International health systems are exploring how to use data to support digital transformation toward connected care. This blog offers key takeaways from a multi-stakeholder roundtable with the Danish Ministry of Health, Danish regions, municipalities, physician associations, Health Innovation Manchester, and the IQVIA Institute for Human Data Science.

Advancing toward a more connected, cohesive healthcare system requires using the right data and insights for the right patients to overcome challenges in the patient journey across sectors and to improve quality of care, patient satisfaction, and efficiency of care delivery. However, the first step should always be to define the problems needed to be solved and determine whether the right data is available or new evidence will need to be generated to support change. Ultimately, moving toward more connected models, such as healthcare clusters across sectors, will require utilizing digital technologies to advance the sharing of data and the redesign of workflows and patient care.

These were among the key points during an international, multi-stakeholder virtual roundtable titled, Data-Driven Quality in Connected Health and Social Care, held on September 14, 2021, which was convened by the Danish regions and had participation of the Danish Ministry of Health, the National Association of Municipalities, the Danish Medical Association, the Organization of General Practitioners, Health Innovation Manchester, UK, and the IQVIA Institute for Human Data Science.

Moving toward connected healthcare clusters

The backdrop for the roundtable is the current movement in Denmark toward establishing cross-sectoral healthcare clusters. According to an agreement among the Danish government, the Danish regions, and the National Association of Municipalities of June 11, 2021, healthcare clusters will be established around the 21 acute hospitals to create more connected care and services for citizens across hospitals, municipal social care, and primary physician care. The strengthening of healthcare clusters is part of a national strategy to address the challenges with a growing population of elderly people and the rise in chronic diseases in order to reduce the pressures on hospitals and put more emphasis on treatment and care in the primary care sector and the home.

The agreement stipulates the need to advance the sharing of data and insights across sectors, i.e., hospital and specialist care, general practice, and municipal care.

As Denmark prepares the establishment and formalization of the healthcare clusters by July 1, 2022, there has been growing interest in learning from international experiences with connected healthcare approaches and the use of data and digital technology to support the transformation toward a more cohesive healthcare system.

Therefore, the roundtable was convened by the Danish Regions with participation of Health Innovation Manchester, the IQVIA Institute for Human Data Science, and multiple Danish stakeholders representing the different Danish Regions, the National Association of Municipalities, medical and patient associations.

Health Innovation Manchester brought to the discussion experiences from building a Smart, Connected Health Care System to improve the health and well-being of the 2.8 million people in Greater Manchester. Health Innovation Manchester is leveraging digital, operational, and business transformation across hospitals, general practice, and municipalities to create connected health and social care and to deliver a seamless experience for citizens. As part of the digital transformation, traditional systems have been converted into digital formats, and care has been wrapped around the needs of citizens and services joined by sharing records and data across settings.

The IQVIA Institute for Human Data Science provided a perspective about improving human health outcomes through data and analytics to address the need for an integrated approach to linking and connecting disparate data sources. Human Data Science integrates the study of human science with breakthroughs in data science and technology to advance understanding of human health and thus enable stakeholders to make better, more insightful decisions to advance health outcomes. The goal is not simply to connect data, but to create new insights that help overcome the challenges in healthcare, rethink how care is delivered, and validate the outcomes of interventions to improve health outcomes.

Key takeaways from the roundtable

The discussions at the roundtable generated a number of key points:

Beyond data

• We already have a lot of data available, and the biggest challenge is not to generate new data and develop new databases, but to transform the available data into information that can be used for cross-sector decision-making.

Sharing of data

• Sharing of and access to data across sectors – hospitals, specialist care, primary care, municipal social care, etc. – needs to be facilitated and advanced.

“Big data is exciting, but it also presents unique challenges. Data is often not clean, it is mostly unstructured, incomplete, inconsistent, and subject to local variability. New technologies and registries also provide additional sources of data. And there are specific challenges when the data extends beyond one institution and encompasses social care or home care in addition to traditional healthcare settings. We also have an acceleration of human clinical data, but the advances in human science have been somewhat disconnected from the advances in data science. Therefore, we see an urgent need for a new approach that we call Human Data Science that integrates the study of human science with breakthroughs in data science and technology, which advances our understanding of human health to enable better and more insightful decisions and has the potential to close the gaps in research, patient care, and health system performance.

Murray Aitken
Executive Director, IQVIA Institute for Human Data Science

Defining the problems first

• The first step should always be to define the problems that need to be solved, such as quality improvements, transparency across sectors, etc., and the use cases (at the individual or population level), and then determine whether the right data is already available or new evidence and data need to be generated.

Developing a clinical framework

• A clinical framework should be developed focusing on the most important problems that are unresolved. Rather than focusing on individual, narrow conditions, it is important to focus on problems affecting larger populations, especially in the crossover between sectors that care for the same patient populations, such as frail, elderly people, people with chronic multi-diseases, and people with psychiatric conditions and abuse.

