HCD-2nd edition Layout 1 - Healthcare...

Healthcare DENMARKI N N O V A T I N G B E T T E R L I F E

Activity

Productivity in Danish

hospitals on the rise

Healthcare expenditure

Learn about the solutions that help

cap healthcare expenses

Patient satisfaction

Explore the Danish approach to

a coherent healthcare system

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2 Healthcare DENMARK

In Denmark our focus on puttingthe patient first – combined withefforts to improve efficiency andquality – has resulted in a widearray of innovative solutions. I sincerely believe Danish solutions and expertise can have a positive impact on global health.

’’

Her Royal Highness Mary, Crown Princess of Denmark.Patron of Healthcare DENMARK

From the Chairman

Throughout the world, governments are facing the same challenge:How can we provide increasingly sophisticated healthcare to a population that lives longer, suffers from an increasing number of

chronic illnesses, and expects easy access to treatment?In Denmark, we have increased public satisfaction with healthcare

services and improved productivity and quality in the sector, while success-fully keeping health expenditures in check.

How did we accomplish this? Most importantly, we place the patient atthe center of attention and design our healthcare sector to support this idea.We combine sophisticated technology and transmission of data with astrong focus on skills and coherent processes. We prioritise design and quality and innovate by involving users and public-private cooperation.Combined, these trademarks lead to cost-efficient and user-friendly care.

In short, our success is the result of a well-functioning public sector supported by innovative companies that provide the technologies, products,and expertise which make it possible. We are not perfect, but we have comefar and continue to push forward to tackle modern healthcare challenges intelligently.

Danish healthcare is not exclusively for Danes: Many years of global presence show that our healthcare products and solutions create value inter-nationally. Danish expertise and products are used every day in ambulances,medical clinics, hospitals, and nursing homes across the world.

This magazine presents ideas and solutions that exemplify our resultsand experiences. The following pages offer a brief insight into the Danishhealthcare sector, its structure and ways of working, and just as importantly,the links and collaboration that tie the sector together into one coherent patient pathway.

We hope to inspire you and would like to invite you to Denmark to learnmore.

Mariann Fischer BoelChairmanHealthcare DENMARK

The case of Denmark

healthcaredenmark.dk 3

Published by Healthcare DENMARK, 2nd edition, February 2014. Text support: Operate. Photos: Steen Evald (page 2), Bjarke Ørsted (page 3), Mikkel Østergaard/Digitaliseringsstyrelsen (page 4 bottom), David Bering (page 5), Martin Wendel/Falck (page 8), Colourbox (page 1, 4 top, 7, 9, 11, 13), KMD (page 15), Vendlet Aps (page 17), Medic OUH I/S (page 18, 19). Graphic design: Christen Tofte. Printed in Denmark by: Oberthur Technologies.

Contents


About Healthcare DENMARKLearn more about Healthcare DENMARK andour services.

At the doctor’sThe general practitioner is the most important gatekeeper in the Danish healthcare sector. Approximately nine out of ten patients are fully treated by their GP. 99% of GPs use EMRs, and all have electronic access to patient data from almost every part of the healthcare sector.

Prehospital treatment In the area of prehospital treatment, Denmark is leading with advanced ambulance equipment, which virtually moves the hospital entrance to the ambulance. The IT and medical equipment in the ambulance and at the hospital are designed to work together and share real time information.

Efficient and innovative hospitalsDenmark is among the EU countries with the highest patient satisfaction and with the lowest GDP spent on healthcare. Learn how Danish hospitals keep the average length of stay low and how hospitals are integrated with other healthcare services to ensure coherent patient treatment.

Treatment at homeDenmark is successfully transforming healthcare to reduce the need for hospitalization and to increase focus on patient empowerment and prevention. A vital element of this is telehealth solutions, which offer healthcare professionals a more frequent interaction with patients at home, and secure a quick and efficient flow of data and health advice.

Supported livingElderly and disabled citizens often value the freedom of living in their own home and to remain as independent as possible. A broad spectrum of technical solutions makes it possible to support living at home while remaining in touch with specialized health professionals.

Rethinking the hospitalA key element in Denmark’s healthcare trans-formation is the investment of more than EUR5.6 billion in new hospitals and the upgradingof existing facilities. Almost one-third of thecurrent Danish hospital capacity will be modernised to meet future needs. This include inventing new approaches inareas like logistics and patient involvement.

