Citizens Participating in their Healthcare – Challenges for Nurses

Keywords: digital health, citizens, nursing care, Finland

Abstract

In Finland, health and welfare is taken care under the common health and social services system that consists of independent private, public and third sector actors. Through taxation, municipalities finance most of the healthcare and the government provides additional support. Functionality and effectiveness of the overall system is vitally important to guarantee today’s good healthcare services. For instance, in social services and healthcare, digital health supports the quality of life, care, dignity and sovereignty. The necessary technology is equally, fairly and easily accessible due to the widespread technological infrastructure. For example, in healthcare, use of technology is agreed with the citizen when preparing the healthcare service plan. The documentation of patient data is carried out virtually at all levels of care. Technology offers options that can paradoxically mean both freedom and slavery depending on how and where technology is used, and who has the right to use it. Furthermore, the digital divide has narrowed, but it still exists. Due to the ageing of people, there is a growing need for healthcare staff who are digitally knowledgeable in order to support citizens and their families in health issues. When studying different digital health related strategies from 1995 to 2020, the vital role of healthcare staff is recognised and their technological competence and skills need to be updated along with the development of technology. During the last decade, in the latest strategies, the role of the citizen as a key part of the healthcare service chain has grown significantly.  Simultaneously, the development of a digital society offers possibilities to participate and the advanced digital expertise of citizens promotes their participation in healthcare. In principle, everyone has possibilities to access health data and gather health related data via Internet databases. This article discusses the elements of citizen or patient and nurse interactions, and how and whether this challenges nurses.

References

Reponen J, Kangas M, Hämäläinen P, Keränen N, Haverinen J. Use of information and communications technology in Finnish health care in 2017. Current situation and trends. Terveyden ja hyvinvoinnin laitos (THL). National Institute for Health and Welfare (THL). Report 5/2018. 207. Helsinki 2018. Abstract in English. Available at: https://www.julkari.fi/handle/10024/136278 accessed on 20 September 2020

Ministry of Social Affairs and Health, Finland. (1992). Act on the Status and Rights of Patients No. 785/1992. Available at: https://www.finlex.fi/en/laki/kaannokset/1992/en19920785.pdf accessed on 20 September 2020.

Kanta. (2020). What are the Kanta Services. Available at: https://www.kanta.fi/en/what-are-kanta-services accessed on 28 September 2020

Kanta. (2020). Statistics. Available at: https://www.kanta.fi/en/statistics accessed on 29 September 2020.

Hyppönen H, Pentala-Nikulainen O, Aalto A. Electronic services in the social welfare and health care sector 2017. Citizens' experiences and needs. National Institute for Health and Welfare (THL). Report 3/2018. Helsinki 2018. Available at: https://www.julkari.fi/bitstream/handle/10024/136258/URN_ISBN_978-952-343-103-4.pdf?sequence=1&isAllowed=y accessed on 29 September 2020.

Kanta. (2020). Client data archive for social welfare services. Available at: https://www.kanta.fi/en/web/guest/professionals/client-data-archive-for-social-welfare-services accessed on 29 September 2020.

Luoma K, Rötsä M, Viljamaa S. (2017). Sosiaalihuollon Kantapalveluiden käyttöönotto I-vaiheessa. Toimeenpanosuunnitelma. Finnish Institute for Health and Welfare (THL) [Article in Finnish]. Available at https://thl.fi/documents/920442/2940835/I-vaihe_Toimeenpanosuunnitelma_julkaistu.pdf/. (only in Finnish) accessed on 26.9.2020

Ministry of Social Affairs and Health. (n.d.). Information to support well-being and service renewal. eHealth and eSocial Strategy 2020. Available at: https://julkaisut.valtioneuvosto.fi/bitstream/handle/10024/74459/URN_ISBN_978-952-00-3575-4.pdf?sequence=1&isAllowed=y accessed on 29 September 2020.

Finnish government publication series 22/2018. Societal integration and sustainable wellbeing Futures Review of the Ministry of Social Affairs and Health. Available at: http://urn.fi/URN:ISBN:978-952-287-596-9 accessed on 28 September 2020

Ministry of Education and Culture. (2019). Competences and Skills In 2035. The first results of the National Forum for Skills Anticipation’s anticipation work. Available at: https://www.oph.fi/sites/default/files/documents/osaaminen_2035.pdf accessed on 27 September 2020.

