Digital Solutions and Technology Training for Social and Health Care in Remote Areas

Insights from RemoTED Partners – Descriptive narrative literature review

Authors

• Sanna Ahponen-Käyhkö, Master of Administrative sciences (Public Law), Lecturer, Karelia University of Applied Sciences
• Jaana Kurki, Master of Health Care (Development and Management of Health Care and Social Services), Project manager, Karelia University of Applied Sciences
• Susanna Leskinen, Master of Health Care, Lecturer, Lapland University of Applied Sciences
• Karla Muñoz Esquivel, Ph.D., Lecturer in Computing, Atlantic Technological University ATU
• Ulla Timlin, PhD (health sciences), Leading researcher, Lapland University of Applied Sciences
• Sini-Tuulia Nissinen Master of Social Services and Health Care, Specialist, Lapland University of Applied Sciences
• Leena Viinamäki D.Soc.Sc, Adjunct professor, Principal Lecturer, Lapland University of Applied Sciences

Preface

• Leena Viinamäki D.Soc.Sc, Adjunct professor, Principal Lecturer, Lapland University of Applied Sciences

Summary

This descriptive literature review aims to describe the current state of technological and digital solutions in social and health care education and training in among RemoTED preparatory projects partner universities and in their regions. Universities are Lapland University of Applied Sciences (Lapland UAS), Karelia University of Applied Sciences (Karelia UAS), and Atlantic Technological University (ATU).

The review defines the needs for education and training in technological and digital solutions, especially in remote areas. The findings indicate that the current state of technological and digital solutions in social and health care education among RemoTED partner universities is evolving, with a significant focus on integrating digital competencies into the curriculum. There is a recognized need for continuous learning in digital client work, with many professionals gaining practical digital skills on the job rather than during their university studies. Digital competence is identified as one of the most underdeveloped skill areas among future professionals, critical for integrating technology and digital solutions into practice.

The review highlights the need for enhancing technological and digital solutions in social and health care education, driven by factors such as skill development, service delivery, professional competence, and emerging technologies. Overall, the literature review underscores the essential role of digital and technological solutions in advancing health and social care education and in practice. The findings highlight the critical need for ongoing education and specialization in digital technologies to meet the evolving demands of modern social and health care settings, particularly in remote areas. Existing technologies and digital solutions, such as telemedicine, digital documentation, connectivity solutions, and work-based training, can significantly enhance professional service delivery in remote areas.

PREFACE

This publication is descriptive narrative literature review form Interreg NPA EU, RemoTED preparatory project. In the RemoTED preparation project, Lapland University of Applied Sciences has partnered with Karelia University of Applied Sciences in Finland and Atlantic Technological University in Ireland.

In both Ireland and Finland, the state is divided into urban-rural dimensions. In sparsely populated rural areas, compared to urban areas, business trips and public services (e.g. study opportunities) are often far from the place of residence (see also Muilu 2021).

Publication Urban and Rural Life in Ireland 2019 uses a six-way urban/rural classification to examine social and economic characteristics of life in Ireland. Urban and Rural Life in Ireland 2019 uses a six-way urban/rural classification to examine social and economic characteristics of life in Ireland. Themes such as income, housing, health, education and commuting patterns are examined. (Urban and Rural Life in Ireland 2019.)

The urban-rural classification update has been carried out by the Finnish Environment Institute (SYKE). In the urban-rural classification system, areas are divided in seven regional classes independent of municipality boundaries. The classification system is based on national information regarding the population, labour force, commuting and construction as well as on data regarding road networks and land use, among others. (Updated urban-rural classification 2020.)

The urban-rural classifications are slightly different in Ireland and Finland, partly due to the different sizes of the countries. The area of Ireland is 70,273 km² and in 2023 the population was 5,056,935 people. The area of Finland is 338,472 km² and in 2023 the population was 5,545,475 people. (Globalis, Suomen YK-Liitto 2023.)

At the EU level, a more precise unified urban-rural classification is challenging to implement. Even the rural areas of Finland are not the same, and they are not comparable to the rural areas of other EU countries. National urban-rural classifications and their development will continue to have an important task and role in the future. For example, Finland’s exceptionally sparse population, the comparably strong diversity of the population and the poor accessibility of rural areas, long distances and large municipalities, provinces and welfare areas challenge the statistical examination of the countryside and also the definition of functional areas, especially if it is delimited by the structural population. (Rural Pact – yhteinen … 2022; see also The long-term vision for the EU’s rural areas … 2024.)

In Ireland, the urban and rural classification is divided into two main categories (Map 1.). Urban areas include 1) Cities, 2) Satellite Urban Towns and 3) Independent urban towns. Rural areas include 1) Rural areas with high urban influence, 2) Rural areas with moderate urban influence and 3) Very rural/remote areas. (Urban and rural classification rules 2024.) Like Ireland, also in Finland urban and rural classification is divided into two main categories. Urban areas include 1) Inner urban area, 2) Outer urban area and 3) Peri-urban area. Rural areas include 1) Local centres in rural areas, 2) Rural areas close to urban area, 3) Rural heartland areas and 4) Sparsely populated rural areas. (Classification system independent … 2020.)

Map 1. Ireland and Finland. Note: Due to the side-by-side presentation of the maps, the country maps are not on the same scale.

Just over three in ten people in Ireland (31.4 %) lived in a rural area, above the rate of 27.3 % in the EU. The definition of rural applied in this instance is that adopted by Eurostat as part of its degree of urbanisation. (Urban and Rural … 2019.) According to the urban-rural classification updated by the Finnish Environment Institute, more than 72 per cent of the Finnish population now reside in the urban areas of the country (Updated urban-rural classification … 2020).

Figure 1. is described Digital Economy and Society Index – Overperforming and underperforming Member States in the years 2017–2022.

Figure 1. Digital Economy and Society Index – Overperforming and underperforming Member States (2017-2022). (Source: Digital Economy and Society Index (DESI) 2022. European Commission).

The Digital Decade policy programme sets out digital ambitions for the next decade in the form of clear, concrete targets. The main goals can be summarised in 4 points: 1) a digitally skilled population and highly skilled digital professionals, 2) secure and sustainable digital infrastructures, 3) digital transformation of businesses and 4) digitalisation of public services. (Europe’s Digital Decade 2024.) Figure 2.

Figure 2. The main goals of the Digital Decade policy programme. (Source: Europe’s Digital Decade 2024).

From the point of view of the objectives of the RemoTED project alongside, the Digital Decade objectives ensure that the digital transformation in Europe benefits all people, by: Building a safe & secure digital world; Ensuring everyone can participate in digital opportunities, and no one is left behind; Providing public services online; Ensuring all organisations adopt cybersecurity measures. (Europe’s Digital Decade 2024.) Cyber security in everyday life and the importance of citizens’ cyber security awareness is emphasized to an increasing extent as society becomes digital. (Kivivirta et al. 2020.)

I have had the pleasure of commenting on the manuscripts of the different stages of the literature review of the RemoTED preparatory project. In addition, I have submitted the literature review of the RemoTED preparatory project that was sent to the financier of the project in the publication series of Lapland University of Applied Sciences. I have received additional information about the limits and possibilities of the digitalization of social and health services from Finland and Ireland.

This publication has taken into account the finishing feedback given by the publication work group of Lapland University of Applied Sciences.

The working group of the RemoTED preparatory project thanks Interreg NPA EU for the funding it received.

Leena Viinamäki

Principal Lecturer, Social services
D.Soc.Sc, Adjunct professor
Lapland University of Applied Sciences

References

Classification system independent of municipality boundaries 2020. Accessed 2.12.2024 from https://www.syke.fi/en-US/Open_information/Updated_urbanrural_classification_Finlan(57443)

Digital Economy and Society Index (DESI) 2022. Thematic chapters. European Commission. Accessed 22.11.2024 from https://digital-strategy.ec.europa.eu/en/policies/desi

Europe’s Digital Decade 2024. Accessed 22.11.2024 from https://digital-strategy.ec.europa.eu/en/policies/europes-digital-decade

Globalis, Suomen YK-Liitto 2023. Accessed 2.12.2024 from https://globalis.fi/maat

Kivivirta, V., Viinamäki, L. & Selkälä, A. 2020. Cybersecurity of Digital Citizens in the Remote Areas of the European High North. In: Salminen M., Zojer G., Hossain K. (eds.) Digitalisation and Human Security. New Security Challenges. Palgrave Macmillan, Cham, 231−265. Accessed 22.11.2024 from https://doi.org/10.1007/978-3-030-48070-7_9

Muilu, T. 2021. Rural policies for sparsely populated areas in finland – old problems, new challenges and future opportunities. Europ. Countrys. Vol. 13 2021 No. 2 p. 479–491. Accessed 22.11.2024 from https://intapi.sciendo.com/pdf/10.2478/euco-2021-0028

Rural Pact – yhteinen kehys osallistumiselle ja yhteistyölle kaikilla hallinnon tasoilla 2022. Accessed 3.2.2024 from https://www.maaseutupolitiikka.fi/blog/rural-pact-yhteinen-kehys-osallistumiselle-ja-yhteistyolle-kaikilla-hallinnon-tasoilla

The long-term vision for the EU’s rural areas: key achievements and ways forward 2024. REPORT FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT, THE COUNCIL, THE EUROPEAN ECONOMIC AND SOCIAL COMMITTEE AND THE COMMITTEE OF THE REGIONS. COM (2024) 450 final. Brussels, 27.3.2024. Accessed 3.2.2024 from https://eur-lex.europa.eu/legal-content/EN/TXT/HTML/?uri=CELEX:52024DC0450

Urban and Rural Life in Ireland, 2019. Accessed 22.11.2024 from https://www.cso.ie/en/releasesandpublications/ep/p-urli/urbanandrurallifeinireland2019/

Urban and rural classification rules 2024. Accessed 2.12.2024 from https://www.cso.ie/en/releasesandpublications/ep/p-urli/urbanandrurallifeinireland2019/introduction/

Updated urban-rural classification 2020. Finland’s degree of urbanisation currently at over 72 per cent. Accessed 22.11.2024 from https://www.syke.fi/en-US/Open_information/Updated_urbanrural_classification_Finlan(57443)

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1. INTRODUCTION

This descriptive narrative literature review describes existing technologies, and digital solutions that can be used to develop professionals service delivery and education in social and health care in remote areas. The purpose is to describe the current state of technological and digital solutions education and training of them in social and health care in RemoTED preparatory projects’ partner areas in Ireland and in Finland (Map 1.; Map 2.).

Atlantic Technological University is operating in the West and Northwest of Ireland (Map 1.). Areas in Finland are more specifically Lapland in the North (Lapland University of Applied Sciences) and Karelia area in the East (Karelia University of Applied Sciences) (Map 2.).