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Quality of life in Denmark

According to the EU, Denmark ranks among the leading European countries in terms of the popula-tion’s satisfaction with their lives in general and with healthcare services (Quality of Life in Europe2012 – ranking among the 27 member states):

About us

Healthcare DENMARK is yourgateway to Danish healthcareexpertise. Our mission is to

communicate knowledge and insightinto the specific solutions and stake-holders that have made the Danish healthcare system one of the leadingand most efficient in the world. On ourwebsite healthcaredenmark.dk, you canfind information about Danish com-panies, organizations, and initiatives.

We would also like to extend a warmwelcome and invite you to come experi-ence Danish solutions in practice andmeet the people behind. Thanks to ourlarge network, we are able to arrangevisits tailored to your specific interestsand help plan logistics, such as localtransportation and interpretation.

About us

Healthcare DENMARK is a public-privatepartnership with a national, politicalmandate to promote Danish healthcaresolutions and competencies abroad. Thepartnership is a framework for linkinginternational partners with efficient Danish solutions and does not representany individual company or product. Healthcare DENMARK is funded by thefollowing public and private partners:the Ministry of Business and Growth, the Ministry of Health, the Ministry ofForeign Affairs, Danish Regions, Regionof Southern Denmark, the Confederationof Danish Industry, the Danish Chamberof Commerce, COWI, Falck, KMD andSystematic.

Healthcare DENMARK- An open invitation


The Danish healthcare system

The Danish healthcare system is primarily publicly funded and based on free and equal access to healthcare for all citizens. It is a key prioritythat patients experience a coherent patient pathway, and to ensureclose and efficient collaboration across the health sector.

The National level is where health policy takes its form. The Ministry of Health draws up guidelines for general planning andoperation of healthcare services.

The Regional level consists of the five Danish regions, which arethe main service providers in the healthcare system. Their healthcareresponsibilities include hospital and psychiatric treatment, and parts of the primary healthcare system such as general practitioners and specialist doctors.

The municipal level provides rehabilitation and general diseaseprevention as well as home nursing and homes for elderly citizens withcare facilities and associated care staff.

Life satisfaction and happiness: #1

Satisfaction with health: #2

Access to healthcare: #2

Health services: #4

Healthcare DENMARK is privilegedto have as patron, Her Royal HighnessMary, the Crown Princess of Denmark.

Hans Erik HenriksenCEOHealthcare DENMARK

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At the doctor’s

Doctor Prehospital Hospital Telehealth Homecare The future

The GP as a gatekeeper

In addition to directly treating their patients, GPs in Denmark have a role asgatekeepers, who can refer their patients to other parts of the healthcaresystem. Upon consultation, patientsmay be referred to a hospital, to treat-ment by a medical specialist, or to pre-ventive services such as weight loss orsmoking cessation. However, most contacts are concluded at the GP’s andonly one in ten GP contacts in Denmarkresult in a referral to another part of thehealth system.

Comprehensive digital access

GPs keep comprehensive electronic medical records on patients. Data isavailable through the GP’s internal systems and from large parts of theother health services patients have beenin contact with previously (e.g. hospitaladmissions, consultations with medicalspecialists, laboratory test results, aswell as medication records). In addi-tion, GPs can use the Danish e-healthportal, sundhed.dk. Through the portal,GPs can extract an array of patient datafrom hospital records. The systemworks irrespective of which hospital thepatient has been admitted to. As a result, GPs are able to include the patient’s complete medical history intheir assessment.

When a patient is admitted to hospi-tal, the various physicians who attendto the patient have electronic access toupdated medical records and to results


99% of authorised GPs in Denmark keep electronic health records.

GPs in Denmark receive 96% of laboratory test results from hospitals electronically.

85% of all prescriptions are sent to pharmacies electronically.

81% of referrals are made electronically.

0 10 20 30 40 50 60 70 80 90 100%

’’The Danish information system is the most efficient

in the world, saving doctors

an average of 50 minutes a day in

administrative work.Commonwealth Fund

cited in New York Times, 2010

of all examinations and tests. When thepatient is discharged after treatment, anelectronic discharge summary is createdand sent to the patient’s GP.

