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Digital hospitals market report norway 20151222

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Market report on the opportunities in the Norwegian healthcare market, prepared for the Team Finland Digital Hospitals growth program by Fintra in partnership with Oslo Medtech.

Published in: Healthcare

Digital hospitals market report norway 20151222

  1. 1. Understanding the market opportunities in the hospital/healthcare sector in Norway December 22nd 2015
  2. 2. Introduction • FinPro ry is running a growth program called "Digital Hospitals" for Finnish companies offering health technology to the hospital sector. • The Digital Hospitals export program is designed for Finnish companies working with medical technology that improves the quality of care. • The companies participating in the program can enter international markets, in this case Norway, as a larger group with the help of the program. • Oslo Medtech has developed this report together with Fintra to prepare the Finnish companies to enter the Norwegian health care market. 2
  3. 3. Table of Content 1. Management Summary 2. Introduction to the report 3. Introduction to Norwegian Health care 4. Demand for Health Technology 5. Ongoing and planned projects 6. Local medical products industry 7. Procurement processes 8. Go-to-market model Appendix 3
  4. 4. Management Summary • The National hospital plan for the years 2016-2019 has just been published, and outlines the visions and upcoming focus areas in the healthcare sector in Norway. Many of the topics raised by the ministry of health represent major business opportunities for Finnish companies providing services and solutions to this sector. These include: – Large hospital projects, both new hospitals and renovation of old ones as their roles change. – Emergency medical services concentrated in fewer hospitals, increasing the demands on first response in the field. Opportunities for providers of communication and IT systems, equipment for ambulance and helicopters. – Cardiac care, cancer, muscular-skeletal diseases as clinical focus areas. Opportunities for diagnostics, treatment, remote monitoring and care. – Mental health and substance abuse as a new focus. Opportunities for care providers, remote consultation. – Patient's role in their own treatment processes is increasing. Opportunities in e-health, m-health. – Increased emphasis on quality and efficiency, implementing systems for measuring the quality, and new management processes. Opportunities in health IT, consulting. – Telemedicine and home care, especially in the less densely populated northern areas. Opportunities for m-health, remote monitoring. 4
  5. 5. Table of Content 1. Management Summary 2. Introduction to the report 3. Introduction to Norwegian Health care 4. Demand for Health Technology 5. Ongoing and planned projects 6. Local medical products industry 7. Procurement processes 8. Go-to-market model Appendix 5
  6. 6. Introduction to the report • Introduction to Norwegian Health care – High level description of the health care governance – The focus areas for the coming years • Demand for Health Technology – The strategy outlined by the government for the period 2016-2019 • Ongoing and planned projects – A high level summary of the ongoing- and projects in planning phase • Vendor structure – Description of the medical products industry in Norway • Procurement processes – Future strategy for health care procurement • Go-to-market model – Services and markets partners needed entering a new international market • Appendix – References to ongoing projects – List of reports and data sources – Authors – Disclaimer 6
  7. 7. Table of Content 1. Management Summary 2. Introduction to the report 3. Introduction to Norwegian Health care 4. Demand for Health Technology 5. Ongoing and planned projects 6. Local medical products industry 7. Procurement processes 8. Go-to-market model Appendix 7
  8. 8. Governance structure 8 Parlament Government Regional health authority Health authority Hospital Regional health authority (RHF) Health authority (HF) Hospital Privat HospitalPrivat Hospital Privat SpescialistPrivat SpescialistCorporate governance Agreement Ministry Norwegian Directorate of health Norwegian Institute of public health Norwegian Board of Health Supervision The Norwegian Radiation Protection Authority (NRPA) Norwegian Medicine Agency Norwegian System of Patient Injury Compensation (NPE) Regional health Authority (RHF) Governance of the hospitals is organized in a Health Care Corporate Structure with four regional authorities. Each of them are organized in a number of HFs. The HFs are managing a number of hospitals.
