1. EHCI – the handbook on healthcare systems!
2. Setting the standard for hepatitis care - EHepI
3. Medequality
4. EU patient mobility
5. Arab Health

Published since 2005, the Euro Health Consumer Index (EHCI) has become a standard reference source for everyone in the need of reliable, up-to-date facts about national healthcare systems in 34 European countries. The monitoring and analyses provide unique and easily accessible data about areas such as patient rights and information, waiting times, treatment outcomes, the generosity of each national system as well as access to pharmaceuticals.

– On a monthly base, more than 2 000 unique visitors consult with the EHCI in the website of the Health Consumer Powerhouse, says the HCP webmaster Mr Hans Eriksson. Each time there is a new annual publication there are of course many more visitors but also the steady visitor level tells us about a sustainable interest in the Index.

– From our regular communication with governments and national health authorities we know that the EHCI as well as other Indices more and more serve as handbooks for experts, comments Dr Arne Bjornberg. Our indices provide lots of data available nowhere else in an easily digestible format. Further, our publications prove to have a long life-span through channels such as Euractive, Google and today also Facebook.

On Google, “Euro Health Consumer Index 2012 report” presently indicates 5.8 million hits.

– Viral hepatitis belongs to the group of the top 10 infectious killer diseases in Europe: 125,000 Europeans die from viral hepatitis each year. 23 Million Europeans suffer from chronic hepatitis type B or C. Despite its considerable impact, and although small efforts could already yield major improvements, viral hepatitis still does not receive much attention by health policymakers, says Achim Kautz, vice president of ELPA (European Hepatitis Patient Association).

– For this reason, ELPA are pleased that the Euro Hepatitis Index is now available. For the first time, we now have an overview about how states perform in the struggle against viral hepatitis how in EU 27 + Norway, Switzerland and Croatia. Now we are able to share existing best practice examples amongst all countries, and work on solutions on a national as well as a European level. This index is an innovative tool to fight against hepatitis, declares Mr Kautz.

Population screening especially in risk groups is not conducted systematically in most EU Member States, making it the weakest spot of hepatitis care policies in comparison to prevention and treatment. This is one of the key results of the "Euro Hepatitis Care Index", a comparison of the performance of hepatitis care in 27 EU Member States, Switzerland, Norway and Croatia, which has been published on 6 November in Brussels in the framework of a conference supported by the Cypriot EU Presidency. Consequently, a large proportion of infections will be detected late, leading to secondary damage and making it more likely that patients unknowingly pass on the virus. This finding confirms observations made by patients’ associations and practitioners.

Tatjana Reic, ELPA President, comments: "Even rich countries like Germany do not perform well on screening. We have the doctors, nurses and facilities in Europe, many are excellent, but they do not treat as many patients as they could because there is no effective and systematic screening to detect patients early. Unrecognised hepatitis leads to severe damage of the liver and cancer which makes an infection with hepatitis a potentially life-threatening condition."

The Euro Hepatitis Care Index has been put together by Swedish think tank Health Consumer Powerhouse (HCP) on behalf of and funded by ELPA. First place is held by France, followed by Slovenia and Germany.”

(Quote from one of numerous media clippings on the EHepI).

The EU healthcare market is characterized by huge inequalities with regard to access to pharmaceuticals. As the above graph reveals, such inequalities are not only a matter of financial resources but can be explained by variations in therapy practice, political priorities, import restrictions and so forth. Or – which is even more upsetting from the patient point of view – the gaps and anomalies can be totally idiosyncratic, depending mainly or entirely on local administrative and/or professional culture streaks.

Health Consumer Powerhouse has developed the diagnostic tool “Medequality™” to identify, measure and describe the variations in pharmaceuticals access and practice. This is a resource of great value to those who want to market and advocate change. For further information about Medequality, please contact Dr. Arne Bjornberg, HCP ( This e-mail address is being protected from spambots. You need JavaScript enabled to view it ).

Positioned by the Brussels EU weekly European Voice as a patient mobility authority, the Health Consumer Powerhouse president is optimistic about the growth of patient mobility information. In an EV article Dec 6 Johan Hjertqvist and DG Sanco Director General Paola Testori Coggi express expectation for a 2013 breakthrough of patient information to support cross-border healthcare. Mr Hjertqvist has already presented his views on this topic in EV May 19, 2011 and Jan 5, 2012.

Full EV article.

