Closed and incompatible data systems hamper the development of platform-type health services

Challenge: Closed and incompatible data systems hamper the development of platform-type health services

• Adapting platform-type solutions to different interfaces takes up resources. Health sector actors have mainly developed their information systems for their own needs, which is why their interfaces are numerous and not compatible with other information systems. It is difficult to create scalable solutions when the same platform services must be adapted to different systems. Maintaining interface compatibility requires a great deal of resources and is complicated. Rather than simply being a challenge for organisations, incompatibility affects different areas of healthcare, including the patient data system and assessment of the effectiveness of treatment. If we do not make national decisions on common standards, small actors can only settle for integrating into the platforms of larger ones on terms that are not equal to all parties.
• Small private actors have little opportunities of participating in treatment paths. Private actors do not have sufficient access to or possibilities for being involved in public service provision. The reasons for this include strict data protection and information security requirements. Descriptions of use cases and services are not available for all services provided by public healthcare, which makes it impossible to develop compatible solutions. The technical and qualitative requirements and approval practises related to treatment are particularly unclear. The linear and rigid ‘clinical pathway’ thinking makes it more difficult to provide and find new services as it does not allow for exceptions and flexible changes to a treatment plan once produced.

Recommendation: Access to public health data systems should be opened up and interface compatibility should be developed

• Opening up involvement and access to public health record systems and processes. Use case and service descriptions, such as workflow descriptions, should be openly available. The Finnish Institute for Health and Welfare has already promoted this as part of the social welfare and healthcare reform (THL, 2021). Based on the use case and service descriptions, actors can create suitable services for care processes and promote the mobility of data. Public health service providers should also be open about the effectiveness of treatment (including the input/output ratio), quality and their indicators.
• Developing interface compatibility. The aim is to create clear practises for implementing functional interfaces that do not need to be tailored separately each time. The interfaces must be easy to use and suitable for health sector processes. It is also important to openly publish interface descriptions. We recommend a model in which a third party’s digital services can be integrated into service processes if they meet the legal and technical conditions for this. The integration conditions would serve as a firewall between basic healthcare infrastructure and the services. There could also be a test environment for social welfare and healthcare data and data systems in Finland, in which new platform-based solutions could be simulated. The development could be directed by a neutral actor who facilitates the creation of common interfaces with health sector actors.