RESEARCH REPORT

In brief

In brief

  • Dr. Markku Mäkijärvi is Chief Medical Officer of the Hospital District of Helsinki and Uusimaa (HUS).
  • HUS is the second largest employer in Finland and offers care to 1.8 million people, across 23 different hospitals in Southern Finland.
  • HUS recently implemented a new EMR platform, Apotti, and 60% of the implementation occurred during the pandemic.


Accenture: Tell us about the Hospital District of Helsinki and Uusimaa (HUS).

Dr. Markku Mäkijärvi: At HUS, we have 27,000 coworkers across 23 different hospitals in Southern Finland. We offer secondary, tertiary and core care for 1.8 million people. We have national responsibility for transplants, national preparedness and we help with major catastrophes, such as COVID-19. Our 3,000 doctors and 15,000 nurses this year have treated 600,000 patients. I’m also pleased to report that Newsweek ranked us 25th on the list of the best hospitals in the world.

A: What are your roles and responsibilities at HUS?

MM: I am responsible for medical care, research, hospital infrastructure and buildings, and preparedness and security. I also manage software, our electronic medical record (EMR) system, international relations and pharmacy.

In the near future, we’ll see the increasing impact of personalized medicine utilizing big data and genetic information.

A: As a clinician specializing in internal medicine and cardiology, what inspired you to work on the business side of healthcare?

MM: I work on the clinical side usually one or two days a week. After 30 years of performing invasive procedures, I am not doing invasive cardiology work anymore.

My exposure to the business side began when I was the part-time chief of development and workplace safety. I was also appointed to be chief of the cardiology laboratory. This was the beginning of moving away from my clinical career. I was then asked to serve as Director of Clinical Services at Kuopio University Hospital. I was not able to refuse the challenge. After one year, colleagues from Helsinki said, “What are you doing there?” It is the smallest university hospital in our system. It was then that I was hired as chief medical officer of HUS. As with many good things that happen in life, I didn’t plan it.

A: HUS recently implemented a new EMR platform, Apotti. Tell us about the endeavor.

MM: We set out to improve patient safety and quality, but at the same time, improve our ability to manage, direct and lead our processes. Our previous system was OK, but it was based on an old program. We had to check numbers from Excel files. After 10 years of development, it became almost impossible to make improvements.

Our organization chose to implement Epic as our EMR system, and it has been a two-and-a-half-year journey. We are nearing full implementation, which is encouraging, especially given that 60% of our implementation occurred during the pandemic.

A: In what ways is Apotti delivering on—or exceeding—your expectations in terms of benefitting citizens and the organization?

MM: Our first hospital went live in November 2018 and our last implementation was three months ago. We are improving speed all of the time. Our chief of development has done an excellent job with it. Those places that have been live for some time are experiencing all that they can do with myChart. We can communicate with patients directly and we can 24/7 communicate with hospitals and professionals. It saves working time. On the professional side, it requires new thinking and a new culture—but we feel it’s a great addition to HUS.

Our ICU platform has been among the most transformational elements. We are very happy with the customized improvements we made. What is also exciting is we are the first in the world to include social care in our system. Epic made this possible for Finland, but they now have the potential to roll out this functionality for health systems all over the world.

A: HUS is the second largest employer in Finland. How have the changes of this past year affected your workforce and are there lessons learned that you could share with others?

MM: In the first wave of the pandemic, there was a lot of stress and fear. There were so many things we just didn’t know. For instance, nobody was prepared for the lack of PPE. Issues like that caused stress for personnel. We organized a program to help reduce that stress for workers across our hospitals and healthcare system. It was highly utilized and valued.

We also tried to divide workload among units as equally as possible so that doctors and nurses feel supported. It’s been demanding. We see in our numbers that the extra load is shared evenly, and so is the risk. It hasn’t been perfect, but we managed. And furthermore, we have almost the same personnel we had in the beginning, so we have been able to weather the storm with the staff we have.

A: What is your future vision of healthcare? What big developments do you see on the horizon?

MM: In the near future, we’ll see the increasing impact of personalized medicine utilizing big data and genetic information. We have to prepare ourselves for that. Healthcare is becoming a commodity, whether we want it or not.

A: Who has inspired or influenced you in your career? What advice or guidance did that person provide?

MM: Several people have helped me. I have a mentor; he is from the private sector and was previously CEO of one of the biggest retail companies. He has been very supportive, as has been my wife and many of my previous superiors.

Throughout my career, I have tried to educate myself. I have an MBA and I studied at IMD in Switzerland. I’ve learned many important lessons. For instance, I took a course on the psychology of leadership. It was a powerful experience. We talked about that as a leader, you have to have an attitude that you love problems. The best way to solve a problem is the same way in which they fish in Sicily. You catch the fish and immediately put it on the table and clean the fish. Just like the fish, problems start to smell if you let them sit around too long uncleaned. It’s about dealing with the issues right away.

I was born on Sunday, so I’m an incurable optimist. I never give up. I always believe there is a solution; together we’ll find it and things will turn out well.

A: What do you like to do outside of work? Do you have any special hobbies or interests?

MM: I like to play golf with my wife. She inherited a farm, so we also like to spend time there. I like to fix the tractor I have and drive it, as there is a lot of open space, fields and forests. We watch birds and a variety of animals. We’re lucky to have many things growing—40 apple trees, berry bushes, carrots, zucchini, strawberries. We are thinking about growing grapes to make wine.

A: This has been a difficult year for people all over the world. How have people in Finland dealt with the challenges?

MM: Finnish people have been amazing in terms of getting along and managing the risk of this crisis. Our culture is one of honesty, freedom to speak and also one of obeying the rules and regulations, which is so important in this time of COVID.

Finland has been independent since 1917, but we began as a rural-based country. We started with very primitive conditions and in the past 100 years, have developed a society and standard of living that is among the top in the world. That is a huge achievement.

Dr. Markku Mäkijärvi

Chief Medical Officer, Hospital District of Helsinki and Uusimaa (HUS)

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