Brief overview of eHealth development in Estonia

1. Arvato Finance Solutions
Aleksandr Kormiltsyn
2016
Tallinn

2.  Historical timeline
 Medicum Information System
 Overview
 First healthcare provider using SNOMED CT
 First online booking system in Estonia
 eHealth foundation
 Overview
 System architecture
 ePrescription
 Synlab – services oriented to individuals
 Estonian eHealthcare: way to go
 Scientific background in Estonia

3. First
healthcare
software
solutions.
1992
Estonian
Health
Insurance Fund
switches to
digital billing.
Start of ID
card.
2002
First online
booking
system in
Medicum
2004
eTervis
organization
established
2005 Start of eTervis2009 ePrescription2010
Synlab offers
patients to
order
laboratory
tests
2014

4.  Main tool for doctors
 Different modules
 Integration with partners
 Application is still being used

5.  The biggest ambulatory healthcare provider in Estonia
 300+ users at the same time(Tallinn and Tartu)
 International healthcare standards
 SNOMED CT
 ICD10
 NOMESCO
 HL7
 DICOM
 NPU, LOINC

6.  Book doctor’s time online
 Reminders by email before the
visit
 Connection with Estonian Health
Insurance Fund to check whether
patient is allowed to book free
time or not
 Now 35% of times are booked
online for both family doctors
and specialists 65%
35%
Bookings
Usual
booking
Online
booking

7.  Shared repository of Electronic Health Records (EHR) for all Estonian
healthcare providers and patients
 All children born from 2008 have all their medical data stored in digital
way
 4 sub projects
 Digital health records (API for healthcare providers, patient portal)
 ePrescription
 Scheduling
 Medical images

8.  Main tasks
 Develop new services for citizens and doctors
 Estonian Health Information System services management
 Standardization and developing digital documents
 OID management, terminology management, publishing of technical standards
 International cooperation
 Scientific cooperation with universities

9.  Opt out data access
policy
 Connection via
security server and
xRoad
 Access only by ID card
for patients and
doctors

10.  Substitution for paper
prescription with some
benefits:
 More easy to manage own
medications
 Always best discount for
patient

11.  After 1 year after goLive
 Around 20% of ePrescription
are not sold out
 88,4% are ePrescriptions
12%
88%
Prescriptions
Paper
ePrescriptions

12.  Order laboratory test
and pay for them online
without visiting a doctor
 The results are
automatically available
online for client when
tests are done
 Access only by ID card

13.  Personal oriented
systems
 CDSS integration
 Individual is responsible
for health
 Processing both PHR
and EHR to improve the
healthcare processes

14.  Celsius Healthcare
 Online booking for all Estonian healthcare providers
 Integration of Sweden decision support system SFINX with Estonian Health Insurance
Fund and legacy systems of the healthcare providers
 HealthIn
 Personal data visualization in the context of individual centric applications
 Special prize of Garage48 in 2014
 All Systems Go
 Individual oriented system development
 Supporting integrations with legacy healthcare providers systems
 Scientific approach
 … and much more

15.  Special faculty of
healthcare engineering
(cross discipline for IT
and healthcare)
 Master’s and PhD
programs