Next trends in health care sector and what that means in designing the services and IT systems. Current status of Espoo in responding to the change.

1. Moving towards
modern healthcare
CaseEspoo
6/26/2014
Kirsi Louhelainen / Futurice

2. whoami
› IT expert, software
consultant
› Member of the EspooCity
Council
› Civil activist for smart
choises in public IT solutions

3. Espoo
› 2nd largest city in Finland
› Part of HUS, Helsinki-
Uudenmaan
sairaanhoitopiiri
› Population:261 000
› Employees: 13 700
› Apotti drop-out

4. › Future trends in health care
and how should we respond
to it
› Status at Espoo today
› Executingthe change

5. Whereareweheadingto?

6. Theseachange
» Riseof the elderly
» New conceptsin care and
changesin demand
» Preventivecare
» Polarization:the haves andhave-nots
» We need to be respondingfastin
quick-pacedchanges
66/26/2014 Futurice

7. Nextbigtrends
» Owndata
» Quantifiedself
» Opendata
» AffordableDNA analysis
› 23andme
› Personalizedtreatment
» Opennessversus privacy
76/26/2014 Futurice

8. Respondingtochanges
» We can’t see what’s needed
» Build for flexibility
› Modular
› Trustworthy
› Easyto update,add and change
› Easyto use
» CaseAmazon
86/26/2014 Futurice

9. Modular
» No monolithic systems
› From beingslave to a singlesuppliertowards owningand managingthe entity
providedby differentsuppliers
» Interfaces,interfaces
› Exportingdata throughan interfaceshouldbe neithercostlyor hard
» Plugging in new services made easy
96/26/2014 Futurice

10. Myprecious…data
» Who owns the data?
› Patientshould
› Accessto all healthcare info,permissionof useand distribution
› Minorsetc.
» Authentication,authorization,roles…
106/26/2014 Futurice

11. Reactivesystem
» Processes not crippled by IT
› Embraceand enablechange
» Open data
› Enablingcitizensand businessesto useinformation
» Timeliness
› Softwaredefinedtoo earlywillbe outdated at launch
116/26/2014 Futurice

12. What’sup,Espoo?

13. Vendorlock-in
» Long-term contracts
» Renegotiation is ineffective
» Closed interfaces,
dataheld hostage
136/26/2014 Futurice

14. Currentsolutions
» Slow,hardto use, onlypartiallyworking
» Efficaas a core system
» Electronicfolder for healthinformation(Terveyskansio)
› Slow,notadoptedbypersonnel
» Electronicreservationsolutions
› Someonlypartial
» Electronicrecipe(eResepti)
› ProblemsbetweenHUSandEspoo
146/26/2014 Futurice

15. Existingstructures
» National enterprise service bus (Kansallinen palveluväylä)
› Goingslowly
» Espoo’s own enterprise service bus
› A projectwithTiera andSitrato improveelderlypeople’shome care
› Test and take intousethe nationalsolution’sways of working
› http://www.sitra.fi/hankkeet/kansallinen-palveluvayla-kokeilukayttoon
» Kanta
156/26/2014 Futurice

16. KAOS
» Enterprise architecture project
» Open datais taken into account
» Necessary project in taking controlof technology and tech decisions
166/26/2014 Futurice

17. Openness
» Part of KAOS
» Outside health care, Espoo is dipping toes in sharing data
› Geothermalheating+ solar powerapp
› HelsinkiRegionInfosharehttp://www.hri.fi/fi/
› Cityplan informationreleased
» Key issue: spread information outside of and within the organization
176/26/2014 Futurice

18. Towardsagile
» Updatingthe models
» Trying to get agile methods in use
» Agile is used in different departments’own projects
186/26/2014 Futurice

19. Towardsmodularity
» Biggestobstacles:
› Openinginterfacesto healthcare core systems
› Expensiveor impossible- currentprovidercannotdeliver
» FastRoimobilesolutionfor homecare
› http://www.fastroi.fi/fi/ratkaisut/sosiaali-ja-terveysala/fastroi-hilkka-kotihoito/
» Electronicvoucher system (palveluseteli)
› https://parastapalvelua.fi/
196/26/2014 Futurice

20. Whatcanwedonext?

21. Competencedevelopment
» More people who understandbuying, contractsand processes
› Not the same as “More people.”
› Understandinghow to buy agile
» Substance understanding
› Outsourcingtoo much willbiteyou back
» Partners alleviate problem but don’t fix it
› Tiera
216/26/2014 Futurice

22. Organization
» Organizationalsiloscan be tough
› They shouldnotpreventinformationto move
› Changeneedstobeallowed
› Espro
» ITreorganization
› Alotofduplicatework
› Peopledonotunderstandwhatthey arebuying
› Informationdoesnotflowwithintheorganization
226/26/2014 Futurice

23. Focusoninterfacesandsharingdata
236/26/2014 Futurice
» We need to be able to extractdatathroughaninterfacewithoutextracost
» Unlessthere are securityconcerns,alldata shouldbe opened
› Growingthemindsetwilltakesometime
› Goodexampleshelp
» We shouldsolvenow the issues between sharingdata between different
silos:healthcare andsocialcare
› Legislationis thebiggestfactorhere

24. Rethinkthehealthcareservices
» . ..andalot of otherthingsas well
» Supportingpreventivecare
» Enablingthird partysolutionsthroughopendata
» Fixingthe wayof working
› “Lonkkaliukumäki”–awesome,butifwe are stilltalkingaboutthis,we haven’tlearned
fromit
› Softwareisnotalwaysthebestfirststep
246/26/2014 Futurice

25. Recap
» We know what’s wrong
» Old ways of working and old contractswill be on our back for a long
while still
» More expertise in buying,managingand legal issues
» The groundwork for the future is underway
› KAOSand organizationalchanges
» There is hope.
256/26/2014 Futurice

26. Thankyou.