  9. 9. Health regions plans and strategies • Health North has population responsibility for about 480 000 inhabitants – of Finnmark, Troms, Nordland, Norway and Svalbard with health authorities Find mark hospital, University Hospital of North Norway, Nordlandsykehuset, Helgeland hospital and hospital pharmacies North. • Health Midst has population responsibility for about 700 000 inhabitants – Møre og Romsdal and the South and Nord- Trøndelag with health authorities Health Møre and Romsdal, St Olavs Hospital, Nord-Trøndelag Health and hospital pharmacies in Central Norway. • Health West has responsibility for the population about 1.1 million inhabitants – for Rogaland, Hordland and Sogn og Fjordane with health authorities Health Port Augusta, health Health, Bergen, Stavanger and Drifts Health Hospital pharmacy West. • Health South-East has responsibility for the RHF population approximately 2.9 million inhabitant for – Østfold, Akershus, Oslo, Oppland, Hedmark, Buskerud, Telemark, Aust-Agder and Vest-Agder with health authorities Akershus University Hospital, Oslo University Hospital, Sunnaas hospital, Hospital Vestfold Hospital, the hospital, Inland Telemark, Østfold Hospital, southern Norway hospital, West Bay, Hospital pharmacies and hospitals partner • The regional health authorities working out each year economic long term plan and budgets for the coming 4- 5-year period, based on national and regional guidance and input from health authorities. • Economic long term plans 9
  10. 10. National shared services for the health care regions Since 2002, the regional health authorities established several jointly owned companies and enterprises for solving challenges across regions: • Air ambulance service • Patient travel • Operating organization for emergency network • National ICT is a health authority for strategic cooperation in the ICT area in the specialist health service. It was established in January 2014 and is owned by the regional health authorities. The regional health authorities will continue the efforts to consolidate and standardize regional ICT systems, coordinate measures with the other actors in the health sector, help in the development of national ICT solutions and support Health's regulatory role in the ICT field. • Sykehusbygg was established 2014 to ensure better coordination of facilities. They have responsibility for analysis, systematization and dissemination of expertise and experiences, as well as to offer consulting and Builder features by implementation of hospital projects. This will ensure a greater degree of standardization in the new hospitals. The Government will investigate how hospitals will be developed building on HF with the aim of an overall responsibility for the construction and operation of health building. • Purchase service (HINAS) is the purchase company for the regional health authorities, established in 2003. HINAS coordinates the national purchase agreements for health authorities in Norway. The goal is to create gains for the hospitals. Drug purchase cooperation (LIS) was established as a joint purchase scheme for the country's hospitals already in 1995. The purpose is to do the groundwork for deals for the purchase and delivery of pharmaceuticals and other pharmacies items by missions from the health authority 10
  11. 11. Strategy documents and how they relate National Budget 2016-> Regional Health Care Investment Plans Existing and new Long term health care strategy –> 2021 National hospital plan 2016-2019 11 Two processes has lead to two strategy documents for the future health care. The proposed actions will be financed through the annual national budget. The regions will develop and execute the implementation
  12. 12. National health care- and hospital plan 2016-2019 • The national health and hospital plan applies for the period 2016-2019, but describes and discusses the developments leading up to 2040. • In this plan period the Government will: – create the patient's health service – prioritize mental health and promotion within the substance abuse treatment – renew, simplify and improve the services – Enough health care professionals with the appropriate competence – strength quality and patient safety, and set clear requirements for hospitals – better collaboration and cooperation between the hospitals – strengthen emergency medical services outside the hospital https://www.regjeringen.no/no/dokumenter/meld.-st.-11-20152016/id2462047 12
  13. 13. Demographic change in Norway is similar to the development in the western world 13 No of persons Registered Prognosis
  14. 14. The number of patients distributed on selected diagnoses and age 14 Source: Cardiovascular Cancer Muscle and skeleton Respiration Noofpatients Age
  15. 15. Table of Content 1. Management Summary 2. Introduction to the report 3. Introduction to Norwegian Health care 4. Demand for Health Technology 5. Ongoing and planned projects 6. Local medical products industry 7. Procurement processes 8. Go-to-market model Appendix 15
  16. 16. Challenges in Norwegian health care • We become older. This will have great significance for health services, when 70+ year-olds use twice as much healthcare services as the 40-year-olds. • The population of the major cities increases. Young people and immigrants settle in the largest cities. The pressure on health services in the cities due to more elderly people, more migrants and more immigrants. • District challenges are related to the increase in the number of elderly people • It is especially the offering to the patients in the largest disease groups that will be under pressure. Disease increases with age, and these disease groups include largely elderly patients, who often also have multiple diagnoses. • The demographic changes will increase the need for years of work with 27 percent up to 2030, and with 40 percent up to 2040. • Resource needs are not affected significantly by changes in assumptions about immigration, life expectancy and health status of the elderly. • Productivity growth and better standard of services are factors that particularly affect the resource requirement. To meet the challenges, it is necessary to both increase resources and to speed up restructuring in the health services. 16
  17. 17. Medical Development • Medical research and innovation brings forward new treatment possibilities, drugs and medical supplies on a large scale and high tempo. • The treatment methods are more efficient, and many more can be treated, also in older age. • Many new therapies require advanced and expensive equipment and multidisciplinary, highly specialized teams of professionals. • But we will also see a development where the equipment gets less complex and more mobile • Many studies and treatments can be performed closer to the patient - in a small hospital and local medical centers, or in patient’s own home 17
  18. 18. Main Goals for the period 2016-2019 1. Strengthen the patients role 2. Prioritize the service offer within the mental health and substance abuse treatment 3. Refresh, simplify and improve the system 4. Enough health care providers with the right skills 5. Better quality of service and patient safety 6. Better collaboration (task distribution) and cooperation between hospitals 7. Strengthen emergency medical services outside the hospital 18
