Sitra's eHealth Miniseminar at WoHIT, Dublin, 13 May 2013

1. APOTTI-
(Asiakas- ja POTilasTIetojärjestelmä)
(Client and Patient data system) Programme
2012-2017
Programme Manager Heikki Onnela
Technical Director Jari Renko
Dublin 12.5.2013

2. Who are we in this programme?
• Participants include the local municipalities Helsinki, Vantaa,
Kirkkonummi, Kerava, Kauniainen, as well as HUS (the Hospital
District of Helsinki and Uusimaa).
• HUS: 21 hospitals, including the largest academic hospital in
Finland (HUCH), over 21 000 employees (approx 2600 physicians,
12 000 nurses), about 3 200 beds
• Helsinki: 6 hospitals, 26 health stations, total 15 000 employees in
social services and health care
• Vantaa: 3 000 employees in social services and health care, 8
health stations, one hospital
• Total number of users approx 50 000, concurrent users 22 000

3. Map of HUS, the Hospital District of Helsinki and Uusimaa
(Members of the Apotti procurement pool indicated with black colour)

4. Facts and figures
HUS area APOTTI area
Population 1 562 796 890 248
Children under 18 years 316 293 (20,24%) 162184 (18,22%)
BENEFITS (2011)
Number of households
receiving income support
74 725 51 537
Recipients of income
support (% of area pop.)
7,5 8,3
Unemployment
percentage (March 2013)
8,1 8,7
GDP per capita in district of Uusimaa (2010): 45 761,5 €

5. What is our goal?
• The Apotti Programme is intended to improve the functionality and
level of service for the social welfare and health care services.
• The social welfare and health care services overlap
• elderly care, mental health and substance abuse services,
• services for the handicapped
• services for the mentally handicapped.
• The IT-systems for clients and patients currently in use do not offer the
necessary level of support for these services, nor do they aid the
development of them
• A part of the project is, therefore, to purchase and adopt a client and
patient it-system of high international quality.

6. What are we excpecting to achieve?
• Patient in the centre
• = more time for the patient
• Patient empowerment
• Patient safety
• Better quality and coordination of care
• Productivity
• Better use of data
• Better user experience and satisfaction

7. Expectations for the system
• Lessened Vendor Lock-In effect
• Configurability and flexibility
• Open interfaces
• Third party solutions
• Innovative future solutions
• Object model
• Future-proof standard solution
• Optimization, coordination and integration of treatment flow
• Clinical overviews of relevant data (for ex relevant diabetic information)
• Decision support
• Automatic collection and delivery of data for documentation

8. Why one system
• Unified solution – all information available to all professionals
• All public primary and secondary health care
• Social sector
• Patient/client in the middle
• Cross regional treatment plans and protocols
• Standardized clinical content and work flow
• Reduced number of different it-systems
• Easier to train personnel
• Increased productivity
• Improved usability
• Centralized 24/7 support
• Common patient portal and services

9. Asiakas- ja potilastietojärjestelmien tietojärjestelmäarkkitehtuuri tavoitetilanteessa

10. Other special
functions/services
•Client and patient database
•Risk information
•Consent and forbiddance management
•Log data
•Electronic prescription
•Client and patient service portal
•Client and patient record
•Announcements, applications, requests
•Medication management
•Prescriptions, referrals
• Institutional care, housing services, wards
•Decisions (e.g. rehabilitation, long-term care,
placement decisions)
•Alerts and alarms
•Care, nursing and operating protocols
•Client/patient office (ambulatory) functions
•On-call duty
•Reporting
•Invoicing information/productisation
•National etc. interfaces
Operating
theatre
Anaesthesia
Births
Oral health care
special functions
Outpatient
emergency care
Imaging
Laboratory
Catastrophe and
emergency case
management
Auxiliary tools
Innovative services
of the future
Order payments,
collection
Intensive care
unit
•Examples of such core functions of the data system that covers the handling of central
client and patient contact information and the operations control.
•Examples of integrable special functionalities (from a data system point of view)
Social services special
functionalities
Decision support
Datawarehouse

11. Overview of the main phases
of the programme
2013 2014 2015 2016 2017 2018 2019
Preparation and
Procurement phase
Implementation phase
Planning, localization, configuration, pilots
Production phase
Clincal change and management of change

12. What we have done so far
• Preparation for the product evaluation phase
• Over 350 social services and health care professionals
• Use cases and their structured evaluation material
• Covers all functions
• Work started at 11/201, ends 5/2013
• Usability consultants from the Aalto University
• Preparation the ICT requirements
• Over 14 different work threads
• Interfaces
• SLO and SLA
• Data security
• Medical devices
• Data migration
• User support
• Market research and technical dialogue
• Preparation of the procurement documentation

13. Challenges
• Decision making
• 6 different bodies
• All major decisions are done in the political level
• Unpredictable
• Keeping the planned timetable is difficult
• The size of the programme
• For ex How to train 50 000 end users?
• Where to find the personnel to implement the system?
• Social sector vs. health care
• Possible major changes on the municipality level
• Possible major changes on the hospital district level
• The change or adjustment of the workflows

14. Good Source for realiable information
www.apotti.fi
Thank You!