Map 1. Map presenting regions of Ireland, 2024 Discovering Ireland. (Source: Discovering Ireland 2024 from https://www.discoveringireland.com/regions-of-ireland/)

Map 2. Finland’s provinces on the map. (Source: Suomen maakunnat kartalla. Accessed 2.1.2024 from https://fi.maps-finland.com/suomen-alueiden-kartta)

RemoTED project was funded by the European Union Interreg Northern Periphery and Arctic (Interreg NPA). Detailed project and partner information, including the description of the areas, can be found from the appendix 1.

Digital competence encompasses the confident, critical, and responsible use of digital technologies across various settings. These various settings include learning or studying, at work, and in social engagements. Digital competence involves a combination of knowledge, skills, and attitudes necessary for effective interaction within digital environments. The key components are information and data literacy, communication and collaboration, media literacy, digital content creation, digital well-being and cybersecurity, understanding intellectual property, problem-solving, and critical thinking (European Union 2019, 10). Digital transformation in education redefines traditional education models by integrating digital technology to enhance the educational journey for stakeholders, such as students, educators, graduated professionals. While many educational organizations have articulated the need for comprehensive frameworks detailing its full implementation remain scarce because digital and technological solutions impact varies across sectors, with each adapting to its specific needs. Effective use of digital solutions requires a clear vision supported by technology, leadership, and stakeholder engagement. Challenges include limited resources, infrastructure, qualified personnel, and balancing private partnerships with educational integrity. Strategic leadership and change management models are essential for successful implementation of digital and technological solutions, and it needs also fostering a culture of collaboration and supporting of continuous learning (McCarthy, Maor, McConney & Cavanaugh 2023, 10–11).

Map 3. illustrates the higher education rates in Europe, including partner countries Finland and Ireland. Compared to Ireland, there seems to be less people holding a higher education degree in Finland.

Map 3. Map of Tertiary education 30-34 years in 2019. (Source: Nordregio)

2. AIM AND STUDY QUESTIONS

The aim is to describe the current state and concept of technological and digital solutions in social and health care education and training in RemoTED preparatory project universities and in their regions. In our literature review, we have gathered existing knowledge of technological and digital solutions that are used in social and health care, and we have justified the need for further research and the need for developing new training strategies for implementing technologies into practice to get more efficient accessible services for clients in sparsely populated areas.

The following study questions were addressed based on the background information:

1. What is the current state of technological and digital solutions in social and health care education in RemoTED partner Universities?
2. Why is there a need for technological and digital solutions in social and health care education in RemoTED partner Universities?
3. How can existing technologies and digital solutions enhance professional service delivery in social and health care in areas with long distances?
4. What technological and digital solutions are out there that have been used to solve the challenges of social and health care workers?

3. LITERATURE REVIEW

A descriptive narrative literature review provides valuable insights, and it is employed in scholarly research to collect, summarize, and analyze existing literature on a particular topic or research question. This descriptive narrative literature review is an overview about the current situation of the needs of technological and digital solutions in social and health care education and practice in remote areas. (Hoitotiede 2013; Fink 2014). The descriptive literature review emphasizes inductiveness and phenomenon-driven knowledge. This method will offer a mechanism for critically examining our research questions from multiple perspectives. Literature review is generating phenomenon-oriented descriptive knowledge, and it will facilitate a critical examination of research questions through diverse viewpoints. Narrative review offers insightful and practical overviews of a topic by interpreting and synthesizing existing literature. (Hoitotiede 2013; Rumrill & Fitzgerald 2001; Salminen 2023; Sukhera 2022.)

The review process entails gathering, describing, and organizing literature to construct a coherent narrative. Consequently, it contributes to the advancement of research endeavors. (Rumrill & Fitzgerald 2001; Salminen 2023.) The overall process of the review is reported, and the results will be shared in the manner of transparency and artificial intelligence (AI), or automated tools will be used by accepted norms (TENK 2023; ALLEA 2023). In this literature review, AI is used during the reviewing process and in reporting to create academic language in English and to clarify the results, without changing the content. Our project partners are multinational, bilingual, with different native languages, so using artificial intelligence to clarify the text is justified. (Khalifa & Albadawy 2024; Spataro 2023.) The AI applications used are Chat GBT 3.5, Chat GBT 4.0 and Microsoft Copilot as a help to categorize the results into discussion and for language and grammar check. All AI generated content has been reviewed, corrected and modified by the authors of this review.

3.1 Data search

The RemoTED partners have formulated research questions for the literature review by justifying them according to the background information and defined the needs for the review. Also, the inclusion and exclusion criteria (Templier & Paré 2015; Elo et al. 2014) for the review are set in the first phase of the search, to support and ensure that the data found is represented accurately. The need for this review is clear, to get more background information and data for the RemoTED main project idea and for the main project application process. The results of this review can be implemented into main project plans or used for future research of the topic.

The main search was conducted between February and May 2024, and four databases were used, resulting in 1417 papers. The screening process was completed by the author SL. Screening started by reviewing the titles, following abstracts and full texts. Finally, 19 papers were selected for analysis during May 2024. Furthermore, the additional search, conducted by all consortium partners between May and November 2024, was completed, which resulted in 26 additional papers. The screening process, including inclusion criteria are presented in the Flowchart (Figure 1.).

Figure 1. Flowchart illustrating the screening process.

3.2 Data analysis

Data analysis in literature reviews involves systematic approaches to organizing, categorizing, and interpreting information extracted from various sources. After the organization phase comes the report of the results. In this stage we have ensured that the results are logically reported, and we need to ensure that all the steps throughout the process are presented in a clear and understandable way as well as the scientific language check (Elo et.al. 2014). We have been selected as a suitable unit of analysis to ensure the validity and reliability of the data. References and citations are marked with the protocols and Codes of Conduct. During the review process the Core Practices Guidelines by COPE are followed (Committee of Ethical Publications) (TENK 2023; ALLEA 2023; COPE 2017).

Researchers must possess proficiency in applying the descriptive narrative literature review method to ensure the reliability and validity of synthesized information. It is important that during collecting data, processing and analyzing it, the trustworthiness issues are identified during the study. The analysis of trustworthiness is crucial, especially in the preparation, organization, and reporting phases. The research integrity processes that are been used in our literature review are following to the Finnish Code of Conduct for Research Integrity by Finnish Board on Research Integrity (TENK) and European Code of Conduct for Research Integrity for project receiving EU funding by All European Academies (ALLEA) (Salminen 2023; Rumrill & Fitzgerald 2001; Elo et al. 2014; TENK 2023; ALLEA 2023).

4. RESULTS

For the overview of technological and digital competencies in social and health care education and training 19 papers selected for full screening (Table 1.). Additional research, conducted by partners, resulted in 26 papers (Table 2.). A These results also prove how digital and technological education and training can enhance professional delivery in social and health care and they are responding to the research questions.

Table 1. Selected papers from the main screening

	Author	Year	Title of the publication
1	Andersson, B., Forsling, N., Berggren, S. & Hadnagy, J.	2019	Healthcare and care through distance-spanning solutions- 24 practical examples from the Nordic region.
2	Barck-Sutinen, M., Immonen, M., Karppinen T., Nousiainen, J., Penttinen, M., Pulli, M. & Siimes, S.	2023	Tulevaisuuden kotona asumista tukevat palvelut iäkkäille 2022–2023 (TulKoti) –hankkeen loppuraportti
3	European Union	2024	The Europe’s Digital Decade Framework
4	Fitzgerald, C., Pagnucci N., Kearns, T., Hallissy, M., Walsh, N., Kelly, C., Killeen, C., White, M. & Aleo, G.	2023	The experience and attitudes of long-term care workers with teaching and learning modalities for the delivery of continuing professional development activities: a mixed-methods study.
5	Härkönen, H., Lakoma, S., Verho, A., Torkki, P., Leskelä, R-L., Pennanen, P., Laukka, E. & Jansson, M.	2023	Impact of digital services on healthcare and social welfare: An umbrella review
6	Jarva, E.	2024	Digital health competence of health care professionals in healthcare setting
7	Kraus, S., Schiavone, F., Pluzhnikova, A. & Invernizzi, A. C.	2021	Digital transformation in healthcare: Analyzing the current state of research
8	Lundgren, A., Omrstrup Vestergård, L., Bogason, Á., Jokinen, J. C., Penje, O., Wang, S., Norlén, G., Löfvik, L. & Heleniak, T.	2020	Digital Health Care and Social Care, Regional development impacts in the Nordic countries
9	Lindgren, L. & Manssila, J.	2021	Jatkuva oppiminen sosiaalialalla.
10	Moreno, R. M., Borrero M. F., Ferri Fuentevilla, E., Medina, F. R., Luchena, A. M. & Aguado, O. V.	2023	Technologies and social services. An overview of technology use by users of social services.
11	Ministry of Social Affairs and Health in Finland	2024b	Strategy for digitalisation and information management in healthcare and social welfare.
12	Ministry of Social Affairs and Health in Finland	2023	Strategy for digitalisation and information management in healthcare and social welfare emphasises flexibillity.
13	Pennanen, P., Jansson, M., Torkki, P., Harjumaa, M., Pajari, I., Laukka, E., Lakoma, S., Härkönen, H., Verho, A., Martikainen, S., Kouvonen, A. & Leskelä, R-L.	2023	Digitaalisten palvelujen vaikutukset sosiaali- ja terveydenhuollossa. Valtioneuvoston selvitys- ja tutkimustoiminnan julkaisusarja 2023:52
14	Pramila-Savukoski, S., Jarva, E., Kuivila, H-M., Juntunen, J., Koskenranta, M., Kääriäinen, M. & Mikkonen, K.	2023	Generic competence among health sciences students in higher education – A cross-sectional study
15	Ronquillo, Y., Meyers, A. & Korvek, S. J.	2023	Digital Health
16	Sirviö, J.	2024	Terveysteknologia osana sairaanhoitajaopintoja Suomessa
17	Stoumpos, A. I., Kitsios, F. & Talias, M. A.	2023	Digital Transformation in Healthcare: Technology Acceptance and Its Applications.
18	World Health Organization	2019	WHO guideline 2019: recommendations on digital interventions for health system strengthening. Recommendations and justification.
19	Ylönen, M., Forsman, P., Karvo, T., Jarva, E., Antikainen, T., Kulmala, P., Mikkonen, K., Kärkkäinen, T. & Hämäläinen, R.	2024	Social services and healthcare personnel’s digital competence profiles: A Finnish cross-sectional study.

