More and more contact online doctors - costs for digital health care services are rising in the Västernorrland region

- The patients have made their choice. They expect a digital contact, but I can say that it is definitely not free, says Hans Wiklund, regional director in Västernorrland.

There is an increase in the number of patients seeking advice through various online physician companies. During January to August this year, private healthcare companies providing distance advice billed the region SEK 2.5 million. This is more than during the whole of last year when the cost landed at 1.9 million. In 2017, the cost was 1.1 million.

The digital services are needed, says the regional director, but he also highlights problems with the system.

- There is an irritation nationally about the regulations - that certain online medicine companies, by establishing themselves in certain regions with special conditions, can compete in something that can be perceived as an unscrupulous way. By making it free for the patient but expensive for the home region.

In normal cases, a patient in Västernorrland is paid a so-called deductible, of SEK 200 for a visit to care. But in some county councils and regions, there is no patient fee in primary care.

It is in these regions that several of the online medicine companies have established themselves. The patient who contacts a web app does not have to pay a fee, but the company then bills your home county and region Västernorrland to pay SEK 650 for a medical appointment, SEK 600 for time with a psychologist or curator and SEK 300 for other medical appointments.

The online medicine companies, for their part, claim that they lower healthcare costs. That a digital meeting is cheaper than a physical one. That accessibility increases and that you get help on time. "Behind every figure is a patient, and with digital care we can both increase accessibility and reduce unnecessary suffering for everyone in our elongated country."

The Västernorrland region is in the process of building its own digital services. They are needed, says the regional director, who at the same time suggests that the work should have started earlier.

- I must say that we were a little late from the start blocks when it comes to digitalisation, but we are working on developing a number of digital healthcare services, admits Hans Wiklund.

For some time now, there has been a major investment in digitization; project Digga health center. 50 million is being spent in three years on digitizing in primary care.

- In the long run, there is only one choice for us, and that is to provide a really good digital offer at your own health center. It is the best quality choice for the patient, with continuity and to combine physical visits with digital contact when appropriate.

- I think there is a need for a discussion about which care is reasonable to provide digitally and which should be given during a physical visit.