Real patients in a virtual hospital

Finnish university hospitals are building a joint national virtual hospital, which in practical terms means a digital service hub for specialist health care.

The Terveyskylä (“Health Village”) portal, intended for the patients, their families and health care professionals, is part of the Virtual Hospital Project.

At the moment, Terveyskylä has six virtual “houses” focusing on mental health, weight management, pain management, women, rehabilitation and rare diseases, respectively. In addition, the Helsinki Biobank has found a niche in the village. Terveyskylä is growing rapidly. In this month, six new houses will launch, and by the end of 2018, organisers believe there will be more than thirty different houses in place.

Terveyskylä is being built by both experts and patients.

COACHING FOR WEIGHT MANAGEMENT

Professor, Chief Physician Kirsi Pietiläinen helped build the weight management “house” for Terveyskylä. She joined the project because she knew that more services were sorely needed for the treatment of obesity.

 “We saw this as an opportunity to help fix the problem.”   

The first version of the weight management house is now open. It has 120 patients, each of whom has a personal coach. Furthermore, the open services of the house are used by a big group of people.

 “All the basic things are working well. We’re now collecting user experiences and using them to develop the service further,” says Pietiläinen.

Next, the service will launch a digital food journal which will be accessible both on a desktop and on mobile devices, and will give immediate feedback to the patients whenever they update it.

Pietiläinen points out that building online services like this is a major undertaking.

“We can’t just throw something like this together alongside other work. We need skills and resources, and the content creators and IT experts must learn to understand one another.”

PAIN MANAGEMENT TOOLS FOR PATIENTS AND THE STAFF WHO CARE FOR THEM

Professor, Chief Physician Eija Kalso and Docent Katri Hamunen, who is the head of department in charge of pain management at Helsinki University Central Hospital (HUCH), have been active in setting up the pain management house, which launched in September 2016.

“We already had information on treating post-surgery pain on our website, hus.fi, and we were planning to include patient information regarding the treatment of chronic pain. The online service provided a suitable platform for this material,” Hamunen explains.

For her part, Kalso realised that there is regional inequality among pain patients when she participated in a working group set up by the Ministry of Social Affairs and Health, investigating the national arrangements for the treatment of chronic pain and pain relating to cancer.

“In most of the country, it was very difficult to access these services. I thought that an online service could make treatment more effective and make health services more evenly available everywhere in the country.”

The pain management house can offer guided exercise or psychological interventions between doctor visits. The service also increases opportunities for distance consultations.

The HUCH Pain Clinic also wanted to bring drug-free treatment methods to more patients as well as instructions and tools for professionals who treat patients with pain. “Pain is a very common symptom, and it is treated by professionals from many different fields in many different contexts,” Hamunen points out.

In its current iteration, the pain management house offers information and self-care tips for patients. The function to launch next will be a component intended for professionals. In the third stage, the house will include a variety of therapies to which patients can be referred.

“Our goal is a national service with comprehensive information about the treatment of a variety of pain, a selection of treatment paths for patients and tools for professionals working with pain patients,” Hamunen states.

Research is also part of the concept.

“We have integrated a research project to evaluate the impact of the service and to support further development. Based on the information from the research, we will profile different patient groups and develop customised care,” Kalso explains.

HELP FOR RARE DISEASES

In rare diseases, the biggest problem facing patients is delayed diagnosis, says Head of Department, Docent Mikko Seppänen, who has been a part of building the  rare disesases house in Terveyskylä.

“I’ve met patients who have had to wait for a diagnosis for fifty years.”

There are also problems with organising care. The treatment of rare diseases among children is usually good, but once the patient turns 16, he or she is cast adrift.

“Terveyskylä can help bring reliable information to the patients and their families, promote the creation of efficient chains of treatment, guide them towards the available support services and increase opportunities for expert consultations. It could also be a good platform through which patients could find the peer support groups they so often crave and that patient organisations offer,” Seppänen states.

Seppänen hopes the digital services will also alleviate the regional inequality in health care. “At the moment, Finland is one of those EU countries where people move to different areas to get better health services!”
 

DIGITAL LEAP FOR THE PATIENT

The builders of Terveyskylä believe that online solutions and digital services will become more prominent in health care, also on the specialist level.

“At their most simple, the online services could provide information, or offer online bookings and symptom navigators that could guide patients to the right place for treatment. The plan is also to launch treatment services. All specialist fields are talking about these issues,” says Professor Kirsi Pietiläinen.

Digital services require patients to be proactive.

“This means the patients would have to assume more responsibility for their care, but they are also given the tools to do so,” says Docent Katri Hamunen.

But what will happen to the patients with no digital skills, or difficulty committing to care in general?

“It’s true that for example the pain management house is most useful for patients who are active, motivated and capable of self-direction. The service could heighten inequality in that sense,” says Professor Eija Kalso.

“On the other hand, people who are capable of being more responsible for their health will have to increasingly do so, if we want comprehensive health coverage to be available at all.”

Kalso emphasises that the purpose of the digital services is to supplement existing services, not to replace them.

“An online solution can never replace the interaction between doctor and patient, nor is that the intention. Neither is this an attempt to save money.”