General Information
Cases/Enablers
              OOP Case
          Appetizer
              Every person needs to have a valid medical certificate for the duration of their driving license. When a medical certificate expires, a new medical certificate must be submitted to the Road Administration. Once issued, the certificate is automatically transmitted to the motor registry. 
          OOP aspect
              The e-medical certificate is automatically transmitted to the motor registry. There is no need to come in personally to the Road Administration to submit your medical certificate.
          Short summary
              Every person needs to have valid medical certificate for the duration of their driving license. Generally the medical certificate issued by the family doctor is valid up to maximum 10 years. When a medical certificate expires or the next medical falls due, a new medical certificate must be submitted to the Road Administration. The validity of a medical certificate can be checked via the e-services to the Road Administration.
Since 1 April 2015 doctors have only been issuing e-medical certificates (only in special cases on paper – for instance in the event of a system malfunction at the doctor’s surgery, whereby the doctor must digitalize it later). In order to obtain an medical certificate, you must fill in a medical declaration online at the National Health Information system regarding your health and then make an appointment with a doctor. Once issued, an e-medical certificate is automatically transmitted to the motor registry. There is no need to come in personally to the Road Administration to submit your medical certificate
          Since 1 April 2015 doctors have only been issuing e-medical certificates (only in special cases on paper – for instance in the event of a system malfunction at the doctor’s surgery, whereby the doctor must digitalize it later). In order to obtain an medical certificate, you must fill in a medical declaration online at the National Health Information system regarding your health and then make an appointment with a doctor. Once issued, an e-medical certificate is automatically transmitted to the motor registry. There is no need to come in personally to the Road Administration to submit your medical certificate
Focus
          Citizens
              Start date
              Domain
          Health
              Scope
              National/Federal
          Country
          Estonia
              Nature and status of project
              Rolled Out
          Is the OOP case/enabler mandatory?
              Opt-in
          ENABLING ASSETS OR COMPONENTS
Relevant Enablers
          
      Legal interoperability
              Traffic Act, https://www.riigiteataja.ee/en/eli/520102014003/consolide
(§ 101.Medical examination of driver of power-driven vehicle and applicant for right todrive)
--------
National Health Information System Regulation, https://www.riigiteataja.ee/akt/106122016011
--------
Requirements for Health Certificate, https://www.riigiteataja.ee/akt/121062011008
--------
Personal Data Protection Act, https://www.riigiteataja.ee/akt/12805972?leiaKehtiv
--------
Public Information Act, https://www.riigiteataja.ee/en/eli/518012016001/consolide
--------
Population Register Act, https://www.riigiteataja.ee/en/eli/523032017001/consolide
          (§ 101.Medical examination of driver of power-driven vehicle and applicant for right todrive)
--------
National Health Information System Regulation, https://www.riigiteataja.ee/akt/106122016011
--------
Requirements for Health Certificate, https://www.riigiteataja.ee/akt/121062011008
--------
Personal Data Protection Act, https://www.riigiteataja.ee/akt/12805972?leiaKehtiv
--------
Public Information Act, https://www.riigiteataja.ee/en/eli/518012016001/consolide
--------
Population Register Act, https://www.riigiteataja.ee/en/eli/523032017001/consolide
Socio-cultural influence factors
              Legal and organizational interoperability: legislation approved by stakeholders
All registers must linked by use commonly accepted keys:
• personal code for citizens,
• code of institution,
• standardised address presentation.
Secure data exchange layer X-Road (https://www.ria.ee/en/x-road.html) is used for gathering data from different registers. X-Road is a technological and organizational environment enabling a secure Internet-based data exchange between information systems. All registers and Statistics Estonia must be a member of X-Road Information regarding the X-Road members and the services they provide is available via the Administration System for the State Information System (RIHA).
RIHA (https://www.ria.ee/en/administration-system-of-the-state-informationsystem.html) serves as a catalogue for the state’s information system. At the same time RIHA is a procedural and administrative environment via which the comprehensive and balanced development of the state’s information system has ensured. RIHA guarantees the transparency of the administration of the state’s information system and helps to plan the state’s information management.
PKI or the public key infrastructure (https://www.ria.ee/en/public-keyinfrastructure.html) enables secure digital authentication and signing. The infrastructure also allows forwarding data by using an encrypting key pair: a publicencryption key and a private decryption key. In Estonia, this technology is used in relation with electronic identity (ID card, mobile ID, digital ID). All members of XRoad are using Digital seal certificates for signing messages. Citizens and officials are using electronic identity tokens.
All participants must be implemented three-level IT baseline security system ISKE (https://www.ria.ee/en/iske-en.html). The goal of implementing ISKE is to ensure a security level sufficient for the data processed in IT systems. The necessary security level achieved by implementing the standard organisational, infrastructural/physical and technical security measures.