Sundhed.dk also provides patientswith similar digital access to their own

The general practitioner isthe most important gate-keeper in the Danish

healthcare system. GPs handlepreventive healthcare, treatment,and coordination of servicesfrom various health professio-nals – for example medical specialists and physiotherapists.Danes can freely choose theirown GP. On average, Danes arein contact with their GP or anemergency doctor 7.5 times peryear. Comprehensive access todigital patient data helps GPs intheir work and creates a uniquedata link between GPs, patientsand other parts of the healthcaresector.

Access to electronic medical records

Sundhed.dk is a public e-health portal that collects and distributes health infor-mation and provides access to electronic health records for citizens and health-care professionals. The Danish e-health portal uniquely brings the entire Danishhealthcare sector together on the Internet and provides an accessible setting forcitizens and professionals to meet and efficiently exchange information.

By serving both citizens and professionals, sundhed.dk enables the two to co-operate on the basis of the same data. This empowers the citizens and gives healthcare professionals tools that continuously improve quality in care.

This means that if Mr. Andersen has pains in his joints, he can prepare himself before a consultation, using information in the e-health portal. If Mr. Andersen isreferred for a hospital examination, the physicians, nurses, and other healthcareprofessionals can access information about the treatment Mr. Andersen has previously received from his GP.

Two weeks after being discharged, Mr. Andersen can access hospital informationthrough the e-health portal. If later, for example, Mr. Andersen is diagnosed witharthritis, through Sundhed.dk, he can read more about this condition and join apatient network. This way, Sundhed.dk helps empower patients and create awareness about their illnesses. Sundhed.dk also provides the basis for activeparticipation in treatment and self-care.

Mr. Andersen’s case

www.healthcaredenmark.dk 7

Summing up

1Electronic health records andshared databases enable GPsto see most patient data from

the rest of the Danish healthcare system. This ensures a high quality oftreatment.

2The GP concludes all treatmentfor nine out of ten patients, ensuring resource efficiency.

health data. The key to this informationis the so-called ‘NemID’ digital signa-ture, which is assigned to all Danish citizens based on a person’s uniquecivil registration number.

Electronic record of medicationand electronic prescriptions

Like all other health professionals, theGP has access to the Shared MedicationRecord, an electronic registry containingall Danish citizens’ medicine informa-tion. This allows health care professio-nals anywhere in the sector to see allmedication which has been prescribedto the patient by the GP, medical spe-cialist or hospital. The majority of theseprescriptions are issued electronically toa central server, making it possible forthe patient to pick up their medicationfrom any pharmacy in Denmark. The same principle applies to patient referrals, which are also stored centrallyand forwarded electronically from theGP to a specialist doctor, municipality,or hospital.


Prehospital treatment


Emergency calls are assessed by specialists

Personnel at the emergency call centerare trained to assess emergency calls toensure that citizens receive the most effective help. The right qualificationsensure the personnel can assess whether an ambulance is required immediately and whether there is aneed for other assistance – for example,an emergency physician, paramedics,an ambulance helicopter, or first aid.

In Denmark, acute calls for an ambulance are answered by a health professional who can help assess the precise need for assistance. If an ambulance is dispatched, the ambulance

personnel can commence treatment already during transport to thehospital. Dialogue during transport with medical specialists at thehospital ensures a fast and accurate diagnosis. All test results and observations taken in the ambulance are transferred electronically inreal-time to specialized staff at the hospital.

Electronic medical record andtelehealth in the ambulance

If the patient is picked up by ambu-lance, the paramedic will keep an electronic ambulance record of all ob-servations, treatment, and medication.Registration and transfer of patient datafrom the ambulance enables dialoguewith specialists at the hospital, ensuringthat acute treatment can begin alreadyin the ambulance and that the right hospital staff is ready to continue treat-ment as soon as the patient arrives.

’’Denmark is at the leading edge of eHealth uptake in Europe. I believe other Member States

have much to gain from taking inspiration from the Danish eHealth model,

rather than re-inventing the wheel. John Dalli, European Commissioner

for Health and Consumer Policy

Specialist support during transit

Ambulance personnel can communicatedirectly with specialists during transit.For example, they can send electro-cardiograms and other readings directlyto cardiologists around the country. As a result, it can quickly be evaluatedwhether a heart patient for example hasto be directly transferred to a specialistheart center. Telehealth solutions havebeen part of the Danish ambulance service since 1999.



Around

20,000 cardiological

telediagnoses are made in Denmark

every year.

75% of all patients with an acute need for heart treatment arrive directly at

a heart center.

