By: Kristin Rosmo

It's a regular day at the dentist office. As the patient leaves the door, the dentist records information about the treatment and provides an overview of the self-interest and reimbursement requirements for Helfo through Norsk Helsenett (NHN). A few days later, you'll see that the money is on account. It's easy, fast and secure. Norwegian dentists have become increasingly active in health care as service services have become wider. The first time a dentist connected to the national network for secure communication and exchange of personal data for healthcare actors was in 2009. 85 percent of the country's 5,000 dentists are currently connected but nearly 600 dentists have currently opted not to buy membership .


Fjerdingen2Still more relevant
Norsk Helsenett is a state enterprise and its task is to provide a secure, robust and appropriate national ICT infrastructure for effective interaction between all players in the health and care sector. 
- Connecting to healthcare is becoming increasingly necessary for dentists. The health system is a solution the authorities have chosen for all actors in the Norwegian health service, and the dental association recommends being a member of the health network, says Geir Fjerdingen, a dentist and adviser to the Norwegian Dental Association in e-health issues. Dentist and adviser to the Norwegian dental association in e-health issues, Geir Fjerdingen. Photo: Vestfold county municipality. "Knowledge of information security is essential and it is important that everyone working in the health sector takes it in." Geir Fjerdingen

Associates Health Norway Together

Product Director at Norsk Helsenett, Frode Johansen, says the vision of Norsk Helsenett is to link health Norway together. It is the Ministry of Health and Care Services that defines their tasks. The goal is that the network should contribute to the simplification, efficiency and quality assurance of electronic services to the benefit of patients and the general public. 
"Our customers and members include all healthcare companies and private hospitals, all the country's pharmacies, landlords and municipalities, as well as a number of other health professionals, such as dentists," says Johansen to the Dental Secretary.

Last year, a total of 192 million medical messages were sent through the Health Network. A medical message is defined as an electronic message containing patient information. Norwegian dentists received and sent 223,000 such messages last year, around 0.1 percent of total traffic. About six out of ten medical messages in the Health Network are e-prescriptions, and it is therefore expected that dentists' share of traffic will increase when e-prescription is also introduced to dentists around the turn of the year.

Safe motorway
According to Fjerdingen, the dentists make up the "highway" for example Helfo for treatment settlement. 
- The Helfo contact has been updated this year, since all dentists now have to provide an overview of the patients' own shares because of the new rules for free card at deductible 2, "says Fjerdingen.

Connecting to the health network also provides much safer and more effective communication with specialists. This may include referrals, receipt of epicrises or advice on choice of treatment for patients. The health network can also be used for SMS notification to patients on hours, emails between colleagues and home-based journals.
"In addition, the industry gets secure dialogue with other parts of the health sector and access to information services from HelseCERT," says Johansen.

High security requirements

Medical messages sent through the healthcare network contain health and personal information and are subject to strict safety requirements. 
- The messages should be encrypted from time to time based on security requirements. The encryption and decryption of the messages takes place exclusively at the sender and the recipient. That is, it is only sender and recipient who has the opportunity to read the content, says Johansen. 

The safety requirements for healthcare are defined in the "Norm for Information Security Health and Care Services", where the Norwegian Dental Association is represented in the steering group. All players in the health network are committed to complying with the security requirements set.
"It is important for everyone who works at the dental offices to know the content of this standard. Knowledge about information security is essential and it is important that everyone working in the health sector takes it in, says Fjerdingen.

Mandatory 'road tax'
All actors who are affiliated with the Health Center pay a membership fee. Dentistry membership costs NOK 1 175 per month - the same as general practitioners, specialists, pharmacies and other health professionals. 
- The membership fee is the "entrance ticket" for the common infrastructure and the possibilities that the health network represents. The fee is not regulated by what parts of the service offer you actually use, but of all the services available to anyone involved, says Johansen.

Some dentists, however, question the price, and think they get too little left for the price they have to pay.
- Especially in the first few years after the healthcare system became available to dentists, many thought that the price was too high and that the service should be financed by the state. Now, however, the membership services have become more and more people therefore accept the price, "says Fjerdingen.

Everyone who participates in the Health Network must pay the fee. Linjeeleie is also available.
- The fee is comparable to road tax; If you are going to use the highway, you have to pay the fee, Johansen illustrates.

Frode JohansenGood teamwork
Fourthly, the cooperation between the Norwegian dental association and Norsk Helsenett is good. He emphasizes that it is a good thing that all health professionals in Norway are affiliated with the same health system, and he finds that it is well-suited for the health network to be attractive to dentists. Norsk Helsenett is also keen to have good dialogue with its members.
"Our customer service can be used 24/7 by the individual members if there is a need for support or if someone has questions related to services in the health network," says Johansen.

Director product in Norsk Helsenett, Frode Johansen. Photo: Thomas Mandelid / Norwegian Health Network

Norwegian Health Center (NHN)

Et statlig foretak eid av Helse- og omsorgsdepartementet som drifter og utvikler en digital arena for sikker kommunikasjon og utveksling av personopplysninger for aktører i helsesektoren.

Finansieres gjennom medlemsavgift, statlige bevilgninger og direkte tjenestekjøp.

Alle fastleger, apotek, helseforetak og kommuner er medlemmer.

Vel 85 prosent av alle tannleger er medlemmer, i tillegg til mange fysio- og manuellterapeuter.

Gir blant annet sikker tilgang til behandlingsoppgjør med Helfo, henvisninger og epikriser.

Kan også benyttes til sikker dialog på e-post eller SMS, samt journaltilgang fra hjemmekontor.

I 2016 ble det sendt 192 millioner medisinske meldinger over NHN.

Kilde: Norsk Helsenett