Ari Järvelä is the managing director of Tietoevry Care. During his visit to Ljubljana, we sat down with him to discuss the (digital) healthcare systems in the Nordics, the benefits of adopting the digital platform approach, why they decided to embrace openEHR, and how they see the partnership with Better. “Everything is better with Better,“ he said, adding that he really appreciates the collaboration of both companies to push for openness and modularity of healthcare systems.
Finland is known for its strong healthcare system. How would you describe the current state of healthcare in Finland and other Nordic markets, and what are the key challenges healthcare providers face today?
In Finland specifically, we just moved to the new model. We called it Social and Healthcare Reform, and we formulated 21 well-being services counties and the City of Helsinki. They are fully responsible for organising everything from social care to primary care to secondary care. Social care in Finland is unique. It consists of helping elderly people, providing family care, and caring for refugees. In addition, primary care and secondary care are very similar across all Nordic countries.
In Finland, we are only in the very beginning. This is now the second year of the reform, but I think that it will help in patient flows, as an example. It is under the same governance, everything from your childhood to healthcare, and all the way when you are an elderly person. The aim is to harmonise everything and have one patient record. So, each of these 21 well-being services counties and the City of Helsinki will be using a one-patient record system. And everything, all the data, is there at the end. What is then unique about Finland is its strong national integration, where certain parts of these patient records are copied to the national systems, including prescriptions and the like. It is a relatively integrated system.
Norway and Sweden are slightly different as their social care and primary care are the responsibility of municipalities. There are hundreds of them, so it’s much more fragmented from the system point of view but also from the decision-making point of view, whereas secondary care is organised on a regional level. So that is the difference between the systems in the Nordic countries.
About the challenges – they are pretty common across all Nordic countries and pretty much the same as elsewhere in Europe. The population is getting older and consuming more and more resources, and the lack of care personnel is a problem. Also, compared to many business-to-consumer types of businesses, I have to say that healthcare is falling behind. If you compare it to telecommunications, banking, or retailers, the end-user experience and digitalisation have fallen behind, and there is a lot to do in achieving a better digital experience and a lot of efficiencies to be gained there.
As you said, digital transformation or digitalisation is playing an important part. There are challenges, of course, but my question is how is Tietoevry Care contributing to this evolution? What’s your role in this?
Overall, we have a pretty holistic role in the Nordics. In Finland, we now have 21 well-being services counties and we are the main system and digitalisation partner for 16 of them. The main partner means that we are providing them with the full health suite, including the social care customer record system as well as the EMR. We also provide them the full data and analytics, including advanced analytics capabilities for the secondary uses of data. We are in the pole position. In Sweden and Norway, we are the strongest in social care and primary care, whereas our current challenge, if you will, in these two countries is secondary care.
As you mentioned, you are playing a very important role in the Nordic market. What’s your vision behind the Lifecare system, and how does it meet the needs of today’s healthcare providers?
Just to clarify, Lifecare is our holistic product portfolio covering everything from social care to EMR to our data platform, advanced analytics, and AI solutions. We have two main guidelines when innovating and developing new products. One is tearing down the monoliths. I think the open architecture customers need to have a choice whether they want to have our clinical modules or somebody else’s or develop them by themselves. And that requires open architectures everywhere, in clinical data repositories as well. The second thing on top of our minds is insights and data insights. We are investing a lot in advanced analytics to make them AI-driven. We want our AI vision to come true to help doctors make decisions on the operational side or clinical side. Our position in society is also the data integrator role. It is clear that advanced analytics and tools are useless if you don’t have access to data. In our position, especially in Finland, we have access to health and social care data. But we have developed an extremely secure, the only actually CE-stamped data platform in Europe, with which we can ensure a secure way of integrating data and hosting the data. And then it is us or somebody else who develops the digital solution on top of that data platform.
Lifecare is deployed in over 70 healthcare centres in Finland.
Actually, nowadays, when we have moved to this social and health reform, we have 21 well-being counties, and we are the main player in 16 of them.
What makes Lifecare different, and what are the insights and feedback of healthcare professionals and organisations that actually use the system?
We measure the end-user experience on a regular basis. We actually have three different measurements. We measure product experience, how our customers feel about our product, whether it fits their purpose, and whether it is easy to use. The second is the delivery level experience, when we are delivering a service or product for our customers, how do they experience it? And then we have a relationship experience, where we determine how easy or not easy our company is to work with. And we get top scores in all three of them. We have really paid a lot of attention to the user experience. I think that, as a company, we have come a long way during the past 4 to 5 years. Typically, EMR systems are relatively complex and complex to use. And I think that the whole user experience has improved. Having said that, I think that we, as well as any other company, still have a lot to do to make this experience even smoother. If we take doctors, for example, we have a very flexible user interface, and doctors can formulate their own daily flows. It’s also very flexible and allows users to change the UI based on their preferences and daily tasks. We have taken that approach, and we have gotten a lot of positive feedback.
A very important part of Lifecare is also the Better digital health platform. How does it improve its capabilities, particularly from the perspective of healthcare organisations and clinicians, how does it work better with Better?
Everything works better with Better. You are one of our key strategic development partners and at the core of making it possible to have this kind of open data model based on openEHR. You have helped us to build the whole system around openness and modularity. You are providing us with the technology that makes it possible for us to develop our software on top of that. I’m super happy with the open atmosphere, an open collaboration between Tietoevry Care and Better.
The partnership between Tietoevry Care and Better started in 2017. Besides Lifecare, what has been the most significant achievement of this collaboration so far?
Karolinska University Hospital is, of course, one of those examples. The flagship customer for both of us in Sweden, which proved that we could bring a lot of value to the hospitals, regardless of their location. I think this is the case ‒ your technology, together with our software. Actually, just last week in Norway, we launched our integrated primary health care solution, where we are combining our social care software with our clinical modules together with your platform. And I think that will be a totally new offering for the Norwegian market. Our first target is to get at least 50% of the municipalities in Norway as our customers. And I believe there are seeds for something bigger in the Swedish market as well.
You have also been a pioneer in adopting and promoting openEHR in the Nordic markets. What convinced you to embrace this standard, and how does it align with Finnish and Nordic healthcare systems?
We used to be a monolithic software vendor. We got a lot of feedback from our customers at the time, saying that our system does not integrate with other systems and that it’s a huge hassle to take any data out. At the time, we decided that we wanted to be open and modular and that our product, mission, and vision is to help our customers be in a better position when they are serving the patients. I think that was the trick. We listened to our customers, and then we changed our product and strategy dramatically to fit that demand. And I think it was absolutely the right decision.
The healthcare market and healthcare needs are constantly evolving. Can you share with us Tietoevry Care’s priorities in terms of innovation and partnerships for the next 3-5 years?
Innovations happen in ecosystems. I think that the platform game is one thing. Take for example the Helsinki University Hospital, which is the biggest user of our data platform. We build the innovation platform, and in addition, there are many other tech companies, smaller and bigger, as well as the hospital itself, building innovations and new solutions on top of that data. We are only part of that ecosystem. Innovating together is important. AI is also definitely the name of the game today. In five or ten years, there will be many other new ideas and new opportunities. And we need to help our customers capture these opportunities.
