Study approach

The study team is currently exploring the wider context of healthcare investment in Europe, including the features of different health systems, and investigating the supply and demand sides of financing eHealth investments.

On the supply side, this involves gathering information on the financing opportunities, for the period 2007-2013, available in the EU-27, the European Economic Area (EEA), and accession countries. The examined sources of supply of funds for eHealth investment include the following broad categories:

  • Institutional funds, mainly current budgets of direct investors
  • Regional funds, including public and private sources on sub-national level
  • National funds, including support from public and private initiatives and organisations operating on a national scale
  • European Commission 9 funds
    • Structural Funds
    • Directorate Generals and research programmes, including FP 7
  • The European Investment Group: Bank (EIB)10 and Fund (EIF)11
  • International institutions, such as the WHO12, the World Bank13, or the EEA Financial mechanism14,

eHealth financing opportunities can rely on an expansion of both capital and revenue finance. Capital can be mainly linked to ICT investment. However, this can be substituted by a revenue model with modern Private Finance Initiative (PFI) and Public-Private Partnership (PPP) options, and so combined with the finance needed to achieve the organisational changes needed to realise the benefits from eHealth. This leads to a potential model where necessary temporary, and also longer-term, increases in annual expenditure on eHealth can be sustained by revenue expenditure for arrangements by leasing and borrowing from institutions, and injections of, e.g. venture capital. An underlying, sustainable financing source from increased annual expenditure often needs, in addition, an injection of additional finance to support eHealth investment spikes, especially at the time of implementation and roll-out, when change management is a critical and resource intensive factor. Achieving a sustainable mix is critical to success.

In this context, it is important to stress that the listed options are not mutually exclusive. eHealth investments can, and often must, be financed by a financing package that includes a mix from several sources, including some of those listed above. Each option could be for either total or partial costs, or for non-recurring or recurring expenditure. The optimal mix of financing models for an eHealth investment, or project, over its whole life-cycle should be determined according to its investment profile.

Classifying different types of investment profiles, with their specific financial needs, defines the demand side of financing eHealth investments. The study team is currently working on an empirical framework for eHealth investments, including:

  • identifying eHealth investment types and respective life-cycle financing needs,
  • insights on decision making processes, barriers and success factors, and
  • an investigation of financing models used at successful investment sites, as well as models not yet used in practice. Such models include:
    • Public-private partnerships (PPP)
    • Private finance initiatives (PFI)
    • Public grants and loans
    • Research projects
    • Private and commercial financing, including loans and leases, as well as venture and equity capital
    • Public procurement, including pre-commercial procurement
    • Health services reimbursement mechanisms facilitating eHealth-enabled activities
    • Charitable donations
    • Citizen out-of-pocket payments.


9. http://ec.europa.eu
10. http://www.eib.org
11. http://www.eif.org
12. http://www.who.int
13. http://web.worldbank.org
14. http://www.eeagrants.org

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