Never Let a Good Crisis Go to Waste - Strategic opportunities After COVID-19

• In 2021 Denmark has progressed healthcare transformation in many areas through a number of well concerted and coordinated strategies over the years.
• The current Danish strategy for Digital Health (2018-2022) includes 27 initiatives, and it is designed to support eight political targets and reach five main objectives.
• The eight targets aim to raise the bar to create better coherence, higher quality and greater geographical equality.
• Digitisation is an important element and a key driver of change.
• The Digital Health strategy will make digital health more available to citizens and patients, enable the use of new technology and prepare for future innovation within AI, apps and wearables.
• Healthcare will return to a new normal after the pandemic, but only those healthcare organisations, which grab the window of opportunity after the pandemic, will gain the full potential of the progress made during the pandemic.

The Danish Healthcare Transformation Strategies

The Danish public sector and healthcare structure reform in 2007 initiated a number of healthcare transformation strategies focusing on healthcare-IT and e-health, but also initiatives to establish the future hospital and acute care landscape in Denmark.

In 2021 Denmark has progressed healthcare transformation in many areas through a number of well concerted and coordinated strategies over the years. This, of course, includes healthcare-IT, where nine different strategies have been completed since 1999, leading to a current situation, where a national EHR has been established in Denmark with full and secure access to healthcare information for all citizens and clinical professionals. And – with the future hospital initiative - reducing the number of hospitals in Denmark from 98 in 2000 to 32 today.

The current Danish strategy for Digital Health (2018 – 2022) includes 27 initiatives, and it is designed to support eight political targets and reach five main objectives.

The eight political targets have been established through an ambitious political agreement: “National Targets for the Health System”. The agreement aims to ensure that all sectors of the health system – hospitals, municipalities and GPs – pursue a clear and common goal of higher quality.

“National Targets for the Health system” is defined by one clear crossbar: better coherence, higher quality and greater geographical equality in the health system. And for the eight targets, which jointly aim to raise the bar to create better coherence, higher quality and greater geographical equality, digitisation is in certain areas an important element – and in other areas a key driver of change.

The Digital Health strategy is a paradigm shift, which will make digital health more available to citizens and patients, enable the use of new technology and prepare for future innovation within AI, apps and wearables.

Implementing the strategy has led to a remarkable shift in the way Danish citizens and patients access their electronic healthcare information – from using a PC and a web browser and to now relying on an ecosystem of apps, where access to healthcare information is everywhere and from the smartphone and pocket of the patient.

The Digital Health strategy and the political targets are supported by the national roll-out of telehealth on a national level, where the first step – during coming years - will be national telehealth for all COPD patients.

Strategic Development in Times of a Pandemic

The reactions and consequences of a serious pandemic like COVID-19 at first make all healthcare authorities focus intensely on handling capacity in order to manage an expected and massive increase in hospitalisation and avoid a serious overload and breakdown of healthcare services.

Existing strategic plans and developments are typically affected, and they are often delayed or put on a temporary hold as all attention is on handling the pandemic. However, those initiatives which were immediately introduced to handle the pandemic have later proved to be fundamental drivers, which can progress existing strategies and plans considerably – and not only during the pandemic.

Increasing the level of digital health and the use of telehealth are obvious initiatives that help reduce personal contacts in the healthcare system and control the outbreak. During the pandemic, already planned teleconsultation services were implemented immediately in Denmark - much earlier than outlined in the Digital Health Strategy.

The reason why big progress in digitalisation and telehealth occurred during the pandemic can not only be attributed to the extreme sense of urgency and determination from healthcare leaders. When all healthcare professionals and leaders came together to fight the outbreak, developments became possible in a very short time, which would normally take a long time to implement successfully. Because everybody had a strong will to take new measures, the pandemic cut through the usual organisational boundaries and silos, and it changed the culture. All the mechanisms, which usually hinder new innovation and progress, were suddenly taken out of the equation.

On 26 March, shortly after the lockdown of Denmark on 11 March, the option to have a teleconsultation (video meeting) with the GP was introduced through the Danish My Doctor app. Immediately, all Danish patients could choose a teleconsultation as an alternative to visiting their GP. This is a massive success. During the first month, 30,000 video consultations were performed, and a total of 270,000 video consultations have been performed in Denmark between March and November.

During the same period, the Danish Healthcare Regions experienced a general increase in the number of teleconsultations, and one region reported a 36% increase.

Introducing the video consultation option helped healthcare authorities control the outbreak and increase efficiency. Patients are extremely happy with the new option, and especially among elderly citizens – who are typically very concerned about the risk of COVID-19 – there was a solid increase in the proportion of patients who used the teleconsultation option.

In many other areas, there are similar examples of how the measures in Denmark to control the outbreak progressed and expanded existing digitalisation initiatives. Hospitals, which already had implemented advanced Realtime Logistics Solutions, were soon able to combine information to provide a precise overview of their capacity and ability to receive COVID-19 patients. Through the existing Danish digitalisation infrastructure, which connects all hospitals in Denmark, a national overview of capacity was established, and the same digital infrastructure was used to connect the COVID-19 test centres in order to also provide a national (and real-time) overview of positive tests.

From a strategy perspective, initiatives during COVID-19 helped accelerate the already planned implementation of teleconsultation in the MyDoctor app, which is one of the initiatives in the Digital Health Strategy. Teleconsultation was introduced much earlier than originally planned, but more importantly, the rapid uptake, where both GPs and patients immediately switched to teleconsultation, was something that strategists could only have dreamed about. Without the pandemic, the uptake period would have taken a much longer time.

The COVID-19 pandemic is an opportunity to strengthen and improve existing strategies that were already in place before the pandemic. Even though healthcare will return to a new normal after the pandemic, where we will generally make more use of digitalisation and telehealth, it will only be those healthcare organisations, which grab the window of opportunity after the pandemic who will be able to gain the full long-term potential of the progress made during the pandemic.

The window of opportunity after the pandemic is about updating existing strategies according to shifts and gains during the pandemic, but the most important factor of value is the special culture and determination by healthcare leaders and professionals to make changes, work in new ways and in new roles. Healthcare organisations, which are able to prolong and preserve this special culture to implement future and long-lasting progress, will be the real winners of the pandemic.

Conflict of Interest

None.