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Enabling change

16.9.2009 Marja Pirttivaara
What is Sitra?

both a capital investor                                                              a builder of both
and a societal opinion    both a visionary and an   both a starter and a           competitiveness and
        leader                 implementer              relinquisher                    well-being




         Sitra is not EITHER/OR, but rather BOTH.



                                                                           Marja Pirttivaara   16.9.2009        2

                                                                                                      © Sitra 2009
We are building a successful Finland for tomorrow
                          • Established in 1967

                          • A fund operating under the
                            supervision of Parliament, with
                            responsibilities stipulated by law

                          • Independent actor

                          Sitra promotes:

                          • Stable, balanced development for
                            Finland
                          • Economic growth, in both quality
                            and quantity
                          • International competitiveness and
                            cooperation



                                            Marja Pirttivaara   16.9.2009        3

                                                                       © Sitra 2009
Business developer and social opinion leader




                               Marja Pirttivaara   16.9.2009   4
Finland succeeds as a pioneer in systemic changes


• Global megatrends pose challenges to Finland’s well-being.

• Finland’s success depends on broad, deep changes.

• We help to recognise and enable changes.

• We grasp key changes through programmes and strategic processes.




                                                         Marja Pirttivaara   16.9.2009        5

                                                                                    © Sitra 2009
Visionary and implementer

Sitra’s programmes:

Health Care
Municipal Services
Energy
Mechanical Industry
Rural Areas
Leadership


                                   Marja Pirttivaara   16.9.2009   6
Sitra’s Health Care Programme 2004-2009

The objectives of the Programme are

• to improve the status of customers
• to increase the profitability and effectiveness and the co-operation
  between the public and private sectors
• to promote comprehensive use of new technologies and services
• to generate new business in Finnish and international markets.




                                                     Marja Pirttivaara 16.9.2009   7
Action for Better Health
              Healthy
              individuals Increased                                 Under               Serious
                                                    Diagnosed                                             Crisis state
                          risk                                      serviced
                                                                                        state




                           REVERSE THE TREND!



                                                                   Intensified
              Support for                                          support
                                                     Support for                     Active              Acute, intensified and
 FUNCTION     management
              of one’s life
                                   Active support
                                                     self care                       personal            specialized care
                                   for lifestyles                  Active            intervention
                                                                   monitoring
 ACTION     Structured health     Preventive        Tools and      and support,
                                                                                      Case
                                                                                                           Future
                                                                   care                                    hospital
            policy, support for   services, new     coaching for                      management
            skills and data to    health            self care      management
            promote health        education                         Source: Prof.Juha Teperi, Ministry for Social Affairs and Health, 2008


                                                                                       Marja Pirttivaara 16.9.2009                8

                                                                                                                        © Sitra 2009
Patient records before EHR…




                   http://www.conect.at/files/papers/20060919/TILAK_KlausSchindelwig.pdf


                                                           Marja Pirttivaara 16.9.2009          9

                                                                                      © Sitra 2009
Personal health info management at home
before PHR’s…




               healthsystems.engr.wisc.edu/papers.../PHRs_An_Overview.ppt
                                                Marja Pirttivaara 16.9.2009       10

                                                                         © Sitra 2009
Organization of health care in Finland
PUBLIC SECTOR 85%
• Municipalities
• Responsible for arranging
• Own health care units (prim and sec)
• Independent in decision making
• Appr 230 Primary health care centres
• 21 Hospital districts
• Serve citizens within the area
• Can send patients to University hospitals (5)
PRIVATE SECTOR 15%
• Primary and specialized health care
• Occupational health care
FINANCE
• Municipal taxes 43%
• Governement subsidy 17%
• Client fees 20%
• Private financing
                                    Population 5.3 million

                                                             Marja Pirttivaara 16.9.2009       11

                                                                                      © Sitra 2009
KanTa - National eArchive, ePrescibing and eView 1/2
NATIONAL eARCHIVE – CONTENT                    eARCHIVE - FUNCTIONS

PATIENT INFORMATION
                                               LONG TERM ELECTRONIC ARHIVE
• Produced by local EHRs
• Coded core information                       • Currently local paper archives
• Diagnosis, medication, procedures, medical   • Summary data is kept 10 years after death
   risks…                                      • born 18th and 28th: kept for ever (for research
• Medical record texts, nursing information      purposes)
• Lab, pathology etc test results
• Radiology, endoscopy etc images
                                               DYNAMIC ARCHIVE
LOGGING                                        • Search for information
                                               • On patients consent
INFORMATION EXCHANGE                           • Search factors
• between health care providers

BY LEGISLATION OBLICATORY BY 2011              DATA AND STATISTICS
• For both public and private sector           • Decision support, management
• Privacy taken account                        • R&D, pharma, health care

