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Over the last 10 years, cross-border mobility has significantly increased in the Nordic and Baltic countries. For example, the Nordic Work Mobility and Labour Market report published in 2019 with the support of the Nordic Council of Ministers states that cross-border employment between Sweden and Denmark, for example, increased by about 60% over the course of 10 years (2005–2015). According to the study, more than 300,000 Nordic citizens live or work in another Nordic country and this number is on the rise.
Due to the rising mobility, the ability to move smoothly in pursuit of, for example, work or studies is more and more in the interest of all the Nordic and Baltic countries. However, cross-border services are rare exceptions and most services are designed only for local use. Since the Nordic and Baltic countries are aiming to be the first region in the world to aspire to observe the ‘cross-border by default’ principle in the organisation of their digital services, the goal of the Nordic Council of Ministers’ Presidency Project during Finland’s presidency is to create a common model and practices for improving and increasing the effectiveness of cross-border data exchange. The intention of the project is to create workable and permanent solutions for cross-border data exchange and cooperation between authorities.
To gather a general understanding of the current situation related to cross-border data exchange in the Nordic and Baltic countries, the Presidency Project started by conducting a baseline study of three selected life events/work packages. The selected life events, later called work packages, are:
- Studying in another Nordic or Baltic country
- The use of health services in another Nordic or Baltic country
- The versatile use of the Nordic and Baltic legal databases.
The baseline study of the selected life events investigated the key parties, data repositories, services, data exchange requirements and possible administrative and legislative bottlenecks from the perspective of cross-border everyday lives of people and businesses. Additionally, data interoperability was assessed at the four interoperability levels of the European Interoperability Framework (EIF): legal, organisational, semantic, and technical interoperability.
The baseline study was completed by KPMG Finland during February-August 2021. The data gathering in the study was conducted through workshops, surveys and interviews targeted at key stakeholders in each work package. The Finnish Digital and Population Data Services Agency, the Finnish National Agency for Education, the Finnish Institute for Health and Welfare, and the Ministry of Justice in Finland were responsible for procuring the baseline study.
The first work package addresses the current situation of the management and digital transfer of study records in the Nordic and Baltic countries. Currently, there are several challenges in cross-border data interoperability and access related to cross-border exchange of study records. First, the shared vision and resource allocation for starting the process of implementing solutions that enable automated, digital transfer of study records between Nordic and Baltic countries varies significantly between the countries. The countries have different capabilities, resources, understanding, and technical know-how for such a project. Furthermore, legislation must be adjusted to enable the transfer of study records in terms of data privacy and ownership. The target state of the project describes a world where digital application for education is easy, simple, and efficient, both for the student and for the education institutes. Study records would also include descriptive information about the contents of completed studies, and the information could be utilised in the selection process.
The second work package presents an overview of the current capabilities of the Nordic and Baltic countries when it comes to exchange of health care data, different structures, ongoing development actions in the field, and plans concerning ePrescriptions and Patient Summaries. Varying structures and a number of actors working with health data issues were identified in different countries. Moreover, there are many technical and semantic interoperability challenges related to current exchange practices of ePrescriptions and Patient Summaries. In general, the countries are using different systems and databases for different purposes, such as ePrescriptions, vaccinations, health records and social welfare. Moreover, the content of the Patient Summary data sets significantly varies between the countries, but standardised fields or a minimum data set are usually found. In general, the compilation of the Patient Summary data set is handled manually, and the amount and quality of data depends heavily on the health care providers and how they update the fields. This may affect the general quality of the data in the systems.
The baseline study also includes an identification of the factors that are slowing down, preventing, or constraining data access and exchange of health data. To establish semantic interoperability among ePrescriptions and Patient Summaries, smooth cross-border health data exchange requires both national and international cooperation. In addition, resources and financial issues were identified as significant organisational barriers to cross-border development. The key legal barriers slowing down, preventing, and constraining data access and exchange of ePrescriptions and Patient Summaries are data privacy and information security-related challenges. Also, the fact that many countries do not have a national legislation that supports cross-border health data exchange is a central legal barrier. Overall, benchmarking, knowledge sharing, and common prioritisation between countries are seen as important aspects in further development. The eHealth Digital Services Infrastructure (eHDSI) especially seems to be a key initiative for the cross-border exchange of ePrescriptions and Patient Summaries. Besides the semantics, patient-accessible electronical health records (PAEHR) and eIdentification (eID) are also important themes that need to be taken into account in future development work.
