The document summarizes key facts about the connected health market in Europe. It notes that the EU population is over 500 million people served by national public health systems with universal coverage. While systems differ by country, expenditures average around 9% of GDP. Chronic diseases represent 80% of health costs and the population is aging. The document then highlights details on Germany, France, UK and EU-wide characteristics, noting fragmentation across countries and a transition toward preventative and personalized health.

1. Connected Health market in Europe
Health & Wellness @ Mobile World Congress 2015
www.echalliance.com / info@echalliance.com
European Connected Health Alliance
Bringing Together the future of Health, Social Care & Wellness

2. European market of Connected Health
• EU Population (2014) = 507,4 millions
• European Union (EU) = 28 countries
• Health system resources & activities
• 3,4 physicians per 1000 population
• 8 nurses per 1000 population
• 35% GPs / 65% specialists
• 6,3 consultations per person per a year
• 5,3 hospital beds per 1000 population (decreasing)
• 7 days average length of stay at hospital

3. European market of Connected Health
• Health system organisation at a glance
– 28 countries in Europe with national rules
– Different models but in all countries a principle : “Universal cover”
– Strong position of public sector in Health systems (73% of Health expenditures)
– Not a EU centralized decision: national budgets, national Health policy and own priorities
– European Commission: only trends and policy for Research and Innovation
– Mix of Private/Public GPs, Specialists
– GPs as main gate: Many countries give incentives to patients in order to start he care
pathway with the GP

4. European market of Connected Health
• Demographic/Epidemiologic facts & figures
– Life expectancy
– Women 86,1
– Men 82,7
– Chronic diseases
• Leading cause of mortality and morbidity in Europe
• Around 80% of global health expenditures (966 billions $USD)
– Ageing population
• Around 20% of European citizens have +60 years old
• 30% in 2030

5. European market of Connected Health
• Financial facts & figures
– Health Expenditures
• 2266 $USD per capita
• 9 % of EU GDP (1150 billions $USD)
– Funders/payers
• For Health: national funds (mainly tax-based), regional health trusts, hospitals, private
insurances
• For Ageing: local authorities are purchasers supported by national funds (tax-based),
private insurances
• For wellness: costumers, some local authorities (tax-based)
– Private insurances (26% of the expenditures)
• Complementary insurance: cover the cost-sharing with public coverage
• Supplementary: additional services
• Duplicate: access faster or larger choice of providers

6. European market of Connected Health
• Health Expenditures % GDP

7. European market of Connected Health
• Health Expenditures by function

8. European market of Connected Health
• Key figures
– Population = 81,8 M
– Health expenditures = 376,2 billions $USD (11,3% GDP / 4 599 $USD/capita)
• Health System key characteristics
– Basis concept: universal access
– Sharing of decision-making powers between the sixteen Länder (states), the federal government and
statutory civil society organizations
• The ministries in each Land (state) are responsible for passing their own laws, supervising subordinate
authorities, and financing investment in the hospital sector
– Statutory health insurance (SHI) (public)
– Private insurances : primary and complementary (choice of citizens – 10%)
• Connected Health in Germany
– 2000: concept of Integrated Care possibility to sign contracts directly with health insurances on Home
care
– 2004: laws for Interoperability between states and PHR with electronic cards (Gematik)
– 2009: Risk stratification of patients – new way of funds sharing
GERMANY

9. European market of Connected Health
FRANCE
• Key figures
– Population = 65,3 M
– Health expenditures = 275,2 billions $USD (11,6% GDP / 4 215 $USD/capita)
• Health System key characteristics
– Centralization of decision: ministry of Health, National Health Authority (HAS)
– Strong National Public Insurance (100% for chronic diseases expenditures)
– Private insurances : only complementary (96% of french population)
– Private GPs
• Connected Health in France
– 2009: creation of regional Health agency
– 2009: national framework of Interoperability – national EHR
– 2010: law about Telemedicine, definition of medical acts but no pricing
– 2013: new National Health strategy – centered on patients and GPs
– 2015: 1st pricing program for Remote monitoring for chronic diseases
– 2015: connected health program (new EHR, chronic diseases services, imaging systems…) / 80M€ invested
by the government in 5 regions
– 2015-16: Ageing new law / population support program, around 200+ M€

10. European market of Connected Health
UNITED KINGDOM
• Key figures
– Population = 63,2 M
– Health expenditures = 229 608 millions $USD (9,4% GDP / 3 633 $USD/capita)
• Health System key characteristics
– National Health Service: 100% public system, managed by the central state
– Universal public service - Free for the citizens
– Organization
• Primary Care Trust (PCT): manage a local area (GPs, nurses, social care and patients)
• Strategic Health Authorities (SHA): assess PCTs and manage funds
• Foundation trusts: hospitals with a large autonomy, free to contract with different providers
– Specificities in Scotland (NHS24) and in Northern Ireland
• Connected Health in UK
• Since 2005: eHealth program with NHS Connecting for Health, 20,7 M$USD; with different
projects: PACS, VPN for Hospitals, Booking for professionals, PHR (Care Records Services)
• 2015: new NHS’ program / PHR on web platform and mobile apps

11. European market of Connected Health
• EU Key characteristics
– Fragmentation of the market
• 28 countries with Regional approaches
• Proof of concept (clinical trials / each country)
• Business models & procurement issues (public procurement)
• Lack of interoperability and legal harmonization within the EU
– Mainly public health and social care systems in Europe
– Policies & Innovation funding programs for Connected Health
– Paradigms transition: from curative to preventive, personalised health
– Private sector is a complement or a substitution or a duplicate system

12. European Connected Health Alliance
Bringing Together the future of Health, Social Care & Wellness
www.echalliance.com / info@echalliance.com
Julien Venne, Strategic Advisor – julien@echalliance.com