References

Nordic Healthcare Group and its subsidiaries have the most extensive and intensive knowledge in the Nordic countries in terms of advisory services in health and social services from the perspective of both the substance of the industry and the methods.

Our experience covers the full range of health and social services from complex social services to specialized healthcare and the adjacent fields, such as welfare services. We also support municipalities and counties in the public sector in other services besides health and social services.

The Central Finland Healthcare District (KSSHP) began to develop a fast track process for artificial joint replacement surgery after seeing the long durations of episodes demonstrated by NHG’s benchmarking results. By relying on the practices of international and Finnish hospitals, KSSHP managed to reduce the duration of its artificial joint replacement episodes by over 50%.

KSSHP combined and mobilized best practices from different hospitals. The artificial joint replacement process became significantly shorter than in other hospitals, and the improvement of benchmarking results encouraged the further development of operations. The durations of episodes in other benchmarking hospitals have also become notably shorter.

NHG’s surgery benchmarking produces tangible knowledge about alternative approaches, resource allocation and quality to participants. By examining operations from multiple points of view, it is possible avoid sub-optimization, such as the reduction of episodes by increasing the share of customers referred to follow-up treatment.

The research project consisted of developing an analytics algorithm which predicts the transfer of home care customers to round-the-clock service housing 6–12 months in advance.

The algorithm utilizes the indicators of the RAI system, which describe the functional capacity and health of a home care customer. Machine learning methods were used to search hundreds of individual RAI variables to identify the ones which best predict the transfer to round-the-clock service housing.

The algorithm proved to be accurate and was integrated into the RAI system. The data provided by the algorithm helps home care providers to plan and target services to those in most need. Targeted services make it possible to help the elderly to live longer safely at home and while staying within the sphere of home care services.

Link to RAIsoft article

The municipalities of Central Uusimaa formed a Joint Municipal Authority for Social and Healthcare to organize the healthcare services in the region; afterwards, service production will also be transferred under the Joint Municipal Authority. We helped the ICT preparation team of the Joint Municipal Authority to draw up a roadmap for the organization of data administration in the Joint Municipal Authority, the control of the data system as a whole and to support changes in service production.

The roadmap was compiled together with the ICT preparation team of the Joint Municipal Authority. During the project, interviews were conducted with leaders of service production preparation teams and participants of national projects and regional preparations, and the observations and preparations were brought together and discussed by a large forum.

As a result of the collaboration, the Joint Municipal Authority has a better understanding of the changes needed in data administration and data systems related to the establishment of the Joint Municipal Authority as well as the ICT needs in service production and the related prioritization and scheduling.

A Finnish company was considering expanding to healthcare alongside its traditional business operations. We created a strategy for the client’s Smart Health business and identified the client’s capabilities for entering the market.

The focus of the project was selected in workshops together with the client, based on analyses prepared by NHG. The most appealing options were selected to define the various ways to enter the market in more detail. During the project, interviews were conducted with international experts and the ways in which technology had revolutionized the market were examined.

The client’s management gained a thorough understanding of the market, its key changes and opportunities as well as possible ways that the client could enter the market. Due to the work, the client’s management received reliable grounds for future investment decisions.

Tampere University Hospital (TAYS) has about 10 million support service events per year. Hospital staff often order support services on paper and using order systems designed by different providers, which is not expedient in a busy hospital environment.

Kaufmann designed and delivered a mobile application named Paketti (“Package”) to TAYS, enabling staff to place orders using a single application. Support staff have more time available when nurses can manage routine orders on the spot. A user-centred development model guarantees that the service meets users’ needs.

The service was created in two-week sprints, supervised by a steering group that meets monthly and a strategy team that meets twice a year. Today, the application is used in the TAYS Central Hospital, Coxa and Heart Hospital.

The aim of the project was to obtain an opinion from an external expert on the vision of the city’s structure of services for the elderly and the service network itself, the development needs of current approaches and new service models and approaches to improve productivity and efficacy.

The project involved interviews with key individuals in services for the elderly, the collection and analysis of data sets and the organization of workshops with key individuals and the management of services for the elderly.

As a result of the project, a strategy for services for the elderly for the years 2015–2025 was created, including a vision for the future service structure and network, including further recommendations for the development of current approaches. The strategy involved a view of future service models and approaches that contribute to boosting productivity and efficacy.

The aim of the commission was to analyse the present condition of the care chains and costs of young, 13–22-year-old substance abuse and mental health patients from Espoo. Espoo wished to streamline the service chains, requiring a thorough analysis of the present state of the services.

