Health care professionals recognise potential of ehealth and electronic patient records

Transcription

1 Health care professionals recognise potential of ehealth and electronic patient records But: there is still need for clarification and information The most important points in brief Swiss ehealth Barometer 201: Key players in health care Study on behalf of InfoSocietyDays, March 201 Project team Lukas Golder Political and media scientist Cloé Jans Political scientist Stephan Tschöpe Political scientist Marcel Hagemann Sociologist Alexander Frind Political scientist Johanna Schwab Secretary s office and administration

2 Bern, 3. März 201 Copyright by gfs.bern Sperrfrist: 10. März 201, 9.00 Uhr Publikation: anlässilich der InfoSocietyDays 2

3 Studieninitiator: Study initiator: The most important points in brief Studienpartner: Study partners: Between December 2015 and January 201, around 1,800 health care professionals from the Swiss health care sector were asked their opinions on the theme of ehealth. Here the following two assumptions summarise the findings of the sixth Swiss ehealth Barometer in their essence. They should act as a reading and orientation aid for this short report and raise awareness of the continued development of ehealth in Switzerland. Assumption 1: The implementation of ehealth is on course. But it is not a matter of relying on an automatism here. The potential for clarification among health care professionals is still great and in many issues for example the electronic patient record there is a certain amount of uncertainty today. Here doctors with their own medical practice in particular have a cautious approach with regard to ehealth. On account of their privileged position as an interface to the population, a priority in the future has to be to take this group on board to a greater extent. Assumption 2: In the summer of 2015, the introduction of the electronic patient record was passed by parliament. This development may have attracted the interest of health care professionals but there has not been a noticeably positive dynamic. In the future an attempt should be made to translate the progress made in the political arena to an even greater extent into additional support among the individual groups of key players. Status of ehealth among health care professionals There is interest in ehealth among an absolute majority of health care professionals in the Swiss health care system. After less clear signals at the start of the series of surveys, in the last two years there has also been an increase in interest (very/quite interested) in issues related to ehealth. On account of their profession, as it were, the interest among IT specialists (IT in cantons 100%, IT at Curaviva 100% and IT at hospitals 93%) is biggest. The clear trend among pharmacists (+7 pp compared to 2015) and at old people s homes and nursing homes (+14 pp compared to 2015) is also particularly eye-catching, however. In the homes in particular this is the first of various indications of a changing perception (and use) of the possibilities of digitisation for everyday working life. In addition, like all other health care professionals, homes have to deal with ehealth and electronic patient records by law. This year, for the first time, members of the grassroots organisations were also surveyed as part of the ehealth Barometer. With 82 percent very/quite interested, ehealth is also already evidently a widely recognised theme in this group today. In the medical profession, people are a little more reluctant. But increasing interest can be seen here too (2%, + pp). 3

4 Grafik 1 Trend in comparison of interest in ehealth "How interested are you in the issue of ehealth?" in % of surveyed doctors, IT at hospitals, pharmacists, old people s homes and nursing homes, IT in cantons, IT at Curaviva,, percentage of people who are very/quite interested IT at hospitals IT in cantons Old people s homes and nursing homes IT at Curaviva (N doctors = in each case approx. 10, N IT at hospitals = in each case approx. 5, N pharmacists = in each case approx. 0, N IT in cantons = in each case approx. 20, N old people s homes and nursing homes = in each case approx. 415, N IT at Curaviva= in each case approx. 15, N = 199) For nearly all health care professionals, the potential has also increased in the last year of ehealth being credited with improvements in the professionals own working environment. Hospital doctors (7%), pharmacists (5%), the IT specialists in hospitals (57%) and also the (%) attribute some or even a very high level of potential for change to ehealth. Here the biggest change is again with the old people s homes and nursing homes, which are now quickly catching up from being slightly behind the other health care professionals in matters of ehealth and in some cases are even overtaking them. The figure below also clearly shows that it does not make sense to lump all members of the medical profession together. Evidently in the last year in particular there has been a divergent dynamic between doctors with their own medical practice and hospital doctors (both subgroups emphasised with solid lines): while no other group rates the potential of ehealth as highly as hospital doctors, the exact opposite applies for doctors with their own medical practice. At only percent (very/quite high potential), doctors with their own medical practice are the group which sees the least potential for improvement. 4