                                               GRADUAL APPROACH



                                                                     Marja Pirttivaara 16.9.2009       12

                                                                                              © Sitra 2009
KanTa - National eArchive, ePrescibing and eView 2/2
ePRESCRIPTION – GOALS                                  eVIEW - For adults only, and own information

•   To have better overall view of patient             Summary of the key information:
    medication
                                                       • Patient permissions and information on the log
    - less multimedication, less interactions            to which he has sole rights
•   To have truly electronical information chain       • Index data, data on care contacts,
    - less mistakes, less work                           prescriptions, care Instructions
•   To make renewal of prescriptions easier for        • Subject to doctor’s permission: referrals,
    - patients                                           summaries o the care records, certificates and
                                                         statements
    - health care units
                                                       • Optional access may also be granted to: data
•   To make it more difficult to forge prescriptions
                                                         onappointments, diagnostic imaging findings,
                                                         etc.
BY LEGISLATION OBLIGATORY BY 2011
• For doctors and pharmacies                           •   Via Internet
• Patients can refuse ePrescription
                                                       •   Authentication by
                                                           - electronical ID card
                                                           - eBanking identification
                                                           - mobile?

                                                                              Marja Pirttivaara 16.9.2009       13

                                                                                                       © Sitra 2009
Markku Kiiski, presentation


         Marja Pirttivaara 16.9.2009       14

                                  © Sitra 2009
Markku Kiiski, presentation


         Marja Pirttivaara 16.9.2009       15

                                  © Sitra 2009
SAINI Electronic Healthcare Services Concept (PHR)
Road Map for Implementation in Finland




                                      Marja Pirttivaara 16.9.2009       16

                                                               © Sitra 2009
Finnish FeelGood Ecosystem, for PHR’s




“Roadmap for an ecosystem of PHR based products and services and start implementing it.”

                                                               Marja Pirttivaara 16.9.2009       17

                                                                                        © Sitra 2009
Cooperation between organizations when integrating EHR’s
to KanTa-archive




                                          Marja Pirttivaara 16.9.2009       18

                                                                   © Sitra 2009
Networks across boundaries
• We gather networks and actively launch projects in cooperation with
  our partners, both domestic and international

• Our networks extend across familiar boundaries and bring together:
  - the public sector
  - the private sector
  - the civil society

• We support others’ success.

• We take responsibility for our operations’ impact on individuals,
  companies, society and the environment.




                                                      Marja Pirttivaara   16.9.2009       19

                                                                                 © Sitra 2009
Enabling competitiveness and well-being




                            Marja Pirttivaara   16.9.2009   20
Economic competitiveness and people’s well-
being are both in the centre of what we do

• maintaining competitiveness is the prerequisite for ensuring people’s
  well-being.

• Finland’s advantages are its small size, ability to cooperate, high
  cultural and educational levels as well as technological know-how.




                                                     Marja Pirttivaara 16.9.2009       21

                                                                              © Sitra 2009
Enabler of systemic changes –
  visionary and implementer
            sitra.fi




                       Marja Pirttivaara   16.9.2009   22

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Sitra Enabling Change, Health care in Finland