Opetushallitus. (2019). Competence Structure 2035 Sectoral Competence Needs Of The Future And Challenges Of Developing Education And Training – Results Of The National Forum For Skills Anticipation’s Work [Abstract in English]. Available at: https://www.oph.fi/sites/default/files/documents/osaamisrakenne_2035.pdf accessed on 27 September 2020.

Finlex. (n.d.). Patient Injury Act 585/1986 [Article in Finnish]. Available at: https://www.finlex.fi/fi/laki/alkup/1986/19860585 accessed on 28 September 2020

Valvira (2018). Patient ombudsman. Status of National Supervisory Authority for Welfare and Health (Valvira) [Article in Finnish]. Available at: https://www.valvira.fi/terveydenhuolto/potilaan-asema-ja-oikeudet-oikeudet/potilasasiamies accessed on 27 September 2020.

Karppinen K. The way words patient and client/customer are written in the web pages of health care organizations: semantic roles, typical features and comparison. [Master’s thesis]. 2018. Faculty of Medicine, Unit of Nursing Science and Health Management / Health Management Science: University of Oulu;2018.

Vehko T, Hyppönen H, Ryhänen-Tompuri M, Heponiemi T. Miten tietojärjestelmät palvelevat terveydenhuollon ammattilaisten työtä? Vaikutukset työhön ja työhyvinvointiin. Digityö ja stressi –hankkeen loppuraportti. [How do information systems operate for healthcare professionals? Impact on work and well-being at work.]. Report available in Finnish. National Institute for Health and Welfare (THL). Discussion Paper 4/2019. 45 pages. Helsinki, Finland 2019. ISBN 978-952-343-278-9 (printed); Available at https://www.julkari.fi/handle/10024/137659 accessed on 27 September 2020.

Leskinen, S. Developing Internet-Based Health Services within Health Care Organizations. [Master's thesis]. Faculty of Social Sciences Department of Health Policy and Management, Social and Health Informatics: University of Kuopio;2008.

Omaolo. (2020). Online medical COVID-19 symptom check-up. Available at: https://www.omaolo.fi/ accessed on 28 September 2020.

Finnish Institute for Health and Welfare. (2020). Koronavilkku service. Available at: https://koronavilkku.fi/en/ accessed on 29 September 2020.

Finnish Institute for Health and Welfare. (2020). Koronavilkku – Infections notifications. Available at: https://thl.fi/en/web/thlfi-en/-/koronavilkku-reaches-2-million-downloads?redirect=%2Fen%2Fweb%2Fthlfi-en accessed on 27 September 2020

Mäntyranta T (eds).Tulevaisuuden terveydenhuolto 2022. 2010. (Future healthcare 2022). Ministry of Health, Sitra. In Finnish. Available at: https://media.sitra.fi/2017/02/27173645/Tulevaisuuden20terveydenhuolto2022-2.pdf accessed on 28 September 2020.

Kunnari T, Koivula R. eHealth-palvelut perusterveydenhuollon vastaanottotoiminnan tukena –

kirjallisuuskatsaus potilaiden kokemuksista. Hoitotiede 2018;30(4):323–333.

Ministry of Social Affairs and Health National Advisory Board on Health Care Ethics (ETENE). Equity and human dignity in health care in Finland. Reports 2001:1. Available at https://etene.fi/documents/1429646/1571616/Equity+and+Human+Dignity+in+Health+Care+in+Finland.pdf/063a0e28-83e2-4452-889b-93b3709f1ee5/Equity+and+Human+Dignity+in+Health+Care+in+Finland.pdf accessed on 28 September 2020.

Sosiaali- ja terveysalan eettiset periaatteet – ovatko ne valideja tulevaisuudessa? Valtakunnallinen sosiaali- ja terveysalan eettinen neuvottelukunta 2014–2018. ETENE-julkaisuja 46. In Finnish only. Available at https://etene.fi/documents/1429646/12259990/ETENE+julkaisu+46+Eettiset+perusteet%2C+kausijulkaisu/5a137eb6-6e68-8f50-96bb-ac844397343e/ETENE+julkaisu+46+Eettiset+perusteet%2C+kausijulkaisu.pdf accessed on 27 September 2020.

