DISCUSSION PAPER ON
THE COMMON PUBLIC SECTOR
STRATEGY FOR DIGITAL WELFARE
THE DANISH GOVERNMENT
LOCAL GOVERNMENT DENMARK
DANISH REGIONS
March 2013
DIGITAL WELFARE
NEW OPPORTUNITIES FOR
THE WELFARE SOCIETY
FOREWORD3
DANES ARE DIGITAL – AND READY FOR DIGITAL WELFARE 4
CAN WE PROVIDE WELFARE FULLY DIGITALLY? 8
HOW DO WE ENSURE AN APPOPRIATE
PACE OF DEVELOPMENT? 9
WILL MORE DATA SHARING LEAD
TO A BIG BROTHER SOCIETY?
10
CAN WE EXPECT THE PUBLIC SECTOR
TO USE OUR OWN TECHNOLOGY?
11
DIGITAL SOLUTIONS FOR COST-EFFECTIVE HEALTH
12
DIGITAL SOLUTIONS TO ENHANCE SOCIAL INTERVENTIONS 14
DIGITAL SOLUTIONS AS A TOOL FOR BETTER
AND MORE EFFICIENT LEARNING AND TEACHING
16
WHERE SHOULD WE STEP IN? – FOUR FOCUS AREAS 18
BACKGROUND FOR THE STRATEGY
MODERN AND EFFICIENT WELFARE
21
DIGITAL WELFARE SERVICES
IN AN INTERNATIONAL PERSPECTIVE
22
FOREWORD
Denmark has come a long way in digitising its public admini­
stration and the communication between individuals and
the authorities. Also, we have gained useful, if somewhat
disjointed, experience with welfare technology. When digital
and technological solutions are introduced with care, they can
help modernise public services and make them more efficient.
Such efficiency improvements are vital. There will be
signi­ficant constraints on public spending for many years
to come. If we are to maintain the current level of service
and welfare, we must challenge and rethink the way we
work in the public sector. In future, we must be able to supply
more service for the same amount of money, or the same
service for less money.
Therefore, we must consider how we can go a step further
and modernise services themselves; how in the future,
we can perform tasks in the large welfare areas more flexibly,
cost effectively and smarter. Digital solutions may be a tool.
PUBLIC SECTOR STRATEGY
FOR DIGITAL WELFARE
We need a clearer and more binding course for digitising public
welfare. In 2013, the government, municipalities and regions
will therefore prepare a strategy for digital welfare covering
health, social services and education.
The strategy will help determine the direction for the public
sector’s work to digitise public welfare for the years to come.
The aim is to retain high-quality public services. This means
that we must be prepared to spread the solutions optimising
socio-economic and qualitative effects so that we can afford
good welfare in all areas: child day care facilities, schools,
further education, hospitals, care of the elderly etc.
Increasing public demand for technological solutions may
also promote innovation and the spread of new products and
services. This will create new jobs and growth in Denmark.
Digital solutions and welfare technology must provide all of
us – be it as individuals, students, patients, patients’ families,
volunteers, etc. – with better opportunities to contribute
to welfare and take an active part in society.
Better exploitation of digital solutions and new technology
will also establish more cohesion in public services. The
authorities must exploit digital solutions to cooperate, share
knowledge, avoid narrow thinking and to improve efficiency.
It is crucial that we focus especially on the opportunities
created by digital solutions and new technology to reduce
resource consumption.
ABOUT THE DISCUSSION PAPER
With this publication, we would like to spur debate on how
we can use digital solutions to secure our welfare society
for the future. This debate will provide the impetus for
the design of the upcoming strategy for digital welfare.
Therefore, we will address a number of difficult issues arising
when moving towards more digital public welfare provision.
We look at some of the opportunities and challenges
associated with the introduction of digital solutions in the
health, social and education areas. We also examine where the
public sector should focus its efforts; this has been narrowed
into four focus areas. The last part of the publication details
the background for the strategy.
The Danish Government, Local Government Denmark
and Danish Regions
DIGITAL WELFARE NEW OPPORTUNITIES FOR THE WELFARE SOCIETY
3
DANES ARE DIGITAL
– AND READY FOR DIGITAL WELFARE
For many of us, the young as well as
the aging, digital technologies have been an
integrated part of our lives for a long time.
day lives are also increasing expectations
that welfare services will also continuously
adapt to the new opportunities.
We buy goods online, follow the news, and
check our payslips in our digital mail-boxes.
Since its launch in 2010, Danes have used
NemID* more than a billion times to log
into public services and netbanks. A total
of 90% of all Danes between the ages of
16 and 89 have Internet connection at home,
and we communicate with our friends and
families using texts, e-mail and social media.
More than half of us go online using our
smartphones, whether we are at home
or on the move.
For example, we expect a cohesive health
care system which continues to offer
new and better possibilities for treatment.
We expect that people with disabilities
have access to technology to assist them
in their everyday lives. We also expect that
digital teaching aids become a natural part
of education and training, so that pupils and
students are equipped for the digital society.
MODERNISATION THROUGH
DIGITAL SOLUTIONS
The high level of ICT readiness in the Danish
population is an advantage when modernising the public sector. It means that in many
ways the population is ready for digital
welfare. The many benefits of the technological development we experience in our every-
These expectations need to be managed at a
time when public finances are under pressure
and the need for public services is growing,
in part because of an ageing population.
We will start where there is the most to gain.
The strategy for digital welfare focuses on
modernising the public sector and making
it more efficient within and across particularly the large welfare areas: health, social
services and education.
* NemID is a digital signature that will accelerate the Danish vision of one login for public and private services on the Internet.
4 DIGITAL WELFARE NEW OPPORTUNITIES FOR THE WELFARE SOCIETY
A great many people are daily in contact
with one or more of these large welfare
areas. Together these three areas account for
almost two-thirds of total public expenditure.
Although there are many challenges, there
is a great potential for digital solutions
to secure quality and more cost-effective
services. Joint efforts and coordination
also create good possibilities to learn from
each other and to reuse knowledge and
methodologies.
At the same time, public demand for new,
efficient welfare solutions could contribute to
creating growth and new jobs. For example,
businesses can exploit and use experience
from the domestic market, when the public
sector works more systematically with
technologies and it is better at documenting
the effects of the solutions. This is crucial
to enable the business community to develop
competitive solutions.
Public spending by sector, 2011
DKK bn. Percentage
(2013 prices)
of total
Health
142
27
Education
125
24
Social services
126
24
Administration,
police, defence, etc. 133
25
Source: Statistics Denmark
and Danish Ministry of Finance, 2011
THE OBJECTIVES OF THE STRATEGY
More extensive use of digital solutions
in welfare areas will in future enable the
public sector to supply services in different
and more efficient ways.
We have to focus on developing and
dissemintating solutions which increase
productivity in public services, reduce
resource consumption, maintain and improve
quality, and which provide individuals with
greater flexibility and better opportunities
to play an active part in welfare provision.
Against this backdrop, the Danish Government, Local Government Denmark and
Danish Regions have agreed on two central
objectives for work on the strategy for
digital welfare:
1. MORE EFFICIENT AND
COHESIVE WELFARE
The authorities should exploit digital
solutions in order to increase efficiency,
cooperation, and knowledge sharing, and
in order to avoid narrow thinking. Better use
of digital solutions and new technology must
engender more cohesion in public services.