5 Grafik 2 Trend in comparison of potential for improvement in working environment "How do you rate the basic future potential for improvements in your working environment thanks to ehealth?" in % of surveyed doctors, doctors with their own medical practice, hospital doctors, IT at hospitals, pharmacists, old people s homes and nursing homes,, percentage who consider very/quite high potential with their own medical practice Hospital doctors IT at hospitals 30 3 Old people s homes and nursing homes (N doctors = in each case approx. 10, N doctors with their own medical practice = in each case approx. 370, N hospital doctors = in each case approx. 180, N IT at hospitals = in each case approx. 5, N pharmacists = in each case approx. 0, N old people s homes and nursing homes = in each case approx. 415, N = 199) ehealth has evidently reached the health care professionals of the Swiss health care system. But the theme is still in its infancy in many respects in terms of awareness, forms of use and possibilities and there is still need for clarification and information among the individual key players. Accordingly, clear majorities among all health care professionals would like training in the field of ehealth today. Among most of the key players this is the case more than ever the only exception here is doctors with their own medical practice who are slightly less interested in training or further training in this area (2%, -2pp). The spread and success of the idea of ehealth require, for example, a greater network among the key players in the health care system because these have not been at all well connected so far in some cases. The figure below provides evidence that things are heading in the right direction in this matter: apart from members of the medical profession, the individual health care professionals are also increasingly participating in regional or cantonal implementation projects or at least have the firm intention of doing this within the next twelve months. 5

6 Grafik 3 Trend in participation in an ehealth implementation project "Do you participate in a regional or cantonal ehealth implementation project?" in % of surveyed doctors, IT at hospitals, pharmacists, IT in cantons, old people s homes and nursing homes, IT at Curaviva,, percentage who say yes, regional / yes, cantonal / yes, planned in the next twelve months IT at hospitals IT in cantons Old people's homes and nursing homes IT at Curaviva (N doctors = in each case approx. 10, N IT at hospitals = in each case approx. 5, N pharmacists = in each case approx. 0, N old people s homes and nursing homes = in each case approx. 415, N IT in cantons = in each case approx. 20, N IT at Curaviva = in each case approx. 1, N = 199) Electronic documentation and networking Across all health care professionals there are actually no longer any organisations which do not at least to some extent have electronic systems for storing and managing patient data. This means that today 9 percent of doctors with their own medical practice record the medical history (not to be confused with the electronic patient record) of their patient entirely or partly electronically and a total of percent are at least considering this. Making the switch soon is not an option at all for only 1 percent. Although the solutions for the electronic documentation of the individual patient, client and inhabitant histories differ between the health care professionals, there are still certain parallels in the level of satisfaction with the systems: at least a relative majority, and as a general rule an absolute majority of health care professionals are very or quite satisfied with their respective system. The share of undecided people (don t know/no answer) is still relatively large in nearly all groups at around 20 percent, however. Finally in all five groups, despite the satisfied majorities, there is need for further improvement and 15 to 3 percent of the respondents are not very or not at all satisfied. One group which stands out to some extent is the pharmacists where more opinions were given than with the rest of the key players and also the verdict is among the most positive. Occasionally, however, this can be connected with the fact that the solutions are somewhat different here than with the other groups

7 Grafik 4 Filter of electronic medical histories available "Do you keep the medical histories of your patients in electronic form?" in % of surveyed doctors with their own medical practice who have an electronic system No, not planned for the next three years 1 Considering introduction Yes, to some extent 19 Don't know/no answer 9 (n doctors with their own medical practice = 373) Yes, enirely 50 Filter of comparison of the assessment of electronic documentation "How do you assess your electronic medical history/the electronic documentation of your hospital / your electronic care documentation / your electronic inhabitant record/your software system today? Are you very satisfied, quite satisfied, not very satisfied or not at all satisfied with this?" in % of surveyed doctors with their own medical practice, hospital doctors,, old people s homes and nursing homes, pharmacists with an electronic system with their own medical practice Hospital doctors Old people's homes and nursing homes Not at all satisfied Not very satisfied Don't know/no answer Quite satisfied Very satisfied (n doctors with their own medical practice = 373, n hospital doctors = 132, n = 19, old people s homes and nursing homes = 498, n pharmacists = 374) Table 1 Among those surveyed health care professionals who, overall, are not satisfied with their electronic documentation, without exception in all subgroups the lack of functionality of the system is given as the main reason. The slowness and also the complexity of the system were also often mentioned. In particular among the pharmacists and in the organisations the price also plays a role in the dissatisfaction with the system. Reasons for dissatisfaction with electronic documentation* Reason for dissatisfaction Functionality of system not sufficient with their own medical practice Hospital doctors Old people s homes and nursing homes NPO-Spitex** System too slow System too complex System too expensive Data protection not guaranteed Other reasons n (number of dissatisfied people) *Mentioned reasons according to frequency of mentions, **"Other reasons" and "System too expensive" mentioned equally often with, gfs.bern, Swiss ehealth Barometer 201, Dezember 2015 Januar 201 Legend: Legend: Among pharmacists, "Functionality of system not sufficient" is given as the most common reason for dissatisfaction. The second most common reason is the slowness of the system, and the third reason for complaints is that the systems are too expensive. The complexity of the systems is mentioned in fourth place, "Other reasons" follows in fifth place and, finally, concern about data protection comes in sixth and last position. The kinds of clinical data which are kept electronically and are available within the individual institutions remain relatively constant among the individual groups of key players and, as a general rule, are tailored for the respective fields of activity. For example, a majority of members of the medical profession can today access data electronically, from the clinical documentation onto the results of laboratory tests and safety aspects, while the pharmacists can primarily access demographic data, invoices and lists of medications. 7

