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Swedish government software developer counters poor health apps claim
As national election season approaches, political opponents of Sweden’s lead coalition party make hay of survey that claims unsatisfactory health apps deter doctor visits
The boss of Sweden’s national health app claims she is unfazed by the revelation that a quarter of Swedes have avoided booking doctors’ appointments because its digital health services are hard to use, as claimed by a survey of national internet habits.
Two months of political reverberations followed the survey’s publication, culminating in a government pledge to make public service apps more user-friendly and an announcement that it had taken steps to do that.
The Ministry of Finance said it had charged the Swedish Digital Governance Agency (Digg) with working out how it could make digital public services easier to use by combining them all into a single super-app.
The statement was, however, a repetition of plans the government unveiled as part of a grand, five-year digital strategy in May 2025. Its core aim was a citizen super-app that would assimilate e-services across the public sector to make life easier for people. The plan included health services.
The pledge came as the government concluded, without fanfare, a decade-long effort to make Sweden the world leader in good and equitable e-health services. Embarrassingly, the survey found that elderly people and those with disabilities were most likely to have been deterred from making doctors’ appointments by encounters with poor-quality apps.
“They have clearly failed to design community services that everyone can use,” Jannike Tillå, head of community benefit at the Swedish Internet Foundation, which published the survey, said in a press statement upon its release.
Digital health services complicated by fragmented market
Near-unnavigable e-services are a part of everyday life in Sweden, according to the foundation, which acts as the country’s national internet domain registrar.
The survey included quotes from people who reported a confusing variety of health apps, describing them as complicated, baffling, unnavigable, frustrating and impersonal. Appointments were reportedly unavailable for urgent cases, and younger, app-savvy users claimed the apps were buggy, poorly designed and unfinished. Elderly users couldn’t make sense of them.
But the survey said health apps had at least eliminated the call queues people had to endure when trying to make appointments by telephone. Two-thirds of people said it was either easier or no harder to make appointments with an app than by phone.
Hanna Emami, head of e-services at Inera, the public sector software developer responsible for 1177, Sweden’s national health app, said people could always call the 1177 phone service for advice if they had trouble with the app.
“We have that for those who find it hard to use digital services. There is always someone to talk to. A lot of primary care facilities also have someone you can call,” she said.
Sweden’s fragmented health market is to blame for the problems people reported in the survey, she said.
“We have the ambition at 1177 to be an easy entry point to healthcare in Sweden, but we don’t have any control. 1177 is not the only app on the market – there are many, both public and private. We have 21 regions, and they decide whether to use their own apps or 1177. That makes it harder for people to know which app to use,” said Emami.
Still, she conceded: “We can be better.” Navigation is a known problem, she said. Inera has taken the survey into consideration. The booking revelation came as a surprise – Inera had no way of knowing from its own data how many people had given up trying to book an appointment after finding navigation difficult.
“We always want to improve and get better. We take feedback from users and make improvements constantly. Part of the feedback we have taken care of in the latest release. Overall, of course, we do not want people to refrain from seeking medical attention. We do not want that to be an issue at all. We want to build apps that are easy for people to use,” said Emami.
Both Inera and Digg do regular audits of app usability.
Tech must not exclude people
Private health companies earned a reproof from their trade body over the survey findings from the Swedish Healthcare Providers Association, which represents 2,000 of them. Private companies might have pioneered health sector apps, but they are giving people problems comparable to the phone queues they were supposed to fix, wrote Daniel Forslund, the association’s development manager. It is unacceptable to have apps that exclude people. Tech firms should do better, he said.
1177 acts as a national portal for regional services, yet only 2.5% of visits to 1177 last year involved people booking appointments, according to Computer Weekly analysis of sparse, highly selective data published by Nordic Health bodies earlier this year.
Only about half of the visits people made to 1177 involved their personal clinical records. The rest were casual lookups of health information, searches, landing pages and prescribed treatment programmes. The single most common reason by far that any Swede had for logging into the 1177 app last year was to view test results, clinical notes and messages. That accounted for half of all visits and about 90% of all app logins.
The publicity data concentrated on total visits and logins, which for 1177 were 199 million and about 160 million, respectively. Per capita, it reported that each person in Sweden, statistically, logged in 16 times in the year. But its statistics did not account for heavy users. Neither did it report what proportion of people actually used the app, nor did it compare them to non-digital channels.
The Nordic data suggests the Swedish Internet Foundation’s revelation amounted to the fact that about 0.5% of people who used the 1177 app last year found it so hard to use that, on at least one occasion, they were deterred from making a doctor’s appointment. The number of people using the app to make appointments at all is also likely insignificant. Moreover, what users can see and do in the 1177 appointments booking system varies by region and clinic. Some cannot even show appointments.
“The Nordic countries are far ahead of the rest of Europe when it comes to national health portals,” Inera said when publicising the report in June. It celebrated that usage of digital apps has been swinging back up after a brief sixfold peak on prior low norms during the Covid pandemic.
Health apps need to improve
Political responses to the survey were made in the shallows of a national election campaign season, marking the end of term for a minority coalition led by the liberal conservative Moderate Party, and decried the inadequacy of Sweden’s health apps.
Vivianne Macdisi, a Social Democrat councillor and chairwoman of the left-governed Uppsala Region’s Health Board, appeared on Sweden’s national public radio station to say the survey data showed that Sweden’s health apps needed improvement.
The Liberal Party filed a regional council motion in left-held Stockholm, calling for government centres where vulnerable people could go and learn how to use health apps, and for a catalogue recording where e-services failed to meet accessibility standards.
Christine Cars-Ingels, the secretary general of the left-leaning National Pensioners Organization, said in her members’ magazine that the state of health apps was unacceptable. She told them not just that a quarter of people had reported that on at least one occasion their experience with a health app had deterred them from making an appointment, but that a quarter of people are fundamentally deterred from doing so.
Moderate-held Jönköping County’s health body also called the situation unacceptable, though it said it works continuously to make its apps more usable. Better apps would cut administration costs as well, because a lot of time is wasted on bookings and rebookings, Jönköping e-strategist Sven-Åke Svensson told the state TV broadcaster.