2. THE PUBLIC AS MORE
ACTIVE PARTNERS
Digital solutions and welfare technology
should provide the individual citizen with
better opportunities to contribute to welfare
and to play an active part in everyday life
and in society.
MORE EFFICIENT AND
COHESIVE WELFARE
A more coherent public sector both within
and across sectors, creates more security and
welfare for the public and ensures that tasks
are carried out more efficiently. For example,
this involves public institutions learning from
each other and sharing important knowledge
they already have across departments,
specialist areas and sectors.
DANES ARE READY TO CONTRIBUTE ACTIVELY TO WELFARE
To what extent do you agree or disagree with the following statement?
”At a time with tight public budgets and an aging population, all
individuals who are capable should in future use welfare technologies
to perform practical tasks themselves in their homes. This could
be in relation to personal hygiene, contact with local authorities,
rehabilitation, e-monitoring of own health etc.”
As individuals, we often prefer to avoid
having to supply personal details to one
authority which we have already supplied
for another authority. We want to avoid
red-tape and errors when we are in contact
with several public authorities and specialists
for the same case.
Strongly agree
18%
Agree
36%
Neither agree nor disagree
17%
Disagree
13%
Strongly disagree
6%
Don’t know
6%
0%
10%
20%
30%
40%
50%
Source: The Agency of Digitisation on the basis of a study carried out by Statistics Denmark (2012)
DIGITAL WELFARE NEW OPPORTUNITIES FOR THE WELFARE SOCIETY
5
POPULATION FORECAST
2012-2040
The graph shows the population trend,
indexed up to 2040 (2012 = index 100).
The graph shows that the younger
population and the working-age popu­
lation will stay at around the same level
from 2012 to 2040. The aged population,
on the other hand, will increase steeply
by as much as 84 percent.
200
150
100
50
2012
0-19 år
2020
2030
20-69 year
Source: Statistics Denmark 2012
6 As a society, we must focus our resources
where public-sector tasks can be carried
out more efficiently and where the individual
can simultaneously be given more flexibility
and empowered.
More digitisation, reorganisation of work
flows, and automation of processes will make
for a more efficient public sector with fewer
possibilities for error and fewer manual tasks.
These can also improve quality and in many
cases provide public employees with better
working conditions and more interesting
tasks – all this for fewer resources.
INDEX 2012
0
We also want to avoid the uncertainty
arising, if as patients we have to take
responsibility for passing on important
knowledge between our GP, the hospital
and a municipal homecare nurse.
2040
70+
THE PUBLIC AS MORE
ACTIVE PARTNERS
We have to use the new technologies and
digital solutions where they help us utilise
society’s resources more efficiently.
DIGITAL WELFARE NEW OPPORTUNITIES FOR THE WELFARE SOCIETY
Digitising welfare can also support equalbasis cooperation between citizens, their
families and the public authorities. This will
help people feel more secure and improve
their competences. In fact, many people
ask whether they can do more themselves.
The new solutions have many advantages
for the public, but they may also mean that
the individual’s tasks and responsibilities
increase. They may also mean that families
and volunteers will be more involved and that
their responsibilities thus increase. On the
other hand, new solutions may also improve
individuals’ quality of life, security and safety.
Quality of life comes from being able to
decide for yourself how your life is organised,
e.g. when people with disabilities can take
care of their own personal hygiene, given
the right technological aids.
Security comes from parents being able
to use digital solutions to take part more
actively in their children’s schooling and
create cohesion between school activities
and life at home.
Similarly, safety comes from chronic patients
being able to routinely monitor their own
blood pressure, weight, oxygen levels, etc.
from home. When we as individuals are
responsible for taking our own readings and
registering health data, we become a sort of
‘experts on our own lives’. People can also
be motivated to change their lifestyle, if they
quickly and specifically can see that it works.
EXPLOITING THE OPPORTUNITIES
The public sector has long been focussing
on more cohesion to benefit individuals
and public finances. With the technological
opportunities available, the various sectors
can increase knowledge sharing and work
across traditional boundaries. The strategy
for digital welfare must ensure that we seize
these opportunities.
Everyone will have to contribute to the
reorganisation of society. But we will all
get something in return: we will be able to
maintain our welfare, and we can spur new
business opportunities and a more efficient
and effective public sector, both for ourselves
and for generations to come.
THE DIFFICULT QUESTIONS
– HOW FAR CAN WE GO?
MAKING WELFARE DIGITAL
Digital welfare evokes different images.
For example, a society in which human care is
replaced by machines, in which everyone must
work ever harder, and in which combination
of register information leads to surveillance
of individuals by the authorities. Some of these
images are myths, while there may be some
truth in others.
The following pages raise a number of difficult
questions and issues which the future strategy
for digital welfare will have to address.
DIGITAL WELFARE NEW OPPORTUNITIES FOR THE WELFARE SOCIETY
7
THE DIFFICULT QUESTIONS – HOW FAR CAN WE GO?
CAN WE PROVIDE WELFARE
FULLY DIGITALLY?
The digital transition is already well on the
way at schools, nursing homes, hospitals,
daycare facilities and many other places.
The change is necessary, and we must help
it along.
Where is the limit for digital welfare?
Should all welfare services be supplied using
technology where possible? And should
we all be able to choose exactly how we
will have our public services supplied?
NEW WAYS FOR WELFARE
Today, much of the public sector’s welfare
service is based on personal attendance
and face-to-face contact. Far from all
public services can be supplied using digital
solutions. However, the way in which
public services are supplied today will not
necessarily be the same as what we can
expect tomorrow.
Sometimes we can get the best of both
the digital and the non-digital worlds.
However, supplying the same welfare service
digitally and non-digitally at the same time
is expensive.
8 In the years to come we must be able
to receive digital mail from the public
author­ities and service ourselves on
municipal websites. Similarly, we will
probably have to get used to receiving
an increasing amount of welfare services
digitally and in several areas this will replace
the more common public services. This is
especially relevant for the areas in which the
high quality of service can remain the same,
while the tasks are carried out for less money.
Sometimes services from the public sector
are actually better if they are provided
digitally. For example, teaching by video
and digital collaboration with the teacher
and other students enable us to study at
institutions far from where we live. We can
also organise our studies so that they fit in
with our work and family life. This gives us
greater possibilities to utilise the teachers’
time more effectively.
Similarly, rehabilitation and training can
take place in our living room in front of
the TV or computer with online guidance
by a physio­therapist. We can supplement
with training programmes when they fit in
with our daily routines. This leads to better
rehabilitation.
DIGITAL WELFARE NEW OPPORTUNITIES FOR THE WELFARE SOCIETY
THE OPINION OF DANES ON SPECIFIC TECHNOLOGICAL SOLUTIONS
Are you positive towards using the following welfare technology solutions
if you had the need and opportunity? (The figure shows the percentage of
Danes who responded either ’Yes, to a high extent’ or ’Yes, to some extent’).
eHealth solutions allowing
e.g. the chronically ill to
live in their own home
77%
Contact with local government
via videoconference instead
of a physical meeting at home
57%
Exercising and rehabilitation via a
TV or pc monitor as partial replacement
of municipal rehabilitation
52%
Sensors installed at home that
register if you fall and are
unable to get up again
92%
Toilet with automatic wash and dry facility
66%
0%
20%
40%
60%
80%
100%
Source: Agency of Digitisation on the basis of study from Statistics Denmark 2012
However, the digital solutions currently being
tested are not always suitable for everyone,
and they are not always cost-effective. We
must always be ready to choose other routes.