  19. 19. 1. Strengthen the patients role • The Government will: – evaluate and extend the arrangement of patient selection of free treatment options – introduce “package processes” (standardized process) for multiple diseases; first for stroke, mental illness and addiction – carry out the system of “contact doctor” and “coordinators” to seriously ill patients – Take patients actively into the restructuring and planning of new patient flow – establish a Youth Council to all hospitals – increase the use of the lessons-learned skills in the service, including through systematic testing of experience consultants – put forward a plan for escalation habilitation and rehabilitation – continue the work of developing quality assured health information and digital solutions for communication with the specialists – continue the work to develop and make use of high quality collaboration tools and publish these on helsenorge.no19
  20. 20. 1. The new role of the patient The patient role is changing. Users of the health service expects both better quality and increased influence. If the possibilities for their own effort and interaction be exploited in partnership with health service, it can lead to better health, less need for attendance at the hospital and fewer hospitalizations. • Greater freedom of choice – With free treatment choices more private treatment places will treat patients at the State's expense, also private businesses without prior agreement with the regional health authority. • Extension of the scheme with Packet processes (standardized process) – The goal of the package of events for cancer is to contribute to rapid diagnosis and treatment without waiting time that is not medically justified. – In 2015 28 package processes was introduced for cancer after the Danish model. The Government will also facilitate to establish package sequence for mental health services and substance abuse treatment. • Patient Coordinator (contact doctor) – In the future health service patients and relatives will participate more in the prevention and treatment of own disease. More and more patients expect to communicate digitally with the specialist • Patient involvement – In the future health service patients and relatives will participate more in the prevention and treatment of own disease. – The development of new digital solutions that support active participation, will lead to major changes in the health service. We have only seen the beginning. • Volunteer – Volunteers are an important complement to the staff at the hospitals. Some hospitals have hired hospital hosts to help patients and family members to orient themselves in the hospital. • The patient's health service for immigrants 20
  21. 21. 2. Prioritize the offer within the mental health and substance abuse treatment • The Government will – give priority to mental health and interdisciplinary specialized substance abuse treatment – to facilitate that mental and somatic health care is better coordinated in future health service – assess the need for specialization, collaboration in network between the regional psychiatric centers and between children and youth psychiatric centers – continue the change process to improve emergency services by regional psychiatric centers – introduce the standardized processes for mental health – introducing standardized processes for addicts – Follow up the plan for substance abuse from 2015 – establish a national quality register for interdisciplinary specialized substance abuse treatment 21
  22. 22. 2. Specialist health services to people with mental illness and addiction • E-health and mental health care – Modern information and communication technologies provide opportunities for new forms of interaction with the user – More use of e-health and ICT will lead to major changes in the ways of working and can provide better availability, service and resource exploitation in the future mental health policy. 22
  23. 23. 3. Refresh, simplify and improve • The Government will – introduce measures across health organizations to take advantage of free capacity – strengthening interaction with private service providers – facilitate “task sharing” between health care professionals where appropriate, to reduce bottlenecks and improve the quality – continue the work with the ICT solutions that support improved working processes and patient flow – establish a national program for clinical treatment research between the four regional health authorities 23
  24. 24. 3. Refresh, simplify and improve • A forward-thinking service must adapt to the medical technological developments, the new patient role and changes in demographics and disease picture. It is necessary with improvements in organization, culture and management. • Shorter wait times – Wait times in the specialist health service has become shorter in recent years. Yet there are still too many patients who wait unnecessarily long. • Quick and efficient diagnosis – The Diagnostics will probably change a lot over the next 10-15 years. To some extent it will required more specialized equipment and expertise so that the patient needs to be looked into by larger hospitals. But the equipment will also be smaller and more mobile, so that diagnosis can decentralized. Part of the diagnostic work can happen in the ambulance on the way to the hospital. • Less unwarranted variation-the standardization of patient progression • New work processes – Developments in modern technology and ICT make it possible to deliver specialist health services in ever new ways, and to help the patients don't have travel to hospital burdensome. • Better staff planning at the hospitals – Labor costs make up between 65-70 percent of the operating costs in the specialist health service. • New task sharing between health professionals 24
  25. 25. 3. Refresh, simplify and improve • The digitization of the specialist health care – Technological opportunities be exploited not yet good enough. Specialist health service are now working together with the municipalities, health services and other actors on how the vision of "one citizen-one journal" can be realized. – "One citizen-one journal" describes a vision in which health professionals who participate in patient care, access to all the necessary and up-to-date information regardless of where the patient is located. • Stronger national management – The Directorate of e-health to be established from 1. January 2016 to strengthen the regulatory role of the eHealth. – To strengthen cooperation and the implementation of ICT projects of common interest, a national ICT organization was established in January 2014 , as part of the efforts to establish national portfolio of plans for e-health. 25