By using telehealth, patients requiring acutetreatment at a specialist

cardiology departmentare treated, on average,

1hour earlier than would

be possible without telemedicine.

For heart patients, treatment one hour

earlier means a

10%relative reduction in

mortality and a

10%relative reduction

in the risk of developingheart failure.

Prehospital facts in cardiology

Summing up

1Use of health technology forcollaboration between theemergency call center, the

ambulance, and the specialists at hospital enables diagnosis and acutetreatment already at the prehospitalstage.

2ICT solutions during the pre-hospital stage save lives due toearly treatment in the ambu-

lance and a well-planned reception ofthe patient by the hospital staff. This process is based on patient databeing transferred from the ambulanceand on efficient communication between a number of healthcare stakeholders.

3Trained professionals at theemergency call centers and inthe ambulances save lives,

time, and resources in the rest of thepatient pathway.

Electronic ambulance record transfers patientdata to the hospital

At 10:36 a.m. the emergency callcenter receives a call from Mr. An-dersen, who is experiencing severechest pain. An ambulance dispat-ches immediately and arrives at10:43. Treatment commences inthe ambulance, while contact ismade with the cardiology depart-ment at the local hospital.Through telehealth communica-tion, the cardiologist diagnoses ablood clot, and Mr. Andersen istherefore taken directly to the cardiology department instead ofbeing taken to the nearest emergency room. At 11:30, Mr. Andersen arrives at the cardiologydepartment, where staff is pre-pared and ready to conduct a balloon operation. Half an hourlater, Mr. Andersen is in the wardafter his operation. By 2:00 p.m.,he is back in his own clothes, en-joying a cup of coffee. A few dayslater, Mr. Andersen is dischargedwith no permanent injury.


Early discharge of patients

In 2000, the average length of stay inDanish hospitals was 6.2 days; in 2010 itdropped to just 4.6 days.As a result Den-mark has the shortest average length ofstay in hospitals in the EU. Danish hos-pitals continuously focus on early dis-charge. This enables patients to returnhome to well-known surroundings morequickly, and it ensures an appropriateuse of resources in the healthcare sector.

A baby born without complications is discharged after just a few hours.First-time mothers are offered to stay at a patient hotel. Mothers who havegiven birth before and who experienceno complications are discharged. Subsequently, locally based healthcare professionals take over.

Telehealth solutions also make it possible to discharge patients earlier for treatment and monitoring in their ownhomes – even those with several chro-nic diagnoses. One of the main reasonsfor an early discharge is the focus on co-hesion in the patient pathway through

close collaboration between hospitalsand local healthcare professionals.

Enhanced quality and productivity

Danish hospitals increased their produc-

tivity by 12% from 2007 to 2012. In thesame period, activity increased and an-nual growth rates in health expendituresdeclined. Persistent efforts to streamlineand optimise procedures and improvetreatment quality have shortened thelength of stays and reduced the numberof readmissions. These and other effortshave contributed to the increased pro-ductivity in the Danish healthcare sector.

Efficiency has also been improved by enhancing communication – for example, by using information screens at hospitals, which prepare patients for visits to the laboratory. Such initiativeshelp staff save time and can provide patients with a better treatment experi-ence. Furthermore, Denmark is the firstcountry ever to establish national standards for interoperability of personalhealth technologies that rely on the guidelines from the Continua Health Alliance.

Efficient logistics at the hospital

One example of efficient logistics in Den-mark is the world’s first fully automaticsterile center, which was implemented at Gentofte Hospital in 2011. The centersterilises surgical instruments after useand sorts and stores them. Whenever asurgical operation is scheduled, relevantinstruments and single-use devices areordered through the hospital’s internalinformation system. Subsequently, thesterile center seeks out the requested instruments and loads them onto atransport cart for delivery to the opera-

Efficient and innovative hospitals


Denmark has the shortest average admission time per patientin the European Union. One significant reason for this is per-sistent efforts to use a gentler operating technique. Another

is the consistent focus on telehealth treatment of patients, who as aresult can be discharged for treatment in their own homes. Medical devices are also increasingly integrated in hospital buildingstructures, which support efficient healthcare service. Partnering onthis type of projects has given Danish companies great experience indesigning simple and useful solutions for hospitals.

Productivity in Danish public hospitalsrose by 12% from 2007 to 2012.

