Region Agder, Norway

Joint health care effort – ensures welfare technology integrated into services

Region Agder and 25 municipalities have successfully secured a collaboration where municipalities and hospitals work together towards better continuity of care. A regional steering group is one of the success factors. 
Regional Coordination Group (RCG) for e-health and welfare technology in Agder was established in 2016. The aim with RCG is to support the effort outlined in the National Health and Hospital Plan; to get the municipalities and the hospitals to collaboratively work towards better continuity of care. Region Agder had already since 2013 worked with several telemedicine/home monitoring projects in close collaboration with the hospital of southern Norway (Sørlandet sykehus, SSHF) and general practitioners (GP).
The reason for establishing the RCG e-health and welfare technology was to go from fragmented small-scale testing to large-scale implementation. RCG secures coordination between the municipalities and hospitals in the region. 
In 2019, the municipal director committee decided to establish a joint regional steering group for projects under the auspices of RCG e-health. Representatives in the joint steering group are from the municipal and hospital management, as well as observers from the State Administrator, KS Agder, Agder County Municipality, and the General Manager level ICT reference group Agder. One of the main success factors in creating the joint regional group was that all municipalities participated based on equal says – which means that the smaller municipalities are as important as the larger ones.

Why RCG e-health?

The purpose of RCG e-health is to coordinate and have an overview of projects and activities within e-health and welfare technology to ensure that the region will:
  • Be the leader in welfare technology in Norway
  • Stimulate research, innovation, and business development through innovation partnerships
  • Ensure municipal anchoring in projects that have regional value
  • Support and facilitate service manager networks
  • Encourage coordinated procurement to attack suppliers
  • Equal says for all municipalities
The overall goal is to ensure welfare technology is integrated into the health and care services in all twenty-five municipalities in such way that it provides value and benefits for the citizen and the health care professionals. This will give managers in the health and care sector the possibility to use competence-enhancing measures to gain increased insight into how their own municipality and department can use welfare technology, create profit plans, measurements, and reports and map needs, initiating services, assist in implementation of new technologies.

E-health Agder 2030 program

RCG e-health introduced in the spring 2020 the program E-health Agder 2030 where the vision of the program is to ensure that "the citizens of Agder have access to simple, secure, comprehensive digital health and care services". The joint steering group have agreed on the below initiatives (not an exhaustive list) within the program and the following investments: TeleCare, safety and warning technology, digital home follow-up (DHO), national e-health solutions, FKJ Agder (One citizen one medical record) and CRANE Agder (EU Horizion 2030 pcp-project).
Based on the above purpose and goal RCG will contribute to coordinate projects and activities within e-health and welfare technology for all the municipalities in Agder.

Network cooperation as a key component

With establishing the regional structure (RCG) in 2016 an increased trust among municipalities, county and the hospital was build working towards common goals.
The cooperation between RCG, municipalities, hospitals, PGs and the joint steering group is based on network management and network organization and are driven by clear goals. The group meets regular to cooperate and reflect on challenges, needs and effects on activities across the region. These meetings run in a very structural way with a firm set agenda and facilitation but in respect for the diplomacy. 
RCG have also set-up innovation partnership between the private sector, municipalities, hospitals and GP’s to test and implement innovative welfare technology solutions to benefit the citizen’s so they have simple, secure, seamless digital health and social care services. Focusing on the Digital home follow-up (DHO) service as the future RCG will gain more and more experience to build a knowledge base to improve good, customized services that will meet the individual citizen’s needs.
RCG is a central part of the digital transformation that Agder started back in 2013, and which they still are in, and the maturity of the digitalization have changed over time. In the beginning the transformation was focus on technology within the region and its organizations, but now the focus has moved into a more end user perspective and acceptance of technology in the support and managing your own health. In projects like DHO there has been focus on user involvement from the beginning to ensure anchoring with the citizens. This has resulted in Agder Living Lab (ALL) which is based on a citizen centric perspective to develop a methodology within health technology area.

Competences – be the best in the class

To be the best in the class also requires focus on development of competences both with employees in the region and the citizens.
RCG has experienced that there was a general is need for increased competence in digitalization, welfare technology, change management and flexible working methods. This is a need within the whole organization from health personnel in the service, middle managers to C-Suite. The project DHO has received several feedbacks on the need for more expertise and knowledge among both employees and from the citizens. Involvement from start to finish, anchoring in all stages and a close collaboration can contribute to valuable knowledge transfer between the involved parties.
Communication is also important in connection with anchoring on many levels   in the region. RCG is making a big effort in having a clear tread in the information flow from information about technical platform, service information and competence development.

Going forward

RCG will going forward and also investigate how to improve and get a more society economic view into the network by involving both national and regional economists, include more research in the field of integrated health and care by involving universities, be better to anchoring results on a local, national, and political arenas and   support the new transformation of the society which is under development related to which society Agder would like to be in the future.

Success factors

The key success factors and reflections from the RCG e-health up until now are many and below are some of the major findings and components identified:
  • Establish a structure is important to create a common framework and governance for all municipalities and the region to succeed with the network cooperation and network management.
  • Anchoring and buy in from top management C-Suite on both the strategic and operational levels, and a continuous focus on communicating the vision and goals for the network.
  • You need common goal and strategy across silos! This is important to chase value and have a constant focus on value for all parts of the network and not only in your silo.
  • Ensure ownership and anchoring in all levels of the entire network and ensure a red tread in all you do.
  • Understand common needs and challenges and cooperate to be the best in class. All municipalities are equal even though they are different in size. Be ready for change and open for iterative processes to build, test and learn from new services.
  • Create trust by working together as an Agder Team that works on behalf of the whole region. Creating arenas (yearly conference) for the employees in to meet a share knowledge and get inspiration for the universities and the private sector. Improve communication competences to ensure the right information to the right target groups on the right platforms.
  • Continuous developing the competences by the employees and the citizen in using technologies, so they can manage the transformation in a safe and trustworthy way. But also make it clear that you as citizen and employee have a responsibility for developing your own competences as well.
  • All projects have worked with profit realization, baseline and value based. However, the system to support the data collection for profit realization needs to be improved.
  • Putting the patients first should not only be a slogan but a true mandate. This is a strong focus going forward.
  • The network has been built around individual persons drive and willingness to change. Going forward it is important to involve society and economic perspectives as well.
  • Common technical platform. Common procurement and common implementation via innovation partnership that will ensure anchoring of the infrastructure in the long run.
  • Improve regional management network across sectors and to connect activities to the national political strategies.

Statements for citizens and health professionals


"I have that security in the back all the way. The fact that someone is watching it my daily form and getting in touch if there is anything is worth gold "- Patient
"I am absolutely convinced that I would have been hospitalized this summer if I had not had this follow-up (DHO)"- Patient

Health professionals

“The big win with DHO lies in interaction in dynamic teams around the patient” - Anonymous from survey


Facts about the model area

Name of regional network
Regional Coordination Group (RCG)
Area in km2
16.434 km2
Population – number of inhabitants
When the network was established
Number of municipalities in the network
25 municipalities
Number of hospitals in the network
1 somatic with 3 departments in the region: Arendal, Kristiansand and Flekkefjord
Target group
Chronic groups, mental health and habilitation, as well as open to other patient
Number of users
Approximately 100 and growing

Useful link

Below you will find link to platform that could be useful to dive into for more details.