Ostrobothnia Digital Clinic Experiment

This randomized controlled trial (RCT) examines the impacts of a publicly provided digital clinic that offers digital primary care services to consumers. This intervention grants access to a public digital clinic that provides chat-based primary care consultations via a mobile phone application and website, including care needs assessment, diagnoses, follow-up care recommendations, and prescriptions. The digital clinic supplements traditional public primary care services, including in-person visits and phone consultations. The trial takes place in Ostrobothnia, Finland, a healthcare district serving a population of 178,000 residents. The investigators will randomize access to the digital clinic at the household level, providing access to 50% of the households. By doing so, the investigators aim to evaluate whether digital services can substitute for, complement, or increase the utilization of traditional primary care, particularly in-person visits or calls to traditional clinics. At the end of the nine-month trial, access to the digital clinic will be expanded to the entire population.

Study Overview

• Status: Active, not recruiting
• Conditions: Primary Care Provider
• Intervention / Treatment: Other: Access to a digital clinic

• Study Type: Interventional
• Enrollment (Estimated): 170306
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Finland
  • Vaasa, Finland
    • Wellbeing Services County of Ostrobothnia

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria for the intervention:

• All residents alive and residing in the region of Ostrobothnia (Finland) on March 14, 2015, AND permanent address observed in the Finnish Population Information System

Exclusion Criteria for the intervention:

• Resides in the city of Kristiinankaupunki OR resides in a household defined as institutionalized care

Exclusion Criteria for the analysis sample:

• The inclusion and exclusion criteria mentioned above AND:
• If an individual from the target population, extracted from the Population Information System, is not observed in Statistics Finland datasets, which is defined as not having a municipality of residence (missing data) at the end of 2024, the investigators will not use that individual in the study population in the analyses because the data do not include have covariates for the individual.
• Age 71 and above

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Access to a digital clinic; Access to a digital clinic, which offers assessments, diagnoses, follow-up care recommendations, and prescriptions	Other: Access to a digital clinic; This intervention grants access to a digital clinic that provides chat-based primary care consultations via phone application and website.
No Intervention: No access to a digital clinic (treatment as usual); Health care as usual without access rights to a digital clinic

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The number of in-person visits in public primary care (Y1.1)	This outcome includes in-person visits to nurses and physicians in traditional public primary care clinics.	From the digital clinic launch to the end of treatment at 9 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The number of other contacts with traditional public primary care (Y1.2)	This outcome includes care needs assessments, remote appointments to nurses and physicians, and professional-to-professional interactions between nurses and physicians in traditional public primary care clinics.	From the digital clinic launch to the end of treatment at 9 months
The number of public digital clinic contacts (D.1).	This outcome includes care needs assessments, remote appointments to nurses and physicians (via chat and video), and professional-to-professional interactions between nurses and physicians in digital public primary care clinics.	From the digital clinic launch to the end of treatment at 9 months

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
The total number of public primary care contacts (Y1.3)	This outcome includes in-person visits to nurses and physicians, care needs assessments, remote appointments to nurses and physicians, and professional-to-professional interactions between nurses and physicians in digital and traditional public primary care clinics.	From the digital clinic launch to the end of treatment at 9 months
Presence or absence of public digital clinic contacts during the follow-up (yes/no) (D.2).	This outcome includes care needs assessments, remote appointments to nurses and physicians (via chat and video), and professional-to-professional interactions between nurses and physicians in digital public primary care clinics. This outcome is 1 if the person has at least one contact with the public digital clinic during follow-up and 0 if the person has no contact during follow-up.	From the digital clinic launch to the end of treatment at 9 months

Collaborators and Investigators

• Sponsor: Finnish Institute for Health and Welfare
• Collaborators: University of Turku; Aalto University
• Investigators: Study Director: Mika T Kortelainen, PhD, University of Turku and Finnish Institute for Health and Welfare

Publications and helpful links

Helpful Links

• Replication codes (GitHub)

Study record dates

Study Major Dates

• Study Start (Actual): April 15, 2025
• Primary Completion (Estimated): January 14, 2026
• Study Completion (Estimated): January 14, 2026

Study Registration Dates

• First Submitted: March 18, 2025
• First Submitted That Met QC Criteria: March 28, 2025
• First Posted (Actual): April 1, 2025

Study Record Updates

• Last Update Posted (Actual): August 20, 2025
• Last Update Submitted That Met QC Criteria: August 18, 2025
• Last Verified: March 1, 2025

More Information

Terms related to this study

• Keywords: randomized controlled trial; primary care; telemedicine; healthcare utilization; digital healthcare; digital clinic
• Other Study ID Numbers: THL/5935/6.02.01/2024

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: The dataset containing individual-level health data and demographic data is regulated under the Act on the Secondary Use of Health and Social Data (552/2019) and cannot be made readily available for the purpose of direct replication. However, access to the data can be obtained by sending requests to the Finnish Social and Health Data Permit Authority, Findata, and to Statistics Finland. The investigators commit to publishing all statistical code and other details of the computations that are sufficient to permit the validation of empirical work. The investigators commit to storing the treatment assignment code and data for future use, allowing interested researchers to construct the full dataset required for further research utilizing the original treatment assignment.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No