04/10/2023

Moving towards modern healthcareCase Espoo

Kirsi Louhelainen / Futurice

whoami

› IT expert, software consultant

› Member of the Espoo City Council

› Civil activist for smart choises in public IT solutions

Espoo

› 2nd largest city in Finland

› Part of HUS, Helsinki-Uudenmaan sairaanhoitopiiri

› Population: 261 000

› Employees: 13 700

› Apotti drop-out

Today…

› Future trends in health care and how should we respond to it

› Status at Espoo today

› Executing the change

Where are we heading to?

604/10/2023

Futurice

The sea change» Rise of the elderly

» New concepts in care and changes in demand

» Preventive care

» Polarization: the haves and have-nots

» We need to be responding fast inquick-paced changes

704/10/2023

Futurice

Next big trends» Own data

» Quantified self

» Open data

» Affordable DNA analysis

› 23andme

› Personalized treatment

» Openness versus privacy

804/10/2023

Futurice

Responding to changes» We can’t see what’s needed

» Build for flexibility

› Modular

› Trustworthy

› Easy to update, add and change

› Easy to use

» Case Amazon

904/10/2023

Futurice

Modular» No monolithic systems

› From being slave to a single supplier towards owning and managing the entity provided by different suppliers

» Interfaces, interfaces

› Exporting data through an interface should be neither costly or hard

» Plugging in new services made easy

1004/10/2023

Futurice

My precious…data» Who owns the data?

› Patient should

› Access to all health care info, permission of use and distribution

› Minors etc.

» Authentication, authorization, roles…

1104/10/2023

Futurice

Reactive system» Processes not crippled by IT

› Embrace and enable change

» Open data

› Enabling citizens and businesses to use information

» Timeliness

› Software defined too early will be outdated at launch

What’s up, Espoo?

1304/10/2023

Futurice

Vendor lock-in

» Long-term contracts

» Renegotiation is ineffective

» Closed interfaces, data held hostage

1404/10/2023

Futurice

Current solutions» Slow, hard to use, only partially working

» Effica as a core system

» Electronic folder for health information (Terveyskansio) 

› Slow, not adopted by personnel

» Electronic reservation solutions

› Some only partial

» Electronic recipe (eResepti)

› Problems between HUS and Espoo

1504/10/2023

Futurice

Existing structures» National enterprise service bus (Kansallinen palveluväylä)

› Going slowly

» Espoo’s own enterprise service bus

› A project with Tiera and Sitra to improve elderly people’s home care

› Test and take into use the national solution’s ways of working

› http://www.sitra.fi/hankkeet/kansallinen-palveluvayla-kokeilukayttoon

» Kanta

1604/10/2023

Futurice

KAOS» Enterprise architecture project

» Open data is taken into account

» Necessary project in taking control of technology and tech decisions

1704/10/2023

Futurice

Openness» Part of KAOS

» Outside health care, Espoo is dipping toes in sharing data

› Geothermal heating + solar power app

› Helsinki Region Infoshare http://www.hri.fi/fi/

› City plan information released

» Key issue: spread information outside of and within the organization

1804/10/2023

Futurice

Towards agile» Updating the models

» Trying to get agile methods in use

» Agile is used in different departments’ own projects

1904/10/2023

Futurice

Towards modularity» Biggest obstacles:

› Opening interfaces to health care core systems

› Expensive or impossible - current provider cannot deliver

» FastRoi mobile solution for home care

› http://www.fastroi.fi/fi/ratkaisut/sosiaali-ja-terveysala/fastroi-hilkka-kotihoito/

» Electronic voucher system (palveluseteli)

› https://parastapalvelua.fi/

What can we do next?

2104/10/2023

Futurice

Competence development» More people who understand buying, contracts and

processes

› Not the same as “More people.”

› Understanding how to buy agile

» Substance understanding

› Outsourcing too much will bite you back

» Partners alleviate problem but don’t fix it

› Tiera

2204/10/2023

Futurice

Organization » Organizational silos can be tough

› They should not prevent information to move

› Change needs to be allowed

› Espro

» IT reorganization

› A lot of duplicate work

› People do not understand what they are buying

› Information does not flow within the organization

2304/10/2023

Futurice

Focus on interfaces and sharing data» We need to be able to extract data through an interface

without extra cost

» Unless there are security concerns, all data should be opened

› Growing the mindset will take some time

› Good examples help

» We should solve now the issues between sharing data between different silos: health care and social care

› Legislation is the biggest factor here

2404/10/2023

Futurice

Rethink the health care services

» . ..and a lot of other things as well

» Supporting preventive care

» Enabling third party solutions through open data

» Fixing the way of working

› “Lonkkaliukumäki” –awesome, but if we are still talking about this, we haven’t learned from it

› Software is not always the best first step

2504/10/2023

Futurice

Recap» We know what’s wrong

» Old ways of working and old contracts will be on our back for a long while still

» More expertise in buying, managing and legal issues

» The groundwork for the future is underway

› KAOS and organizational changes

» There is hope.

Thank you.