„Data Security“ - · PDF fileeHealth Business climate: The business trend for eHealth continues to be positive in all surveyed countries, despite a slight decrease over the last

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© HIMSS Analytics | eHealth TRENDBAROMETER Q2/2017

1www.himss.eu/analytics

„Data Security“

Results, 2nd Quarter 2017

http://www.himss.eu/analytics

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TABLE OF CONTENT

• Survey methodology page 3

• Survey overview page 4

• Results

Overall page 5

Protection of medical data by government page 7

Protection of medical data in different environments page 8

Protection of medical data by software vendors page 10

Electronic health information exchange security page 11

Role model for health information exchange and continuity of care page 13

Hospital Information System / Electronic Medical Record System purchase plans page 14

Hospital Information System / Electronic Medical Record System sales opportunities page 15

Business expectations page 16

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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 healthcare IT in Europe. HIMSS Analytics’ offerings include database and advisory solutions which encompass market research, IT adoption benchmarking, IT Maturity Models for topics like Electronic Medical Records or Continuity of Care. These offerings are designed to support Management and CIOs, IT Executives and Clinicians from across Europe to compare and measure their progress.

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. CIO’s, CEO’s, 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: approx. 300 – 500 per survey wave

Survey period o Typical field time: Approx. 2 months

o Specific field time for „Data Security“ Trend Barometer:

March – April 2017

Access all eHealth Trend Barometers 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. How satisfied are you with the regulation put in force by your national government in order to protect your medical data?

3. In your role as a patient, how well protected do you see your personal medical data in the following environments?

4. As a healthcare provider, how satisfied are you with the level of data security offered by software vendors?

5. If you look at the health system in your country, how well prepared is it in order to enable secure electronic health information exchange between different types of healthcare providers?

6. In your opinion, which country do you consider being a role model for advanced health information exchange and continuity of care?

7. How likely is it that your organisation will purchase a new Hospital Information System / Electronic Medical Record System from a different vendor within the next 12-24 months (i.e. not the one you are currently using)?

8. In your opinion, which of the following countries provide the best sales opportunities for HIS/EMR vendors in Europe over the next 12-24 months?

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

Main Topic: „Data Security“

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KEY FINDINGS

eHealth Business climate: The business trend for eHealth continues to be positive in all surveyed countries, despite a slight decrease over the last months.

Lessons on data security and recommendation for EMR vendors5

Lesson 1: Medical data are perceived to be relatively well protected, but not all of it.eHealth professionals are not particularly concerned about the protection of medical data, neither in terms of national regulation nor with regards to measures used by different healthcare providers. But there are a few exceptions, e.g. security from wellness and fitness applications or by home and social care providers.

Lesson 2: Europe is not equal when it comes to perceived levels of data security.The Nordics are more satisfied than most other European countries/regions, especially with regard to the safety of their own personal medical data and the appropriateness of data security efforts by public hospitals and health authorities. On the other end of the scale is Germany where data security concerns are stronger.

Lesson 3: You can trust your software vendor’s data security efforts, but they won’t necessarily trust you (until you buy more).Healthcare employees are, by and large, rather satisfied with the data security measures put in force by software vendors. But software vendors themselves are less satisfied with the way healthcare providers protect medical data. SW vendors might want to sell additional products offering higher levels of security (which care providers cannot afford) or they might have a higher awareness (than healthcare employees) about potential gaps in their products.

Lesson 4: (More) financial incentives are needed to improve the security of medical data. It’s the financials, stupid! eHealth professionals do not blame legislation, IT infrastructure, technical standards, software vendors, not even the patients to be a roadblock for secure Health Information Exchange (HIE) with external organisations. They call for financial incentives to stimulate and push secure HIE.

Lesson 5: Denmark is the role model for secure Health Information Exchange and Continuity of Care. eHealth professionals across Europe see the Danish Health System as the most advanced one regarding secure HIE. With some distance Estonia and Sweden follow on rank 2 and 3.

EMR Vendor Recommendation: Find new clients in the UK and Nordics, try to retain existing clients in other European countries.Healthcare providers in the Nordic countries expect most EMR replacements (to different vendors) over the next 1-2 years. Software vendors themselves feel that the UK is the most attractive market for EMR and HIS for that same timeframe.

