A customer of Finnish public health care may have a long waiting time when calling to discuss with a trained nurse, to make an appointment with a doctor or to renew a prescription form. It may also happen that a customer will not be served at all and she/he has to turn to a private clinic. In addition, the handling of the costs of medical treatments causes a lot of paper work, when an insured files a claim for an insurance company. According to my idea, a platform which combines a customer - a sick person - and public health care with chemist's shops, private clinics, Kela and insurance companies will provide better health care services for a customer.
In the essay I introduce my concept of public health care platform and describe its users, components and rules. I also briefly introduce some existing web services such as Duodecim/Terveyskirjasto, Rokote.fi, Tohtori.fi, Kela.fi, If.fi, Pohjola.fi and a calling service Terveysneuvonta. In addition, customer satisfaction, cost and benefits of the platform (e.g. one time data entry, administrative handling expenses, disputes between insurer and insured, legal issues and preventing fraudulent insurance practices) as well as e-invoicing possibilities are analyzed.
Check out Kauppalehti 18.2.09 (page 13) and this new Finnish company Mediweb that runs this healthpage: www.hoitonetti.fi. It is the first communal health service in Finland, based on idea of web 2.0 providing for example peer support.
This site could give you some new ideas although the owners of this company Mediweb say that their purpose is not to diagnose.
Again, a very important and interesting topic. I believe that the platform that Merja is talking about will become reality, sooner or later. Let's just hope that the developers of the platform read the two-sided networks papers... :)
I am working for OP-Pohjola and see daily the work of the insurance sales and service people. This topic is interesting and would I hope this kind of development in the systems integrationg will happen soon. On the otherhand, OP bank and Pohjola merged about a year ago and the integration of our systems is so slow and difficult, plus the employees tend to resists new software (although it would be faster and easier to use..) :)
Discussing about the health care platform you could refer to problems initiating and implementing changes in health care organizations (HUS), different personnel + doctor + management interests, motives and incentives. The change in health care stands or falls due to change implementation and strategy itself. How could e-platform help the change? Which change strategy to choose (TQM/BPR/some other method)? How do support systems and processes help the whole diagnostics process? Should you some way change the 'status quo' in the main processes? How to implement them and by whom the implementation decisions are made?
As a mother of three children under 10 years old, I find current health care system combined with Kela and insurance companies complicated and frustrating. I am even willing to pay for certain digital information, which will save my time and effort. My idea of Finnish health care platform is to combine a customer and different service providers (information, material and money flows). Although existing web services are using similar rules and components, they are not integrated and a holistic health care platform is needed. In order to identify a customer, network banking IDs (Nordea Solo etc.) and single sign on can be used. In my opinion one time data entry, common procedures, digital storage of information and audit trail will increase customer satisfaction, support e-invoicing, decrease paper work and administrative handling expenses as well as disputes between insurer and insured or fraudulent insurance practices. On the other hand some issues concerning privacy, competition laws, chemist's licenses (selling or shipping chemist's articles) etc. must be solved beforehand.
The main challenges of the platform will be that service providers are unable to see the potential payoffs of the platform, they do not have sufficient process measuring and monitoring systems, or the system integration will not work properly. Also this kind of major technological change may act as a driver or an enabler of organizational change, but the discussion requires another time and place and is not included in my essay (re: Matti Kuusela). Anyway, in my opinion the idea of Finnish health care platform is worth further study and it may help to find out opportunities or slacks in the Finnish health care system. And most importantly, the platform would provide easy-to-use and beneficial (maybe even enjoyable) digital health care services for us
(re: Merja Mattila) You have very good ideas, I see. Really interesting study area, indeed. You are discussing about slacks and opportunities, to say it simple, those are areas for development work. The great problem is to get ideas implemented. Maybe money will be the first driver to the change. However, I am a bit worried about the level of knowledge and sincerety of various stakeholders.
(re: Matti Kuusela) Thank you for your comments. The important principle of the platform should be that citizens and service providers are treated equally, the new platform is a part of municipal network (kuntalaisverkko), fierce competition between service providers is prevented or decreased and the platform is governed by a trusted partner. However, I am also concerned that some user groups, which are not classified as "digi-native" (e.g. uneducated or elderly people), will not be treated equally. Therefore user-friendliness of the platform must be taken into account and technological improvements must be applied. Further, some new technologies such as Skype may improve health care services for scattered settlement.
(re: Merja Mattila) User-friendliness together with usefulness of service are top priorities. How about enabling free, fierce competition of service providers through a kind of public health care purchasing portal? Platform governed by a trusted partner is a good idea too.
One example of a kind of "user-friendliness" and "freely flowing process" is possibly the queueing system in Peijas. A kind of 'negative wating time activity' is applied making wating time feel even more longer. First, you queue to reception 0.5 - 1.5 hours (according to patients), second you might be accepted to wait up to 2 hours to see a doctor (according to policy and measurement method). "Not being able to control waiting time in queueing to reception" (municipal representative). "Not being able to get rid of all queueing", is inevitably true, but why not move resources to top demand periods? What might be service level target of Peijas? (That's not mentinoned in the article)
