Happiness is a healthy mind in a healthy body, such was the wisdom in Aristotle's ancient Greece. These days, the loudest proponent of this understanding is Norwegian - Director-General of the World Health Organization, Dr. Gro Harlem Brundtland.
A medical doctor and Master of Public Health (MPH), the former Norwegian Prime Minister has raised the profile of health care professionals in Norway, helping attract a dedicated cadre to the health field. Dr. Brundtland's self-proclaimed international role is to 'unleash development' and 'alleviate suffering' while creating 'equitable health systems in all countries', a calling taken up in her native Norway by an ever-diversifying group of researchers, product developers and health care professionals.
All over the world, hospitals - the cornerstones of health systems - are experiencing rapid change. Hospital managers are looking for new solutions in order to expand funding and economize on essential services. While Norwegians have traditionally enjoyed comparatively long hospital stays and in-hospital consultations with their doctors, the current trend is towards improving overall care by raising the learning curve of both health care professionals and patients. New products generated by new technology are helping people live longer, while expanding the training needs of health care staff and reinforcing the patient's role as consumer. The goal, and result, are shorter hospital stays. For the Norwegian health care economy, the challenge is to preserve the quality of care and treatment that has helped foster one of the leading life expectancy rates in the industrialized world.
Evolving the Model
Increasingly, Norwegian hospitals are turning into centres of excellence in research. From admittance and surgery, through to outpatient care and beyond, health care innovations born of Information and Communications Technology ICT are expanding the knowledge base in hospitals, while broadening the range of future possibilities for patient treatment, care and support.
RiT 2000 is an acronym for the imminent reconstruction of St. Olav's Hospital (the University Hospital in Trondheim), into a new health care concept built on ICT. Set to open in 2010, staff and patients are to have access to the hospital's computer network via a 'portal' providing live updates of medical information and a link to a national, clinical handbook currently under development. SINTEF Unimed, one of Norway's foremost medical research institutes, is directly involved in the project via its Centre for Shared Health Care: the centre's goals are the development of high-quality, cost-effective patient care, and fostering better communication between the various branches of the health services.
Moreover, Norwegian hospitals not only avail themselves of ICT in daily operations, they are key ICT research partners. Developed in close cooperation with hospital staff, DIPS electronic patient record systems are used for clinical computing in more than a third of Norwegian hospitals: the company offers routines for waiting lists, scheduling, assigning ambulatory, home and psychiatric care along with serving up details of billing, prescriptions, medications and storing radiology results.
Even the complicated operation of running a hospital kitchen could soon be streamlined by the program Nutshell, from Norwegian company Embla. With St. Olav's Hospital as partner, Nutshell has attracted enquiries from hospitals in Iceland and Singapore.
Doctors of Innovation
Meanwhile, Norwegian doctors are key players in the burgeoning clinical studies contracts of Norwegian hospitals that are becoming increasingly popular as controlled research environments. In 2001, the number of international medical and pharmaceutical companies interested in carrying out their clinical studies in Norway was higher than ever. The range of hospital research milieux and Norwegian research outfit SINTEF Unimed's ability to match the right research project with the right medical specialists and researchers have been key in making Norwegian hospitals popular research environments.
Some Norwegian doctors have used their experience to identify needs in the health care system and to devise products to meet them. The founder of Med-Storm Innovation, Dr. Hanne Storm, developed the world's first pain detector based on the principles of the lie detector.
The company's PainDetector measures pain responses immediately after stimuli. The patent brought Dr. Storm the 2000 Norwegian Reodor Prize for entrepreneurial excellence.
