The Seinäjoki intermunicipal federation for health care launched "The web-nurse service" in February 2003. The idea is quite simple: the customers can ask anything they like concerning their health and a registered nurse will give them an answer within 1-3 days. The purpose of the service is to improve the flexibility of basic health care services and improve the quality of life in the rural and remote populations in Finland. The web-nurse service has grown to be an impressive system and it can be widely used regionally. The service is a forerunner in its field in Finland because the web-nurses have access to the customers’ case history, meaning that the customer can be served on a very personal level.

Policy Context

The Seinäjoki intermunicipal federation for health care is one of the first in Finland to launch this kind of service where the web-nurse can serve customers on such a personal level. This service meets the demands of the European Union concerning the introduction of new technology in health care. The system is designed to take into consideration the National Health Act and also the information security guidelines. The Regional Council of South Ostrobothnia is a statutory federation of municipalities consisting of 26 municipalities. In the Regional Plan for health and social services (2030) the data system issues have been raised as one of the main focuses. Another focus is to enhance and develop the health and wellbeing technology. The Regional Plan 2007-2010 encourages to develop the accessibility of the data network. According to the Regional Plan the standardisation of the software and the services will bring great benefits to the entire region. The services that could be united are f.ex. electronic transactions, social and health care services and co-operation. One goal of the National Project to restructure municipalities and services is to utilize the information technology as a means to enhance the production of the services. The web-nurse system meets these requirements.

Description of target users and groups

The system has been designed to serve all the citizens. Also some special groups like the students and the deaf people can benefit greatly from the service. 26 municipalities and 240,000 inhabitans can now use the service.

Description of the way to implement the initiative

All the web nurses of the 26 municipalities participate in developing the system. Every health care centre that has access to the service has trained a nurse to answer for the service. The customers may contact the health care centre and the health questions may be submitted 24 hours a day. The nurse reviews the question and will answer within 1-3 days. In most cases the questions will be answered on the next business day after receipt. Every reasonable attempt to ensure the confidentiality has been made. The information the customer sends to the nurse is encrypted and restricted. The mailbox is accessible only to the nurse and to the system administrator. The customer fills out an interactive form describing the symptoms and sends it to the nurse after having accepted the terms of use. The nurse may consult a doctor or suggest that the customer makes an appointment with a doctor. She may even refer the customer to other areas of health care, for example to laboratory or x-ray unit, rehabilitative treatment or speech therapy. Unique to this service is that the web-nurse has access to the customers case history electronically.

Technology solution

Technology choice: Mainly (or only) open standards

Main results, benefits and impacts

The web-nurse service makes the health care services more effective. It has grown to be an impressive system and it can be widely utilized regionally. The system has improved the organization and the ways of interaction in the field of health care. One of the main achievements and goals is to ensure the availability of the local services and to support the activity of the citizens. The service is a forerunner in its field in Finland because the web-nurses have access to the customers’ case history. This means that the customer can be served on a very personal level. It is also quite unique that the pharmacists serve customers through the Internet. Seinäjoen Keskus-Apteekki (The central Pharmacist in Seinäjoki) is the first pharmacist in Finland to offer customers advice about the medication on the Internet. These services are totally free for the customers. The web-nurse system is realized in co-operation with several municipalities and it has been developed constantly since its launch. One of the latest services is the weight management service, which is preventive health care. There are other two new services: a site for the deaf people and a national health library. The web-nurse service is an open system and can therefore be easily expanded. Future challenges are going to be for example the development of the online appointment system and introducing the system to the specialised hospital care and to the social services. This is the quicker and easier way for the citizens to find what they are looking for concerning their health.

Return on investment

Return on investment: Not applicable / Not available

Track record of sharing

The Seinäjoki intermunicipal federation for health care launched this service in February 2003. The project was realised by two students. One of the students, Mr. Jari Saari, is working at the moment as a project manager. Together with Mr. Hakala they developed this new eHealth web. From the very beginning the web-nurse service was available for the Seinäjoki intermunicipal federation and its municipalities (Seinäjoki, Nurmo, Peräseinäjoki and Ylistaro), but since October 2003 the service has been available also to the inhabitants of Kurikka, Jalasjärvi and Ilmajoki. Due to an eHealth project with the hospital district of South-Ostrobothnia the web-nurse has expanded to 26 municipalities.

Lessons learnt

Lesson 1- New thinking. One of the most important learning points was the fact that people should change their way of thinking. The use of the Internet in health care is still a very new idea for many people. In the Seinäjoki intermunicipal federation for health care we develop the web-nurse system as a new thinking - new way of serving people. Lesson 2 - Easy to use. The development of this kind of system starts from the customers needs. The system must be easy to use and the information security must be taken into consideration. When creating the web-nurse service, the following things were taken into consideration: Information security, the system can be used 24 hours a day, the system is easy to use, customers can ask anything they like about their health, the web-nurse is an experienced nurse, the web-nurse has the patients case history in use and the special groups should be taken into consideration (the system is ideal for example for deaf people because there is no need for an interpreter service). Lesson 3 - Important tool. One learning point is that in these years the system has become an important tool to serve citizens.

Scope: Regional (sub-national)