Improving data quality

• It is important to consider whether we have the right kind of data. Is data “fit for purpose?” Is the quality of the data accurate enough for decision-making, or are we simply registering transactional activity and not the outcomes of treatment?

Collaborating around data

• Generating data and insights is not the goal in itself. The goal is to use data and insights to change behavior in order to improve quality of patient care and satisfaction. Collaboration among stakeholders is the way to facilitate change, for example by bringing patients and clinicians together in the same room to co-create better patient pathways, redesign workflows, and improve patient care.

Digital transformation is critically important

• Digital technology represents a powerful opportunity to share data and insights across sectors, map existing care pathways, and redesign clinical workflows and patient care.

“You need to be really clear about the problem you are trying to solve and decide how much technology you are going to apply to address the problem. By using technology in the right way, the effect at the population-level can be enormous. This is more than data-driven healthcare, this needs to be technology-driven healthcare, where we see data and analytics as a component of digital in its widest context. However, digital doesn’t change anything unless you get operating model transformation. This is about changing the way you do things, which is made possible through digital. Using technology, you can get better and more efficient care, but to do that you need to transform your operating model and your business model.”

Ben Bridgewater
CEO, Health Innovation Manchester

Cultural change

• While digital technology is an important enabler, changing the way we generate insights, how we work and collaborate, and how we drive cultural change is the fundamental challenge and opportunity.

“The healthcare clusters will not be a success unless the clinical frontline people take ownership. How do we get the frontline people on board? We need to look at the current patient pathways all the way from diagnosis to rehab, identify and separate the data, and use them in a structured way in order to generate insights about how we can improve the care and experience for patients.”

Erik Jylling
Executive Vice President, Danish Regions

Manpower and resources

• Enabling healthcare clusters to drive change is not just a matter of having access to the right data across the sectors, it is also important to ensure that the individual sectors have the resources and manpower necessary to engage in advancing a data-driven culture. The municipal sector will need more healthcare and clinical expertise, and primary physician practices need to be strengthened with more resources.

Unique opportunities in Denmark

• The data infrastructure in Denmark is unique in many ways due to the personal identifier and the proliferation of various clinical and national databases. However, in order to support the clusters in cross-sectional quality improvement, we still need to ensure uniform, valid, and real-time data. This specifically concerns data from municipalities and GPs. Patient reported outcomes measures also represent an important data source.

The future of digitally-enabled, data-driven healthcare clusters

The successful implementation of healthcare clusters in Denmark will depend on a number of key factors, including:

• Focusing on the key problems that need to be solved through data-driven quality improvements across sectors.
• Embracing digital transformation to enable necessary change in workflows and patient care.
• Enhancing collaboration among all stakeholders involved in the transformation.
• Driving organizational and cultural change within and across the sectors involved.

The future is bright when healthcare systems move from a fragmented to a more connected, integrated model that utilizes data sharing and digital transformation to advance collaboration between healthcare and social care and across hospitals, primary physician care, and municipalities.

Participants in the Roundtable on September 14, 2021:

• Erik Jylling, Executive Vice President, Danish Regions
• Thomas Jensen, Assistant Director, Danish Regions
• Jens Winther Jensen, CEO, Danish Clinical Quality Program
• Ole Thomsen, EOO, Central Denmark Region
• Kurt Espersen, EOO, Region of Southern Denmark
• Jesper Gyllenborg, EOO, Region Zealand
• Mads Ellegaard Christensen, Director, Region Zealand
• Søren Gaard, Deputy Permanent Secretary, Danish Ministry of Health
• Christian Harsløf, Director, National Association of Municipalities
• Morten Ellersen, Programme Manager, National Association of Municipalities
• Lars Hulbæk, CEO, MedCom
• Camilla Noelle Rathcke, President, Danish Medical Association
• Torben Buse, CEO, Danish Medical Association
• Inge Kristensen, CEO, Danish Society for Patient Safety
• Jørgen Skadborg, President, Organization of General Practitioners (PLO)
• Henrik Øregaard Dam, CEO, Organization of General Practitioners (PLO)
• Jan Mainz, Professor, Executive Director, Psychiatry, North Denmark Region, Aalborg University
• Ben Bridgewater, CEO, Health Innovation Manchester
• Guy Lucchi, Digital Innovation Director, Health Innovation Manchester
• Murray Aitken, Executive Director, IQVIA Institute for Human Data Science
• Stig Albinus, Senior Advisor, IQVIA Institute for Human Data Science
• Ben Hughes, Senior Vice President, Artificial Intelligence & Real-World Data, IQVIA
• Kenneth Mikkelsen, General Manager, IQVIA Denmark
• Majlis Mølenberg, Senior Sales Director, IQVIA Denmark
• Tina Juul, Assistant Director, IQVIA Denmark