Table 2. Selected papers (26) from the additional search by RemoTED partners

	Author	Year	Title of the publication
1	Asikainen, U., Hiltunen, P., Kasurinen, S., Kolari, S., Nenonen, M., Penttinen, M. & Turkia, M.	2023	Karelia-ammattikorkeakoulun sisäinen auditointi 2022–2023
2	Auvinen, P., Asikainen, E., Hakonen, A., Marjanen, P., Risku, P. & Silvennoinen, S.	2022	Recommendation on the shared competence of universities of applied sciences and application
3	Byrne, T., Murray, N., McDonnell-Naughton, M. & Rowan, N. J.	2023	Perceived factors informing the pre-acceptability of digital health innovation by aging respiratory patients: a case study from the Republic of Ireland
4	eHealth Ireland	2023	Better Together for Digital Health Conference
5	Government of Ireland	2024	Digital for Care — A Digital Health Framework for Ireland 2024-2030. Department of Health.
6	Government of Ireland	2023	Sláintecare. Progress Report 2021–2023
7	Government of Ireland	2022, March 2	Connecting Government 2030: A Digital and ICT Strategy for Ireland’s Public Service.
8	Government of Ireland	2022, February 1	Harnessing Digital: The Digital Ireland Framework.
9	Government of Ireland	2021	Civil Service Renewal 2030
10	Hiltula, M., Kemppainen, T., Kostamo-Pääkkö, K., Liikanen, S-L. & Sotaniemi, U.	2024	Sosiaalihuollon ammattilaiset pohjoisella yhteistyöalueella.
11	Holappa, T., Immonen, M. & Kinnunen, A.	2023	Co-development of digital solutions in the health industry-piloting of the Welfare Technology shower-concept at Master education.
12	Holappa, T. & Rautio, A.	2024	Hyvinvoinnin ja terveyden robotiikka-missä mennään?
13	HSE	2019	Health Services People Strategy 2019–2024: Leaders in People Service.
14	HSE	2013, July 14	Statutory and Mandatory Training Policy for Health Service Executive Employees.
15	Karelia UAS	2023	Karelia 2030 – päivitetty strategia vuosille 2023–2030. (Karelia 2030 – strategy)
16	Karelia UAS	2022	Karelia 2021 – toimintakertomus
17	Koskeli, O.	2024	Digitaalisen palvelualustan käyttöönotto, Pohjois-Karjalan HVA (RRP, P4, I4)
18	Kurki, J. & Leppänen, S.	2023	Inclusion with digital tools
19	Lapin Hyvinvointialue	2024	Digihoitopolku tarjoaa työkaluja omahoitoon
20	Lapland UAS	2023a	Expert of Digital Health Services and Health Promotion
21	Lapland UAS	2023b	Etähoidon osaajakoulutus
22	Salminen, R., Sihvo, P., Rokkila, M. & Ignatius, M.	2024	Digipedagoginen osaaminen kehittämiskohteena korkeakoulussa – Osa 2: Osaamistarvekyselyn tuloksia
23	Sorjonen, K.	2022	”Kaikki mitä teen, on digiä?” – Sosionomiopintojen digipolulla.
24	Telehealth Working Group	2023	HSE Telehealth Roadmap 2024–2027: Building Blocks for Embedding and Expansion and Telehealth
25	Turunen, J.	2020	North Karelia Strategy 2040
26	Vesa, P.	2021	DigiNurse Model. A new approach to digital coaching for nursing

The challenges and the need for enhancing Social and Health care professionals and future professionals digital and technological education and training

Digital services are transforming traditional tasks and replacing parts of work and service processes. However, their impact on professionals’ workloads has been minimally studied. In specialized health care, digital solutions for data utilization, service access, and interaction are emphasized, aiding in risk identification, disease prevention, and urgency assessment. As the social and health sectors digitize, professionals need new skills developed through accessible methods. Digital work suits experienced professionals who can assess client conditions with less information (Pennanen et al. 2023, 40). Digital health care and social welfare technologies can increase professionals’ work speed, resulting in improved efficiency, by reducing the need for travel and enabling them to allocate more time to client or patient care effectively, irrespective of location. Digital health technologies can facilitate better coordination of care or customer service. These technologies can at their best connect professionals to other stakeholders in the social and health care welfare system as well as communities, patients or clients because of improved delivery of the service (WHO 2019; Ministry of Social Affairs and Health in Finland 2023). There is a need to develop digital platforms and services all the time because of the rapid development of technology, but also the demands of end-users. Organizations that are not used to using digital technologies need to modify their processes to develop services for online use. It is researched that in social services the foremost action is to ensure that the service is easy to use and reachable from the client or user perspective. (Kraus, Schiavone, Pluzhnikova, Invernizzi 2021.) Andersson, Forsling and Berggren (2019, 10, 21, 91) have categorized these distance solutions as (1) Remote treatment, (2) Remote monitoring, (3) Remote meetings, (4) New digital solutions. Remote treatment includes telemedicine, online treatment and advice, and self-treatment. Remote monitoring involves wearables such as sensors and cameras, as well as reminders and data collection. Remote meetings occur between professionals and citizens, patients and health care professionals. Innovations and new digital solutions are necessary to develop distance solutions in social and health care for new service models.

Europe’s Digital Decade Framework defines the digital ambitions for the next decade (European Union 2024) with four objectives: (1) Attain a digitally skilled population and highly skilled digital professionals; (2) Attain secure and sustainable digital infrastructures; (3) Achieve the digital transformation of businesses; and (4) Achieve the digitalization of public services. The goal is for digital technological transformation to benefit all people in Europe. The framework also defines principles such as providing public services online, ensuring all organizations adopt cybersecurity measures, and promoting research that measures the impact of digital technologies.

The Finnish Talentia Union of Professional Social Workers conducted research on newly graduated social care professionals (Bachelor of Social Services, Master of Social Services, Master of Social Work, or other higher degrees in social care and welfare fields). The study focused on continuous learning in professional competence development during and after their studies. The research shows that over a quarter of respondents wish to develop their skills in digital client work in the future. It also revealed that more than 20 % of respondents gained their documentation skills in practical settings rather than during their university studies. When asked about the types of skills they were interested in acquiring, 35 % of the 392 respondents mentioned digital skills. Most participants preferred to gain these skills through continuing education at a University of Applied Sciences (37 %) or postgraduate education at a university (35 %). Additionally, 29 % of respondents expressed a desire to acquire further professional skills through continuing education at an open university (Lindgren & Manssila 2021).

Support personnel and goal-directed education are crucial for all end users of digital services and technological solutions. End users include patients and clients, as well as service providers in healthcare and social welfare services. A significant barrier identified is the lack of digital competence, which is related to the undefined roles of both patients or clients and healthcare professionals in using digital services. Healthcare professionals in sparsely populated areas face logistical issues when utilizing digital and technological solutions, such as connectivity problems and limited access to electricity for device charging. These challenges can result in delays in the delivery service. While professionals recognize the potential of technologies, they encounter usability issues and integration problems with existing systems. Concerns about data protection and privacy also persist. It is important to educate healthcare and social welfare professionals to understand and accept the systems used, comprehensively utilizing digital health technologies (Härkönen, Lakoma, et al. 2023; World Health Organization 2019). In healthcare, providing adequate and consistent orientation is challenging due to irregular work schedules and the large number of employees, potentially leading to varying levels of digital health competence (Jarva 2023, 55-63).

Engaging in meaningful dialogue and collaboration is imperative to better understand the challenges and concerns raised by health workers regarding the integration of digital healthcare and social welfare services. The WHO (2019) recommends fostering a supportive and inclusive environment where all stakeholders’ voices are heard and valued. Healthcare and social welfare professionals need ongoing support, education, and training in utilizing digital programs and devices. Competence development initiatives should include strategies to motivate and prepare older or early-career professionals to embrace digital tools and maintain a positive outlook toward technological changes (Jarva 2024, 94–95). Recent Finnish cross-sectional study shows that there are three profiles of digital and competences among social and health care professionals: 1) Motivated digital experts, 2) Burdened digital users and 3) Frustrated survivors (Ylönen, Forsman, Karvo, Jarva, Antikainen, Kulmala, Mikkonen, Kärkkäinen & Hämäläinen 2024, 3). This study revealed that the training and education of digital and technological solutions should be steered to the profiles 2) and to 3) to address their needs. These profiles are generalized to be mostly professionals that are already working on the social and health care services, and they need to adapt new technologies all the time in their profession.

Jarva’s (2024) study created and tested the DigiHealthCom framework and DigiComInf while examining professionals’ digital health competences and organizational factors. The results of these tests suggest that healthcare education and training can be enhanced by integrating these frameworks into educational programs to support curriculum development and research. Recognizing managers’ traits and leadership approaches is crucial when introducing digital technologies and designing tailored competence development strategies for individual healthcare professionals and teams. The study also revealed that social influence from peers and the work environment plays a significant role in digital health competence. Open discussions within work communities about perceptions and concerns related to digital technologies are essential to encourage their adoption and use.

In social services, many users are unfamiliar with new technologies (NTs) and prefer in-person administrative tasks, often due to their older age, lower educational levels, and limited technology use. Strategies to promote digitalization in social services must be tailored to the specific needs of different user groups. Older users may find it challenging to adopt these tools, especially when they primarily use mobile phones for social communication rather than managing personal affairs. However, with adapted tools and tailored training, significant progress can be made in improving NT usage for many users, provided both user profiles and device availability are considered. Utilizing digital services in sparsely populated areas like Lapland is highly desirable, as they can improve access to social and health services, optimize the time of professionals and residents, and reduce unnecessary travel (Moreno, Borrero, Fuentevilla, Medina, Luchena, Aguado 2023; Pennanen et al. 2023, 27). Digital competence in health sciences has emerged as one of the most underdeveloped skill areas among future professionals. These competencies are critical for integrating technology and digital solutions into healthcare practice. The use of digital tools is seen as an integral part of competence development due to limited resources in clinical practice and training methods (Jarva 2024, 55–63, 94–95).

The ongoing scarcity of social and health care professionals in remote regions continues to hinder the achievement of equitable access to essential services. Despite progress made through various initiatives, disparities remain due to the challenges of geographical inaccessibility and the tendency of health workers to prefer urban locations. To mitigate these imbalances, various initiatives have been introduced, including incentives and alternative training methods. (WHO 2019.) In Finnish Lapland, there are various digital and technological solutions in the social and health care services, but they require further development. Previous case studies from four different Nordic areas have demonstrated that digitalization in social and health care impacts regional development across all three dimensions of sustainability: economic, social, and environmental (Lundgren, Omrstrup, Vertesgård, Bogason, Jokinen, Penje, Wang, Norlen, Löfvik & Heleniak 2020, 9).

The digital and technological skills and competences enhancing professional service delivery

Digital technologies enable professionals to provide social and health care services remotely, effectively overcoming geographical barriers. Digital technologies include remote monitoring, asynchronous communication, and synchronous communication. These services and solutions are improving access to health care and social services in remote areas. Digital health refers to the use of information and communication technologies in healthcare to manage health risks and illnesses. Digital health using those technologies also provides a chance to promote wellbeing. Digital health includes various devices such as wearable sensors, mobiles and telecommunication devices (WHO 2019; Härkönen, Lakoma, et al. 2023; Ronquillo, Meyers, Scott 2023).