Help must be available for those who lack the
skills to use digital or technological solutions.
Some people will perceive it as a drop in
the level of service. However, a great many
will stress that the technologies offer new
opportunities and provide us the freedom
to organise our own lives.
Society is changing and we as citizens have
to be ready for this; including in our dealings
with the public sector. This will be easier for
some than for others, but conversion of the
welfare services may be necessary. Perhaps,
we will just have to accept that in many areas
digital welfare will be the first choice for
the public sector?
THE DIFFICULT QUESTIONS – HOW FAR CAN WE GO?
HOW DO WE ENSURE AN
APPOPRIATE PACE OF DEVELOPMENT?
This is not least relevant for joint or crosscutting services with many participants from
throughout the public sector. The individual
authority does not always have the incentive
or capacity to invest in new digital solutions
or to reorganise work flows so as to generate
synergy and benefits for society as a whole.
areas. For example, a target could be that,
in a number of years, a specific group of
patients monitor their heart conditions from
home. Or a target that within a set number
of years a specific percentage of tests and
papers in secondary and higher education
programmes will be handed in digitally.
Not many of the new digital solutions have
been tested at large-scale level. They have
not all been evaluated in ways to ensure an
easy decision to introduce them more widely.
It is important to challenge the status-quo by
testing innovative solutions, and to be better
at disseminating solutions and integrating
them into everyday operations once we
have the right experience. However, it is also
important to make informed and responsible
decisions when modernising the way in which
we supply welfare.
Common targets will provide businesses
with clear indications of the solutions and
technologies in demand in the years to come.
This will help them set the framework for
their investments in innovation and development. Is this the way forward?
We just do not know enough about the
effects of the new solutions on quality and
finances to make quick decisions about using
them. This applies to both local decisions
and decisions to be made jointly: by the
municipality and the region or across levels.
Therefore, we must find the right balance
between not taking unnecessary risks and
at the same time spurring a development in
which we employ the new digital solutions
we know work in order to maintain our
welfare.
Front runners in municipalities and regions
already have significant experience in digital
welfare. They are showing the way for others.
At the same time, the good results have
raised expectations that there are a number
of technologies ready to be disseminated
nationally. There is also a perception that, as
a society, we are missing out on both quality
and resource benefits by not implementing
the technologies more widely in Denmark.
So why don’t we just do it?
THE NECESSARY EXPERIENCE
COMMON TARGETS?
The authorities who are to invest in and
introduce new solutions will not necessarily
be those who later reap the financial rewards.
One way to accelerate the spread of smart,
efficient solutions is to set specific and
common targets for digitising the welfare
In some areas there is agreement across the
public-sector that this is the right direction
for development. This applies where there
is a high level of knowledge and where the
technologies and organisations are ready
for the public authorities to establish their
common targets.
But what about the areas for which we are
not yet clear about the consequences of the
new solutions – for individuals, for the quality
of services, or for public budgets? How can
we be sure that we have set the right targets
and made responsible decisions?
In the future, it may be commonplace
to monitor a heart rate automatically
using wireless sensors attached to the
body. These can measure irregularities
in the heartbeat and health personnel
can be warned if the patient is at risk
of a heart attack.
DIGITAL WELFARE NEW OPPORTUNITIES FOR THE WELFARE SOCIETY
9
THE DIFFICULT QUESTIONS – HOW FAR CAN WE GO?
WILL MORE DATA SHARING LEAD
TO A BIG BROTHER SOCIETY?
Sharing certain information and register data
about citizens is in some areas necessary
so that the public authorities can carry out
vital tasks. Sharing some of the information
on individuals which authorities already have
can create greater cohesion across parts of
the public sector. This can be of great benefit.
For example, the doctor’s access to up-todate information about our current medication and treatment can be crucial if we are
admitted to hospital in an emergency.
In cases involving ‘nomad families’, prompt
intervention has become easier because
the social services administration in a municipality can more readily access knowledge
from the previous municipality. In education,
information on grades, enrolment in the
10th grade, subject choices, etc., can be used
in the guidance of an individual pupil.
Sharing information also makes for a more
cost-effective public sector. The authorities
can save costs by avoiding double registration of information in different ICT systems.
However, it can also mean that the public
sector has knowledge about people which
some may perceive as disempowering and
an intrusion on privacy. For example, is it
acceptable for a municipal social worker to
have access to a pupil’s school attendance
records or information from a hospital? How
should this be weighed against the possibility
that sharing this information could allow
the social worker to initiate more accurate
preventive measures for a marginalised child?
More extensive use of our personal data
in an anonymised form could also improve
public services and make them more
efficient. For example, access to registers
with anonymised personal data could
improve courses of medical treatment and
preventive initiatives because the experience
obtained from the treatment of an individual
can also benefit other patients.
TELEMEDICAL ASSESSMENT OF ULCERS
Using digital technologies, the authorities
can share relevant patient data across
sectors.
A medical specialist can then assess
the information at the hospital and write
back to the homecare nurse.
Using mobile phones with a camera,
common online patient records and closer
coordination with specialists at the hospital, municipal homecare nurses can better
treat citizens for very complicated foot
and leg ulcers.
Thus, the two sectors are sharing
information which is collected at both
the hospital and at the patient’s home.
The homecare nurse can thereby draw
on expertise from the hospital, leading to
better treatment and an ulcer which heals
more rapidly. Moreover, the patient does
not have to make a trip to the hospital.
In a secure ICT system, the homecare
nurse can send photos and information
about the extent of the ulcer, infection
etc. directly from the patient’s home.
All in all: better quality for fewer
resources.
WHERE DOES IT STOP?
Future work on sharing data must be
carefully balanced so that the new digital
opportunities are targeted to provide better
treatment, better prevention, enhanced
social efforts and higher quality education.
At the same time we must keep within
the limits of what we as a society find
to be ethically right.
10 DIGITAL WELFARE NEW OPPORTUNITIES FOR THE WELFARE SOCIETY
What information should the authorities
be able to collect and share across organisational boundaries – and for what purposes?
as individuals have adequate insight and
access to our own information and how
it is used?
Do we as a society run security risks, if
we introduce more technological cohesion
and more common solutions? And do we
Where is the border between consideration
of the individual and consideration of the
common good?
THE DIFFICULT QUESTIONS – HOW FAR CAN WE GO?
CAN WE EXPECT THE PUBLIC SECTOR
TO USE OUR OWN TECHNOLOGY?
In the future, welfare services will more
often be supplied at home or on the move,
and we will often be able to do part of the
job ourselves using intelligent tools and
technologies.
