Kapittel 6.2Initiated: Prepare a report on competence needs for the digital transformation based on artificial intelligence in the health and care services

What is the problem?

There is an expectation that AI will be increasingly used to streamline various areas [69]. To continue providing high-quality health and care services to an ageing population, it will be crucial to implement effective measures. This will lead to changes in competence needs for health managers, employees in the healthcare sector, including the health administration, and citizens.

As patients live longer, contract more medical conditions and the proportion of elderly people in the population rises, we are seeing more patients per health professional. This challenge cannot be overcome by simply hiring more people in the health and care services. Expectations concerning the use of AI have arisen parallel to a number of major changes: Personalised medicine will become an integral part of the health service, more health services will be provided at home using digital tools – both with and without AI – and the population will increase their health competence, including their digital skills.

The use of AI will lead not only to competence needs linked to the individual AI system in use, but also to more secondary competence needs, such as changes in the duties performed by different groups of personnel, in addition to changes in the performance of medical specialities. This will lead to a need for enhanced or new skills in addition to AI expertise.

These factors, most of which can be linked to artificial intelligence in diverse ways, thus influence how processes in the health service are provided and the extent to which the health system changes. These changes are expected to be both substantial and pervasive, meaning that digital transformation will be involved.

What is happening within the area?

The Norwegian Digitalisation Agency has created a competence framework for digital transformation that is being used as a framework for the work to prepare a competence report within AI [70].

A number of countries have implemented measures for competence-sharing and enhancement relating to AI in their health services. Examples of different types of measures include bringing together different stakeholders (public/private, research/health service) in labs, networks, HUBs or ecosystems. Some are aiming for more technology training at the primary or lower secondary school level, while others are aiming to raise the level of understanding of technology among managers. The United Kingdom has created a capability framework that is of interest in this work [71]. 

In Norway, a wide range of stakeholders offer training, courses and other competence-enhancing activities that are aimed at managers and personnel in the health service and/or general population. Relevant research is also being conducted in the area, and there are also a number of relevant national reports, documents and strategies.

What we want to achieve

The Norwegian Directorate of Health will prepare a report setting out recommendations to meet the competence needs for digital transformation based on artificial intelligence in the health and care sector. This will provide an overview of stakeholders who offer training, courses, etc. that are of relevance to AI and health. The report will then go on to describe unmet competence needs relating to the changes that the use of artificial intelligence in the healthcare sector will entail. The report will also identify competence measures linked to four different levels, where the first three levels are based on the Norwegian Digitalisation Agency’s competence framework. These levels are explained below.

Politics and general guidelines

The work being carried out in the public health and care services takes place within a political framework and must underpin the government’s wishes and ambitions. Politics and general guidelines [72] form the first level of the Norwegian Digitalisation Agency’s competence model for the digital transformation, and help enterprises gain an overview of the political guidelines in the field and understand the societal importance of working on digital transformation. The level aims to bring about greater awareness of how to rethink the social mission and support the goal of one digital public sector with the user at the centre.

The report sets out proposals for measures that are in addition to the public guidelines, targeted specifically at the competence area. One of these measures concerns the establishment of a number of study places within artificial intelligence. This applies not only to pure ICT subjects, but also to more knowledge about artificial intelligence for students who will work in roles other than IT in the healthcare sector. As part of this work, there has been no attempt to determine what constitutes an appropriate number to support the health sector’s needs, but it is believed that the supply of people with competence within ICT and AI in particular must be increased. ICT Norway recommends that the educational institutions offer at least 1,000 new ICT study places from autumn 2024, and then increase this number to 2,500 new places from autumn 2025 (cross-sectorally) [73]. Funding must be provided for the creation of study places.

Management of the digital transformation based on AI in the health and care services

Management is the second level of the Norwegian Digitalisation Agency’s competence model for digital transformation. This level aims to clarify what is required of those who hold leadership roles to succeed in the digital transformation of an enterprise. In digitally mature organisations, the digital transformation is led from the top. Managers and directors of the health and care services must therefore possess the necessary competence, understanding and interest to lead the digital transformation linked to the use of artificial intelligence. They do not need to master the technology themselves, but they must understand and see the opportunities that artificial intelligence offers.

