Funding and steering of the digitalization of healthcare and social welfare

The responsibility for organizing health and social services was transferred from municipalities and joint municipal authorities to the wellbeing services counties, the City of Helsinki and the Joint Authority HUS at the beginning of 2023. The establishment of wellbeing services counties and the transfer of the responsibility for organizing the services meant major changes to the ICT infrastructure and information systems. The change and development work related to the ICT and digitalization in healthcare and social welfare will continue in the coming years.

The audit examined the appropriateness of the funding package for the ICT change and digitalization in healthcare and social welfare. In addition, the audit examined the effectiveness of steering in the transition phase and the clarity of the future ICT steering model. The audit also assessed the development of common digital health and social services and how well they meet the needs of the wellbeing services counties.

In 2021 and 2022, government grants totalling hundreds of millions of euros were allocated under three different budget items to the ICT change and the development of digitalization in healthcare and social welfare. The government grant package was built gradually and partly in response to revised information on the counties’ needs for changes and their costs. According to the audit, the project-type funding model based on applications for different government grants did not support the counties in the best possible manner in the implementation of a long-term ICT change and in the development of digitalization. In the future, it will be important that the Ministry of Social Affairs and Health and the Ministry of Finance develop the digitalization of healthcare and social welfare and the national digital health and social services in a systematic and long-term manner.

Most wellbeing services counties felt that the steering in the transition phase did not take sufficiently into account the counties’ different starting points and needs as regards ICT. The wellbeing services counties have different hopes for the future steering of ICT and digitalization in healthcare and social welfare. In general, the counties find that the digitalization of healthcare and social welfare calls for a uniform target state. The Ministry of Social Affairs and Health launched strategy work related to the information management and digitalization in healthcare and social welfare  during the audit. The Ministry should sharpen the steering of ICT and digitalization on the basis of the audit, taking into account the special characteristics of the counties, and steer the counties to cooperate in the ICT change and the development of digitalization.

The Kanta Services have an important role as common information system services in healthcare and social welfare, but their development has not progressed fully in line with the Act on the Electronic Processing of Client Data in Healthcare and Social Welfare. DigiFinland Oy develops national digital service solutions for the wellbeing services counties. The counties have different attitudes to these services. Based on the audit conducted, the counties see potential in common digital services but emphasize that they should meet the different needs of the counties. In addition, the development and funding models of common services should have a sustainable basis.