Kanta services for healthcare: Prescription service and Patient Data Repository.Outi Lehtokari, Development Manager, Finnish Institute for Health and Welfare Konstantin Hyppönen, Chief Architect for Kanta Services, Kela (Social Insurance Institution, Finland). Webinar on Kanta Services 30 October 2019

1. @Kantapalvelut
@khypp
Kanta services for healthcare:
Prescription service and
Patient Data Repository
Outi Lehtokari, Development Manager, Finnish Institute for Health and Welfare
Konstantin Hyppönen, Chief Architect for Kanta Services, Kela (Social Insurance Institution, Finland)

2. Pharma-
ceutical
database
Kelain
(web-based
prescription)
Delivery of
medical
certificates
Archive of
legacy
patient data
Prescription
My Kanta
PagesKanta client
test service
eHDSI
ePrescription
Dental
care
Archive of
imaging
data
Kanta
Personal
Health
Record
Benefits:
Data availability regardless
of the person’s location
Patient safety
Support for new care
processes
Cost efficiency
Data repository
for social
services
Patient Data
Repository

3. With Kanta services,
the citizen’s data is
always up-to-date
and available.
Smooth flow of
information enables
better care.
The users of Kanta
services include
citizens and
professionals in
pharmacies,
healthcare services
and social welfare
services.
Service providers in
both public and
private sector use
Kanta services.

4. Kanta is a data repository, not a user
interface*.
Kanta is actively used through patient
record and pharmacy systems.
Tiia Lundqvist4
*Kelain (web-prescription system) is a
small exception to this general rule

5. How do we ensure interoperability?
Functional and security requirements
 Joint testing is a statutory obligation for systems connected to
Kanta
 In addition to joint testing, systems must implement key functional
requirements and pass data security audit
 Functional requirements and audit criteria are defined by THL.
 Systems are registered by National Supervisory Authority for Welfare
and Health
 Accredited auditing bodies verify the compliance with audit criteria
 Every health and social service provider must in addition
implement a self-supervision plan
5

6. Use of Kanta Services in healthcare
6
Public primary
healthcare centres
of prescriptions and
medicine dispensing data
are electronic
Patient Data Repository
100%
Public
hospitals
100%
Prescription Centre
Community
pharmacies
100%
100%
of Finnish population
were prescribed medicine
by electronic prescriptions
80%
Private healthcare
service providers
1,400
Private healthcare
service providers
1,300
The first cross-
border electronic
prescription
exchange between
Finland and Estonia
records on service events
and treatments
Over 1 billion 187 million
electronic prescriptions
persons has patient data in
Patient Data Repository
Over 6 million

7. Prescriptions
 From 1.1.2017 all prescriptions for humans are electronic (by law).
Prescriptions may only be issued on paper and over the phone in
exceptional situations.
 Renewal requests can be submitted through healthcare, pharmacies
and My Kanta pages.
 A web-based prescription system (Kelain) is available for personal use
by prescribers.
 New: Finnish prescriptions may also be dispensed in Estonia and
Croatia and later in other countries through eHDSI (My Health @ EU).
 Upcoming: National medication list

8. Dispensation of Finnish prescriptions
abroad, average per day in 2019
8
Total: 5376
dispensations during
21.1-23.10.2019
Currently 600-800
dispensations
per month
0,0
5,0
10,0
15,0
20,0
25,0
30,0
Jan Feb Mar Apr May Jun Jul Aug Sep Oct
*Data for Oct: until 23.10.2019
*

9. Electronic prescription in Europe – a Finnish patient purchasing medication in a pharmacy abroad
This is reality right now

10. Patient Data Repository
 Public healthcare organisations are obliged to enter patient records in a nationally
centralised archive by law
 Deployment is mandatory for private healthcare organisations, if they have an
electronic system for long-term storage of patient records
 In production since 2013
 Contains
 data from patient records (also dental care, optometric data)
 summary data of the patient’s main health information (for example diagnoses, risks, laboratory
results)
 medical certificates
 living will and wishes regarding organ donation
 New: Sharing Images through Archive of Imaging data
 New: Connection to the national data exchange layer (based on X-Road)
 First service: transmission of medical statements to Finnish Transport and Communications
Agency (Traficom) system for the issuance of driver’s licenses

11. Change in healthcare mindset!
 ”to share data, you have to store data in unified form”
 Form of patient records: structured data and unified documentation
 ”protect the information and take care of data confidentiality”
 Access rights to patient records
 Patients right to see the use of his data via My Kanta pages
 Patients consent and right to restrict access
 ”use the data!”
 Check the previous and valid prescriptions before prescribing new ones
 Check the patient history from other hospitals and healthcare centres
11

12. Kanta
Finland’s Digital
Health and Social
Care Treasure

13. Secondary use of health and social data
 Act on the Secondary Use of Health and Social Data passed on
26.4.2019
 Facilitates better utilization of Finnish exceptionally comprehensive
and high-quality health and social data resources
 Establishes a data permit authority and a service operator
(Findata), enabling a one stop service for all types of secondary
use

14. Data lake for health
and social care
Kanta
services
Reporting tools
Analytics tools
APIs, including ones
for open data
Other data
loading
capabilities
Side data lakes
Side data lakes
Data production Data consumption
Data virtualization
Relational databases
Data quality management
Pseudonymization and
anonymization
Data search and
refinement mechanisms
Analytics and artificial
intelligence environments
Object stores
Clustering and data
segregation
Directory services
Logging and supervision
tools
APIs and micro services Secure user
environments
National
registers
Regional
data lakes
Demographic data
and other data
sources outside
health and social
services
Research
Development and
innovation
Teaching
Knowledge
management
Steering and
supervision
Planning and
reporting

15. Summary
 Finnish eHealth infrastructure is well-managed and is in active use
 Services are based on legislation
 Growth and expansion is continuing with new services
 It has not been a mere technical change. Healthcare professionals
must adopt new operations models.

16. Thank you!
Outi Lehtokari, Development Manager, Finnish Institute for Health and Welfare
Konstantin Hyppönen, Chief Architect for Kanta Services, Kela (Social Insurance Institution, Finland)
@Kantapalvelut
@khypp