2007

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Average length of stay in hospital


Denmark has the shortest average length of stay in hospitals in the EU: 4.6 days in 2010.The average length of stay has dropped from 6.2 days in 2000 to 4.6 days in 2010. During the same period, the percentage of patients that had to be readmitted also dropped by 4.2%.*Average lenght of stay.

Source: OECD

’’Denmark has impressive quality monitoring and improvement initiatives.

It has extensive databases on the processes and outcomes of care and a strong

agenda to strengthen its information infra-structure; it can also boast many local

clinical guidelines, national guidelines and standards developed as part of disease

management programmes and pathways OECD reviews of healthcare quality:

Denmark, 2012

ting theatre. Back in the sterile center,robots empty the transport carts andprepare them for use again. In additionto streamlining work processes, the in-stallation positively impacts health andsafety at the storage facility as robotsnow do all the heavy lifting.

A long tradition of health registries and databases

Denmark has a long tradition of thoroughly monitoring and registeringwhen and why citizens are in contactwith the healthcare sector. Some data-bases go back more than 30 years.

EU countrywith lon-gest ALOS*

EU (27)

Denmark

0 1 2 3 4 5 6 7 8 9 10 11 12 days

Page 12

2000 2010


MaltaDenmark

EstoniaSwedenFinland

UKNetherlandsLuxembourg

AustriaBelgium

IcelandNorway

SpainIreland

ItalyCyprusFrance

GermanyPortugal

CroatiaCzech Rep.

RomaniaHungaryBulgaria

LatviaSlovakia

LithuaniaSlovenia

GreecePoland

2010 2012

0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9


A network of more than 50 national databases has been established con-taining information on more than 60different areas of disease and preven-tion. The use of a unique and personalcivil registration number makes it possible to trace patients across variousdatabases, which creates great oppor-tunities for clinical research and development. An excellent example ofthis is the population-based nationalbiobank. The biobank contains collections of tissue, blood, and otherbiological samples from humans andconstitutes a virtual gold mine of in-formation for research and healthcare.

Denmark on top

The vision for Danish healthcare is toprovide coherent clinical pathways, forexample, when patients are hospital-ised. Digitalization is a key element inachieving this goal by giving healthcareprofessionals in hospitals access to anypatient’s data and test results. Accord-ing to the EU’s e-health deployment in-dicator, Denmark is one of the e-healthdeployment front-runners. The figurebelow shows the deployment ratesacross Europe and the general develop-ment towards the increased use of e-health solutions.

For many years, the development ofe-health in Denmark has been based onthe cooperation of all involved parties:the government, the regions, the muni-cipalities, and the system providers.This public-private cooperation hasbrought innovation and implementationto a level where nearly all basic in-formation from the various sectors hasbeen digitalised and made shareable. In recent years, efforts have been con-centrated on integrating and stream-lining the way patient data is accessedand shared across the healthcare sectorto make all relevant patient data access-ible wherever and whenever needed.

Dissemination of e-health at hospitals in the EU(+3).Source: European Commission & OECD: Benchmarking Information and Communication Technologies in Health Systems, 2013.



Summing up

1High quality healthcare and financial benefits can be achieved if electronic health

records are shared across specialistgroups, hospitals, and regions.

2Significant human and financialbenefits can be achieved by designing buildings and work

processes efficiently, with a focus onoccupational health and safety.

3Shorter admission times at hospitals cut costs and can beachieved through close co-

operation with the rest of the health-care sector and by supporting earlydischarge to patients own homes.

Central Denmark Region

North Denmark Region

Region of Southern Denmark

RegionZealand

Capital Region ofDenmark

Central Denmark Region

Common e-health platform across 17 hospitals

In 2010, the Central Denmark Region began implementing one common e-healthplatform, which supports more than 10,000 users every day in 17 hospitals,including both somatic and psychiatric hospitals. All 17 hospitals can easily shareinformation within and between the hospitals. The system creates a completeoverview of patient data with information integrated from different hospitalunits.

If Mr. Andersen is admitted to the nearest hospital with a fractured hip, and he islater moved to another hospital with a specialist orthopaedic surgery depart-ment for hip replacement, physicians from the two hospitals and other specialistgroups can see from the common records system what treatment Mr. Andersenhas received. Furthermore, different modules of the e-health platform supportimportant functions in every hospital to ensure an efficient workflow, optimalsupport for hospital personnel, and increased patient safety through standardi-sation of clinical pathways in treatments. For example, Mr. Andersen’s medicalrecord will describe what X-rays and tests are required before the operation andwhat rehabilitation he should have after the operation. Modules in the e-healthplatform also include administration of patients, handling of laboratory work,medication administration, along with efficient booking of procedures, hospitalresources, and gathering of business intelligence data. This type of flexibility inthe e-health platform allows the region to increase coherency and quality of treatment for patients.


