“e-Estonia, model for the future”. We with envelopes, they with clicks. How practical is the digital health system

While we still dictate the envelope in hospitals, and patients carry stacks of referrals, analyzes and prescriptions from one doctor to another, in Estonia, the health system has been fully digitized since 2008.

The patient can schedule his consultation online with any specialist in the country, pick up his prescribed drugs via electronic prescription from the pharmacy and control at any time who and what information accesses his electronic medical record, which actually works. And, more recently, including the parameters recorded by the medical equipment, from the Intensive Care Unit, are automatically transferred to the patient’s electronic file.

Estonia’s medical system is certainly among the most digitized in Europe. In recent years, it has contributed decisively to improving the health of the inhabitants of the small northern country. The life expectancy of Estonians has increased from 69 years in 1991, when they gained independence from the Soviet Union, to 79 years today.

Liisa Lvova, patient: “It just makes our lives so much easier. Everything is in the computer, all your medical data. It’s super easy!”.

Hans-Erik Ehrlich, Head of Intensive Care Unit: “Everything goes automatically. We have the electronic health record in the hospital, we have a button there: check the medical history and that’s it! We push the button and see all the medical history from past medical providers.”

And the electronic health record proves its usefulness especially in the case of emergencies when every minute is vital for the patient.

Carmen Raal, digitalization advisor e-Estonia: “If the person can be identified then the ambulance, first of all, can access critical medical information: if we are allergic to certain medications, if we are currently on treatment or if we have had an operation.”

The digital health system, protected with blockchain technology

In the electronic register, the patient’s option regarding organ donation is also recorded, thus saving valuable time for saving other lives. With an average of 2.6 million monthly hits from patients, which is twice the population of the country, the digital health system is fully protected with blockchain technology and has never failed so far.

Access to the system is secured with the electronic identity card. But the challenge was great to arrive at a unitary system that would work safely.

Tonis Jaagus, IT solution developer TEHIK: “What we had to do was standardize the datasets. So all doctors, specialists, etc. to send the same data, in the same format”.

In the age of personal information protection, every citizen is in control of their data which they manage from the patient portal.

Carmen Raal, digitalization advisor e-Estonia: “I get a diagnosis I’m not happy with so I want a second opinion. But I don’t want this second opinion to be influenced by the first diagnostic, so to make sure of that I hide this information”.

In the 14 years of exclusively digital operation, the system has fully proven its efficiency.

Hans-Erik Ehrlich, Head of Intensive Care Unit: “In the last two years we have already been in the process of digitizing the Intensive Care as well, so now all the monitors automatically send the data about the patient’s vital signs directly to the computer, the results of the laboratory analyzes automatically reach the patient’s profile.”

Tonis Jaagus, IT solution developer TEHIK: “It’s basically an all-inclusive counter where the patient logs in and looks for a suitable time for an appointment. The portal presents all available places for the desired programming all over Estonia”.

And prescribing a prescription is done in a few seconds, without the patient having to go to the doctor.

Kaidi Sarv, Chief Pharmacist: “It’s very easy to click on drugs. All the patient’s data, name, address, personal code, are already in the system and just click, click and send and the prescription has gone into the system”.

And the patient or anyone else designated by him only has to go to any pharmacy in the country to get the medicines.

Digital prescription, also valid in other countries

The digital prescription has already crossed the country’s borders and thanks to the interconnection of the systems, Estonians can now take their prescribed medicines electronically not only from the neighboring country of Finland, but also from Portugal or Croatia.

Digitization of the medical system in Estonia is not over yet. Work is now underway to streamline all IT processes. In addition, with the help of artificial intelligence, the system will help in prevention. Each patient’s medical profile will be closely analyzed to determine exactly what are the risks of illness to which he is exposed.

By analyzing the databases, the experts will determine which diseases the patients are prone to. Thus, time is gained, money is saved and, most importantly, patients are given more chances. And with each new step in the digitalization of medical services, with each new online functionality, those in charge have increased the comfort and well-being of patients.

Liisa Lvova, patient: “I think I was in kindergarten when the doctors and nurses had stacks of paperwork and when I got out of kindergarten I remember they gave me the file and I was like, wow…what am I going to do with this? it was strange and fortunately, we don’t have that anymore… seriously, think of the trees, how many we can save like this!”.