Recommendations for a solid and integrated European e-health environment

Brussels 25 November 2000The Deloitte & Touche Health Centre of Excellence, based in Diegem, Belgium, has recently issued a report with in-depth analysis figures and recommendations for the building of a well-structured European health telematics market, which should be beneficial to all the involved parties. The Health Information Society Technology (HIST) based industry study has been ordered and financed by the European Commission's Directorate General for the Information Society under the title Market Analysis on the emerging European Health Telematics Industry. The results of this first-of-its-kind report in Europe were presented to the MedNet 2000 Congress audience by Mrs. Véronique Lessens, who is a manager at the Health Centre of Excellence.


The HIST mission involved a quantitative market analysis on the implementation of Information Technology and Communication (ICT) in the European health care sector. Mrs. Lessens described the target as threefold: to make a review of all available statistics in connection with ICT and health within the European Union; to evaluate the market trends at the demand as well as the supply side; and to provide recommendations to the partnering triangle in this process, namely the industry, the health care providers, and the governments.

Mrs. Lessens equally formulated a number of key messages which have to be carefully considered before taking any action. At present, the European ICT investments in the health care sector amount to 14 billion euro. This means six percent of the entire European ICT market, representing 232 billion euro, and two percent of the 724 billion euro health care market in Europe. Within the next five years, experts anticipate that the ICT market will double in size. Similar to what happened in the banking sector a year or two ago, the health industry revolution is on the move. The arrival of innovative technologies will radically change the way of working between the health organisations, health providers, and the information-empowered consumer-patients.

The shift towards multiple medical ICT implementation will benefit all of the four parties involved in the health care delivery. The ICT industry will receive promising opportunities for both turnover growth and novel service offerings. Business process re-engineering will become a new buzz-word for the health practitioners who will learn to use this powerful tool to improve productivity and efficiency, as well as the quality of patient services. Citizens will get full access to medical information, offering them the means to control the health system. National and local governments will utilise pioneering technology to create integrated and effective models of patient care to control the expensive costs for health care.

Yet, Mrs. Lessens pointed out that this optimistic scenario will be unable to materialise itself unless a number of vital conditions are satisfied. If we look at today's health ICT industry, we see a market which is very fragmented and shows a highly competitive structure. A variety of companies only offers local and partial instead of turnkey solutions. On the other hand, there is a strong trend towards consolidation on the demand side with medical centres trying to merge and implement "managed care". This will lead to a level of complexity of IT requirements which can only be met by companies with a sufficient size and investment capacity to develop their technology and skills base. Further consolidation of the industry is thus required, as Mrs. Lessens stated, adding that alliances through mergers, acquisitions and partnerships are mandatory if the European industry wants to stay competitive.

Companies providing open and cost effective solutions, in order to create an integrated health care IT environment in partnership with the hospitals will have more chances to succeed than the ones offering closed, all-in solutions. Still, there will remain plenty of opportunities for small and medium sized companies (SMEs) to develop dedicated tools for specific components within the ICT infrastructure. At the demand side, the integration strategy should be realised in a reasonable time span. Therefore, a more ambitious level of ICT investment than the current 1.2 percent within the European hospital sector is required, in comparison to the USA where a level of 2.5 percent has been reached. In this regard, Mrs. Lessens referred to the 4 percent level in the manufacturing business and to the 5 or 6 percent level in the banking sector.

Here lies a task for the health authorities who should set up an ICT strategy plan rapidly by defining a sound health strategy first. This requires a strong implementation planning and the promotion of regional health networks. The role of the governments is equally important and mainly consists in outlining clearly defined objectives and accompanying measures at Europe-wide level, thus indicating to the IT sector that a cohesive European market will emerge. Mrs. Lessens also stressed the need for a financial and regulatory framework for innovative technologies, such as telemedicine. Furthermore, the industry, the users, as well as the health care authorities have to accept the existence of standards which have to be implemented within short-term target dates.

In order to generate a successful ICT integration into the health care sector, a lot remains to be done on the level of information availability. Instead of keeping existing fragmented health ICT knowledge confidential, Mrs. Lessens made a plea to develop an in-depth database to assist health executives in building excellent strategies to adapt and transform their organisation into a soundly integrated and beneficial e-health environment. The promotion of creativity, constructive debate, and partnership between the health care authorities, the ICT industry, the health professionals, as well as the patient-citizen constitutes the highest priority, in order to have the European health telematics market emerge as a winner. Detailed figures about European market trends in the health ICT sector are available in this issue's article Deloitte & Touche study to analyse today's and upcoming European health telematics market trends.

Leslie Versweyveld

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