The following report on the reference trip to Denmark was written by our project manager Michael Mut.
Day 1: The Danish healthcare reform & patient flow systems
The program of our trip started in Copenhagen with a presentation by a representative from Healthcare Denmark, the public-private representative of the Danish healthcare system.
She pointed out that both, the Danish and the German healthcare system, face similar challenges, for example regarding an aging population, an increasing number of multimorbid people and a shortage of medical staff, especially in rural areas. Because of these difficult challenges, Denmark decided a reorganization of the healthcare system in 2007.
The Danish “superhospital program” reduced e.g., the number of public hospitals to 21 across the whole country. The overarching goal of the change and modernization initiative was to ensure universal access to efficient and modern healthcare services. This goal should be achieved through decentralization, more outpatient care and a progressive specialization. The results confirm the success: the number of beds supplied has been drastically reduced, the average length of stay has fallen and the number of outpatient treatments has increased significantly. All these actions are implemented in a strong cooperation and coordination structure between the government, the regions and the municipalities.
The reform also called for an increase in the efficiency of clinical processes. Through the connection of medical technology applications and the use of information and communication technologies, the hospitals should explore possibilities for standardization, harmonization and optimization of their working processes.
The patient flow systems were a crucial instrument in this context. These systems are enabling the control of patient pathways, the connection of involved staff and the creation of continuous process transparency. Patient flow systems operate in all Danish hospitals. The use of the software led to a measurable increase in productivity and capacity utilization.
According to the Danish government's plans, the ongoing restructuring process will continue. In addition to the super hospitals, nearby-care centers will be established. These centers should relieve central structures by providing services for less complex emergencies or minor surgical interventions.
We continue our trip with many exciting impressions, further to Aarhus. There, the implementation of these projects in the clinical reality of the university hospital will be presented to us.
Day 2: The digital “superhospital” in Aarhus
At the beginning of our visit to the Aarhus University Hospital (AUH), we got basic information about the hospital: 854 beds, 81 operating rooms and over 10,000 employees spread over 41 clinical departments. In 2008, the patient flow system was introduced in the first departments, which is now running in all areas of the hospital on over 600 monitors and via an app on the employees' mobile devices.
The added value is apparent in the improved exchange of information between employees. Simply by providing adequate information, numerous phone calls are eliminated, which provides more time for other activities related to patient care. Furthermore, the coordination between the departments leads to improved decision-making in resource planning. At a higher level, clinical key figures can provide an overview of the current status of work processes at any time.
Information about the staff (staffing, contact details, responsibilities), the patients (health information, vital data) and the planning (beds, surgical plans and capacities) are shown on several monitors at critical locations throughout the whole clinic. In addition, every employee can track patient-related activities in diagnosis and treatment and, if necessary, contact other clinical staff directly. The overviews are managed and updated by trained coordinators who exchange ideas daily and serve as important contacts for the central departments.
During the exchange, it also became clear that the installation is exceeding clinical borders. The system provides important information about capacities in the region for all important care fields, such as emergency or intensive care. Therefore, the regional hospitals are able to exchange data about capacities, which became enormously important, especially during the pandemic.
In summary, it was exciting to experience how the software has been established as a central control element of clinical processes as well as an essential instrument for many employees in their daily work.
Day 3: Planning, organization and data use
In addition to the patient flow systems, there are numerous established digital use cases in Denmark that have been struggling to achieve market penetration in Germany for years. Today we discussed solutions for sterile goods management and operation planning. Above all, the sterile goods cycle has so far been an area that has received insufficient attention in Germany and is nevertheless very cost intensive. However, many hospitals continue to rely on outdated manual routines to manage their trays and instruments. The results are lost or misplaced inventory, too many unused instruments and incomplete infection control information.
Therefore, a more efficient alignment of the existing processes became the focus of Danish hospitals a long time ago due to the prevailing challenges and the obvious potential. Supporting software solutions play an important role to improve coordination between the OR, the functional areas and sterilization. Due to the large number of organizational interfaces, there are also many potential points of friction in surgical planning, which can result in delays or other deviations. Software- or AI-based planning can ensure more precise planning. Various parameters such as age, weight, previous illnesses or the time of operation are taken into account. The results include higher resource utilization and less overtime for staff.
Due to the advanced digital transformation in recent years, Denmark also has one of the most extensive structured records of population health data. In perspective, these could be the basis for exciting AI-based approaches, which represents a possible next development step for the Danish healthcare system
For us, the reference trip allowed a valuable exchange with various stakeholders of the Danish healthcare system, from which insights can be drawn for the progressive digitization of our member houses. At the same time, we got the opportunity to see how digital transformation can work in practice in many clinical areas. At the end of this report, we would like to thank our member delegation for their active commitment. Also a special thanks to our hosts in Denmark for the hospitality and professionalism, which they showed towards us.