Future proofing healthcare through personalization: Finland case study

Minna Hendolin , PhD

Leading Specialist, HealthData, Sitra, Finnish Innovation Fund

Future proofing healthcare through personalization: Finland case study

10 March 2021 | 13min

Quick Takes

  • A holistic, value-based approach is key to implementing personalized healthcare as modeled by Finland’s healthcare system

  • Data and artificial intelligence used in collaboration with individuals, corporations and governments across the globe has the potential to drive down healthcare costs and generate prosperity and better health

  • Collaboration and partnerships will help to connect and harmonize healthcare systems, policy and technology at a global level to improve efficiencies and focus on what matters most, which is the health outcomes for people

Future proofing healthcare with data-driven insights 

As the number of people suffering from and dying of non-communicable diseases grows, so does the unsustainability of health systems and the costs of care. The FutureProofing Healthcare initiative was set up to be a catalyst and facilitator for improving healthcare systems globally.

It’s mission is to build new, personalized, data-driven and resilient health systems that are ready for the future. The initiative was set-up and funded by Roche, yet an integral part is the independent international expert steering panel.

FutureProofing Healthcare Indices bring together third-party data into one place, making them comparable, visible and easy to use – allowing government policy makers, clinicians, patient groups and others to measure how far countries are progressing towards more personalized, integrated, digital health systems.

Finland currently ranks the highest in the personalized health index (PHI). We sat down with Minna Hendolin, health sector global influencer and leading health data specialist of Sitra, to get her insights into what makes Finland so advanced in personalized healthcare (PHC) and where she sees the growth opportunities in PHC to achieve better patient care and improve healthcare costs. 

A holistic approach is the best approach

HT: Personalized healthcare is key to building future health systems that better serve patients through improved patient experiences and health outcomes. Finland ranked the highest in the Personalized Health Index (PHI).  What attributed to Finland scoring so high in the PHI?  

Minna Hendolin: The index is built upon seventeen building blocks with four different categories – Health Information, Health Services, Personalized Technologies, and Policy Context, which created a holistic picture. Finland got quite good scores in each of these categories and this lifted Finland to the top tier countries of the Index. 

Just as the index looks at several different aspects of a country’s healthcare system, Finland’s good performance is due to a combination of different factors that build up and influence the Finnish healthcare model. It rises from the relatively short but hard history of the nation as an independent country, the government models, strategic decisions made during the decades and even the geography and extreme weather conditions that have influenced the mindset of the people. 

Healthcare is not a remote island and in order to improve the system and the value for citizens you need to see it as a part of the whole ecosystem around you.

All these factors have shaped and conditioned the Finnish mindset to be prepared and proceed pragmatically. That’s why I am not surprised that Finland got the highest points in the Index for the category of Policy Context, which considers the policies, frameworks, partnerships, people, and drivers that facilitate personalised healthcare.. 

The reason for the good overall performance could also come from a high level of trust and safety within the society, freedom for innovation and choices in life. When one understands all this it is easier to see why Finland has been ranked number one on the United Nations World Happiness Report (2020) already for the third time.1

One specific thing I’d like to raise is the cross ministerial and governmental collaboration that Finland has emphasized during the last decade. A good example of that is the National Health Sector Research and Innovation Strategy that was published in 2014, which focuses on the growth and renewal of the health sector and better care for people.

The implementation is jointly steered by three ministries, Ministry of Economic Affairs and Employment, Ministry of Education and Culture and the Ministry of Social Affairs and Health. Also national research and innovation financiers, the Academy of Finland and Business Finland, are on board. So, you really need to break down the silos, set a common vision and wrap up limited resources, especially in a small country like Finland. 

Finland has been doing this for the last hundred years and has gradually built the whole society to the current level. The work never stops and the need for resilience and adaptation to change is important.  Healthcare is not a remote island and in order to improve the system and the value for citizens you need to see it as a part of the whole ecosystem around you.

Progressing towards personalized healthcare: Goal setting, trust and collaboration

HT: What advice would you give to other countries that want to progress their personalized healthcare goals to reach Finland’s level?

Minna Hendolin: That’s a tricky question because every country is different. The history is different, the population is different, the geography is different. If I were in the position where I had to give advice, I would say that you first need to understand your own society and health ecosystem as a holistic combination. Weaknesses, strengths, and potential must all be considered, but also, it is important to determine what you want to achieve and at what level you will lift the bar. 

