"Artificial Intelligence (AI)" - AI use in European healthcare - HIMSS
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„Artificial Intelligence (AI)“
AI use in European
healthcare
www.himss.eu/analytics 1
Results, May 2018
© HIMSS Analytics | eHealth TRENDBAROMETER May 2018
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
© HIMSS Analytics | eHealth TRENDBAROMETER May 2018
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 audience o Key audience: eHealth professionals from several European countries, especially:
and participants 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. 300 – 500 per survey wave
Survey period o Typical field time: Approx. 2 months
o Specific field time for „Artificial Intelligence“ TRENDBAROMETER: Access all eHealth TRENDBAROMETERS here:
February – March 2017 www.himss.eu/healthcare- 3
providers/ehealth-trends
© HIMSS Analytics | eHealth TRENDBAROMETER May 2018
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
© HIMSS Analytics | eHealth TRENDBAROMETER May 2018
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 2017.
5 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 2023. 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 to 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 health-
care, 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
© HIMSS Analytics | eHealth TRENDBAROMETER May 2018SAMPLE DISTRIBUTION – SURVEY PARTICIPANTS
Respondent‘s occupation
Geographic distribution
Germany Health facility Software vendor
• CIO (21.5%) • CEO (18.9%)
Austria
21% 20% • Medical Profession (Physician) (21.5%) • Organisational and Corporate
Switzerland • IT Staff (15.2%) Governance (15.6%)
Netherlands • Medical Profession (Nurse, Pharmacist...) • IT Staff (7.8%)
9% n=562 7%
(5.9%) • Researcher/Scientist (7.8%)
Nordic Countries
7% 12% • Organisational and Corporate • Software Developer (5.6%)
Italy Governance (5.6%) • CIO (4.4%)
16% 8%
Spain • CMO (4.8%) • Quality Management Staff (3.3%)
Other • CEO (4.8%) • Other position (86.7%)
• Quality Management Staff (4.4%)
Country n
Germany 121
• Researcher/Scientist (4.4%)
Switzerland 65 • Other position (11.9%)
Spain 50 n=562
Netherlands 44 Other Governmental health authority
Austria 42 • Researcher/Scientist (32.6%) • Organisational and
Countries or regions Other* 41 • CEO (14.9%) Corporate Governance
with more than 30 Italy 37 • Organisational and Corporate (26.6%)
participants are Denmark 32 Governance (8.5%) • CIO (17.2%)
shown individually. Belgium 25 • IT Staff (4.3%) • IT Staff (15.6%)
Sweden 22 • Quality Management Staff (3.5%) • Researcher/Scientist (10.9%)
*„Other“ respondents Norway 20
are from: Greece, • CIO (2.1%) • Quality Management Staff (6.3%)
United Kingdom 17
Turkey, Estonia • Other position (34.0%) • CEO (3.1%)
France 16
Finland 15 • Clerk (1.6%)
Ireland 15 • Other position (18.8%)
Total 562
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© HIMSS Analytics | eHealth TRENDBAROMETER May 2018USE 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
© HIMSS Analytics | eHealth TRENDBAROMETER May 2018USE 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
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© HIMSS Analytics | eHealth TRENDBAROMETER May 2018PLANS 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 2021.
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? Do you think your organisation provides
[Only participants who are working in a healthcare facility or for a SW vendor and who have sufficient budget to invest in AI over the
plans to implement/launch AI tools]
next 12 months?
[Only participants who are working in a healthcare facility and
32% who already use or plan to implement AI tools; total including
25% Within 1 year „other“]
37%
… of health facility
respondents have
specific plans to 37%
purchase AI tools 1 - 2 years
39%
34%
Healthcare
providers n=83
23% only
51% 2 - 3 years 66%
17%
… of software
vendor respondents 9%
More than 3 years Yes No
have specific plans 7%
to launch AI tools
Health facility (n=57) Software vendor (n=41) 9
© HIMSS Analytics | eHealth TRENDBAROMETER May 2018TYPE 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
© HIMSS Analytics | eHealth TRENDBAROMETER May 2018CHALLENGES 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 Lack of Data Privacy Interope- Lack of legal Lack of Insufficient High costs Lack of trust Implemen-
maturity of trust from rability with approval to sufficient user from tation of
the products medical other soft- use AI high quality education/ patients new
available staff /hardware applications data to train knowledge software
on the AI tools
market 11
© HIMSS Analytics | eHealth TRENDBAROMETER May 2018CHALLENGES 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]
Netherlands
Switzerland
Countries
Germany
Austria
Insufficient maturity of
Nordic
Spain
Total
Italy
the products available
on the market (18%)
Insufficient maturity of the
Data Privacy (17%) 13% 14% 11% 8% 18% 9% 11% 13%
Data Privacy (16%) products available on the market
Lack of trust from medical
Lack of trust from medical staff 10% 16% 11% 15% 10% 20% 16% 13%
staff / Interoperability with
other soft-/hardware (15%) High Costs (14%) Data Privacy 10% 15% 13% 17% 16% 7% 12% 12%
Insufficient maturity of Interoperability with other soft-
the products available 12% 10% 13% 15% 10% 5% 13% 11%
Data Privacy (13%) /hardware
on the market (13%) Lack of legal approval to use AI
Insufficient user 11% 11% 11% 8% 12% 21% 12% 11%
applications
education/knowledge /
Lack of sufficient high quality
Interoperability with other 9% 8% 11% 8% 13% 13% 15% 11%
data to train AI tools
soft-/hardware (13%) Lack of trust from
Insufficient user
medical staff (16%) 11% 12% 13% 6% 8% 11% 8% 11%
education/knowledge
Data Privacy (15%)
High costs 13% 5% 7% 7% 5% 8% 6% 8%
Lack of trust from patients 5% 5% 6% 5% 2% 2% 4% 4%
Lack of legal approval to
Lack of trust from medical staff (16%) use AI applications (21%) Implementation of new software 2% 3% 2% 5% 3% 1% 4% 3%
Lack of sufficient high quality data to Lack of trust from
N answers 334 118 174 111 220 85 137 1490 12
train AI tools (15%) medical staff (20%)
© HIMSS Analytics | eHealth TRENDBAROMETER May 2018BENEFITS 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
© HIMSS Analytics | eHealth TRENDBAROMETER May 2018BENEFITS FROM USING AI IN HEALTHCARE – SELECTED QUOTES
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 will allow us to do tasks much more efficiently
and around the clock - like reading Radiology - AI offers the possibility to consider the complete
done by costly professionals who work on a 9-5 knowledge about healthcare and learn from
basis. previous experiences.
