Development of SADe

28.8.2015 Pekka Värmälä 1

The SADe programme 2009-2015 and service portfolio in the social and

health sector.

Mr. Pekka Värmälä, M.Sc. (Tech, KM)

Development Manager, Institute of Health and Welfare

Strategies and plans for citizen's participation and electronic services in social welfare and health care

• The first information technology strategy in Finnish social welfare and health care was created in the mid-1990s. The goal was to use new information technology to improve the availability, quality and efficiency of social welfare and health services as well as clients' independent initiative and participation, and to increase health awareness and empowerment of the clients.

• The Ministry of Social Affairs and Health has launched several nationwide pilot projects to promote citizens' initiative and use of electronic services. Execution of the strategy began with an experiment in a seamless service chain. The strategy is also implemented through legislation on use of electronic services and construction of nationwide information system services, which include a service where citizens can view their own information.

• For its part, development of health-care legislation has begun to strengthen the client's position. Access to treatment has been promoted through legislation, and it has been further enhanced along with the new Health Care Act.

• For the period 2009 - 2015, the Ministry of Finance has started an Action Programme on eServices and eDemocracy (the SADe programme) to promote citizens' eServices in various branches of government. It is a national programme designed to promote the use of information technology. The purpose of the SADe programme is to ensure that all the key public services are available as eServices for citizens and companies alike by 2015.

28.8.2015 2 Pekka Värmälä

The eServices and Democracy Acceleration Programme (SADe) 2009-2015

• The goal is to promote the use of eServices in public administration so that, by the year 2015, it would cover all key services.

• The following procedures must be followed during the implementation:

– Electronic services will be developed in interaction with the service users, taking into consideration their ease of use.

– At all stages of development, the programme will take into account the fulfilment of citizens’ privacy protection, and it will be ensured through efficient collaboration with the Data Protection Ombudsman.

– In public-sector procurement contracts, the programme will utilise solutions offered by the marketplace as well as private-sector innovations. The programme will promote the use of open information system architecture and the open source code in systems in public administration.

– During the development of eServices, decisions will be made that support the provision of services in the two official languages in Finland.


• The service portfolios are associated with the key conditions and the needs of citizens and businesses, and transcend administrative boundaries.

• The Ministry of Finance asked public administration organisations for proposals for service portfolios to be developed. The Ministry received a total of 74 proposals by the deadline, 31 from municipalities, 36 from the Government and seven from other organisations. Of these, 18 were related to health and well-being.

• The proposals worked as a foundation in creation of the actual service portfolios that will be implemented in the programme (10–12 in total).

• The service portfolios included in the programme were approved in two batches: the first one (3–4 projects) in October 2009 and the second one in February 2010.


The eServices and Democracy Acceleration Programme (SADe) 2009-2015, cont’d

Scope and content of the preliminary analysis stage of the programme (Committee on Economic Policy, 16 June 2009)

1. For the preliminary analysis stage of the programme, the Committee accepted 10–12 service portfolios approved on the basis of the criteria used, and the support services needed to execute them.

2. Selection criteria for the service portfolios: 1. client orientation and quality

2. significance

3. cross-administrative approach

4. productivity potential

5. cost efficiency of execution

6. availability for launch and rate of implementation

7. availability and eligibility for adoption

8. need for changes in regulations and readiness to implement them

9. compatibility with the enterprise architecture in public administration

10. innovativeness and creativity

3. Selection of the service portfolios emphasises particularly projects that promote the productivity of municipalities


Situation report – current challenges in Finland (Hyppönen and Hämäläinen et al. 2011 http://urn.fi/URN:ISBN:978-952-245-835-3) • Electronic services that have been implemented thus far

are regional solutions made by municipalities, cities and hospital districts – overlapping development wastes resources.

• The processes and methods of operation are local or regional. The same functions and processes have been executed in different ways at various locations.

• Current specifications contain many good practices and use standard solutions, but they do not take into consideration national requirements because they have not been defined. There is no national model for the distribution of best practices.