Secondly, collaborate with different stakeholders, get insight and involvement from other government sectors, researchers, companies and citizens – building transparency and trust.

Thirdly, follow up on actions, evaluate outcomes and make things transparent by communication and then proceed.  It has been a long journey in Finland and the roadmap of the Finnish National Health Sector Growth Strategy has been updated three times during the last eight years. The foundation of the strategy itself is strong and the political commitment has outlasted the changes in parliament and several government programs during all these years.

Next steps for healthcare in Finland

HT: Continuity seems to be key, which is something that doesn’t necessarily exist elsewhere. It sounds like Finland has been very successful compared to other countries, but what’s left to be done? Are there other things still top of the agenda to improve in terms of next steps and if so, what are the priorities?

Minna Hendolin: The work never ends and I could say that this is more a marathon run rather than a hundred-meter dash by any means. There is definitely a lot to be improved in Finland as well. 

Finland got its lowest score (11th) in the Index for implementation of advanced technologies, availability of personalized medicine solutions, diagnostics and treatments. We haven’t been so good in that, even though everything should be ready – the infrastructure is there, people are very well educated and ready to contribute, and there are digital tools and data available.

 We have very advanced healthcare services, but we need more agile ways for integrating these new innovations and care models into our system. Finland has a nationwide public healthcare service system that ensures equality and standardized, high quality services but it can also be rigid and slow. Our reimbursement structure also needs development to be more forward looking. 

Another area where there is room for improvement is in international collaboration.  Finland is a very small country in the terms of professionals, companies and even the market. International collaboration of all sectors – government, academics, and companies is extremely important for us. Tapping into the world’s best research, innovation and business ecosystems is vital. Today, world leading innovations are made in ecosystems and the global competition is done between them. 

Key elements of success for personalized healthcare in Finland

HT: In addition to the “Policy Context” category of the PHI, Finland also did exceptionally well (2nd place) in the “Health Information” area, which relates to the data, infrastructures, and technical expertise that will drive personalized healthcare. Could you give more insights into Finland’s high score, especially in this latter category? 

Minna Hendolin: Finland’s top marks in the PHI index came from having the highest scores for availability of funding for scaleups, environmental/social determinants of health and access to data for research purposes. As an example of the policy actions, Finland was the first country in the world to launch the biobank law 2012 and a law for the secondary use of social and health data 2019.

A year after the law was passed on the use of secondary data, the national health data permit authority FinData started operation as a one stop shop for access to the data. The pragmatic mindset of Finns can be seen also in the way that Finnish biobanks and data registers go back decades – having longitudinal digital data and high quality biological samples. 

The role of data and data exchange in personalized healthcare

Minna Hendolin: Kanta is the national portal and platform where we store social and health data and offer services for citizens via a digital platform. These services benefit the citizens as well as social welfare and healthcare service providers. You can access the Kanta services wherever you live in Finland. One unique feature of the Kanta platform is the so called MyKanta service portal where citizens can browse their own medical records, manage consents and prescriptions and soon also add their own data to the repository. 

It is known that social determinants have a huge impact on health and vise versa.  This is something that has been taken very seriously in Finland’s approach to healthcare. This is  seen in how the government has built infrastructures, services and data repositories where social and healthcare data can be linked. Even our ministry is the Ministry of Social and Health Affairs.  

There’s still a lot to do to interconnect different systems and build seamless service pathways for citizens. Getting all of this to work across borders is another challenge. Finland has been doing pilots already with Estonia for pharmacy prescriptions and the results have been promising. I hope to see many more new openings in this field in the near future.

Finland is a tech leader

Minna Hendolin: I was not very surprised that Finland got high index scores in the area of “Health Information”.  Finland has been a leader in IT and telecommunications for decades. Nokia is known worldwide for their mobile phones and telecommunication networks, but the Finnish IT industry is much more than Nokia. The strong engineering expertise that was gained in telecommunications is of great value in healthcare and life science. 

The combination of these two areas where Finland scored highest sets a good foundation for digital health, bioinformatics and data science expertise. It has allowed Finland to create one of the biggest digital health ecosystems in Europe. Now emerging technologies like artificial intelligence (AI), robotics, 3D printing and mixed reality are taking healthcare towards a totally different level of digitalization and data usage. 

