A Composite Index for Benchmarking eHealth Deployment in European Acute hospitals

1. A Composite Index for Benchmarking eHealth
Deployment in European Acute hospitals
Catalonia
Presentació Pla de Salut i Pla Estratègic SITIC 2012-2015
23 Març 2012
Francisco Lupiáñez-Villanueva
@flupianez
http://www.ictconsequences.net
Information Society Unit
European Commission's Joint Research Centre (JRC)
Institute for Prospective Technological Studies (IPTS)
The views expressed in this presentation are those of the authors and do not necessarily reflect the position of the European Commission.
Neither the Commission nor any person acting on behalf of the Commission can be hold responsible for the use which is made of this presentation

2. IPTS: Part of Joint Research Centre (JRC) of
the EC: 7 Research Institutes across EU
As a service of the European Commission, the
mission is to provide customer-driven scientific
and technical support for the conception,
development, implementation and monitoring
of EU policies.
JRC functions as a reference centre of science
and technology for the Union. It serves the
common interest of the Member States, while
being independent of special interests, whether
private or national.

3. eHealth has figured high in the European Commission
Information Society policy agenda for a decade:
•eEurope framework
•i2010 strategy
•Digital Agenda for Europe (2010-2015) – Pillar 7: ICT for Societal
Challenges
• Action 75a: Give Europeans secure online access to their medical
health data
• Action 75a: achieve widespread telemedicine deployment
• Action 76: Propose a recommendation to define a minimum
common set of patient data
• Action 77: Foster EU-wide standards, interoperability testing and
certification of eHealth

5. Benchmarking
eHealth
Deployment in
European Acute
Hospitals
Codagnone, C. and F. Lupiañez-Villanueva, (2011). A composite index for the benchmarking of eHealth Deployment
in European acute Hospitals. Distilling reality in manageable form for evidence based policy. Institute for
Prospective Technological Studies (IPTS) - European Commission's Joint Research Centre (JRC).

6. Codagnone, C. and F. Lupiañez-Villanueva, (2011). A composite index for the benchmarking of eHealth Deployment
in European acute Hospitals. Distilling reality in manageable form for evidence based policy. Institute for
Prospective Technological Studies (IPTS) - European Commission's Joint Research Centre (JRC).

7. Codagnone, C. and F. Lupiañez-Villanueva, (2011). A composite index for the benchmarking of eHealth Deployment
in European acute Hospitals. Distilling reality in manageable form for evidence based policy. Institute for
Prospective Technological Studies (IPTS) - European Commission's Joint Research Centre (JRC).

8. Codagnone, C. and F. Lupiañez-Villanueva, (2011). A composite index for the benchmarking of eHealth Deployment
in European acute Hospitals. Distilling reality in manageable form for evidence based policy. Institute for
Prospective Technological Studies (IPTS) - European Commission's Joint Research Centre (JRC).

10. Overall indicator
Infrastructure Application HIE Security and Privacy
Factor Analysis Factor Analysis Factor Analysis Factor Analysis
Computer system Electronic Patient Security and privacy
Clinical Information Laboratory results
connected Record (EPR) electronic patient data
With a hospital
Broadband above Personal Health or hospitals outside With a hospital or hospitals outside
50 MBps Record (PHR) National level
your own hospital your own hospital system
system
Hospital support Picture archiving
External general
wireless and Communication External general practitioners Regional level
communications practitioners
systems (PACS)
Hospital video An integrated system
Protect the patient
conference facilities for billing management External specialists External specialists data Encryption
An integrated system to
Health care providers in Health care providers in
send or receive electronic referral letters All stored data
other EU countries other EU countries
An integrated system to
Health care providers Health care providers
send electronic discharge letters All transmitted data
outside the EU countries outside the EU countries
An integrated system for
Protect the patient
tele-radiology Medication list Radiology reports
data Workstations
A computerized system for With a hospital
or hospitals outside With a hospital or hospitals outside with access only through
ePrescribing your own hospital your own hospital system health professional cards
system
An adverse health events
External general with access only through
report system External general practitioners
practitioners fingerprint information
An electronic Clinical with access only through
External specialists External specialists a password
Tests
An electronic service Health care providers in Health care providers in Protect the patient data
order placing other EU countries other EU countries with digital signature
An electronic appointment Health care providers Health care providers
booking system outside the EU countries outside the EU countries
Tele-homecare/tele-monitoring
services to outpatients (at home)

11. eHealth Hospital
Deployment
Overall indicator
(weighted sum)
0.25 weighted 0.25 weighted 0.25 weighted 0.25 weighted
Application HIE Security & Privacy
Infrastructure Dimension Dimension
Dimension Dimension
Summary indicator
Summary indicator Summary indicator Summary indicator
(weighted sum)
(weighted sum) (weighted sum) (weighted sum)
Factor Analysis Factor Analysis Factor Analysis Factor Analysis
Physical oriented Clinical and Image Country Encryption
(Sub-dimension) (Sub-dimension) (Sub-dimension) (Sub-dimension)
EPR and patient
Services oriented management Health professionals Regulation
(Sub-dimension) Intra-mural (Sub-dimension) (Sub-dimension)
(Sub-dimension)
Patient access and
Medication list Workstation
safety
(Sub-dimension) (Sub-dimension)
(Sub-dimension)
PHR & tele-monitoring
Hospital
Extra-mural
(Sub-dimension)
(Sub-dimension)