• Competitive bidding has been arranged locally – rights are held by local/regional actors or, most frequently, commercial service providers.

• Finland has lacked a strong, national actor that would have coordination and executive authority both at the municipal and national levels.

• There are only a few national My health -services: 1) general health and health care information services (such as terveyskirjasto.fi, tervesuomi.fi) and 2) commercial services (such as terveyskeskus.fi, tohtori.fi). Funding of tervesuomi.fi has ceased!

• There are very few electronic information and management services in social services. These services are offered only by the largest municipalities/cities.

Publicly funded projects


Citizen eServices in Health and Social Care SoTe-SADe: International lessons (Sweden, Denmark, Great Britain and the USA)

• Priorities must be set on the basis of clear political objectives (such as citizens' freedom of choice and equality) and benefits gained (such as customer satisfaction, cost benefits in the long term).

• The starting point must be communication between the citizen/patient and the professional/care unit. Key target groups are not interested in mere self-monitoring services involving health.

• Service allocation and marketing for the correct client groups must be done carefully, so the users' expectations, sufficient numbers of users and benefits achieved from the service can come together.

• Usability is very important.

• Successful services have a clear administrative model and funding base. Legislative support ensures implementation.

• All development work must be done in simple sections that can be controlled.

• The premise must be specification of shared concepts, information contents and structures on the national level, while utilising international standards.

• The service architecture and components that can be easily connected to each other will reduce the total costs of development.


Key national development subjects and benefits of collaboration in the social and health sector proposed in the projects

• The need for common infrastructure, rules and standards, and models of operation

The respondents highlighted the need to coordinate public funding and a mechanism that would enable projects developing similar eServices to collaborate and learn from each other.

• Models for user-oriented planning and user engagement – need in development.

• The need to develop legislation.

• The most immediate impact anticipated from the SADe project was savings in public service providers’ ICT costs due to collaboration and coordination of the development of eHealth services.

Source: Hyppönen, H, Iivari, A, Ahopelto, M. Sosiaali- ja terveydenhuollon sähköisen asioinnin hankkeet Suomessa 2010 (eServices Projects in Social Welfare and Health Care in Finland in 2010). National Institute for Health and Welfare. Report 31/2011.


Service portfolio in the social and health sector (2012–2015)

• The service portfolio of the social and health sector develops uniform social welfare and health care eServices aimed at Finnish citizens.

– The National Development Plan for Social Welfare and Health Care (the Kaste Programme) of the Ministry of Social Affairs and Health, measure 11 Enhancing use of electronic services will be implemented as part of the service portfolio in the social and health sector.

• Responsibility for the strategic control and monitoring of the service portfolio belongs to the Ministry of Social Affairs and Health and operative execution to the National Institute for Health and Welfare (THL).

• Development work is carried out in collaboration with the Association of Finnish Local and Regional Authorities and various municipal actors.


The eServices and Democracy Acceleration Programme of the Ministry of Finance (the SADe programme)

The service portfolio in the social and health sector provides

Services that support citizens' initiative and use of eServices

• National services

1. an electronic service directory that is based on official registers

2. researched, assessed, general social and health information combined with methods of self-assessment of the need for help

3. a model for collection of structured feedback (customer satisfaction)

• National specifications in support of regional implementation

1. for appointments

2. for secure communication

• Support and coordination services of development of electronic services in the social and health sector, aimed at citizens, in collaboration with the Association of Finnish Local and Regional Authorities.


Selected client focus areas

1. Promoting the health and welfare of families with children and preventing social exclusion

– Themes in promoting health and welfare include, e.g., prevention of child obesity, inactivity and excessive playing of computer games.

– Clients of child welfare services: a handbook on child welfare and possible other

existing material from public authorities, revised for use by citizens.

2. Promoting the health, welfare and capacity of the elderly throughout the service chain

– Themes include, e.g., maintenance and promotion of health, welfare and capacity

and prevention of memory disorders and falling.

3. Preventing arterial diseases

4. Intoxicants and mental health

– Themes include prevention, early support and use of basic services.

