ehealth and esocial in Finland - today and 2020 Anne Kallio MSAH Finland

ehealth and esocial 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 OECD 2 19.3.2015

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 19.3.2015

Local and Regional ehealth situation in Finland by 2014 Delights Strong base for further development: ehealth 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 ehealth Benchmarking 2012-2013: Nordic countries are the leading countries in EU Drawbacks forerunners dilemma: old EHR systems, usability interoperability slow adaptation of citizen eservices *) 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. 4 19.3.2015

EU European Hospital Survey: Benchmarking Deployment of e-health Services (2012 2013) Finland Sweden Denmark Norway Norway 5 19.3.2015

National ehealth house in Finland today Functionalities now eview and Patient Information service for citizens structured patient information available for professionals eprescription National ehealth 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, eprescription 6 19.3.2015

IHE XDS epsos NCP IHE XDS-I Kanta messaging layer Public healthcare providers Hospital districts (20) Primary care org. (192) Private healthcare providers (4000) Pharmacies (~800) Citizens (> 5 000 000) Health care professionals Swedish epsos NCP Other NCPs not yet connected Aged 18 and older Kanta services Top 10 webpage in Finland My Kanta pages Web services for HCPs Pharmaceutical database eprescription service Renewals Patient data repository Health records, legacy (CDA R2 L1) Patient summary management Diagnoses Procedures Risks Consent and will management Organ donation wills Prescriptions Radiology DICOM studies Patient data management service Vaccinations Lab Health and care plan Living wills Logs Dispensations Metadata Logs Health records, structured (CDA R2 L3) Radiology Physical findings Medication Opt-ins and opt-outs Main standards HL7 V3: CDA R2 Level 3 and Medical Records IHE IT-I Profiles W3C XML DSig WS Addressing, WS-I TLS, X.509 6.9.2011 Other national services National code server Code lists and terminologies Form and document structures Certification services 7 19.3.2015 Healthcare and social care organizations register Pharmacies register Health care professionals register

Information in support of well-being and reforming services ehealth and esocial 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 19.3.2015

ehealth and esocial 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 19.3.2015

Citizen - I can! National approach for ehealth and mhealth 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 use of web: 27% 75-89 y 92% 16-74 Freedom of choice I get quality and availability information about social and health care services 11 19.3.2015

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 19.3.2015

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 19.3.2015

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 19.3.2015

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 19.3.2015

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 16 and 19.3.2015 procurements

Implementation of strategy 31 strategical measures have been prioritised and collected in five baskets Basket 1 Citizens services chair Teemupekka Virtanen/MSAH, secr Karri Vainio/Kuntaliitto Basket 2 Professionals and service system chair Sirpa Mäntynen/Kouvola, secr Jari Porrasmaa/STM Basket 3 Refinement of information and knoledge management chair Sari Mäntylä/Tampere, secr Mika Gissler/THL Basket 4 Steering and cooperation chair Maritta Korhonen/STM, secr Minna Saario/Kuntaliitto Basket 5 Infostructure chair Juha Mykkänen/THL/OPER, secr Jari Porrasmaa/STM Follow up and comments: https://www.innokyla.fi/web/verkosto1248184 17 19.3.2015

Innokylä - materials and comments: https://www.innokyla.fi/web/verkosto1248184 LinkedIn - 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 18 19.3.2015