Today, people receiving practical help at
home make available their own vacuum
cleaners, washing machines etc. to municipal
homecare. These appliances are now so
commonplace that we hardly consider them
'technology'. Digital technologies such as
wireless Internet access, tablet computers,
smart phones, laptop computers with
cameras and loudspeakers etc. are increasingly becoming consumer goods which many
can afford and already have in their homes.
Technological development is rapid. It is
expensive for the public sector to procure
and install updated technology for citizens,
and specially developed solutions will always
be more expensive. At the same time, it
increases safety when a public service is
supplied in part by standard technology
which people already know well.
When more of us acquire the new techno­
logies, the market will also be steered in the
direction of greater supply. Also, the Danish
business community can be strengthened
if the public authorities increasingly base
solutions on standardised 'off-the-shelf'
technologies rather than specially developed
solutions. This enables the launch of new
welfare solutions which suit the technology
and equipment already present in Danish
and foreign homes.
TECHNOLOGY IN THE HOME
Yet can the public sector reasonably ask
people to acquire the necessary technological
equipment, e.g. an Internet connection with
a certain speed, a computer with a camera,
etc., as a condition for supplying a specific
service? This could e.g. be a requirement
for individuals with some types of chronic
diseases so that they can measure and
register online certain health data instead
of having to spend time and energy getting
to a hospital for routine check-ups.
help, e.g. an automated toilet with wash-dry
functions?
In some areas where very specialised
equipment is needed, the public sector will
continue to have an obligation to provide
support. This may be specific health
equipment or specially developed aids
for the disabled.
However, as technologies become increasingly widespread as ordinary consumer
goods, would it not be reasonable that
the public sector more extensively adapts its
service and bases it on citizens’ technology
rather than specially developed solutions?
This would be one way to ensure that we can
also afford to maintain welfare in the future.
COMMON RESPONSIBILITY FOR
TECHNOLOGICAL SOLUTIONS IN
EDUCATION
Many pupils in primary and secondary
schools bring and use their own tablet
or laptop computer in the classroom.
Primary and secondary schools supply a
com­puter for pupils who do not have their
own, and make available wireless internet
connection with adequate capacity.
Producers of digital teaching aids make
solutions which can be used with all
the common devices.
The government co-finances procurement
of digital teaching aids.
Common responsibility creates cohesion
between schools, the home and the
market.
Also, can the public sector reasonably expect
individuals to procure a solution which will
make them more independent of external
DIGITAL WELFARE NEW OPPORTUNITIES FOR THE WELFARE SOCIETY
11
DIGITAL SOLUTIONS FOR
COST-EFFECTIVE HEALTH
Danish health services are undergoing
change. Demand for health services is
increasing and patient treatment is becoming
ever more advanced. The elderly population
is increasing, and ever more of us suffer from
one or more chronic diseases. Also, we live
longer with our diseases. This is a challenge
for health services and public finances. At the
same time, we expect high-quality medical
treatment, timely coordination between
those involved in the treatment, and we
expect to be involved in our own treatment.
Fewer and more specialised hospitals in
combination with new treatment options
provide part of the answer. Concerted efforts
are needed if we wish to create coherent
digital health services.
The emergency care unit at Horsens Hospital receives around
12,000 injured or severely ill patients every year.
An ICT system with interactive monitors provides physicians and nurses
with an overview of the patient’s course of treatment, from when
the patient arrives until he or she is discharged or sent on to other
departments. The overview ensures that all relevant tests (e.g. blood
pressure, pulse, etc.) have been performed and documented in the
patient record. The system also provides an overview of the department’s
occupancy and can track the employees who are assigned to the patient.
This reduces coordination and frees up staff time.
The system is also being introduced in many other places in Denmark.
12 DIGITAL WELFARE NEW OPPORTUNITIES FOR THE WELFARE SOCIETY
Individuals, general practitioners, and staff
at hospitals and in municipal homecare
all have to be better at exploiting existing
and new digital tools.
In this way we can achieve better and less
costly treatment, and we can ease the everyday work of healthcare staff. The Government, in turn, is responsible for making
the required ICT infrastructure available.
GREATER RESPONSIBILITY
FOR OWN HEALTH
Digital tools give us new opportunities to
become more involved in our own treatment
and prevention. This is of special significance
for less advantaged individuals and patient
groups whose lives are affected by poor
health and worry.
For example, people with a chronic disease or
long-term illness will have greater possibility
for an active life if their treatment is less
dependent on scheduled check-ups with
the health services. Using measuring devices,
individuals can themselves keep track of
e.g. their pulse, blood sugar and heart
rhythm. Such measurements can provide
better insight into their health status.
Compared with less frequent consultations
and check-ups with physicians, these
measurements can help quickly reveal when
something is wrong. Also, health professionals will have better opportunity to strengthen
the individual’s actual resources. In this
way, we can help prevent hospital admission
and care-demanding diseases or complications which cost society significant sums.
The result is also better quality of life, safety
and empowerment. However, it also requires
that we take greater responsibility for our
own treatment and life.
NON-UNIFORM COMMUNICATION
CHANNELS
Regardless of where we live and how
mobile we are, we can receive treatment
and monitoring via modern technology,
e.g. video conference.
For example, the psychiatry sector in the
Central Denmark Region has tested an online
treatment solution for people with anxiety
and phobia. Most of the conversational therapy at the hospital is being replaced by an ICT
treatment programme which the individual
completes via the computer at home.
The individual can still contact his or her
therapist over the telephone or by e-mail.
Meanwhile, the therapist can monitor the
individual’s progress and treat more people
than before. In this way, health service
resources are used more efficiently – and
so far, results show that the individuals in
question feel more empowered and have
more structure in their everyday life.
COHERENT AND EFFICIENT TREATMENT
WITH BETTER USE OF IT
We must improve collaboration between
various players in the health services in order
to improve the quality and efficiency of treatment for the individual. This requires better
digital support and exchange of health data,
When we are discharged from hospital,
the home municipality may need health
data to initiate or adjust possible homecare
initiatives. Our general practitioner may also
need data about diagnosis and treatment,
etc. Today, this exchange is possible through
digital messages with prescriptions, letters
of discharge, referrals etc.
as treatment and care often cross sector
boundaries and involve several players.
The necessary information is not always
available to healthcare staff at the right time
and place to support a coordinated and quick
course of treatment. However, it should not
be the individual’s responsibility to ensure
that important health data is passed on in
the health service. Therefore, a number of
digital solutions exist today to ensure access
to relevant health data across hospitals,
home care, and general practitioners. Nonetheless, there is still room for improvement.
Digital data on individuals is typically
recorded in a way which makes it difficult
for other players in the health sector to reuse.
Furthermore, the information is often only
used to a limited extent in the treatment
and care of the patient. We must do better
in this respect, so that collaboration about
the individual is strengthened, and so that
we ensure more coherent and efficient
courses of treatment. It is also important
that individuals have access to their own
health data.
It may be a challenge for some organisations,
and for collaboration efforts in general,
to take on new technology. Technology
changes the division of responsibilities
Some municipalities can receive the relevant
patient data from the hospital electronically,
others only by letter or fax. Also not all
hospital departments use these messages.
for the treatment of patients, e.g. between
general practitioners, homecare staff and
hospitals. This requires explicit agreements
about who does what, how and when, in the
course of a treatment. The strategy for digital welfare must help find solutions to this.
INCREASED COORDINATION AND SPEED
Danish regions, municipalities and other
players are at various stages in their
digitisation work. We lack an overview
of the progress across municipal, regional
and central-government levels. This makes
it difficult to identify where to take action
to strengthen efforts.
Also, digitisation efforts so far have
shown that creating sufficient speed
in developments is difficult. An important
precondition for further work to digitise
health care is that targets already agreed
on are met.
The Region of Southern Denmark has therefore introduced the Sam:Bo collaboration
to ensure use of electronic communication
between the relevant parties.
It involves clear agreements on and descrip­
tions of procedures, deadlines and formats
for messages sent between hospitals,
GPs and municipalities in connection with
a patient’s course of treatment. This means
that patient data is sent digitally in a quick,
safe and efficient way to the party taking
over responsibility for the further treatment
of the patient.
For example, work to get general practi­
tioners to use the electronic medicine card
to a greater extent needs to be stepped up.
(The electronic medicine card is a national
service based on a central database of
information about the medicine being
administered to an individual citizen.)
This means that obvious benefits for patient
safety as well as easier and faster exchange
of information on medication have not yet
been achieved.
As use of digital health services increases,
we need closer and more binding coordination between all parties involved. Firstly,
because a united approach is often a
pre­condition for full use of techno­logy’s
potential. And secondly, because uniform
and efficient treatment for all Danes requires
that we can disseminate good, well proven
solutions quicker and on a larger scale.
DIGITAL WELFARE NEW OPPORTUNITIES FOR THE WELFARE SOCIETY
13
DIGITAL SOLUTIONS TO
ENHANCE SOCIAL INTERVENTIONS
Social services is a large and complex area
covering welfare for the elderly, the disabled
as well as for vulnerable children, young
people and adults.
Many individuals receive several types of
social services at the same time and will
therefore be in contact with several specialists as well as different public authorities
and institutions for the same case.
Moreover, the tasks of the social authorities
are often closely related to health care,
education and employment. Therefore,
it may be difficult for public authorities as
well as for individuals to get an overview
of, and to ensure coherence between, the
measures initiated by the public sector for
the indi­vidual.
Experience from recent years’ work on
the introduction of digital solutions, e.g. in
the health sector, shows that it is possible
to provide better and cheaper services if
the public sector starts using new technology
and reorganises work so that we can provide
welfare more intelligently.
If we are to go in the same direction in the
social sector, the public sector will have to
change the way services are being provided.
As individuals, we will be met with new
requirements to participate actively in
welfare and public sector employees will
have to be more ready for change. Civil
­society – relatives, volunteers and interest
groups – will be expected to assume more
responsi­bility.
TECHNOLOGY CAN MAKE
US MORE SELF-RELIANT
Gribskov Municipality is testing online rehabilitation for patients
with e.g. shoulder injuries. The patient rehabilitates via a
computer with a video link to the training centre and can talk
to the therapist as well as to other people taking part. This
enables more frequent and more intensive training at flexible
hours for the patients and saves transport time for the therapists.
Gribskov Municipality is currently expanding the project to
the homecare service, and the solution is being tested to check
patients’ general well-being and to monitor their medication.
14 DIGITAL WELFARE NEW OPPORTUNITIES FOR THE WELFARE SOCIETY
Solutions with good effects on the economy
and on quality must be disseminated on
a larger scale. The public authorities must
be better at this.
In the social area, it is vital that services are
assigned properly and with a view to making
individuals active players. At care centres,
‘meal assistance robots’ can enable some
individuals to eat their meals with less
assistance. This enhances individuals’ quality
of life and saves time for the employees.
Smart technology can make the elderly or
persons with disabilities more self-reliant
and independent. This may be automatic
wash and dry toilets or technology which
makes the home ‘intelligent’: sensors
registering if an elderly person has fallen
and is unable to get up, etc. Reminders from
the homecare service to drink fluids or to
take medication may also be possible in the
future through text messages or video links.
This changes welfare, which will become
more flexible and independent of where we
live, and individuals as well as employees will
save unnecessary waiting and transport time.
On the other hand, new requirements may
be imposed on the technological equipment
in the homes of individuals.
Introducing new technology will not always
increase efficiency. A precondition is often
that the digital solution can replace help
from human staff.
If society is to use technologies to supply
better and cheaper welfare, the work
processes of employees and organisations
must be adapted to the new digital welfare.
A HOLISTIC APPROACH
Efficient and holistic social intervention
requires that the public authorities have
the right information about the individual.
However, it is often not possible to retrieve
otherwise relevant information from the
different ICT systems. This is sometimes
because the ICT systems do not work
together. At other times because legislation
prohibits that information about the indi­
vidual be shared across administrations and
sectors.
Not sharing relevant information can have
huge consequences for the individual.
In cases involving mentally ill persons with a
substance-abuse, the alarm will often sound
too late if information about changes in the
individual’s abuse is not exchanged in time
between the social psychiatric service and
the centre for substance abuse treatment.
Sharing relevant knowledge across the public
sector is therefore a cornerstone in ensuring
transparency and coherence in the course
of treatment of the individual. This requires
the public sector to have a better overview
of which data is being collected, from where,
how and by which authorities.
Currently, there is only limited systematised
knowledge about the effects of a social
intervention for certain groups of individuals.
Typicalle, the various players in the social
area have had neither a tradition for measuring and documenting the effects of an
inter­vention, nor the digital tools to do so.
This can make it difficult for society and for
the individual municipality to choose the
most effective interventions for an individual.
In addition, the effect of a social intervention
is not necessarily measurable in simple
figures or indicators. The effects of a social
intervention can often only be seen after
a long time.
Together with changes in work processes,
digital solutions can be part of the way
forward and can help us to use resources
where the effects are greatest.
MORE EFFICIENCIENT AND QUALIFIED
CASE PROCESSING
Case officers in the social area should
have fewer tasks in front of their desks
and better possibilities to engage in direct
dialogue with individuals with special needs.
In this, ICT can help.
‘Jonstrupvang’ is a residential
activity centre for people suffering
from spastic paralysis. Here,
technological eating devices have
enabled many residents to eat
a meal with significantly less help
from the staff.
There is already ongoing digitisation of processes, e.g. in the areas of vulnerable children
and young people, and of adults. Strengthening these efforts further would make work
processes more efficient and increase quality
in case processing.
For example, using ICT with speech-to-text
conversion will result in faster documentation. Furthermore, digital decision-support
systems can streamline parts of case
processing and qualify the case officer’s
decision-making process in connection with
referrals.
DIGITAL WELFARE NEW OPPORTUNITIES FOR THE WELFARE SOCIETY
15
DIGITAL SOLUTIONS AS A TOOL FOR BETTER
AND MORE EFFICIENT LEARNING AND TEACHING
When the children of today have grown up,
they will have to navigate in a global reality
which places high demands on knowledge
and competences.
Therefore, we need digital solutions to boost
education, from nursery schools to universities, in which digital solutions strengthen
the learning of children, pupils and students.
We must ensure that as an integrated
part of education, ICT and digital tools
help provide high-quality education for
our children and young people in order
to make them as skilled as possible.
ICT and digital solutions must help involve
pupils, their parents and students,
and help them take active responsibility
for learning. Also, ICT and digital solutions
must create greater coherence in learning
and in education.
Each year 2,400 examiners meet at Odense Congress Center to grade
190,000 written exam papers from upper secondary schools. Before
the papers reach this destination, they have been sent by registered
mail from the school to the first examiner, who then sends them
on to the second examiner, who brings them to the meeting in the
city of Odense. In Odense, the papers are gathered (see photograph)
and returned together with grade sheets to the school by post.
16 DIGITAL WELFARE NEW OPPORTUNITIES FOR THE WELFARE SOCIETY
WHY ARE WE NOT FURTHER WITH
IT IN LEARNING AND EDUCATION?
Danish children and young people
are already IT pioneers. A total of 99%
of all children in Denmark have access
to the Internet at home. They use
computers, tablets and mobile phones
in their everyday lives and search for
knowledge, build social networks, and
play games online.
This is a solid foundation for more and better
use of ICT in education. However, there are
still obstacles. More daycare centres use
ICT in their pedagogical work, but experience
is still very local.
Many primary and lower secondary schools
do not have stable WiFi and Internet capacity
to support video streaming and digital
teaching aids. Therefore, wireless networks
are currently being expanded at Danish
primary and lower secondary schools toward
the school year 2014/2015.
Currently, there is not enough knowledge
on the use and results of ICT and digital
learning materials in education and training,
nor on the effects on academic and
pedagogical results or resources used.
Analysis of this in primary and secondary
education has been initiated, but it is still
difficult to assess what solutions to go
for – both for the individual educational
institution and across the educational sector.
The supply of digital learning materials is still
limited, and it is necessary to ensure develop-
ment of digital learning materials that
increase academic output and enable better
use of resources in education. It should also
be possible to purchase individual parts of a
copyright-protected digital teaching material
and combine these with other materials.
For the individual teacher, it can be difficult
to legally share digital teaching materials
with colleagues if the material is subject to
copyright protection. This inhibits knowledge
spillover, reuse of good solutions, and ultimately more efficient planning of teaching.
IT AS A TOOL FOR EDUCATION
AND LEARNING
Experience with integrating ICT into learning
and teaching from nursery schools to further
education programmes is often local. A more
coordinated approach and greater dissemination of experiences across the different
institutions will lead to better exploitation
of the potential of integrating ICT into
learning and teaching.
ICT must help children and young people
to greater academic achievement, regardless
of their academic level. Also, ICT must include
and retain as many pupils as possible in
regular teaching. It will be easier to focus on
the learning needs of the individual through
a learning process using digital tools. These
may include gaming elements in digital
teaching aids, which can motivate the pupils
and at the same adjust the level of difficulty
automatically according to the individual’s
academic level.
Increased and better use of ICT can support
more targeted organisation of teaching and
provide teachers and child carers with a more
flexible and efficient framework to carry
out teaching and learning. By e.g. combining
digital learning universes and online teaching
with classroom teaching and group work,
the teacher can plan teaching more efficiently
and provide better teaching for the individual
pupil or student. Moreover, the young person
can be offered a more flexible education.
In addition, public demand for digital
teaching aids can contribute to growth and
employment for Danish businesses.
THE OPPORTUNITY TO TAKE
RESPONSIBILITY
Many parents are actively involved in their
children’s development and education.
If parents have digital tools to monitor
their children’s work and evaluations by the
teachers, they can support their children’s
learning to a much higher degree. This helps
boost the academic level of children, streamlines the teaching and creates coherence
between the activities at school and at home.
ICT IN SCHOOLS
The Danish government has earmarked DKK
500 million for the ‘It i folkeskolen’ project
(IT at schools) which is to increase the use of
digital learning materials in teaching. Danish
municipalities have also committed themselves to ensuring all pupils in primary and
lower secondary school access to secure,
stable and high capacity wireless Internet.
A MORE COHERENT EDUCATIONAL
SECTOR
In a number of areas there is a lack of digital
coherence and knowledge spillover across
the educational system. Easier and more
cross-disciplinary access to updated information about processes and the results of pupils
and students can ease administration and
ensure better knowledge about the effects of
the money spent in the educational system.
In future, we must be better at reusing
solutions across the entire educational sector,
and set goals for the transition to digital
support of key work procedures where this
can make for more efficient execution of
tasks. This applies for example to work
procedures related to admissions, super­
vision, tests, exams and coursework at all
levels in the educational system.
E-LEARNING AT UNIVERSITY COLLEGE
ZEALAND
All study programmes at University College
Zealand are offered as ordinary teaching
programmes as well as e-learning. For
the programmes offered as e-learning,
the students primarily use the institution’s
Internet-based learning platform from home.
At the same time they are able to take part
in group work with other students through
Skype.
This ensures flexible educational programmes
which can accommodate all groups of students,
including older students with children and
perhaps a job. In this way, they can qualify
as, for example, a nurse or a child carer.
DIGITAL WELFARE NEW OPPORTUNITIES FOR THE WELFARE SOCIETY
17
WHERE SHOULD WE STEP IN?
– FOUR FOCUS AREAS
Tasks in the health, social and educational
areas differ in nature and in how they are
addressed. Also, the degree of digitisation
of welfare services varies between the three
areas. Therefore, the initiatives needed in
each area will often vary, too.
The difficult questions raised in previous
sections have revealed a number of issues to
which the common public sector strategy for
digital welfare must find answers. However,
there are also a number of shared challenges
across the three welfare areas.
There are four general areas in which action
is needed if we are to achieve the strategy’s
aim of providing individuals better opportunity
to contribute actively to welfare and to create
more coherent and cost-efficient public
services. Concrete initiatives will be developed within each of the strategy’s four focus
areas.
1. LOCAL FOCUS ON IMPLEMENTATION
AND CHANGE MANAGEMENT
COMMON PUBLIC-SECTOR STRATEGY FOR DIGITAL WELFARE
The strategy for digital welfare will involve concrete initiatives within all welfare
areas in order to pave the way for greater digitisation of processes and services
and for greater use of welfare technologies. This will also include initiatives across
welfare areas.
Overall, the strategy for digital welfare is to ensure more efficient exploitation
of resources in the public sector.
Ensuring digital welfare which can help
maintain a high level of service and lead to
more efficiency in the public sector requires
focussed efforts by management and
employees alike.
If we are to exploit the potential in new
technologies and become even better at
reaping the benefits, we must rethink tasks
and work processes on the basis of the new
opportunities offered by technology and
with the citizen at centre stage.
TWO OBJECTIVES OF THE STRATEGY
– More efficient and cohesive welfare
– Individuals as more active partners
CROSS-CUTTING INITIATIVES
Health
Sector-specific
initiatives
Social services
Sector-specific
initiatives
Education
Sector-specific
initiatives
18 DIGITAL WELFARE NEW OPPORTUNITIES FOR THE WELFARE SOCIETY
Management must assume responsibility
for changing work processes, ensuring that
employees have the required digital competences (e.g. through systematic exchange
of experience), and ensuring a focus on
implementation and realisation of benefits.
In several areas, common or national
solutions may help local managements
achieve better results. Furthermore, in a
number of areas, we must become better
at coordinating support for implementing
efficient solutions, thereby ensuring that
we reach every part of the organisation.
Specialists in the major welfare areas are key
agents in the digital transition. They need
to be confident with new ways of working
and with using new technologies, including
guiding others in their use.
If e.g. a nursing home employee feels insecure about using a hoist to lift an elderly
resident in and out of bed alone, the job will
be done by two employees. This means that
the opportunity for efficiency improvement is
lost, despite the investment in new technology.
The public must also receive proper instruction in how to use new technologies, e.g. how
to measure one’s own health data at home
and submit it to the hospital, so that each of
us can assume our part of the responsibility
for the new digital welfare services.
Students in welfare educational programmes
therefore need to acquire the necessary
digital competences. Through their formal
Every day, employees at nursing homes help elderly
citizens get from their bed and to the bathroom, etc.
The lifting involved is time consuming and is often
carried out by two employees.
With a fixed ceiling-mounted hoist and a wheeled shower/
toilet chair, the job can be performed by a single employee.
This reduces heavy lifting in bad postures and the risk
of occupational attrition and injuries.
and practical training they should acquire
knowledge and experience with digital and
welfare technology solutions. Furthermore,
there should be a match between employer
demands for specific competences and the
content of training programmes.
2. MORE KNOWLEDGE ABOUT WHAT
WORKS
Digitisation increases opportunities for
collecting information. We must become
better at exploiting this opportunity. But
we must also produce and disseminate more
knowledge about which technologies actually
work. This will make decision-making easier,
improve work processes and reduce costs.
Experience shows that up to 75 % of all lifting of citizens
can be carried out safely by one employee. However,
it requires continuous focus by management and
employees on changing work routines if the organisation
is to reap the benefits of this efficiency improvement.
Similarly, the considerable experience gained
from the use of welfare technologies in
municipalities etc. must be systematised
and disseminated in a manner which makes
it easier to make the right decisions regarding
technologies which are guaranteed to have
positive effects on resource use and on the
quality of services.
Generally, we need to make sure that
the public sector can produce and share
knowledge about the effects of new digital
solutions. This is the basis for making
informed decisions about how to exploit
new opportunities responsibly to modernise
our welfare services.
The public sector registers a host of information about individuals. Documenting interventions – e.g. accurately recording which
medicine and treatment a patient receives
at hospital – is key to ensuring knowledge
about what works. This provides for greater
quality as well as for better exploitation
of resources.
For example, we need more knowledge about
which digital teaching aids, teaching methods
and work processes have the greatest effect
on learning, the quality of programmes and
the institutions’ resource use.
However, in many places interventions
and efforts need to be documented more
systematically, and we also need to use this
information better in order to understand
the effects and quality of what we do.
3. INCREASED DATA SHARING AND
INTEGRATED INFRASTRUCTURE
If the public sector becomes better at sharing
data, citizens and public employees will avoid
having to report the same data several times.
This will save time for the individual and provide for a simpler and more seamless public
sector. Furthermore, if data is made available
to businesses, it may be used to develop new
services and new areas of business.
Legislation, work processes, lack of technical
solutions, and different data formats still
make it difficult to share knowledge and
disseminate efficient work processes. There
is a need for concerted efforts, as well as for
clear and long-term framework conditions,
so that authorities, institutions and other
relevant players can safely compare data
from different sources and share relevant
data with each other when it is necessary
and sensible to do so.
The technical platforms are becoming an
increasingly important foundation for future
welfare services. Stronger collaboration about
these would therefore be of great value.
There is shared data in a number of areas,
as well as national infrastructures, e.g. in the
health sector. However, these have not yet
been fully exploited in all sectors, nor have
they been coordinated across public sectors.
For example, all five Danish regions are
currently in the process of introducing interpretation via video conference at all relevant
hospital departments. However, remote
interpreting, and videoconferencing, could
also be used for other situations, e.g. for
patient discharge interviews. The municipal
homecare nurse, who typically participates in
the hospital discharge interview if a patient
requires support in the home afterwards,
could participate via videoconference.
DIGITAL WELFARE NEW OPPORTUNITIES FOR THE WELFARE SOCIETY
19
A national videoconferencing system has been established,
which can be used by all authorities. The infrastructure works
independently of specific video equipment. At Danish hospitals,
the system is used for remote interpreting services. The
interpreter is called up as soon as the physician and patient
are ready. The interpreter saves transport time and waiting
time. This frees up time to interpret for acute patients.
This would streamline the meetings and
save the nurse transport time.
The state, regions and municipalities could exploit videoconferencing to a far greater extent, e.g. for meetings between
authorities or between geographically separated units.
Videoconferencing could e.g. support specialist collaboration
across hospitals or between municipal administrations and
municipal institutions, such as daycare centres, schools or
social services.
ICT systems can more easily communicate
with each other if they are based on the same
technical standards and use a standardised
set of concepts. Moreover, internationally
recognised standards can make dissemination
of effective solutions easier, both nationally
and internationally.
For example, pupils often bring their own
various types of tablets or laptops with
them to class. We must therefore ensure
that digital teaching aids can be used across
various platforms. If not, the risk is that
teachers will have difficulties organising
their teaching and they will be unable
to use new digital teaching aids which
work for all pupils.
In the public sector, we must also be better
at developing new ICT solutions which meet
the requirements of mobile employees.
Many employees carry out administrative as
well as practical work when they are on the
move or in their homes. We therefore need
digital solutions that can be used on different
mobile platforms such as tablets, laptops,
cell phones, etc.
Finally, where relevant we must make data
available to the business community.
This can support the development of new
products and services which can help meet
the responsibilities of the public sector
and create new opportunities for exports
and growth.
4. BETTER COORDINATION
AND OVERVIEW
Better coordination will contribute to holistic
interventions and will support collaboration
across sectors, authorities and specialist areas.
If we are to achieve the goals of the strategy
for digital welfare, we need coordination
and collaboration across established sectors
and authorities.
20 DIGITAL WELFARE NEW OPPORTUNITIES FOR THE WELFARE SOCIETY
The health, social and educational areas have
much to learn from one another. We must
be better at reusing effective solutions within
and across sectors. Ever greater attention
is being paid to coordinating efforts to implement new technologies and digital solutions,
and there are several examples of municipalities and regions working together. This is
a positive sign; however, there is still room
for stronger collaboration and coordination,
both within and across sectors.
There should be more efforts within and
across individual sectors to ensure more
transparency about the use and dissemination of successful digital solutions. Better
overview and coordination will make it easier
for authorities, institutions and other
relevant stakeholders to cooperate and
to streamline cross-disciplinary work
processes, and reap the benefits of digital
solutions.
We need to clarify models for how procurement and dissemination of digital solutions
can be coordinated between relevant players,
both within and across welfare areas. This
could e.g. be procurement models which,
within the framework of current tendering
regulations, function as practical and useful
tools to disseminate solutions that meet
the common requirements.
We must also become better at entering into
binding partnerships so that all stakeholders
can rest assured that responsibilities will be
met and that data will be shared between
the right players and in a timely fashion.