OECD/European Observatory on Health Systems and Policies. State of Health in the EU Finland: Country Health Profile 2019. https://www.oecd-ilibrary.org/docserver/20656739-en.pdf?expires=1602074693&id=id&accname=guest&checksum=B9E2A5355E26EBE74A3B29E9935F94EEaccessed on 26 September 2020

Sairaanhoitajaliiton kannanotto STM:n Sosiaali- ja terveyskeskusohjelmaan hoitotyön merkittävästä osuudesta sosiaali- ja terveyskeskusten tarjoamissa palveluissa [Article in Finnish]. (2020). Available at: https://sairaanhoitajat.fi/wp-content/uploads/2020/02/15.10.2019-Sairaanhoitajaliiton-kannanotto-hoitoty%C3%B6n-osuudesta-terveyskeskusty%C3%B6ss%C3%A4-_Sosiaali-ja-terveyskeskusohjelma.pdf accessed on 28 September 2020

Ahlstedt C. Eriksson Lindvall C, Holmström I, Muntlin- Athlin Å. What makes registered nurses remain in work? An ethnographic study. Int J Nurs Stud 2019;89:32-38. DOI: 10.1016/j.ijnurstu.2018.09.008

Viholainen K. Nurses’ expertise in advanced practice nursing in specialised medical care. [Master´s Thesis]. Faculty of Health Sciences. Department of Nursing Science:University of Eastern Finland;2018.

Mayer MA, Rodríguez Blanco O, Torrejon A. Use of Health Apps by Nurses for Professional Purposes: Web-Based Survey Study. JMIR Mhealth Uhealth 2019;7(11):e15195. DOI: 10.2196/15195

Salakari M. Blog 23.11.2018. Miltä näyttää sairaanhoitajan tulevaisuus? Viisi skenaariota hoitotyöstä. [Article in Finnish]. Tarttumapintoja. Etusivu. Available at: https://blog.skhole.fi/milta-nayttaa-sairaanhoitajan-tulevaisuus-viisi-skenaariota/ accessed on 28 September 2020.

Finnish Nurse association. (2016). Sairaanhoitajien uudet työnkuvat – laatua tulevaisuuden sote-palveluihin [Article in Finnish]. (2016). Available at: https://sairaanhoitajat.fi/wp-content/uploads/2020/01/Laajavastuinen-sairaanhoitaja-muuttaa-sote-palveluita.pdf accessed on 28 September 2020.

Sulkakoski M. Collaboration between nurse prescribers and GPs at the Finnish health center receptions. [Master´s Thesis]. Department of Health Sciences: University of Jyväskylä, Heath Education;2016.

Karisalmi N, Kaipio J, Kujala S. Hoitohenkilökunnan rooli potilaiden motivoinnissa ja ohjaamisessa terveydenhuollon sähköisten palveluiden käyttöön. Fin J eH eW 2018;10:2–3. Abstract in English.

eHealth strategy of the Finnish Nurses Association 2015–2020. Available at: https://sairaanhoitajat.fi/wp-content/uploads/2020/01/eHealth_RAPORTTI-_ENGLANTI.pdf accessed on 29 September 2020.

Vehko T, Ruotsalainen S, Hyppönen H.. E-health and e-welfare of Finland. Check Point 2018. Available at: https://www.julkari.fi/bitstream/handle/10024/138244/RAP2019_7_e-health_and_e-welfare_web_4.pdf accessed on 29 September 2020.

Yle. (2020). Yle is Finland's third highest valued brand and the most valued media brand in 2020. Press release. Available at: https://yle.fi/aihe/artikkeli/2020/08/20/yle-is-finlands-third-highest-valued-brand-and-the-most-valued-media-brand-in accessed on 29 September 2020.

Published
2020-12-28
How to Cite
Kouri, P. (2020). Citizens Participating in their Healthcare – Challenges for Nurses. Journal of the International Society for Telemedicine and EHealth, 8, e17 (1-6). https://doi.org/10.29086/JISfTeH.8.e17
Section
Special Theme: DigiHealthDay-2020 (Keynote Papers)