The health service also has many highly trained employees with considerable responsibility and professional managerial tasks. The capabilities in this chapter are important to them as well. Many municipal leaders also need this expertise.

Various parts of the health administration must implement adopted policies and supervise the health and care services. It is therefore important that the health administration also possesses the same competence as health managers and health professionals.

The aim of the measures relating to management of the digital transformation is for:

• the managers to implement strategic planning, risk management and appropriate measures and projects linked to the use of AI
• the managers to be good change leaders, understand the implications for the workplace and healthcare services, and plan for the continuation of a good working life in the future
• the managers to implement, facilitate participation in, and follow up collaboration both within their own enterprise and across enterprises and national borders
• the managers to dedicate time to continuous and systematic competence-building to address changing competence needs
• the health managers to facilitate productive meetings between health professionals and patients with greater needs, and higher competence health managers to ensure that the use of AI also safeguards the patient’s rights and provides better healthcare from a patient perspective

Professional knowledge and skills for digital transformation using AI in healthcare

This level will provide an overview of the collective competence that the enterprise should possess to succeed in the AI-based digital transformation.

In its report entitled Tid for handling (Time for action), the Health Personnel Commission points to the strong need for competence within the health service: “Competence among developers, personnel, patients/users and relatives is a fundamental prerequisite for the use of technology and digital solutions. It is crucial that those affected by this master technological innovations and want to adopt them. They must also be perceived as useful by the users (in this context, this means health professionals) and make a difference in the way they work, such as contributing to greater efficiency at work or higher quality work. This means that targeted training measures must be implemented for the different personnel groups".

The impending competence report sets out competence measures relating to numerous groups of personnel in the health service (employees in the health sector at large, health professionals, personnel without any health or social science education, lawyers and technologists). The aim of the measures is to ensure that:

• all health professionals understand the basic principles of AI and can identify appropriate AI applications
• employees who use AI systems as part of their work use them safely and efficiently
• employees actively participate in streamlining based on AI and multidisciplinary collaboration relating to AI
• personnel with patient contact possess the competence to meet patients with greater needs, AI-based apps and a higher level of competence
• lawyers possess competence with regard to technology, the unique characteristics of AI, and legal implications associated with the development and use of AI in healthcare
• technologists/technical staff have sufficient knowledge of medicine and health to understand the key principles behind the development of AI systems for healthcare

Competence of the general population relating to the use of AI

The trend to relocate health and care services closer to people’s homes and users entails a greater need to use digital tools – developed either with or without machine learning. In turn, this entails a need for greater digital competence among patients to master their own health [74]. The population needs to have a balanced understanding of why the use of AI is desirable, the benefits and disadvantages of AI, and the use of AI in healthcare.

In May 2024, ICT-Norway published an analysis entitled Kappløpet på kunstig intelligens i Norden (The race for artificial intelligence in the Nordic region) [75]. This analysis showed that Norway has a lower proportion of the population with a positive attitude towards AI compared with the other Nordic countries. Nevertheless, Norwegians are more positive than the OECD average.

Through the measures in the impending competence report, we aim to help the part of the population that is interacting with the health service to understand:

• why the streamlining of healthcare services and the use of AI are desirable
• the fundamental principles of AI
• specific use of AI as part of their own healthcare

How to make it happen

• Prepare a report setting out recommendations to meet the competence needs for digital transformation based on artificial intelligence in the health and care sector.
  • A version of the report will be distributed for consultation, probably during September and October.
• Work to follow up the recommended measures according to priority and capacity.

Who is responsible?

The Norwegian Directorate of Health

Who collaborates?

Who cooperates on the measures will depend on the types of measures concerned and who is responsible for the area. The Norwegian Directorate of Health is in dialogue with relevant stakeholders, and also wants relevant partners to contact them. Examples of some relevant partners include the Norwegian Digitalisation Agency, the Norwegian Board of Health Supervision, the Norwegian Radiation and Nuclear Safety Authority, the USHTs, Kompetansebroen (the Bridge of Knowledge), SKIL and the senior management programme for health leaders. We also received feedback during the input meeting at the end of May, which was attended by delegates from municipalities, hospitals, the research and education sectors, private enterprises and others.