4PM Ventures

Friday is here, and so is your favorite series!

We continue our Friday series where we review and announce studies that we find interesting and that we recommend investors and founders pay attention to. Today, we will be providing an overview of the 2026 eHealth Indicator Study published by the European Commission.

This report tracks progress toward the Digital Decade goal of giving all EU citizens access to their electronic health records by 2030. The data comes from all 27 EU member states plus Iceland and Norway, reflecting the situation as of December 2025.

The average eHealth score for the EU-27 is now 87%, up from 83% in 2024. Eighteen member states improved their scores, while nine stayed at the same level. Belgium and Estonia hold perfect 100% scores. This is the fourth year of data collection using this methodology.

All participating countries now report having some form of online access to electronic health records, meaning this foundational layer has reached full maturity since 2023. Twenty-three member states use centralized access services, while Ireland, Italy, Spain, and Sweden operate regional services. Ireland launched a national patient application in 2025. Sweden provides a nationally available portal jointly owned by regions and municipalities. The Netherlands uses the MedMij framework alongside services from private healthcare providers.

In terms of available data types, personal identification information is accessible in all 27 member states. Current and past medicines are available in 26 countries. eDispensation records, ePrescriptions, laboratory tests, and hospital discharge reports are each available in 24 or 25 member states. The least mature data categories are medical images and data about devices and implants, which lag due to technical limitations and fragmented systems. Nine member states and Iceland improved on this layer. Greece increased its score by 21 points and France by 17 points.

On access technology, 22 member states now use electronic identification compliant with the EUDI Regulation. Greece and Ireland now use two-factor authentication. Almost all member states, 96%, provide an online portal, while 74% also offer mobile applications. Twenty-three member states report that 80% to 100% of their population can technically access their records.

Provider connectivity reveals a notable gap. Public providers average 85% connectivity, while private providers lag at 66%. Geriatric nursing homes, rehabilitation centres, and mental health facilities have lower connectivity rates than other types of providers.

On equitable access, 22 member states facilitate access for legal guardians to their wards' health data. The same number provide assistance for using online services. Only 18 member states allow citizens to authorize others to access their health data and act on their behalf. Five member states have neither legal provisions nor implemented functionality in this area. Compliance with web accessibility guidelines reached 81% in 2025.

The 2025 results show continued progress toward the 2030 target. More health data types are becoming available in a timely way. More private sector providers are connecting. More member states are adopting compliant authentication methods. The share of the population with technical ability to access records continues to grow. However, gaps remain. Medical images and device data lag behind, private providers and specific facilities like nursing homes and mental health centres remain less connected, and legal and technical provisions for authorized access are not yet universal.

Our Venture Builder is looking for projects in the digital health market and is ready to help founders develop them. If you have such a project, please send your investment deck to us [email protected]

Attention LPs, Family Offices, Fund of Funds, and everyone who has already invested or is considering investing in venture funds and Venture Builders as a new asset class.

PitchBook recently published two studies that, at first glance, appear to be completely unrelated.

But perhaps one is actually a direct consequence of the other.

The first study:

"Europe's PE capital consolidates around established firms."

According to PitchBook, first-time fund managers raised just €3.4 billion, representing only around 10% of the total capital raised. Meanwhile, established managers secured €34.1 billion across 35 funds.

In other words, European capital is increasingly concentrating around established players, proven strategies, and familiar investment models.

The second study:

"European VC returns edge back into positive territory."

After two consecutive quarters of negative performance, the rolling one-year IRR of European venture funds reached just 0.3% in Q3 2025.

Just 0.3%.

And that raises an important question.

Could these modest returns be, at least in part, the result of the growing conservatism of European capital?

If most of the capital continues to flow to the same managers, the same funds, and the same investment models, the market inevitably becomes less open to experimentation.

And that means fewer:
• new fund managers;
• new investment strategies;
• sector-specific Venture Builders;
• platform models;
• corporate venture building initiatives;
• and new mechanisms for creating and scaling companies.

Yet historically, new teams and new approaches have been the source of asymmetric returns.

Exceptional performance rarely comes from consensus.

It usually comes from backing new ideas, new managers, and new models before they become mainstream.

Europe does not suffer from a lack of talent or innovation.

World-class technologies are being developed every day in our universities, hospitals, research centres, and deeptech companies.

What Europe often lacks is capital willing to experiment with new ways of creating companies and commercialising innovation.

In my view, the greatest risk facing European venture capital today is not that investors are taking too much risk.

It is that the market is taking too little new risk.

And that is why conservative capital increasingly generates conservative returns.

At 4PM Ventures, we believe that the next growth cycle in European HealthTech will be built not only around individual startups, but also around new company creation models: Venture Builders, platforms, and innovation ecosystems.

Do you agree?

Perhaps today's market is creating a unique opportunity for investors willing to look beyond traditional investment models.

Perhaps you are one of the LPs, Family Offices, or Fund of Funds looking for:
• new management teams;
• new investment strategies;
• new value-creation mechanisms;
• new asset classes such as Venture Builders;
• and access to the next generation of market leaders before they become obvious to everyone else.

If everyone continues to allocate capital to the same managers and the same strategies, who will finance the next generation of winners?

My team and I at 4PM Ventures are always open to meeting like-minded investors, exchanging ideas, and discussing new approaches to building and scaling companies.

Let's connect.

Europe's PE capital consolidates around established firms - PitchBook Germany is the only major market where emerging managers raised more funds than their experienced rivals.

👏 Great to see Sifted mapping Europe's rapidly growing **Preventative Health** ecosystem.

From biological age testing and early diagnostics to personalized prevention and health management, a new generation of companies is reshaping how we think about healthcare.

But perhaps the most interesting takeaway is this:

**Preventative Health is no longer a niche market segment. It is becoming a strategic priority for the entire healthcare industry.**

Today, it matters not only to patients, but also to:

✅ healthcare systems;
✅ employers;
✅ insurers;
✅ investors;
✅ pharma and MedTech companies.

At 4PM Ventures, we believe this is part of a much bigger transformation.

Healthcare is becoming:

• more predictive;
• more preventive;
• more personalized;
• more data-driven;
• and increasingly platform-based.

But great companies do not emerge in isolation.

They need:

🔹 ecosystems;
🔹 data;
🔹 clinical partners;
🔹 investors;
🔹 infrastructure;
🔹 cross-border collaboration.

This is precisely why we have been studying the development of the Baltic HealthTech ecosystem and created the **Baltic HealthTech Ecosystem Interactive Map**.

🌍 [https://4pmventures.com/map/](https://4pmventures.com/map/)

Our goal is to better understand where innovation is emerging, help ecosystem participants find each other, and build stronger infrastructure for the next generation of HealthTech companies and platforms.

We invite startups, investors, healthcare providers, corporations, and ecosystem builders to explore the map and join us in making Europe's healthcare innovation ecosystem more connected, transparent, and visible.

Because perhaps the next winners in healthcare will not be individual products.

**They may be the ecosystems and platforms that enable prevention at scale.**

And perhaps healthcare is no longer just about treating disease.

**It is becoming an infrastructure for maintaining health.**

https://sifted.eu/articles/preventative-health-market-mapped

Europe’s proactive health startups, mapped From full-body scans to biological age tests, startups are building for consumers who want more data, earlier warnings and personalised ways to take control of their health