Denmark – Delivering eHealth through a Joined-up and Collaborative Approach

Denmark - Delivering eHealth Through a Joined-up and Collaborative Approach

Digital tools and the use of health data are transforming how health services are being delivered. The OECD’s ‘Health at a Glance 2023’ report ranks Denmark as ‘number one’ in Europe in ‘digital health readiness’; with linked data used for healthcare quality, performance, research, and monitoring.

Danish residents can easily access their health data. Established in 2002, sundhed.dk is a national platform for accessing and managing personal health data. This helps individuals stay informed about their own health conditions, facilitates communication with healthcare providers, and enables better coordination of care across different healthcare settings.

Background

The use of digital technologies is integrated into Danish society, with Denmark amongst leading countries according to several international indicators on the use of ICT, digitalisation of the public sector etc.

Denmark with a population of just under 6 million, has 10% of its GDP allocated for healthcare expenditure (UK annual spending on public healthcare accounts for 9.3% of GDP). Responsibilities for health are split between the state, 5 regions and 98 municipalities - representing centralised planning and regulation but decentralised responsibility for primary and secondary care as follows:

  • The Ministry of Health has a coordinating and supervisory role.
  • The 5 regions are responsible for hospitals and primary care.
  • Municipalities ensure that healthcare is close to their residents, with a focus on prevention & health promoting initiatives and rehabilitation. Services include those relating to social care.

Examples of eHealth programmes include:

  • Telecare Nord - monitoring Chronic Obstructive Pulmonary Disease (COPD) This teleHealth programme is a partnership with the North Denmark Region, 11 North Jutland municipalities and GPs. The objective of this programme is to monitor patients closely, adjust their medication and treatment to avoid hospital admissions. The system allows for real-time updates, communication and information sharing between hospitals, GPs, municipalities, and pharmacies.
  • E-hospital – Region Zealand introduced ‘E-hospital’ to enable residents to receive treatment and expert guidance without leaving their homes or by visiting closer satellite locations. Key to the success of this programme has been the strong partnerships between the hospital and primary healthcare as well as municipalities.
  • Icura –improving home-based rehabilitation through sensor-based training and user-friendly app to improve home based physical activity and exercise for patients. This was successfully implemented in 25 municipalities and hospital-based clinical projects.

 

A strong of culture of collaboration between industry and healthcare

Invest Denmark positions the country as ‘the ideal sandbox for testing new technology and business models to the healthcare sector’. As well as a joined-up approach between regions and municipalities, there is a strong networking and cooperation culture to encourage business investment in eHealth. This is supported by digital health related cluster organisations including HealthTech HUB CPH and the Danish Life Science Cluster (which supports public-private innovation from development to market). Other organisations encouraging business engagement within the health sector include:

  • Nordic Health Lab matches companies and knowledge institutions with hospitals and municipalities so the companies can test and co-create their solutions together with healthcare professionals.
  • Trial Nation offers a single, national entry point for global companies, wishing to conduct clinical trials in Denmark.
  • Health Innovation Centres –each region has its own Health Innovation Centre which is in direct contact with regional healthcare services. They support partnership and cooperation between companies and the healthcare sector as well as providing insights into challenges and needs within the healthcare sector.

Conclusion

Whilst Denmark’s overall digital strengths have been critical in enabling the growth of eHealth, the country’s long-term eHealth strategies and of working across national health authorities, the regions, the municipalities and other relevant organisations and businesses has been key to the delivery of pilots and implementation of large eHealth programmes. Even the municipalities which typically represent 57,000 inhabitants are seen as key partners as they are the most connected to the local ecosystem.

Denmark’s well-connected health infrastructure also makes it much easier for eHealth related businesses to be involved in testing and rolling-out their eHealth products and services.

Opportunities for increasing local eHealth initiatives in England

England’s 42 ICSs (Integrated Care Systems) present an opportunity for councils and combined authorities to work more closely to maximise the opportunities that eHealth can bring to their areas in prevention and helping people stay out of hospital. A more connected approach as is undertaken in Denmark, will also make a geography more attractive for eHealth solutions businesses to trial, test and roll-out their technologies.

ICSs are local partnerships bringing health and care organisations together to develop shared plans and joined-up services. They are formed by NHS organisations and upper-tier local councils in their areas and include the voluntary sector, social care providers and other partners with a role in improving local health and wellbeing. The Kings Fund report (July 2023) ‘Driving Better Health Outcomes Through Integrated Care Systems – the Role of District Councils’ emphasises the important role that district councils can play as they also influence some of the significant determinants of health.  As in the case of the Danish municipalities, district councils are often much more connected to their residents and can create better services based on local need.

Similarly to Denmark’s regional Health Innovation Centres, England’s regional Health Innovation Networks (formerly known as the Academic Health Science Networks – AHSNs) bring together the NHS, industry, academic, third sector and local organisations.

There are clearly opportunities in eHealth to be seized through a joined-up and collaborative approach!

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