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


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. 



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


Datum: Diens­tag, 19. Septem­ber
Uhrzeit: 09:00 – 10:00 Uhr