Many Arabic countries, especially around the Persian Gulf, have a high per capita spend on healthcare. Patient mobility is a growing phenomenon, with more and more patients looking for regional care options rather than going to Western Europe or the US for treatment, which used to be the pattern. Johan Hjertqvist is invited to lecture at the Arab Health Congress Jan 28-31, 2013, in Dubai. His topic will be: What patient mobility requires when it comes to patient information and outcome transparency and how healthcare management can make open outcomes accounting a competitive force.

For comments and questions about this letter, please turn to: This e-mail address is being protected from spambots. You need JavaScript enabled to view it .
Here you can also subscribe to the HCP newsletter or close you present subscription.

1. Commissioner Dalli on EHCI
2. May 15 is I-Day
3. Slow progress on e-Health
4. Short intro to EHCI 2012
5. I want the next newsletter!

March 27 HCP met with EU health commissioner John Dalli to provide a brief on the upcoming EHCI. We discussed with the commissioner and his cabinet how to develop and use the only recurring measurement of European healthcare.

May 15, 2012 will be the Index Day. The 2012 EHCI, ranking the healthcare performance of 34 European nations, will be presented May 15 10.00 hrs in the European Parliament, Brussels.

We hope to see you at the seminar! Register by sending us the full name, birth date, address, organization and e-mail address of the participant to: This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Please let us know if you already have an EP pass. We will confirm with meeting details.

In the last newsletter we looked into potential impact on European healthcare from the financial crises. So far there are few signals in the EHCI system with regard to negative effects (which of course says little about what might show up in the near future). One possible indication on financial crisis impact might be that there seems to be an increase in waiting times for (expensive) elective surgical procedures, most noticeable in countries which were severely hit by the crisis.

A field which in many healthcare systems has had large investments – with uncertain outcomes – is e-Health. The EHCI 2012 will be looking into indicators such as the penetration of EPR (Electronic Patient Records) in primary care (statistics from hospitals are still very uncertain), e-Prescriptions and solutions allowing patients to book their appointments on the Internet. The implementation of such solutions can indicate how efficient the delivery of healthcare is and to what extent patients are involved in raising the process value.

After 20 years of efforts, the practical use of EPR:s is still fragmented around Europe. It looks as if a little more than one third of the 34 national systems will gain a green score on EPR:s (i.e. at least 90 percent penetration among primary care doctors). Around half a dozen countries offer patients the facilities to book appointments on the Internet, a time- and staff-saving resource. E-prescriptions, which speed up the distribution process and make the life of patients easier, show roughly the same low level of impact, as shown to commissioner Dalli in the preview the other day.

Compared to other service sectors, such as banking or flight travels, the Internet impact in healthcare is still limited in most parts of Europe, which harms productivity, efficiency, service orientation and consumer involvement.

The Euro Health Consumer Index is the single pan-European measurement of how well national healthcare systems meet patient/consumer expectations with regard to user information, equal and timely access and treatment outcomes. The initial Index was put together 2005 and has since then expanded, today covering every EU member state and accession nations as well as Norway, Switzerland, Iceland, Albania and FYHR Macedonia, in all 33 countries. This year's update will bring Serbia into the system as the 34th country.

EHCI builds the ranking on ~40 indicators in five sub-disciplines: Patient rights and information, Waiting times, Outcomes, Range and reach of services and Pharmaceuticals. The selection of indicators is decided in co-operation with the External Reference Panel, a group of senior healthcare experts to advise on the Index composition. The Index outcomes are presented in a user-friendly way, with traffic-light colors to tell if a country performs quite well, medium or poor.

The sub-divisions are given a weight indicating how HCP looks at their respective importance, providing Outcomes and Waiting times with the highest weight. Depending on how well a national healthcare system responds to the indicator criteria a total maximum of 1 000 points can be rewarded. The last winner (2009) – the Netherlands – scored 863 points while the weakest competitor, Bulgaria, scored 448 points.

EHCI not only provides a status assessment for each of the 34 countries but as well gradually make longitudinal analysis possible, as performance data have been generated since 2005. To patients and care consumers EHCI is an opportunity for lay-persons to inform themselves, to compare and to take action to achieve the best possible healthcare. To healthcare industry stakeholders this unique benchmark has an awareness and opinion forming potential. Altogether, better performance transparency and common ways to foster accountability drives healthcare quality – a win-win situation for Europe!

The EHCI methodology is explained on our website www.healthpowerhouse.com.

Do you want the next EHCI 2012 newsletters in your mailbox? If so, just send us a request to This e-mail address is being protected from spambots. You need JavaScript enabled to view it and we will add you to the subscription list for free. The next letter will arrive March 29.

If you want to avoid receiving the newsletter, you can use the same address to disengage from the newsletter list.