April 17, 2017

World leader in e-health by 2025 – how to go from vision to action

Johan Höglund

Vice President, Head of Healthcare, Welfare and Education, Tieto


Last year the Swedish government introduced the "Vision e-health 2025” initiative with the ambitious target for Sweden to become the world leader in e-health by 2025. This is in line with the goals of Sweden’s Nordic neighbors (Norway, Finland and Denmark) who also aim to become leaders in e-health. A coherent vision is critical in shaping direction and stating objectives. But how do you move from vision to action? How do you begin making this vision tangible?

Crystallizing the vision

The term e-health is broad, but generally speaking it’s about the digitalization of processes and communication (via hardware and software) in the healthcare and welfare sector. To scale an e-health vision nationally certain prerequisites need to be met. They include modern IT infrastructure with high geographical coverage, a technologically mature population and a vibrant entrepreneurial environment. The Nordic countries all have these prerequisites in place and companies such as Tieto are already investing in this digitalization journey.

So with the e-health vision crystallized and the necessary prerequisites in place, how far have we to go? According to a 2016 survey conducted jointly by Tieto and the Swedish Young Doctors Association (SYLF) we are not even close. 83 percent of the 500 young doctors who answered the survey said they were either unhappy or quite unhappy with the IT tools they have today. According to public information, a healthcare region in Sweden spends on average between 2–3 percent of its total budget on IT and a municipality often below 2 percent. These investments are mostly used to maintain the current systems, meaning that very little goes to innovation and improvement. Other industries spend much more of their budgets on IT. In the financial sector it’s close to 10 percent. The average for governmental agencies is an estimated 9 percent.

Citizen power

Imagine a future scenario where Nordic citizens actively monitor their health and get involved with their own healthcare via apps, devices and digital services. If this doesn’t seem ambitious enough, then how about a future where they complement this personal health monitoring by engaging with healthcare professionals via telephone and video calls – only needing a physical consultation in rare cases. To bolster these innovations even further, citizens will become the custodians of their own personal health record. They will possess their own medical data and they will decide which of their care providers to share it with. This allows the patient to be directly involved in monitoring the outcomes of chemotherapy treatment, for example, or to follow up on the efficacy of medical implants such as pacemakers. The patient can feel confident and secure when communicating with various care units because she knows they have the latest information through “my journal online”. In this future, her journey through the healthcare system (from care provider to care provider) is completely digitized, frictionless and transparent for all the care providers, the patient herself, as well as her family.

Collaboration is crucial

This is still a vision, but I’m convinced it’s a vision within reach - cooperation is the key. To get to this version of 2025 there needs to be close collaboration between healthcare institutions, the IT industry, academia and patient support groups. Together we need to form the right ecosystem, one where openness and flexibility brings us to the best solution. We also need to be sophisticated enough to recognize the impact an ecosystem has on the user experience, when the different front-end components are delivered by different vendors with their own level of design maturity. We must cooperate in a manner that ensures basic interactions (searching, creating, updating, etc.) are presented in a uniform way and that the same information is recorded only once.

Ecosystems are healthcare enablers

Furthermore, I believe it is essential that our customers are given the ability to easily separate data from applications. This would create non-proprietary data repositories upon which an ecosystem could form and re-form over time, while keeping the data intact and in situ. Ecosystem integration would occur via services accessing the data itself rather than via services to any proprietary application. Such a solution has high technical demands and requires a high level of semantic interoperability. Adopting recognized international standards such as HL7 FHIR and OpenEHR will prove critical.

The long-term goal for the integrated ecosystem is well summarized in the Norwegian vision for e-health: one citizen, one record.  In this scenario, when a medical situation occurs it’s possible to establish a unified medical record where care and home care are included.

Population health will also be a key component. This means many different things to different stakeholders, but at its core it’s about applying analytics to data across the continuum of care to provide better prediction and ultimately prevention. The citizens themselves play a central role in population health.  The objective is to enable citizens to avoid patterns of behavior which lead to illness, and motivate and engage them in their own healthcare.

Tieto Lifecare leading the way

What does this mean to us at Tieto? Firstly, we need to continue to drive the digitalization agenda forward, together with our customers. There can be no e-health without digitalization. Moreover, I am convinced that it benefits Tieto to increase cooperation with other companies in the ecosystem. I strongly believe tomorrow's successful companies will be those that are open and able to play a vital part in the ecosystem.

We have been investing in Lifecare over the last five years. Lifecare is a modern, modular and open system for both healthcare and welfare. Lifecare is designed with the users at the center, ensuring the very best experience. We will continue along this path. We also need to constantly adapt our portfolio to meet future demands; we are already in a solid position to continue to outperform the market with our strong offerings. My personal vision and ambition is for us to first lead the Nordic market and then scale our solutions outside it. Looking around, I see no company in a better position to lead the European e-health market. This is our opportunity - and we will certainly go for it.

We have an exciting journey ahead of us. We will create products that become global successes and while doing so create many new jobs in the Nordic countries. I believe Tieto, together with our customers, can turn the attention of the world to the Nordic countries and realize the ambition for this region to become the world leader in e-health.

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