The project was carried out in cooperation with experts from the City of Espoo and the Hospital District of Helsinki and Uusimaa. It consisted of compiling data on customers’ care chains and service use as well as defining customer groups, care chains, costs and segments. Finally, the data was converted into solution models in workshops.

Care chains were analysed from the perspective of multiple different patient groups with a particular focus on the start of care and the subsequent service contacts. The analysis also involved multiple care chain analyses for example one’s for customers. Costs were examined customer- and segment-specifically as well as individually in terms of the most expensive customers.

The growth of health and social services costs in Central Ostrobothnia in 2010–2014 was substantially higher than the Government’s new budget framework. NHG helped Central Ostrobothnia assess the adequacy of the cost development according to the health and social services strategy of the Joint Municipal Authority and the programmes of measures relative to the Government’s budget framework. The study was carried out together with the heads of services across all of the health and social service areas.

The study began by assessing the future cost development of Central Ostrobothnia in selected scenarios and specifying the preconditions set by the framework budget for future development. After an overview of the total budget had been created, the potential for savings in each service area was assessed. The cost impact of strategic programmes was validated against the preconditions of the budget framework and the estimated savings potential.

As a result of the study, Central Ostrobothnia received a factual overview of the cost impact of its intended strategic programmes of measures relative to the preconditions of the Government’s framework budget and the estimated savings potential.

The regional preparations in Uusimaa identified a critical need to define the content, practices and rules in the organization of health and social services. The aim was to prepare a document to describe the operating environment and goals of the health and social services organizer in Uusimaa, the organizer’s tools and levers for the strategic management of the service system and the actual duties and approaches of the organizer. The change management relied on NHG’s facilitation and structuring skills when defining and processing the document’s content.

NHG facilitated and supplied the required frameworks and background materials for workshop activities, which consisted of the defining the organizer’s duties, the resources available to guide the service system, the division of duties between the organizer and providers’ and the organizers’ decision-making mechanisms and processes. The outputs of the workshop were compiled and structured into a coherent document outline. The project management used the outline as a framework for the final writing process, supported by NHG.

The first version of Uusimaa county’s health and social services organizer document was sent for a public round of comments included:

  • The principles of structuring the health and social services organization operations
  • A description of the organizer’s operating environment, the roles of different parties and steering mechanisms as well as the organizer’s tools
  • A description and definition of the contents, mechanisms and processes in the health and social services organization operations

The client was a group operating in the construction industry in the Nordic countries for whom the Finnish health and social services sector is a significant business segment. We helped the client to understand the changes that the health and social services reform will cause in the sector and to anticipate the impact of the reform in segments in the construction industry that are relevant to the client.

NHG analysed the health and social services construction market in Finland and established a segment-specific picture of the market size, competitive conditions, dynamics and key drivers of change. A comprehensive statistical analysis and expert interviews served as a basis for forming a prognosis of the market development.

The project involved providing a factual impression to the client of the market development in health and social services construction and the effects of the health and social services reform. The client was able to use this to anticipate upcoming changes and to prioritize its future development projects.

A Finnish company was considering expanding to healthcare alongside its traditional business operations. NHG created a strategy for the client’s Smart Health business and identified the client’s capabilities for entering the market.

The focus areas of the project were selected in workshops together with the client, based on analyses prepared by NHG. The most appealing options were selected to describe various ways to enter the market in more detail. During the project, interviews were conducted with international experts in the field and the ways in which technology had revolutionized the market were examined.

The client’s management gained a thorough understanding of the market, its key changes and opportunities as well as possible ways that the client could enter the market. Due to the work, the client’s management received reliable grounds for future investment decisions.

We responded to challenges in continuous reporting in Kemi by combining financial and operational data into indicators that support the city’s goals. We created a visual reporting tool for the city where key figures can be easily examined.

Operational and financial data were combined using the Maisema (“Landscape”) service. The operational data collected in connection with the annual accounts are used to prepare an annual municipal reference analysis to support budgeting for the following year.

Financial and operational data combined using the Maisema service are reported on the visual dashboard platform. In addition, Kemi receives an annual municipal reference analysis that covers all the municipal services and can be supplemented with various targeted reports such as those concerning the staff and the service network.

Before the Central Ostrobothnia Joint Municipal Authority for Social and Health Services Soite began its operations, the financial and operational data in the region were collected into one system. Computation rules for the new organization were created for the municipal invoicing of basic services and to achieve a solution for reporting that would combine operations and the economy.

Reporting was carried out using a Numerus solution. Numerus reported on the data of basic services produced by Soite per municipality and independent of the organization. The data is compiled in Numerus from accounting and other source systems.

