Japan Association for Medical Informatics

[3-A-3-CS4-7] Tips Toward Successful Nation-wide Healthcare Information Platform Implementation and Management - Estonian Experience since 2008.

Peeter Ross (Tallinn University of Technology)

Estonia is one of the world leaders in the provision of public digital services. The national communications and transactions platform provides modern and safe governance by allowing for transparency, security, privacy, entrepreneurship and, among other things, trusted way to exchange health data between healthcare professionals and citizen. Estonian Nation-wide Health Information System (EHIS) is globally unique as it covers all the country, integrates healthcare data of all healthcare providers and provides overview of health condition of every resident from birth to death. EHIS is functional since the end of 2008. It makes possible to access medical data, prescriptions and images on-line in a secure and trusted way.
EHIS includes certain data that is supposed to reflect the person´s and population’s health status, entered into the database mainly by the healthcare professional but partly also by the person himself. The list of medical files and images exchanged is defined by the law, all healthcare providers are obliged to connect and the data is equally accessible for healthcare providers and citizen.
Based on the more than 10 years´ experience of planning, design and implementation, main drivers for the successful deployment of EHIS could be listed as follows:
• Clear governance of Estonian e-health services
• Legal clarity
• Mature ecosystem for e-services in Estonia
o Secure data exchange platform provided by the state
 Established on-line identification methods (ID-card, Mobile-ID)
• Agreement about access rights
• Standardization of medical data and data exchange rules.