Macro Pilot Project: The Solution for Seamless Social and Health Care in Finland

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Macro Pilot ProjectThe Solution for Seamless
Social - and Health Care in Finland

• Tuire Mikola
• Development Manager
• Satakunta Macro Pilot Association
• Pori, Finland

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Social - and Health Carein Finland

• Providing of social - and health care services is
  the responsibility of the municipalities
• Primary care The Health Care Centres in the
  municipalities
• Specialized health care 21 hospital districts
• Private sector Physicians centres
• Social and Health Care Expenditure 4.818 FIM
  (817 ECUs) per citizen

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Problems In Social - and Health Care

• Organization centric model
• Management of the service chains
• Increase in demand of services
• The service sector is dispersed
• The technical support for client centric model
  and for new regional services
• different patient information systems
• telemedicine solutions not implemented in normal
  operation

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Satakunta Macro PilotA strategy for the Future

• The Ministry of Social Affairs and Health
  launched a call for proposals for a national
  pilot project in April 1998
• common customer-oriented Social and Health care
  services
• regional basis
• 19 proposals
• Satakunta region was selected in August 1998.
• The project was named Satakunta Macro Pilot
• 1.12.1998 - 31.12.2000

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Participants

• National level e.g.
• Ministry of Social Affairs and Health
• Ministry of Trade and Industry
• Technology Development Centre (TEKES)
• Social Insurance Institution (KELA)
• National Research And Development Centre for
  Welfare and Health (STAKES)
• Institute for Occupational Health
• The Association of Finnish Local and Regional
  Authorities
• Local level e.g.
• 7 Municipalities Primary Social care
• Satakunta Hospital District
• Pharmacies, Employers, Private Physicians centres
• Pori School of Technology and Economics
• Satakunta Polytechnic
• Diaconia Institute of Higher Education
• Several enterprises

240 000 inhabitants
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The goals of Macro Pilot

• New regional and common services for social -
  and health care
• Client-oriented basis
• Seamless services for citizens and professionals
• A minimum of run-around for client
• The ability of citizens to be served in their
  homes.
• Information is to be available electronically
• Information and client services focused for the
  citizen
• Support of independent living

New operation models and services
Piloting
Data protection data privacy
Technology
Education, communication and evaluation
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The Enablers

• New legislation
• LEX Macro Pilot
• Technology
• Scalable information system from regional to
  national level
• Integration of legacy systems
• Integration of new innovative products and
  services
• Privacy Protection
• Data security mechanisms based on smart card and
  electronic identity

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SCALABLE REGIONAL INFORMATION SYSTEM
POINT TO POINT CONNECTIONS
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Scalable Information System

• Common services for
• data protection and privacy
• access to the data
• Common
• environment descriptions
• Common user interface

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Requirements for the scalable information system

• Access across organizational boundaries
• Users Citizens, clients, professionals
• Users Offices, homes, other organizations
• Very tightly controlled privacy protection
• 24 h x 7 days availability
• Modular structure
• Based on standards (HL7, Dicom)
• Architecture is a framework,the applications
  provide theactual contents

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The Regional Information System

• Allows Social Welfare and Health care to develop
  new ways of working and new services

• Affairs can be taken care of from a single
  location (information moves- not people)

• Offers citizens choises in handling their affairs

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Components of the regional information system
Service providersService descriptions Service
chain templates
Archive
User directoryUser rights ProfilesBelongings
Web pages
Client permissions Case manager agreements
Rights to access user data
Windows PC
Client service chainsService bookings and orders
Smart card reader
Reference data base
Web browserAcrobat ReaderSecure e-mailJava
appletsEID packageTerminal emulator
Client home pages Professional home pages
Audit log
Messaging system
Application data
Customer card data
Legacy systems
Electronic applications Electronic
remissionElectronic consultation
Local Data Warehouse
EID Authority
Data Warehouse
Reference creation Access to data Conversions
Transformations
Client permissions Chain identifiers
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The Clients Homepage

• The clients personal view into the regional
  information system

• Allows the viewing of ones personal
  information, find and make appointments for
  services as well as get information on health and
  social welfare questions

• The use of the homepage requires a social
  insurance card

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Service chains
Best practices

• evidence based on best practices

• based on regional agreements
• documents care practices

Service templates

• for one patient, for his/her problems
• can be modified and adjusted

Service plan

• across organizational boundaries
• data available where and when needed
• managed by a care giver

Service chains

• part of the patient record
• supports measurements of effectiveness
• supports resource management

Given care
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The Challenge of Macro Pilot..
Operative models and services
Social and Health Care Vision 2005
Piloting, Evaluation -gt31.12.2000
Technical architecture, products
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Challenges after Macro Pilot

• How do we continue the co-operation both in the
  national and international level
• legistlation
• technical solutions
• How do we organize the development and
  maintenance of
• common services
• the regional information system
• information security politics

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More information

• www.makropilotti.fi