Margus ViigimaaTallinn, Estonia

An Estonian example –Digital Health in Estonia

EHH, March 7, 2019

3700 IT companies in Estonia7% GDP in IT sectorSKYPE Development Centre in TallinnNATO Cyber Defence Centre in Tallinn

Estonia is an e-country

Innovative e-solutions in Estonian healthcare

• 99% of health data digitized

• 99% of prescriptions are digital

• e-referral, e-consultation

• 100% electronic billing in healthcare

X-Road, ID-card, State IS Service Register

HEA

LTH

CA

RE

BO

AR

D

-H

ealt

h c

are

pro

vid

ers

-H

ealt

h p

rofe

ssio

nal

s

-D

isp

ensi

ng

chem

ists

STA

TE A

GEN

CY

OF

MED

ICIN

ES

-C

od

ing

Cen

tre

-H

and

lers

of

med

icin

es

PO

PU

LATI

ON

REG

ISTE

R

PH

AR

MA

CIE

S

20

10

Jan

uar

y

BU

SIN

ESS

REG

ISTE

R

HO

SPIT

ALS

INFO

RM

ATI

ON

SYS

TEM

S

20

09

FAM

ILY

DO

CTO

RS

INFO

RM

ATI

ON

SYS

TEM

S

20

09

SCH

OO

L N

UR

SES

20

10

Sep

tem

ber

NATION-WIDEHEALTH

INFORMATION EXCHANGE

PLATFORM

(EHIS)2008 December

ESTONIAN

HEALHT

INSURANCE

FUND

2001

PRESCRIPTION CENTRE

2010 January

PATIENT PORTAL2009

PHARMACIES AND FAMILY DOCTORS

2009

X-ROAD GATEWAY SERVICE

2009

QU

ALI

TY R

EGIS

TER

S.

Can

cer.

HIV

. Myo

card

ial i

nfa

rcti

on

.

Tub

ercu

losi

s. E

tc.

NATION-WIDE

PICTURE

ARCHIVING AND

COMMUNICATION

SYSTEM

2005

ESTONIAN

GENOME

CENTER

UNIVERSITY

OF

TARTU

Secure data exchange layer provided by the stateX-Road, ID-card, mobile-ID, State IS Service Register

EMER

GEN

CY

MED

ICA

L

SER

VIC

E

20

14

AM

BU

LAN

CE

MO

BIL

E

WO

RK

STA

TIO

NS

Architecture of Estonian nation-wide Health Information System (since 2008)