  26. 26. 4. Enough health care providers with the right skills • The Government will: – implement the new model for education of the physician specialists, based on today's professional development, the modern physician role and effective education – establish a new physician specialty geared towards the emergency departments – review educational offers and consider offers of clinical Advanced Nursing geared towards needs in hospitals – improve knowledge of the personnel and skills needed in the future specialist health service as the basis to meet the needs for health care professionals – strengthen health service's impact on the programs undertaken, and ensure better correspondence between the education content, students ' end expertise and health service's needs – that the new national staffing model developed by the regional health authority is taken into use for strategic planning of personnel and expertise needs locally and regionally – ask health authorities to strengthen their work on personnel planning, recruitment and skills development to meet the hospitals needs – stimulate flexible skills development in hospitals, including through e-learning and simulator training 26
  27. 27. 5. Better quality and patient safety The Government will: • continue the work to develop important and relevant measure of quality and patient safety in hospitals • introduce national quality requirements for treatment facilities, and national approval of regional management services • introduce a system of quality certification of the hospitals, and investigate what kind of certification scheme will create the most value • establish a national network for revision of the hospitals 27
  28. 28. 5. Quality, patient safety and quality management • Variety in quality • Better data for quality management at all levels • Stronger national management where necessary: national quality requirements for treatment services in hospitals • National system for the introduction of new methods in the specialist health service • Certification of hospital 28
  29. 29. 6. Better task sharing and cooperation between hospitals • The Government will propose the following categorization of the hospital to clarify the responsibilities and make use of health services more unified – Regional hospital, one hospital in each health region that is designated as the main hospital. The four regional hospitals are the University Hospital of North Norway, St. Olav's Hospital, Haukeland University Hospital and Oslo University Hospital. These hospitals will have the largest supply of regional features and national treatment services in the health region. – The term large emergency hospitals are hospitals covering more than 60-80 000 inhabitants, and which have wide emergency services with acute surgery and several medical specialties. – The term emergency hospital is used for hospitals that have at least acute feature of internal medicine, an anesthesiologist in emergency service and scheduled for surgery. The hospital may have emergency surgery if the geography and settlement pattern, the distance between hospitals, access to car, boat and air ambulance services and weather conditions make it necessary. – The term hospitals without emergency functions are used on hospital with scheduled treatments only 29
  30. 30. 7. Strengthen emergency medical services outside the hospital • The Government will – that the assessments of the changed collaboration between the hospitals should include pre-hospital services, and ensure that these have the necessary capacity and expertise – that capacity and base structure for the air ambulance service in the health region shall be reviewed in the light of the guidance set out in the national health and hospital plan and Emergency Committee's final report – that the cooperation agreements between the health authority and the municipalities are to be developed and detailed, so that they can act as a common planning tool for emergency medical services – strengthening the competence of analysis, research and development work in emergency medicine by establishing a trade network based on existing expertise – establish several national guidelines, guides and standards on the emergency medical area – instituting national pilot projects for education at the bachelor's level for ambulance personnel 30
  31. 31. 7. Strengthen emergency medical services outside the hospital – principles: • The Government will add the following principles for better task sharing and cooperation between hospitals: – It should still be a decentralized and differentiated hospital structure in Norway. A backbone of acute hospitals is necessary to ensure emergency and urgent help. – Functions to be centralized when it is necessary for the sake of quality, but at the same time decentralized when possible – to give the widest possible services with good quality for the community. – For patients with needs for more specialized acute services, as a general rule the treatment will happen at a big acute hospital. This means that over time, fewer hospitals than today will have emergency surgery. Recommended lower limit for the capture area for emergency surgery in the 60-80 000 inhabitants is one of several guiding principles in this assessment. Factors such as geography and settlement pattern, the distance between hospitals, access to the car-, boat and air ambulance services and weather conditions shall also be attributed with great weight – Other acute hospitals are to treat patients with common conditions that need immediate assistance in hospitals. 31
  32. 32. 7. Strengthen emergency medical services outside the hospital – principles: – Significant change in task sharing between the hospitals need to be clarified in the local processes in which the municipalities also should be heard. – A separate quality assurance system for health enterprises' work on the development plans should be created, in the form of a supervisor, to support the changes in the business is in line with national guidance, and to ensure that it is properly carried out in local processes. – There are demands for binding network between hospital and health authority in health regions. These networks will ensure the appropriate task distribution. – Hospital structure and ambulance services must be seen in context. Changed task distribution must be accompanied by the necessary strengthening of the ambulance service. – Decentralized specialist health services, possibly co-located with municipal health care services, should be further developed in order to provide good services in the near environment and overall patient flow. 32
  33. 33. Annual results and investments in the health care regions 33 Good financial governance provides room for priorities The regional health authorities have the responsibility to provide the necessary specialist health services within the given financial framework. This involves a comprehensive responsibility to see the resources for the operation and investment in context. The control system means that the health authorities have the responsibility to prioritize investment in buildings, equipment or maintenance against the other operation. To be able to make good priorities it is critical that health authorities have good management and control of resource use.