12. Benchmarking eHealth Deployment - Parameters
Indicators Overall Dimension Sub-dimension Weight of Weights of Weights of
weight factors in variables in selected
dimensions summary factor** variables in
indicators*** factor***
Sub-dimension
Computer system connected Infrastructure 0.381 0.464
0.512
Broadband above 50 MBps physical oriented 0.441 0.536
0.25 Infrastructure
Hospital support wireless communications Infrastructure 0.711 0.717
0.488
Hospital video conference facilities service oriented 0.28 0.283
Picture archiving and communication
0.294 0.383
systems (PACS)
An integrated system for tele-radiology Emphasis on 0.242 0.316
0.305
An electronic Clinical Tests clinical and image 0.11 0.143
An electronic service order placing? (e.g.
0.121 0.158
test/diagnostic results)?
An integrated system to send electronic
0.231 0.309
discharge letters Emphasis on EPR
An integrated system to send or receive and patient
0.294 0.223 0.299
electronic referral letters management
0.25 Application
A computerized system for ePrescribing (intramural) 0.171 0.229
Electronic Patient Record (EPR) 0.122 0.163
An integrated system for billing
0.37 0.549
management Emphasis on
An electronic appointment booking patient demand 0.234
0.165 0.245
system? and safety
An adverse health events report system 0.139 0.206
Tele-homecare/tele-monitoring services to Emphasis on PHR
0.509 0.647
outpatients and tele 0.168
Personal Health Record (PHR) monitoring 0.278 0.353

13. Laboratory results Health care providers outside the EU
0.149 0.154
countries
Radiology reports Health care providers outside the EU
0.136 0.140
countries
Clinical information: Health care providers outside the
0.126 0.130
EU countries
Medication lists information Health care providers
0.122 0.126
outside the EU countries
Country 0.353
Laboratory results Health care providers in other EU
0.12 0.124
countries
Radiology reports Health care providers in other EU
0.116 0.120
countries
Clinical information: Health care providers in other EU
0.104 0.107
countries
Medication lists information Health care providers in
0.096 0.099
other EU countries
Laboratory results External specialists 0.25 HIE 0.14 0.179
Laboratory results External general practitioners 0.137 0.175
Radiology reports External general practitioners Health 0.136 0.174
0.328
Clinical informacion: External general practitioners professionals 0.131 0.168
Clinical information: External specialists 0.119 0.152
Radiology reports External specialists 0.118 0.151
Medication lists information External specialists 0.255 0.346
Medication lists information External general
Medication list 0.164 0.252 0.341
practitioners
Medication lists information With a hospital or hospitals
0.231 0.313
outside your own hospital system
Radiology reports With a hospital or hospitals outside
0.257 0.364
your own hospital system
Clinical information: With a hospital or hospitals outside
Hospital 0.154 0.226 0.320
your own hospital system
Laboratory results With a hospital or hospitals outside
0.224 0.317
your own hospital system
Protect the patient data Encryption of all stored data 0.521 0.537
Emphasis on
Protect the patient data Encryption of all transmitted 0.346
encryption 0.45 0.463
data
Security and privacy of electronic patient data at
0.499 0.527
national level Emphasis on
Security & 0.344
Security and privacy of electronic patient data at 0.25 regulation
Privacy 0.447 0.473
regional level
Protect the patient data Workstations with access only
0.569 0.593
through health professional cards Emphasis on
0.31
Protect the patient data Data entry certified with digital workstation
0.391 0.407
signature

15. ,000
0
,100
0
,200
0
,300
0
,400
0
,500
0
,600
0
,700
0
,800
0
,900
0
1,000
0
IRELANDD
DENMARK K
ICELANDD
FINLAND D
SWEDEN N
NORWAY Y
UK
K
AUSTRIAA
CATALONIA A
NETHERLANDS S
LUXEMBOURG G
SPAIN
N
BELGIUM M
BULGARIA A
CROATIA A
FRANCEE
PORTUGAL L
AVERAGE E
CZECH REPUBLIC
H C
Infrastructure
e
LATVIA
A
ITALY
Y
GERMANY Y
CYPRUSS
HUNGARY Y
MALTAA
LITHUANIA A
ROMANIA A
SLOVANIA A
GREECEE
ESTONIA A
POLAND D
SLOVAKIA A

18. ,000
0
,100
0
,200
0
,300
0
,400
0
,500
0
,600
0
,700
0
,800
0
,900
0
1,000
0
UK
K
ESTONIA
A
SWEDEN
N
IRELAND
D
ICELAND
D
CATALONIA
A
SPAIN
N
NORWAY
Y
AUSTRIA
A
DENMARK
K
PORTUGAL
L
ROMANIA
A
ITALY
Y
NETHERLANDS
S
y
GERMANY
Y
AVERAGE
E
FRANCE
E
FINLAND
D
BELGIUM
M
Privacy & Security
y
CZECH REPUBLIC
H C
POLAND
D
HUNGARY
Y
LUXEMBOURG
G
MALTA
A
LITHUANIA
A
GREECE
E
SLOVANIA
A
CROATIA
A
SLOVAKIA
A
CYPRUS
S
BULGARIA
A
LATVIA
A

20. Composite index as:
 Transparent and robust policy-making tool
 Monitoring (results - targets)
 Learning (inputs – process)
 Impact assessment – health indicators

21. Moltes gràcies
Francisco Lupiáñez-Villanueva
@flupianez
http://www.ictconsequences.net
Information Society Unit
European Commission's Joint Research Centre (JRC)
Institute for Prospective Technological Studies (IPTS)
The views expressed in this presentation are those of the authors and do not necessarily reflect the position of the European Commission.
Neither the Commission nor any person acting on behalf of the Commission can be hold responsible for the use which is made of this presentation