8 Demographic patient data Invoices List of medications Diagnosis Allergies Results Laboratory tests Results of radiological examinations Clinical documentation Vital signs List of problems Emergency data Electronic prescriptions Vaccinations Electronic reminders for treatment planning Demographic patient data Invoices List of medications Allergies Diagnosis Vital signs Clinical documentation List of problems Results Laboratory tests Emergency data Electronic prescriptions Results of radiological examinations Vaccinations Electronic reminders for treatment planning Grafik 5 Filter of comparison of recording data in one s own institution doctors and pharmacists "Please indicate whether the following types of clinical data which are kept in your organisation are available electronically for individual patients of your organisation. Please distinguish here between data which are recorded in your organisation and those which are received from organisations outside of your own." "Data are recorded in your own organisation:" in % of surveyed doctors, pharmacists with an electronic system, share who say "Yes, as a matter of routine" (n doctors = 553, n pharmacists = 31) Grafik As good as the availability of the necessary data is within the individual organisations, there is still a lot to do with regard to the transition to other institutions: none of the data listed above can also actually be received by a majority outside of one s own institution. This applies for all health care professionals in equal measure (shown again below with the example of doctors and pharmacists). Filter of comparison of receiving data from institution outside of own institution doctors and pharmacists "Please indicate whether the following types of clinical data which are kept in your organisation are available electronically for individual patients/inhabitants of your organisation. Please distinguish here between data which are recorded in your organisation and those which are received from organisations outside of your own." "Data can be received from institutions outside of your own organisation:" in % of surveyed doctors, pharmacists with an electronic system, share who say "Yes, as a matter of routine" (n doctors = 553, n pharmacists = 31) 8

9 If an index is calculated on the basis of every kind of data recorded and exchanged internally or externally, this gives a coherent picture of the networking: in terms of the internal networking this is in relatively good shape and it is evidently increasing (see figure on the left below). Although the leap within the last year is not as pronounced as between the years 2014 and 2015, progress can still be seen among nearly all health care professionals. The IT departments of the hospitals are constantly at the top in terms of internal networking. Besides, one exception is the pharmacists whose internal networking has remained at the same level for three years now and which, in its extent, also clearly stands out from the rest of the health care professionals. In external networking, pharmacies are also bringing up the rear among the surveyed key players of the health care system. But the differences are less pronounced here. What needs to be emphasised in this regard, however, is the development in the hospitals where external networking is evidently continuously increasing. Nevertheless, in this area there is still a lot to do for all groups of health care professionals. Grafik 7 Internal networking index External networking index IT at hospitals Old people s homes and nursing homes Overall gfs.bern, Swiss ehealth Barometer 201, December 2015 February 201 (N doctors = in each case approx. 10, N IT at hospitals = in each case approx. 5, N pharmacists = in each case approx. 0, N old people s homes and nursing homes = in each case approx. 415, N = 199) IT at hospitals Old people s homes and nursing homes Overall gfs.bern, Swiss ehealth Barometer 201, December 2015 February 201 (N doctors = in each case approx. 10, N IT at hospitals = in each case approx. 5, N pharmacists = in each case approx. 0, N old people s homes and nursing homes = in each case approx. 415, N = 199) Introduction of electronic patient record The introduction of the electronic patient record in accordance with the law passed by parliament on 19 June 2015 is, in principle, still supported by a majority of nearly all health care professionals (and also by the eligible voters). But to some extent there has been a relatively clear drop in support among some health care professionals in the course of the last year. This change is particularly evident in the old people s homes and nursing homes (1%, -10pp), the IT at hospitals (%, -9pp) and among the doctors with their own medical practice (4%, -10pp). Among the pharmacists (78%, +4pp) and the hospital doctors (82%, +3pp) the support remains roughly constant or increases slightly at a high level. Here the division of the different stakeholders of the health care system into two groups is certainly remarkable: the doctors with their own medical practice and the eligible voters have been relatively less enthusiastic so far while the support among the rest of the health care professionals is greater. It remains to be seen, however, how exactly the developments will now continue within the individual groups. 9

