Imple­men­ta­tion of the nation­al HIS and HIE services and their post-deployment follow-up since May 2010 in Finland

Abstract

Since the demand for health­care system and service reforms is compelling, there seems little choice but to intro­duce complex infor­ma­tion and commu­ni­ca­tion tech­nol­o­gy on a large, often nation­wide scale. Major restruc­tur­ing of health services is rarely possi­ble with­out perva­sive infor­ma­tion infrastructure.

Top-down, bottom-up and middle-out imple­men­ta­tion approach­es a briefly discussed. In Finland, a middle-out approach was applied and it combined local consul­ta­tion, local­ly driven invest­ment and system choice with central govern­ment support, lead­er­ship, resources and nation­al­ly agreed inter­op­er­abil­i­ty stan­dards and goals. The middle-out approach worked well in case of the nation­wide Kanta Services.

In 1995, the Ministry of Social Affairs and Health of Finland published a strat­e­gy for utiliz­ing tech­nol­o­gy in the field of social welfare and health­care in Finland. Finland’s first large-scale health infor­ma­tion devel­op­ment program in health­care and social welfare services was the Satakun­ta Macro Pilot region­al program in West­ern Finland 1998–2001. It large­ly failed but gave oppor­tu­ni­ties to learn how to execute simi­lar or nation­wide HIS mega-projects, includ­ing health infor­ma­tion exchange (HIE).

Accord­ing to a long-term Govern­ment Reso­lu­tion in April 2002, and inte­grat­ed nation­al elec­tron­ic patient record system was to be intro­duced by the end of 2007.

Finland phased in elec­tron­ic prescrip­tion with the Act on Elec­tron­ic Prescrip­tion, which became effec­tive on 1 April 2007. Togeth­er with the Act on Elec­tron­ic Process­ing of Health Care and Social Welfare Client Data, became effec­tive of 1 July 2007, legis­la­tion on the nation­al Kanta Services was thus in place. Perma­nent legis­la­tion oblig­ed all public health­care providers to inte­grate their oper­a­tions into a shared nation­al, central­ized and inte­grat­ed elec­tron­ic archiv­ing system – a stip­u­la­tion that also applied to private health­care units that did not use paper-based archives.

The eHealth Roadmap – Finland was published in 2007, and it aimed to provide solu­tions to support elec­tron­ic services for inhab­i­tants built on top of the nation­al archi­tec­ture published in 2006.

The imple­men­ta­tion and adop­tion of the nation­wide Kanta Services were intro­duced in a step-by-step fash­ion. The My Kanta pages for users and Prescrip­tion Centre services for profes­sion­als were imple­ment­ed and adopt­ed first from May 2010 onwards and there­after the Patient Data Repos­i­to­ry services for profes­sion­als from Novem­ber 2013 onwards. Public health­care service providers imple­ment­ed and adopt­ed the Kanta Services first and there­after private health­care service providers. Large-scale nation­wide imple­men­ta­tion was support­ed by a nation­al oper­a­tive coor­di­na­tion unit with an appro­pri­ate legal mandate in the perma­nent legis­la­tion. The unit was locat­ed at the Finnish Insti­tute for Health and Welfare (THL), an estab­lished public health institution.

It took 5.5 years to imple­ment and adopt two large-scale nation­wide HIS and a HIE cover­ing public prima­ry health­care centers and phar­ma­cies, hospi­tals and private health­care providers in a coun­try with 5.5 million inhab­i­tants. The propor­tion of health­care service providers that utilize (elec­tron­ic) Prescrip­tion Centre services is 100%, where­as over 90% for the Patient Data Repos­i­to­ry services.

In addi­tion, there will be a discus­sion on system perfor­mance of the Kanta Services as followed-up by utiliz­ing user log-based infor­ma­tion since May 2010. 

Speak­er

Vesa Jormanainen, MD, MSc

Special­ist in Public Health Medi­cine. Senior Minis­te­r­i­al Advi­sor, Medical Affairs in the Ministry of Social Affairs and Health in Finland, Univer­si­ty of Helsinki

Date

Day: Tues­day, Septem­ber 19
Time: 09:00 am – 10:00 am
Place: AULA