Introduction

The Nordic region has set the ambitious goal of becoming the world’s most sustainable and integrated region by 2030. Vision 2030 comprises interlinked strategic priorities: a green Nordic region, a competitive Nordic region and a socially sustainable Nordic region. Achieving this vision requires actions to promote a green transition in the Nordic countries, working towards achieving carbon neutrality, fostering green growth based on knowledge, innovation, mobility and digital integration, and enhancing social sustainability by ensuring good, equal and secure health and welfare for all. Distance spanning solutions in Nordic health care and care are closely aligned with this vision and each strategic priority.

Digital solutions in health care and care represent a promising avenue for improving service accessibility for citizens and enhancing sustainability. Environmental sustainability and the green transition are relatively new topics of discussion concerning the digitalisation of health care and care, despite the numerous connections between climate change and challenges in these sectors. It is estimated that the healthcare sector is responsible for over 4 percent of global greenhouse gas emissions, and in some industrialised countries, this figure could be as high as 15 percent. Digitalisation is viewed as one way of mitigating the negative environmental impacts of health care and care production. However, practical tools are needed in order to comprehensively assess the impacts of digitalisation in this field.

The purpose of this publication is to enhance understanding of the implications of digitalised health care and care on the different dimensions of the Sustainable Development Goals (SDGs). The publication comprises two parts that are presented below. Five model Nordic regions were presented in the iHAC publication from 2022, Integrated Healthcare and Care through distance spanning solutions – for increased service accessibility, and four of these regions – Päijät-Häme wellbeing services county, Finland, Fjallabyggd municipality, North East region, Iceland, Agder, Norway and Tiohundra Norrtälje, Sweden – have participated in and contributed to this publication. Päijät-Häme wellbeing services county is the focus of the first part and all four regions have contributed to the second part through workshops and interviews.

This part introduces a novel methodology to assess the environmental – especially the climate impacts and social impacts of digital healthcare and care services. Digitalisation, such as distance spanning solutions, is seen as one way of reducing the negative environmental impacts of healthcare and care production and advancing the green transition. However, negative climate impacts result from every digitalisation action due to the equipment and energy that are needed. Concrete practical tools are required in order to assess the impacts of digitalisation in the field of health care and care. 

In this part, authors from Lappeenranta-Lahti University of Technology (LUT) and the Finnish Environment Institute present the study results of a combined quantitative and qualitative assessment on the impacts of distance spanning solutions in home care services in Päijät-Häme, Finland, focusing on medicine robot services for older people. The study shows how such distance spanning solutions in health care and care can contribute to the green transition. Practical guidance for future impact assessments is also given.

While the reduction in greenhouse gas emissions and the saving of productive time are well-documented benefits, focusing on these metrics alone will not be enough to achieve a sustainable transformation in the sector. A broader perspective is essential to understand the implications of digital healthcare solutions on other environmental and socio-economic factors and their contribution to a green transition that is inclusive and sustainable. This includes ensuring sustainable livelihoods and access to health care services for vulnerable and disadvantaged communities.

The Stockholm Environment Institute’s (SEI) compilation of insights from multi-stakeholder workshops across the four Nordic model regions indicates there is a solid understanding among the stakeholders of what sustainability means in their respective contexts. The SDG Synergies tool of the SEI was used in one of the workshops. The tool is open source and freely available and allows for a deeper analysis and pathway design towards realising the Nordic Vision 2030. The SDG Synergies exercise revealed trade-offs and synergies concerning economic development, biodiversity, resource rights, consumption and production, as well as gender equality.

The aim of this chapter is to broaden the perspective on the potential impact of digitalisation in the Nordic welfare sector, from focus on climate impacts and carbon footprints to include social, economic and other environmental dimensions. A broadened scope reflects the 17 Sustainable Development Goals (SDGs) and the United Nation’s 2030 Agenda. This is also in line with the Nordic Council of Ministers’ Vision 2030 of the Nordic region becoming the most sustainable and integrated region in the world by 2030.