AI use in European healthcare
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1 Artificial Intelligence (AI) AI use in European healthcare Results, May
2 TABLE OF CONTENT Introduction & methodology page 3 Survey questions page 4 Results Key Findings page 5 Used and planned Artificial Intelligence (AI) tools page 7 Budget for AI investments page 11 Challenges for AI in healthcare page 12 Benefits from AI in healthcare page 13 Breakthrough for AI tools in healthcare page 17 Most advanced country with regards to the use of AI in healthcare page 18 Business expectations page 19 2
3 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 Study design Target audience and participants 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 o Structured quantitative online survey o Quick completion (time-to-complete is < 5 min) o Survey language(s): English, German o Participation via personal invitation or via public link on and other channels o 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) o Number of participants: approx per survey wave Survey period o Typical field time: Approx. 2 months o Specific field time for Artificial Intelligence TRENDBAROMETER: February March 2018 Access all ehealth TRENDBAROMETERS here: 3
4 SURVEY QUESTIONS Main Topic: Artificial Intelligence 1. What type of organisation are you working for? 2. Does your organisation already use or do you have specific plans to implement/provide Artificial Intelligence (AI) tools? 3. When will the planned AI tools be implemented/launched? 4. In which areas does your organisation use/have or plan to implement/provide AI tools? 5. Do you think your organisation provides sufficient budget to invest in AI over the next 12 months? 6. In your opinion, which are the biggest challenges for AI in healthcare? 7. In your opinion, which are the biggest benefits from using AI in healthcare? 8. When do you expect a breakthrough for AI tools in healthcare, i.e. when will they become powerful, useful and widespread in your country? 9. In your opinion, which country has made most progress so far with regards to the use of AI in healthcare? 10. How will the environment for ehealth innovation and investment in your country develop over the next 12 months? Artificial Intelligence in this study is defined as computer applications designed to sense, understand, act and learn so that they can perform administrative and clinical healthcare functions, either on their own or to augment human activities. Typically, this would include the use of deep learning technology. 4
5 KEY FINDINGS ehealth Business climate: The business trend for ehealth continues to be positive, albeit at a slightly lower level than at the end of Lessons on Artificial Intelligence (AI) in healthcare Lesson 1: Healthcare providers are just starting to use AI tools. Only 16% of healthcare facilities in Europe currently use AI tools (of which they are aware). In general the use of AI tools in health facilities appears to trail significantly behind what the industry is already offering. The variety of available AI tools is pretty broad, with solutions that provide better workflow support slightly dominating. The Nordic countries and the Netherlands are European pioneers in the use of AI tools. Lesson 2: AI for healthcare is a growing market expected to breakthrough in 5 years. Get ready to see AI tools being used all over the place in about 5 years. ehealth professionals expect them to be powerful, useful and widespread by In the meantime, 21% of health facilities have specific purchase plans for AI tools, every second software vendor plans new product launches in that field, and nearly all of this will be executed within the next 3 years. However, health facilities remain cash-strapped, with a majority not having sufficient budgets for AI, at least in the near term. Lesson 3: AI tools must mature and confidence in products needs to be increased. Employees from health facilities and governmental authorities are concerned about the maturity of currently existing AI tools. Software vendors are aware of those concerns and will face this lack of trust from clinicians and other potential customers. AI tools also need to prove that they can handle data privacy and are either providing a clear return on investment or can be implemented and used relatively inexpensively. Lesson 4: This is no hype! ehealth professionals, users and producers, see a world of opportunities