If you live in the countryside, the nearest doctor might be far away. Many remote communities are struggling to recruit medical professionals and often, the bulk of the health and care services have been centralised in larger towns or cities. But what if, instead of travelling to see a doctor, you could have a video consultation from a remote clinic in your local area or even from your own living room? Pilot projects introducing digital services in healthcare and social care across the Nordics have produced highly satisfactory results.
Quality, efficiency, inclusion and accessibility
Rural communities all across the Nordic countries are testing new digital solutions to transform their provision of healthcare and social care services. A new Nordregio report outlines the Nordic countries’ visions for digitalisation in health and care and presents the experience from seven case studies in the Nordic countries, Greenland and the Faroe Islands. The report is part of the VOPD initiative – Healthcare and care with distance-spanning solutions.
The case studies have tested a broad range of distance-spanning solutions, including virtual health clinics and video consultations, remote analysis of X-rays and body scans, and various technologies that enable elderly people to stay longer in their own homes. These solutions include digital safety alarms and sensor-based passive warning systems, automatic medicine dispensers and night-time supervision with cameras, just to name a few.
“Digitalisation in healthcare and social care carries massive potential,” says Senior Researcher Anna Lundgren, who has led the work on Nordregio’s VOPD report. “Digitalisation enhances the quality of care and increases efficiency, such as by reducing the need for transportation of patients and staff. Moreover, digital solutions foster inclusion and better accessibility, which is highly relevant, in particular to people living in remote and rural areas.”
New digital choices introduced
The region of Sogn and Fjordane in Norway is currently piloting a new type of remote service that offers the rural population better access to emergency doctors. The service is provided at so-called ER satellite units, which are located strategically throughout the region. Here, a nurse receives the patient and conducts the initial assessment, followed by a video consultation with a doctor.
“This approach allows us to provide better and more efficient emergency services to a larger group of people,” says Gry Elise Albrektsen, General Practitioner and Head of Emergency Services in Flora Municipality. To gain critical mass, the service operates across a number of municipalities, with twelve doctors serving a population of around 12,000 people. “The doctor decides on the patient’s treatment based on the nurse’s initial assessment and the video consultation. However, if further examination is needed, we can always ask the patient to come see us or go to the nearest hospital.”
Improved accessibility to care
Similar solutions have also been implemented elsewhere, for example in Västerbotten in Sweden. According to Nordregio’s GIS mapping of healthcare facilities in the case study regions and municipalities, the implementation of digital solutions can significantly reduce the need for travel.
“Our mapping shows that the virtual health rooms in Västerbotten have reduced the travel distance to primary care by almost 50 per cent for 10,000 of the most rural residents – from 42 to 23 kilometres per capita,” says Oskar Penje, GIS Analyst at Nordregio. “This is obviously a significant improvement for these citizens.”
Digitalisation of healthcare services has also been high on the agenda in the North Denmark Region. The Region has joined forces with Morsø Municipality, a small island community of around 21,000 people, to experiment with new ways of improving access to primary care and, at the same time, solve the growing problem of attracting general practitioners. As in the other pilot communities, the population of Morsø is ageing, and the old-age dependency ratio is above national average.
“We were worried that especially our elderly citizens would be sceptical toward the digitalisation of healthcare services,” says Daniel Simonsen, Deputy Head of the North Denmark Region’s Department of Planning. “These concerns were, however, entirely unfounded. Our patient council made it clear to us that they weren’t at all afraid of digitalisation, as long as the solutions were intuitive and user-friendly and the users knew whom to turn to if they needed assistance.”
Among the solutions implemented in Morsø are autonomous outpatient clinics, where the patients are guided through a series of steps before joining a video consultation with a specialist. This saves them the two-hour drive to the university hospital in Aalborg.
“Our experience is that in addition to the benefits for the patients, these clinics provide increased flexibility with regards to recruiting doctors,” Simonsen says. “Rather than receiving patients in their clinic every day, the general practitioners can now attend to patients in Morsø say three days a week and two days in Bornholm or somewhere else in Denmark. The patients are still seeing the same doctor who knows their health history, so it’s also been a very positive experience for them.”
The best care for the most fragile
One of the key priorities in Sogn og Fjordane has been to use digital solutions to support people with one or more chronic illnesses in self-managing their disease. According to the Swedish Agency for Health and Care Services Analysis, patients with chronic disease, such as diabetes, COPD and cardiovascular diseases, account for around 80-85 per cent of all healthcare costs.
“Our main goal is to provide the best possible healthcare services to our most fragile patients, often with multiple diagnosis, as close to their homes as possible,” says Gry Elise Albrektsen. “This is the group of patients that is most frequently in contact with the healthcare system. Introducing digital solutions therefore offers several advantages to improve their treatment and make their life easier. Not only does this dramatically improve their quality of life, it also frees up valuable resources in the healthcare system.”
Webinar: Health & Well-being in the Nordic Region
On 21 October, Nordregio hosted an online launch of three studies on Nordic well-being, health care and digital tools that regions have already successfully implemented. If you missed the launch, we invite you to watch the recording.