AI should help to identify We will gain new insights and knowledge, deliver more care with
“the abnormal" to improved quality, put the patients in the drivers seat, focus human
I think AI is over hyped in healthcare professionals, resources on complex tasks.
Health, it will take long and reduce their
time to achieve cases that workload by helping Apart from settings that require
will give benefit for them to discard AI will offer support creative thinking and rational, AI
patients. everything that is for clinical decision obviously trumps human memory and
normal. making by diversity of knowledge.
analyzing large
volumes of
information, from It will help with the optimization and
AI will help to overcome boundaries between health EMR and any other standardization of procedures, support and
care facilities, early detection or prognosis of diseases, sources of improvement of diagnostic and therapeutic
support doctors in diagnosis and therapy. information. safety
14
Selected quotes related to the question: “In your opinion, which are the biggest benefits from using AI in healthcare?”
© HIMSS Analytics | eHealth TRENDBAROMETER May 2018BENEFITS 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
© HIMSS Analytics | eHealth TRENDBAROMETER May 2018BENEFITS 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]
Netherlands
Switzerland
Countries
Germany
Austria
Nordic
Spain
Total
Italy
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%
Save time (13%) Improve quality of Improve diagnostics 13% 10% 8% 7% 8% 8% 10% 10%
care (22%)
Process large amount of data 8% 8% 15% 7% 16% 4% 10% 10%
Improve diagnostics
Improve quality of care (18%) (13%) Lower costs 9% 3% 10% 9% 3% 9% 8% 8%
Process large amount of
data(15%) Save time 11% 5% 10% 13% 8% 4% 6% 8%
Improve quality of care (23%)
Reduce medical errors 4% 8% 7% 7% 2% 8% 10% 7%
Improve medical decision
making / Improve diagnostics Standardize processes 4% 10% 7% 4% 3% 6% 2% 5%
/ Standardize processes (10%)
Generate new knowledge 3% 0% 3% 9% 8% 4% 6% 5%
Improve medical decision Improve precision medicine 2% 3% 0% 6% 3% 4% 4% 3%
Improve medical decision making (25%)
Relief of personnel 7% 3% 5% 0% 3% 2% 0% 3%
making (25%) Improve quality of care
(21%) 16
Improve quality of care (13%) N answers 116 39 60 54 97 53 52 619
© HIMSS Analytics | eHealth TRENDBAROMETER May 2018YEAR 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 2023. 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 a more cautious 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?
Country n Average estimated
year of AI
Average year of breakthrough
AI breakthrough
Optimistic
countries
Netherlands 41
2023 Spain
Italy
45
35
2022
Germany
Nordic 103
Countries 82 2023
Other 107
Countries
countries
Cautious
Austria 35
2024
Switzerland 55
Total 503 2023
17
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)
© HIMSS Analytics | eHealth TRENDBAROMETER May 2018MOST 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 Health facility IT Software vendor Governmental health authority
n=308 n=136 n=50 n=36
18
© HIMSS Analytics | eHealth TRENDBAROMETER May 2018BUSINESS EXPECTATIONS
Business prospects for the eHealth sector continue to be positive, albeit at a slightly lower level than at the end of 2017. Dutch eHealth
professionals are particularly optimistic, 77% expect an improvement and only 2% believe the situation will become
-100 +100 worse. The dip seen last
year in the UK appears to have been temporarily only, with ratings having picked up this time. However, due to the relative low response from
UK participants in the current survey wave this needs to be interpreted 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]
Results by country (2018 – Q1)
Very positive expectations
worse steady improve N
89
Germany 10% 40% 50% 121
Balance of business expectations*
74 77 73 73 75
65 69
65 69 70 Austria 12% 50% 38% 42
57 60 60
52 54
50 48 53
49 Switzerland 11% 42% 48% 65
42 43 46
38 36
35 35 Netherlands 2% 20% 77% 44
28 30
24 27 Belgium 0% 32% 68% 25
Denmark 13% 38% 50% 32
-6 Norway 5% 25% 70% 20
20151– Q2 20152– Q3 20163– Q2 20164– Q3 20165– Q4 20176– Q2 20177 – Q3 20188– Q1 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% 562
Very negative expectations
DACH Nordic Countries Netherlands UK All countries
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© HIMSS Analytics | eHealth TRENDBAROMETER May 2018Thank you for your participation!
HIMSS Analytics
Office Leipzig
Schwägrichenstraße 9
04107 Leipzig
Germany
www.himss.eu/analytics
www.himssanalytics.org
Join the European eHealth community panel
research@himssanalytics.eu
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