Norwegian Healthcare Market Opportunities

Understanding the market opportunities in the
hospital/healthcare sector in Norway
December 22nd 2015

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

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

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

Table of Content
Appendix
5

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

Table of Content
Appendix
7

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.

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

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

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

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

Demographic change in Norway is similar to
the development in the western world
13
No of persons
Registered Prognosis

The number of patients distributed on
selected diagnoses and age
14
Source:
Cardiovascular Cancer Muscle and skeleton Respiration
Noofpatients
Age

Table of Content
Appendix
15

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

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

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

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

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

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

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

3. Refresh, simplify and improve
– 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

• 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

• 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

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

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

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

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

7. Strengthen emergency medical services
outside the hospital
– 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

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

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

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.

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

Long term health care strategy –> 2021
Strategy Action plan
35

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

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

Table of Content
Appendix
39

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

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

Projects in Region West
– Health Bergen HF: new hospital phase 1 and 2
– Stavanger health trust HF: hospital development
in the Stavanger health trust
– Førde Health-HF: area plan Førde Central
Hospital-build somatic
42

Projects in Region Midst
– 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

Projects in Region North
– 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

Table of Content
Appendix
45

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

Medical products industry in Norway
47

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.

Table of Content
Appendix
49

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

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

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

http://leverandorutvikling.no/
53

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

Table of Content
Appendix
55

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

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

What services are needed for a company to
enter a new international market?
58

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

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

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

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

Table of Content
Appendix
A. References to ongoing projects
B. List of reports and data sources
C. Authors
D. Disclaimer
63

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

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

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

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

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

Purchase service (HINAS)
69
Ongoing procurement projects
2016 action plan
Doffin

National ICT
• http://www.nasjonalikt.no/no/prosjekter
/prosjekter_og_programmer/
• http://www.nasjonalikt.no/filestore/Dum
my_graphics/Artikkelbilder/Portefljeover
siktALLERHF.pdf
70

Sykehusbygg.no - projects
• http://sjukehusbygg.no/prosjek
ter/
71

http://leverandorutvikling.no/tags/category
736.html?tags[]=anskaffelse
72

Table of Content
Appendix
C. Authors
D. Disclaimer
73

National hospital plan 2016-2019
https://www.regjeringen.no/no/dokumenter/meld.-st.-11-20152016/id2462047
74

Long term health care strategy –> 2021
Strategy Action plan
75

Medical products industry in Norway
76

Table of Content
Appendix
C. Authors
D. Disclaimer
77

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.

Table of Content
Appendix
C. Authors
D. Disclaimer
79

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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