  34. 34. Privates role in future specialist health service • The Ministry of health and care services has for 2015 set requirement that the regional health enterprises increase the scope of acquisitions from private providers within the confines of the somatic disciplines within the adopted strategies. • The regional health authorities is also asked to consider specific acquisitions from private within the three somatic disciplines that have the longest waiting lists in the region, and for services where there are persistent bottlenecks in health authorities. 34
  35. 35. Long term health care strategy –> 2021 Strategy Action plan 35
  36. 36. The 10 strategic initiatives of the Health&Care21 process are: • Increased user involvement; • The health care industry as an industrial policy priority; • Knowledge mobilization for the municipalities; • Health data as a national comparative advantage; • Improved clinical interventions; • Efficient and effective services; • Meeting global health challenges; • Increased, high-quality internationalization; • Development of human resources; • Strategic and evidence-informed governance and management. 36
  37. 37. Action plan 37
  38. 38. Action plan area #7 and #10 • 7 = Better clinical treatment – Establish a joint program for clinical treatment research in specialist health care – Give the regional health authorities the mission to strengthen the infrastructure for testing of new diagnostics and medical devices – Create a new program in the Research Council for better diagnostics, treatment and rehabilitation – Further development of the Web pages with patient information about clinical studies on helsenorge.no – Establish a national database for clinical trials – Establish a research network within dental health – Introduce particle treatment through the establishment of a proton Center • 10 = Health and care as political focus areas for industry development – Strengthen the tools for industry oriented research and innovation in 2016 – Strengthen the standardization work within e- Health and AAL – To facilitate that the public health- and care service has an effective dialog with the industry about the needs – To facilitate more use of innovative procurement – Strengthen the national program for vendor development in 2016 – To facilitate a more coordinated collaboration about research, innovation and industry development 38
  39. 39. Table of Content 1. Management Summary 2. Introduction to the report 3. Introduction to Norwegian Health care 4. Demand for Health Technology 5. Ongoing and planned projects 6. Local medical products industry 7. Procurement processes 8. Go-to-market model Appendix 39
  40. 40. National, regional and local projects • This section is listing some of the major projects ongoing and under planning , and references to where to find procurement projects 40
  41. 41. Projects in Region South East Health South-East • Projects under implementation: – Hospital Østfold HF: new Østfoldsykehus completed on schedule – Oslo University Hospital HF: completion of the co- location phase 1 – Vestfold HF: Tønsbergprosjektet – Digital renewal: continuation of the regional commitment, scope will be considered on the basis of the implementation strategy and the available budget. • Projects under planning: – Oslo University Hospital HF: maintenance investments – Vestre Viken HF: New hospital in Drammen – Southern Norway hospital HF: the entry of new build Hospital Psychiatry – Telemark HF: Build the project – Oslo University Hospital HF: The new build step 1 – Innlandet HF: New hospital – process to decide the location is ongoing 41
  42. 42. Projects in Region West • Projects under implementation: – Health Bergen HF: new hospital phase 1 and 2 • Projects under planning: – Stavanger health trust HF: hospital development in the Stavanger health trust – Førde Health-HF: area plan Førde Central Hospital-build somatic 42
  43. 43. Projects in Region Midst • Projects under planning: – Health Møre and Romsdal HF: • new hospital in health Møre and Romsdal • ICT – status and plans – patient administrative systems (PAS), laboratory systems and electronic medical records (EMR) is considered old. All the systems are being planned. – Plans to carry out the acquisition of new EMR and PAS in the period 2015-2021. – The region is also developing tools for standardized patient processes, digital storage, communication and presentation of medical images, ICT-support in emergency medical chain, interactive attribution for primary health care, e-prescription and core journal and patient and public services. Standardized systems for finance and logistics is in the introduction. 43
  44. 44. Projects in Region North • Projects under implementation: – Nordland hospital HF: • upgrading and modernization of the hospital in Bodø – University Hospital of North Norway HF: • the new Afløy • PET-Centre Projects in the planning stages • new hospital in Narvik – Finnmark hospital HF: • new hospital in Kirkenes • new hospital in Hammerfest – Helgeland hospital HF: • development of Helgeland hospital 44
  45. 45. Table of Content 1. Management Summary 2. Introduction to the report 3. Introduction to Norwegian Health care 4. Demand for Health Technology 5. Ongoing and planned projects 6. Local medical products industry 7. Procurement processes 8. Go-to-market model Appendix 45
  46. 46. Medical products Industry in Norway - status and economic report • The Norwegian medical products industry consists of 490 companies with products and services that are designed to serve the health sector (excluding pharmaceuticals) • Compared with our neighboring countries the industry activities related to health and wellness technology is modest in Norway. We have not managed to develop major industrial locomotives like Sweden, Denmark and Finland. 46 March 2014
  47. 47. Medical products industry in Norway 47
  48. 48. Development in turnover and value creation 2005-2012 • The overall growth for the entire industry was 46 percent. Biomedical and Medtech companies have the greatest health-related revenue in total, but the growth of these groups is lowest with respectively a growth of 43 percent for biomedical companies and 32 percent for Medtech companies • The entire Medical Products Industry created values for 13.5 billion NOK in 2012. The value creation (*) has increased by 3.5 billion in 7 years, which corresponds to a growth of 36 percent. In the same period, the value creation in the Norwegian business community has grown by 60 percent, so the development in the medical products industry has been clearly lower than in the Norwegian business community as a whole. 48 *) Value creation: Is the companies' turnover minus bought goods and services.