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SAMPLE DISTRIBUTION – SURVEY PARTICIPANTS

Geographic distribution Type of organisation Respondent‘s occupation

13%

10%

16%

10%16%

9%

9%

17%

Germany

Austria

Switzerland

Netherlands

Nordic countries

UK

Spain

Other

n=383

Country nGermany 50Austria 37Switzerland 60Netherlands 40Denmark 17Finland 13Norway 17Sweden 16United Kingdom 33Spain 34Other* 66Total 383

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

*„Other“ respondents are from: Italy, Belgium, Estonia, USA, Portugal, France

57%

12%

31%

Health facility

IT Software vendor

Other

46%

19%

17%

5%

13%

IT officers

Governance

Nursing staff

Other

Physicians

27%

19%

17%

10%

5%

22%

Health Authority

Academic Sector

Consulting

Research

Journalism & PR

Other

Other: IT hardware vendor, pharmaceutical company, governmental organisation

Other: Pharmacy, research, IT, marketing

Strong participation from D-A-CH, Netherlands, Nordics, UK and Spain. The survey attracts a broad range of eHealth professionals: „only“ 40% are responsible for IT (in health facilities or for SW vendors), another 60% work as clinicians, in governance, consulting or other areas.

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3.3

3.0

3.3

3.3

3.4

3.6

3.7

3.6

3.3

2.8

3.4

3.4

3.7

3.5

3.7

3.3

3.2

2.6

3.0

3.2

3.6

3.4

1.0

4.2

Total

Germany

Austria

Switzerland

Netherlands

Nordics

UK

Spain

RESULTS – NATIONAL DATA PROTECTION REGULATION

How satisfied are you with the regulation put in force by your national government in order to protect your medical data?[Mean values; scale from 1 “very unsatisfied” to 5 “very satisfied”; without “other” organisations]

Most eHealth professionals, no matter if they work in health facilities or for software vendors, are neither particularly satisfied nor unsatisfied with the regulation of medical data protection in their country. As such, a call for governmental action doesn’t seem urgent.

Valid responses by country: Germany: n=48; Austria: n=35; Switzerland: n=35; Netherlands: n=40; Nordic Countries: n=62; UK: n=32; Spain: n=34

Veryunsatisfied

Verysatisfied

Veryunsatisfied

Verysatisfied

Veryunsatisfied

Verysatisfied

3.3Total average

Health facilityn = 214

Software vendorn = 42

Totaln = 371

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3.1 3.6 3.4 3.2 2.8 3.4 3.6 2.03.2 3.7 3.4 3.3 2.8 3.3 3.6 2.02.5 3.2 3.2 2.6 2.4 3.2 3.4 1.9

GeneralPractioners andSmall Day Clinics

Public Hospitals Private Hospitals RehabilitationFacilities

Home and SocialCare

Organisations

HealthInsurance

Organisations

GovernmentalOrganisations

Wellness andFitness

ApplicationProviders

Totaln = 291-372

Health facilityn = 168-213

Software vendorn = 38-44

RESULTS – DATA PROTECTION IN DIFFERENT ENVIRONMENTS 1/2

In your role as a patient, how well protected do you see your personal medical data in the following environments?[Mean values; scale from 1 „very unsafe“ to 5 „very safe”; without “other” organisations]

Medical data are perceived to be protected relatively well in most health environments. An exception is the wellness and fitness application environment, where data protection is perceived to be unsatisfactory. Home and social care organisations are also rated below average. Hospitals, which topped the headlines during recent cyber attacks, receive some of the best ratings. Professionals working for software vendors are generally more sceptical than people working in health facilities (do they know the gaps?).

3.1Total average

Veryunsatisfied

Verysatisfied

9


2.5

2.9

2.6

2.9

3.8

3.8

3.5

3.3

3.5

3.2

3.4

4.3

3.6

3.8

3.2

3.8

3.3

3.0

4.0

3.4

3.6

2.7

3.5

3.0

2.9

3.9

3.3

3.7

2.2

2.6

2.4

2.6

3.6

2.8

3.1

3.1

3.3

3.5

3.2

3.9

3.2

3.2

3.5

3.2

3.6

3.5

4.3

3.7

3.8

1.6

1.8

2.0

2.0

2.1

2.1

2.5

Germany

Austria

Switzerland

Netherlands

Nordics

UK

Spain

RESULTS – DATA PROTECTION IN DIFFERENT ENVIRONMENTS 2/2

In your role as a patient, how well protected do you see your personal medical data in the following environments? [Mean values; scale from 1 „very unsafe“ to 5 „very safe”; without “other” countries]

The perception of how well data are protected in different health environments varies by country. This perception is mostly in line with the findings from national medical data security regulation, i.e. eHealth professionals from the Nordic countries feel more safe about their personal medical data than Germans.

