Characterise and predict patient flows associated with high healthcare utilisation
The research project is Region Kronoberg’s initiative to develop more integrated, proactive and person-centred care. Local authorities and the region are working together and using data to improve care outcomes for older people and patients with multiple health conditions.
Older patients and those with multiple health conditions often move between several care providers, such as local authority care, regional primary care and hospital care. Under current working practices, care can easily become fragmented, leading to:
- a lack of continuity
- difficulties in identifying high-risk patients in good time
- over- or under-treatment
- unnecessary visits and admissions
- increased costs for both local authorities and the region
The ‘Information-driven Care’ research project aims to develop working methods and digital decision support tools that make healthcare more proactive. Through advanced analysis and AI modelling, the aim is to identify early signs of increasing care needs and strengthen coordination between all actors in the care chain.
The project is a key part of the work towards high-quality, local healthcare. By using data in a sensible, ethical and coordinated way, the aim is to create better decision support, better use of resources and, above all, better care for those who need it most.
Activities, objectives and outcomes
Activities within the research project
The aim is to use shared health data – from both the region and local authorities – to understand patterns, risks and care needs at an early stage of the care pathway.
The project is working, amongst other things, to:
- integrate data from local authorities and the region
- carry out advanced analysis and AI modelling
- identify risk factors and care pathways
- develop forecasting tools that predict increasing care needs
- develop decision support and visualisations for healthcare staff
- create new working methods for proactive care
- improve coordination between local and regional healthcare
The work will be carried out in dialogue with healthcare staff and organisations.
Objectives
- Better collaboration between the region and municipalities
- Fully developed decision support tools and forecasting tools to assist staff in their daily work
- More efficient and accurate care pathways
- Increased security and better health outcomes for older people in Kronoberg
- An established and long-term sustainable model for data-driven care
Expected outcomes
- Reduced healthcare consumption through earlier interventions
- Better continuity and safer care transitions
- More efficient use of resources
- Greater patient benefit and improved outcomes throughout the care chain
About the project
Project period
- 2026-05-01–2027-12-31
Project Manager
- Main Project Manager: Johanna Loeb, Campus Ljungby
- Local Project Manager: Farzaneh Etminani, Senior Lecturer, Halmstad University
Collaboration partners
- Region Kronoberg
- Ljungby municipality
- Campus Ljungby
The project owner is Region Kronoberg. The project partners are Ljungby Municipality, Halmstad University (responsible for research) and Campus Ljungby (acting as coordinating project manager). All municipalities in Region Kronoberg are invited to participate in the project.
Financiers
- Region Kronoberg
- Ljungby kommun
- Effektiviseringsdelegationen
The research project is funded under a decision by Effektiviseringsdelegationen for the period 2025–2027.
