e Health and e Social in Finland today

e. Health and e. Social in Finland today and 2020 Anne Kallio MSAH Finland

Finland? § population 5, 4 million § GDP per capita 47 000$ § Life expectancy M 77 / F 83 years § Total fertility rate 1. 85 § Infant mortality 2. 4/100 § 38% have tertiary education NEWSWEEK's list of the world’s best counties to live 2010 1. Finland 2. Switzerland 3. Sweden OECD Why cold, dark, small, and depressive nations top the rankings. Newsweek, Aug 16, 2010 8: 00 AM EDT Codrescu is the author of The Poetry Lesson and the editor of Exquisite Corpse (corpse. org). 2 3/16/2018 Etunimi Sukunimi

Health care in Finland OECD Economic Surveys: Finland 2012: The highly decentralised health care system with multiple tracks and parallel financing contributes to inequality and inefficiency Key principle • Residence-based, universal and equal right to health services Provision • Municipalities (320) are responsible for organising primary health care and specialised medical care • 20 municipality owned hospital districts and appr 170 health care centres • employers organise preventive occupational health care • private health care appr 25% => Reform to be planned Funding • Public services by tax revenues collected by the state and municipalities plus client charges • Private services are partly reimbursed under the national health insurance system • Medication is partly reimbursed under the national health insurance system => financing reform to be planned 9, 2% of GDP to healthcare services 3 3/16/2018 Etunimi Sukunimi

Local and Regional e. Health situation in Finland by 2014 Delights Strong base for further development: e. Health study 2011* • EHR coverage 100% (public prim and sec healthcare) , 80% (private) • EHR information exchange 90% (public, hospital districts) • Electronical referrals and discharge letters 95% ITIF 2009: • Finland, Denmark and Sweden are leading Health IT countries (http: //www. itif. org/files/2009 -leadership-healthit. pdf) EU comission e. Health Benchmarking 2012 -2013: • Nordic countries are the leading countries in EU Drawbacks • forerunners dilemma: old EHR systems, usability • interoperability • slow adaptation of citizen e. Services 4 3/16/2018 *) Use of ICT in Finnish Health Care in 2011. Status and Future Directions. National Institute for Health and Welfare (THL). Report 3/2012, Helsinki, Finland 2012. Etunimi Sukunimi

EU European Hospital Survey: Benchmarking Deployment of e-Health Services (2012– 2013) Finland Sweden Denmark Norway 5 3/16/2018 Etunimi Sukunimi

National e. Health house in Finland today Functionalities now § e. View and Patient Information service for citizens § structured patient information available for professionals § e. Prescription National e. Health Kanta-services Local infrastructure 100% EHR, Pacs etc Roof § local implementations -> standard patient information in national repository § obligatory for private and public, primary and secundary health care Floors § adjustement of local EHRs § auditing of EHRs and health care providers Foundation § semantic and technical standards for interoperability § national repository, e. Prescription 6 3/16/2018 Etunimi Sukunimi

Kanta services Public healthcare providers Hospital districts (20) e. Prescription service Primary care org. (192) Aged 18 and older Other NCPs not yet connected Main standards • HL 7 V 3: CDA R 2 Level 3 and Medical Records • IHE IT-I Profiles • W 3 C XML DSig • WS Addressing, WS-I • TLS, X. 509 6. 9. 2011 ep. SOS NCP Swedish ep. SOS NCP IHE XDS Health care professionals Top 10 webpage in Finland My Kanta pages Kanta messaging layer IHE XDS-I Pharmacies (~800) Citizens (> 5 000) Prescriptions Renewals Private healthcare providers (4000) Web services for HCPs Logs Patient data repository Dispensations Metadata Radiology DICOM studies Health records, legacy (CDA R 2 L 1) Logs Health records, structured (CDA R 2 L 3) Patient data management service Patient summary management Diagnoses Vaccinations Procedures Risks Lab Health and care plan Radiology Physical findings Medication Consent and will management Pharmaceutical database Organ donation wills Living wills Opt-ins and opt-outs Other national services National code server Code lists and terminologies Healthcare and social care organizations register Form and document structures Pharmacies register Certification services 7 3/16/2018 Health care professionals register Etunimi Sukunimi