BACKGROUND FOR THE STRATEGY
MODERN AND EFFICIENT WELFARE
In Denmark, the public sector spends more
than DKK 500 billion every year. The sector
thus accounts for about one-third of the
Danish economy, which is more than in any
other country in the OECD.
However, in coming years, public sector
spending will be tight. In addition, there will
be fewer employees to provide an increasing
number of welfare services, due to demographic developments.
If we raise our level of productivity and
reap more from the many resources that
are already being used by the public sector,
we can get more welfare for the same effort.
Or, we could keep services at the current
level using fewer resources. Also, we can
improve the international competitiveness of
businesses in Denmark and create new jobs.
Some progress originates in the individual
workplace. For example, for several years
now, Danish hospitals have focussed on getting as much health as possible for the same
money, and this has increased productivity
levels considerably.
Other productivity improvements require
decisions at central level, as when common
tools are introduced, e.g. the NemID digital
signature, the electronic medicine card,
and mandatory online self-service solutions
such as minSU (when students apply for
study grants). Such initiatives require united
efforts across the public sector, and often
close collaboration with the private sector.
The strategy interacts with a range
of other initiatives aimed at safeguarding
and modernising public sector welfare
services. These initiatives are both
cross-institutional (e.g. the common
public sector eGovernment strategy
2011-2015 on which the upcoming digital
welfare strategy builds) and sector-specific
(e.g. the school reform, social security
reform, etc.).
MODERNISING THE WELFARE SYSTEM
The upcoming strategy for digital welfare is
rooted in the necessity to rethink the Danish
welfare system.
THE STRATEGY’S OVERLAP WITH OTHER INITIATIVES
Telemedicine
Action Plan
The strategy for digital welfare should
contribute to modernising the public sector.
It is one of the means by which we can
achieve the government’s ambition to free
up DKK 12 billion for other purposes towards
2020. This will enable us to maintain today’s
high level of public services, even with an
ageing population, more citizens with chronic
diseases, more expensive treatments in
health services, etc.
Business and
growth area
Health area
New strategy for
digitising health care
2013-2017
Growth team for
health and welfare
Common public-sector
eGovernment strategy
2011-2015
IT in Schools
Digital solutions are to help the public sector
perform tasks more efficiently. At the same
time, they can pave the way for members of
the public to become more actively involved
in welfare. Also, they must ensure better
coherence between public services.
Educational area
Social area
The Government’s
school reform
Report on the
prevalence of
welfare technologies
in the social area
Development
programme for
daycare
Social Security Reform
DIGITAL WELFARE NEW OPPORTUNITIES FOR THE WELFARE SOCIETY
21
DIGITAL WELFARE SERVICES
IN AN INTERNATIONAL PERSPECTIVE
As in Denmark, the OECD countries are
focussing on how new digital solutions can
address the demographic challenge, increase
efficiency and effectiveness in the public
sector, and improve the quality of life
of individuals.
The OECD is therefore in the process of
analysing the use of new technologies in
the following six countries: Denmark, Finland,
Italy, Japan, Korea and Sweden. Among other
things, the analysis focuses on improvements in homecare and nursing services,
better ICT skills with a view to enhancing
social communication, social inclusion of
the elderly, and the use of robot technology
in welfare services.
The European Commission is also addressing
the subject of how to better exploit the
new digital opportunities in the organisation
of welfare services. In December 2012, the
Commission launched its eHealth Action
Plan in order to promote the use of digital
solutions in health services.
The goal is also to create coherence across
national borders in order to offer Europeans
better healthcare. For example, the EU has a
target of ensuring individuals a secure access
to their online patient records by 2015, both
nationally and when travelling within the EU.
This will both ease the work of physicians
and make it possible for individuals to receive
better medical help, should the need arise.
DENMARK’S RANKING INTERNATIONALLY
Denmark ranks number 4 out of a total of 190 countries in the most
recent UN report on eGoverment readiness, outranked only by South
Korea, the Netherlands, and Great Britain.
Among other things, Denmark owes its ranking to the government’s,
regions’ and municipalities prioritising a digital public sector. Also, Danish
citizens, businesses, and public employees are among the most digital
in the world.
1. Chorea
2. Netherlands
3. UK
4. Denmark
5. US
6. France
7. Sweden
8. Norway
9. Finland
10. Singapore
COMMERCIAL USE OF HEALTH DATA
80
The health services maintain a large quantity of high-quality health data
and registers which hold a considerable commercial potential for research
and development of innovative products and solutions.
Weighted average score in hundredths
Access to these health data and registers could e.g. make it easier for the
pharmaceutical industry to identify patients who would benefit from new
medicines and who might therefore be willing to participate in clinical trials.
Commercial exploitation of public-sector data requires strict supervision
that sensitive personal data is being managed with confidentiality and in
compliance with the Act on Processing of Personal Data.
22 DIGITAL WELFARE NEW OPPORTUNITIES FOR THE WELFARE SOCIETY
82
84
86
Source: United Nations E-Government Survey 2012
88
90
92
94
CHINA CALLING DENMARK
FASTER BROADBAND IN DENMARK
China today needs around 3.5 million
more beds at nursing homes for the elderly.
Denmark wishes to export elderly-care
products and consultancy to China. A Danish
model nursing home for 500 elderly Chinese
in western China is to pave the way for
exports of Danish welfare services.
Many digital and welfare technology
solutions require internet access. Fixed
and mobile broadband connections need
to be fast and stable enough for solutions,
e.g. based on video, to work optimally.
The nursing home will be built, equipped
with new technology, run and managed
according to a Danish model – but adapted
to Chinese demands, e.g. for more and
larger common rooms. It is expected to
be completed in 2015.
VIA University College in Denmark, which
trains nurses, physiotherapists and nutrition
experts, will be in charge of recruiting and
training Chinese healthcare staff for the
nursing home. Danish health employees and
students will also be employed and receive
training at the nursing home.
Furthermore, Denmark is investing massively in new hospitals which in the future can
serve as showcases for a modern, efficient
and green healthcare system, including
to China and other BRIC countries that are
on the verge of establishing a large number
of new hospitals, and investing in welfare
technology solutions.
However, there are still areas of Denmark
in which people cannot get the desired
broadband speed.
DIGITAL WELFARE - NEW OPPORTUNITIES FOR
THE WELFARE SOCIETY
The roll-out of broadband in Denmark
is market driven and technology neutral.
The government is working towards the
goal that all Danes should be able to get
a broadband connection with at least
100Mbit/s download speed by 2020.
Based on this, the availability of highspeed broadband connections has
increased significantly in recent years.
Discussion paper on the new common public sector
strategy for digital welfare
March 2013
Enquiries about this publication can
be addressed to the
Agency of Digitisation
Landgreven 4
PO box 2193
DK-1017 Copenhagen K
Telephone: +45 33 92 80 00
www.digst.dk
In March 2013, the government presented
a proposal for improving mobile and
broadband coverage throughout Denmark.
Design: BGRAPHIC
Photos: Stig Stasig, Mikkel Østergaard,
Henriette Skov Andersen, Colourbox
ISBN, printed version: 978-87-995647-8-1
ISBN, electronic version: 978-87-995647-9-8
DIGITAL WELFARE NEW OPPORTUNITIES FOR THE WELFARE SOCIETY
23
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