
8,50
5,80
13,03
5,00
5,91
3,44
4,12
11,00
3,75
8,57
1,11
6,37
11,74
8,52
6,67
8,81
1,80
4,32
4,55
9,07
5,88
5,33
8,33
0,00
0,00
5,77
Enhance overall organisational
performance
8,55
4,43
9,25
4,69
4,48
2,97
4,66
4,67
6,91
8,67
2,92
7,50
4,72
5,72
Improve access to care and
reduce waiting lists
3,49
4,17
10,42
8,49
9,32
3,51
4,66
3,36
5,00
7,33
3,75
5,71
1,11
5,41
3,38
3,33
6,17
8,94
9,43
7,16
2,95
4,22
6,26
1,00
5,00
7,14
0,00
5,00
8,43
6,61
3,50
5,71
2,29
6,49
5,80
6,22
3,44
2,67
7,92
2,86
2,22
4,94
Healthcare ICT Investments in
Europe
Meet legal requirements
Reduce avoidable medical errors
Improve overall quality of care
Improve control of costs
Improve interaction with patients
Increase revenues and reduce
costs
12
HINE (24 May 2005)
© 2005 Deloitte
HINE 2004 eHospital Census reveals:
•
•
•
•
•
•
•
•
•
•
•
•
Prevailing rate of IT spend around 1,8% of revenue
Recognised lack of inhouse eHealth skills
CIOs generally unwilling/scared to outsource support
Failure of CIOs to recognise changing job role
IT strategies disconnected from business objectives
Lack of basic IT tools and essential infrastructure
Operating efficiencies have been the main focus
Painfully slow progress towards clinical buy-in
Electronic prescribing (not ETP) still a pipe dream
Little evidence of GP or consumer access facilities
Reluctance to accept opportunity to address patient safety through ICT
Call for Government intervention, guidance and support
•
Hospitals are a key component of the health care system and are central to
the process of health system reform.
•
BUT as organisations, they have received too little attention. Policy makers
embarking on eHealth should also focus on hospitals. Change will require
investment and we should ensure that hospitals have access to these funds
for future investment in eHealth. This will request high political profile and
Government interest. Government and industry must collaborate.
13
HINE (24 May 2005)
© 2005 Deloitte
For further information, contact
Véronique Lessens, Manager
(vlessens@deloitte.com)
Phone: + 32 2 800 28 49
… or visit the HINE website at:
www.hineurope.com