Measuring the Penetration of Intelligent Technologies in Medical Business

1. Measuring the Penetration of Intelligent Technologies in Medical Business N. S. Thomaidis, G. D. Dounias

2. Overview • Methodology of the Research • Target group and domain specification • Objectives • Survey procedure • Questionnaire design • Presentation of the Results • Sample Analysis • Current state of intelligent technologies • Future prospect of intelligent technologies in medical business • Conclusions

3. Target group Medical companies / organisations specialised in either of the following business fields: • Medical technology (equipment, apparatuses, instruments, packaging material, production-line technology) • Medical Information Systems: information systems for medical or healthcare applications (medical software, medical networking, computer integrated systems, etc.) • Medical Management; management or consulting services to healthcare providers, such as hospitals or clinics. • Pharmaceuticals: pharmaceutical products.  Each national branch was contacted separately

4. Objectives • Which is the current state of intelligent technologies in medical business? • How familiar are the actors of medical business with intelligent methodologies? • To what extent are intelligent techniques used in any of the above sectors of medical industry? • How do medical entrepreneurs see IT (capability in solving problems, profitability, effectiveness)? • Which is the future prospect of intelligent methodologies in medical business? • Are the adoption of IT among the business priorities of medical companies? Are medical companies and organisations ready to adopt ‘intelligence’ in their operational environment. • Do medical entrepreneurs see any competitive advantage in IT? • Would they be interested in keeping track with latest developments on intelligent technologies (e.g. by joining a network of excellence)? • Would they invest on a programme specialised in training employees/executives on intelligent technologies/methodologies? • Which are the potential areas for the application of IT? • Correlate responses to the above issues with various sample variables: • Intensity of the market competition • Size or growth of the company (number of employees, annual turnover, product/activity diversification, etc.) • Business sector (technology, computing, consulting, pharmaceuticals) • Range of business activity (national/international) • Geographic location (South Europe, North/Central Europe, non-Europe)

5. Medical Technology & Equipment Medical software & computer systems Medical management & consulting Pharmaceuticals Total reply rate Reply rates 10.40% 12.66% 9.09% 17.39% 10.89% Distribution of contacts and replies per business sector

6. Non European South European North/Central European Distribution of contacts 46.93% 17.60% 35.47% Distribution of replies 43.59% 23.08% 33.33% Reply rate 10.12% 14.29% 10.24% Distribution of contacts and replies per geographic location

7. Questionnaire design • The objectives of our survey served as a guideline for the structuring of the questionnaire • Mostly close-format questions Advantages: • Easy to process • Require less thought on the part of the respondent • Filter-out useless and extreme answers to open questions • Careful phrasing of questions- avoid asking too personal information • Implemented on Excel 2000 (option buttons, text boxes, check boxes) • user-friendlier environment • minimise shipping and processing times from both sides of the survey (respondents and analysts) • A paper-based version also available

8. Sample analysis • Most companies are specialised in medical consulting, medical information systems or medical technology and equipment. Pharmaceutical companies are a small fraction of our sample. answers to our survey are not quite representative of the situation in the pharmaceutical sector • Modest to keen market competition. • Medical technology and pharmaceuticals two most competitive sectors • Medical software and consulting two less competitive sectors. • Small/Medium enterprise dominant type of company • Ratio of SM to L companies 7:3. • This proportionality approximately holds for all the business sectors except pharmaceuticals, in which case it is totally inverted.

9. Sample analysis • The business activity of the majority of the companies is extended beyond national borders (international 74%) • Slightly more than a half of the sample companies located within the European zone, while there is a 43.59% which is based outside Europe, mostly in US. • Most of the South European companies deal with medical technology (61.54%), • Most of the non-European ones are specialised in medical software (64.71%). North/Central European companies, on the other hand, are almost evenly distributed among the four business sectors. • The small/medium company is the dominant type of business in the South and the Non- European cluster. (78% , 82%) • The situation is more balanced for North/Central European companies. Results referring to the South European and the non-European region are possibly affected by those concerning small/medium companies or the business attitude of the sectors that dominate each of the above regional clusters!

10. Current state of intelligent technologies Very popular among medical entrepreneurs: • Intelligent web browsing/search engines, • Intelligent data analysis tools, • Smart algorithms for image processing • Intelligent knowledge management. • Low overall level of acquaintance with fuzzy logic Possibly due to the fact that the aforementioned technology is mainly encountered in industrial applications, while medical industry represents almost a third of our sample. However, relating responses with the business sector shows no significant correlations that could justify this claim.