  • 2. What is Sitra? both a capital investor a builder of both and a societal opinion both a visionary and an both a starter and a competitiveness and leader implementer relinquisher well-being Sitra is not EITHER/OR, but rather BOTH. Marja Pirttivaara 16.9.2009 2 © Sitra 2009
  • 3. We are building a successful Finland for tomorrow • Established in 1967 • A fund operating under the supervision of Parliament, with responsibilities stipulated by law • Independent actor Sitra promotes: • Stable, balanced development for Finland • Economic growth, in both quality and quantity • International competitiveness and cooperation Marja Pirttivaara 16.9.2009 3 © Sitra 2009
  • 4. Business developer and social opinion leader Marja Pirttivaara 16.9.2009 4
  • 5. Finland succeeds as a pioneer in systemic changes • Global megatrends pose challenges to Finland’s well-being. • Finland’s success depends on broad, deep changes. • We help to recognise and enable changes. • We grasp key changes through programmes and strategic processes. Marja Pirttivaara 16.9.2009 5 © Sitra 2009
  • 6. Visionary and implementer Sitra’s programmes: Health Care Municipal Services Energy Mechanical Industry Rural Areas Leadership Marja Pirttivaara 16.9.2009 6
  • 7. Sitra’s Health Care Programme 2004-2009 The objectives of the Programme are • to improve the status of customers • to increase the profitability and effectiveness and the co-operation between the public and private sectors • to promote comprehensive use of new technologies and services • to generate new business in Finnish and international markets. Marja Pirttivaara 16.9.2009 7
  • 8. Action for Better Health Healthy individuals Increased Under Serious Diagnosed Crisis state risk serviced state REVERSE THE TREND! Intensified Support for support Support for Active Acute, intensified and FUNCTION management of one’s life Active support self care personal specialized care for lifestyles Active intervention monitoring ACTION Structured health Preventive Tools and and support, Case Future care hospital policy, support for services, new coaching for management skills and data to health self care management promote health education Source: Prof.Juha Teperi, Ministry for Social Affairs and Health, 2008 Marja Pirttivaara 16.9.2009 8 © Sitra 2009
  • 9. Patient records before EHR… http://www.conect.at/files/papers/20060919/TILAK_KlausSchindelwig.pdf Marja Pirttivaara 16.9.2009 9 © Sitra 2009
  • 10. Personal health info management at home before PHR’s… healthsystems.engr.wisc.edu/papers.../PHRs_An_Overview.ppt Marja Pirttivaara 16.9.2009 10 © Sitra 2009
  • 11. Organization of health care in Finland PUBLIC SECTOR 85% • Municipalities • Responsible for arranging • Own health care units (prim and sec) • Independent in decision making • Appr 230 Primary health care centres • 21 Hospital districts • Serve citizens within the area • Can send patients to University hospitals (5) PRIVATE SECTOR 15% • Primary and specialized health care • Occupational health care FINANCE • Municipal taxes 43% • Governement subsidy 17% • Client fees 20% • Private financing Population 5.3 million Marja Pirttivaara 16.9.2009 11 © Sitra 2009
  • 12. KanTa - National eArchive, ePrescibing and eView 1/2 NATIONAL eARCHIVE – CONTENT eARCHIVE - FUNCTIONS PATIENT INFORMATION LONG TERM ELECTRONIC ARHIVE • Produced by local EHRs • Coded core information • Currently local paper archives • Diagnosis, medication, procedures, medical • Summary data is kept 10 years after death risks… • born 18th and 28th: kept for ever (for research • Medical record texts, nursing information purposes) • Lab, pathology etc test results • Radiology, endoscopy etc images DYNAMIC ARCHIVE LOGGING • Search for information • On patients consent INFORMATION EXCHANGE • Search factors • between health care providers BY LEGISLATION OBLICATORY BY 2011 DATA AND STATISTICS • For both public and private sector • Decision support, management • Privacy taken account • R&D, pharma, health care GRADUAL APPROACH Marja Pirttivaara 16.9.2009 12 © Sitra 2009
  • 13. KanTa - National eArchive, ePrescibing and eView 2/2 ePRESCRIPTION – GOALS eVIEW - For adults only, and own information • To have better overall view of patient Summary of the key information: medication • Patient permissions and information on the log - less multimedication, less interactions to which he has sole rights • To have truly electronical information chain • Index data, data on care contacts, - less mistakes, less work prescriptions, care Instructions • To make renewal of prescriptions easier for • Subject to doctor’s permission: referrals, - patients summaries o the care records, certificates and statements - health care units • Optional access may also be granted to: data • To make it more difficult to forge prescriptions onappointments, diagnostic imaging findings, etc. BY LEGISLATION OBLIGATORY BY 2011 • For doctors and pharmacies • Via Internet • Patients can refuse ePrescription • Authentication by - electronical ID card - eBanking identification - mobile? Marja Pirttivaara 16.9.2009 13 © Sitra 2009
  • 14. Markku Kiiski, presentation Marja Pirttivaara 16.9.2009 14 © Sitra 2009
  • 15. Markku Kiiski, presentation Marja Pirttivaara 16.9.2009 15 © Sitra 2009
  • 16. SAINI Electronic Healthcare Services Concept (PHR) Road Map for Implementation in Finland Marja Pirttivaara 16.9.2009 16 © Sitra 2009
  • 17. Finnish FeelGood Ecosystem, for PHR’s “Roadmap for an ecosystem of PHR based products and services and start implementing it.” Marja Pirttivaara 16.9.2009 17 © Sitra 2009
  • 18. Cooperation between organizations when integrating EHR’s to KanTa-archive Marja Pirttivaara 16.9.2009 18 © Sitra 2009
  • 19. Networks across boundaries • We gather networks and actively launch projects in cooperation with our partners, both domestic and international • Our networks extend across familiar boundaries and bring together: - the public sector - the private sector - the civil society • We support others’ success. • We take responsibility for our operations’ impact on individuals, companies, society and the environment. Marja Pirttivaara 16.9.2009 19 © Sitra 2009
  • 20. Enabling competitiveness and well-being Marja Pirttivaara 16.9.2009 20
  • 21. Economic competitiveness and people’s well- being are both in the centre of what we do • maintaining competitiveness is the prerequisite for ensuring people’s well-being. • Finland’s advantages are its small size, ability to cooperate, high cultural and educational levels as well as technological know-how. Marja Pirttivaara 16.9.2009 21 © Sitra 2009
  • 22. Enabler of systemic changes – visionary and implementer sitra.fi Marja Pirttivaara 16.9.2009 22