In our #SmartHealthSystems study, we analyzed 17 countries on the state of digitization in healthcare. As our country report shows, Sweden is among those countries that decided very early on to adopt a strong comprehensive digitization strategy. Its systematic implementation has resulted in Sweden having one of the most advanced digital health systems. With its e-Health Vision 2025 Sweden aims at becoming the “best in the world at using the opportunities offered by digitization and eHealth”. In an interview, Erik Frisk, International Coordinator of the Swedish eHealth Agency (E-hälsomyndigheten), explains the importance of coordinating digital health efforts as well as of developing new digital health services. He underlines that cooperation and consensus building are key components for the implementation of Sweden’s e-Health Vision 2025.

Why did Sweden decide to digitize healthcare delivery?

Frisk: “Sweden has a relatively long history of digitalizing healthcare and has, for example, been using electronic patient records for decades. Considering the current population trends, where the number of people over the age of 80 will increase by 44 percent, while the working-age group will only increase by some six percent in the coming ten years, we can conclude that Sweden will have a lot more elderly to care for with a proportionally smaller working population to cater for this need. The use of digital healthcare is an important part of the solution to this problem and therefore a major focus is put on the development of health technology.

How did and do digital solutions make it into regular healthcare delivery? What role does a dedicated agency like E-hälsomyndigheten play when it comes to implementing digital health?  

To answer these two questions, we need to look at how the health and social care system in Sweden is structured. The role of the central government, which includes the Swedish e-health agency, is to establish principles and guidelines and to set the political agenda for health and welfare at the national level. In addition, the Swedish healthcare system is tax-financed and decentralized, meaning that 20 county councils/regions finance almost all healthcare and provide most of the services. These 20 regions cover all residents and very few citizens have additional private healthcare insurance. Sweden has reimbursement systems for paying healthcare providers and the number of private providers with public financing varies significantly depending on the county council/region. There are 290 municipalities that are responsible for caring for the elderly at home or in a special accommodation. Moreover, the municipalities are involved in the care of people with physical and psychological disorders.

In the context described above, the Swedish e-health agency plays an important role, as we store and distribute all e-prescriptions in Sweden. The agency also administers and develops a range of different e-health services, such as the national medication list for example. We also make an important contribution to the nurturing and coordination of digital health projects and are at the same time the point of contact for questions regarding the implementation of digital health.

Citizens’ and healthcare professionals’ trust is key when it comes to digital health. How does Sweden build trust?

In Sweden and the Nordic countries, citizens generally have a very high level of trust in their healthcare systems, both currently and historically. By providing service- and security-oriented solutions, we believe that we can nurture and even strengthen the trust that citizens have placed in us.

Sweden has developed a vision for digital health for the year 2025. What are the key principles and aims of that vision?

The key components of the Swedish e-health Vision 2025 are cooperation and consensus-building. For Sweden to be able to create a well-functioning digital health setting in which we optimize the use of e-health, we need to co-create an environment in which all stakeholders can contribute by driving this project forward with a shared vision and goal.

I’m sure that in 2025, Sweden will be the best in the world at using the opportunities offered by digitization and eHealth. We want to give people equal access to good healthcare and social services, while strengthening their own resources for more independence and participation in society. The Vision 2025 is a result of this cooperation, which focuses on four main tasks:

Legal framework: If regulations need to be changed, privacy and security needs must be ensured

Consistent terminology: Enables information exchange through the use of uniform terms and structures

Standards: Enables systems to share information in a secure way

Follow up: Tracking and monitoring progress

This vision forms the basis for further work on the digitization of the Swedish healthcare system.


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