Lessons Learnt in Implementing Remote Services: Examples from Estonia and Norway

May marked the end of a project that had been going on with our good colleagues from Norway. To summarise what we and our partners had learned during this time, we organized a workshop that engaged both the Estonian and Norwegian counterparts. In the last workshop we discussed collaboration as a key for identifying and leveraging funding opportunities and developing sustainable business models for remote services.

Estonia and Norway have both demonstrated that successful implementation of remote services requires a strong digital infrastructure, robust security measures, user-friendly interfaces, collaboration, and continuous improvement. Project funded by EEA & Norway Grants gave a valuable insight into the best practices for implementing remote services, based on the experiences of Estonia and Norway. 

Tallinn welcomes new ideas and innovation

Tallinn City Enterprise Director Kalle Killar (on the photo) opened the workshop and gave a couple of examples of public-private partnerships in the health and care sector in Tallinn. He described Tallinn as a test-bed for new products and services where innovation is highly valued – for instance, the city has an initiative together with Tehnopol Science and Business Park, called Tallinnovation that welcomes Estonian companies that want to test their various solutions in the capital. Killar said that they have had solutions from the social sector as well. There is also an international initiative Test in Tallinn that is open to all companies around the world that would like to test their products or services in Tallinn. The main focus areas of Test in Tallinn are mobility, energy efficiency, renewable energy but not limiting only to those fields.

When talking about the biggest obstacles in Tallinn in implementing new solutions, Killar said that there is insufficient cooperation between the healthcare and social care in Tallinn – we are still on different pages, Killar admitted. Another obstacle is that we might already have the technology but we do not integrate it with existing and working practises.

He said that the cooperation with the private sector needs to improve, because this can initiate the change and bring forth new ideas. “We need to create trust between different stake holders and not try to solve all the problems of the world, but rather go service by service and see what can be fixed,” Killar pointed out.

When asked, how can Tallinn turn into a hub of innovation in the health and care sectors, Killar said that in the future, Tallinn Hospital might and must aim to become the innovation hub that addresses the problems we’ll have in 50 years time. Although, Killar admitted that the hospital cannot do it alone, they need to collaborate with Tartu University Hospital and other regional and global innovation centres to get the best results.

Viljandi Hospital offers several mobile remote services

Viljandi Hospital representatives gave an overview of their mobile remote services – mainly mobile clinics. As of spring 2023, the hospital has 6 mobile clinics: mobile x-ray unit, an occupational health clinic, a harm reduction mobile clinic, a mammography bus, a mobile dermatology clinic, mobile men’s and women’s health clinic. Mobile clinics help bring healthcare services to people in areas where access to medical care is limited and transportation connections to major centres are inadequate. 

In the newest mobile mental health clinic, various medical services can be provided. One of the most important services offered in the clinic is the mobile outpatient psychiatric compulsory treatment service. In the mobile mental health clinic, patient consultations and discussions take place similarly to regular outpatient work, but closer to the patient’s place of residence. The clinic conducts treatment team appointments, interviews, psychological assessments, and counselling.

The importance of the community-based mobile mental health clinic service lies in ensuring the continuity of patient treatment and rehabilitation, including assessing and supporting patient adherence to treatment and coping abilities. The service aims to prevent repeated hospitalizations and the occurrence of risk behaviour.

Viljandi Hospital team’s future goals include evaluating the impact of the service and expanding the psychiatric services offered in the mobile clinic.

The completion of the mobile healthcare clinic was supported by the project “Development of Assessment and Management System for Patients with Chronic Mental Health Problems”, funded by the Norway Grants 2014-2021 program “Local Development and Poverty Reduction”, the Ministry of Social Affairs, and the Viljandi Hospital Foundation.

Ambitious plans for the Nordic countries

Anders Tunold-Hanssen, the CEO of Nordic Interoperability Project (NIP), spoke about empowering remote services innovation through international collaboration. NIP is focusing on a holistic approach for both system and individual collected data.

Tunold-Hanssen brought out the prerequisites for unlocking the digital health potential:

• It’s all about awareness – this includes patients, doctors, specialists, etc
• Accessibility – when people know about their options, then they need easy access to the solutions
• Trust – people need to trust the solution in order to start using it; they should have the confidence that the solution is working as promised and that their data is taken care of
• Governance models
• Sustainability – Market opportunities are needed for the new startups to actually be viable

Anders Tunold-Hanssen said that they support the ambition set by the Nordic council of Ministers – in 2030, the Nordics will be the most sustainable and integrated health region in the world, providing the best possible personalized health care for all of its citizens.

This ambition is important for several reasons:

• To build a better and safer everyday life for the Nordic citizen/patient
• To build a bigger Nordic home market for the Nordic healthcare industry
• To build a Nordic market for the international healthcare industry
• To build a simplified access to health data for research and innovation

A report (The Market Opportunity: Nordic Health 2030 Report) showed that right now, the Nordic healthcare system is not sustainable – too much focus is put on the “sick care”, too little on “preventive care”. This report had some important insight for the NIP and helped to plan their next steps.

This workshop was funded by EEA&Norway Grants 2014-2021 project e-Healthcare Initiative: providing equal treatment opportunities for everyone. All activities are supported by Iceland, Liechtenstein and Norway through the EEA and Norway Grants.