11. Overall level of acquaintancewith applications of IT

12. Intelligent web browsing/search engines Intelligent data analysis/ data mining/ decision support Smart algorithms for image processing Business intelligence/ knowledge management Fuzzy logic controllers Medical Technology & Equipment 92.31% 84.62% 61.54% 61.54% 30.77% Medical software & computer systems 95.00% 95.00% 65.00% 80.00% 40.00% Medical management & consulting 100.00% 93.33% 73.33% 86.67% 40.00% Pharmaceuticals 100.00% 100.00% 75.00% 75.00% 50.00% Acquaintance with intelligent technologies per business sector

13. Current state of intelligent technologies Almost 80% of the respondents were able to identify intelligent technologies/techniques in their operational environment. • Most popular applications of ‘intelligence’ in software and networking (87.10%), data analysis tools and web services (77.42%). • In principle, the kind of application co-varies with the thematic area. • Most noticeable was the presence of intelligent technologies in medical technology and least noticeable in medical management and consulting. Only 8% of the respondents representing the medical industry were unable to identify intelligent technologies in their company’s business practices. This percentage was about 33% for medical consulting companies.  ‘The Market competition and the ‘maturity’ in medical technology seem to be responsible for this result. • Market competition generally seems to have a positive effect on the current spread of intelligent technologies. As the intensity of competition decreases the popularity of intelligent technologies decreases as well. • The presence of intelligent technologies seems to be affected by the range of the business activity as well as the growth of the company. The percentage of respondents who were able to identify intelligent technologies increases from national to international and from small/medium to large companies. • Intelligent technologies have been proven to be most popular between South European companies and less between non-European and North European. this result is probably due to the high percentage of medical technology companies that make up the South European cluster.

14. Medical Software, Computer Integrated Systems, Computer tools & Applications Hardware, apparatuses, devices, manufacturing lines Medical Services/ Monitoring/ Support Managerial Decision Support, Data Analysis, Web services No I can't identify Medical Technology & Equipment 92.31% 38.46% 53.85% 76.92% 7.69% Medical software & computer systems 75.00% 15.00% 25.00% 60.00% 20.00% Medical management & consulting 46.67% 20.00% 33.33% 53.33% 33.33% Pharmaceuticals 75.00% 25.00% 25.00% 75.00% 25.00% Identification of intelligent applications vs sector

15. Identification of intelligent applications vs competition

16. Identification of intelligent applications vs range of business activity and growth

17. Current state of intelligent technologies • Most of the respondents have a concrete attitude towards intelligent technologies, sharing the view that intelligent technologies are capable of solving problems arising in medical business. Opinions on the profitability and the effectiveness of intelligent technologies seem to diverge. • From the totality of participants, those dealing with medical management have the highest percentage of respondents being unable to express any opinion on the topic. This is probably an indication of their low level of acquaintance with intelligent technologies. • International companies generally count more on intelligent technologies and seem to have a clearer view on the topic. The situation is more mixed up as regards the size of the company.

18. Capable of solving problems arising in medical business More profitable compared to less ‘intelligent’ and conventional techniques Not at a stage to make profit yet I do not have any concrete opinion on the topic Other Percentages 82.35% 44.12% 17.65% 12.82% 8.82% Attitude towards IT

19. Capable of solving problems arising in medical business More profitable compared to less ‘intelligent’ and conventional techniques Not at a stage to make profit yet I do not have any concrete opinion on the topic Medical Technology & Equipment 92.31% 23.08% 15.38% 7.69% Medical software & computer systems 75.00% 50.00% 15.00% 5.00% Medical management & consulting 60.00% 33.33% 13.33% 20.00% Pharmaceuticals 75.00% 50.00% 0.00% 0.00% Attitude towards IT

20. Current state of intelligent technologies • Most of the respondents have a concrete opinion on the topic, sharing the view that intelligent technologies are capable of solving problems arising in medical business. Opinions on the profitability and the effectiveness of intelligent technologies seem to diverge. • From the totality of participants, those dealing with medical management have the highest percentage of respondents being unable to express any opinion on the topic.  This is probably an indication of their low level of acquaintance with intelligent technologies. • International companies generally count more on intelligent technologies and seem to have a clearer view on the topic. The situation is more mixed up as regards the size of the company.

