1 Introduction

Digital maternity cards are being developed at the same time in many of the Nordic and Baltic countries. They are expected to aid in optimizing workflows, maximizing the value of clinical data, and connecting medical professionals. Currently, there is no cross-border agreement on developing the digital maternity card and its data models. Development is done separately in each country, and the utilization of international data standards varies. However, the EU allows the exchange of patient summaries and electronic prescriptions (ePrescriptions) and aims to have medical images, laboratory results and reports, and hospital discharge reports available across the EU

eHealth Network eHealth Network (europa.eu)

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Based on these digitalization efforts, a common Nordic vision for developing digital maternity cards and its data models could ensure ‘cross-border by default’ to be considered in the development as well as possibly create cost savings in case the development teams benefit from the shared data and experiences. The cross-border digital maternity card strengthens the continuity of care, which includes both planned and unplanned care. Especially between the Nordic and Baltic countries, there is a large population of working-age cross-border commuters. Pregnant women cannot be excluded from this group, and it is an important aspect of ensuring gender equality. Based on the Nordic cooperation program on gender equality, it is stated that men’s and women’s equal access to care services and equal treatment in healthcare are important conditions for participating in the public and private spheres

Nordic cooperation programme on gender equality FULLTEXT01.pdf (diva-portal.org)

. In addition to cross-border commuting, people in the Nordic and Baltic countries travel across borders for many other reasons. for example for services and family visits on both sides of the border.

The aim of the study is to share knowledge between the Nordic and Baltic countries on the stage of development, aims, and content of digital maternity cards. To achieve this, KPMG Finland interviewed Minna Maria Hernandez regarding the digital maternity card situation in the Nordic countries. Minna Maria Hernandez is a Norwegian official for the Directorate of e-Health. The Directorate of e-Health is a sub-institution of the Norwegian Ministry of Health and Care Services. The main responsibilities of the Directorate of e-Health include developing and implementing the national policy on e-Health as well as establishing standards and administrating the use of e-Health methodology nationwide.

Directorate of e-Health English - ehelse

The Directorate of e-Health conducted a preliminary survey in 2022 on the Nordic countries of the possibilities to develop a digital maternity card. The result of the survey was that it might be possible to develop the digital maternity card. KPMG Finland broadened its understanding of the Norwegian survey by interviewing Minna Maria Hernandez, and on this basis, created a similar study in the Baltic countries. As a result, a broader comparison between Nordic and Baltic countries is possible. An important clarification in this regard is that KPMG Finland’s purpose was not to survey the Nordic countries but to gather similar information on the Baltic countries as e-Health had gathered on the Nordic countries.

The overall core process of collecting pregnancy data in each Nordic and Baltic country is illustrated in Figure 1 below. The maternity card discussed in this paper refers to and contains information on the following steps: data about the prenatal period, data about birth, and data about the postnatal period. It is possible that other information on pregnancy is being collected, but the interest of this paper is focused on the core elements of the maternity card.

The results of the interviews are presented in this report, and the content is structured as follows. At first, KPMG presents the current situation in the Nordic countries based on the interview with Minna Maria Hernandez. Subsequently, the results of our own interviews in the Baltic countries are presented. Both of the main chapters contain summary sections comparing the countries covered. Attachment B.4 summarizes the most relevant information in a table, allowing a cross-comparison between the Nordic and Baltic countries.

Before proceeding to a further review of the results, it is important to assess the reliability of this report. Firstly, the background information for the project (regarding Nordic countries and their state) was based on an interview with Minna Maria Hernandez, not on written records. Therefore, some of the background information may be incorrect and/or misunderstood. Secondly, the information collection process for the study was rapid. It included partly interviews and partly email conversations, and it was conducted in a foreign language (not the mother tongue of any of the participants). However, the reliability of the information was aimed to be improved by a comment period during which participants were given the opportunity to correct information that concerned them. The errors identified during the comment period were corrected in the final version of this report.