Previous studies have identified factors to optimize the effectiveness and success of adopting new technologies for the benefit of patients or clients. Social and health care service providers can leverage information technology when developing or updating service procedures. Units can utilize information and communication technology applications to analyze and understand patients’ or clients’ needs and preferences, thereby improving their service innovation processes. Technological capabilities positively impact both patient services and innovation within the service process. To gain a more comprehensive understanding of digital health transformation, it is crucial to conduct research on the management implications of digitalization from various stakeholders’ perspectives. Additionally, advancing telemedicine, improving digital security, and enhancing technological information systems will play key roles in achieving widespread acceptance of digital health transformation among all parties involved (Stoumpos, Kitsios, Talias 2023).

Erika Jarva (2024, 62) studied the digital health competence of healthcare professionals in healthcare settings as part of her doctoral dissertation. The study found that healthcare professionals perceive digital competence to include: (1) the capability to deliver patient-focused care via digital platforms, (2) the expertise to utilize information technology and digital health systems, (3) proficiency in engaging with patients using digital tools, (4) the skill to assess the concept of digital health, (5) the ability to integrate digital solutions with conventional practices, and (6) the capacity to evaluate their own competence in digital health. Jarva’s dissertation (2024, 55–63, 94–95) summarizes that continuous education and adequate training in digital health services are essential for developing digital health competence. The study participants highlighted that higher education, self-driven learning, and using digital resources contribute to this development. University studies, in particular, foster interest in digital health services and boost confidence in navigating digital environments and finding reliable information. However, professionals’ own motivation also affects competence development, as pre-graduation education lacks sufficient coverage of digital health topics.

Digital competence includes the ability to securely design user-centered digital services, effectively interact with these services, and support others in using them. It also involves guiding colleagues within a work community to improve their use of digital tools and services, as well as maintaining ethical conduct in digital environments. As highlighted by Pramila-Savukoski et al. (2023), digitalization and the rise of artificial intelligence are reshaping the landscape of social and health care, which can lead to uncertainty and challenges when professionals assess their own competencies and skills. The study emphasizes the need for enhanced teaching and learning strategies that support young professionals in developing their core competencies and gaining practical work experience. Future professionals should be provided with more opportunities to hone their skills through diverse roles and leadership experiences, making the implementation of work-based training programs essential. The insights from this research can guide competency management and inform the professional development of healthcare workers. Additionally, incorporating mentoring and knowledge-sharing into education can help students build strong, well-rounded competencies, preparing them to navigate the evolving demands of the healthcare sector.

Digital solutions enable health care and social welfare workers to take on a broader range of tasks assigned by higher-level professionals such as physicians. This means a shift in responsibilities in patient or customer care and service. Health care professionals and social welfare professionals, particularly those operating in rural and remote areas, appreciate this efficient way of working offered by different digital health and welfare technologies, but some of the professionals, because they perceive them, as contributing to an already high number of tasks to be done. Factors that contribute to this phenomenon include the need to maintain multiple systems, lack of staffing, and a lack of understanding or the lack of appreciation integrating these interventions into the practice. Some of the health care professionals are struggling with the implementation of digital technologies because they have increased the workload and responsibilities (WHO 2019; Ministry of Social Affairs and Health in Finland 2023).

Strategical choices play a crucial role in implementing new digital solutions and technologies into social and health care services and education

In recent years, the strategic importance of digital services has grown within Finland’s social and health care sectors. Interviews with service system leaders indicate that many welfare regions prioritize digital services in their strategies or are developing separate digital strategies. Supplementary research shows that digital services are especially used in outpatient services for both primary and specialized health care, across public and private sectors. In social care, digital services are widely utilized in elderly home care, though their use in other areas remains limited. Clients primarily access their health and wellness information through the national Kanta service. Digital services, like remote consultations and electronic messaging, are widely used for client-professional communication in social and health care. However, professional communication still relies heavily on phone and remote meetings. The main challenge is securely sharing client information across different organizations, and while some digital solutions exist, a widely adopted one is still needed. (Pennanen et al. 2023, 21, 26.)

Finnish Strategy for digitalization and information management in healthcare and social welfare is published in January 2024 by The Ministry of Social Affairs and Health and it emphasizes the importance of digitalization and its connection to information management. The operational practices of digitalization are based on a platform created by information management. This transformation process is described as the modification of organizational processes and the digitization of services, and it can only be successfully implemented if a key actor is involved in the change process, rather than being driven solely by information management and technology. Information management is defined by the content of the information, the purpose of use, and organizing the collection and storage of the information so that the information can be processed in a controlled, accessible and safe manner. (Ministry of Social Affairs and Health 2024b, 9–10.) Connecting Government 2030 (Government of Ireland 2022,3e March 2) is a strategy to develop and deliver digital/ICT public services to benefit the society and economy in Ireland. This will transform how people, businesses, and policymakers interact and will seek to ensure interoperability at all levels. This is aligned with “Harnessing Digital” – The Digital Ireland Framework (Government of Ireland 2022, February 1) and the Civil Service Renewal 2030 (Government of Ireland 2021, May 10).

The Digital Health Framework for Ireland aims to use digital technology, data, and innovation (Government of Ireland 2024) to enhance and make more accessible social and health care services. The goal is attaining affordable and equitable care; enhanced patient care and productivity; improved patient health and well-being; and achieving seamless, safe, secure, and connected digital health systems. The Government of Ireland (2024) has invested in digital health for the HSE in recent years, which has allowed the HSE to build resources and expertise to tackle achieving digital health records in place for every individual who receives care in Ireland, since Ireland is behind its peers regarding the use of Electronic Health Records (EHR). These must be available for acute hospitals and community services, which is a big challenge. In addition, the establishment of new health regions (six regions) to provide integrated social and health care services for the population in each region.  However, there are also there are more competing and immediate demands for acute hospitals, such as medication management systems, communication systems, Emergency Department (ED) systems, and Patient Administration Systems (PAS), which cannot wait until HER is delivered. The vision is that access to patient records is going to be attained by social/health care professionals and providers using an app. Therefore, currently, there is a need to consolidate solutions deployed in the health services to handle data complexity, standardization, interoperability, build expertise, and support complex systems soon. To attain these goals – stakeholders, acute hospitals, community care, and new regional health area management in collaboration with the Department of Health, HSE, Health Information and Quality Authority (HIQA), National Standard Authority of Ireland (NSAI) and other relevant standards/regulatory bodies – will define critical standards for data sharing and use to be adopted, interoperability, and clinical terminology, and establish a clinical procurement framework for future EHRs (EHR vendors).

The HSE (2023, July 14) has a commitment to maintain and create a safe and positive working environment, ensuring the right skills and knowledge of the staff to perform their work at the required standard to keep risks at the minimum for themselves, visitors, and colleagues; and to deliver service to users. The Health Services People Strategy 2019–2024 (HSE 2019) defines the future direction of people services across the healthcare system. It aims to create an engaging employee experience that nurtures their leadership, enable teams to work together to deliver safer better healthcare. The Priority 3 of this strategy seeks developing a culture that prioritises learning and development to ensure individual and team capability and capacity to confidently deliver person-centred help, problem-solve, and innovate, which is reflected in Sláintecare. So, the HSE is committed to ensuring employees access to training and education appropriate to their roles.

There is a lack of GPs in Rural Ireland (The Growth Catalysts Team, 2024, July 28). There are only seven GPs for every 10000 people, which falls short of EU standards. About 25 % of the population of Ireland lives in rural areas, in contrast, 15 % of all GPs in Ireland work rurally. Currently, 600 GPs are close to retiring, so the HSE and the Irish College of General Practitioners aim to bring 100 GPs from abroad each year. The General Medical Services (GMS) scheme covers 30 % of the population and it is the main source of income for GPs. Another initiative is to increase training spots for new GPs, start a rural fellowship program, and offer financial initiatives for non-EU doctors. Also, the Irish Government Rural Health Policy is focused on setting up primary care centres in poor areas. In addition, telemedicine is a big step forward in rural areas. Ireland is currently encouraging telemedicine programs that offer consultations and treatments over the internet, and training healthcare workers online. However, the challenges of telemedicine in rural areas are: (1) attaining a reliable Internet, (2) patients’ attitudes towards receiving care in another way, and (3) lack of telehealth training for care professionals (professionals’ lack of familiarity). The people who are more likely to use it in Ireland currently are people with private insurance or people with chronic diseases. Mobile health facilities are another approach used to provide care in rural areas. In addition, community healthcare workers are key to keeping healthcare in rural areas, e.g. giving personalized care, and coordinating services. They fill in gaps of care.

According to the North Karelia Strategy 2040, the population issue is a decisive challenge in many ways for the long-term development of the region. Population concentration, the decrease in the number of working-age people, and aging are key factors for the vitality and future of North Karelia. The solutions to population challenges are primarily ensuring the sufficiency of skilled labor and adjusting the service structure to meet demand. Utilizing digitalization to address North Karelia’s challenges can be significant. Automation, digitalization, robotics, and artificial intelligence can increase labor productivity and develop service structures to better meet the needs of sparsely populated areas. (Turunen 2020, 5,12.) As one solution to address the challenges of North Karelia, one example can be highlighted. Siun sote has implemented a modern digital service platform, which was launched in April 2024. Residents of the North Karelia region can connect with social and health care professionals using this digital service platform. The goal is to provide smooth and user-friendly digital tools for both clients and professionals. With Siun sote’s new solution, the accessibility of social and health care services in the sparsely populated welfare area can be improved. (Koskeli 2024.)

In Siun sote, the benefits and impact of technology have also been investigated. The North Karelia region has had automatic medication dispensers in use since 2017. The number of devices has grown from 30 to about 500. According to a preliminary study conducted by the “Tulkoti” project, the investment in medication dispensers pays for itself in just over a year. The dispensers enable home care to serve more clients with the same number of staff. This results in cost savings, for example, from fewer home care visits to clients’ homes. Additionally, other benefits are achieved, such as a reduction in medication errors and an increase in clients’ independence. (Barck-Sutinen, Immonen, Karppinen, Nousiainen, Penttinen, Pulli & Siimes 2023, 17.)

In Finnish Lapland, Lapha region (2023) has set strategic goals also according to digitalization in health and welfare services, including social services. In Lapland, the availability of personnel and the transformation of work are evident. Changes in operations, values, and mindsets are occurring. Work structures and methods are evolving with robotics and digitalization. There is a shortage of skilled labor, and efforts are focused on developing skills and leadership. Diminishing resources increases the need for productivity improvements. Lapland’s unique conditions include long distances and a sparsely populated area. It has a strong local identity and diverse conditions with special needs. Lapland is responsible for developing services that respect the Sámi language and culture nationwide. The welfare region’s task is to serve all of Lapland, requiring successful strategic planning. The one aim for strategic planning is that the necessary skills and competencies of personnel for effective operations are identified, and functional models for skill development are collaboratively developed.

