How Sweden Improved Patients Involvement and Self Service with eHealth Johan Eltes

Swedish Association of Local Authorities and Regions, Inera AB

Deputy CTO

Johan.eltes@inera.se, +46 708 22 41 86

How Sweden Improved Patients Involvement and Self Service with eHealthSince 2006, a national Health Advice Line – 1177 - has been Swedish residents first point of contact with healthcare. In 2006, a national patient portal was set up to facilitate form based, secure information exchange between patients and Swedish care providers. The next step was to introduce fully digitalized self-service e-services. These services offload health care personnel from manual registration tasks and improves the service to the patients. As an example, 1177 provides a national e-service for online appointment management with primary care providers across the country. Another e-service of the national patient portal provides online access to electronic health records from the majority of the EHR systems of Sweden’s 21 county councils and 300 municipalities. The appointment e-service has had a linear increase in patient transactions, starting at 25 000 per year with a current rate of 1,2 million per year. The current development is focused on tele medicine services (a national platform for remote treatment programs), the ability for the patient to share EHR data with apps and services and a national architecture for personal connected health (home monitoring). The presentation gives an overview of e-services offered to patients, their adoption and share some lessons learned.

Sweden has a regionalized care system

21 counties 290 Municipalities

Government vision: - At the top of the e-health world in 2025

Swedish e-health has been coordinated since 2006

21 counties

290 Municipalities

REGIONS AND MINICIPALITIES IN

COOPORATION FOR E-HEALTH

Challenges:•10 000 000 residents•Every resident may consume public care at any location•Large installed base (legacy) of EHR (99%)

Opportunities:• National resident identification and authentication•National resident registry•National care provider registry•World class 4G (internet coverage)•Large installed base of EHR (99%)

• A national entry point to support the patients care journey

The Swedish patient portalAm I ill?

Do I need care?

Find care

Make appoint-

ment

Meet doctor

Rehab / care plan

Self-test

Catch up

Visit pharma

Am I ill?

• 1177 web advise– Quality assured published content– Advisors respond to anonymous questions– In use since 1999

• Statistics (12 months)– ≈ 10 search sessions per resident– ≈ 12 000 anonymous questions answered

Do I need care?

• 1177 Health Advice Line– Distributed, load-balanced call center– Supported by a dedicated national EHR

system – In use since 2006

• Statistics (12 months)– ≈1 consultation/resident

Find care

• 1177 Find and compare care– All publically financed healthcare– Direction, phone number, care types, the e-

service offerings – Compare by quality measures– In use since 2011

• Statistics (12 months)– ≈ 1 search session per resident

Make appointment (demo)

• 1177 Appointment self-service– An authenticated e-service of the patient

portal– Single user interface provides online access

to EHR systems across Sweden– ≈ 50 EHR systems connected as back-ends,

supporting 3 000 facilities– ≈ 20 additional e-services available– In use since 2010

• Statistics– 500 000 appointment transactions per year– 32% of residents have logged in to the portal– 8 000 facilities offer e-services through the

portal

Meet a doctor

• 1177 Video meeting– Currently being piloted in Stockholm County

Council – There are competing private video care

offerings– Regional solutions are in production (without

national coordination)• Statistics (12 months)

– Not available

Catch up

• 1177 EHR Viewer – what did the doctor say?– An authenticated E-service of the patient portal– Online read access to all connected EHR

systems– Helps remember doctors advise, prescription

dose etc– Patient may grant access to care giver, private

doctor and other individuals– In the planning: Patient may share EHR data with

health apps– In regional use since 2012. In national use since

2015• Statistics

– 9% of the residents use the service

Rehab and care plan (telemedicine)

• 1177 Telemedicine treatment platform– Doctor may subscribe self treatment

supported by remote service centers (telemedicine)

– Chronic diseases (diabetes…)– Monitored health plans (overweight…)– Remote treatment (CBT…)– Personal connected health (sensors)– Video sessions– Currently in pilot with 1000 patients (CBT)

• Statistics (12 months)– Not available

• The architecture supports all national e-health initiatives

• Manages EHR data access (two-way)• Manages interoperability through approx 100

interoperability profiles• National service-oriented HIE architecture in

operation since 2010• 400 000 000 API invocations per year• All EHR data is access at the source

(distributed) on demand

1177 depends on a national HIE architetcure

• Meet Inera at the Business Sweden booth…– HIE architecture and infrastructure– National reference architecture– Governance model– Portfolio management– Funding of national e-health– More on 1177

• I will attend the conference. In case I’m not at the booth, send me an e-mail and I’ll try to get in contact:

– johan.eltes@inera.se– +46 708 22 41 86

• Thank you!

If you have questions…