Digital health (and hockey?): What Canada can learn from Finland

Teamwork makes the dream work

Many jurisdictions — Canada included — have historically looked at digital health as a healthcare-only development area. As such, the onus has often been put exclusively on ministry of health-equivalents to figure out how to make digital health happen. The problem with this approach is that it already puts limits on what you feel digital health can (or should) enable.

If you build it, they will come

Finland’s claim to digital health fame largely comes from the aforementioned Kanta. As the digital backbone of Finland’s health and social care system, Kanta enables a number of capabilities for both citizens and clinicians.

High-level view of Kanta’s architecture (2016)

Let’s bring it home

Although valuable as a peer to learn from, building something similar in Canada presents many of the same opportunities (i.e. citizen empowerment, better care collaboration, at-scale health system innovation), but a vastly different set of challenges.

1. Don’t just make it another large public sector project

Many of our major digital health projects have faltered because they were largely designed and developed in a public sector silo (non-collaborative) with a public sector mindset (short-sighted). They try to be too much, too quick and governments — somewhat rightfully so — always struggle with giving up control on how these solutions should evolve over time. So although well-intentioned, we end up rolling out these clunky, overly-prescriptive solutions that are not being built for sustainability, innovation, or private sector participation.

We need to develop the digital health backbone that isn’t just perceived as another large public sector initiative, but one that actually encourages and incentivizes private sector participation.

Successful platforms also remove friction from the process of onboarding users and vendors. Think how seamless it is to become an Airbnb host or an Uber driver. It is important to make whatever the manifestation of this concept is as easy as possible for vendors (and eventually, citizens) to meaningfully participate.

2. Focus on creating value first, and monetizing value second

With healthcare organizations and systems facing increasingly dire fiscal situations, there has been a heightened focus on identifying new revenue sources to fund capital projects (or just keep the lights on). From hospitals building “innovation hubs” to commercialize more in-house products, to provincial agencies increasingly selling access to health data to researchers and vendors, we are starting to become more revenue-driven than impact-driven.

3. Build it with the citizen in mind

Our large-scale digital health initiatives in Canada have historically been predominantly clinician-facing. As citizens increasingly want to become the quarterbacks of their healthcare, we need to equip them with the tools to do so safely and effectively. It is still a hassle to get copies of our health record, and when we do, we usually get them on a CD! None of my devices even have a CD drive anymore.

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