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  1. Investing in Health Systems of the Future Budapest, Hungary 10 – 12 May 2011

  2. European EHR Market Analysis The EuroRec Institute Jos Devlies, M.D.

  3. Topics • The EHR-QTN project • Purpose of the project • Partners • Main results • The European EHR Market Analysis • Methodology • The EHR system suppliers overview • The EHR stakeholders overview • Cross – domain suppliers • Cross – border suppliers European EHR Market Analysis - WoHIT2011 - Budapest

  4. European EHR Market Analysis - WoHIT2011 - Budapest The EHR-QTN Project

  5. EHR-QTN • Thematic Network project : 238912 • “The main objective of the Thematic Network is to better prepare the health community across Europe for systematic and comparable quality assurance and certification of e-Health products, more specifically of Electronic Healthcare Record systems.” • Three years (February 2009 – January 2012) • Budget: 789.000€ • 28 partners in 25 countries European EHR Market Analysis - WoHIT2011 - Budapest

  6. European EHR Market Analysis - WoHIT2011 - Budapest Partners

  7. Main Results of the EHR-QTN • Awareness (72 National Workshops) • Validation of the EuroRec Descriptive Functional Statements (+1.700) and the Certification Procedures • Translation of the Statements in 19 languages • EuroRec Seal Level 1 and Level 2 definition • Quality labelling of EHR Market Products • EHR Market Overview • Roadmap towards Sustainable Pan-European Certification of EHR Systems European EHR Market Analysis - WoHIT2011 - Budapest

  8. European EHR Market Analysis - WoHIT2011 - Budapest The European EHR Market Analysis

  9. European EHR Market Analysis - WoHIT2011 - Budapest

  10. Methodology • Data collection per country • Template • Web Questionnaire • Completed by the EHR-QTN partner • Where feasible: strict inclusion criteria: • Suppliers based on market share. Goal: > 90% of the market • Other stakeholders: “decisional impact” • Authorities • User groups (mostly on demanding side but also possible obstructers) European EHR Market Analysis - WoHIT2011 - Budapest

  11. Origin of the information • Not so easy to collect • Either not available as such or considered as “classified” • Possibilities: • Official list of labelled applications (a few countries for a limited number of domains of application) • Expertise of the partners • Web searches (e.g. professional organisations) • Health Ministries • Health IT suppliers organisations European EHR Market Analysis - WoHIT2011 - Budapest

  12. Result • 24 National Market Overviews • Two Deliverables • Del. D3.1 Part I: Suppliers and Supplier Organisations: 1.019 supplier / product ID • Del. D3.2 Part II: Authorities and important stakeholders: 663 addresses European EHR Market Analysis - WoHIT2011 - Budapest

  13. Suppliers and their products European EHR Market Analysis - WoHIT2011 - Budapest

  14. EHR Market Overview: Suppliers • 849 “Commercial” EHR systems • 25 “in house” large HIS with EHR • 101 health IT service providers (health telematics, privay enhancing etc…) • 44 eHealth / Health IT representative organisations • Total: 1.019 addresses, contact persons etc… European EHR Market Analysis - WoHIT2011 - Budapest

  15. Extract of the list (ambulatory care) per country European EHR Market Analysis - WoHIT2011 - Budapest

  16. Extract of Hospital Systems (Alphabetically) European EHR Market Analysis - WoHIT2011 - Budapest

  17. EHR Overview : Suppliers European EHR Market Analysis - WoHIT2011 - Budapest

  18. Some conclusions • International applications/suppliers: • rather limited • most in Hospital Care and in Dental Care • Number of applications: most “medical” applications … easiest to get the information • Most suppliers support ONE application only (and in the same domain) . Average 1,21 for ambulatory systems, 1,22 for hospital systems. European EHR Market Analysis - WoHIT2011 - Budapest

  19. Suppliers per domain of application European EHR Market Analysis - WoHIT2011 - Budapest

  20. Applications per domain European EHR Market Analysis - WoHIT2011 - Budapest

  21. International / Cross-border applications European EHR Market Analysis - WoHIT2011 - Budapest

  22. International suppliers / applications • International = • Product used in more than one country • Product owned by an entity in another country • Countries with most international systems: United Kingdom, Spain, Italy, Denmark and Austria. • Domains with most international systems: • Hospital systems 31,88% • Dental systems 14,75% • Paramedical systems 12,64% • GP – Ambulatory systems 8,97% European EHR Market Analysis - WoHIT2011 - Budapest

  23. Cross-Border & Cross-Domain • International suppliers: • 6 in Primary / Ambulatory Care • 19 in Hospital Care (… hardware oriented?) • Cross-Border applications • None or nearly no applications in primary care / ambulatory care • Same “product names” in several countries: same application ???(Alert, Clinicom, HP-HCIS, Impax, Lorenzo, Maxims Clinical, Orbis, PCS, Sorian, StaproAkord, Cerner) • Cross-Domain suppliers: 89(at least in one country more than one target market) European EHR Market Analysis - WoHIT2011 - Budapest

  24. Authorities, users and other stakeholders European EHR Market Analysis - WoHIT2011 - Budapest

  25. Importance of stakeholders • Involvement of all important stakeholders is vital to the success of implementation and use of EHR systems. (EHR-Implement project) • Listed stakeholders are • Health authorities • Healthcare insurance organisations • Public health organisations • Research organisations – Academic institutes • Healthcare institutes (associations) • Healthcare professionals organisations European EHR Market Analysis - WoHIT2011 - Budapest

  26. Selection criteria • Do they actually have an active role in quality assurance of EHR systems, if any in the country? • Did they manifest a particular knowledge of the domain (certification / quality labelling) in the past? • Is their approval or at least their cooperation essential in order to introduce successfully certification and quality labelling of EHR systems? • Is there a risk of obstruction not including them in the process of certification and quality labelling? • Are they representative or an important party in the particular EHR market, addressing a specified group of users? European EHR Market Analysis - WoHIT2011 - Budapest

  27. [1]Not all the regional health authorities and regional organisations are listed; [2]Specific for England Authorities European EHR Market Analysis - WoHIT2011 - Budapest

  28. EHR Overview Stakeholders European EHR Market Analysis - WoHIT2011 - Budapest

  29. (e)Health authorities European EHR Market Analysis - WoHIT2011 - Budapest

  30. Role of Stakeholders (also regarding EHR and EHR Certification) European EHR Market Analysis - WoHIT2011 - Budapest

  31. Market Fragmentation… • Not only a problem of the market • Internationally operating trusts • Not per definition leading to product consolidation… even differentiating the same product in different countries. • More interested (actually) in • Market presence • Making use of the outcome of EHR systems: clinical content • More consolidation within one area (country / region) between the domains than cross-border consolidation within the same domain. European EHR Market Analysis - WoHIT2011 - Budapest

  32. And now? • Maintenance is an important issue • Maintenance requires resources • Involve the market to maintain the database • Use the database to promote quality labelling and certification • Make the data available to the market (restricted) European EHR Market Analysis - WoHIT2011 - Budapest

  33. Exploitation of the Overview • Mail to National Health Authorities • EuroRec Letter • National Partner Letter • End of April: mail to the Suppliers about • Importance of quality • Importance of quality assessment • The EuroRec Seal European EHR Market Analysis - WoHIT2011 - Budapest

  34. Thank you European EHR Market Analysis - WoHIT2011 - Budapest