European Perspective on Personal Health Information

Personal Health Information Workshop – September 2005

Christopher Keene – Entrepreneur In Residence, INSEAD


This describes the European perspective on Personal Health Information (PHI), contrasts it with PHI activities in the US and identifies several innovators in the European market.

European Environment for PHI

Europe is of course many different markets but there are still some generalizations that apply. For example, Internet adoption in Europe (Italy, Germany, France, UK) remains several years behind North America. Internet cafes are rare, public internet hotspots are rarer and ads for e-commerce sites often prominently highlight their safety for secure payment.


This same suspicion spills over into the PHI space. Because European health care systems are nationalized, these fears compounded by the natural concerns that arise any time citizens give their government personal information.

Current State of PHI In Europe

While Europe has the advantage of homogeneous, single-payer markets for health care, they must also contend with the oxymoron of government-driven  health-care innovation. With the notable exception of Denmark, nationalized e-health initiatives have not been any more successful in Europe than in the US.


In Holland, early PHI initiatives have stalled over concerns about the privacy of centralized patient information. France is implementing a PHI system in which the information is stored on a personal “smart card” to get around these concerns. This smart replaces the pharmacy card the French use to get free prescriptions today, so seems likely to gain customer adoption.

European PHI Initiatives

Personal Health Information can be used to increase quality of healthcare while also reducing costs. Much of the European focus on PHI has looked at ways to put more power in the hands of consumers. The most daring PHI approaches in Europe and the US look to reverse the power equations in the health care market, using the internet and computers to transform health care into a customer-centered activity.


Every year, the European Community awards certain e-health initiatives with the eEurope awards for eHealth (admittedly, an awkward name). It is perhaps a telling oversight that the eEurope web site does not give the web site addresses for all of the eHealth winners. Here are some of the recipients of the eHealth award over the last two years:

·        Danish public health portal (Denmark, a website that allows any Danish citizen to book appointments with their general practitioner, conduct e-mail consultations and renew prescriptions. Unfortunately in Danish.

·        Pure Quality Life - PQL (Sweden, allows consumers to take a qualitative test describing their health status, analyze results against “typical/ideal” norms, create an action plan to improve their status, and then track their progress over time, with some simple tools/information to improve quality of life.

·        Health on the net foundation (Switzerland, a web search service designed to protect citizens from false or misleading health information. Search results highlight information on medical topics from “trusted” sources.

·        NHS Direct (UK, provides health-care information on the web. Mostly simplistic, but links to an interesting site on best treatments.

·        Diabcarnet (France, a web-based logbook for diabetes monitoring, particularly for children with diabetes


Other Interesting PHI Initiatives in Europe

·        Best treatments (UK, recommends the best treatment for over 200 conditions by evaluating existing research literature. Links to NHS site.

·        The informed patient project at Cambridge (UK, research/health/tip/) describes the need to educate patients without overly alarming them, and the dangers of letting patients troll the web to learn more about their conditions.

·        Comparison of EU and US perspectives on Personal Health Information by Don Detmer (UK, very good presentation on the issues in PHI in general, with some discussion of European market.

Summary and Next Steps

Europe is a vibrant incubator for a range of innovative e-health initiatives. In particular, there are three areas where Europe seems to be setting the pace:

·        Internet-enabling the customer/general practitioner relationship: Denmark has achieved the health care “nirvana” of making common patient/physician interactions such as scheduling appointments, e-mail consultations and prescriptions available over the web.

·        Enhancing the quality of health care information: both Switzerland and the UK have undertaken broad initiatives to assure that their customers have access to high-quality information about their health care.

·        Addressing quality of life as well as quality of health issues: Sweden has deployed a very interesting interactive site to help individuals better understand the relationship between their activities and their qualitative feelings of healthiness.


Not only are these initiatives helping define the potential for PHI,  many of these initiatives could be successfully adapted to the US market.

About the Author

Christopher Keene ( is an Entrepreneur in Residence at INSEAD University in France. In his initial startup, he helped create one of the first medical office management systems for physicians. More recently he was president and co-founder of Persistence Software a Nasdaq-listed data tools company that was sold to Progress Software in 2004. He is now preparing to launch a new startup in the area of customer-driven healthcare.


Copyright 2005 Christopher Keene

Be careful about reading health books. You may die of a misprint. - Mark Twain


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