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  • September 2023
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The Digitalization of Healthcare in Europe: Implications for Insurers in the COVID-19 Era

  • Diana Bosworth
  • Emma Hickey
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A man holds a smartphone displaying a healthcare application
In Brief
The pandemic’s acceleration of healthcare digitalization in Europe revealed the great potential of this transformation as well as systemic challenges. Insurers will play an essential role in creating an ecosystem that makes quality care accessible to all those who need it.

COVID-19 served as a catalyst for the digitalization of healthcare systems across the continent. Amid this progress, however, pandemic-driven adaptations also exposed socio-economic inequalities and digital literacy gaps. This dynamic presents a range of challenges and opportunities, and taking action now can help usher in a new era of healthcare accessibility and health insurance coverage.

The CEOWORLD Magazine Health Care Index, which ranks 110 countries according to factors that contribute to overall health, is a statistical analysis of the overall quality of each nation's healthcare system, including healthcare infrastructure, healthcare professionals' competencies, cost per capita, quality medicine availability, and government readiness. In 2023, Europe occupies five of the top ten places: Sweden (5), Ireland (6), the Netherlands (7), Germany (8), and Norway (9).

Accelerated Digital Adoption

COVID-19 brought about a rapid surge in the use of digital tools for healthcare delivery, public health management, and COVID-19 vaccination administration across Europe. Various countries embraced telemedicine, remote consultations, patient apps, and wearables to monitor and manage patients effectively. 

For example, in the Netherlands, the Luscii app allowed doctors to remotely monitor and guide patients with mild COVID-19 symptoms, using an AI clinical engine. This technology was endorsed by 94% of insurers and adopted by 50% of hospitals. Germany utilized the Divi intensiviregister, an online platform providing free information on available ventilator facilities, intensive care capabilities, and COVID-19 cases treated in hospitals. In the U.K., NHS England and NHS Improvement instigated a total triage model by phone or online, thereby eliminating the need for face-to face consults. Meanwhile, Italy introduced provisions to facilitate remote renewal of repeat prescriptions.

Booking systems and patient portals also played a crucial role in streamlining healthcare services during the pandemic and remain in use today.

In the U.K., the DrDoctor Patient Portal enables patients to book and change medical appointments online and is now live in 16 NHS Trusts across the country. Portugal's National Strategic Telehealth Plan features an Online Citizen Area, allowing access to electronic health records (EHRs), appointment booking with general practitioners, and vaccination card verification. Germany's Samedi platform enables people to manage doctor's appointments online and receive reminders on their smartphones.

Digital health tools were also deployed to support contact tracing efforts. While some countries faced delays due to regulatory hurdles, most European countries developed national contact tracing and warning applications. The European Federation Gateway Service enabled cross-border exchange of contact tracing keys, ensuring users received warning notifications regardless of the app used or member state visited.

Online Mental Health Services

The pandemic brought a new urgency to the issue of mental health, and European countries stepped up remote prevention and promotion measures. Germany and Austria, for example, expanded digital telephone and counselling services. In May 2021, the European Commission organized the online conference – “Mental health and the pandemic: living, caring acting!” – scaling up mental health capacity through innovative delivery methods and facilitated access. 

SilverCloud Health in the U.K. offers an example of an online platform that provides digital interventions for mental health conditions as well as cognitive behavior therapy (CBT) courses that can be accessed 24/7. It is used by 75% of the NHS mental health services and was made free to all NHS staff and their families throughout the pandemic.

Mental health remains an important issue, particularly for frontline health workers.

The Ipsos Global Health Service Monitor is an annual study that explores the biggest health challenges facing people today and evaluates citizens’ perceptions of their country’s healthcare services’ ability to tackle them. Mental health came out as a top concern for countries around the world. In Europe, this concern was particularly acute among the following countries: Sweden, the U.K., Spain, Belgium, Germany, and the Netherlands.

A woman leads a brainstorming session
RGA's 2023 Global Mental Health Survey provides insights into insurers' current offerings and initiatives related to mental health and a unique view of where the industry may be headed.

Inequalities Exposed

Crises often reveal socio-economic inequalities, and this certainly proved to be the case with COVID-19 in Europe. Making up much of the “essential” workforce, people with lower income levels had increased exposure to the virus at work, and possible overcrowding at home may have also contributed to increased risk of infection. People from an immigrant background were disproportionately affected. The pandemic also highlighted the limited access to healthcare for people living in rural and remote areas compared to their city-dwelling counterparts.

In addition, the lack of digital literacy among certain populations hindered their ability to navigate healthcare systems effectively during lockdown protocols. According to the EU's 2019 Digital Economy and Society Index (DESI) report, almost one-third of Europeans aged 16-74 (28.9%) still lack basic digital skills. This lack of awareness regarding the potential benefits of digital health technologies further complicated the pandemic situation.

To address these challenges moving forward, the EU established the Digital Education Action Plan (2021-2027) to support the adaptation of education and training systems to the digital age.  Work remains to be done, however, as one quarter of low-income households lacks access to computers and broadband.

Implications for Insurers

The digitalization of healthcare presents both risks and opportunities for insurers and requires adapting processes and services to the rapidly evolving digital landscape. 

It starts with privacy and data security. Patients in Europe wish to own their own healthcare data and to determine with whom and for what purpose it is shared. Countries now offering this include Estonia, Finland, France, Iceland, Norway, Scotland, Sweden, and more recently England. Denmark, through its e-health portal, has been sharing digital health data for over 15 years. 

For insurers, digitalization requires investing in infrastructure, data security, and privacy measures to ensure the smooth integration of digital health technologies.

Additionally, insurers need to address potential biases and inequalities that may arise from relying on digital tools, ensuring accessibility for all consumers.

Digitalization opens up new opportunities to improve operational efficiency and the customer experience, including streamlined underwriting and claims processing and innovative services such as telemedicine coverage, wellness programs, and wearable device incentives. Insurers can also apply data analytics to gain insights into policyholder behavior, risk assessment, and healthcare trends, enabling them to tailor offerings more effectively.

Action Needed

To successfully navigate the future of healthcare in Europe and elsewhere, insurers should consider the following steps:

  1. Embrace digital transformation: Invest in digital infrastructure, data analytics, and cybersecurity to support the integration of digital health technologies into operations.
  2. Enhance partnerships: Collaborate with healthcare providers, technology companies, and startups to leverage their expertise and develop innovative solutions that align with evolving customer needs.
  3. Focus on customer-centricity: Prioritize customer experience by offering user-friendly digital platforms, personalized policies, and value-added services that align with policyholders' changing needs and expectations.
  4. Ensure data security and privacy: Establish robust data protection measures and comply with relevant regulations to maintain the trust and confidence of policyholders in the digital healthcare ecosystem.
  5. Address socio-economic disparities: Develop inclusive strategies to bridge the digital divide and enhance digital literacy among underserved populations, ensuring equitable access to digital health tools and services.

The COVID-19 pandemic’s acceleration of healthcare digitalization in Europe revealed the great potential of this transformation as well as systemic challenges that will need to be addressed. Innovators in the insurance space have new opportunities, through more supportive governments and more receptive consumers, to make long sought-after advances in this area.

Insurers will play an essential role in creating an ecosystem that makes quality care accessible to all those who need it. 

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Meet the Authors & Experts

Diana Bosworth
Diana Bosworth
Senior Research Analyst, Strategic Research
Emma Wilkins
Emma Hickey
Vice President, Digital Health and Propositions, Global Health


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