There is a connection between developing digital services in social and health care and positive regional development. The potential effects and causes of digitalization include increased quality and safety in home care, cost-efficiency, and greater inclusion and accessibility for patients and clients to the services they need. The overall impact of digitalization in social and health care is anticipated to extend beyond the advancement of these sectors, influencing broader health and wellbeing outcomes, as well as regional development across the Nordic territory. Rural and remote areas are expected to benefit from improved access to welfare services, enhancing the attractiveness of these regions and supporting their long-term development (Nordic Welfare Center 2019, 10, 21, 91, 98).

4.1 Current situation in Lapland, Finland

In Lapland UAS health and social welfare educational programs there are several digital and technological approaches in their curriculums from the point of view of teaching methods and pedagogical approaches. The most obvious program of them is the Master School program: Expert in digital health services and health promotion. In the Bachelor degree programs in Nursing, Public Health and Social Care the students have multiple study modules combining digital and technological solutions and introductions of them. In Lapland UAS Bachelor degree of Health Care students will learn distance learning and digital services among the professional studies. Inside the curriculum there will be both theoretical and practical education about the structure and operations of the social and health care system in Finland, social, health care and service chains, legislation governing health care and the practice of the nursing profession, data protection in health care and information security in social and health care. Lapland UAS offers also specialized education for postgraduate professionals in remote care (Lapland UAS, 2023a; Lapland 2023b; Holappa, Immonen & Kinnunen 2023).

There are also projects to digitalize social and health care in Lapland such as Artic RoboWelfare in Lapland UAS. Artic RoboWelfare has created a comprehensive picture of the current situation of welfare technology robotics available and in use in Universities of Applied Sciences in Finland. In the project research they found out that robotics and technology are already integrated into education responding to digital transformation of social and health care practice. There is still a need for continuing education and specialization for solutions such as robotics. (Holappa & Rautio 2024.)

In Northern Finland, Hiltula, Kemppainen, Kostamo-Pääkkö, Liikanen, and Sotaniemi (2024, 5, 22) have examined the status and future needs of social service professionals, including social workers, social services professionals, gerontologists, and rehabilitation counselors. Their research focuses on staffing levels, skill sets, job content, work well-being, and leadership. Building on studies from 2018 and 2021, they collected data in 2023 through surveys distributed to supervisors and employees in the social sector. The research indicates that additional training is particularly beneficial in client work. Social care professionals often feel their initial education is sufficient and believe studying during work hours is feasible, which supports career advancement. While many professionals feel their education is adequate, they express a significant need for further training and feel less supported by employers in pursuing long-term education. Participants agree that employers support participation in short-term training. In the study, participants were asked about their additional training needs, including professional continuing education, supplementary training, and retraining. Social workers expressed a strong need to deepen their expertise and stay current with discussions, desiring more research and societal dimensions in their roles. Key training needs included specialization in social work, legal education, and issues like substance abuse and criminality. Social care professionals highlighted the need for advanced degrees, therapy training, and neuropsychiatric coaching. Both groups emphasized the importance of training in client work methods, leadership, supervision, therapy, and IT skills. A few respondents also expressed a need for retraining.

The most general need for training and adding competence among Northern-Finnish social service professionals are the competences and skills in structural documentation and documentation overall in digital platforms, especially the concerns in data-protection is pointed out. Professionals feel the need for regular maintenance of both content-related and technical skills related to documentation. Many social care professionals feel they have the necessary skills for documentation, but only some believe they can maintain high-quality records due to time constraints and ineffective client information systems. High client loads and prioritizing other tasks over documentation are significant challenges. Some professionals must document in multiple systems simultaneously. According to the study, documentation covers approximately 20 % of the worktime of social service professionals. 12 % of the work time consists of discussions on the phone with the clients. (Hiltula et. al. 2024, 26, 60, 65.) From these results it can be evaluated that approximately 32 % of the working time the professionals are using digital and technological solutions in their practice.

The practices for remote client work in social services in Northern Finland vary significantly. Remote connections are particularly useful for network meetings, involving family members, collaborating with various authorities, and reaching clients in distant locations, effectively replacing in-person visits. They are also used for team meetings and multidisciplinary client meetings. However, remote methods cannot replace home visits in specific areas. Challenges include inadequate remote work tools for employees and clients’ lack of suitable devices or skills. Opinions differ on whether phone contact counts as remote work (Hiltula et al. 2024, 63).

A portion of social workers and social care professionals feel they can document effectively, but they are hindered by time pressures and poor system functionality. While documentation of service needs assessments and appealable decisions is generally well-executed, mobile documentation and various technical issues with information systems remain major challenges. Many professionals rate their systems poorly, and satisfaction with system functionality is low. Despite ongoing updates, only some professionals believe documentation aligns well with client information structures. Additionally, only a portion of social workers and social care professionals feel client plans are up-to-date and properly recorded. Although many professionals say clients receive appealable decisions, some social workers find decision-making poorly executed. Timely documentation, defined as completion by the next working day, is received by only a portion of professionals, with some reporting delays. There should be accuracy in data collection, but only some professionals feel clients are adequately informed about data handling, with a few ratings this poorly (Hiltula et al. 2024).

In Northern Finland, the design of digital care pathways in social and health care services prioritizes speed, ease of use, and accessibility. These pathways support self-care by providing essential information, instructions, and tools for symptom monitoring and communication. They complement or replace traditional appointments, tailored to the needs of different clients and patient groups. Challenges include ensuring all clients have access to and can use digital tools, maintaining data security and client confidentiality, and adapting to the limited number of professionals available. However, these pathways offer significant possibilities, such as enhancing the continuity and accessibility of care, especially in remote areas, reducing the need for routine check-ups and in-person visits, and allowing flexible and secure communication between clients and healthcare professionals. Continuous feedback from professionals and clients is used to improve the system, with training provided for professionals on using digital tools effectively and educating clients on how to engage with digital care pathways. Pilot projects are being implemented, with ongoing adjustments based on feedback, aiming to expand these pathways across the region (Hiltula et.al. 2024, 63; Lapin Hyvinvointialue 2024).

A study conducted by a master’s student at Lapland UAS Jenna Sirviö (2024, 22) examined the current nursing education curricula for students starting in 2023. The comparison revealed that all universities of applied sciences in Finland include some level of health technology and digital skills training for nursing students. However, the curricula vary significantly across different institutions, with not all offering the same courses. Even when courses cover similar topics, such as internal medicine nursing, the content and course names differ, making direct comparisons and detailed analysis challenges. At Lapland UAS, the current situation reflects these national trends. Nursing students receive training in health technology and digital skills, but the specific courses and their content may differ from those at other institutions. This variability can pose challenges for standardizing education and ensuring consistent competencies across the country. The study highlights the need for more uniformity in course offerings and content to facilitate better comparison and evaluation of nursing education programs.

Nursing education at Lapland UAS already incorporates a wide range of health technology tools, with simulation environments that mimic real hospital settings and scenarios, bringing students closer to real-life situations. According to Sirviös’ study (2024,41–42) Most teaching materials have moved online, and assignments typically require digital skills and are conducted through online exercises. As new health technologies are introduced into healthcare, the importance of nurses’ proficiency in these technologies will continue to grow. With the increasing use of various electronic services and systems by healthcare clients, nurses must be equipped to meet this growing demand, and their education should prepare them for this. Teaching the use of wellness technologies is also crucial, as nurses need to instruct patients on using devices like hearing aids, electric wheelchairs, walkers, and various safety alarms, depending on their job roles.

As a challenge in the context of higher education, for example a laptop is almost an essential tool. A student’s socioeconomic status can influence their enthusiasm for digital learning. Some students naturally have a greater desire to learn about various health technologies, while others may feel they are not good with technology. It is important to break technology-resistance mindsets during education and encourage all students to engage with digital solutions and technologies, recognizing their potential benefits. Health technology solutions using robotics and artificial intelligence are becoming more common in healthcare. Specific training for these devices should be provided by employers, as it is not feasible to cover all health technologies within education programs. It is more cost-effective to focus on the most used devices and services during education and leave specialized training to the workplace. However, universities of applied sciences can influence enthusiasm and commitment to technology. As the roles of professionals evolves, education must adapt to the changing technological and digital work environment and meet the expectations of what newly graduated should know and be able to do. It is also important that service providers also discuss with educational institutions their expectations of competences among newly graduated professionals. By incorporating a suitable amount of high-quality online teaching methods and enabling practice with real technology tools, education can meet modern requirements and align with employer expectations. (Sirviö 2024, 42).

4.2 Current situation in North Karelia, Finland

Karelia University of Applied Sciences (Karelia UAS) strives to meet the challenges in the region of North Karelia. The central change trends in this area are e.g. change of working life, digitalization, ageing population and climate change. Technologies as well as the ways of working and competence requirements change. Employment requires a solid educational base, and responding to quick changes in working life calls for the constant update of competences and education. Digitalization serves as a major transformative power in changes in technology and competence. The nature of work changes from routine tasks to information-intensive expert work and the productivity requirements rise. Karelia UAS supports the vitality of North Karelia in collaboration with other regional actors by training future experts and developing local services. (Karelia UAS 2023.)

The curricula of social and health care in Karelia UAS are competence-based and include both program-specific and common competencies. The curricula are reviewed and updated every few years. The most recent revision took place from 2020 to 2022, and the new curricula were implemented in 2022. During the revisions, the degree objectives were updated and their level assessed. Karelia UAS follows the national recommendations of Arene for common competencies in Finnish universities of applied sciences and considers the needs of the labor market in curriculum development. (Asikainen, Hiltunen, Kasurinen, Kolari, Nenonen, Penttinen & Turkia 2023, 7.) Arene’s recommendations consider the perspective of digitalization. Graduating students should be able to utilize the opportunities provided by digitalization in their learning and leverage the possibilities offered by technology and digitalization in their own work. (Auvinen, Asikainen, Hakonen, Marjanen, Risku & Silvennoinen 2022.)

Therefore, digitalization is a strong component of Karelia’s social and health care education and the development of future professionals’ skills. In recent years, the digital skills of Karelia’s social and health care students and teachers have advanced as part of continuous development of education and through various RDI projects. For example, in the international DigiNurse project, nursing students had the opportunity to develop their skills in online remote coaching. The DigiNurse Model, which resulted from the project, was integrated into Karelia’s curriculum for the second and fifth semesters. (Vesa 2021, 200-201.)

