Oslo Agency for Health: weathering the pandemic storm with low-code technology

“We’re not just talking about an overnight change, but a transformation. Something that happened layer by layer – all thanks to technology.”

Ottar Wiklund, Product Manager at the Oslo Agency for Health, is reflecting on his organization’s response to the pandemic and the solution that helped it succeed. 

“As the organization responsible for providing digital services to Oslo’s healthcare sector, when lockdowns hit, we found ourselves right at the heart of its crisis management efforts,” explains Wiklund. “For us, that meant one thing: coming up with quick, easy-to-use solutions designed to help our care teams to stay on top of the crisis.” 

Luckily for the city of Oslo, the organization wasn’t caught unprepared. Using low-code technology, Wiklund and his team were able to build more than 25 apps and digital solutions for a range of uses – from contact tracing to vaccinations and vaccine distribution, test booking, vaccine booking predictions and more. All in a matter of days. 

“If you're out at sea on a boat and a storm is coming, the main goal for you will be to stay afloat and not to take in any water,” he says.

“Thanks to low-code technology, we were able to do that and much more – safely steering the ship through these unknown waters as quickly as possible.”

Building a patient data system for the city of Oslo

Known locally as Oslo kommune Helseetaten, the Oslo Agency for Health handles the operation and development of professional systems in the healthcare services. It employs approximately 1,700 people and provides services to more than 27,000 internal and external users spread across the capital’s 15 precincts and three agencies. 

“We are a key point of reference for Oslo’s healthcare network and the city’s 750,000 inhabitants,” says Wiklund. “And for many years, Microsoft has played a crucial role in empowering our work.”

The organization has been running on Microsoft Azure since 2016 – initially using it as foundation for an IoT platform and gradually expanding its use to other services.  

“IT-wise, our organization has traditionally operated in silos,” explains Anne-Marthe Hellgren, Team Coordinator at the Oslo Agency for Health. “Each department or service uses their own electronic patient journal system, and none of these communicate well with each other.” 

To ensure that patient records are better stored and shared across the network – particularly in coordination with national registers – the organization has turned to low-code solutions within the Microsoft Power Platform, and has used it to create an entire new data system. 

“Over four years, we’ve been able to create a new ecosystem that we call ‘High Productivity, Low Code’, which is a development model that allows us to create sophisticated solutions fast,” she says. 

“It’s a bit like building with LEGO bricks, but creating solutions ready for large-scale use. Little did we know how useful this would turn out to be during the pandemic.”

A simple app ignites the city’s pandemic response

When the pandemic hit Norway in February 2020, healthcare services around the capital found themselves in desperate need of optimized solutions and efficiency. 

“The national and local processes for registering and controlling contagious diseases that we had at the time simply did not scale along with the extraordinary volume we faced,” says Ottar Wiklund. “Most of them relied on paper forms, emails, phone calls… they were just too inefficient.”

“Thankfully, we already had our low-code platform in place, which allowed us to start developing new solutions fast and with very little training needed.” 

Looking back at the early days of the crisis, he recalls how small his team initially was. “In February 2020 our team consisted of just four people, half of which were pro-dev resources,” he continues. “Since then, we have increased to 15 and doubled the number of pro dev resources. 

"And it’s the most multifaceted of teams too: we have a pilot-turned-contact-tracer, a journalist, an environmental scientist, an auditor, a chaos physicist, an occupational therapist and two nurses – all hands-on fulfilling their unique role of developing solutions in the Power Platform.”

Using the platform as a digital backbone, the team quickly moved on to develop a solution designed to keep track of infections. “The simple and straightforward solution we created meant that we could use people without a background in healthcare to work on contact tracing,” he says.  “To identify people who needed clinical follow-up and send them to their doctor.

“And as soon as we saw that the rules and recommendations changed from week to week, we further upgraded the platform to make it even more simple to use and create software.”

Adding more bricks to the platform

Since the very first solution, the agency has moved on to create some 25 apps to support patient-doctor communications, contact tracing, covid-19 test booking, vaccinations and more. In just four months, the number of users went from 30 to 3,000 without seeing any performance hits.

“All the data we have is now saved in a Dataverse that helps us keep track of patients,” says Ottar Wiklund. “And on top of that, we’ve now introduced Power BI functionality that assists us on the analytics side of things, as well as to know which precincts are doing well and which need our support.”

This in turn guarantees greater collaboration between Oslo’s 15 precincts and the population they’re responsible for – facilitating access and sharing of information across the city. This is also made possible by a Power Automate flow that works in the background to mine data and patient information that is stored in national registers. All with the highest standards of security. 

“One of the greatest things about the Power Platform is that it’s ISO certified, which makes it easier for us to handle the data we mine using Power Automate in a GDPR-compliant way,” he continues. “It fits very well with the dynamic, agile way of developing.”

He adds that being able to integrate Azure with its wider services is crucial too. “Using Azure Functions has allowed us a clean decoupling between the teams creating the test answer import,” he says. 

“And with a nightly integration with Azure SQL, we were also able to provide the Norwegian Institute of Public Health with secure access to the data they needed to plan national measures.”

Looking ahead

It has been more than two years since the Oslo Agency for Health first used its Power Platform to manage the city’s pandemic response. With the crisis now more under control, the agency has expanded the use of its platform to other services in need.

“What I love about our solution is that the apps can be disposable,” says Ottar Wiklund. “This is a complete novelty, as it means that we don’t get lost in long and tedious processes or stuck with monolithic solutions that are hard to change without breaking other parts.”

He explains how the platform was lately used to create solutions that allow to provide health services to people without a valid Norwegian ID, as well as to translate digital forms to multiple languages.

“In Oslo, we have a significant number of people who are here with no documents or place to stay,” he explains. “They live on the street, but they still have the same right to health services. 

“At the same time, our national systems don't really support people without a social security number. That’s why we are looking into ways to use a new digital identity and give these vulnerable groups the same quality of services we give others - allowing them to retrieve their patient journals and vaccinations and obtain any information needed by our health personnel.”

This, he says, is truly what Power Platforms and low-code technology are about. “For so many years, the use of our apps was limited by long waiting and rollout times, resulting in solutions that were out of date, sometimes even before their release” he concludes. 

“With this model, we’re finally free to test assumptions, try out and develop our own solutions, in a much more agile and dynamic way.”