Trends in eHealth from Almedalen 2022
We brought together Strikersoft's eHealth strategist Ulf Lesley and Nasim Farrokhnia, chairman of the eHealth Medical Association and previously, among others. Operations manager for the emergency department at SÖS, research manager at KRY, and now Nordic responsible for health and medical care at Microsoft.
There was a lively conversation about what was discussed, and not discussed, in seminars and personal meetings during Almedalen Week.
No one can escape the horrible deed that happened during Almedalen Week. At the same time, the will to continue the discussions shows that there is an enormous force in democracy and open dialogue. Let us therefore, together, strengthen the good forces.
Smaller but surprisingly good
The restart of Almedalen after the pandemic breathed a little uncertainty. Some significant players had chosen not to participate this year, so there was less congestion in the alleys. However, most politicians were there, and societal issues, contacts, and discussions were at least as heated as usual. "Surprisingly good" was the summary of many, and some of those who had chosen to sit at home had a sound of jealousy in their comments in digital media.
The patient is still not with (enough)
There was much talk about the patient in the center, but most talk about the patients, not WITH them. This year, there seemed to be fewer patient representatives on the panels than usual. Patients are knocking on the door and want to take greater responsibility; they want to be able to share in the power that today lies with healthcare organizations and professions. Doctors, nurses, and others in healthcare need to dare to trust patients more, but it is a long journey. The education and training the care professionals receive today are mainly traditional, i.e. it is routine for the patient to tell their story as the care documents. Plus, the vital signs are survey results and values (data) that the healthcare measures and registers. However, the trend is clear: more and more actors, innovators and caregivers are developing and disseminating hardware, software and processes for individuals (which healthcare calls patients) where they report their data themselves - so-called PROMs and PREMs (Patient Reported Outcome / Experience Measure). Examples of this are wearables, home monitoring, apps for symptom control and home tests. Moreover, the educations and universities also need to keep up.
Self-monitoring and preventive care
The Swedish Government inquiry into “Good quality, local health care” takes care closer to patients, and the growing interest in self-monitoring can be seen as part of this. This can also be described as site-independent care, i.e. that care takes place (or is created) where and when it suits the patient. Not always at the hospital or health center as decided by the care staff, not at times that suit the care actors, but when and where the patient has the time and opportunity. If we see healthcare as a service similar to other services that citizens need and expect, for example, to service the car, cut their hair, pay taxes, book a trip or make a payment at the bank, the changes have already taken place there in those areas. Suppose we include the technical solutions from other sectors. In that case, technology can support individuals/patients and healthcare professionals in processes that otherwise steal unnecessary time and effort and even create frustration. Examples of this are the many different logins, the lack of integration between different systems, or the care staff’s administrative tasks that the patient can and wants to do themselves.
A bit tentative and sprawling trend with everything from robots and chatbots to automation of the entire care process, as Aleri’s CEO Sofia Palmquist described for their Sleep Apnea care in Stockholm, where the automation of the care process meant that they could work off the entire previous care queue. Letting the systems take care of repetitive administration probably gets everyone’s approval. The question is how these are integrated in a smooth way with the rest of the care processes. Automation may be up and coming trend of the year.
4th technological revolution
The digital transformation has begun to enter care and nursing in earnest. There is indeed a long way to go before healthcare catches up with other industries, but the pandemic’s need gave healthcare a huge boost going forward. Now the challenge is to keep going and continue at the same speed and not go back to the working methods, processes, and replacement models we had before Covid19 struck. How do we ensure that?
European Health Data Space (EHDS)
EHDS is an EU directive in which the individual’s right to their data is emphasized for co-creation. The nations within the EU are required to identify the authority that will have the lead, plus to put in place a national infrastructure for health and care data. The directive can be the catalyst we need to significantly increase the level of data application in order to spread the benefits of digitalization for health and care. It will be exciting to see how it is implemented and used in Sweden.
Consolidated health and welfare documentation - finally!
Speaking of laws, it seems to have finally been resolved, the issue of sharing information between regions and municipalities in Sweden, i.e. between health and welfare. For the patient, there is only one journey that begins when they become ill and ends when they recover. Few patients understand why it must be divided into different silos, or why nothing has been done about it. Nevertheless, now it is on track, and the next step will be to see how we can get the systems to support a seamless process, i.e. apply standards and build in interoperability, so the systems talk to each other.
Credibility and ethics around data
How much collection and storage can society do before citizens begin to feel monitored? Today, there is a great deal of trust in authorities in terms of collecting information (source: Internet Foundation). At the same time, more and more people are blocking their medical records, which might be an indication that trust needs to be constantly nurtured and safeguarded. How healthcare should be able to receive a person’s own collected health data from watches and rings has increasingly been debated. However, perhaps it is instead the patients’ future willingness to provide their health data to healthcare that should be discussed? The Swedish Patient Act today gives the patient the freedom to turn to the care provider with the best quality outcome, which provides the continued incentive for open comparisons for the good of the patients (and healthcare).
And what was NOT talked about this year:
NOT about Vision eHealth 2025
It was strangely quiet this year about the Swedish vision to be the leader in eHealth by 2025 compared to previous years. With only three years left, and Sweden on a sloping level in the rankings, perhaps most players wanted to close their eyes to the goal. Or we have finally begun to understand that we should focus more on all “HOW”, i.e. action plans for goal fulfillment, and we are on our way to the top position.
NOT about new journal systems
It was also strangely silent about the next generation of Electronic Health Records (EHR), or Future Care Information Environments. Is it a “work in progress” or is everyone waiting for the results from Region Skåne and VGR?
NOT about digitization in healthcare from party leaders
Healthcare was mentioned in different ways in the party leaders’ speeches on the Almedalen stage but stated THAT (healthcare must be improved) and not HOW (it would happen). Healthcare is still one of the voters’ most important issues in the Swedish election this autumn, so perhaps simple messages are strategically correct right now, or do politicians have a magical solution that they have not yet uncovered?