In 2017, Numerus was the primary solution for member municipality invoicing of the basic services of Soite. Numerus currently serves as one of the systems that brings together Soite’s financial and operational data. In addition, an annual financial statement analysis is produced for Soite where services are compared to other municipalities.

The project involved the planning and implementation of an incentive bonus model for the Central Uusimaa service voucher trial. The aim of the model was to encourage outpatient service providers to optimise their operations from the perspective of customers and care chains as well as to support investments in preventative care.

The project initiated by calculating the municipal, age group and service need capitations to encourage the treatment and activation of challenging population groups. Following this, an incentive bonus model was created where service quality, efficacy and cost-efficiency were measured according to the so-called triple aim model.

The model was adopted in the freedom of choice trial and proved to steer providers in the right direction. The model also encourages the continuous development of providers and their cooperation with others.

The aim of the project was to make the division of duties between different occupational groups in the city’s health centres more reasonable and thereby make service more efficient and customer-oriented.

The project involved the development and implementation of a so-called acute team for urgent care where six nurses and three doctors work as a team. The model enabled the more effective utilization of the skills of both nurses and doctors and productivity increased by 30–40%.

The model created during the project has been further developed and adopted at other health centres in the city.

Funded by Cancer Foundation Finland, the study examined the development of costs of cancer and treatment outcomes in Finland in 2009–2014.

The costs of cancer included treatment-related costs in specialized healthcare and basic healthcare. The total costs also included the ward treatment by private providers and foundations, screening costs as well as medicine reimbursement, rehabilitation services, rehabilitation and sickness allowances and pensions and travel expenses paid by Kela.

The costs of cancer have increased slower than was predicted in previous studies. The costs have increased the most in the outpatient care of specialized healthcare and in terms of the medicines reimbursed by Kela. The costs have decreased in the ward treatment of specialized healthcare and in terms of disability pensions. Two articles based on the study were published in Acta Oncologica Scandinavica.

The set of indicators consists of ten primary indicators that allow organizations to monitor the development of the effectiveness of services at an organizational, unit and individual level. The continuous service involves twenty organizations from both the public and the private sector. The service already covers about half of the Finnish population.

The set of indicators have been developed together with a broad group of experts and is continuously refined as the recording practices of organizations become more harmonized. Data collection is automated, and the indicators based on longitudinal data are updated four times a year.

The set of indicators helps organizations to assess the effectiveness of development projects and to monitor the achievement of quality and effectiveness goals. In addition, professionals receive important, timely knowledge about their own successes in connection with, for example, development discussions.

NHG supported a notable international private equity investor interested in purchasing a leading service provider in Finland by preparing a commercial due diligence report. This included a comprehensive segment-specific assessment of the Finnish health and social services sector and the impact of the health and social services reform on the industry.

NHG analysed the provider’s turnover and potential profitability by conducting a thorough market survey in the company’s primary market areas in Finland. The survey included a segment-specific analysis of the market size, structure, dynamics, drivers of growth, trends and competitive conditions. Additionally, using this analysis a growth prognosis was modelled. The project also involved the identification of potential risks and opportunities to create added value.

During the project, the impact of the health and social services reform on the industry in Finland was examined in depth. As part of the survey, a regional capitation calculation was produced, based on the operating expenses of health and social services centres in each municipality.

A leading Nordic service provider was planning to divest its health business operations and focus on its core business. A special challenge was posed by the health and social services reform under preparation, which added uncertainty to the growth outlook of the company’s key market. NHG produced a Commercial Vendor Due Diligence report for the client on the market and growth plans of the company’s health business operations.

NHG produced a detailed market survey on the present condition and development outlook of the market for the business to be divested and validated the company’s growth plan. NHG relied on facts to assess the development outlook of the market in a situation where the health and social services reform will be carried out and in a situation where it will not.

As a result of the survey, the client and the investment bank received a detailed report that helped to form a clear, well-founded picture of the company’s market, outlook on the future and growth plan. The report contributed to facilitating the company’s successful sale to a new owner within the timeframe intended.

NHG is the project manager of the programme to address child and family services in South Karelia. The programme (abbreviated LAPE in Finnish) is a key project of the Government, aiming to strengthen the well-being of children, young people and families.

As project manager, NHG is responsible for the steering and systematic progress of the entire project including coordination, the networking of participants, change management and daily support for project personnel in South Karelia.

As a result of the workshop activities carried out under the programme, cross-administrational cooperation within the South Karelia Social and Healthcare District (Eksote) has increased and cooperation networks have grown. In addition, customer inclusion has been strengthened and the methods used when working with children and families have been reformed.