Terhi Rasmussen, Finpro. Changes in Scandinavian healthcare sector - oppportunities for Finnish companies. Finpro seminar materials 19.4.2012.

1. Introduction to the seminar topics:
Scandinavian healthcare systems & ongoing
building/restructuring at a glance
Terhi Rasmussen, Consultant
Finpro Scandinavia
19.4.2012

2. Common future scenario for all the
Scandinavian countries
• Due to aging population and life-style changes (increasing diabetes, obesity, chronic illnesses, etc.) the need for
healthcare services will change and the demand for healthcare related services both in private and in public sector will
increase
• monitoring and treatment
• often life-long medication
• To meet the future challenges there is a demand for new, modern and effective hospitals, healthcare systems and
solutions
• Modern & flexible hospital facilities
• New digital hospitals with welfare technology
• Modern supportive functions: devices, logistics, IT
• Home monitoring / self monitoring, interactive patient consultancy and distance dialogue
• Increased partnerships with public and private actors
19.4.2012 Terhi Rasmussen, Finpro Scandinavia

3. Scandinavian healthcare sector in figures
Denmark Norway Sweden
Population: 5 580 516 (2012) Population: 4 985 900 (2012) Population: 9 486 591 (2012)
Number of hospitals: Number of hospitals: Number of hospitals:
 60 public hospitals/clinics  73 public  70 county public hospitals (incl.8
 ca. 10-30 private hospitals  ca.12 private regional/university hospitals, special care)
 Private hospitals have about 2-5% of the  Role of private hospitals is rather limited  ca. 9 private
activity between 5-10%  The counties and regions buy about 10-
15% of the healthcare services from
Professionals: Professionals: private care providers
 3500 GPs  4109 GPs
 Ca. 12 000 doctors in hospitals Professionals:
 14 500 doctors in hospitals  4600 GPs
 ca. 13 0000 doctors in hospitals
Health expenditure per capita: Health expenditure per capita:
 4781 EUR  5840 EUR Health expenditure per capita:
 3241 EUR
Procurement: Procurement:
 Regionsudbud.dk gathers information  Public hospital procurement is done on a Procurement:
regarding purchasing and tenders in the 5 regional and local level
 Each county has their own purchasing unit,
Danish regions  www.hinas.no e.g. SLL and Region Skåne
 http://www.regionsudbud.dk  www.english.doffin.no  http://system.allego.se/common/mirror/mirror.p
hp?id=YY834773YX
 http://www.skane.se/sv/Webbplatser/
Regionservice-samlingsnod/Regionservice/
For_vara_entreprenorer/Upphandling/Planerad
e-upphandlingar/
Source: OECD, RHF, Regionerne, County Councils and
19.4.2012 Terhi Rasmussen, Finpro Scandinavia regions, SINTEF, private hospital organizations, etc.

4. Structure of the Danish healthcare
sector
• The Danish public health insurance gives everybody in
Denmark an equal and free access to health services
• Denmark is divided into 5 state-owned regions and 98
municipalities
 Regions are responsible for
 the provision of hospital services
 psychiatric services
 general practitioners and specialists
 Municipalities are responsible for
 home nursing
 public health
 school health service & child dental treatment
 prevention and rehabilitation
 elderly care
• Financed through taxation
• Free choice of hospital
19.4.2012 Terhi Rasmussen, Finpro Scandinavia

5. Structure of the Norwegian healthcare
sector
• Public healthcare system, which is mainly free of charge
• The Ministry of Health and Care Services has supervisory Helse Nord
responsibility for all hospitals in Norway, and the state owns the public
hospitals
• Divided into four health regions (RHF) with regional health trusts,
which are responsible for
 operating the hospitals as effectively as possible
 ensuring adequate supply of specialist care services for people
in their own region through own hospitals, private hospitals or
hospitals in other regions
• There are 430 municipalities with the responsibility to provide
services such as
 Regular General Practitioner Scheme Helse Midt-Norge
 care of the elderly
 work with addiction and psychiatric health
 municipal social services
 dental care services
 alternative treatment
 public physiotherapy services
Helse Vest Helse Sør-Øst
• Funded mainly through taxes
• Free choice of hospital
19.4.2012 Terhi Rasmussen, Finpro Scandinavia

