Intro

The presentation will describe how the World Health Organization Region Europe (WHO EURO) came to select Sweden as its Demo Platform, and South Lapland and the Centre for Rural Medicine as the demo site for showing good practice of how to ensure access to health in remote areas with digital health tools, why Business Sweden initiated this collaboration with WHO, what the Demo Platform entails and how the next planned steps are strategic to Swedish digital health industry internationalisation.

Business Swedens role promoting Swedish competency in digital health internationally

Industry has asked Business Sweden for advice and support of how to engage with the UN and how to establish dialogue to explore collaboration. To this end, for the past ten years, Business Sweden has taken the role of a technology and solutions partner to the UN, building trust to complement the role of Sweden as a longstanding donor and policy partner. An important component has been to create a forum for dialogue in close concert with other Team Sweden members such as embassies and permanent missions around the world.

Business Sweden is mandated by Government and industry to support Swedish industry in its internationalization. One long term strategic focus for Business Sweden is to position Swedish best in class HCLS competency and a system solution partner internationally within strategic areas. Areas include e.g. precision medicine, and digital health. The approach is demand driven in close concert with strong partners internationally as well as in Sweden to find common ground.

Sensitising industry partners to the benefits of engaging with the UN has been important, both for commercially reasons but also as a conduit for insights into international development and humanitarian market needs connected to the normative support to member states UN organisations provide. For the past five years one Swedish key collaboration partner has been the World Health Organization.

The World Health Organization Region Europe

WHO coordinates and formulates global health policy. Its approach is demand driven, and advice to Governments includes national health systems design and support to identify supporting models and solutions for inspiration. WHO is a decentralised organisation and much of the operational support to member states is coordinated and originates at the regional level.

WHO Region Europe is increasing efforts to meet member states requests for support to identify digital health best practice for strengthening health systems, including primary health care systems for access to health in rural settings. WHO EURO is taking bold steps to increase operational support, including piloting and scaling.

WHO EURO Demo Platform Concept 

The WHO EURO Demo Platforms are intended to present inspiration and lessons learned to member states for health system design. The initial focus of the Swedish Demo Platform is to illustrate how countries can ensure access to health in rural settings by strengthening primary care with digital tools.

To the demo platform WHO EURO invites high-level representatives from its member states to see and learn for inspiration. Visiting delegations are typically led by a minister or a deputy minister accompanied by thematic experts with responsibility for health care and digital infrastructure.

It is the intention of the WHO EURO to bring 2-3 country delegations to the Swedish Demo Platform per year.

The emergence of the Swedish WHO EURO Primary Health Care and Digital Health Demo Platform

In 2020 Business Sweden ran a series of high-level meetings with WHO HQ based directors and their thematic experts together with leading industry experts. Then objective was to establish a dialogue to discuss global health challenges and let industry share best practice around topics of common interest.

The format for exchange was much appreciated, and in early 2021 Business Sweden learned of an interest from the European Regional Office of the World Health Organization to explore similar collaboration model connected to the increasing number of requests for advice from member states on how to use digital tools to strengthen health systems.

A dialogue was established, and series of iterations filtered out access to health in sparsely populated areas, and how this could be strengthened with digital tools, as a key area of common interest.

Discussions were coordinated from WHO EURO by Director of Country Health Polices and Systems, Natasha Azzopardi Muscat, and her key digital health and primary health care experts. From Sweden business Sweden engaged experts from the Swedish digital health scene such as the Swedish eHealth Authority and the Swedish Association of Local Authorities and Regions. Region Västerbotten was identified as a good example of a successful model for developing and test patient centric solution in a rural setting.

On invitation by the WHO EURO PHC Centre a five-page case study (Country Vignette) was developed during fall 2021 for publication on the WHO EURO website. The Country Vignette target group is policy makers, and the publication is intended to draw attention to the opportunity of visiting the demo site for deeper insights.

A WHO EURO scoping mission to Sweden was organised in February 2022 as a demo platform visiting programme pilot. As part of the visiting programme Business Sweden organised a digital health innovation workshop to allow invited industry experts discuss challenges and solutions with visiting WHO experts and key decision makers from Region Västerbotten such as the Center for Rural Medicine. This forum is central to the Demo Platform concept, and illustrates the Swedish multi helix approach of mobilising the innovativeness of the private sector for co-creation and innovation.

In September 2022, on invitation by WHO EURO, Business Sweden in capacity of implementing partner, together with representatives from Region Västerbotten and remote care industry experts, participated at the annual meeting of the WHO EURO hosted by Israel in Tel Aviv. The WHO Demo Platform collaboration was presented and discussed with participating member states ministerial delegations, and bilateral a pre demo site visit meeting was organised with the first deputy Minister of Health from the Government of Georgia, the first WHO EURO member state to visit the Demo Platform in Sweden.

The Swedish WHO EURO Demo Platform was inaugurated in Storuman, Region Västerbotten, on October 18 2022 by Dr Hans Kluge, the Director of WHO Region Europe. The inauguration was part of the week-long visiting programme of a ten delegates strong high-level group from the Georgian Ministry of Health, the Georgia Medical Holding company and the Georgian IT Agency. Dr Kluge and the Georgian delegation was accompanied by eight WHO EURO digital and primary care experts. For 2023 discussions are under way with the Ministries of Health in Spain as well as in Kazakhstan to visit the Demo Platform.

Demo Platform site Västerbotten

Västerbotten was selected as a first demo site due to the successful work in the region on the model of care and innovative ways of strengthening primary health care with digital tools. WHO EURO acknowledges that a large group of countries in Europe share similar challenges as found in the region such as large distances, demographic change/increasing burden of chronically ill, as well as staff retention.

A key role in the demo platform is played by the cottage hospital. The foundation of primary health care services in the sparsely populated area of South Lapland rests on the cottage hospital model, which has been in place for more than a century. The cottage hospitals are small primary care units staffed with general practitioners. Their scope of practice is broader than in more urban areas, and they are more equipment than you would normally find in primary care, including solutions for telemedicine and digital health.

Located in rural Storuman, the research and development unit Centre for Rural Medicine (GMC) plays a central role in the multi helix innovation and testbed model to develop many of the implemented digital health solutions. WHO acknowledges that this model constitutes a successful example of multi stakeholder co-development, which mobilises the innovativeness of the private sector to address well-defined challenges in the health care system.

Conclusion

The World Health Organization is the global authority on all things health. When the WHO speaks countries listen, and its policy advice is being implemented into national policy. Its recommendations also include technical advice around pharmaceuticals and medical technology to be deployed in the health care systems.

Having the World Health Organisation Region Europe as a champion for Swedish model of care internationally, and the solution used in Sweden is therefore an asset when sharing best practice to exploring international collaboration.

The insights WHO ERURO into specific needs in countries is an invaluable source of information, and an opportunity to identify potential areas for Swedish industry to explore collaboration.  

Full presentation: