The future is connected healthcare – and it is founded on data consolidation
Canadian-born Kirsten Freadrich spearheaded a huge and complex project of data consolidation, and a template of transformative change for all Swedish health regions. She is now using the power of connection to deliver innovation at CSAM’s Connected Healthcare arm
If it wasn’t for the eruption of an Icelandic volcano, Kirsten Freadrich would not be in Sweden, much less head up CSAM’s delivery portfolio of Connected Healthcare solutions.
“I’m from the Canadian prairies originally,” she says. “I’m one of these people who just can’t stop exploring. When I was younger, I never stayed very long in one place. I loved moving around and meeting new people and having new experiences and that’s very much a part of who I am.”
So Freadrich wasn’t fazed when on her way to Europe to meet friends her flight to Paris was diverted to Glasgow, and then to Norway.
“It was 2010 and I had just completed my master’s degree in Information and Archival Science. The Eyjafjallajökull volcano erupted, and this messed up my travel plans. I ended up in Oslo which it turned out was not that far from Karlstad in Sweden where one of my friends from university was living. So I thought, why not? A matter of days later I met the future father of my two children.”
She found work easily. First, at the Regional Archive, then at Karlstad University “to help students with information literacy and research methodologies”. In 2014, Freadrich was approached by Sahlgrenska University Hospital in Gothenburg to conduct Health Technology Assessments (HTAs) of new medical interventions that could be of interest to the hospital.
“I don’t have a medical background,” Freadrich says, “but these HTAs covered everything: medical devices, health practices, drug treatments, software.”
What mattered was not medical but database & research methodological expertise.
“You have to be able to compare or develop a comparative analysis between everything that is published and not published [about a new intervention] and what is referred to as grey material. You need to have a very inquisitive mind to identify where all the comparative information about these new medical technologies and interventions could be captured. And the complicated part is that it’s never a one-to-one comparison. You have one intervention, but it could be 80% closely correlated to 60 other types of intervention that are being used and studied, so you have to be able to capture this.”
Arrival at CSAM
When Freadrich was approached by CSAM in 2021, after a three-year stint running a MDR Department, (the HTA equivalent for manufacturers), it was for two reasons: the highly technical nature of the project CSAM wanted her to lead, but also her “soft” knowledge of the Swedish healthcare system.
Freadrich explains. “I was recruited specifically to work on a problem that is a thorn in the side of every health region in Sweden: the data siloes that have been built up over many, many years. The consolidation of data across these massive and fragmented archives is the Holy Grail of e-health transformation. I don’t think that’s an exaggeration.”
Having one central database instead of three or six (“or hundreds in the case of the English NHS”) slashes operational overheads for IT and simplifies clinical and administrative workflows.
“And those are what you might call the first-order advantages,” Freadrich says. “But data consolidation also represents a radical leap forward for health analytics and for the cross-fertilization of existing healthcare systems and solutions. This why the project is so important to CSAM.”
Of course, Freadrich and her team are not the first to take on the challenge; the problem of disparate data has dogged health authorities since the beginning of the Digital Revolution. In the early 2000s, the NHS embarked on an ambitious project to digitise and consolidate patient records across its health regions; a decade and at least £10bn later, the idea was scrapped as unworkable.
One of the mistakes made by the NHS was to regard its data consolidation project as purely technical.
“My expertise in information architecture and the migration of electronic archives was a necessary condition,” says Freadrich, “yet it was not enough. It had to be complemented by a huge dose of trust and cultural sensitivity to the history and practices of the health region.”
“The expertise had to go hand in hand with the relationship, because I don’t think that there’s anybody in Sweden that has ever undertaken such a massive data project as we are doing at CSAM to centralise these archives.”
The data consolidation project is called CSAM XDS where XDS stands for Cross Document Sharing, a method for electronically sharing medical information.
“To put it in its simplest terms, our task is to map out the new system and migrate the ‘old’ data,” Freadrich explains.
Then she adds: “But the size of the archive(s) is mind-blowing.”
Although each Swedish health region organises its archives in a different way, they all struggle to a greater or lesser degree with data fragmentation, and CSAM XDS is the template for what all regions need.
“For this reason, we have embarked on an extensive campaign of trust and trust building with all of our healthcare regions. For the CSAM XDS initiative we have a very large reference group that is watching the project closely and over the course of the next five years we will sell upgrades [to each of the regions]. So this CSAM XDS project is really the first of very many that we have in the pipeline.”
Freadrich was the CSAM XDS project lead for 18 months. During that time, she did most of the heavy lifting in terms of putting a team in place, creating an understanding and agreement in terms of the methodological roadmap, and overseeing the first waves of data migration. The project has now been folded into the CSAM Medical Imaging business area.
“And for the reason I mentioned earlier,” says Freadrich. “The synergies between a central XDS database and CSAM’s other e-health solutions has already begun, and my colleagues in Medical Imaging are at the forefront of that and best-placed to take that forward.”
But CSAM XDS remains core to Freadrich’s strategic conception of her new role within CSAM.
The new role in Connected Healthcare
Freadrich was recently given the larger role of Delivery and Support Manager for the entire CSAM Connected Healthcare portfolio. This is a logical extension of the work she did for CSAM XDS because at some point in the future all the software in Connected Healthcare – and beyond – could be connected to a XDS archive.
The different solutions in Freadrich’s portfolio help hospitals connect radiology, cardiology and other services, but are used in different markets across the Nordics.
CSAM already operates a XDS database in Denmark, but it is limited to radiology data. “The CSAM Web Client is in Denmark; Infobroker, Helsemail, and Arcidis are only implemented in Norway. And CSAM S7 is in Finland,” says Freadrich.
“Our objective for next year is to work with the CSAM sales team on how we can get these products across Scandinavia and beyond. Because right now, we have really good installations in each of the countries but want to build value for customers with all our customized solutions across the whole of Scandinavia.”
Freadrich has particularly big plans for CSAM S7, a self-care and health counselling solution that simplifies the interaction between a patient and their healthcare provider(s), currently installed only in Finland.
“This product has the most potential for Scandinavia-wide use because it not only delivers important patient information, but moreover helps hospitals ‘save’ beds,” she says. “It is a number one objective of all hospitals to keep bed occupancy down.
“Almost all healthcare that’s non-critical is outsourced, or that’s the goal. That means working closely with private hospitals, private clinics, private caregivers – we need to connect all of these external caregivers to the hospital and to the main patient databases where the information can be consolidated in one place for those that need it.”
The power of connection
Freadrich’s appetite for change and exploration is as keen as ever. The ambition for Connected Healthcare is to break into new markets, but also to create new products and markets by expanding the capabilities of other CSAM e-health software.
“We have our objective to sell from country to country and encourage the products from Finland over into Sweden and from Denmark to Sweden and Finland and Norway,” she says. “But there is also a vast inward opportunity to synergise our solutions with the products in CSAM’s other business areas. CSAM XDS is already instrumental in taking our Medical Imaging solutions to the next level, and there will be many other opportunities like that.”
“How can we work more closely with CSAM’s other products to create this common integration which we can then sell to clients that we already have or that they can sell to theirs?” asks Freadrich.
“At the heart of this potential is connected healthcare, and the CSAM XDS archive project will prove foundational to that.”
Freadrich is an explorer at heart, and this is how she sees her mission at Connected Healthcare: to open up new opportunities for better patient outcomes through the power of connection.
The challenge is considerable – but Freadrich would have it no other way. As a former competitive swimmer, she has the drive and focus to succeed; as a child of the Canadian prairies she is used to long journeys and distant horizons.
“I am proud of the work we did on CSAM XDS, and I am now taking that experience into an amazing new challenge. We have a great team and a great suite of products – and together, we are exploring a future of great possibilities,” Freadrich concludes. “In everything we do, connectedness is key. That’s what will propel us forward.”