6. Structure of the Swedish healthcare
sector
• Everyone has equal access to healthcare services
• Responsibility for health and medical care is shared by the central government, county
councils, regions and municipalities
 Central government is responsible for establishing principles and guidelines for care
and for setting the political agenda for health and medical care
 County councils and regions are responsible for providing healthcare and general
practices
Sweden is divided into
• 18 county councils and two regions
 Responsible for organizing health care to citizens, hospitals, and primary care
 Around 10 % of the work involves other areas, such as culture and infrastructure
 It is becoming more common to buy services from private healthcare providers
• 290 municipalities, which are responsible for
• elderly care and care of the disabled, accounts for almost 30 %of their budgets, care
and assistance is provided in the home and in sheltered accommodation
• social services
• providing support and services for people discharged from hospitals
• school health care
• Mainly taxpayer-funded
• Free choice of hospital
19.4.2012 Terhi Rasmussen, Finpro Scandinavia

7. Hospital building projects in Denmark
• In order to future-proof the health care in Denmark the
hospital structure is currently undergoing a change process
with the help of heavy investments in new hospitals, and
renovating and expanding the existing
• The government and the regions have agreed to invest 5,56
billion EUR in the renewal of hospital sector in the coming 10-
15 years.
 Estimated 20-25% of the investment to be invested in
technology
 Includes 16 projects, 5 new hospitals and 11
renovation projects
 Fewer, larger, and more specialized hospitals
 Changed patient flow, flexible surroundings
 Innovation in organization, logistics and use of IT
 Use of telemedicine
• Altogether now 38 ongoing hospital construction projects
all over Denmark
 E.g. new university hospitals in Aarhus 853,5 million
EUR and Odense 846,7 million EUR
Constructions financed Regionally financed
 E.g. new hospitals in Alborg 551,1 million EUR, Køge by Kvalitetsfond constructions
537,6 million EUR, Hillerød 510,7 million EUR, (governmental fund)
Gødstrup 423,4 million EUR
19.4.2012 Terhi Rasmussen, Finpro Scandinavia Source: www.godtsygehusbyggeri.dk

8. Hospital building projects in Norway
• Different building projects related to new hospitals, renovation of old
ones, or retirement homes going on in all the four regions, examples:
• Helse Sør-Øst
 Østfoldsykehus project (2011-14), 657,5 million EUR
• Helse Midt
 St. Olavs Hospital
 Full reconstruction and renovation of a university hospital in
Trondheim, 1,66 billion EUR
 Construction started in 2002, expected to finish in fall 2013
 The project is in the last construction phases
 In pre-planning phase hospitals in Møre and Romsdal
• Helse Nord
 Vesterålen 115,6 million EUR
 Nordlandssykhuset Bodø 420,8 million EUR
• Helse Vest
 Child and youth center in Haukeland University hospital
 460,3 million EUR, 63.000m2, 2011-2020
19.4.2012 Terhi Rasmussen, Finpro Scandinavia Source: the four health regions RHF, Tekniskugeblad

9. Hospital building projects in Sweden
• Also in Sweden many hospitals are undergoing renovation, examples:
• Nya Karolinska Solna
 New university hospital in Stockholm
 1,63 billion EUR, 320 000 m2, 2010-2017
 Biggest construction site in Europe
 Medico technical device procurement to start in 2012
 Interior procurement is in the planning phase
 Danderyd hospital
 224,4 million EUR, 48.000m2, start in Nov. 2012
• Södertälje Hospital
 134,7 million EUR
 Reconstruction and renovation to start in 2013
• Löwenströmska hospital
 Renovation project for 53,9 million EUR
19.4.2012 Terhi Rasmussen, Finpro Scandinavia Source: bygglo.se, County councils and regions