for AI use in healthcare. ehealth professionals appear very confident that AI will help to improve care quality, support clinicians to take better and more informed decisions, provide more personalised treatments, enable healthcare professionals to save time, be more efficient, focus on complex or urgent cases etc. Software vendors in particular also highlight the potential that AI will help to reduce medical errors, raise efficiency and enable cost savings which needs to be proven. Lesson 5: The US is considered the most advanced country in terms of using AI in healthcare. The European ehealth community has the impression that the US is the key market for AI tools and usage at the moment. A mature IT infrastructure in healthcare, a large market with 325 million citizens and the fact that the most successful and innovative software vendors and venture capitalists are located there, might stimulate that impression. In Europe, the Nordic countries (incl. Estonia) are perceived to be most advanced to use AI tools. 5
6 SAMPLE DISTRIBUTION SURVEY PARTICIPANTS Germany Austria Switzerland Netherlands Nordic Countries Italy Spain Other Geographic distribution Countries or regions with more than 30 participants are shown individually. * Other respondents are from: Greece, Turkey, Estonia 9% 7% 21% n=562 16% 20% 8% 7% 12% Country n Germany 121 Switzerland 65 Spain 50 Netherlands 44 Austria 42 Other* 41 Italy 37 Denmark 32 Belgium 25 Sweden 22 Norway 20 United Kingdom 17 France 16 Finland 15 Ireland 15 Total 562 Health facility CIO (21.5%) Medical Profession (Physician) (21.5%) IT Staff (15.2%) Medical Profession (Nurse, Pharmacist...) (5.9%) Organisational and Corporate Governance (5.6%) CMO (4.8%) CEO (4.8%) Quality Management Staff (4.4%) Researcher/Scientist (4.4%) Other position (11.9%) Other Researcher/Scientist (32.6%) CEO (14.9%) Organisational and Corporate Governance (8.5%) IT Staff (4.3%) Quality Management Staff (3.5%) CIO (2.1%) Other position (34.0%) Respondent s occupation Software vendor CEO (18.9%) Organisational and Corporate Governance (15.6%) IT Staff (7.8%) Researcher/Scientist (7.8%) Software Developer (5.6%) CIO (4.4%) Quality Management Staff (3.3%) Other position (86.7%) n=562 Governmental health authority Organisational and Corporate Governance (26.6%) CIO (17.2%) IT Staff (15.6%) Researcher/Scientist (10.9%) Quality Management Staff (6.3%) CEO (3.1%) Clerk (1.6%) Other position (18.8%) 6
7 USE OF AI TOOLS BY TYPE OF ORGANISATION The vast majority of health professionals in Europe (84%) currently does not use AI (Artificial Intelligence) tools, or are at least not aware of it. One out of four health professionals is aware about specific plans to implement AI tools over the next 1 3 years. Software vendors are a bit ahead of the curve. More than one out of four (28%) already offer AI tools, and another 51% have specific plans to launch such products. We expect this to become a very competitive market over the next few years due to many new solution providers entering that sector, many of them being start-ups or established companies from non-healthcare related industry segments. Does your organisation already use or do you have specific plans to implement/provide Artificial Intelligence (AI) tools? [Only participants who are working in a healthcare facility or for a SW vendor] 7
8 USE OF AI TOOLS BY COUNTRY OR REGION Healthcare providers in the Nordic countries and the Netherlands are at the forefront of AI usage in Europe. At the bottom of the table are the D-A-CH countries, with just 5% to 10% of health professionals currently using AI tools. When looking at plans to purchase and implement AI tools it also appears that healthcare professionals in Germany and Austria are more cautious than their peers in other countries to use such products in the near future. However, in general the demand for AI tools is certainly increasing, especially in Switzerland and Spain where between 37% to 42% of health professionals claim to have purchase plans for AI solutions. Does your organisation already use or do you have specific plans to implement Artificial Intelligence (AI) tools? [Only participants who are working in a healthcare facility; total including other ] Nordic Countries n=29 Netherlands n=18 Italy n=16 Spain n=19 Switzerland n=30 Germany n=68 Austria n=21 Total n=249 8
