Mehiläinen’s Oma Lääkärisi primary healthcare service model

Mehiläinen is a leading provider of private social and healthcare services to individuals and insurance, corporate, and municipal customers in Finland. Mehiläinen’s Oma Lääkärisi (“Your Own Doctor”) health centers operate as a part of Finland’s public health center network.

How it works

The service works on a capitation funding model, where municipalities pay Mehiläinen a set amount for each person enrolled at an Oma Lääkäräsi health center. The outsourcing contracts have different value-based financial incentives based on outcomes as determined by the municipality. For example, in Tampere, Mehiläinen receives a bonus if they are able to reduce referrals to specialized care, radiology or laboratory testing  and the amount of ER visits compared to the average for all of Tampere’s patient population. In Espoo, Mehiläinen receives a bonus if they are able to reduce referrals to laboratory testing, radiology, and specialized care. In Jyväskylä, the incentive scheme is tied to a range of clinical outcome measures such as diabetes and cardiovascular disease quality measures via improvement in laboratory results, patient waiting times and emergency care use.

In order to deliver high-quality services for patients on a fixed budget, Mehiläinen has implemented a new way of organizing its basic healthcare services where nurses, under the supervision of physician, take a leading role. This allows physicians to work more efficiently and focus their efforts on more complex cases.

All Oma Lääkärisi health centers offer a digital clinic where patients are able to contact their own nurse or GP and renew their prescriptions. Mehiläinen also offers digital tools for healthcare professionals to assist with their work.

The goal of the Oma Lääkärisi model is to guarantee patient-centric, effective, and cost-efficient primary healthcare services. Multidisciplinary teamwork and accurate measurement of the effectiveness of the treatment, along with numerous incremental process improvements, are key. Mehiläinen helps to ensure the success of Oma Lääkärisi health centers through the following steps:

  1. A customer-oriented approach means that all processes are designed from the patient’s point of view, including reasonable waiting times and measurement of customer satisfaction.
  2. A data-driven approach means that health centers undertake broad measurement of all aspects of their operations, with the help of data visualization and LEAN methodologies.
  3. Cooperation between professionals is important, with nurses trained to take broad responsibility to ensure that doctors’ time can be spent on patient work.
  4. Standardized customer journeys based on triage are available through the Oma Lääkärisi toolbox, along with quick guides for staff.
  5. Flat organization and no hierarchy mean that health centers have broad autonomy within set financial and operational frameworks to achieve their goals.
  6. Continual service development together with staff and customers ensures continuous improvement based on LEAN methodologies, workshops, customer panels, and feedback analysis.
  7. Standardized clinic designs are based on an examination-room model with standardized setups and back-office floor plans.
  8. Utilization of digital services, including a wide range of tools for staff and patients.
  9. Quality control includes education and training of personnel, internal and external audits, in-house controls, quality indices, and health-center ranking.
  10. Focusing on health benefits means promoting preventive care with a special focus on chronic illnesses.

Outcomes

For patients, the Oma Lääkärisi concept has helped to tackle one of the biggest challenges facing basic healthcare in Finland by reducing long waiting times. In 2020, the average waiting time for a doctor’s appointment has been under 7 days and under 3 days for a nurse’s appointment, which is significantly lower than the average for municipality-run health centers (according to government studies, only about one-fifth of patients at Finnish health centers receive a non-urgent appointment within two weeks). Overall customer satisfaction is also high, with approximately 90% of patients indicating that they are happy with the service provided.

Long-term work has continued to improve the treatment results for those patients with diabetes. When a diabetic’s sugar balance is part of the treatment goal, it has a strong preventive effect by significantly reducing the risk of developing many diabetes-related diseases while improving a patient’s quality of life.

Special attention has also been paid to the treatment of patients using Marevan at Jyväskylä's Oma Lääkärisi stations. The goal has been to switch to newer, safer and more effective medicines, which have fewer serious side effects and can provide better results. This not only improves the patient’s quality of life, but also leads to cost savings, for example through a reduction in the need for laboratory controls.

For municipalities, the capitation funding model ensures that costs remain competitive and predictable as there is a fixed price for services. In addition, municipalities can achieve further savings as the need for specialized healthcare is reduced, with fewer referrals needed due to more patients being treated entirely within the health center.  Each OmaLääkäräsi health station is compared to a set of chosen parameters within a municipality. The results show that OmaLääkäräsi health stations, when compared to the municipal average, have needed to use less specialized and emergency care as well laboratory and radiology referrals.

For doctors at Mehiläinen's medical centers, they receive a personal report on their treatment practices to support the management of their own work. In addition, several reports on clinical guidelines are being developed to enable the clinician to evaluate their own practices in relation to their colleagues and current care recommendations.

Read more: the statistics of safety, effectiveness and other quality metrics at Mehiläinen (in Finnish)

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The fundamentals of value-based healthcare

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