Background

The National Health and Coordination Plan for 2024-2027 (the Coordination Plan) stresses that AI could make a significant contribution to the sustainable development of our joint health service.

The Coordination Plan states that there is considerable potential for establishing a more appropriate division of tasks and organisation of work processes among the healthcare services [2]. It is noted that tasks must be continually assessed to determine whether they can be performed in other, less personnel-intensive ways, e.g. by using artificial intelligence, automating tasks or altering work processes that were previously carried out manually. It is also anticipated that artificial intelligence and other personnel-saving technology will help us to maintain the quality of services over the coming years, and help to reduce waiting times in areas where it has been put to use.

The Health Personnel Committee’s report Tid for handling (Time for action) states that the main priority for health policymakers over the coming years should be to develop measures and invest in solutions that result in the lowest possible growth in the number of staff in the health and care services. In this regard, AI can play a key role, a point which is also made in the report. It is also claimed that “The digital transformation is characterised by the rapid development of new technologies, which are still evolving rapidly and offer major opportunities. Artificial intelligence and personalised medicine are examples of such technologies, which have led to, and can lead to, completely new types of healthcare and ways of working. If this happens, new types of jobs will also be created, along with new types of competence and knowledge needs.” [3]

Through the so-called AI billion, the Government intends to establish up to six new AI research centres in 2025. A number of healthcare environments have taken the initiative to apply, but it is not certain that research centres will be established within the field of health [4].

Through the National Roadmap for the Healthcare Industry, the Government aims to promote and strengthen the healthcare industry in Norway. Artificial intelligence can be one of a number of relevant focus areas [5].

The Ministry of Digitalisation has announced that it will publish a digitalisation strategy after the summer holidays in 2024. The Minister of Digitalisation has also signalled that it will cover ambitions relating to the adoption of artificial intelligence, including in the health sector. She also stated that, by 2025, 80 per cent of the public sector will have adopted the use of artificial intelligence (AI) [6].

Digitalisation, including artificial intelligence, is also high on the agenda of the EU, which is developing and implementing policies through strategies such as the EU’s Digital Decade Strategy, and initiating numerous plans, legislative changes and programmes to support the ambitions of the strategies [7].

About the assignment

In its letter of allocation for 2024, the Ministry of Health and Care Services (HOD) asked the Norwegian Directorate of Health (Hdir) to continue the work to facilitate the safe introduction of AI in the health and care services in cooperation with the Medical Products Agency, the Norwegian Board of Health Supervision, the Norwegian Institute of Public Health, the regional health authorities and KS in an appropriate manner. The Norwegian Directorate of Health will lead the work [8].

The assignment states that the work must contribute to the greater use of AI solutions that are safe and contribute to healthcare services of equal or better quality and free up time for healthcare professionals. 

The Ministry asks the agencies to continue work on the following:

• support and guidance relating to the validation of solutions, to ensure the safe introduction of AI. 
• cross-agency guidance and updated information pages, which make it easier for the service and other stakeholders to navigate regulations and guidance.
• assess the risks that large language models introduce and identify measures to ensure that the health and care services have access to language model(s) which are adapted to Norwegian conditions.

Furthermore, the Ministry asks the stakeholders to:

• draw up a joint plan setting out which measures should be implemented by which stakeholders in 2024 and 2025 to support the needs of municipalities and health authorities. The Ministry requests that the Norwegian Directorate of Health, in cooperation with the other stakeholders, submit its proposal for a joint plan by 1 July 2024.
• Reference is made to the national coordination project Better use of artificial intelligence in the health and care services and the final report of 15 October 2023 [4]. 

Relevant assignments for other stakeholders are presented in Appendix 1. Collectively, the AI plan and the overview of other assignments provide a clear overall description of the stakeholders that are responsible for each of the measures.

Concerning recommendations from the final report from the AI coordination project

The health and care services have begun using artificial intelligence. The work of the national coordination project for artificial intelligence (the AI coordination project) showed that close cooperation between the stakeholders in the health and care sector remains essential. This is especially true for strategic topics so that measures and initiatives can be viewed in context. The aim of the collaboration is to ensure that the sector has a shared understanding of opportunities and challenges. Furthermore, the development and use of AI systems will require the entire sector, including government agencies, to regulate, control, set frameworks and quality-assure the use of artificial intelligence in health and care services. It is important that the stakeholders in the public health and care sector cooperate, are informed and have a common understanding so that they can use artificial intelligence safely and effectively.

In its final report in October 2023, the steering committee for the coordination project recommended areas that should be continued and new areas that should be specified [9]. These recommendations form the basis for the work to draw up this plan.

Concerning the joint AI plan for the health and care services

The steering committee in the AI coordination project has largely been continued as an AI council for this assignment. A unified AI council stands behind the plan.

The joint AI plan for the safe and effective use of AI in the health and care services (this report) states:

• Continuation of the work to facilitate the safe introduction of AI into the health and care services in collaboration with the other agencies is primarily described as initiated activities in the report.
• Recommendations concerning new activities are based on the recommendations in the final report from the AI coordination project and have been considered and clarified in a dialogue with the stakeholders involved.

The introduction and development of AI-based services is happening very quickly. It has thus been necessary to adopt a format for the plan which ensures sufficient flexibility and relevance. It is therefore proposed that a number of thematic seminars with broad involvement and a focused agenda be arranged to ensure that the work is relevant and topical.

The joint AI plan has been discussed in a number of rounds with the AI council [10]. The health and care sector discussed and provided input to an early version of the plan at the consultation meeting held on 23 May 2024. During the period from 16 to 31 May, it was also possible for stakeholders to provide written input concerning the same version. The plan has also been presented and discussed within the Prioritization Committee (NUIT) and the National Council for eHealth (which are national forums in the National council model for eHealth [11]).

The recommendations are anchored in the management of the Norwegian Directorate of Health, which is the sender of the plan.