Welcome to a special pre-webinar interview with Hans Erik Henriksen, CEO of Epital Health and former CEO of Healthcare DENMARK. Here we delve into the intricacies of Denmark’s healthcare system and explore its potential implications for Australia.

In August, Hans will bring his wealth of knowledge and experience to an online ‘Evening Exchange’ held by the Centre for Healthcare Knowledge & Innovation. He will offer insights into Denmark’s healthcare transformation, digital health strategies supporting home treatment, and advancements in elderly care. This interview aims to provide a foundational understanding as we prepare for the upcoming Evening Exchange.

Evening Exchange with Hans Erik Henriksen: Insights from Denmark and Australia

August 7, 2024 | 6pm to 9pm

Whether you’ve already registered or are considering joining us, this discussion will equip you with essential insights to maximise your learning experience. If you haven’t registered yet, you can secure your spot here.

Pre-Webinar Interview

Bronwyn: 

Hans, it was great catching up with you in Copenhagen, where we were both attending the Copenhagen Health Tech Summit. I was fortunate enough to spend some time in the city in the lead-up to the conference and have made some personal observations about the systems here, specific to the people of Denmark.

Q: What can you tell me about the people of Denmark and what similarities and differences do you see between the Australian and Danish people?

Hans: 

Australian and Danish citizens share similar values and a similar culture, which means that you always feel at home as a Dane when you visit Australia, and I guess, the same goes for Australians visiting Denmark. While it is my impression that Australians trust their healthcare system, their trust in the National Government has fallen since 2010, down from 61% in 2010 to 50% in 2022 according to OECD. At the same time, the trust of the Danish population in their (digital) Government is at 78% (2021, 2022, and 2023). Trust in our Government, the public authorities, and in public healthcare is a fundamental prerequisite for citizen and patient support for significant empowerment and digitalisation of healthcare services.

Bronwyn: 

Q: What can you tell us about the main differences between the Australian and Denmark health system?

Hans: 

While both Denmark and Australia provide high-quality healthcare, Denmark’s system is universal and based on the principles of free and equal access to healthcare for all citizens. Australia, however, combines public funding with significant private-sector involvement. This offers more consumer choice but also leads to some disparities in access and cost. The major differences between the two systems can be broken down into:

• • Funding, Financing & Equity:

Denmark maintains a robust focus on equity, ensuring minimal out-of-pocket expenses and comprehensive access to essential medical services for all residents. This approach aims to provide universal healthcare without financial barriers. Australia’s healthcare system prioritises consumer choice and flexibility, particularly for those with private health insurance. While this affords patients options for tailored healthcare services and potentially faster access to specialists, it can also result in disparities in healthcare access and affordability, depending on insurance coverage and financial means.

• • Structure, Service Delivery, and Access:

In Denmark, healthcare is structured with five regional health authorities responsible for organising and delivering a wide range of services, including hospitals, psychiatric care, and specialised medical services. Additionally, 98 municipalities handle primary care services such as GPs, home care, and preventive services, fostering local governance and community-based healthcare delivery. This decentralised approach contrasts with Australia’s more centralised healthcare system, where federal and state governments manage services, including public hospitals, and coordinate primary healthcare through 31 Primary Health Networks (PHNs).

• • Electronic Health Records (EHRs):

Denmark’s advanced system enhances care coordination and continuity across various healthcare system levels, ensuring comprehensive and integrated patient management. Danish GPs have access to their patients’ comprehensive EHRs, supporting seamless care coordination and enhancing patient outcomes through better-informed decision-making. Australia utilises electronic health records through initiatives like My Health Record, which aim to centralise patient health information, but participation is voluntary, and GP access is not as comprehensive or uniformly integrated as in Denmark.

• • Patient Access to Specialist Care:

Danish GPs act as gatekeepers, requiring patient referrals for specialist consultations and hospital services (including Emergency Room), except for very acute emergencies. Similarly, in Australia, patients generally need a referral from a GP to access specialist care and claim Medicare or private health insurance benefits for specialist consultations. However, depending on the policy, private health insurance policies in Australia may offer more direct access to specialists and elective surgeries without the need for a GP referral.

Bronwyn: 

Q: The conference we both attended discussed the empowerment of primary care providers and patients in Denmark. How do you see empowerment occurring?

Hans: 

In Denmark, the healthcare system emphasises individual ownership and control of health data, empowering patients to decide how their information is used and shared. This fosters trust and promotes patient autonomy in healthcare decision-making. There is a strong emphasis on educating patients about their rights and responsibilities regarding health data, ensuring transparency and fostering informed consent. For professionals like GPs, comprehensive access to electronic health records supports patients in informed decision-making. In Australia, patients have some control over their health information, but the focus is more on ensuring explicit consent and adhering to stringent privacy policies rather than granting explicit ownership rights.