Monitoring from a distance

When telehealth solutions are intro-duced, focus is primarily on improvedquality of life for patients. Numerouspatient groups experience significantadvantages from being closely moni-tored while they are in their home.These include patients with ulcers,chronic obstructive pulmonary disease(COPD) patients, and heart patients,who often feel more secure at home anddo not have to commute to and fromoutpatient departments. Telehealth solutions not only benefit the patientsin terms of avoiding unnecessary trans-portation; they are also cost-efficient forsociety as a whole. An example of bothadvantages is an ePatch for heart patients. After discharge from the hospi-

patients or patients with poor blood circulation. The images are saved on ashared ICT system together with a de-scription of the ulcer. Subsequently, onthe basis of the images and descriptionsof the size, healing, and infection of the ulcer, specialists at the hospital can assess whether the ulcer is getting better or new treatment is required.This effective collaboration, in whichmunicipalities involve experts from hospitals, ensures that patients receivebetter treatment with both faster andbetter outcomes.

Rehabilitation at home

Many treatments and operations requiresubsequent rehabilitation. In this con-text, telehealth solutions enable patientsto carry out rehabilitation exerciseswhen it suits them but still receive pro-fessional guidance. One area where tele-health is widespread in Denmark iswith COPD patients. After being admit-ted to a hospital, patients with COPDoften need rehabilitative guidance. As asupplement to physical consultationswith caregivers, online tools for re-habilitation are increasingly being im-plemented to prevent readmissions. On-line dialogue-based tools provide care-givers in the municipalities with the ability to tailor rehabilitation program-mes for their patients. This means that

Treatment at home


’’The Danes have succeeded in deploying

telemedicine, because all relevant

stakeholders have beenencouraged to join in.

Mobile Healthcare Information andManagement Systems Society, 2012

tal, the patient wears the patch for oneto three days while it measures pulseand ECG. If the pulse is abnormal, thepatch stores a 10-second ECG recording.The ePatch then sends the recordeddata through a portal to the hospital.Here, a doctor can determine whetheror not the heart rate calls for a reaction.

Telemedical ulcer assessment at home

A good example of Danish collaborationacross different sectors in the healthcaresector is telemedical ulcer assessment.Municipal home care nurses take a pic-ture of the patient’s ulcers – typically,ulcers with complications in diabetes

Over the past years, telemedicine has in-creased substantially. Several full-scaleprojects are being implemented nation-wide, enabling significantly more patientsto be monitored and treated at home. At least 44 of Denmark’s 98 municipalitieshave telemedical ulcer assessment.

Denmark is a global tele-health leader. Telehealthsolutions help meet

demographic challenges withaging citizens and patients withchronic disorders. An increasingnumber of solutions are developed and designed to makeit possible for patients to be discharged to their own homes,even though they still requiretreatment, monitoring, and rehabilitation. Many telehealthsolutions cut across differentparts of the healthcare sector.


TeleCare North – telehealth and empowerment

For most COPD patients, it is vital that their lung capacity is monitored regularlyover a long period of time. This type of task is both time-consuming and resourcedemanding, for the patient and for the physician. COPD is therefore an area inwhich telehealth solutions can add value.

TeleCare North is a cross-sector collaboration to develop telehealth solutions forCOPD patients. The partners are the 11 municipalities in Northern Jutland, theNorth Denmark Region, GPs in Northern Jutland, and Aalborg University. COPDpatients are often hospitalised for long periods of time. The objective of the Tele-Care North project is to monitor patients closely, adjust their medication and treatment, and thereby avoid hospital admission.

When Mr. Andersen agrees to take part in the project, he receives a small bag tobring home. The bag contains devices which enable him to measure his oxygensaturation, pulse, blood pressure, and weight a couple of times per week. Hismeasurements are transmitted through a small tablet computer to healthcarepersonnel in his municipality or at the local hospital. Here, healthcare personnelmonitor the data and if necessary provide further counselling to Mr. Andersen. By measuring his own health, Mr. Andersen becomes aware of what he can actively do to ease life with COPD – for example, the effects of exercise and theright diet on his oxygen saturation and pulse.