Finland’s goal is to be a global forerunner in the application of AI throughout the whole society, and healthcare is one of the priorities.

Collaboration across European borders

HT: Are there other countries that are advanced in the use of data that Finland looks to for inspiration or models after?  Or is it too country-specific as mentioned earlier?

Minna Hendolin: Each country is different as we found on the index and there is a lot of diversity between countries in terms of data infrastructure, the level of digitalization and policies. As we know, the health sector still lags far behind other sectors in harnessing the potential of data and digital technologies and is missing the opportunity to save a significant number of lives and billions of euros as well as generating equality and good healthcare services for citizens. 

Also missing are scalable business opportunities. The PHI was a great exercise to see the polymorphism in Europe and to realize how much we could learn from each other. Everybody should do their homework and develop platforms for the exchange of good practices. 

Secure, easy and seamless access to protected health data for the benefit of society

HT: In terms of policy and infrastructure within Finland and the rest of Europe, what are the next action steps when it comes to harmonizing the systems and data sharing?

Minna Hendolin: The European Commission has recognized the importance of digitalization and taken actions to secure Europe’s competitiveness and data sovereignty. Last year the commission launched the European Data Strategy that includes a special initiative called European Health Data Space. It is a collection of actions in the coming years to boost digital transformation within the health sector and to build the future for better policy, better healthcare for citizens, and a better environment for research and innovation. 

One of the first concrete operations of Europe’s health data strategy is the Joint Action Towards the European Health Data Space, also called TEHDAS. Sitra, the Finnish Innovation Fund is coordinating this three-year program that is co-funded by the European Commission and has 26 European countries involved. 

The purpose of this joint action is to help member states and the European commission in developing concepts for the governance, usage and sharing of health data for secondary purposes. This means in practice for research, innovation and decision-making purposes, but also for citizens themselves. 

Outcomes of this program will be to make proposals for guidelines around governance and data sharing, ethical and legal issues as well as infrastructures. All this will be used in the preparation of coming EU legislation and other policy issues related to health data. 

The vision is that in the future there is secure, easy and seamless access to protected health data for the benefit of citizens, researchers, companies and communities in Europe. There will be an open forum for stakeholders to contribute to these proposals. More information can be found on www.tehdas.eu 

The collaboration should not be limited to Europe and I believe that this European level harmonization in policy, targeted funding and strong data infrastructures will also enable better global collaboration and hopefully make us better prepared for future global health crises. 

Future proofing healthcare: A message for our readers

HT: What advice would you give to our readers who want to improve their readiness and effectiveness for personalized healthcare now, whether it be in Finland or outside of Finland?

Minna Hendolin:

1Get a holistic view of the health ecosystem: We are so overwhelmed with information and everything develops so fast. If you just think about the recent advancement of technology, science, new business models, startups, changes in global geopolitics – it is impossible to keep track of everything. But as much as possible, try to keep an overview of the developments of the ecosystem around you and follow foresight reports to understand what might come around the corner.
2Follow policy issues and initiatives: Gain an understanding of what is happening in your own business, in your country and also at the European level regarding policies and major initiatives.
3Look outside of the health sector for solutions: You might find that someone in another industry or technology sector has a solution to your problem. Breaking down the silos and being open to new collaborators’ opinions inside or outside your normal daily working environment is always valuable.
4It is all about people: Even though everything is going digital and we are accelerating towards a data-driven society, it is the people that matter at the end of the day. Whether it is your colleague, collaborator, your customer, or patient – we need trust, respect and presence. It is up to all of us to generate a better life for all of us.

Minna Hendolin, PhD has influenced health sector research, innovation and business ecosystems during the last 25 years in multiple roles. In addition to an academic career, she has managing and leadership experience in both private and public organizations resulting in a wide understanding on business development, innovation, financing and strategic planning. At her recent positions at Business Finland and Sitra, she has contributed to national, Nordic and EU-level health sector innovation strategies and policies. She is an active influencer and thought leader in international networks including World Economic Forum Expert Group, Horasis Global Leaders and United Nation Innovation Lab in health. She holds a doctoral degree in biochemistry and molecular biology.

References

  1. World Health Organization. (2020). World Happiness Report available from https://happiness-report.s3.amazonaws.com/2020/WHR20.pdf [Accessed March 2021]