In select client groups, the focus is on groups of clients who use or need a great deal of services. Focus area of development:

1. promoting health and well-being, and

2. facilitating access to service in basic services.


Regional partners that receive discretionary government transfers

• The National Institute for Health and Welfare acts as an authority that distributes government aid.

• In the autumn of 2012, the service group of the social and health sector in the SADe-programme arranged a search for development partners that looked for partners among municipalities and federations of municipalities to develop electronic social welfare and health services aimed at citizens.

• The development partners will participate in the specification of national eServices, enterprise architecture of citizen's eServices, and the openness and compatibility of eServices.

• In addition, the development partners will take part in the design, implementation, piloting and adoption of citizen's eServices provided in collaboration with various municipalities.

• The participants include the Association of Finnish Local and Regional Authorities, five cities, 13 hospital districts and several organizations.


SADe-programme’s map of all services


Complete list of SADe-programme’s map of services, see: http://sadepalvelut.fi/en/

Nationwide developed web services of SADe-programme by Institute of Health and Welfare

• Service directory (Palveluvaaka.fi)

– For whom: Citizens, professionals and service providers.

– Description: An electronic service directory containing information on private and public sector social welfare and health care services and service providers.

– Timetable: The launch and introduction of the service will happen in end of August 2015.

– Status information:

• The implementation is in progress.


Nationally developed web services of SADe-programme by Institute of Health and Welfare, cont’d

• Customer feedback surveys in the health and welfare sector

– For whom: Citizens and service providers.

– Description: National, electronic customer feedback surveys will be prepared for implementation by the National Institute for Health and Welfare (THL) at two-year intervals. Information collected through these surveys will be published through the Palveluvaaka.fi online service.

– Timetable: The first service providers to conduct customer feedback surveys will be maternity/child care clinics and oral health care providers. A nationwide maternity/child care clinic survey was implemented in October 2014. The oral health care service survey was conducted at health centres in large and medium-sized cities in December 2014. A nationwide survey will be conducted in 2016.


• Surveys will gradually cover the entire country.


Nationwide developed SADe specifications in cooperation with regional developer (Hyvis) and University of Eastern Finland

• Electronic appointment booking

• For whom: Citizens and service providers.

• Description: Nationwide specifications are being developed for the electronic booking of appointments. These can be introduced when implementing appointment bookings for social welfare and health care services in all areas. The appointment booking system will be piloted in collaboration with Hyvis, one of the development partners, and the acquisition will be implemented in cooperation with KL-Kuntahankinnat.

– Timetable: Piloting, regional implementation in autumn 2015. Nationwide specifications will be completed in 2015.


• Implementation is under way.


Social and health services just one click away - Website designed responsively

OMAHOITOPOLUT.FI


Omahoitopolut.fi - Website for citizens & social and health care professionals

• Soft launch on May 2015 for pilot developers, web service will be opened in end of August 2015.

• Tools to enhance citizens health and well-being.

• Social welfare and health care information with welfare-promoting self-assessment tools as follows:


Health and welfare promotion among families

with children

Promoting mental health and

preventing alcohol and drug abuse

Preventing arterial diseases

Maintaining elderly people’s ability to function

Omahoitopolut.fi - Designed and tested together with different user groups

• Concept designed and tested in many workshops by various groups of real users.

• Usability tests and accessibility evaluation made by Cresense Ltd. to help and ensure quality of the website.

• Accessibility evaluation done according to Web Content Accessibility Guidelines (WCAG 2.0).

– AA-level conformed.


Omahoitopolut.fi: Self-management tools and tests


Case: Preventing arterial diseases

Pekka Värmälä 28.8.2015 21

Questions e.g.

• Age

• Weight

• Cholesterol

• Systolic blood

pressure

• History of arterial

diseases

Filling the test form


Integration to local

eHealth care systems

• Coming in autumn

2015

Test results



THANK YOU FOR ATTENTION

Health & Medicine

Development of SADe