Data guidelines of Estonian Data Protection Inspectorate (http://www.aki.ee/et/juhised) must followed.
          All registers must linked by use commonly accepted keys:
• personal code for citizens,
• code of institution,
• standardised address presentation.
Secure data exchange layer X-Road (https://www.ria.ee/en/x-road.html) is used for gathering data from different registers. X-Road is a technological and organizational environment enabling a secure Internet-based data exchange between information systems. All registers and Statistics Estonia must be a member of X-Road Information regarding the X-Road members and the services they provide is available via the Administration System for the State Information System (RIHA).
RIHA (https://www.ria.ee/en/administration-system-of-the-state-informationsystem.html) serves as a catalogue for the state’s information system. At the same time RIHA is a procedural and administrative environment via which the comprehensive and balanced development of the state’s information system has ensured. RIHA guarantees the transparency of the administration of the state’s information system and helps to plan the state’s information management.
PKI or the public key infrastructure (https://www.ria.ee/en/public-keyinfrastructure.html) enables secure digital authentication and signing. The infrastructure also allows forwarding data by using an encrypting key pair: a publicencryption key and a private decryption key. In Estonia, this technology is used in relation with electronic identity (ID card, mobile ID, digital ID). All members of XRoad are using Digital seal certificates for signing messages. Citizens and officials are using electronic identity tokens.
All participants must be implemented three-level IT baseline security system ISKE (https://www.ria.ee/en/iske-en.html). The goal of implementing ISKE is to ensure a security level sufficient for the data processed in IT systems. The necessary security level achieved by implementing the standard organisational, infrastructural/physical and technical security measures.
Data guidelines of Estonian Data Protection Inspectorate (http://www.aki.ee/et/juhised) must followed.
DATA HANDLING / DATA EXCHANGE
Type of data sharing
          Actual data
              Data handler 
          Stakeholder name
              Health Information System services - certificates (TEHIK)
          Stakeholder category
              Government
          Stakeholder Role
              Database owner
          Kind of data
              Health data
          Stakeholder name
              Population Register
          Stakeholder category
              Government
          Stakeholder Role
              Data provider
          Kind of data
              Health data
          Stakeholder name
              Business Register
          Stakeholder category
              Government
          Stakeholder Role
              Data provider
          Kind of data
              Health data
          Stakeholder name
              Citizen (www.digilugu.ee)
          Stakeholder category
              Citizen
          Stakeholder Role
              Data consumer
          Kind of data
              Health data
          Stakeholder name
              Health Care providers (GP, Hospital, Emergency service, Dentists IS)
          Stakeholder category
              Business
          Stakeholder Role
              Data provider
          Kind of data
              Health data
          Stakeholder name
              Health care providers Register (Health care Board)
          Stakeholder category
              Government
          Stakeholder Role
              Data provider
          Kind of data
              Health data
          Stakeholder name
              Health professionals Register (Health care Board)
          Stakeholder category
              Government
          Stakeholder Role
              Data provider
          Kind of data
              Health data
          Stakeholder name
              HIS X-Road MISP – Portal for GP
          Stakeholder category
              Business
          Stakeholder Role
              Data recorder
          Kind of data
              Health data
          Stakeholder name
              Patient Portal
          Stakeholder category
              Citizen
          Stakeholder Role
              Data consumer
          Kind of data
              Health data
          Stakeholder name
              Road Administration Board
          Stakeholder category
              Government
          Stakeholder Role
              Data consumer
          Kind of data
              Health data
          Stakeholder name
              State Information Board (X-road, eID, Mobile-ID, ID-card)
          Stakeholder category
              Government
          Stakeholder Role
              Data supervisor
          Kind of data
              Health data
          Image upload
           
Lessons learned
              Benefits:
- Already collected data can be used to develop various new services
- Decrease the number of GP visits
- Makes the certificates reproduced form for long period (for 10 years for drivers licences)
- Certificates are available for the Road Administration as well as Police
Enablers:
• Legal, organizational, technical, social-cultural, fiscal and professional interoperability between different sectors (Health care and Road Administration)
• Security and technical
• Clear Responsibilities, rules and technical solutions are made for optimizing the working flow
Barriers :
Economical motivation and feasibility
Cooperation between different authorities
Doctors dashboards needs the general modernization for adding new services to their desks
          - Already collected data can be used to develop various new services
- Decrease the number of GP visits
- Makes the certificates reproduced form for long period (for 10 years for drivers licences)
- Certificates are available for the Road Administration as well as Police
Enablers:
• Legal, organizational, technical, social-cultural, fiscal and professional interoperability between different sectors (Health care and Road Administration)
• Security and technical
• Clear Responsibilities, rules and technical solutions are made for optimizing the working flow
Barriers :
Economical motivation and feasibility
Cooperation between different authorities
Doctors dashboards needs the general modernization for adding new services to their desks
