How Karolinska is modernizing its approach to IT

For the past year, Malin Fahlén has been IT manager at Karolinska University Hospital, a stark contrast to her previous job as global head of e-commerce platforms for H&M.

“I made a U-turn,” she says. “After being there for nine years, I decided I wanted to break new ground.”

Karolinska University Hospital is not only one of Europe’s largest hospitals, but also one of the world’s best, so the demands on the IT environment, and expectations of its capabilities, are constant.

“If we want to be a world leader in healthcare, we must be a world leader in IT in healthcare as well,” she says.

Building a new platform

To move on from an outdated IT environment, a new platform is being developed, for Karolinska as well as the entire Stockholm region, to make data available both operationally in care and treatment, and analytically for follow-up, analysis, and research.

“We have the task of building this infrastructure,” she says. “The region monitors what we do, and with the procurements the region is now carrying out, it also looks at how this new infrastructure and platform can be used.”

In parallel with Karolinska developing new infrastructure, Region Stockholm has made several procurements including one for a common medical record system, and another of a clinical data repository (CDR), the database where health data is stored, and a real-time database that consolidates data from a variety of clinical sources.

Reduce administration

In the first stage, they want to get to grips with the enormous amounts of administration in healthcare.

“We’re looking at how we can transfer data automatically to the various quality registers in the new platform, where work is underway to see how it can be scaled,” she says. “It would be a huge time-saver.”

Both automation and AI are included in the plan to streamline and reduce admin, and thus enable healthcare professionals to have more time with patients.

“We’re also looking at how we can use AI not only in clinical routines, but to improve scheduling, operation planning, and reduce complexities in financial processes, for example.”

Another priority area is to allow AI to find information from other sources such as the intranet and document management systems.

Have a decommissioning plan

Under the platform, however, many legacy systems are still hidden, and how to deal with them raises questions. Some older systems are linked to the new platform, though, which makes all the data in there better available to the business. But Fahlén stresses that Karolinska also needs to be better at not only bringing in new systems, but looking at decommissioning.

“We need to have long-term plans for how we change our system landscape in both the short and long term,” she says. “When the need arises, a system is often purchased, but we have to better think about not just adding to the system park. It’s also about how we work with suppliers.”

The amount of systems not only creates complexity but also risks, so it’s important decommissioning takes place in a standardized and secure way to establish as few individual integrations as possible. Plus, IT is also integrated in medical equipment.

“All of this makes IT security very important for us, given both Sweden’s NATO entry and the fact we’re in a sector that’s a clear target for cyber attacks,” she says. In order to decommission and bring in new systems safely and efficiently, it’s crucial we have targeted architecture both in the region but also for us at the hospital.”

A seamless experience

In addition to a clear target architecture, it’s necessary to have a dynamic integration strategy to keep up with developments and not end up in legacy.

“Basically, we need to reduce administration and enable doctors to spend time in clinical activities, and not spend too much time in different IT systems,” she says. “The context has to work for each patient, and the data should be handled efficiently and correctly, regardless of the system so as to achieve a seamless experience where staff don’t have to spend unnecessary time logging in and out of different systems to manage documentation.”

To safely try out and test new technologies, Karolinska plans to set up sandbox environments that can be used not only by IT but also the healthcare business.

“We need to enable IT environments where driven employees in healthcare can work,” she says. “It’s important we do it in a safe way instead of it being procured or purchased in different environments. After all, innovation is essential to make sure we’re at the forefront.”

Full engagement

After a year at Karolinska, Fahlén is seeing the biggest differences between the public and private sectors with how she and her team works with third parties and suppliers. In the public sector, there are long processes with public procurements, and the legal framework is strictly regulated. And the scope for making quick decisions and adjusting the direction along the way is smaller than in a private business.

In many private businesses as well, the systems are in the cloud. At Karolinska, nothing is there yet, although it’s being evaluated.

“That door was completely closed when I started, but we’re now looking at what opportunities exist,” she says. “Then we’ll probably also need on-prem solutions and our own internal cloud services for systems that aren’t suitable for being outsourced to the cloud.

There are similarities, however, not least when it comes to the work of getting IT and operations coordinated toward common goals.

“It’s not only in the private sector to understand value creation,” she says. “We must prioritize our work to generate value in healthcare. The solutions we deliver must be scalable so we can build cost-effectively and generate maximum business benefits.”

This means finding good methods for governance and prioritizing toward common goals. “We work a lot on that,” she says. “IT as a function can’t work in isolation. It’s everyone in the business who needs to work together for us to be successful.”