10 Grafik 8 Trend in comparison of the assessment of the introduction of the electronic patient record "Do you basically support the introduction of an electronic patient record? Are you " in % of surveyed doctors with their own medical practice, hospital doctors, IT at hospitals, pharmacists, IT in cantons, old people s homes and nursing homes, IT at Curaviva,, eligible voters, percentage of those who are definitely/to some extent for with their own medical practice Hospital doctors IT at hospitals IT in cantons Old people s homes and nursing homes IT at Curaviva Eligible voters (N doctors with their own medical practice = in each case approx. 0, N hospital doctors = in each case approx. 180, N IT at hospitals = in each case approx. 5, N pharmacists = in each case approx. 0, N IT in cantons = in each case approx. 20, N old people s homes and nursing homes = in each case approx. 415, N IT- Curaviva = in each case approx. 15, N = 199, N eligible voters = in each case approx. 1000) Grafik 9 Members of the medical profession and also the members of the organisations were asked if they themselves actually want to offer their patients or clients an electronic patient record in the future. Evidently this is the case today only among a minority of between 20 percent (doctors with their own medical practice/) and percent (hospital doctors). Relative majorities of the respondents are still undecided about this question. With the offer of an electronic patient record, people primarily want improved work processes, increased availability of data and also more transparency. Future offer of an electronic patient record "Do you yourself want to offer your patients/clients an electronic patient record in the future?" in % of surveyed doctors, Filter of reason for offer of electronic patient record "Why do you want to offer your patients/clients an electronic patient record in the future?" in % of surveyed doctors, wanting to offer electronic patient records in the future No Don t know/no answer Yes Improvement of work processes Availability of data Transparency General with their own medical practice Hospital doctors Other 2 2 with their own medical practice Hospital doctors (N doctors= 594, N = 199) Don t know/no answer 17 (n doctors= 153, n = ) 2 There are clear differences between the openness of the doctors with their own medical practice and those in hospitals in matters of ehealth, patient records and digitisation. In this sense it is also less surprising that the various contemplated measures for the introduction of the electronic patient record are generally a little less well received among the doctors with their own medical practice than among hospital doctors. Apart from the proposal of an incentive 10

11 system with tariff points which has lost a lot of support among hospital doctors in the last few years, the individual measures are consistently given more support in this group than among the doctors with their own medical practice. Across both groups it is the same, however, that education measures and the specification of standards enjoy more support in particular than the incentive systems mentioned above. Grafik 10 Trend in opinion on measures for the introduction of the electronic record hospital doctors and doctors with their own medical practice "Are you in agreement with the following possible measures for the introduction of the electronic patient record?" in % of surveyed doctors with their own medical practice, hospital doctors, share of those who are very much in agreement/to some extent in agreement Incentive system with tariff points/ doctors with their own medical practice Specification of standards/ doctors with their own medical practice 7 Political commitment of canton/ doctors with their own medical practice Education measures/ 5 7 doctors with their own medical 58 4 practice 57 Incentive system with tariff points/ hospital doctors Specification of standards/ hospital doctors Political commitment of canton/ hospital doctors 33 Education measures/ hospital doctors (N doctors with their own medical practice = in each case approx. 370, N hospital doctors = in each case approx. 180) Although the introduction of the electronic patient record has lost a little support, at least in individual groups, vast majorities are still of the opinion that this is helpful for progress in coordinated treatment (see Figure 11 below). Hardly anyone sees this development as actually an impediment nevertheless in most groups a share of around 20 percent continues to have reservations with the specific opinion that, in their eyes, it is primarily a matter of the specific design. 11