  49. 49. Table of Content 1. Management Summary 2. Introduction to the report 3. Introduction to Norwegian Health care 4. Demand for Health Technology 5. Ongoing and planned projects 6. Local medical products industry 7. Procurement processes 8. Go-to-market model Appendix 49
  50. 50. Change towards a more innovative procurement process? • Most procurement done by the health care is done according to standard «non-innovative» processes. • There has been a political strategic will to change this to more use of «innovative procurement» and collaboration with the health care industry: – To facilitate that the public health- and care service has an effective dialog with the industry about the needs – To facilitate more use of innovative procurement – Strengthen the national program for vendor development in 2016 – To facilitate a more coordinated collaboration about research, innovation and industry development 50
  51. 51. The main buyers 51 Regional health authority Health authority Hospital Regional health authority (RHF) Health authority (HF) Hospital Norwegian Directorate of health Norwegian Directorate of health will be the buyer for technology and services at a national level The Regional and Local Health Authorities will be responsible for regional and local procurement National shared services The Shared Services will manage the procurement processes for technology and services on behalf of one ore more regions
  52. 52. Doffin.no Doffin is the Norwegian Web-based database for notices of public procurement and procurement in the utility sector (water and energy supply, transport, and telecommunications) that are subject to the European Union regulations. • The purpose of the base of the procurement notices is to: – Ensure competition and openness about business opportunities – To forward all procurement notices for the announcement in TED when this is necessary – Ensure the Control of procurement notices before publishing – To publish and distribute the procurement notices in a searchable format – Make relevant statistics in the public sector 52
  53. 53. http://leverandorutvikling.no/ 53
  54. 54. Step-by-step guide 54 The vendor development program («Leverandørutviklingsprogrammet») has been established as a collaboration program to increase the use of innovative procurement in the public sector. A guide to innovative procurement can be found on http://www.anskaffelser.no/innovasjon
  55. 55. Table of Content 1. Management Summary 2. Introduction to the report 3. Introduction to Norwegian Health care 4. Demand for Health Technology 5. Ongoing and planned projects 6. Local medical products industry 7. Procurement processes 8. Go-to-market model Appendix 55
  56. 56. Company and product development phase vs type of procurement 56 Your Product Your Company The procurement process Gartner hype cycle Early phase products => Innovative procurement What does you company need? - Proof of Concept / Clinical Trial - Innovative development together with an advanced customer - First market customer - Scaling
  57. 57. Where you are in the development – Services needed in a new market 57 Regulatory Proof of Concept Export/import logistics Office space/set-up Market potential Distribution Channels Company structure People strategy Reimbursement Culture Market dynamics Choose Market Project financing Capital to start Production set-up Capital to grow Reference Project Marketing strategy Set up Meeting Places Establish network to partners Facilitate and Initiate Projects Establish Office Infrastructure Collect Market Analysis Info 1. Product & Service Development (PoC) / Clinical Trial 2. Reference Project / First Commercial Deal 3. International Growth
  58. 58. What services are needed for a company to enter a new international market? 58
  59. 59. Go-to-market partner model Market access partner Own affiliate Joint Venture Collaborator Distributor Establish company Management Office facilities Financing Network Knowledge Business Development Two type of partners important for the market entry phase: 1. Establish the company in Norway: The Life Science Clusters have incubator/ accelerator and growth house services to provide. This will be good place to start 2. Market access partner: The type of partner needed would depend on the product and company development phase and the type of product, but the clusters will have access to, and the ability to match companies to partners
  60. 60. Market Players in Norway • Entering the market can be considerably more efficient with the right market access partner. • To enter the Norwegian market you may consider: – Global players like Siemens, Cerner, Philips and Microsoft – Norwegian companies in the global ultrasound market: Medisteam and GE Vingmed Ultrasound – The regional vendors and integrators like Tieto, Steria, Evry and Accenture – Local SMEs with success: eg Cesam and Imatis – International mHealth market: Telenor Global. – Through the clusters (next slide) 60