In the Living Lab project implemented by Karelia UAS, students had the opportunity to explore new technology together with end-user clients, teachers, and professionals. Popup-style workshops were a great opportunity to bring different stakeholders together to test various technologies that can be utilized in the social and healthcare field. (Kurki & Leppänen 2023.) In the Sotydigi project (“Digital services and distance guidance in social and employment services in long-distance areas”), a digital pathway was developed as part of the education of Bachelor of social services. The digital pathway describes how digital skills are integrated into the curriculum and various courses in a process-oriented manner. It supports the development of a student’s digital skills from a beginner to a digitally proficient social services professional. (Sorjonen 2022, 118-121.)

New learning environments utilizing technology have also been developed to meet the needs of local labor market stakeholders in North Karelia. The Future Work project works as a good example of this. It was implemented from 2020 to 2023. The aim was to develop education, pedagogy, and Karelia’s learning environments to meet the demands of future work in collaboration with the labor market. The project developed and modernized Karelia’s learning environments and acquired new teaching technologies, such as a digital learning material production facility and an immersive learning environment. The pedagogical skills of teachers and the implementation of new technology-enhanced learning environments in teaching were supported by developer teachers working on the project. (Karelia UAS 2022, 20-21.)

As part of the Future Work project, Karelia UAS has introduced many new pedagogical tools, learning environments, spaces, and practices in recent years. The goal was to develop learning environments and pedagogy in a multidisciplinary and work-life-oriented manner. In relation to the development of the Future Work project, a survey of skill needs was conducted for Karelia’s teachers and RDI staff to determine what digital pedagogical skills teachers need and where they require support. The responses highlighted the importance of utilizing digital tools and technology in a pedagogical way and developing one’s own skills. Three key areas for development emerged from the survey: 1) sharing experiences with peers, 2) pedagogically utilizing digital tools to support student learning, and 3) the teacher’s own activity in digital pedagogical skills and maintaining them. Based on the results of this survey, pedagogical skills training for teachers and RDI staff was organized during 2023. (Salminen, Sihvo, Rokkila & Ignatius 2024.)

4.3 Current situation in West and Northwest of Ireland

Sláintecare is the HSE and Department of Health’s overall improvement plan and strategy for reforming Ireland’s health and social care system to enhance equal access to health services for every citizen (Government of Ireland 2023, 7). In the context of digital services and technological solutions, the Sláintecare project saw rapid digital transformation during COVID-19, introducing tele-consultations, and e-Scripts for electronic prescriptions sent to pharmacists.

During Sláintecare project A new Digital Health & Social Care Strategic Roadmap (2024–2030) is being finalized, developed through extensive stakeholder engagement, and set for publication in 2024. Between 2021 and 2023, several essential support programmes were advanced to reform Ireland’s health services. These include initiatives in workforce planning and development, digital health, and health and safety. These programmes are foundational to the ongoing transformation of healthcare delivery. Especially on digital reform, the Project 6 Implement the Digital Health Programme is supporting digital transformation and the Healthy Age Friendly Homes initiative, launched in July 2021, aims to enhance the health and well-being of older adults, enabling them to stay in their homes and communities longer. This program, a collaboration between the Department of Health and the Department of Housing, Local Government and Heritage, involves a Local Coordinator conducting home visits and holistic needs assessments, focusing on health, housing, community support, and assistive technologies. During this overall project development has been made, e.g. virtual clinics, remote monitoring and using telehealth as well as triage via telephone (Government of Ireland 2023, 9, 11, 14, 18, 27).

The pandemic accelerated the use of video conferencing for remote collaboration and telehealth solutions to maintain care continuity, showcasing the healthcare system’s ability to quickly adopt digital tools for improved patient care. Also, The Department of Health is working with education sectors to ensure enough trained professionals in health services by increasing student training places in Medicine, Nursing, Midwifery, and Health and Social Care to ensure sufficient workforce and skills in the social and health care service delivery. (Government of Ireland 2023, 50, 62.)

In December 2023, the national conference, entitled Better Together for Digital Health Conference (eHealth Ireland, 2023) was held in Dublin. This conference aimed to capture the vision and ambition of the HSE’s staff and patients. This conference concluded that to explode the potential of digital healthcare it is going to be necessary to make a collaborative effort. At this conference, the HSE Telehealth Roadmap 2024-2027: Building Blocks for Embedding and Expansion and Telehealth was launched, which was developed by the HSE National Telehealth Working Group (2023).

Telehealth can be defined as the delivery of healthcare services using technologies where patients and providers are geographically separated (Telehealth Working Group, 2023). The adoption of Telehealth in Ireland was accelerated by COVID-19, it supports remote consultations, care delivery, remote health monitoring, online support, and online therapies. Its noted advantages are supporting early intervention, reduced hospital admissions, the empowerment of patients for handling their own health/well-being, reduced travel time and its associated costs, emissions and time away from work, family, school, and community.

The HSE Telehealth Roadmap 2024-2027 is a strategy/plan that aims to identify the key building blocks which are critical to Ireland’s telehealth foundation, which allow it to be safe, sustainable, efficient, and interoperable (Telehealth Working Group, 2023). This will be developed in the next three years. It will include national/international learnings, and involvement/feedback of key stakeholders. Several national/international challenges and facilitators were identified, i.e. building blocks: (1) Funding and Resources, (2) Technology and Infrastructure, (3) Leadership, Governance, and Implementation, (4) Healthcare Workforce, (5) Patients, family carers, service users, and community, (6) Monitoring, evaluation, and research, and (6) Innovation. Each building block has defined several aims and actions that need to be completed by 2027.

Six principles were identified to guide the development, implementation, innovation, and operation of telehealth in Ireland (Telehealth Working Group, 2023):

1. Care is Care: High-quality care is a priority, despite the medium.
2. Patients as empowered patients: Individuals and users are put at the center, concerning personal choice.
3. Digital Inclusion: Ensuring inclusive and equitable digital access for all.
4. Digitally Enabled Workforce and Workplace: Empowering the workforce to deliver effective healthcare using technology.
5. Data-Driven Service Improvement: Continue commitment to patient safety, quality of care, continuous improvement, and evaluation.
6. Digitally Secure Foundations and Digital Enablers: Sustain and build upon precise data, security, and interoperability standards for continuous operation.

Digital for Care is a framework that defines a plan/strategy/vision to digitalize social and health care services in Ireland and improve access to services in the next 6 years (Government of Ireland, 2024). The aim is to explode the power of data, digital technology and innovation, enable access to social/health care services, provide improved/affordable/equitable care, and enhance patient safety and productivity. This framework was developed by extensive consultation of key stakeholders in social/health care: patients, professionals, staff, industry, and innovator groups. The goal is to improve health outcomes and care experience for users/patients using efficient/safer digital solutions.

The reasons why the Digital for Care framework has been developed now include the following (Government of Ireland, 2024): (1) The Irish population has grown 11% since 2016, and the population aged 65 years old and above has increased 28%. This increase is putting health and social care services in high demand. Also, there was an increase in the amount of population living with multiple morbidities; (2) Digital healthcare must be aligned to national healthcare strategies, e.g. Sláintecare, Harnessing Digital – The Digital Ireland Framework, and upcoming legislation, e.g. Health Information Bill. Also, capabilities should be in line with wider public sector strategies, e.g. Civil Service Renewal 2030, Connecting Government 2030, and AI – Here for Good: A National Artificial Intelligence Strategy for Ireland, 2021; (3) Learning of the COVID-19 pandemic that show the population’s desire to drive digital health transformation; (4) Significant change in the experience of technology and information on the daily lives of the Irish population; (5) Per EU policy, digital health delivery must be transformed in line with the Digital Decade Policy by 2030, also the European Health Data Space (EHDS) Regulation.

Fitzgerald et al. (2023) conducted research that aimed to attain an enhanced understanding of healthcare professionals’ and managers’ attitudes and experiences – working in Long-Term Care (LTC) in the Republic of Ireland – while conducting continuous professional development (CPD) in the modalities: face-to-face, online asynchronous (pre-recorded), and online asynchronous (live). Researchers conducted focus groups’ interviews, five themes emerged: flexibility, resources and support, networking, engaging and meaningful learning, and balancing blended learning (online and face-to-face). Results showed that the preferred modality was face-to-face (32 %), followed by blended learning (30.4 %). Synchronous online education was qualified as convenient, flexible, and enabling interaction with peers, and its quality depends on the educator’s skills. About 92 % of participants mentioned they need workplace support to implement knowledge/skills, which requires employers’ endorsement since it requires technical support, mentors/facilitators, and dedicated time for learning. In addition, participants mentioned that engagement is key to improving the delivery of CPD.

Byrne et al. (2023) focused on identifying relevant themes to respiratory health and digital health experts in Ireland. These themes (perceptions, beliefs, cues to action, and barriers towards digital health) will be used to inform future decisions in respiratory patients to create living labs in respiratory care for remote patient monitoring. The goal is to inform the selection and future deployment of technology to empower patients to manage their respiratory system in real-time through remote consultations. The specialists participating in this study were a respiratory physician, a psychologist, a digital health expert, a technological expert, a respiratory nurse specialist, a health innovation representative, and a government representative. Braun and Clarke’s data analysis framework was used to analyze this data using NVivo.The topics identified were: (1) Utility and patient understanding, (2) Digital Literacy, (3) Data privacy and trustworthiness, (4) Equality, and (5) IT Education). Findings suggest that there is a strong concern that “people’s awareness of digital technologies and their perceived usefulness could be poor” and that “poor awareness could hinder the acceptance of technology”. However, the availability of proper infrastructure was also a concern. Lack of digital literacy skills and IT Education were also flagged as concerns.

5. DISCUSSION

The results of the main search are compared and synthetized into the findings from additional search by RemoTED partners. From this comparison, common themes and unique challenges, needs and justifications were found in the context of enhancing digital and technological solutions in education, training and professional service delivery. All RemoTED partners emphasize the importance of digital competencies, continuous improvement, and practical application to prepare future professionals for the evolving social and health care landscape. However, the areal disparity in sparsely populated areas causes challenges. These challenges are related to workforce shortages and economic constraints. The need for ongoing specialization and development is important in all partner areas.

Current state and the needs

The Covid-19 pandemic has been accelerated the adoption of digital tools in social and health care (Government of Ireland 2023, 50, 62). The adoption of technologies such as telehealth in RemoTED partner areas has emerged and there is a need for further development. According to the results telehealth includes remote consultations, care delivery using digital technologies, remote health applications, remote monitoring, online support and online therapies (Telehealth Working Group 2023). The current state of technological and digital solutions in social and health care education among RemoTED partner universities is evolving, with a significant focus on integrating digital competencies into the curriculum. According to Lindgren and Manssila (2021), there is a growing recognition of the need for continuous learning in digital client work, with a substantial portion of graduates expressing a desire to enhance their digital skills through further education. The research highlights that many professionals gain practical digital skills on the job rather than during their university studies, indicating a gap in the formal education system. Telehealth Working Group (2023) mentioned the importance of digitally enabled workforce and workplace that means that it is important to empower the workforce to deliver effective service using technology.