Finally, the third work package discusses the current state of legal databases, access to legal information and data interoperability. Currently, there are several barriers and issues in cross-border legal data interoperability and access. Legal barriers of data availability and interoperability include data protection and privacy issues and a lack of common cross-border interoperability requirements. The organisational barriers are mostly about perceiving the actual need to provide easy access and cross-border interoperability in legislative data. Semantic barriers are caused by language barriers, a lack of translations and a lack of common metadata standards and thesauri. Finally, the lack of common data formats and open machine-readable legal data are significant barriers to interoperability of legal data. One proposed solution for improving the access to legislation and regulations from the cross-border perspective is a new joint Nordic-Baltic search interface for legal data.
Additionally, to support the study of all three work packages and the Presidency Project as a whole, a general overview on digital service infrastructure enabling cross-border data exchange and a high-level look at current cross-border data exchange practices between a few selected administrative registers was also addressed. All in all, to support cross-border digital data exchange, a strong shared vision, and motivation investing in development at the same time are the primary priorities for cross-border projects to succeed. Furthermore, shared reliable electronic identification and other supporting eService infrastructure are key to forming a foundation for smooth cross-border public eServices in the future.
Although ongoing collaboration and practices between the Nordic and Baltic countries do already exist, there is lot to be done for smooth and comprehensive cross-border data exchange. The three work packages have a lot in common when it comes to legal, organisational, semantic, and technical barriers in cross-border data exchange and interoperability. The report recognised and recommended more detailed analyses to be able to continue with developing models for cross-border data exchange.
The development of cross-border data exchange can be a very long road. The cross-border development projects are doable, but they take an expressive amount of time combined with strong shared motivation across borders and very strong commitment, a significant amount of funding and prioritisation of resources. Without strong shared political will and commitment to actions and investments at the same time, international cross-border development projects can be very challenging to execute successfully. It all comes down to shared vision, motivation, and a clear business case. When all the stakeholders of the project are able to see the value and real benefits of the development projects and shared vision and goals are established, it is much easier for political decision makers to justify large scale investments. If different stakeholders are equally strongly committed to shared goals, the success rate of the projects may grow even higher.
Even if the baseline study covers an analysis of the current state regarding all three of the work packages in the Nordic-Baltic region and forms a basis for future work, it is recommended to conduct a more detailed analysis of requirements. It is recommended that this analysis include, for example, a mapping of predicted costs and potential benefits of the potential solutions in each of the three work packages. The analysis should describe in detail what the precise challenges are for which solutions are desired and what the benefits are for the related countries, organisations and citizens, as well as to the Nordic-Baltic region as a whole.
In addition, a detailed analysis of the countries’ technical infrastructure considering the three work packages and work package specific use cases is recommended to be conducted. This includes the mapping of systems, solutions, interfaces and linkages between systems, data structures and formats, and an overall technical view of the information management in each country considering each use case. The IT architecture analysis also includes a description of how user authentication and electronic identification is organised in each country. Further analysis of potential use and implementation of single digital gateway CEF building blocks is also recommended. Moreover, it is recommended to ascertain all implementation requirements of the single digital gateway regulation for all use cases in the three work packages.
Furthermore, a crucial factor in the success of the whole Presidency Project is to find the key representatives from each country who possess deep knowledge of the practices, processes, key responsible parties in the country as well as the country-specific challenges, strengths, concerns, and other viewpoints to the project execution and outcomes regarding each of the three work packages. Alternatively, the country representatives must retain a strong network of experts that can be consulted in the project. In addition, the country representatives need to be fully engaged in the project from start to finish. This requires that the project participants be motivated. Motivation can be generated with the previously mentioned cost-benefit analysis and active communication of the significance of the project.
Finally, as financial issues are perceived as a barrier in all three packages, the question is raised regarding whether all the countries are aware of different possibilities and instruments on which bases and to which projects funding could be received. It could be discussed in conjunction with this Presidency Project if there would be common prioritisations between countries that could work as the basis for, for example, EU funding for the development of cross-border data exchange in the Nordic and Baltic countries. Another approach could be to arrange a workshop or information sharing event for the participating countries about the different funding options and instruments that are available.