  61. 61. Norwegian Innovation Clusters • The Innovation Clusters will be a good alternative for international companies to initiate their activities in Norway. Today we have the following clusters in the health care/life science area: • Oslo Medtech (www.oslomedtech.no) – Oslo Medtech is a health technology cluster, dedicated to accelerate and support the development of new Medtech and eHealth products, services and innovative solutions for the Norwegian and global health care market. We have app. 190 members and the full health value chain is represented. • Oslo Cancer Cluster (www. http://oslocancercluster.no/) – Oslo Cancer Cluster is an oncology research and industry cluster dedicated to accelerating the development of new cancer diagnostics and medicines. We gather almost 70 members from Norway and Northern Europe representing the entire oncology value chain. • Norwegian Smart Care Cluster (http://www.smartcarecluster.no/) – The Cluster mission is to contribute to the innovation, development and commercialization of new solutions within welfare technology (AAL).61
  62. 62. Some Medtech events in Norway in 2016 • The main annual health care event in Norway is Health World (September): – http://event.cw.no/HW2015-hjem • Other events focusing on specialized topics: – eHealth 2016 (april) • http://event.dnd.no/norhit/event/konferansen-ehelse- 2016/ – European Telemedicine Conference (ETC) 2016 (November) • http://event.dnd.no/norhit/event/european- telemedicine-conference-etc-2016/ – EHiN (November) (eHealth in Norway) is a national eHealth conference organized by the Ministry of health and care services and the ICT-Norway. • www.ehin.no • In addition there will be other events on focused topics in different regions 62
  63. 63. Table of Content 1. Management Summary 2. Introduction to the report 3. Introduction to Norwegian Health care 4. Demand for Health Technology 5. Ongoing and planned projects 6. Local medical products industry 7. Procurement processes 8. Go-to-market model Appendix A. References to ongoing projects B. List of reports and data sources C. Authors D. Disclaimer 63
  64. 64. Projects in Region South East Hospitals: – Akershus universitetssykehus • http://www.ahus.no/fagfolk_/forskning_/helsetjenesteforskning_/prosjekter_/Si der/side.aspx – Oslo universitetssykehus • http://www.oslo-universitetssykehus.no/aktuelt_/prosjekter_ – Sunnaas sykehus (re-hab) • http://www.sunnaas.no/aktuelt/prosjekter – Sykehuset i Vestfold • http://www.siv.no/aktuelt_/prosjekter_ – Sykehuset Innlandet • http://www.sykehuset-innlandet.no/omoss_/prosjekter_ • Doffin – Sykehuset Telemark • http://www.sthf.no/aktuelt_/prosjekter_ – Sykehuset Østfold • http://www.sykehuset-ostfold.no/aktuelt_/Kalnes_/Sider/side.aspx – Sørlandet sykehus • http://www.sshf.no/aktuelt_/prosjekter_ – Vestre Viken • http://www.vestreviken.no/aktuelt_/prosjekter_ Pharmacy: – Sykehusapotekene • http://www.sykehusapotekene.no/aktuelt_/prosjekter_ ICT / Shared Services: – Sykehuspartner • http://www.sykehuspartner.no/omoss_/prosjekt 64
  65. 65. Projects in Region West Hospitals – Helse Førde HF – Helse Bergen HF • http://www.helse- bergen.no/no/FagOgSamarbeid/forsking/Sider/Innovasjon.aspx • http://www.helse-bergen.no/no/OmOss/Vi-byggar-for- framtida/Sider/default.aspx – Helse Fonna HF – Helse Stavanger HF • http://www.helse- stavanger.no/no/OmOss/sykehusutbygging/Sider/default.aspx ICT / Shared Services: – Sjukehusapoteka Vest HF – Helse Vest Innkjøp • http://www.helse-vest-innkjop.no/no/anskaffingar/Sider/default.aspx – Helse Vest IKT AS • http://www.helse-vest- ikt.no/no/ProsjektOgSammarbeid/Sider/default.aspx 65
  66. 66. Projects in Region Midst • Projects: – http://www.helse- midt.no/no/Sok/80472/?quicksearchquery=prosjekter • St. Olavs Hospital HF • Helse Nord-Trøndelag HF – Sykehuset Levanger – Sykehuset Namsos – DPS Stjørdal – DPS Kolvereid • Helse Møre og Romsdal HF • Kristiansund sjukehus • Molde sjukehus • Volda sjukehus • Ålesund sjukehus ICT and Shared Services: • Sykehusapotekene • Ambulanse Midt-Norge • HEMIT (ICT) 66
  67. 67. Projects in Region North http://www.helse-nord.no/?lang=no_NO • Finnmarkssykehuset • UNN – http://www.unn.no/tidsplan/category 31508.html • Nordlandssykehuset • Helgelandssykehuset • Sykehusapotek Nord • Helse Nord IKT 67
