1. Examplefrom Austria ELGA – Electronic HealthFile

2. Background information(In a nutshell) Positive aspects Room for improvement Coexistence of federal state and self-governing stakeholders => fragmentation of responsibilities and inadequate coordination* Unrestricted access – makes it more difficult for patients to find the care most appropriate to their condition, illness profile and personal requirements within the maze of options Inpatient sector is over-represented => better coordination needed Spending on preventive medicine is very low (2%) – “Key weakness” The costs of HCS are high Out-of-pocket payments are frequent Efficiency is low due to* • 99.9% of population is covered (2011) by social health insurance • Insurance funds do not compete for members (determined by occupation or place of work or residence) • Unrestricted access to comprehensive care at all levels (GPs, specialists & hospitals) • Benefit payment system e.g. 24-hour care for elderly people in need (reaction to demographic change) • More than 90% of Austrians think that the system is “very good” or “good” (Eurobarometer) Source ofinformation: e.g. Hofmarcher M, Quentin W. Austria: Healthsystemreview. Health Systems in Transition. 2013; 15(7):1-192.

3. ELGA Electronic HealthFile • April 2011: first trial implementation in 3 Austrian provinces • 2014: ELGA launch in all areas (actively advertised for!) • Content: record of medication, e-results, e-physician‘s letters (hospital discharge notices) and living wills • Moreover, also net income and prescription fees already paid noted => e.g. easy administration of prescription fee cap => ensures comprehensive access to health care • Personal health account accessible under: www.gesundheit.gv.at • Opt-out system Conclusion: e-Health infrastructure holds great potential for greater connectivity (overcome fragmentation). Field in which Austria, in comparison, is relatively advanced.