A SINTEF Unimed-operated agency, the National Centre for Innovation and Business Development in Health Care (InnoMed) assists businesses in helping the health sector by supporting product ideas destined for the market. InnoMed currently assists dozens of projects devoted to business development and innovation. As SINTEF Unimed enjoys acess to a comprehensive network in the Norwegian research and development community, the institute offers companies in the medical sector comprehensive prototype testing through the application of hospital research, medical technology, health technology assessments, health expertise on work environment and ergonomic technology geared toward the handicapped and the elderly
In 1995, the Norwegian Ministry of Health and Social Affairs established the Centre of Excellence in 3D Ultrasound at the site of St. Olav's Hospital (the University Hospital in Trondheim) in central Norway. The centre houses research cooperation between the hospital's surgeons and engineers from SINTEF Unimed toward evolving the use of ultrasound in surgery.
A hub of medical technology, the centre collaborates closely with the Norwegian University of Science and Technology (NTNU) and the MR Center (Magnetic Resonance Research Center) to train engineers working towards a PhD in medical technology. MISON, a spin-off of this research concentration, has recently won the prestigious European First Grand Prize for the best IT product in Europe: 294 innovative companies and institutions from 26 countries participated in the Grand Prize competition. MISON's product was the SonoWand, an ultrasound-based, neuro-navigation system that gives surgeons up-to-the-minute 3D imagery for precision-guidance during surgery. In addition to carrying out research, SINTEF Unimed backs up the swell of ultrasound research with neuro-navigation courses.
A number of factors have contributed to the advent of monitoring technology for home or distance health care in Norway. First, over one-quarter of Norwegians are near, or of retirement age - a striking figure, as Norwegian doctors spend just 6 per cent of their total labour output in the municipal health services where remote care for the elderly is concentrated. The number of bed-days in general hospitals is declining. Finally, interns and municipal physicians paid by municipalities are commonly seen in thinly populated municipalities located far from big towns. Enter telemedicine: the examination, observation, treatment or administration of patients with the help of telecommunications. More commonly in Norway, this means the long-distance consultation and diagnosis between a patient and a doctor at a local medical facility and a specialist at another location, made possible by two-way audio-visual communications. With the elimination of extensive travel expenses, telemedicine is in the course of offering a cost-effective way to ensure equitable health care nationwide.
The Norwegian health care industry already produces an array of equipment suitable for use in telemedicine. MedIT's CardioOnline software, for example, enables users to send recordings of rest electrocardiographs via digital networks for remote consultation.
Norway's national centre for telemedicine is the Department of Telemedicine at the University Hospital in Troms¯. The department has extensive experience developing telemedicine together with Russia, and enquiries have been streaming in from other countries. Some of the department's current and planned activities include implementing telemedicine in remote areas of Scotland and Scandinavia; Internet-based nursing courses for Latin America; WHO-sponsored telemedicine projects in Kazakhstan, Lithuania and Moldavia; and setting up telemedicine solutions in Nepal, Botswana, Brazil and Sri Lanka.
If Dr. Brundtland has raised the profile of Norwegian medical doctors, Norway's Princess Martha Louise, a physiotherapist, seems also to have spurred the rise of her profession in Norway. Physiotherapists are now second in number to bioengineers in hospital employment demographics.
Norwegian manufacturers of specialist equipment for this field, among them Nordisk Terapi, have produced a unique product range. In collaboration with physiotherapists and physicians, Nordisk Terapi developed S-E-T (sling exercise therapy), a treatment concept for providing long-term relief from muscular-skeletal complaints. The concept is designed around the company's patented TerapiMasterÆ equipment and training programmes, currently in use in over 1,800 physiotherapy practices and hospitals in Norway.
A number of Norwegian companies are award-winners in their field. Among the companies that dominate their market segment is Laerdal Medical AS. Laerdal emergency and medical training aids and trauma equipment are anchored in their markets by the practice manikin, Resusci Anne, introduced in the 1950s and still being bandaged and resuscitated. Since the manikin's introduction, the company has been a leading supplier in its emergency medical market niche.
Staying power is also a trait of other niche market stalwarts from Norway: the sensor stethoscope from Meditron, Alu Rehab's comfort wheelchairs for children, patient lifters from M¯ller Vital and GSI patient transfer systems. Norway's growing ranks of health care manufacturers continue to win acclaim for quality and reliability, as they help shape a future for the people they serve.