Finland revolutionalised itself in the last century and one of its great success stories was healthcare. Finnish healthcare is worldwide state of the art, with leading positions in terms of diagnostics, life expectancy and universal quality healthcare among its 5.5 million inhabitants. Finland encompasses a vast area for a small population. It is in the constitution that the state is responsible to promote welfare, health and security. Accessibility and quality of healthcare services surged forward in recent decades, although Finland still faces challenges in terms of sustainability amid an aging population. Its response is to maximise the utilisation of data, believing information can benefit all stakeholders. The data hub Finland has created builds on current available registries, benefiting from the homogenous nature of the population as well as their high level of awareness and education and the trust built between citizens and public authorities. With new regulations ensuring maximum security and the right of each citizen to control who accesses his information, Finland is betting all its cards on its data revolution. This move was the core subject of the discussion when Ahram Online met with Dr Päivi Sillanaukee at the headquarters of the Finnish Ministry of Social Affairs and Health at the end of April in Helsinki. Päivi Sillanaukee was appointed permanent secretary at the Ministry of Social Affairs and Health in 2012. The ministry's responsibilities include promotion of health and welfare, social and health services, social insurance, occupational health and safety and gender equality. As of May, Sillanaukee acts as a representative of Finland on the executive board of the World Health Organisation (WHO) Data is the keyword At the outset, Sillanaukee stressed that Finland is experiencing a new age, introducing new concepts in health technology, and that the key factor is data. “Data is not only concerned with health information, but also socio-economic information, and it is used on a primary level to deliver services to clients and patients, and on a secondary level to assist in innovation, research and development,” she said. Sillanaukee clarified that Finnish legislation will enable many entities to benefit from secondary data, including startups, clients of health and social services, ICT enterprises, research institutions and universities, pharmaceutical companies, and others. Trust is the word Information about health and society has a long history of being pivotal in Finland. “The Finnish cancer registry was in effect since 1953, and most of the population agrees to cooperate with giving out records," Sillanaukee said. Asked about the basis of this unique trust, Sillanaukee said that trust takes time, but Finland managed as a society to build it. "People have trust because they get a lot, equally, and we are a very open society with a huge amount of transparency. People are used to the fact that civil society does what it promises to do.” A history of data collection Finland has over 50 years of experience in gathering health survey information at both the national and regional levels. The data for key health indicators is of good quality and the information is widely used in health policymaking. The registers are computerised and they cover the whole country and all age groups. Unique personal identification numbers enable record linkage across different registers. Sillanaukee says that even with stigma related topics in other societies, like HIV, Finns are willing to give out their records. "We are on the forefront. And we regard data as the real treasure — the new oil," she said. Security never compromised Asked about internet and Facebook security breaches, Sillanaukee said that all data sources in Finland are governed by authorities," and so the data is technically very secure. Sillanaukee explained that Finnish projects like IHAN represent the next step, where a large portion of data is governed by the individual him or herself, with control of access. "Legislation will ensure that security is maintained as people willingly give permission of use of their records for research," she said. The quest for a perfect ecosystem "The big picture here is that business and the health sector work together. Ministries work hand in hand to reach the full potential of healthcare possibilities," Sillanaukee said. She stressed that Finland is proud to be a forerunner in bringing together on a common platforms different stakeholders: biobanks and registries, academia, the private sector and startups. "Many of the important innovations and discoveries are in local startups, and for those, we make a connection with other parties in order for the bright ideas to be realised." Prevention and personalised medicine The aim of healthcare in Finland is to maintain and improve people's health, wellbeing, work and functional capacity and social security, as well as to reduce health inequalities. "Digitalisation plays an important role in health and social services reform. And we are shifting the focus from treating diseases to prevention," says Sillanaukee. "The government is emphasising the digitalisation of the system because we have quite a big country for 5.5 million people, and there are areas with few inhabitants, so having remote services is one way of trying to be more effective. Also Finland is a leading country in prevention promotion." In Finland, projects like FinnGen present examples of personalised medicine projects with a collaborative component between the public and private sectors, bringing together in one platform universities, hospitals, pharmaceutical companies and thousands of Finns. "We are witnessing the era of personalised medicine. Our powerful tools are developed to address the causes rather than the symptoms of diseases. We can use tech to identify people at risk, we use AI as well to enhance peoples capacities, even in older age", Sillanaukee says. Challenges Finland boasts the most efficient healthcare system in the world and a strong collaboration between academia, industry and the public sector. Still, challenges loom. "We come second after Japan in terms of aging population, so we acknowledge that a problem of rising costs looms ahead because of that, and because of some inefficiencies as well." "We have a sustainability gap, and we try now to solve the problem, and that's why we had to address the issue of healthcare reform," Sillanaukee says. Asked about those who can't access the internet easily, how they can make use of personalised healthcare, Sillanaukee stressed that services are offered to help them in using the internet. Otherwise, face to face services are provided. Other challenges mentioned by Sillanaukee include the social aspects of health. "We are known to be one of the happiest nations in the world, but we have other social problems to be tackled, including the feeling of marginalisation and polarisation felt by young Finns, typically aged 18 to 27," she said.
