'Finland is the first country in Europe to consolidate EMR data at a national level.'

"When you have a countrywide ability to mine data, then you start to secure yourself a powerful future."

(HealthTech Wire / Interview) - The way that countries manage healthcare data is changing – not just at an organisational level but also at a national one. We spoke to Anne Kallio, Head of Development at the Ministry of Social Affairs and Health in Finland, who gave a presentation at on the topic at this year’s eHealth Week in Riga - and Michael Graetz, VP Healthcare EMEA Sales, Enterprise Content Division, at EMC, who moderated the session - to distil some of the highlights of the conversation around this.

Can you tell us a little about how the way we manage clinical data is evolving, from your perspective?

MG: There seem to be two philosophies playing out across Europe at the moment -with some countries doing one thing and some doing the other. The discussion centers around the question, ‘Do I create a national health archive, which contains all the people’s care data – or do I simply bring the data together when the physician needs it, at the point of care?’

Sweden and Austria are good examples of the latter approach – as is, I believe, Switzerland. In these countries, data is held in many diverse locations and, when the physician needs it, at the point of care, the data on the patient is brought together.

Countries like Finland are taking the former approach – they are building a national archive, so that everybody that needs to see a patient’s data can access these archives and get the complete file on the patient (providing of course the patient has given their consent).

Anne, can you tell us a bit more about Finland’s approach to clinical data management - and what is unique about it?

AK: As Michael says, we have built a national archive – a national repository for medical information, which is collected from healthcare providers across the country. And the idea is that the professionals who are taking care of a particular patient can take a look at that information if the patient has given their consent for that information to be shared.

This information is also available to the citizens themselves, via a web page which they have secure access to. And it’s creating a win-win situation for everyone. What is unique is that we are in fact the first country in Europe to consolidate EMR data at a national level.

Could you tell us a bit more about this 'win-win', from both an individual perspective and from the perspective of the whole?

AK: So far, people are really rather happy about these services, not just because the information is available at their fingertips but also because they think it is a good way to guarantee data security. When they check their information, they can also access a log that tells them exactly which organisations have been looking at their data – and this helps build trust in the system.

We published our new national eHealth strategy at the beginning of this year - and it appears, at least at this point, that it’s been very well adopted. One of the reasons for its success is that it was created in consultation with a wide range of people and organisations – we involved them all in creating this strategy.

And one of the lessons we have learnt are that these kinds of things have to be built in co-operation with both the citizen and the healthcare provider – not simply as a ‘top-down’ thing. Of course we have passed legislation that is top-down, but even this has involved lots of discussions with healthcare providers to gain a common understanding of what we need to do.

So it’s a 'win-win' situation – but has it also been an ‘easy-win’ for Finland?

AK: Not at all. Quite the reverse, in fact. As I said in my presentation at Riga, to build a house correctly you have to lay the foundations correctly first. And there’s no quick-fix for that, as far as national archives are concerned. There are so many things you have to do before you can collect your data correctly.

In Finland, we have now built the foundations of our house and we have been building a house on those foundations for some time. We can now start having different functionalities on top of that. But it’s been a long and gradual process. Our first legislation came out in 2007; we have had some standards work and the first one of these services, our ePrescriptions service, was launched in 2010. So it’s taken us nearly ten years to get to this point.

And that’s the message that I would like to get across. Everyone is excited about the potential of mobile health, but there’s no quick way of implementing it: you have to start at the beginning and lay the foundations correctly. You simply can’t afford to cut corners.

And of course, in order to keep the healthcare system running smoothly, we all have to change the way we work at a fundamental level. That’s a big task for us as professionals - we have to change the way we think and the way we work.

So what are the bigger-picture implications of this transformation, for you?

MG: For the last three or four years, I’ve observed how many conversations are taking place on national archives, with people expressing how they will start to become a massive advantage for any country that has them. But as Anne said, you have to set your foundations the right way. By removing all the silos and enabling managing citizen/patient information independently from the system or application generating them, you can then fully leverage all the opportunities that telemedicine, mobile health and wearables can add to a solid and secure base.

When you have a countrywide ability to mine data, then you start to secure yourself a powerful future. As Anne has said, it is one of those situations where technology is creating a win-win for everyone and today, many countries can also take advantage of the experience done by early adopters like Finland to reduce the time and complexities to get there.


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