Optimizing Healthcare Integration with Kafka at NHN | Use case

Connecting Hospitals and Advancing the Digital Health Ecosystem in Norway.

Problem Context

Norway’s healthcare system is complex, serving a population of 5.5 million people across 400 municipalities and 80 hospitals. The healthcare sector consists of 400,000 healthcare personnel (excluding administrative staff) working across four regions.

This system's heart is Norsk Helsenett (NHN), Norway's national health network organization. NHN plays a critical role in ensuring secure and efficient digital communication between healthcare providers across the country. By offering shared IT services and infrastructure, NHN enables hospitals, municipalities, and other healthcare organizations to collaborate more effectively while adhering to strict privacy and security regulations.

A major challenge is that healthcare institutions, including hospitals and municipalities, are not allowed to communicate directly about individual patients due to these strict privacy regulations. As a result, it becomes difficult for healthcare providers to collaborate and share patient information effectively, hindering care coordination. Additionally, 17,000 healthcare organizations independently procure their own systems, leading to collaboration and data-sharing inefficiencies.

NHN previously used Kafka, but it was not implemented in a way that was scalable or suitable for a controlled rollout across the organization under the right conditions. With the implementation of the Axual platform, NHN now has the capability to address these challenges. Currently, NHN is in the process of migrating its existing setup to the newly delivered Axual environment. Once completed, by the first quarter of 2025, the uncontrolled situation will be resolved, opening the door for the controlled and scalable use of the platform across the organization.

In this use case, we will examine how NHN and Axual have started creating a Kafka health ecosystem that benefits healthcare organizations and their patients.

Problem Identified

• Fragmentation: The independent procurement of systems by 17,000 organizations creates fragmented processes, inefficiencies, and difficulty sharing data across regions, municipalities, and hospitals.
• Coordination Challenges: The healthcare system’s multiple stakeholders—hospitals, municipalities, and healthcare providers—face significant hurdles when coordinating care across different regions. This is done with the help of Kafka, but the current setup isn’t scalable.
• Regulatory Communication Barriers: Due to privacy laws, hospitals, and healthcare institutions cannot directly communicate with each other about patients. This limits collaboration and makes efficient information sharing about patient care difficult.
• Redundancies in Procurement: Independent purchasing decisions across 17,000 organizations result in redundant, incompatible systems that raise costs and complicate collaboration.

Solution: Kafka Health Ecosystem for Healthcare Integration

Recognizing the need for a better Kafka transformation, NHN (Norwegian Health Network) and Axual set out to develop a new Platform solution that would unify disparate systems, improve communication, and ultimately create a scalable healthcare environment.

The goal was clear: create a seamless, interoperable digital ecosystem where healthcare providers could securely communicate and share patient data without compromising privacy or efficiency.

Key Steps in Building the Kafka Solution

1. Understanding the Stakeholders

The key stakeholders are at the heart of this project: 400,000 healthcare personnel, 80 hospitals, and 400 municipalities. However, secondary stakeholders—patients, administrative staff, suppliers, and policymakers—whose needs need to be considered in this digital ecosystem also exist.

NHN is the bridge between these groups, and it plays a crucial role in facilitating secure and compliant communication between healthcare providers and patients and among different health institutions.

2. Enabling Seamless Communication and Data Sharing

The first technical hurdle was ensuring data interoperability. A unified platform that could securely share data across regions, municipalities, and hospitals was needed. The system needed to ensure that patient data could be securely shared when necessary, helping coordinate care and improve decision-making.

3. A Platform for Secure Communication

NHN knew that, due to strict privacy laws, direct communication about patients could not happen between healthcare providers. So, Axual was brought in to develop a platform to bridge this gap—enabling hospitals and healthcare providers to communicate indirectly but securely about patients, all while maintaining compliance with Norwegian privacy regulations.

The Axual Platform allowed healthcare providers to communicate with each other, share medical data, and manage appointments—all without directly sharing patient information between organizations.

4. The Importance of Regional Coordination

To ensure regional alignment, four regional health hubs were established to oversee the integration of healthcare systems within their respective regions. These hubs played a crucial role in facilitating the seamless connection of local healthcare providers and municipalities to the network, supported by the deployment of Axual Kafka, which ensured the platform's reliable functionality.

5. Training the Workforce

With the technology deployed, the next challenge was equipping people with the knowledge to use it effectively. Digital training and onboarding became essential for success. The Axual platform team conducted training sessions for Axual Admin and Axual Operator, working closely with DevOps teams to ensure seamless implementation across all organizations. All of this was done to ensure the platform was adopted smoothly and efficiently.

6. Ongoing Maintenance and Support

Building the system was only the beginning. NHN uses the Axual platform daily for continuous updates, monitoring system performance, and addressing issues. Axual delivers 2nd line support. This maintenance and support is crucial to ensure the system's longevity and effectiveness.

The Results: A More Connected, Efficient Healthcare System

Axual’s deployment enabled NHN to scale its use of Kafka for large-scale, event-driven information processing. This was previously unfeasible due to fragmented infrastructure that lacked readiness for a more governmental approach. As the platform began to be adopted, the results became clear. With Axual, NHN now benefits from enhanced:

Control: Centralized oversight of event streams, ensuring that data flows are managed and monitored efficiently across the organization.

Security: Strong encryption and secure authentication mechanisms, protecting sensitive healthcare data and ensuring compliance with strict regulatory requirements.

Auditability: Comprehensive logging and traceability, enabling better visibility into data usage and changes for compliance and accountability purposes.

Features such as self-service capabilities: Empowering teams to manage and deploy their own event streams with minimal dependency on central IT, improving agility and reducing bottlenecks.

Desired future situation

Once the migration is completed in Q1 2025, the previous situation will have been resolved, opening the door for a controlled and scalable increase in usage. This shift will bring about several key benefits:

Enhanced Communication: Healthcare providers will securely exchange information and share data across regions, improving care coordination and response times.

Improved Collaboration: A centralized platform will enable hospitals, municipalities, and healthcare professionals to work together more effectively, ensuring consistent and well-coordinated patient care.

Cost Efficiency: The streamlined procurement process will eliminate redundancies, reduce costs, and ensure system compatibility across healthcare organizations.

Better Patient Care: With real-time access to integrated patient data, healthcare professionals will be empowered to make informed decisions, leading to improved patient outcomes.

Scalability and Flexibility: The platform will be capable of growing with the system while remaining adaptable to future regulations and technological advancements.

Conclusion

The Digital Health Ecosystem enables the seamless integration of Norway’s healthcare systems, addressing fragmentation, inefficiencies, and regulatory communication barriers. By leveraging the platform built by Axual for NHN, this solution allows healthcare providers to collaborate effectively while adhering to regulatory constraints, improving patient outcomes and care coordination. The successful onboarding of DevOps teams and the ongoing maintenance and usage of the platform by numerous healthcare organizations showcase the system’s scalability and long-term sustainability. This approach creates a more connected, efficient, and patient-centered healthcare system in Norway, setting a new standard for compatibility and secure communication in healthcare.