Contributed by Patrick Kitchen
Throughout recent years, a recurrent health problem has required me to make frequent visits to my family physician, a specialist’s clinic and occasionally the ER. I became used to the routine of explaining what happened, describing previous events to various clinical staff, and providing context in lieu of a personal and up-to-date health record that the physicians or nurses could review. After each appointment or ER visit, I would request that the information be faxed to my GP or cardiologist, as well as take a personal printed copy in case the records were not sent, which turned out to be a common pattern.
In 2017, I was accepted to graduate school in Copenhagen, where I completed a Master’s degree in Business Administration and Innovation in Health Care this past June. Throughout the first semester of the program, discussions on digital health and how to improve outcomes, efficiency and the patient experience using digital health tools were fairly common. During classes we would hear from speakers who worked in the Danish health care sector, health care practitioners (HCPs) and professors who would proudly mention Denmark’s progress in achieving a largely digital health system. Numerous examples of these innovations included: MedCom, a non-profit agency developed in 1994 and responsible for the development of data standards and a national health data network; the national IT health portal launched in 2003 (Sundhed.dk); the extensive use, interoperability and portability of EMRs across primary and secondary care settings; ePrescription rates of nearly 100%; highly sophisticated public health registries, and many other examples. While impressive, these statistics and figures never fully resonated because I had not seen a doctor in Denmark, nor experienced these technologies or platforms as a patient or user.
When my health problem returned while I was studying in Copenhagen, I felt some uncertainty given that I was outside of Canada, and I had never visited my doctor before (I say ‘my doctor’ because I was automatically assigned one when registering with civil authorities based on my address). I arranged a visit with my GP the following day. She felt that we should do some diagnostic work, and as I left, I asked if there was any documentation I needed to bring. She looked at me with a curious face, and then stated it was all submitted digitally, and that she would receive the results digitally, which would also be available to me through my profile in the national patient portal. When I arrived at the lab, I simply swiped my personal ID card (all residents in Denmark have a unique personal identifier that is used in the public sector) in their scanner, and the lab tech knew what tests I needed to complete. While this process might feel insignificant and routine to Danes, it felt worlds ahead of the care process at home in Ontario. It was reassuring that the onus was not on me to ensure my doctor or the lab technician had the correct information, and that I could access it digitally and send the information back to my Canadian doctor if necessary.
When the problem presented itself again the following year, I called the acute nurse line as it was a Saturday. I was then referred to a nearby hospital, which had anticipated my arrival, and whereby I was immediately taken to an examination room, swiftly examined and discharged shortly after. On the Monday, my family doctor called and asked me to come in for an appointment, because she was notified that I had visited a hospital over the weekend. After discussing my results with me, she referred me to a specialist who’d conducted further testing by the following Wednesday. Again, the results and lab work were sent digitally, and I could access them online using the Sundhed.dk patient portal. Gone was the added stress associated with visiting the doctor or ER and needing to ask for documentation, retelling my medical history to various HCPs, or even being asked basic personal information over and over again. My experience both as a patient in the Danish health system and student in a Master’s program aimed at supporting innovation while sustaining publicly-funded health care allowed me to gain a real understanding of the importance of a digitally-connected health system, and provided me with further motivation in my studies. Knowing that my GP and other clinicians could easily access my records, easily communicate with each other and order tests and prescriptions if necessary, and that I had access to all this information in the patient portal, felt like another world – one that would be a luxury to have in Canada.
Like many aspects of Danish society, consensus-building has been crucial in the continuing development of a strong, nationwide digital health strategy. Denmark may be a small country of approximately six million people. However, a country’s population should not dictate its ability to deliver high-quality and well-integrated health care assisted by the extensive use of digital health innovations. I decided to write this post since there is a lot of talk in Ontario about integration and digital health. Based on my experience as a patient in another country, and my Master’s studies in Copenhagen, I know what is possible and what we should strive for – a digitally-enabled health care system that benefits and empowers clinicians and patients to be true partners in care.
Patrick Kitchen recently graduated from Copenhagen Business School in Denmark, completing an MSc in Business Administration and Innovation in Health Care. Prior to that, he received a Bachelor’s degree from the University of Toronto in Political Science, with a specialization in Comparative Politics. Through his educational and professional experience, Patrick has developed a passion for digital health, health policy and strategy, and health system sustainability. Patrick recently returned to Canada and is looking to start a meaningful career in the digital health sector.