  68. 68. National shared services • As of today, the regional health authorities have the following shared procurement and operational companies: – Sykehusbygg (SB HF) – HQ inTrondheim • Sykehusbygg HF • http://sjukehusbygg.no/prosjekter/ – National ICT (NIKT HF) – HQ i Bergen • Nasjonal IKT HF • http://www.nasjonalikt.no/?module=Articles&action =Article.publicOpen&id=388 – Purchase service (HINAS) – HQ in Vadsø • HINAS (Helseforetakenes innkjøpsservice) • http://www.hinas.no/index.php/anskaffelser • http://www.hinas.no/images/nyheter/Handlingsplan _-_nasjonale_anskaffelser_2016.pdf – Air ambulance service (LAT) –HQ in Bodø • Luftambulansetjenesten ANS – Operating organization for patient travel (Pasientreiser ANS) – HQ in Skien • Pasientreiser – Operating organization for emergency network (HDO HF) – HQ in Gjøvik • Helsetjenestens driftsorganisasjon - nødnett 68 HINAS LAT Patient Travel HDO NIKT Sykehusbygg
  69. 69. Purchase service (HINAS) 69 Ongoing procurement projects 2016 action plan Doffin
  70. 70. National ICT • http://www.nasjonalikt.no/no/prosjekter /prosjekter_og_programmer/ • http://www.nasjonalikt.no/filestore/Dum my_graphics/Artikkelbilder/Portefljeover siktALLERHF.pdf 70
  71. 71. Sykehusbygg.no - projects • http://sjukehusbygg.no/prosjek ter/ 71
  72. 72. http://leverandorutvikling.no/tags/category 736.html?tags[]=anskaffelse 72
  73. 73. Table of Content 1. Management Summary 2. Introduction to the report 3. Introduction to Norwegian Health care 4. Demand for Health Technology 5. Ongoing and planned projects 6. Local medical products industry 7. Procurement processes 8. Go-to-market model Appendix A. References to ongoing projects B. List of reports and data sources C. Authors D. Disclaimer 73
  74. 74. National hospital plan 2016-2019 https://www.regjeringen.no/no/dokumenter/meld.-st.-11-20152016/id2462047 74
  75. 75. Long term health care strategy –> 2021 Strategy Action plan 75
  76. 76. Medical products industry in Norway 76
  77. 77. Table of Content 1. Management Summary 2. Introduction to the report 3. Introduction to Norwegian Health care 4. Demand for Health Technology 5. Ongoing and planned projects 6. Local medical products industry 7. Procurement processes 8. Go-to-market model Appendix A. References to ongoing projects B. List of reports and data sources C. Authors D. Disclaimer 77
  78. 78. The Authors Oslo Medtech • Oslo Medtech is a health technology cluster, dedicated to accelerate and support the development of new Medtech and eHealth products, services and innovative solutions for the Norwegian and global health care market. We have app. 190 members and the full health value chain is represented. Our mission is to develop and industrialize world class health technology products and services that enables sustainable and high quality treatment and care, and Norwegian Medtech industry growth. • Our focus areas are facilitating R&D&I collaboration between research, industry and health care providers, nationally and internationally; stimulate and facilitate market driven innovation and innovative procurement processes; facilitate clinical trials, testing and verifications; accelerate business development and international scaling; attract development and investment capital; provide co-working space in Medtech Growth House and spread the word of the Norwegian Health technology industry nationally as well as internationally. 78 Odd Arild Lehne, Advisor Innovation Projects, Oslo Medtech Odd Arild has more that 25 years of consulting experience. He has a Master of Science degree in Information Technology. Odd Arild has extensive experience from design and implementation of IT systems and from business development in the ICT and Health care. Bent-Håkon Lauritzen, Advisor Market Development, Oslo Medtech Bent-Håkon is advisor for innovative procurement in Oslo Medtech.
  79. 79. Table of Content 1. Management Summary 2. Introduction to the report 3. Introduction to Norwegian Health care 4. Demand for Health Technology 5. Ongoing and planned projects 6. Local medical products industry 7. Procurement processes 8. Go-to-market model Appendix A. References to ongoing projects B. List of reports and data sources C. Authors D. Disclaimer 79
  80. 80. Disclaimer • This report has been produced independently by Oslo Medtech on the request of Fintra OY. • The information, statements, statistics and commentary contained in this Report have been prepared by Oslo Medtech from publicly available material and from discussions held with stakeholders. Oslo Medtech does not express an opinion as to the accuracy or completeness of the information provided, the assumptions made by the parties that provided the information or any conclusions reached by those parties. • Oslo Medtech have based this Report on information received or obtained, on the basis that such information is accurate and, where it is represented to Oslo Medtech as such, complete. The Information contained in this Report has not been subject to an audit. 80

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