A large-scale project like TeleCare North, in which all stakeholders in the regionalhealthcare system collaborate across sectors, is unprecedented in Europe, making the project unique.


Summing up

1Videoconferencing and homemonitoring reduce length ofstays in hospitals.

2Image exchange helps optimisecooperation among health pro-fessionals and ensures better

cohesion in patient pathways.

3Regular training for health professionals working with ICT isnecessary.

patients can do exercises at home withclose guidance from healthcare pro-fessionals. The results are available on-line, and the caregiver can assess thedata and adjust the exercises if needed.The municipality of Slagelse has madeimpressive results with this type of tool.Estimates indicate that 11 readmissionshave been avoided in a time period ofthree months. In Denmark, a readmis-sion costs between EUR 1,750 and EUR2,000.

Hanne Rode, a specialised nurse inSlagelse says; “One thing is the eco-nomic aspects. But the benefits are justas much linked to the fact that chronic patients can stay in their own home,where they feel safe and they can receivea treatment, which reduces complica-tions. With this system we can train different skills and achieve goals, whichempower the citizen. For me, this is themost significant gain.”


At home as long as possible

Every day rehabilitation is at the core ofthe Danish efforts to give elderly and disabled citizens a meaningful and in-dependent life. With technological sup-port schemes and empowerment

initiatives, citizens can remain in theirown home for as long as possible. As a result of this focus, Denmark wasawarded the European Public SectorAward in 2012.

Danish results show that the elderlycan often do much more than they mightfirst assume, provided that they receivethe necessary support and guidance.Products such as ‘paperless’ toilets or ergonomic knives can ease daily life.Another example is an integrated ICTplatform, which citizens can use to drawthe curtains, set the kitchen worktop atthe right height, and operate a hoist toget themselves into bed. Similarly, a QR-coded communication system can helppeople with mild dementia make coffeeor operate the washing machine.

Ceiling hoist gives better communication

A number of tasks in elderly care havepreviously required two helpers to sup-port the citizen – for example, when a

person is lifted from one place to another. Using a ceiling hoist to move aperson from the bedroom to the bath-room through rails in the ceiling onlyrequires one care helper. This saves resources, but it also means the citizenonly needs to keep eye contact with oneperson when being moved, promotingmeaningful interaction and trust between the caregiver and the citizen.

User-friendly technology helps the elderly

A large number of Danish companiesdevelop products and solutions for theelderly and the disabled. As a resultnew technological solutions are con-tinuously being tested and implementedin the Danish care sector which canhelp elderly citizens cope on their own,while at same time saving time and resources. Generally, the elderly and disabled in Denmark are very willing toadopt new technology, providing it iseasy to use and helps them to be moreindependent.

Supported living


’’Denmark emerges as anexample where good cooperation between

government and other key stakeholders such

as health professionalshas speeded up the

integration of personal health systems such as

remote patient monitoring systems into

healthcare delivery. Joint Research Centre,

European Commission, 2012

Supporting citizens in remaining self-sufficientand independent is a very

important element of Danishcare for the elderly and the dis-abled. It is an ambition to helppeople as much as possible sothey can remain in their ownhome or alternatively in sup-ported accommodation. Allow-ing people an independent andempowered life optimizes well-being and result in significantsavings for the care sector.

The Danish rehab companies aregood at including the users in the

product development phase.

88%of Danish rehab companies

always or sometimes include users in the product

development phase.

The National Board of Social Services database

includes around

30,000different rehab products that are accessible on the Danish

market. You can find everythingfrom advanced hoists and

hearing aids to ergonomic knifes.


The reversible bedsheet puts focus on health and safety

Occupational health and safety for health professionals is an importantissue when designing and developingnew care technologies. One productwith a special focus on care personnelis the electric reversible bed sheet. Thissystem helps to deal with heavy andvery infirm patients confined to a bed.If, following a hip replacement, Mr. Andersen cannot turn in his bed, thenursing staff can just push a button toturn Mr. Andersen, pull him to the edgeof the bed, or sit him up. This meansthat the nursing staff avoids most ofthe heavy lifting and that Mr. Andersenexperiences being moved calmly andgently. It also speeds up the process.


