Sharing of healthcare data with citizen in mobile platform – Estonian experience .

Peeter Ross , MD, PhDTallinn University of Technology, Estonia

Exploratory seminar on eHealth benefits & cooperatio n in the Southern Mediterranean countries and the EU

December 04, 2014, Rabat, Morocco

Outline

� Facts about Estonian e-services

� Estonian nation-wide Health Information System� Estonian nation-wide Health Information System

� Mobile services in Patient Portal

Facts about Estonia

� Basic facts:

� Population is 1,3 million

� Area 45 227 km²

� Native language is Estonian

� Member state of the European Union since 2004

� Income tax 21% (flat tax); Currency – Euro

� Every citizen has unique ID-number (like in Scandinavia)

� Health care system

� Compulsory health insurance paid by employers; 13% of payroll tax

� Health care costs make up to 6% of GDP (9,5% in OECD)

� Healthcare providers are private, municipal or governmental

� Hospital system – publicly owned private hospitals

� General practitioners are private entrepreneurs

Facts about e -services

� 100% of schools and government organisations have broadband connection

� 75% of households have internet access at home (2012)

� 99% of bank transfers are performed electronically� 99% of bank transfers are performed electronically

� 95% of income tax declarations made via the e-Tax Board (2014)

� 24% of votes were cast over the internet on 2011

� 62% of persons have completed the e-census (2012)

Estonian e -state architecture

Estonian nation -wide Health Information System (EHIS)

�The Estonian HIS is unique as it� Encompasses the whole country

� Registers virtually all residents’ health history � Registers virtually all residents’ health history from birth to death, and

� Is based on the comprehensive standard based IT infrastructure

Basic components

�The HIS platform consists of 3 main layers� The secure internet-based data exchange

layer

� Health information exchange database and software

� Application and service layer

�E-health expenditure until 2012

– 12 mio euros / 9,1 euros per person

Estonian eHealth architecture

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NATION-WIDEHEALTH

INFORMATION EXCHANGE PLATFORM

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PRESCRIPTION CENTRE

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PATIENT PORTAL2009

X-ROAD GATEWAY SERVICE

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Mobile access to the databases

Design for tablets and smart phones

• Nation-wide health information system• Available documents

• Medical files• Time critical data (allergy, chronic diseases)• General practitioners and hospital visits

eHealth services in Estonia

• General practitioners and hospital visits• Summary of ambulatory and stationary case• Link to medical images• Referral letter

• ePrescription• Digital images

• Available all over the county• eReferral

Access to Patient Portal

Patient Portal

Patient Portal – 2013

ePrescription covers 94% of issued prescriptionsOver 90% of Hospital discharge letters are digital

Acceptance

digitalAmbulatory case summaries sending level is growingPatient portal usage is accepted gradually by the citizen

54 721 unique visitors (4,1% of population)1 267 408 persons have documents (95% of population)

500 000

600 000

700 000

800 000

900 000

1 000 000

ePrescription (94%)

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100 000

200 000

300 000

400 000

500 000

ISSUED SOLD

8000

10000

12000

The aim of iP atient portalusage (2008 – 2010 )

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6000

2008 2009 2010

Viewing of EPRBooking

Thank you!Peeter.Ross@ttu.ee