12 Grafik 11 Assessment of the electronic patient record for coordinated treatment "In your view, for progress in coordinated treatment, is the electronic patient record " in % of surveyed doctors, IT at hospitals, pharmacists, old people s homes and nursing homes, IT in cantons, IT at Curaviva, Don t know/no answer Very much an impediment An impediment to some extent It depends IT at hospitals IT in cantons Old people s homes and nursing homes IT at Curaviva 38 Quite helpful Very helpful for progress in coordinated treatment (N doctors= 594, N IT at hospitals = 95, N pharmacists = 374, N old people s homes and nursing homes = 498, N IT in cantons = 22, N IT-Curaviva = 1, = 199) Data protection With the digitisation of the health care sector, data protection is gaining an increasingly important role. This finding is also clearly emphasised in the population survey in 201. Overall, voters in Switzerland in terms of the trust expressed in data protection at the corresponding authorities are in the best company with most health care professionals: a not overwhelming but constantly clear majority entirely or to some extent trust the authorities which deal with patient data in terms of protection. The members of the medical profession are a little more cautious here, however. Among hospital doctors it is still just about an absolute majority that trust data protection (52%), among doctors with their own medical practice, however, the level of trust has temporarily made a huge drop from 52 percent last year to 35 percent this year. 12

13 Grafik 12 Trend in comparison of trust in compliance with data protection "How much trust do you have that the authorities which work with patient data/inhabitant data also comply with data protection in connection with the electronic patient records?" in % of surveyed doctors, IT at hospitals, pharmacists, old people s homes and nursing homes, IT in cantons, IT at Curaviva,, eligible voters, share of those who trust them entirely/trust them to some extent with their own medical practice Hospital doctors IT at hospitals IT in cantons Old people s homes and nursing homes IT at Curaviva Eligible voters (N doctors with their own medical practice = in each case approx. 370, N hospital doctors = in each case approx. 180, N IT at hospitals = in each case approx. 5, N pharmacists = in each case approx. 0, N IT in cantons = in each case approx. 20, N old people s homes and nursing homes = in each case approx. 415, N IT-Curaviva = in each case approx. 15, N = 199, N eligible voters = in each case approx. 1000) Grafik 13 If we compare the perceived security of the data with electronic storage and with storage in paper form, there are different beliefs: on the one hand, 4 percent of the eligible voters consider it very or quite likely that unauthorised third parties are able to access medical data when these are stored electronically. With storage in paper form, 48 percent consider improper access to be very or quite likely. In contrast to the eligible voters, health care professionals overall consider it less likely that unauthorised third parties are able to access medical data. In accordance with their profession, the IT departments of the hospitals and cantons together with the old people s homes and nursing homes also assume that misuse is, overall, less likely with electronic data storage than with storage in paper form. Members of the medical profession, pharmacists and the IT of Curaviva, however, are of the opinion that misuse is less likely with storage in paper form. Data protection with storage in paper form "How likely do you find it that unauthorised third parties can access medical data which are relevant for treatment if these data are stored by a health care professional or in the health care professional s establishment in paper form?" in % of surveyed eligible voters, doctors, IT at hospitals, pharmacists, old people s homes and nursing homes, IT in cantons, IT at Curaviva, 9 9 Very unlikely Eligible voters IT at hospitals IT in cantons Old people s homes and nursing homes IT at Curaviva Rather unlikely Don t know/no answer Quite likely Very likely (N eligible voters = 1212,N doctors= 594, N IT at hospitals = 95, N pharmacists = 374, N old people s homes and nursing homes = 498, N IT in cantons = 22, N IT-Curaviva = 1, = 199) Data protection with electronic storage "How likely do you find it that unauthorised third parties can access medical data which are relevant for treatment if these data are stored electronically by a health care professional or in the health care professional s establishment?" in % of surveyed eligible voters, doctors, IT at hospitals, pharmacists, old people s homes and nursing homes, IT in cantons, IT at Curaviva, Eligible voters IT at hospitals IT in cantons Old people s homes and nursing homes IT at Curaviva Very unlikely Rather unlikely Don t know/no answer Quite likely Very likely (N eligible voters = 1212,N doctors= 594, N IT at hospitals = 95, N pharmacists = 374, N old people s homes and nursing homes = 498, N IT in cantons = 22, N IT-Curaviva = 1, = 199) 13