Valid responses by country: Germany: n= 41-48; Austria: n= 29-37; Switzerland: n= 49-57; Netherlands: n= 28-38; Nordics: n= 40-62; UK: n= 17-33; Spain: n= 26-33

General Practitioners

and Small Day Clinicsn = 357

Public Hospitalsn = 372

Health Insurance

Organisationsn = 314

Private Hospitalsn = 311

Home and Social Care

Organisationsn = 316

Rehabilitation Facilitiesn = 291

GovernmentalOrganisations

n = 354

Wellness and Fitness

Application Providersn = 331

3.1Total average

Total(All respondents)

10


3.2 2.7 3.2 3.1 3.2 3.3 3.8 3.2 3.4

Totaln = 214

Germanyn = 28

Austrian = 27

Switzerlandn = 37

Netherlandsn = 18

Nordicsn = 30

UKn = 22

Spainn = 19

Othern = 33

RESULTS – DATA PROTECTION BY SOFTWARE VENDORS

From the perspective of healthcare employees, data security measures put in force by software vendors are also perceived to be, by and large, acceptable. This is in line with previous findings, i.e. efforts made through national regulation or by different care settings/stakeholders. Healthcare employees in the UK are most satisfied with their vendors, their German peers are (again) the most critical.

Veryunsatisfied

Verysatisfied

As a healthcare provider, how satisfied are you with the level of data security offered by software vendors?[Mean values; scale from 1 “very unsatisfied” to 5 “very satisfied”; only participants who are working in a health facility; without “other” countries]

3.2Total average

11


3.4 3.1 2.2 3.2 2.8 3.3 3.13.4 3.1 2.1 3.2 2.8 3.2 3.03.3 3.0 2.2 3.3 2.7 3.3 3.6

Data PrivacyLegislation

IT Infrastructure FinancialIncentives

TechnicalStandards

Flexibility andWillingness ofClinical Staff

Flexibility andWillingness of

Patients

Flexibility andWillingness of

Software Vendors

Totaln = 329-370

Health care facilityn = 185-213

IT software vendorn = 41-44

RESULTS – SECURE HEALTH INFO EXCHANGE ENABLEMENT 1/2

If you look at the health system in your country, how well prepared is it in order to enable secure electronic health information exchange between different types of healthcare providers?[Mean values; scale from 1 „flop“ to 5 „top“; without “other” organisations]

It’s the financials, stupid! eHealth professionals do not blame legislation, nor IT infrastructure, nor technical standards, nor software vendors, and not even the patients to be a roadblock for secure Health Information Exchange (HIE) with external organisations. They call for financial incentives to stimulate and push secure HIE. In terms of self-perception healthcare employees are self-critical: Clinicians should be more flexible and motivated to embrace HIE. SW vendor employees perceive themselves to be particularly flexible, which is not as much the case from an external perspective.

3.0Total average

!

Flop

Top

12


2.9

3.6

3.5

3.0

3.7

3.5

3.6

2.3

3.3

3.0

2.9

3.5

2.8

3.6

1.8

1.9

2.0

2.3

2.7

2.0

2.4

2.2

3.4

3.5

3.1

3.3

3.2

3.6

2.4

2.6

2.6

2.8

3.2

2.8

3.1

3.1

2.8

3.0

3.7

3.8

3.5

3.2

2.9

3.4

3.2

2.7

3.2

2.9

3.3

Germany

Austria

Switzerland

Netherlands

Nordics

UK

Spain

RESULTS – SECURE HEALTH INFO EXCHANGE ENABLEMENT 2/2

If you look at the health system in your country, how well prepared is it in order to enable secure electronic health information exchange between different types of healthcare providers?[Mean values; scale from 1 „flop“ to 5 „top“; without “other” countries; without answer option “other”]

More financial incentives are demanded across all countries, but particularly in Germany and Austria (although Austrians already have a nation-wide health record infrastructure (ELGA) in place). In Germany, eHealth professionals also have a negative perception of their Health-IT Infrastructure and Technical Standards. This is a likely reaction caused by multiple delays with the national EHR platform. eHealth Professionals from the Nordics and Spain see themselves (mostly) on the right track.