21. Future prospect of intelligent technologies As far as the business priorities are concerned, answers are almost equally distributed among the various options of this question. • Slightly more than a half of the participating companies declare themselves interested in adopting intelligent technologies/methods. • Still, a significant percentage of companies not having already gone through the stages of electronic data interchange, construction of databases and data processing.  probably due to the fact that the majority of our sample consists of small-to-medium companies. • A great majority of medical technology and pharmaceutical companies consider the adoption of intelligent technologies among their immediate business plans. Possible explanations for this result are that a) most of the pharmaceutical group consists of big multinational enterprises and b) in both sectors the intensity of market competition is generally high. • The tendency towards intelligent technologies increases with competition. Many companies operating in a competitive environment seem to have already gone through the ‘preliminary’ stages, giving priority to the adoption of more innovative business practices. • Large & International enterprises are on average found more willing to incorporate intelligent technologies into their business practices.

22. Electronic Data Interchange (EDI) Construction of Databases Data processing Adoption of Intelligent technologies Others Percentages 41.03% 38.46% 51.28% 53.85% 25.64% Business priorities

23. Electronic Data Interchange (EDI) Construction of Databases Data processing Adoption of Intelligent Technologies Medical Technology & Equipment 38.46% 23.08% 38.46% 76.92% Medical software & computer systems 50.00% 40.00% 60.00% 45.00% Medical management & consulting 46.67% 46.67% 66.67% 20.00% Pharmaceuticals 50.00% 25.00% 75.00% 75.00% Business priorities vs sector

24. Future prospect of intelligent technologies The majority of respondents expect that intelligent technologies are likely to become a competitive advantage for those enterprises that will adopt them in the future. • There is, however, a small but significant percentage of respondents not able to express a concrete opinion on the issue. • The majority of medical technology companies believe on the competitive advantage of intelligent technologies, This probably justifies their tendency towards considering them among their business priorities for the near future (see the comments above) • A considerable percentage of respondents representing a medical management/consulting company are not sure about the opportunities that intelligent technologies offer as regards the market share. This is probably an indication of their average low level of familiarity with intelligent technologies. • In total, large and international enterprises seem more convinced about the opportunities that intelligent technologies offer on a business level.

25. quite likely fairly likely hardly likely I am not sure Percentages 62.86% 37.14% 0.00% 10.26% How likely is it that intelligent technologies become a competitive advantage of the future ?

26. quite likely fairly likely hardly likely I am not sure Medical Technology & Equipment 61.54% 30.77% 0.00% 7.69% Medical software & computer systems 55.00% 45.00% 0.00% 0.00% Medical management & consulting 40.00% 40.00% 0.00% 20.00% Pharmaceuticals 50.00% 50.00% 0.00% 0.00% The view on the competitive advantage of intelligent technologies per business sector

27. Future prospect of intelligent technologies • Most of the companies would like to keep track with latest developments in intelligent technologies, by joining, for example, a EUNITE-type Network of Excellence. • However, a significant percentage is either sceptical about or rejects that alternative. • The interest in the developments in this scientific field gradually falls as one moves from medical technology to medical software and from medical software to medical consulting companies. • Market competition affects company’s policy as to whether to keep track with latest developments in intelligent technologies. • As found, the presence of competition generally pushes companies to seek innovative technologies in their business practices. • Both the global character and the big size of the company have a positive effect on the tendency of the company towards following developments in innovative scientific fields, such as that of intelligent technologies.

28. Would your company be interested in keeping track with latest developments in intelligent technologies (by joining a network of excellence)?

29. Yes, I would be interested in keeping track I would might be interested in keeping track No, I wouldn’t be interested in keeping track Medical Technology & Equipment 84.62% 15.38% 0.00% Medical software & computer systems 75.00% 20.00% 5.00% Medical management & consulting 53.33% 6.67% 40.00% Pharmaceuticals 100.00% 0.00% 0.00% Interest in intelligent technologies vs the business sector

30. Future prospect of intelligent technologies • In contrast to the relatively alive interest in intelligent technologies, most of the participating companies were found reluctant to invest money or other resources on them. • The striking majority of participants are at best sceptical about investing money or other resources on intelligent technologies. • Medical technology companies declare themselves on average more interested than the others in adopting a training programme on intelligent technologies. • Market competition seems to have a negative effect on the investment. As the intensity of market competition increases the percentage of ‘no’ responses becomes higher. This is probably due to the fact that in the presence of market competition companies are reluctant to commit money or human resources in rather innovative business actions. • global and large enterprises show on average more interest in intelligent technologies (as noticed in many cases before)

31. Would your company invest on a programme specialised in training employees/ executives on intelligent technologies/methodologies?