9 PLANS AND BUDGETS FOR AI TOOLS BY TYPE OF ORGANISATION If plans exist to implement or launch AI tools, most of them will be realised within the next 2 years. This is similar for healthcare providers as for software vendors. In general, more than 90% of already existing plans will be realised within a 3-year period, i.e. by the year Despite the interest and will to purchase AI tools, lack of funds can be a roadblock for healthcare providers, at least in the short term. 34% of those that already have plans claim that their organisation doesn t provide a sufficient budget to invest in AI over the next 12 months. When will the planned AI tools be implemented/launched? [Only participants who are working in a healthcare facility or for a SW vendor and who have plans to implement/launch AI tools] 25% of health facility respondents have specific plans to purchase AI tools 51% Within 1 year 1-2 years 2-3 years 17% 23% 32% 37% 37% 39% Healthcare providers only Do you think your organisation provides sufficient budget to invest in AI over the next 12 months? [Only participants who are working in a healthcare facility and who already use or plan to implement AI tools; total including other ] 34% n=83 66% of software vendor respondents have specific plans to launch AI tools More than 3 years 7% 9% Yes No Health facility (n=57) Software vendor (n=41) 9
10 TYPE OF AI TOOLS BY TYPE OF ORGANISATION At the moment, healthcare providers use AI tools most frequently for Workflow Assistance (14%) and in Research (13%), closely followed by Medication Administration (12%) and Radiology (11%). Those areas, plus Oncology, are also where healthcare providers have most of their AI investment plans. A similar pattern is visible when looking at what software vendors already offer, or plan to launch in the near future. AI tools that provide better workflow support for clinicians or offer a preliminary diagnosis stand a bit out and appear to be exceptionally promising for software vendors. In which areas does your organisation use/have or plan to implement/provide AI tools? [Only participants who are working in a healthcare facility or IT software vendor and who already use/have or plan to implement/provide AI tools] 10
11 CHALLENGES FOR AI IN HEALTHCARE BY TYPE OF ORGANISATION Overall, a lack of product maturity and trust from medical staff are perceived to be the biggest challenges for a more widespread use of AI in healthcare. This perception differs quite significantly by type of organisation. Software vendors on the one hand are currently mostly challenged by having insufficient access to high quality data to train their AI tools as well as missing trust from medical staff in their tools. Health facility employees on the other hand are cautious to use or purchase AI tools because they think they are immature, too expensive and there s a lack of knowledge about their availability and capabilities. Governmental health authorities tend to be more concerned about gaps regarding to the interoperability of those tools (15%). In your opinion, which are the biggest challenges for AI in healthcare? [multiple responses possible] Insufficient maturity of the products available on the market Lack of trust from medical staff Data Privacy Interoperability with other soft- /hardware Lack of legal approval to use AI applications Lack of sufficient high quality data to train AI tools Insufficient user education/ knowledge High costs Lack of trust from patients Implementation of new software 11
12 Germany Austria Switzerland Netherlands Nordic Countries Italy Spain Total CHALLENGES FOR AI IN HEALTHCARE BY COUNTRY OR REGION Italian ehealth professionals identify legal approval issues (21%) and lack of trust (20%) from medical staff as biggest roadblocks for more widespread use of AI solutions. Professionals from the Nordics are waiting for more mature AI solutions (18%). Dutch professionals are challenged by data privacy regulations (17%). Germans are concerned about high costs (13%). In your opinion, which are the biggest challenges for AI in healthcare? [Total including other ; overall top 2 answers; multiple responses possible] Data Privacy (17%) Lack of trust from medical staff / Interoperability with other soft-/hardware (15%) Data Privacy (13%) Insufficient user education/knowledge / Interoperability with other soft-/hardware (13%) Insufficient maturity of the products available on the market (18%) Data Privacy (16%) High Costs (14%) Insufficient maturity of the products available