Summing up

1Developments in recent years in welfare and health techno-logy provide elderly and

disabled citizens with completelynew opportunities to live more independently.

2Investment in support schemescan yield significant financialand human benefits, if they

make it possible for people to remainin their own home instead of having tomove to a nursing home.

3The elderly are generally happyto try new technology, as longas it is easily available and

clearly improves their quality of life.


Building tomorrow’s hospitals

The new hospitals are built to provide abetter and more cohesive patient flow,improved patient safety, efficiency, andquality. To achieve this, the number ofbeds at the new hospitals will be re-duced by 20% compared with presentlevels, and outpatient treatment will beexpanded by 50% from 2007 to 2020.This requires new technologies andmore intelligent solutions to ensurecost-effective health solutions and shorter average length of stays. At thesame time, the hospital layout will en-hance communication between patientsand their families, and the ICT infra-structure will play an important part indeveloping communication.

Releasing resources for treatment and care

Modernising Denmark’s hospital capacity enables dissemination of thenewest knowledge, technology, and bestpractices throughout the country.

In the next 10 years, Denmarkwill invest more than EUR5.6 billion in 16 new hospital

projects. These include new greenfield projects as well as ex-pansion of existing capacity. Intotal, the projects will moderniseone-third of the current Danishhospital capacity. The goal is toensure nationwide access tomodern health services and toraise quality levels in the entirehealthcare sector. Designing thenew hospitals involves a broadcollaboration with research institutions and private busi-nesses in the health area.

The process of modernising Den-mark’s future hospital capacityhas a focus on continued specia-lization and flexibility. The goalis to ensure flexible functionsand capacity which can be changed, expanded, or reduceddepending on future demand fortreatment and care. Therefore,20% of the costs have been ear-marked for procurement and development, and realization ofnew equipment and new techno-logies for ongoing implementa-tion.


Rethinking the hospitalIncreasing digitalisation ensures efficientoperation of core services in hospitals,with new work methodologies, techno-logies, and organisation. This releasesresources for treatment and care, whilealso providing better health and safetyconditions for personnel. For example,the new hospitals will have storage facilities for linen, utensils, medicineswhich are monitored electronically,enabling a real-time overview of whatthe hospital has in stock and where relevant devices are located. Inventorycontrol systems will be integrated withprocurement systems, which meansutensils are always ordered and receivedin due time. Moreover, there will be acoupling to the electronic patient records, ensuring medication is alwaysincluded in the patient record. Evenlaundries will have production data tomonitor the amount of linen at both de-centralised and central storage facilities.


Patient involvement in hospital construction

Denmark has a tradition for a high degree ofuser involvement in the development ofnew products and solutions. This also applies in the healthcare sector. Patients,families, managers, and employees were allinvolved in the planning process in the con-struction of a new psychiatric departmentat Vejle Hospital. It can be difficult to involvepsychiatric patients in this type of process.Therefore, the Region of Southern Denmarkhas specialised in not only involving but co-creating with even very ill patients. Usinganthropological studies from existing hospitals, challenges and improvement potentials were identified. For example, thestudy showed that the admittance processitself is very important for patients and thatpatients appreciate being able to movearound freely. The process has resulted inclear visions and guidelines for the con-struction of the new psychiatric hospital.

Intelligent patient bracelets

In order to provide high-quality healthcare, itis important that each patient is at the rightplace at the right time. The increasing number of patients in the future will gene-rate greater demands on logistics. Today, alot of time is spent localising inpatients.Very often, this causes considerable waitingtime for laboratory staff, physiotherapistsand physicians. It can also lead to the deterioration of a patient’s condition or, inworst instances, patient death. A futuregoal is to develop an electronic bracelet forpatients with traceability and identificationdata. The bracelet will also feature staff-to-patient communication through short messages, as well as an option to integratereadings of vital signs. Traceability of patients, goods, and devices entails opportunities to improve patient safety, release personnel resources, and optimizeoperation efficiency at hospitals.

Cases

Healthcare DENMARK

Forskerparken 10 H DK-5230 Odense M

healthcaredenmark.dk

Partners

Ministry of Business and GrowthMinistry of HealthMinistry of Foreign AffairsConfederation of Danish IndustryDanish Chamber of CommerceDanish RegionsRegion of Southern DenmarkCOWIFalckKMDSystematic

HCD-2nd edition Layout 1 - Healthcare...

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