32. Interested in investing Slightly interested in investing Not interested in investing Medical Technology & Equipment 7.69% 84.62% 7.69% Medical software & computer systems 5.00% 75.00% 20.00% Medical management & consulting 6.67% 46.67% 46.67% Pharmaceuticals 0.00% 100.00% 0.00% The intention to invest per business sector

33. Interested in investing Slightly interested in investing Not interested in investing High competition 0.00% 66.67% 33.33% Medium competition 6.67% 60.00% 33.33% Low competition 0.00% 83.33% 16.67% The intention to invest versus market competition

34. Future prospect of intelligent technologies • As regards possible areas of application for intelligent systems, responses vary a lot with to the business sector in which every company is specialised. • There is however a significant percentage of participants (72.22%) being able to state at least on possible area for the application of intelligent technologies/techniques.  there seems to be enough space for intelligent solutions in medical applications. • Respondents representing a medical software/consulting company find on average slightly more areas for the application of intelligent technologies. • The same holds for those representing either an international or a large enterprise.  However, this result cannot easily be trusted, as the way that the question is posed mostly prompts for the personal opinion of the participant rather than the overall policy of the company. • Finally, North/Central and non-European companies provide in total more alternatives for the application of intelligent technologies.  However, care has to be taken as regards the non-European cluster for reasons explained in the analysis of the sample.

35. -Operational management in Healthcare- procedures, orders, diagnoses to orders-Comparing building design options - resolving design conflicts-Profiling, Scoring, Capacity planning-Establishment of priorities between the received emergency and non-emergency calls. -Web-based technologies for data mining and industry benchmarking-Development of sales & marketing -Removing duplicated items from databases-Sales of intelligent medical image processing systems-Motion control of medical respirators; pumps, fans and gas/fluid control-Data mining in clients’ databases-Telematics -Information Management -Discovery, Development, Sales and Marketing-Diagnosis to treatment, resource allocation optimisation-Instrument result analysis & reflex decisions-Database Networking; image processing-Software development -Medical Software Applications and Healthcare Process Optimisation-Medical decision support systems

36. Conclusions-current state • Most of the inquired actors of medical business showed a good level of acquaintance with intelligent technologies • Most of them were able to identify applications of intelligent technologies in their operational environment (mostly software and networking, data analysis tools and web services) • The capability of intelligent technologies in solving problems arising in medical business is widely recognised (opinions on the profitability and the effectiveness diverge)

37. Conclusions-future state • Slightly more than a half of the participating companies declare interested in adopting intelligent technologies/methods • There seems to be a significant percentage of companies not having already gone through the stages of electronic data interchange, construction of databases and data processing • Intelligent technologies are likely to become a competitive advantage for those enterprises that will adopt them in the future (large international companies seem more convinced on that) • Most of the companies would also like to keep track with latest developments in intelligent technologies, (although a significant percentage is either sceptical about or reject that alternative) • The great majority of participants are at best sceptical about investing money or other resources on intelligent technologies (market competition seems to have a negative effect on the intention to investment) • As the intensity of market competition increases the percentage of ‘no’ responses becomes higher  major implications on the effectiveness and the profitability of intelligent technologies.

38. Conclusions-some methodological issues The medical business world hides many complexities that hinder the task of the questioner. • A great variety of medical services and products-difficult to categorize • The very unit of our target group, the medical company, seems to be a rather vague concept (complicated internal structure, network of parent and affiliated companies) • Which level of contacts should one reach in order to gain a respectable view of the enterprise (and the medical business world in general)? • The role of respondents: to what extend does the respondent express his/her company’s policy. Probably, the best thing to do is to ask as many executives (holding different positions) as possible and then average out across subjective views. But, this requires time from both sides of the research.Besides, you cannot force the reply of a particular person • Similar considerations apply to the ‘branch’ problem stated above • Market competition respondents are usually suspicious to others approaching them with questions on their companies low reply rate • Possibly you can increase the reply rate by contacting people more familiar with content of the survey. But how representative is their view?

39. Future directions  A more thorough study of the present and future of intelligent technologies would definitely require a richer sample and the adoption of more advanced tools for detecting interesting clusters in the data set. Important signals coming from the medical business sector: • there is enough space for intelligent solutions in medical applications • intelligent technologies have been proven capable of solving real-world problems • But why reluctance to invest? Questions posed: • Should EUNITE focus its activity on finding ways to increase the profitability and the effectiveness of intelligent systems? • Is it necessary to improve the marketing strategy regarding intelligent technologies? • Should priority be given to these issues, possibly at the expense of scientific research on this area?