on the market (13%) Lack of trust from medical staff (16%) Data Privacy (15%) Insufficient maturity of the products available on the market 13% 14% 11% 8% 18% 9% 11% 13% Lack of trust from medical staff 10% 16% 11% 15% 10% 20% 16% 13% Data Privacy 10% 15% 13% 17% 16% 7% 12% 12% Interoperability with other soft- /hardware Lack of legal approval to use AI applications Lack of sufficient high quality data to train AI tools Insufficient user education/knowledge 12% 10% 13% 15% 10% 5% 13% 11% 11% 11% 11% 8% 12% 21% 12% 11% 9% 8% 11% 8% 13% 13% 15% 11% 11% 12% 13% 6% 8% 11% 8% 11% High costs 13% 5% 7% 7% 5% 8% 6% 8% Lack of trust from medical staff (16%) Lack of sufficient high quality data to train AI tools (15%) Lack of legal approval to use AI applications (21%) Lack of trust from medical staff (20%) Lack of trust from patients 5% 5% 6% 5% 2% 2% 4% 4% Implementation of new software 2% 3% 2% 5% 3% 1% 4% 3% N answers
13 BENEFITS FROM USING AI IN HEALTHCARE OVERALL RESULTS The advent of new AI solutions, many of them based on artificial neural networks and deep learning, trigger a lot of optimism to improve health outcomes and enable new ways to deliver healthcare services. Many statements from ehealth professionals circle around the hope that AI will help to improve care quality, support clinicians to take better and more informed decisions, provide more personalised treatments, enable healthcare professionals to save time, be more efficient, focus on complex or urgent cases etc. While there is a lot of enthusiasm, some ehealth professionals also raise their concerns about AI currently being a hype and that real benefits are, at best, to be seen in many years. In your opinion, which are the biggest benefits from using AI in healthcare? [free text responses] 13
14 BENEFITS FROM USING AI IN HEALTHCARE SELECTED QUOTES AI will allow us to do tasks much more efficiently and around the clock - like reading Radiology - done by costly professionals who work on a 9-5 basis. It will enable each citizen drive their health and well-being, to improve the overall quality, access and cost effectiveness of our healthcare services. AI offers the possibility to consider the complete knowledge about healthcare and learn from previous experiences. I think AI is over hyped in Health, it will take long time to achieve cases that will give benefit for patients. AI should help to identify the abnormal" to healthcare professionals, and reduce their workload by helping them to discard everything that is normal. AI will help to overcome boundaries between health care facilities, early detection or prognosis of diseases, support doctors in diagnosis and therapy. We will gain new insights and knowledge, deliver more care with improved quality, put the patients in the drivers seat, focus human resources on complex tasks. AI will offer support for clinical decision making by analyzing large volumes of information, from EMR and any other sources of information. Apart from settings that require creative thinking and rational, AI obviously trumps human memory and diversity of knowledge. It will help with the optimization and standardization of procedures, support and improvement of diagnostic and therapeutic safety Selected quotes related to the question: In your opinion, which are the biggest benefits from using AI in healthcare? 14
15 BENEFITS FROM USING AI IN HEALTHCARE BY TYPE OF ORGANISATION AI is expected to improve the quality of care. Especially professionals working in health facilities (21%) see this as a key benefit. Those professionals think that, if rightly used, AI will support better medical decisions and improve diagnostics. Software vendor professionals on the other hand focus more on error reduction, efficiency gains and cost savings when they think about AI benefits. Health authority representatives perceive AI to be very beneficial by helping to process large amounts of data (to support clinicians to take better medical decisions). In your opinion, which are the biggest benefits from using AI in healthcare? [free text responses, categorised by HIMSS] 15
