Benchmarking deployment of eHealth among GPs

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RAND Europe and Open Evidence measured the use of information and communication technologies (ICTs) and eHealth applications by primary care physicians in the EU and compared it with the results of a 2013 study. They found that eHealth adoption in primary healthcare in Europe increased from 2013 to 2018, with variations by country.

The researchers also found that a majority of GPs surveyed consider ICTs to be useful for their practice, both for its effectiveness and the quality of care. The number of GPs enthusiastic about the impacts of eHealth has more than doubled, from 13% to 27%, between 2013 and 2018.


“Europe is facing a healthcare crunch as a result of our ageing population”. In 2014, the then Vice President of the European Commission, responsible for the Digital Agenda for Europe, explained the need for increased uptake of the eHealth action plan (2012 to 2020). Broadly defined, eHealth is the use of Information and Communication Technologies (ICT) in all things health – from products, services and processes to organisational changes in healthcare systems. By adopting and deploying eHealth, EU member states hope to reduce healthcare costs, increase the efficiency of healthcare and give more control to patients.

In 2008 and 2013, two major studies on benchmarking eHealth among General Practitioners in Europe were conducted. Almost ten years after the first study, RAND Europe, together with Open Evidence and BDI Research, conducted a third benchmarking study. Commissioned by the European Commission, this research offered the first opportunity to identify long-term trends in eHealth and to assess what this means for healthcare in Europe.


The study’s aims were to measure the use of ICT and eHealth applications by primary care physicians in the EU. Comparing results with the 2013 study, the researchers analysed the main drivers of change and factors that can enhance or inhibit the role and use of technologies within health care.


The study was conducted via a data collection and analysis approach, including a rapid evidence assessment of work published since 2013, as well as a survey of almost 6,000 GPs conducted between January and June 2018.


Adoption levels of eHealth among countries analysed

  • Overall, eHealth adoption in primary healthcare in Europe has increased from 2013 to 2018, but there are differences among the countries surveyed. On average, this has been more so among NHS system countries, compared with social insurance and transition countries.
  • eHealth adoption correlates with the type of practice. GPs working in health centres and group practices have higher adoption levels than those working in solo practices or freelance.
  • Electronic Health Record (EHR) is currently available across all analysed EU countries, with basic health data functionalities almost fully adopted in all, whilst more than half are routinely using clinical decision support functionalities as well.
  • Health Information Exchange (HIE) is lower than EHR adoption. However, there has been a large increase in functionalities to certify sick leaves and transfer prescriptions to pharmacists.
  • Telehealth has shown progress, but is still relatively low in its availability and use. While training and education functionalities have shown an increase in availability to GPs, from 36% in 2013 to over 50% in 2018, the availability of telehealth communications with patients (12%) and telemonitoring (4%) are still low.
  • Personal Health Records adoption levels appear similar to Telehealth. While the availability of functionalities to request appointments and prescriptions has increased, as well as the options for patients to view their medical records and test results, this has been in only a handful of countries.

Opinions of GPs concerning eHealth

  • The majority of GPs surveyed consider ICTs to be useful for their practice, both for its effectiveness and the quality of care. However, they are more sceptical about the positive impact on waiting lists, patient satisfaction and the efficiency of consultations. GPs also claimed a lack of positive eHealth impact on the doctor-patient relationship.
  • Financial difficulties, operability issues and confidentiality and privacy were perceived as the main barriers to eHealth adoption.
  • The number of GPs enthusiastic about the impacts of eHealth, regardless of the barriers, has however increased from 13% to 27% between 2013 and 2018.