Levels of activity and political interest are high within the sphere studied by this report. Strong political determination has contributed to the lead-ing international position enjoyed by the Nordic countries. The Nordic countries have more similarities than differences as regards culture, tradi-tions, and the organisation of health services. However, the countries differ in how far they have progressed with the various applications of IT in the health sector, and there are opportunities for learning from each other.
To fully exploit this learning potential, indicators should be developed that make it possible to assess and evaluate progress in the countries in a compatible way. This would yield useful information about one’s own achievements and show where useful lessons can be learnt.
Activities and initiatives for developing IT applications in the health sector are well established, and the field is advancing. However, progress has been slower in other social services. Hence, the social service sector could benefit from the lessons found in the health sector, e.g. the need to solve “sow-harvest” problems, the benefits of breaking down traditional boundaries and collaborating, the need for a co-ordinating body or a structural framework to overcome these obstacles, the importance of fo-cusing on the real goal and not view digitalisation as an end in itself, and the importance of focusing initially on the need to improve services.
Co-ordination of actors is essential in the decentralised environment of the Nordic countries. The benefits from investing in communication are realised when development is co-ordinated. A more centralised proc-ess does not, however, necproc-essarily imply that all communication should be co-ordinated. An important task is to identify the crucial information flows that need to be communicated between actors. Large-scale use of applications – and the organisational change this implies – requires co-ordinated programmes covering technical, economic, and organisational issues.
The Nordic countries can learn from each other when developing ini-tiatives for IT in the health care sector. The social sector can learn both from the experiences in other Nordic countries and from the health care sector. There is a need to exchange lessons, experiences, ideas, and appli-cations within the social sector. Co-ordinating bodies such as NOPUS (Nordiska Utbildningprogrammet för Utveckling av Social Service) could play an important role in the development of IT in the social sector.
Within the health sector the Collaborative Network of Nordic eHealth Competence Centres is a group that has taken a multidimensional ap-proach towards exchanging information about applications, barriers, and solutions.
Nordic co-operation can be expected to increase in the future as re-gards IT in health services. The Nordic countries have reached a stage
where the national level of development in this field has extended to a Nordic level. The Nordic health care network opens new opportunities for a Nordic market of health services, which will further enhance the need for Nordic collaboration. A Nordic market will benefit citizens and will enable a more efficient market structure for these services. To reap the benefits of this development, a suitable organisational structure with the appropriate resources, legal foundation, skills, and capacity is needed.
Denne rapport er resultatet af en undersøgelse, der på foranledning af Nordisk Råds sundheds- og socialministre blev gennemført af partnerne i Samarbejdsnetværket af Nordiske Kompetencecentre inden for eSundhed (MedCom/Danmark, KITH/Norge, STAKES/Finland, Sundhedsminis-teriet/Island og Carelink/Sverige). Rapporten beskriver brugen af IT i sundhedsplejen og den sociale sektor i de nordiske lande. Formålet med undersøgelsen er at forøge de nordiske landes muligheder for at lære af hinanden og samarbejde i større omfang.
IT indenfor sundheds- og socialsektoren rummer muligheder for at opnå øget velfærd samtidig med en forbedring af systemernes effektivitet.
Budgetterne bliver strammere og strammere, befolkningen ældre og ældre, arbejdstiden bliver dyrere, og folk kræver individuel tilpasset og sømløs pleje. Tilgængeligheden og kvaliteten af tjenesterne skal forbedres, og sektoren skal gøres mere attraktiv for fremtidigt personale.
eSundhed og eForvaltning er de definitioner, der bruges i litteraturen til at betegne IT inden for sundhedspleje og sociale serviceydelser. eFor-valtning omfatter hele den offentlige sektor og dermed også de lokale myndigheders aktiviteter. Hensigten er at yde en bedre service, der leveres mere effektivt, alt sammen til gavn for borgerne, virksomhederne og den offentlige sektor. Det handler mere om forvaltning end om "e", og der fokuseres på en lang række spørgsmål, som f.eks. hvordan man kan samarbejde mere effektivt på tværs af organer og institutioner for at klare komplekse, fælles problemer, hvordan man kan øge kundefokus, og hvordan man kan opbygge samarbejdsrelationer til partnere i den private sektor. eForvaltning drejer sig ikke blot om at omdanne manuelle proce-durer til IT-systemer.
Vi skal overvinde mange udfordringer, før vi kan høste fordelene af de seneste fremskridt. En af de største udfordringer handler om decentral-iserede systemer og den store indsats, der kræves for at koordinere udvik-lingen. Omkostningerne ved og nytteværdien af investeringerne falder måske ikke inden for samme organisation, hvilket reducerer incitamentet.
Desuden har dårlig ledelse i nogle tilfælde også forhindret ændringer, og det samme har love og regulativer. De tekniske problemer er reduceret i de senere år, men de organisatoriske problemer i denne proces bør ikke undervurderes. En anden vigtig opdagelse er, at aktiviteter baseret på markedskræfterne, f.eks. udviklingen af digitale tjenester baseret på bor-gernes efterspørgsel og behov, synes at halte bagefter. "e" er ikke et mål i sig selv. Det er ikke nok blot at gøre nuværende administration og tjenester elektronisk tilgængelige.