Valid responses by country: Germany: n= 44-47; Austria: n= 31-36; Switzerland: n= 55-59; Netherlands: n= 33-38; Nordics: n= 50-63; UK: n= 27-33; Spain: n= 31-34

Data Privacy Legislation

n = 362

IT Infrastructuren = 368

Flexibility and Willingness of

Patientsn = 361

Financial Incentives

n = 329

Flexibility and Willingness of Clinical Staff

n = 370

Technical Standards

n = 367

Flexibility and Willingness of SW Vendors

n = 361

Total(All respondents)

3.0Total average

13


24

15

12

9

7

7

6

6

5

27

19

11

27

8

28

7

21

7

21

7

31

13

10

8

10

8

15

19

16

19

23

6

6

38

12

10

10

14

6

6

16

24

16

12

12

12

17

8

17

8

21

25

Denmark

Estonia

Sweden

Netherlands

Austria

Finland

Norway

United Kingdom

Switzerland

Spain

Germany

Belgium

Other*

RESULTS – ROLE MODEL COUNTRY FOR CONTINUITY OF CARE

In your opinion, which country do you consider being a role model for advanced health information exchange and continuity of care?[Responses in percent; labels only shown when >5%]

Overall, Denmark is perceived to be the leading country for continuity of care and HIE. One in four eHealth professionals puts the Danes on top. With some distance Estonia and Sweden follow on rank 2 and 3. This order changes slightly from country to country. Dutch and Spanish eHealth professionals perceive their own country to be leading. Spain in particular seems to have an issue with external perception, hardly any respondent from outside Spain values their achievements. Germany and Belgium are trailing behind.

Totaln = 294

Germanyn = 37

Austrian = 29

Switzerlandn = 48

Netherlandsn = 31

Nordicsn = 50

UKn = 25

Spainn = 25

* “other“ country: USA, France, Iceland, Andorra

DKLeading Country

14


14% 10% 8%18%

11%27%

19%

13%7% 8%

10%17%

17%

10%

28%

7%

3%15%

17%

5%

18%

21%12% 21%

11%

17%

14%17%

47%59% 58% 51%

61%

23%

52% 56%

Totaln = 215

Germanyn = 29

Austrian = 26

Schwitzerlandn = 39

Netherlandsn = 18

Nordicsn = 30

UKn = 21

Spainn = 18

RESULTS – PURCHASE PLANS FOR HIS/EMRs

How likely is it that your organisation will purchase a new Hospital Information System / Electronic Medical Record System from a different vendor within the next 12-24 months (i.e. not the one you are currently using)?[only participants who are working in a health facility; without “other” countries]

EMR/HIS vendors are likely to find best market opportunities in the Nordic countries, where healthcare professionals indicated that their organisation is likely to purchase a new system – from a different vendor – over the next 1-2 years. The lower values in other countries might be an indicator that hospitals there are more loyal to their current vendor or find it more difficult to switch to a different one.

Most active market

NORDICS

2.3 1.9Means 2.0 2.2 3.1 2.3 2.02.1

Very likely

Likely

Very unlikely

Unlikely

Neither likely nor unlikely

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RESULTS – SALES OPPORTUNITIES FOR HIS/EMRs

In your opinion, which of the following countries provide the best sales opportunities for HIS/EMR vendors in Europe over the next 12-24 months?[only participants working for a software vendor; n = 31]

The UK is the land of milk and honey for HIS/EMR sales, at least from the view of software vendor employees. Denmark, Sweden andSwitzerland, albeit much smaller, are ranked on the same level as Germany.

Best opportunities

UK

29% 13% 13% 13% 13% 6%3% 3% 3% 3%

UnitedKingdom

Denmark Germany Sweden Switzerland Finland Austria Belgium Norway Spain

16


28 24

42 4338 35

7469

77 73

89

65 6960

65

27

50

3628 30

57 52 5448

1 2 3 4 5 6

DACH Nordics Netherlands UK All countries

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]

+100-100

Bal

ance

of

bu

sin

ess

exp

ecta

tio

ns*

Very positive expectations

Very negative expectations

2015 – Q2 2015 – Q3 2016 – Q2 2016 – Q3 2016 – Q4

Business prospects for the eHealth sector continue to be very positive, albeit at a slightly lower level than at the end of 2016.While to be digested with caution (low response rate) eHealth professionals from Finland are particularly optimistic (92% expect an improvement).

worse steady improve N

Germany 2% 60% 38% 50

Austria 11% 62% 27% 37

Switzerland 7% 33% 60% 60

Netherlands 5% 30% 65% 40

Belgium 0% 0% 10% 7

Denmark 6% 29% 65% 17

Norway 6% 18% 76% 17

Sweden 0% 31% 69% 16

Finland 0% 8% 92% 13

United Kingdom 12% 39% 48% 33

Italy 13% 56% 31% 16

Spain 3% 44% 53% 34

All countries 6% 40% 54% 369

Results by country (2017 – Q2)

2017 – Q2

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Thank you for your participation!

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Office Leipzig

Schwägrichenstraße 9

04107 Leipzig

Germany

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„Data Security“ - · PDF fileeHealth Business climate: The business trend for eHealth continues to be positive in all surveyed countries, despite a slight decrease over the last