Smart indicators as the key to improve service integration in health care

User-driven indicators improve data accessibility and utilization, strengthen public health monitoring, and enhance collaboration and integration of health care services.

Background: The Norwegian health care system faces increasing challenges in achieving seamless integration between specialist and primary health care services, particularly for patients requiring care across multiple levels. Municipalities and county-authorities play a critical role in primary care, particularly concerning national priorities for five patient groups. Ensuring effective service integration requires access to relevant and reliable data. The Health Care Integration Barometer (Samhandlingsbarometeret) is an open access portal designed to support informed decision-making, planning, and quality improvement in health services. In accordance with the Norwegian Public Health Act, municipalities are responsible for maintaining an overview of population health, associated risks, and implement appropriate interventions. Achieving this objective requires availability of population and health care data. However, a lack of timely and relevant indicators has hindered the ability to improve integration of health care effectively. To address this gap, Samhandlingsbarometeret conducted a national survey to identify relevant key indicators to monitor public health and integration of primary and specialized health care services. Methods A national survey was distributed in January 2025 to all municipalities, county authorities, hospitals and their healthcare collaboration unit "helsefellesskap", regional and national health authorities. A two step study included national survey to identify relevant indicators for public health monitoring and for integration between specialist and municipal health care services. And qualitative in-depth interview, wherein stakeholders elaborated on the responses from the survey. Results: The findings identified key indicators highly relevant to users, along with an additional set of indicators tailored to the five national priority patient groups. The highest response rate was observed among public health advisors in municipalities, underscoring the demand for accessible and actionable data to support municipal public health efforts. The integration of these indicators in Samhandlingsbarometeret will significantly improve access to relevant data, enhancing knowledge-based decision-making across different levels of health care. Conclusion: A User-driven selection of indicators has strengthened the foundation for preventive and health-promoting interventions, improving integration and patient pathways. By facilitating access to relevant data, this model supports more efficient, data-driven decision-making in health care. Additionally, the approach demonstrates strong scalability, with potential applications for improving integration and collaboration practices.