14 Evidently there is agreement in principle among health care professionals about which forms of data transfer are rather unsafe and with which forms data misuse is unlikely. The specific level of trust differs slightly, however. Overall people trust normal s and delivery by fax the least, followed by internetbased systems. Trust in traditional letter post is clearly higher and secure is generally seen as the best way of preventing unauthorised access to data. Grafik 14 Likelihood of data misuse during transfer very/quite likely "How likely do you find it that unauthorised third parties can access medical data which are relevant for treatment if these data are transferred between health care professionals and their establishments in the following way?" in % of surveyed doctors, IT at hospitals, pharmacists, IT in cantons, old people s homes and nursing homes, IT at Curaviva,, share of those who consider it very/quite likely in % of eligible voters who would open and use an electronic patient record or would be prepared to open such a record on the recommendation of a health care professional Normal Fax Internet-based systems Letter post Secure IT at hospitals IT in cantons Old people s homes and nursing homes IT at Curaviva Eligible voters (N doctors= 594, N IT at hospitals = 95, N pharmacists = 374, N old people s homes and nursing homes = 498, N IT in cantons = 22, N IT-Curaviva = 1, = 199, n eligible voters = 598) Data base For the sixth Swiss ehealth Barometer carried out on behalf of InfoSocietyDays, in an online study 594 doctors, 95 people responsible for IT at hospitals, 374 pharmacists, 498 people responsible at old people s homes and nursing homes, 22 people responsible for IT at the level of the cantons, 1 people responsible at the cantonal associations of Curaviva and 199 members of NPO Spitex grassroots organisations were surveyed. The survey was carried out between 1 December 2015 and 31 January 201. For members of the medical profession there was also the possibility in this period of filling out the survey on paper and sending it back by post. 14

15 Conclusion of the study We summarise our findings as follows: Finding 1: ehealth is continuing to become established in the Swiss health care system. The interest is rising among health care professionals and the potential for improvement for one s own working environment is perceived more broadly. Finding 2: In particular at the directly affected level of IT, but also among the rest of the health care professionals, people are participating increasingly actively in implementation projects for ehealth. Finding 3: It is necessary to differentiate between members of the medical profession with regard to ehealth issues. Between hospital doctors and doctors with their own medical practice there are generally big differences. While ehealth and the various forms of digitisation have arrived and are supported in hospitals, doctors with their own medical practice are increasingly keeping their patient records in electronic form but they also increasingly doubt the benefits of electronic patient records. Finding 4: The introduction of electronic patient records is still supported by a majority of health care professionals. But this support has stagnated over the course of the last year or has even decreased. Finding 5: Ensuring the trustworthy handling of health data is essential for the success of ehealth in Switzerland. Overall people expect careful data protection. Members of the medical profession have much less trust than the rest of the health care professionals that there will be compliance with data protection. Finding : The grassroots organisations are well placed in ehealth matters. They are open to contemplated innovations, recognise potential for improvement and form a network where it is beneficial for their own work, at least internally within the organisation. But here, like with the rest of the health care professionals, there is still a lot to do. 15

16 Appendix gfs.bern team LUKAS GOLDER Senior project manager, member of the executive board, political and media scientist, Master of Advanced Studies in Communication Management Areas of focus: integrated communication and campaign analyses, image and reputation analyses, media analyses/media impact analyses, youth research and social change, votes, elections, modernisation of the state, health policy reforms. Publications in omnibus volumes, specialist magazines, daily press and on the internet CLOÉ JANS Junior project manager, political scientist Areas of focus: votes and elections, society research, campaigns, analysis of political themes and issues, media content analyses, teaching STEPHAN TSCHÖPE Head of analysis and services, political scientist Areas of focus: coordination of services, complex statistical data analytics, EDP and survey programming, projections, party and structural analyses with aggregate data, integrated communication analyses, visualisation MARCEL HAGEMANN Data analyst, social scientist Areas of focus: data analysis and databases, programming, integrated communication analyses, media analyses, research, visualisations, projections 1

17 ALEXANDER FRIND Intern, political scientist Areas of focus: data analysis, programming, qualitative methods, research, media analyses, visualisations JOHANNA LEA SCHWAB Secretary s office and administration, management assistant (Swiss Federal VET Diploma) Areas of focus: desktop publishing, visualisations, project administration, administration of presentations 17

18 The research institute gfs.bern is a member of the Swiss Association of Market and Social Research and guarantees that no interviews are carried out with overt or concealed advertising, sales or ordering intentions. More information can be found at gfs.bern ag Hirschengraben 5 Postfach CH 3001 Bern Telefon Telefax info@gfsbern.ch