Haverinen Jari, Keränen Niina, Tuovinen Timo, Ruotanen Ronja, Reponen Jarmo
FinnTelemedicum, Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
Finnish Coordinating Center for Health Technology Assessment, Oulu University Hospital, Oulu, Finland.
JMIR Med Inform. 2022 Aug 12;10(8):e35612. doi: 10.2196/35612.
eHealth increasingly affects the delivery of health care around the world and the quest for more efficient health systems. In Finland, the development of eHealth maturity has been systematically studied since 2003, through surveys conducted every 3 years. It has also been monitored in several international studies. The indicators used in these studies examined the availability of the electronic patient record, picture archiving and communication system, health information exchange, and other key eHealth functionalities.
The first aim is to study the national development in the maturity level of eHealth in primary health care and specialized care between 2011 and 2020 in Finland. The second aim is to clarify the regional differences in the maturity level of eHealth among Finnish hospital districts in 2020.
Data for this study were collected in 2011, 2014, 2017, and 2020, using web-based questionnaires from the Use of information and communication technology surveys in Finnish health care project. In total, 16 indicators were selected to describe the status of eHealth, and they were based on international eHealth studies and Finnish eHealth surveys in 3 areas: applications, regional integration, and data security and information and communications technology skills. The indicators remain the same in all the study years; therefore, the results are comparable.
All the specialized care organizations (21/21, 100%) in 2011, 2014, 2017, and 2020 participated in the study. The response rate among primary health care organizations was 86.3% (139/161) in 2011, 88.2% (135/153) in 2014, 85.8% (121/141) in 2017, and 95.6% (130/136) in 2020. At the national level, the biggest developments in eHealth maturity occurred between 2011 and 2014. The development has since continued, and some indicators have been saturated. Primary health care lags behind specialized care organizations, as measured by all the indicators and throughout the period under review. Regionally, there are differences among different types of organizations.
eHealth maturity has steadily progressed in Finland nationally, and its implementation has also been promoted through various national strategies and legislative changes. Some eHealth indicators have already been saturated and achieved an intensity of use rate of 100%. However, the scope for development remains, especially in primary health care. As Finland has long been a pioneer in the digitalization of health care, the results of this study show that the functionalities of eHealth will be adopted in stages, and deployment will take time; therefore, national eHealth strategies and legislative changes need to be implemented in a timely manner. The comprehensive sample size used in this study allows a regional comparison in the country, compared with previous country-specific international studies.
电子健康日益影响着全球医疗保健服务的提供以及对更高效卫生系统的追求。自2003年以来，芬兰通过每3年进行一次的调查，对电子健康成熟度的发展进行了系统研究。它也在多项国际研究中受到监测。这些研究中使用的指标考察了电子病历的可用性、图像存档与通信系统、健康信息交换以及其他关键的电子健康功能。
第一个目标是研究2011年至2020年芬兰初级卫生保健和专科护理中电子健康成熟度的国家发展情况。第二个目标是阐明2020年芬兰医院区之间电子健康成熟度的区域差异。
本研究的数据于2011年、2014年、2017年和2020年收集，采用来自芬兰医疗保健项目中信息和通信技术使用情况调查的基于网络的问卷。总共选择了16个指标来描述电子健康的状况，这些指标基于国际电子健康研究和芬兰在3个领域的电子健康调查：应用、区域整合以及数据安全和信息与通信技术技能。所有研究年份的指标保持不变；因此，结果具有可比性。
2011年、2014年、2017年和2020年所有的专科护理机构（21/21，100%）都参与了研究。初级卫生保健机构的回应率在2011年为86.3%（139/161），2014年为88.2%（135/153），2017年为85.8%（121/141），2020年为95.6%（130/136）。在国家层面，电子健康成熟度的最大发展发生在2011年至2014年之间。此后发展持续进行，一些指标已经饱和。在所审查的整个期间，通过所有指标衡量，初级卫生保健落后于专科护理机构。在区域上，不同类型的机构之间存在差异。
芬兰全国范围内电子健康成熟度稳步推进，其实施也通过各种国家战略和立法变革得到促进。一些电子健康指标已经饱和，使用率强度达到了100%。然而，发展空间仍然存在，特别是在初级卫生保健方面。由于芬兰长期以来一直是医疗保健数字化的先驱，本研究结果表明电子健康功能将分阶段采用，部署需要时间；因此，国家电子健康战略和立法变革需要及时实施。与以前针对特定国家的国际研究相比，本研究使用的综合样本量允许在国内进行区域比较。