Bronwyn: 

Q: How do you see the different funding approaches impacting healthcare’s long-term sustainability and equity in Denmark and Australia?

Hans: 

Denmark’s tax-funded model effectively controls healthcare expenditures and supports long-term financial planning and sustainability. Predictable funding through taxation enables efficient resource allocation towards preventive care and public health initiatives, potentially reducing costly chronic diseases and hospital admissions over time. This system ensures more uniform access to high-quality care, contributing significantly to its sustainability. At the same time, the tax-funded model reduces excess treatment which tends to be an issue for systems based on dual or private funding. Australia’s dual funding approach requires continual policy evaluation to manage cost containment challenges and ensure equitable healthcare access across diverse socioeconomic groups. Sustainable healthcare in Australia depends on balancing public and private sector contributions, improving coordination between providers, and enhancing healthcare service integration to mitigate cost pressures and promote fair access across the population.

Bronwyn: 

Q: What three things could Australia learn from the Danish health system?

Hans:

• Universal Access with Minimal Out-of-Pocket Costs:

By reducing or eliminating co-payments for essential healthcare services, Australia could enhance equity and accessibility across its population. This change would alleviate financial strain on individuals, reduce excess treatment, and promote a healthier society where everyone can seek timely medical care without worrying about affordability. Such a shift could potentially lead to better health outcomes and lower healthcare costs in the long term by addressing health issues early, rather than waiting until they become more severe and costly to treat.

• Strong Focus on Preventive Care:

Denmark’s focus on preventive care and public health initiatives effectively lowers long-term healthcare costs by preventing chronic diseases. Australia could benefit from adopting comparable strategies to promote healthier lifestyles and alleviate strain on the healthcare system. Collaboration among urban planners, healthcare professionals, policymakers, and educational institutions ensures that urban designs support active lifestyles, aligning public health objectives with urban development strategies. Educational campaigns further enhance these efforts by promoting healthy behaviours, nurturing a culture of wellness, and prioritising preventive care throughout Denmark.

• Comprehensive Electronic Health Records (EHR) System:

Denmark’s commitment to an advanced electronic health record (EHR) system demonstrates how seamless care coordination and improved patient outcomes can be achieved through robust digital infrastructure. Moreover, Denmark’s emphasis on patient ownership and control of health data sets a precedent for transparency, trust, and informed decision-making in healthcare. By prioritising policies that empower patients with greater control over their health information, Australia could foster a culture of autonomy and engagement among healthcare consumers.

Bronwyn: 

Q: What three things can the individual Australian healthcare professional, manager, or policymaker implement today to align with the Danish health system?

Hans:

• Promote Preventive Care Initiatives:

Take proactive steps to integrate preventive care into daily practice. Encourage screenings, vaccinations, and lifestyle counselling during patient visits. Implement community health education programs to raise awareness about healthy behaviours and disease prevention strategies. By prioritising prevention, healthcare professionals can mitigate future healthcare costs and improve patient outcomes.

• Facilitate Integrated Care Systems:

Advocate for improved coordination and communication between healthcare providers and services. Explore opportunities to collaborate with other practitioners, hospitals, and community organisations to streamline patient care pathways. Implement shared care plans and utilise digital health tools to enhance care continuity and efficiency.

• Enhance Patient Data Transparency:

Start by ensuring patients have easy access to their medical records and encourage discussions about their data’s use. This can foster trust, improve patient engagement, and empower individuals to take a more active role in their healthcare decisions.

Bronwyn: 

Q: In what ways is Australia shifting from a hospital-centric system to one that emphasises primary care?

Hans: 

Primary Health Networks (PHNs) play a crucial role in this shift by coordinating and integrating primary healthcare services at the regional level, aiming to improve health outcomes and reduce hospital admissions. Aboriginal Community Controlled Health Organisations (ACCHOs) also contribute significantly by delivering culturally appropriate primary healthcare to Indigenous communities, enhancing access and continuity of care. Additionally, the Healthcare Homes initiative supports patients with chronic conditions through comprehensive, coordinated care plans delivered by their usual GP. These efforts reflect Australia’s broader strategy to enhance the role of primary care in preventive health, chronic disease management, and community-based healthcare delivery.

Hans Erik Henriksen is CEO of Epital Health, which delivers patient centered digital health solutions and services that help society and healthcare authorities manage chronic patients. Until 2021, Hans was CEO of Healthcare DENMARK, a public-private partnership organisation, with a national mandate to promote Danish healthcare solutions and competencies abroad. He has a solid healthcare background from different executive positions during the latest 20 years including being responsible for IBM Healthcare and Life Sciences in the Northern and Eastern part of Europe.

Bronwyn Thirkell is the Coordinator of the Centre for Healthcare Knowledge & Innovation and is responsible for delivering information on the ideas and technologies shaping the future of health and social care. She has a keen interest in cross-sector collaboration and integration and believe that continuous and shared learning is the basis for delivering better health outcomes.