Pramila-Savukoski et al. (2023) highlights that digital competence in health care is one of the most underdeveloped skill areas among future professionals. These competencies are critical for integrating technology and digital solutions into practice. Digital competence includes the ability to securely design user-centered digital services, effectively interact with these services, and support others in using them. It also involves guiding colleagues within a work community to improve their use of digital tools and services, as well as maintaining ethical conduct in digital environments. Social and health care professionals and future professionals need more training opportunities, ensuring a sufficient and skilled workforce to support the digital transformation (Government of Ireland 2024; Telehealth Working Group, 2023). Erika Jarva’s research (2024) on digital health competence provides valuable insights into the skills required for effective digital health practice. Her findings emphasize the importance of continuous education and adequate training in developing digital health competence. The study also highlights the role of higher education, self-driven learning, and digital resources in fostering interest and confidence in digital health services. The WHO’s recommendation to foster a supportive and inclusive environment for all stakeholders is crucial. Engaging in meaningful dialogue and collaboration can help address the challenges and concerns raised by health workers regarding the integration of digital healthcare and social welfare services. Competence development initiatives should focus on motivating and preparing professionals to embrace digital tools and maintain a positive outlook toward technological changes.

RemoTED partners are actively integrating digital and technological approaches into their health and social welfare educational programs to meet the evolving demands of the workforce and regional needs. At Lapland UAS, health and social welfare programs incorporate digital and technological solutions extensively. The Master School program, “Expert in Digital Health Services and Health Promotion,” and Bachelor degree programs in Nursing, Public Health, and Social Care include modules on distance learning, digital services, data protection, and information security (Lapland UAS 2024; Holappa, Immonen & Kinnunen 2023). Projects like Arctic RoboWelfare have mapped the current state of welfare technology robotics in Finnish universities of applied sciences, highlighting the integration of robotics and technology into education. However, there is a need for continuing education and specialization (Holappa & Rautio 2024).

Karelia UAS addresses regional challenges such as changes in working life, digitalization, an aging population, and climate change by training future experts and developing local services (Karelia UAS 2023). The curricula for social and health care are competence-based, regularly reviewed, and updated to meet the needs of practical field. The “DigiNurse Model” integrates digital coaching into the curriculum, emphasizing the importance of digital tools in modern healthcare (Vesa 2021). Various RDI projects have advanced the digital skills of students and teachers. For example, the Living Lab project allows students to explore new technologies with end-users, and the Sotydigi project developed a digital pathway for social services education (Kurki & Leppänen 2023; Sorjonen 2022). Karelia’s activities are systematically developed based on the development needs identified in audits. One of the key new development projects for 2024 is to strengthen the AI skills of staff and students. (Karelia UAS 2024b.) In this way, Karelia UAS aims to respond to current global change trends in the North Karelia region, such as the versatile use of AI in social and health care fields and other sectors.

All partners emphasize digital competence in their curricula, including training in digital services, data protection, and information security. Continuous learning and specialization in digital technologies are crucial due to the rapidly evolving technological landscape. There is a strong focus on the practical application of digital technologies. Students are taught not only theoretical aspects but also how to apply these technologies in real-world settings, but it needs also more focus and hands-on training at educational institutes but also in the practical field. Projects and specialized programs encourage innovation and practical skills development.

Enhancing technological and digital solutions training and education in social and health care in RemoTED partner areas – driven by several factors

1. Need to enhance professionals and future professionals digital and technological competences: Lindgren and Manssila (2021) significant number of social work graduates feel the need to develop digital skills to meet the demands of work. There is variety in technology and digital skills, and educational institutions should do uniformity in course offerings to ensure consistent competencies (Sirviö 2024). Jarva (2024) highlights the need for continuous education and adequate training in digital health services to develop digital health competences. This includes the ability to deliver patient-focused care via digital platforms, utilize information technology and digital health systems, engage with patients using digital tools, and integrate digital solutions with conventional practices. Mentoring and knowledge-sharingcan help future professionals to build strong, well-rounded competencies, preparing them to navigate the evolving demands of the healthcare sector (Pramila-Savukoski et al. 2023).
2. Need to provide continuous education and online training programs: To maintain professional competence and ensuring that healthcare and social welfare professionals can effectively use digital tools in their practice (WHO 2019). Education must adapt to evolving professional roles and align with employer expectations through online teaching and practical technology tools (Sirviö 2024). Online training programs that help professionals stay updated with the latest practices and technologies (European Union 2024). Implementing work-based training programs can help professionals and future professionals to develop their core competencies and gain practical work experience, which is essential for navigating the evolving demands of the healthcare sector (Pramila-Savukoski et al. 2023). Jarva (2024) emphasizes the importance of ongoing education and training to build digital health competence. This involves equipping professionals with the skills to effectively use digital tools, integrating them into their practice, and maintaining a high standard of patient care through digital means.
3. Need to support social and health care service delivery: Härkönen et al (2023) and WHO (2019) are emphasizing the importance of digital services in improving the efficiency and reachability of social and health care services, especially in sparsely populated areas.
4. Need to share knowledge about emerging technologies: The rise of artificial intelligence and digitalization is reshaping the landscape of social and health care, leading to uncertainty and challenges when professionals assess their own competencies and skills (Pramila-Savukoski et al. 2023). Training for advanced technologies like robotics and AI should be provided in an ongoing training supported by employers (Sirviö 2024).

Strategical choices play a crucial role in implementing new digital solutions and technologies into social and health care services and education

Europe’s Digital Decade Framework provides a strategic roadmap for achieving digital transformation across various sectors. Its objectives and principles align with the need for a digitally skilled population, secure digital infrastructures, and the digitalization of public services. This framework can guide the development of policies and programs that support the integration of digital technologies in healthcare and social services (Government of Ireland 2024). During the review the importance of integration of National Strategies of digitalization was significant when adopting digital and technological solutions in social and health care services and education. Strategical choices such as Irelands Sláintecare project aligns with broader national strategies like the Digital Health & Social Care Strategic Roadmap (2024–2030) and the Digital for Care framework. This shows a cohesive approach to digital transformation. It is important to understand also the meaning of stakeholder engagement when developing these digitalization strategies, that ensures the strategies to be comprehensive and inclusive. (Digital Health & Social Care Strategic Roadmap 2024–2030.)

Digital technologies enhancing service delivery and addressing challenges in the sparsely populated areas

Existing technologies and digital solutions can significantly enhance professional service delivery in sparsely populated areas, found in the review:

• Telemedicine and telehealth: Telemedicine allows healthcare providers to offer consultations and follow-ups remotely, reducing the need for travel and making healthcare more accessible (Stoumpos, Kitsios & Talias 2023). Telehealth Services allow healthcare professionals to provide consultations and follow-ups remotely, reducing the need for travel and making healthcare more accessible (Sirviö 2024).
• Digital Documentation: Digital tools for documentation can streamline administrative tasks, allowing professionals to focus more on the client (Lindgren & Manssila 2021).
• Connectivity Solutions: Addressing connectivity issues and ensuring reliable access to digital tools are critical for effective service delivery in remote areas (Härkönen et al. 2023).
• Digital Health Platforms: Platforms that integrate various health services and provide a centralized system for patient data management (Kraus et al. 2021).
• Mobile Health Applications: Apps that assist in patient monitoring, appointment scheduling, and providing health information (WHO 2019).
• Telehealth Services: Services that enable remote consultations and diagnostics, improving access to care in underserved areas (Stoumpos, Kitsios & Talias 2023).
• Digital care pathways and remote client work offer significant possibilities, including enhanced continuity and accessibility of care, reduced need for routine check-ups, and flexible communication between clients and professionals. Continuous feedback from professionals and clients helps improve digital systems. Pilot projects and specialized programs support the development of advanced skills and knowledge in digital health services. Hiltula et.al. 2024; Lapin Hyvinvointialue 2024).

6. CONCLUSIONS AND FUTURE RECOMMENDATIONS

This review highlights the need for ongoing education and specialization in digital technologies, addressing the specific challenges faced by sparsely populated areas, and proposing technological solutions to enhance professional practice. By focusing on these aspects, the review provides insights into how digital and technological solutions can be leveraged to improve social and health care education and practice, particularly in regions with unique challenges like those faced by the RemoTED partner universities. By leveraging their strengths and addressing their weaknesses, these institutions can continue to innovate and enhance the quality and accessibility of healthcare education and services.

Leveraging information technology to develop or update service procedures can enhance service innovation processes and improve service delivery outcomes. Research on the management implications of digitalization from various stakeholders’ perspectives is essential to gain a comprehensive understanding of digital health transformation. Support personnel and goal-directed education are essential for all end users of digital services, including patients, clients, and service providers. The lack of digital competence, particularly in sparsely populated areas, poses significant barriers to the effective use of digital technologies. Issues such as connectivity problems and limited access to electricity highlight the logistical challenges faced by healthcare professionals in these regions. Additionally, concerns about data protection and privacy persist, indicating a need for comprehensive education and training to address these issues.

Future research should focus on the management implications of digitalization and the role of social influence in digital and technological competence, especially from the perspective of sparsely populated areas. By incorporating mentoring, knowledge-sharing, and work-based training into education, we can better prepare future professionals to navigate the evolving demands of the healthcare sector. Additionally, offering continuous education and adequate training to professionals in the practical field is essential for developing the digital and technology competencies needed to leverage the full potential of digital technologies in social and health care services.

7. ACKNOWLEDGEMENTS

This research was supported as part of [RemoTED], an Interreg Northern Periphery and Arctic project co-funded by the European Union.

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Appendix 1

Description of the RemoTED project and its’ partner universities and areas

1. Background

This literature review is a part of the the RemoTED preparatory project funded by the European Union Interreg Northern Periphery and Arctic (Interreg NPA), supporting projects aims to provide more knowledge for The RemoTED main project application. Interreg NPA is A European Union (EU) funding initiative that fosters collaboration among remote and sparsely populated communities in Europe’s northernmost regions on common interests. Interreg NPA aims to transform ideas into sustainable solutions to enhance the quality of life for residents in the Northern Periphery and Arctic area (Interreg NPA 2024).

By this review RemoTED partners can define the needs for enhancing education and training of technological and digital solutions in social and health care, especially in remote areas in future. Partners in this Interreg NPA funded preparatory project are Lapland University of Applied Sciences (Lapland UAS) as a lead partner and Karelia University of Applied Sciences (Karelia UAS) from Finland and Atlantic Technological University (ATU) from Ireland.

The preparatory project duration is between January 2024 to March 2024.

