Improved Health Through Cohesion and Individualisation

Although Denmark has one of the world’s best healthcare systems, there are still areas that can be improved to better meet patients’ needs. Patients and their relatives often experience their healthcare journey as fragmented, divided into silos that lack cohesion and individualisation. Challenges also exist in the communication and transfer of vital information between primary healthcare and hospitals, between hospitals and municipalities, within hospitals, and not least between patients and their relatives.

The lack of cohesion, individualisation, and support for managing one's illness leads to challenges with over- and underdiagnosis, as well as over- and undertreatment.

The consequences can be significant—for the individual, their relatives, and society as a whole. These issues particularly affect patients with multiple simultaneous conditions and those with chronic pain—two patient groups that are growing in number as the proportion of elderly citizens continues to rise. This challenge is supported by AAU’s own survey data, the Health Structure Commission's report, and the current government proposal for a healthcare reform in Denmark.

The healthcare system of the future should be characterised by more cohesive patient pathways that consider each patient’s individual needs. Greater cohesion and a rethinking of how patients can be supported in managing their illnesses are essential. Technological solutions should be developed and implemented to support all relevant stakeholders across professions and sectors.

Success Criteria for the Mission

• Cohesion: New technology that consolidates patient data and supports the healthcare system’s use of data in cohesive and individually tailored care pathways, spanning both primary and specialized healthcare services.
• Individualisation: New decision-support technology for clinical practice that integrates experience, data, and evidence. This data is used to facilitate individualised treatment, resulting in more effective care where each patient receives precisely the treatment with the highest likelihood of success.
• Empowerment: Development of digital technologies that help patients manage their illness independently in their daily lives.

 

Examples of Subgoals, Critical Milestones, and Success Criteria

Cohesion:
Technology-supported, cohesive patients pathways

Example - Critical Milestone
Development of new AI technology that consolidates patient data and supports the healthcare system's use of data in cohesive and individually tailored care pathways, spanning both primary and specialised healthcare services.

Measurable Success Criteria
Comprehensive overview of the patient’s overall health condition, enabling accurate diagnosis and early initiation of appropriate treatment.

Reduction in unnecessary tests and hospital admissions.

Increased patient satisfaction among patients with multimorbidities and those with non-specific symptoms (e.g., patients with chronic pain).

Individualization:
Decision-support for clinical practice

Example - Critical Milestone
Development of new technology for clinical practice that integrates experience, data, and evidence to support individualised treatment for patients in long-term care pathways.

Measurable Success Criteria
Improved diagnostics, follow-ups, and support for patients throughout their treatment pathways.

Enhanced monitoring and control of patients' conditions during treatment.

Empowerment:
Digital tools supporting patients' management of chronic diseases 

Example - Critical Milestone
Development of digital technologies that assist patients in managing their illnesses independently in everyday life.

Measurable Success Criteria
Increased sense of security and quality of life for individual patients.

Optimized use of healthcare services—reduced utilisation for some patient groups and increased for others as needed.

Improved self-management among patients during treatment pathways.