10. E-health in Scandinavia
Denmark Norway Sweden
• Already has electronic health records • E- prescription already in use in some • Electronic transfer of prescriptions exists
regions and underway in others
• “sundhed.dk” portal with wide register of • “1777.se” is a portal for information
information for patients and professionals, • Health portal ”helsenorge.no” opened in regarding sicknesses and for comparing
developed since 2001 June 2011, includes information about hospitals’ treatment levels, etc.
• Bring together relevant information from all  sickness, treatment, and
parts of the health service prevention of sickness • ”My health care contacts” is a portal,
• Offer a shared platform of communication  own prescription history where individuals can make contact with
• Empower patients by offering maximum  access to own doctor doctors and book appointments, etc.
insight and transparency in the health care  vaccinations
sector  e- prescription • Nation wide patient summary (NPÖ) is
• Offer health care providers easy access to  patient rights underway, already adopted in some
clinical information about their patients’ regions
medical history.
• Norwegian government investing this • National e-health strategy focuses on
• Current development areas: year 19,9 million EUR on e-health following areas:
 telemedicine • Current development areas:  patient empowerment
 to facilitate the communication  national patient records  usable and accessible patient data
between the local authorities and (Kjernejournal) for the staff
other healthcare sector players  e-health as part of training
(primary and secondary care)  health portal
 national health register  improving technical infrastructure
 expansion of common medication  data usage and protection
card  standardization
 communication between different  standardization, legislation and
 further development of e-records security, etc.
 better communication between actors in the health sector
laboratories and GPs  data protection
• www.1177.se/
 National patient index (NPI)  e-prescription
• www.minavardkontakter.se
• www.sundhed.dk • www.helsenorge.no
19.4.2012 Terhi Rasmussen, Finpro Scandinavia

11. Finpro Scandinavia
• Offices in Copenhagen, Oslo and Stockholm
• A team of 10 Nordic people with various industry
expertise
• Team headed by Sissi Silván, based in Copenhagen
• Contact:
Sissi Silván
Tel. +45 2244 0338
sissi.silvan@finpro.fi
Finpro Norway
Finpro Sweden
Finpro Denmark
20/04/2012 © Finpro 11

12. Agenda for today
8:30 Registration and coffee
9:00 Introduction to the topic: Nordic healthcare systems & ongoing building/restructuring at a glance,
Terhi Rasmussen, Consultant, Finpro
9:30 Denmark is building super hospitals,
John Bendix, Building project director, Herlev Hospital
10:10 Telemedicine from the Nordic and Danish perspectives,
Klaus Phanareth, Chairman, DSKT (Danish Society for Clinical Telemedicine)
Terhi Rasmussen, Consultant, Finpro
10:50 Quick Break
11:00 Private health care sector in Sweden,
Håkan Tenelius, Head of Public Affairs, The Association of Private Care Providers, ALMEGA
11:40 Industry summary & introduction to company clinics,
Christine Grumbach, Head of Industry, Life Science, Finpro
12:00 Lunch
12:30 Company Clinics
19.4.2012 Terhi Rasmussen, Finpro Scandinavia

13. More information
Denmark Norway
 www.regioner.dk  http://www.helse-sorost.no/Sider/side.aspx
 www.sundhedstyrelsen.dk  http://www.helse-midt.no/
 www.sundhed.dk  http://www.helse-nord.no/
 www.regionh.dk  http://www.helse-vest.no/Sider/side.aspx
 www.regionsjaelland.dk  Http://helsenorge.no/Sider/default.aspx
 www.rn.dk  www.prisy.no
 www.regionmidtjylland.dk  http://www.helsedirektoratet.no/publikasjoner/nokkelta
 www.regionsyddanmark.dk ll-for-helsesektoren-2011/Publikasjoner/nokkeltall-for-
 www.privatehospitaler.dk helsesektoren-2011.pdf
 http://www.ssi.dk/Sundhedsdataogit/National%20Sun
dheds-it.aspx Sweden
 http://www.medcom.dk/wm109991  www.skl.se
 http://www.godtsygehusbyggeri.dk/  www.socialdepartement.se
 http://www.vardforetagarna.se/
 http://www.cehis.se/om_cehis/
 www.socialstyrelsen.se
 www.regeringen.se/sb/d/15119
19.4.2012 Terhi Rasmussen, Finpro Scandinavia