2. Partners and their areas

Lapland University of Applied Sciences and Finnish Lapland

Lapland UAS is a part of Lapland University Consortium (LUC). The University of Lapland offers academic fields of education, law, art and design, social sciences, and northern and Arctic issues while Lapland UAS is a polytechnic University that offers work-oriented bachelor’s and master’s degree programs. One of the LUC Consortiums strategic choices is future services and reachability, which aims to identify future service needs and to design and develop service solutions in response to the requirements regarding reachability, equity in education, and well-being in sparsely populated areas (University of Lapland 2024; Lapland UAS 2023a; Lapland UAS 2023b).

Lapland UAS has social and health care education in bachelor’s and master’s levels: Bachelor of Social Services and Health Care (Geriatric, Nursing, Public health nurse, Physiotherapy, Social services) and Master education programs in Social Services and Health Care. Lapland UAS has learning and development environments in effective use, but there is a need to develop them more to serve the needs of practical field and to develop students’ professional delivery for the future. Lapland UAS is using digital technologies in education e.g. the Nursing study programs are multimodal studies and on campus studies including distance learning and in social care education, Bachelors’ Degree studies are in multimodal and online. The study programs for Masters’ degree students are online and multimodal (Lapland UAS 2024a).

Figure 1. Information about Lapland University of Applied Sciences 2024b.

Lapland is the largest region in Finland by area, with a population of approximately 179,000 people. The region is characterized by long distances, extensive wilderness and protected areas, the traditional homeland of the Sámi people and their indigenous livelihoods, sparse population, and shared land borders with three countries: Russia, Norway and Sweden (Lapin ELY-keskus 2023). Approximately 42 % of Lapland’s’ population are residing outside urban areas. The region faces several challenges, including the risk of services, education, and innovation shifting to larger growth centres, economic uncertainty, population loss, declining birth rates, and an aging population. The region’s weaknesses include its remote location that possesses significant challenges for the implementation of social and health care services, long distances, high structural unemployment, and inconsistent availability and quality of services or skilled professionals across different municipalities. However, there are notable strengths, such as strengthening economic growth, increased demand for work force, improved accessibility, and enhanced opportunities for remote work. (Lapin Liitto 2024; The Lapland welfare regional council 2023, 4.)

In the Lapland, Laphas’ social services are working in a joint co-operational area agreement of Northern Finland: The Centre of Expertise on Social Welfare (Poske). Poske covers functions in the Administrative Districts of Oulu and Lapland. The area consists of 51 municipalities (Lapland 21). The Centre for Expertise on Social Welfare aims to strengthen both foundational and specialized knowledge in the social sector by collaborating with various stakeholders. It engages in development, research, and experimental projects alongside practitioners, offers specialized services and expert consultations, evaluates and forecasts social impacts, and promotes social services that respect the Sami language and culture. Additionally, it serves as a networking hub for professionals, service users, researchers, and students (Pohjois-Suomen sosiaalialan osaamiskeskus 2020).

Map 1. Illustration of Lapha areas in Finnish Lapland. Lapha organizes social and health care services in Lapland. Population of each service area of Lapha. (Source: Lapin hyvinvointialue 2024)

Reforms in service networks, digitalization, and structural changes within the social and health sector are reshaping job roles and redefining skills and workforce needs. The long-recognized shortage of workers remains a significant challenge, with many job openings difficult to fill. Collaboration between the public and private sectors is essential to enhance the sector’s appeal and support workforce availability. In Lapland, alongside retirements, substitute recruitment represents a significant portion of the workforce demand. Workforce availability challenges are most pronounced in smaller communities. The private sector experiences better workforce availability and fewer retirement issues compared to the public sector. Decreased funding impacts the number of employees in nonprofit organizations, which in turn affects clients receiving lighter support and assistance. Skills requirements are expanding across all roles as technology increasingly necessitates data monitoring and interpretation related to clients’ health and wellbeing. In Finnish Lapland there is a critical shortage of skilled professionals of digital services and remote care in social and health care sector. (Työ- ja elinkeinoministeriö 2024a.)

Karelia University of Applied Sciences and North Karelia

Karelia University of Applied Sciences (Karelia UAS) is a multidisciplinary university of applied sciences whose main tasks are education, research, development and innovation (RDI) activities, and service business. Karelia UAS is located in North Karelia, Finland. Karelia UAS offers education leading to bachelor’s and master’s degrees. Education in the social and health care field is provided in six different Bachelor’s degree programs: Physiotherapy, Applied Gerontology, Nursing, Social Services, Occupational Therapy and Public Health Nursing. Master’s degree programs include Development and Management of Health care and Social Services, and Development and Management of Active Aging. (Karelia UAS 2024a; Karelia UAS 2024b.)

The other study fields of Karelia UAS are media, business, tourism, technology, and natural resources. Karelia offers education also for international students. For example, there are English-taught degrees such as the Master of Information and Communication Technology. Karelia UAS also provides a wide range of courses of lifelong learning and expert services and actively participates in the development of the North Karelia region through various research and development projects. Regional development is carried out in cooperation with local businesses and the labor market, as well as national and international partners. Karelia UAS engages in close strategic cooperation with organizations such as North Karelia Municipal Education and Training Consortium (Riveria), Student association of Karelia UAS (POKA), City of Joensuu and Wellbeing Services County of North Karelia (Siun sote). Additionally, Karelia UAS, University of Eastern Finland, and Savonia University of Applied Sciences have entered into a strategic cooperation agreement for the years 2021–2024. This agreement outlines collaboration in educational activities, increasing societal impact, and higher education services. (Karelia UAS 2024a; Karelia UAS 2024b.)

North Karelia is a region in Eastern Finland (Figure 2) and its population is approximately 162,000 residents (Pohjois- Karjalan Maakuntaliitto 2023). Regions’ challenges are that the state of population development is twofold: natural population change is negative, while migration remains exceptionally strong. Aging presents challenges for the availability of skilled workforce in social and health care services. Unemployment is on the rise, and it is the highest in Finland, yet certain industries and occupations still face a shortage of skilled workers. Exceptional circumstances are challenging the development of the business sector, with weakened prospects for companies, although opportunities exist in areas such as the green transition and education. Additionally, well-being faces challenges, marked by the lowest income levels in the country and high morbidity rates. (Niiranen 2024.)

The social and health sector is the largest industry in North Karelia in terms of employment, with over 12,000 people working in the field. The demand for workers in this sector is driven by the growing need for services due to an ageing population and the retirement of current employees. Several professions within the social and health sector are facing workforce shortages. The demand for workers is expected to remain steady at current levels throughout the next year. The greatest need is for nurses, practical nurses, social work professionals, and doctors, particularly outside of regional centers. The overall situation in the sector is characterized by an increasing demand for staff, coupled with a challenging financial situation. Professionals in the social, health, and well-being sectors have strong employment prospects, but there are not enough students entering these fields to meet the demand for skilled labor. The sector is becoming more international, with an influx of students and workers from abroad. Emerging skill needs are driven by the growing service demand of an aging population, the use of new technologies in client work, and the increasing multicultural nature of both the workforce and the clients. (Työ- ja elinkeinoministeriö 2024b.)

The Finnish social and health care model is based on publicly funded services, complemented by private companies and organizations. Finland has 21 wellbeing services counties and the city of Helsinki, which are responsible for primary health care, specialized medical care, social services, and rescue services. (Ministry of Social Affairs and Health 2024a.) Wellbeing services county of North Karelia (Siun sote) provides public social, health, rescue, and environmental health services to the residents of North Karelia in Eastern Finland. It covers 13 municipalities, including the City of Joensuu. Siun sote was initially operated as joint municipal authority from 2017, and it transitioned to a wellbeing services county in 2023. With nearly 8,000 employees, Siun sote is a significant employer of social and health care professionals in North Karelia. Siun sote aims to offer high-quality and cost-effective social and health care services and promote health and well-being of residents of North Karelia. (Siun sote 2024.)

Map 2. A map presenting urban-rural areas in Nordic countries, including Finland. (Source: Nordregio, Map designers: Anna Vasilevskaya and Oskar Penje 2023)

Atlantic Technological University and West and Northwest of Ireland

Atlantic Technological University (ATU) is a multi-campus technological university in the west and northwest of Ireland. ATU has substantial experience carrying on innovative research technologies and social and health care. ATU aims to support the local communities and industry to solve actual challenges. Ireland is facing overloaded social and health care systems. Besides, remote health and social care delivery is more challenging due to the lack of specialists and long distances. Moreover, government funding is scarce. The Nursing, social and health care department at ATU has recognized that it is more difficult to find placements for students in remote areas owing to the lack of mentors. Further, the trained workforce is lost to other countries with enhanced job offers. So, praxis must change to speed delivery and enable access, and education must change to be better prepared to be dealt with the challenges of the remote areas. Incorporating technologies might enhance outcomes in both. ATU has a strategic choice on promoting the use of digital technologies and communicating in higher education and society. (Atlantic Technological University 2023, 8, 16.) In Social and Health care education ATU has several programs of Health Sciences and Social Sciences such as midwifery, public health, nursing and social care. They offer multimodal and on- campus education for their Social- and Health care students. (Atlantic Technological University 2022.)

ATU has worked in partnership with the HSE, the Letterkenny University Hospital (LUH) Saolta Group, Donegal and Sligo Leitrim Mental Health (MH) Services, and Donegal Intellectual Disability (ID) Services. All to ensure placements in accordance with professional bodies, standards and requirements of programs (ATU News 2022).

The West and Northwest (WNW) Region, the fourth largest Regional Health Authority in Ireland. WNW consists of 15 Community Health Networks (CHNs) with populations ranging from 33,000 to 81,000. The region’s total population is 759,652, making up 14.8% of the national population. The WNW region has a higher proportion of older adults and the lowest proportion of those aged 15-64 years. It also has fewer affluent individuals and more deprived groups compared to the national average, with significant variation in deprivation levels across CHNs. The Health Service Executive (HSE) manages all public health services in Ireland, including personal social services (Department of Public Health, HSE West and Northwest 2024, 3; Citizens Information, 2024).

The HSE services are delivered through medical professionals (such as doctors, nurses, and physiotherapists), hospitals, local health offices, health centres, and community clinics. These services include promoting good health, preventing illness and diagnosing and treating illness. The HSE also provides community care and personal social services to help people live in their communities despite illness, disability, or age. These services include home nursing, home help, occupational therapy, and social work. Additionally, the HSE plays a role in preventing infectious diseases. Starting in 2024, HSE services will be organized into 6 health regions, each managing all integrated health services in its area. By the end of 2024, current hospital groups and community health care services (CHOs) will merge into these new health regions. The HSE will manage nationally delivered clinical and support services, while the Department of Health will set health policy and oversee funding. The Department of Children, Equality, Disability, Integration and Youth (DCEDIY) will handle policy, legislation, and funding for community-based disability services. Social and health care services are delivered through National Service Delivery Divisions, including acute hospitals, social care, mental health, primary care, health and wellbeing, and the National Ambulance Service (Citizens Information 2024).

Map 3. Rural areas in Ireland. (Source: Central Statistics Office 2024)