16 Germany Austria Switzerland Netherlands Nordic Countries Italy Spain Total BENEFITS FROM USING AI IN HEALTHCARE BY COUNTRY OR REGION In general country differences are rather nuanced. Italian ehealth professionals appear to have the biggest expectations regarding AI helping to improve care outcomes and supporting better clinical decision making. In Austria there s little hope that AI will contribute to decrease healthcare costs or leads to time savings. Swiss and Nordic professionals perceive to gain value from AI by processing large amounts of (patient) data. In your opinion, which are the biggest benefits for AI in healthcare? [Total including other ; overall top 2 answers; free text responses, categorised by HIMSS] Improve quality of care (21%) Process large amount of data (16%) Improve quality of care 22% 23% 18% 19% 21% 21% 13% 19% Improve quality of care (19%) Improve medical decission making 9% 10% 10% 11% 12% 25% 25% 13% Improve quality of care (18%) Process large amount of data(15%) Save time (13%) Improve quality of care (22%) Improve diagnostics (13%) Improve quality of care (23%) Improve medical decision making / Improve diagnostics / Standardize processes (10%) Improve diagnostics 13% 10% 8% 7% 8% 8% 10% 10% Process large amount of data 8% 8% 15% 7% 16% 4% 10% 10% Lower costs 9% 3% 10% 9% 3% 9% 8% 8% Save time 11% 5% 10% 13% 8% 4% 6% 8% Reduce medical errors 4% 8% 7% 7% 2% 8% 10% 7% Standardize processes 4% 10% 7% 4% 3% 6% 2% 5% Generate new knowledge 3% 0% 3% 9% 8% 4% 6% 5% Improve medical decision making (25%) Improve quality of care (13%) Improve medical decision making (25%) Improve quality of care (21%) Improve precision medicine 2% 3% 0% 6% 3% 4% 4% 3% Relief of personnel 7% 3% 5% 0% 3% 2% 0% 3% N answers
17 Cautious countries Optimistic countries YEAR OF BREAKTHROUGH FOR AI TOOLS IN HEALTHCARE Get ready for widespread use of AI in 5 years! According to their own estimation, ehealth professionals in Europe will routinely and effectively use Artificial Intelligence tools by Respondents from southern Europe and the Netherlands are a bit more enthusiastic and expect a breakthrough by 2022 while their peers from Austria or Switzerland are more cautious and see it happen 2 years later. When do you expect a breakthrough for AI tools in the healthcare space, i.e. when will they become powerful, useful and widespread in your country? Average year of AI breakthrough 2023 Country n Average estimated year of AI breakthrough Netherlands Spain Italy Germany Nordic Countries Other Countries Austria Switzerland Total Grey line: percent of respondents indicating a specific year of AI breakthrough Columns: cumulated percentage of respondents (i.e. no respondent indicated a year after 2028) 17
18 MOST ADVANCED COUNTRY WITH REGARDS TO THE USE OF AI BY TYPE OF ORGANISATION The vast majority sees the US as a pioneer in the field of using AI in healthcare (Total: 52%). Estonia was rated as the most advanced European country (8%), especially from the perspective of health facility employees. Software vendors rather see Denmark and Finland in the lead in Europe when it comes to the use of AI. In your opinion, which country has made most progress so far with regards to the use of AI in healthcare? [Total including other ] Total n=308 Health facility n=136 IT Software vendor n=50 Governmental health authority n=36 18
19 Balance of business expectations* BUSINESS EXPECTATIONS Business prospects for the ehealth sector continue to be positive, albeit at a slightly lower level than at the end of Dutch ehealth professionals are particularly optimistic, 77% expect an improvement and -100 only 2% believe the situation will become +100 worse. The dip seen last year in the UK appears to have been temporarily only, with ratings having picked up this time (not shown in chart, due to low response rate in current survey wave, please interpret carefully). 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] Very positive expectations Q Q Q Q Q Q Q Q1 Please note: trend lines will only be shown if we have data from >30 participants over more then 3 survey waves Very negative expectations DACH Nordic Countries Netherlands UK All countries Results by country (2018 Q1) worse steady improve N Germany 10% 40% 50% 121 Austria 12% 50% 38% 42 Switzerland 11% 42% 48% 65 Netherlands 2% 20% 77% 44 Belgium 0% 32% 68% 25 Denmark 13% 38% 50% 32 Norway 5% 25% 70% 20 Sweden 0% 27% 73% 22 Finland 0% 20% 80% 15 United Kingdom 18% 24% 59% 17 Italy 11% 51% 38% 37 Spain 10% 43% 47% 49 All countries 9% 37% 54%
20 Thank you for your participation! HIMSS Analytics Office Leipzig Schwägrichenstraße Leipzig Germany Join the European ehealth community panel research@himssanalytics.eu 20
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