Use of digital data in Estonia

0

200000

400000

600000

800000

1000000

1200000

1400000

1600000

1800000

2000000

20

08

.12

20

09

.03

20

09

.06

20

09

.09

20

09

.12

20

10

.03

20

10

.06

20

10

.09

20

10

.12

20

11

.03

20

11

.06

20

11

.09

20

11

.12

20

12

.03

20

12

.06

20

12

.09

20

12

.12

20

13

.03

20

13

.06

20

13

.09

20

13

.12

20

14

.03

20

14

.06

20

14

.09

20

14

.12

20

15

.03

20

15

.06

20

15

.09

20

15

.12

20

16

.03

20

16

.06

20

16

.09

20

16

.12

20

17

.03

20

17

.06

20

17

.09

20

17

.12

Patient queries per month Healthcare professional queries per month

X-Road, ID-card, State IS Service Register

HEA

LTH

CA

RE

BO

AR

D

-H

ealt

h c

are

pro

vid

ers

-H

ealt

h p

rofe

ssio

nal

s

-D

isp

ensi

ng

chem

ists

STA

TE A

GEN

CY

OF

MED

ICIN

ES

-C

od

ing

Cen

tre

-H

and

lers

of

med

icin

es

PO

PU

LATI

ON

REG

ISTE

R

PH

AR

MA

CIE

S

20

10

Jan

uar

y

BU

SIN

ESS

REG

ISTE

R

HO

SPIT

ALS

INFO

RM

ATI

ON

SYS

TEM

S

20

09

FAM

ILY

DO

CTO

RS

INFO

RM

ATI

ON

SYS

TEM

S

20

09

SCH

OO

L N

UR

SES

20

10

Sep

tem

ber

NATION-WIDEHEALTH

INFORMATION EXCHANGE

PLATFORM

(EHIS)2008 December

PATIENT PORTAL2009

PHARMACIES AND FAMILY DOCTORS

2009

X-ROAD GATEWAY SERVICE

2009

QU

ALI

TY R

EGIS

TER

S.

Can

cer.

HIV

. Myo

card

ial i

nfa

rcti

on

.

Tub

ercu

losi

s. E

tc.

NATION-WIDE

PICTURE

ARCHIVING AND

COMMUNICATION

SYSTEM

2005

ESTONIAN

GENOME

CENTER

UNIVERSITY

OF

TARTU

Secure data exchange layer provided by the stateX-Road, ID-card, mobile-ID, State IS Service Register

EMER

GEN

CY

MED

ICA

L

SER

VIC

E

20

14

AM

BU

LAN

CE

MO

BIL

E

WO

RK

STA

TIO

NS

ESTONIAN

HEALHT

INSURANCE

FUND

2001

PRESCRIPTION CENTRE

2010 January

SFINXDrug-drug

Interaction database

2016DRIVING LICENCE

HEALTH CERTIFICATEAPPLICATION

2015

e-services crossing institutional borders

EU launch of a cross-border drug prescription on 21.01.2019

X-Road, ID-card, State IS Service Register

HEA

LTH

CA

RE

BO

AR

D

-H

ealt

h c

are

pro

vid

ers

-H

ealt

h p

rofe

ssio

nal

s

-D

isp

ensi

ng

chem

ists

STA

TE A

GEN

CY

OF

MED

ICIN

ES

-C

od

ing

Cen

tre

-H

and

lers

of

med

icin

es

PO

PU

LATI

ON

REG

ISTE

R

PH

AR

MA

CIE

S

20

10

Jan

uar

y

Dig

ital

Dec

isio

n S

up

po

rt S

yste

m

HO

SPIT

ALS

INFO

RM

ATI

ON

SYS

TEM

S

20

09

FAM

ILY

DO

CTO

RS

INFO

RM

ATI

ON

SYS

TEM

S

20

09

SCH

OO

L N

UR

SES

20

10

Sep

tem

ber

NATION-WIDEHEALTH

INFORMATION EXCHANGE

PLATFORM

(EHIS)2008 December

PATIENT PORTAL2009

PHARMACIES AND FAMILY DOCTORS

2009

X-ROAD GATEWAY SERVICE

2009

QU

ALI

TY R

EGIS

TER

S.

Can

cer.

HIV

. Myo

card

ial i

nfa

rcti

on

.

Tub

ercu

losi

s. E

tc.

NATION-WIDE

PICTURE

ARCHIVING AND

COMMUNICATION

SYSTEM

2005

ESTONIAN

GENOME

CENTER

UNIVERSITY

OF

TARTU

Secure data exchange layer provided by the stateX-Road, ID-card, mobile-ID, State IS Service Register

VPN

EMER

GEN

CY

MED

ICA

L

SER

VIC

E

20

14

AM

BU

LAN

CE

MO

BIL

E

WO

RK

STA

TIO

NS

ESTONIAN

HEALHT

INSURANCE

FUND

2001

PRESCRIPTION CENTRE

2010 January

PERSONALISED MEDICINE

DIGITAL DECISION SUPPORT SYSTEM

Digital Decision Support System

Digital Cardiology in Estonia

EU Digital health innovation conference

Tallinn 2017

Welcome to the ESC Digital Summit!

Tallinn, October 5-6, 2019

THANK YOU VERY MUCH!

eHealth screen