Drivers of political choice
It is becoming clearer that more data are required more frequently to address emerging health threats and provide services that are high quality and cost-effective – and Finland is leading by example
Impactful common data and knowledge drive political choice
Throughout the Covid-19 pandemic, we have seen increased demand for comprehensive and real-time data on the spread of the virus and the effectiveness of various countermeasures. The demand accelerated the adoption of digital services and intelligence gathering and sharing locally, nationally and globally, due to a common objective and sense of urgency. What if these data could be available to support all health policy?
Supporting health policy
Finland has a long history of maintaining comprehensive social and health registers. Traditionally, they have been a source for statistics and analysis of long-term policy choices. It has become increasingly evident that more data are needed more frequently both to address emerging health threats and to provide high-quality and cost-effective services. Finland has moved from yearly statistics towards real-time data on primary and secondary health care as well as social care for the past 10 years. This transformation will continue by leveraging e-health and e-welfare solutions. Finland has also been a leader in adopting digital services in health and social care, and it is time for the full benefits of the available health data to be realised.
High-quality decisions are based on high-quality data. High-quality data are created through their use and clear feedback. The data should be generated as close to the actual services as possible. The primary use is to provide the best possible care for the patient. The same data are used for management, statistics and other secondary purposes leading up to local, regional and national policy and decisions for better public health. The Finnish model unites the data from primary use to policymaking to create a virtuous cycle to generate better data for better health policy. When possible, data created through health and social care services are complemented by longitudinal health interview studies and surveys to provide further insight on public health (see figure).
Ingredients for long-term success
The recipe for long-term success needs three key ingredients.
First, trust is a prerequisite for e-welfare. In general, citizens have high levels of trust in health and social welfare professionals with whom they already have a personal relationship. Trust in the government and institutions has been exceptionally high in the Nordics, which has contributed to successfully adopting large-scale solutions for individual health and social care data in Finland. Trust can be cultivated through transparency on how data are used, who has accessed the data and clear value propositions on the benefits of sharing data. Citizens must always have control over how their data are used.
Second, process and data interoperability is vital to ensure the comparability and usefulness of data. The European Interoperability Framework models interoperability through legal, organisational, semantic and technical layers. Although data can be shared technically, it is of little use if common definitions and classifications are not used or if the differences in processes are not accounted for. Interoperability has been one of the leading principles for developing e-health and e-welfare in Finland since 1995 and is one of the key mandates for the Finnish Institute for Health and Welfare.
Third, governments should offer public and private health and social care providers incentives to accelerate sharing data between organisations and with government institutions. A strong legislative basis for processing data and using it for policy support, budgeting and supervision provide positive incentives and also steer health and social care services towards common objectives.
In Finland, all these dimensions concern both social and healthcare data. Consequently, we have a unique knowledge base that can be used to manage health policy and political choices at local and national levels.
The journey towards comprehensive real-time data has taken time, but it has been worth it. But development work will never end. New information management needs will always arise.
Finnish reform and knowledge management
The organisation of public healthcare, social welfare and rescue services will be reformed in Finland in 2023. The responsibility for organising these services will be transferred from municipalities to well-being services counties. The central government will mainly finance the costs incurred for organising the services. As a result, the importance of managing with comparable information is significant.
Central government guidance and direction will be strategic in nature, focusing on the responsibility of the well-being services counties to organise services. They will have value-based information as their foundation. Strategic leaders of well-being services counties will also lean on the same data and knowledge when managing their own organisations.
The end result is that health policy will be backed by shared, real-time data at the local and national levels. This will bring the lessons learnt from the Covid-19 pandemic into use in health policy in general. Just as with the pandemic, it will take time to learn and improve the use of all the available data resources. Fortunately, the first leg of the journey has already been completed.