Information in support of well-being and reforming services e. Health and e. Social strategy 2020 Finland

Focus areas in the strategy Active citizen § can take responsibility of his/her own well-being and health § is an active partner in his/her social and health care processes Effectivity of social and health care services § good use of technology and repositories § new ways to deal services § important role in renewing social and health care system in finland 9 3/16/2018 Etunimi Sukunimi

e. Health and e. Social strategy 2020 Knowledge to support welbeing and reforming services 1. Citizen: Yes I can 2. Professional: Capable users and smart systems 3. Service system: Good use of diminishing resources 4. Knowledge management: Knowledge first, then decisions 5. Management and co-op: from arias to operas 5. Infostructure: Solid base 10 3/16/2018 Etunimi Sukunimi

Citizen - I can! National approach for e. Health and m. Health services A platform for managing the citizens' personal information § I can put in personal health and welfare information § I use selfcare devices and apps § information is available also for professionals, with consent § I can contact my health and social care providers electronically Life control § I get reliable information on welbeing and health § I can contact my health and social care providers eelctronically § I have a cross-sectoral treatment plan Freedom of choice § I get quality and availability information about social and health care services use of web: 27% 75 -89 y 92% 16 -74 11 3/16/2018 Etunimi Sukunimi

Professionals - smart systems for capable users Strategic objectives § Professionals have access to information systems that support their work and its operating processes § Electronic applications in the use of professionals Measures § § National criteria for the usability of information systems Decision-making support for professionals Training of professionals Active user involvement in the development and adoption of information systems and operating models 12 3/16/2018 Etunimi Sukunimi

Service system – effective utilisation of limited resources Strategic objectives § Client and patient information is accessible to professionals and clients § Solutions of tinformation management increase the effectiveness and impact of the service system § The availability and accessibility of the services is being improved through electronic solutions Measures § Legislation on the use of information related to social welfare and health care services § Information resource solution for social welfare implemented as part of Kanta services § Implementation of Kanta-services § expand of information contents and functionalities of Kanta-services § Development and use of online services § Support for processes and operations 13 3/16/2018 Etunimi Sukunimi

Refinement of information and knowledge management – knowledge based management Strategic objectives § Data sets support in real time the management of service production and decision-making in society § Data sets support research, innovation and industrial and commercial activities Measures § Legislation on secondary uses (unrelated to care or client relationship) of social welfare and health care data § Development and resourcing of secondary use of data – Population-level statistical and indicator services – Common infrastructure – for secondary use of the data 14 3/16/2018 Etunimi Sukunimi

Steering and cooperation in information management – from soloist to harmony Strategic objectives § The structures are clear and support the social welfare and health care service reform Measures § The steering and organisation will be clarified as part of the reform of social welfare and health care services § A model for cooperation between social welfare and health care regions and national operators will be established § Common procedures in preparing and making decisions on national solutions in information management, their funding and their adoption methods 15 3/16/2018 Etunimi Sukunimi

Infostructure – ensuring a solid foundation Strategic objectives § Interoperable and modular architecture § Information security i. e. the accessibility, integrity and protection of data § Sufficient data connections will be ensured § Good development and procurement processes Measures § Adoption of enterprice architecture § Development of standards and support for their use and dissemination § Ensuring information security and data protection § Improving data connections of professionals and citizens § Cooperation in development and procurements 16 3/16/2018 Etunimi Sukunimi

Innokylä - materials and comments: https: //www. innokyla. fi/web/verkosto 1248184 Linked. In - discussion group http: //www. linkedin. com/groups? home=&gid=6526167& trk=anet_ug_hm Strategy: http: //www. stm. fi/julkaisut/nayta/-/_julkaisu/1900412#fi anne. kallio@stm. fi THANK YOU WWW. KANTA. FI 17 3/16/2018 Etunimi Sukunimi