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april 2013

#67

Last issues Portada #67

The European Commission diagnoses the state of eHealth in Europe with two new comparative analyses

A survey made of 1,800 acute hospitals and another made of over 9,000 family doctors point to the growth in the use of eHealth in Europe. According to the results, in 2013 60% of family doctors already used electronic health solutions with an increase of 50% over the figures for 2007. Despite the positive tendency, “this is not enough” according to the vice-president of the European Commission, Neelie Kroes. Tonio Borg, the European commissar for health said that “the member states most using electronic medical records and electronic prescriptions must be a source of inspiration for us all”. 

In order to make a contribution in improving the public services, the European Commission periodically publishes comparative analyses with data from the member states. In the case of health, they have just published the results of two surveys in Europe on ICTs and health, which allow a study of the deployment of the eHealth Action Plan 2012-2020 and the Europe 2020 strategy

The first is the European Hospital Survey: Benchmarking Deployment of e-Health services study (2012-2013), carried out by the Institute for Prospective Technological Studies (IPTS), one of the seven research centres of the European Commission. The aim was to collect and analyse the development of eHealth in acute hospitals as a key institution of healthcare systems, in order to identify tendencies. To carry out the project, more than 1,000 interviews were made with medical directors and Chief Information Officers (CIO) from over 900 hospitals in 30 countries. 

According to the results, the development of eHeath in European hospitals grew from 39% to 42% in the period 2010-2013. The countries with highest indexes of electronic health deployment are Denmark (66%), Estonia (63%), Sweden and Finland (both with 62%). Furthermore, the differences between the countries in which eHealth has most been adopted, largely Nordic countries, and the less advanced countries (Eastern Europe and Greece, Latvia and Lithuania) have fallen. 

Development of eHealth in 2012 by country (source: European Commission). The number in brackets next to each country indicates the number of hospitals which took part in the European Commission survey. The asterisk alongside Malta indicates that only one hospital took part in the survey and that the results for this country are not representative, according to the authors.

Despite everything, not all of the hospitals have advanced eHealth solutions available to them. Nevertheless, when they are available, their use is majority. For example, the radiological PACS is only available in 53% of European hospitals, but in these it is used by 92% of the professionals. 

The results of the study suggest that connectivity is one of the pending subjects, as the majority of centres do not share information. As for expenditure, 63% of European hospitals devote less than 3% of their annual budget to ICTs. A little over half of the hospitals (57%) of the member states have a strategic plan in ICT, rather more habitual in the countries of Western Europe. 

As for the computerisation of medical records, the Netherlands are more advanced in this question (deployment in 83.2% of centres), followed by Denmark (80.6%) and the United Kingdom (80.5%). Furthermore, 85% of the participating hospitals have very clear rules as to patient access to their medical data, although only 9% of all centres in the EU give accessibility and many only allow partial access. Denmark, Finland, Norway and Croatia are the most accessible. This puts the brake on greater patient involvement in self-managing their own health. 

How do European GPs use eHealth?

The second study published by the European Commission corresponds to the Benchmarking Deployment of eHealth among General Practitioners 2013, whose results show that eHealth applications are ever more present in medical practices. 

Despite this, from interviews with 9,196 doctors from 31 countries (from the UE27, Croatia, Iceland, Norway and Thailand) significant differences were found in the availability of solutions around Europe and areas in which a greater drive is needed such as the electronic prescription, telemedicine or cross-border interoperability. By contrast, one positive result is found that is consistent in all countries: computers with internet connections are available in almost all surgeries and a large percentage of family doctors use the net for on-going training. 

93% of doctors have access to a basic Electronic Health Record (EHR) service, but the study shows a lack of deployment of the most advanced features in the European area. Furthermore, at the present time these kinds of services are mainly being used to store reports and data rather than for clinical purposes such as on-line consultation, for instance. In total, only 10% of European general practitioners currently use the possibilities of on-line consultation. 

The adoption of eHealth is influenced by the level of a country’s development, but also by the individual characteristics and aptitudes of the doctors, say the authors of the report. In fact the large majority of surveyed professionals stress more the barriers than the benefits of eHealth. The obstacles most referred to are the lack of financial incentives and resources (79%), insufficient computer skills (72%), the lack of interoperability (73%) and the non-existence of a framework of resolution on confidentiality and privacy for patients (71%). 

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